Radiological Incidents Research Articles

Is the Osteopathic Medical Profession Prepared for a Radiologic or Nuclear Incident?

Is the Osteopathic Medical Profession Prepared for a Radiologic or Nuclear Incident?

Management of Ionizing Radiation Injuries and Illnesses, Part 1: Physics, Radiation Protection, and Radiation Instrumentation

Ionizing radiation injuries and illnesses are exceedingly rare; therefore, most physicians have never managed such conditions. When confronted with a possible radiation injury or illness, most physicians must seek specialty consultation. Protection of responders, health care workers, and patients is an absolute priority for the delivery of medical care. Management of ionizing radiation injuries and illnesses, as well as radiation protection, requires a basic understanding of physics. Also, to provide a greater measure of safety when working with radioactive materials, instrumentation for detection and identification of radiation is needed. Because any health care professional could face a radiation emergency, it is imperative that all institutions have emergency response plans in place before an incident occurs. The present article is an introduction to basic physics, ionizing radiation, radiation protection, and radiation instrumentation, and it provides a basis for management of the consequences of a radiologic or nuclear incident.

Rapid determination of 226Ra in emergency urine samples

A new method has been developed at the Savannah River National Laboratory (SRNL) that can be used for the rapid determination of 226Ra in emergency urine samples following a radiological incident. If a radiological dispersive device event or a nuclear accident occurs, there will be an urgent need for rapid analyses of radionuclides in urine samples to ensure the safety of the public. Large numbers of urine samples will have to be analyzed very quickly. This new SRNL method was applied to 100 mL urine aliquots, however this method can be applied to smaller or larger sample aliquots as needed. The method was optimized for rapid turnaround times; urine samples may be prepared for counting in 90 %), and removes interferences effectively. The sample preparation method can also be adapted to ICP-MS measurement of 226Ra, with rapid removal of isobaric interferences.

EURADOS intercomparisons and the harmonisation of environmental radiation monitoring

After the Chernobyl nuclear power plant accident in 1986, all Member States of the European Union have installed area dose rate monitoring networks so that radiological incidents can be detected quickly. However, the different technical approaches and procedures led to inconsistencies in the area dose rate data. In the last 15 years, the working group 'Environmental Radiation Monitoring' of the European Radiation Dosimetry Group (EURADOS) has performed six pan-European intercomparison exercises for detector systems operated in national dosimetric early warning networks. These intercomparisons aimed at the harmonisation of area dose rate measurements of radiation monitoring stations in Europe. The intercomparisons revealed differences in technical properties of the dose rate monitoring systems as well as in the calibration and measuring methods that led to deviations of measured dose rate values by a factor of 5 or more under the same measuring conditions. As a result of the intercomparisons, the accuracy of dose rate measurements could be improved considerably. Further progress in metrologically correct measurements of area dose rates in the natural environment and necessary steps towards a metrologically sound pan-European system for environmental radiation monitoring will be discussed.

A Sustainable Training Strategy for Improving Health Care Following a Catastrophic Radiological or Nuclear Incident

The detonation of a nuclear device in a US city would be catastrophic. Enormous loss of life and injuries would characterize an incident with profound human, political, social, and economic implications. Nevertheless, most responders have not received sufficient training about ionizing radiation, principles of radiation safety, or managing, diagnosing, and treating radiation-related injuries and illnesses. Members throughout the health care delivery system, including medical first responders, hospital first receivers, and health care institution support personnel such as janitors, hospital administrators, and security personnel, lack radiation-related training. This lack of knowledge can lead to failure of these groups to respond appropriately after a nuclear detonation or other major radiation incident and limit the effectiveness of the medical response and recovery effort. Efficacy of the response can be improved by getting each group the information it needs to do its job. This paper proposes a sustainable training strategy for spreading curricula throughout the necessary communities. It classifies the members of the health care delivery system into four tiers and identifies tasks for each tier and the radiation-relevant knowledge needed to perform these tasks. By providing education through additional modules to existing training structures, connecting radioactive contamination control to daily professional practices, and augmenting these systems with just-in-time training, the strategy creates a sustainable mechanism for giving members of the health care community improved ability to respond during a radiological or nuclear crisis, reducing fatalities, mitigating injuries, and improving the resiliency of the community.

EMERGENCY DOSIMETRY USING CERAMIC COMPONENTS IN PERSONAL ELECTRONIC DEVICES

The rapid assessment of radiation dose to members of the public exposed to significant levels of ionizing radiation during a radiological incident presents a significant difficulty in the absence of planned radiation monitoring. However, within most personal electronic devices components such as resistors with alumina substrates can be found that have potentially suitable properties as solid state dosimeters using luminescence measurement techniques. The suitability of several types of ceramic-based components (e.g., resonators, inductors and resistors) has been previously examined using optically stimulated luminescence (OSL) and thermoluminescence (TL) techniques to establish their basic characteristics for the retrospective determination of absorbed dose. In this paper, we present results obtained with aluminum oxide surface mount resistors extracted from mobile phones that further extend this work. Very encouraging results have been obtained related to the measurement of luminescence sensitivity, dose response, reusability, limit of detection, signal reproducibility and known-dose recovery. However, the alumina exhibits a rapid loss of the latent luminescence signal with time following irradiation attributed to athermal (or anomalous) fading. The issues related to obtaining a reliable correction protocol for this loss and the detailed examinations required of the fading behavior are discussed.

Assessment of biodosimetry methods for a mass-casualty radiological incident: medical response and management considerations.

Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual's radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual's dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a standalone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, the authors reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point.

An Overview of Radiological Incidents recently reported to the RPII

An Overview of Radiological Incidents recently reported to the RPII

Decontamination of Radionuclides From Skin

The accident in Fukushima has emphasized the need to increase the capacity of health protection for exposed workers, first responders, and the general public in a major accident situation with release of radioactivity. Skin contamination is one of the most probable risks following major nuclear or radiological incidents, but this risk also exists and incidents can happen in industry, research laboratories, or in nuclear medicine departments. The aim of this paper is to provide an overview of the products currently used after skin contamination in order to highlight the needs and ways to improve the medical management of victims. From this review, it can be observed that the current use of these radiological decontamination products is essentially based on empiricism. In addition, some of these products are harsh and irritating, even toxic, possibly damaging the skin barrier. In some emergency situations in which clean water is in short supply, most of the current products cannot be used. Research on the mechanisms of action of decontaminating products is needed to develop a decontamination strategy.

EFRMAC Overview: Data Management and Enabling Technologies for Characterization of a Radiological Release.

The eFRMAC enterprise is a suite of technologies and software developed by the U.S. Department of Energy National Nuclear Security Administration's Office of Emergency Response to coordinate the rapid data collection, management, and analysis required during a radiological emergency. This enables the Federal Radiological Monitoring and Assessment Center assets to evaluate a radiological or nuclear incident efficiently to facilitate actions to protect public health and the environment. This document identifies and describes eFRMAC methods including: (1) data acquisition, (2) data management, (3) data analysis, (4) product creation, (5) quality control, and 6) product dissemination.

SU‐E‐I‐89: Real‐Time Information and Decision Support for Radiological Emergency Response

Purpose: Emergency response and medical preparedness for radiological incidents is one of the critical cornerstones for Homeland Security, along with biological and chemical incidents. The recent Fukushima Daiichi nuclear plant incidents underscore the paramount importance of such preparedness and response capability. Such needs are wide‐spread as many nations employ nuclear plants for energy generation. In this work, we focus on development and deployment of a real‐time simulation and decision support system, RealOpt‐CRC, along with the knowledge data bank that can be used by regional/local radiation/public health administrators to prepare for and deal with radiological emergency situations. Methods: Large‐scale simulator for modeling systems operations and performance, computer graphics for mouse‐click facility design and optimization for resource allocation are designed and implemented into a web‐base secured system. The RealOpt system offers operations capability to i)rapidly setup shelters to house the displaced/at‐risk population, ii)determine optimal resource allocation and operations for rapid screening and decontamination; iii)recommend and facilitate practical steps to minimize exposure risk; iv)perform effective population registry for long‐term health monitoring; and v)service the displaced population on day‐to‐day needs. Results: Comparison of current planning versus plans from our system shows a 5‐fold efficiency improvement. This translates to more people being screened and decontaminated within limited time and resources and thus improve safety and health monitoring for the affected population. Further, workers are more confident and operations are smoother and more organized, thus ensuring public confidence and team‐morale. Conclusions: The system has real‐time computation capability and can be used by emergency management administrators for actual strategic and operational planning and execution; to educate and train current and future personnel on decision making under uncertainties; and to simulate responses to catastrophic events through systematic analysis of numerous scenarios, including worst‐case, to learn of erratic as well as efficient response strategies. Real‐time data‐feeds allow re‐configuration on‐the‐fly as the event unfolds. National Science Foundation

Design and Implementation of a Mobile Radiological Emergency Unit Integrated in a Radiation Monitoring Network

The first hours elapsed after a radiological incident are critical to take appropriate actions to protect the population and to assess its impact on the environment. The development of mobile laboratories equipped with different radiation detectors, with robust communication systems, and with a highly autonomous uninterruptible power supply constitutes the spearhead of modern radiological warning networks. Their main function is to provide additional radiation information with acceptable accuracy in the shortest possible time. This paper describes our development of a mobile laboratory and the demonstration of its usefulness in various emergency drills conducted in the vicinity of a nuclear power plant.

Radiological incidence of parastomal herniation in cancer patients with permanent colostomy: What is the ideal size of the surgical aperture?

BackgroundParastomal herniation frequently complicates stoma formation. Aperture size has been shown to be an independent predictor of hernia development but there is a paucity of data regarding the ideal stoma diameter. The aim of this study was to establish the radiological incidence of herniation in patients with a permanent colostomy and correlate it with the size of the abdominal wall defect in order to identify an aperture diameter associated with a reduced herniation risk. MethodsAll patients who underwent permanent colostomy formation for colorectal cancer over a five-year period in a single institution were recruited to the study. Patient demographics, operative details and stoma-related symptoms were recorded. Post-operative CT scans were reviewed for evidence of parastomal herniation. The diameter of the abdominal wall defect was measured radiologically. Results43 patients (mean age 69 years) were included in the analysis. Radiologically, 25/43 (58%) had evidence of a parastomal hernia. The median aperture diameter was 35 mm (range 25–58 mm) in patients with a parastomal hernia and 22 mm (range 10–36 mm) in patients without herniation (p < 0.0001). There were no cases of herniation with an abdominal wall defect size <25 mm. The median follow up was 26.0 months (range 6–55) in patients with herniation as opposed to 16.0 months (range 7–36) in patients without herniation (p = 0.11). ConclusionThe majority of patients with a permanent colostomy develop a parastomal hernia within the first two post-operative years. Parastomal herniation appears unlikely to develop with an abdominal wall defect diameter ≤25 mm provided this does not enlarge with time. Surgical techniques that utilise stapling devices to form a ‘custom-made’ and rigid trephine might reduce the herniation risk.

Emergency Physicians' Preparedness for CBRNE Incidents in Hong Kong

Background Recent terrorist attacks with biological and chemical weapons have caused much concern for the public. The purpose of this study was to assess emergency doctors' preparedness in handling Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) incidents. Methods This is a cross sectional survey of all emergency doctors working in public emergency departments (ED) in Hong Kong. Apart from the experience and confidence to handle these events, data on participants' willingness to participate in CBRNE incidents and training motivations were also analysed. Results Biological and radiological events were found to be the least commonly encountered. Few respondents reported they were confident to manage biological events (10.6% to 29.8%), despite 66% of respondents reported having prior training in CBRNE management. Conclusions This study demonstrates ED doctors' low confidence in managing specific CBRNE incidents. Current strengths identified include the good awareness of hospital emergency plans and high motivation to get more training.

Modeling of the fate of radionuclides in urban sewer systems after contamination due to nuclear or radiological incidents

After an accidental radioactive contamination by aerosols in inhabited areas, the radiation exposure to man is determined by complex interactions between different factors such as dry or wet deposition, different types of ground surfaces, chemical properties of the radionuclides involved and building development as well as dependence on bomb construction e.g. design and geometry. At short-term, the first rainfall is an important way of natural decontamination: deposited radionuclides are washed off from surfaces and in urban areas the resulting contaminated runoff enters the sewer system and is collected in a sewage plant. Up to now the potential exposure caused by this process has received little attention and is estimated here with simulation models. The commercial rainfall-runoff model for urban sewer systems KANAL++ has been extended to include transport of radionuclides from surfaces through the drainage to various discharge facilities. The flow from surfaces is modeled by unit hydrographs, which produce boundary conditions for a system of 1d coupled flow and transport equations in a tube system. Initial conditions are provided by a map of surface contamination which is produced by geo-statistical interpolation of γ-dose rate measurements taking into account the detector environment. The corresponding methodology is implemented in the Inhabited Area Monitoring Module (IAMM) software module as part of the European decision system JRODOS. A hypothetical scenario is considered where a Radiation Dispersal Device (RDD) with Cs-137 is detonated in a small inhabited area whose drainage system is realistically modeled. The transition of deposited radionuclides due to rainfall into the surface runoff is accounted for by different nuclide-specific entrainment coefficients for paved and unpaved surfaces. The concentration of Cs-137 in water is calculated at the nodes of the drainage system and at the sewage treatment plant. The external exposure to staff of the treatment plant is estimated. For Cs-137 radiation levels in the plant are low since wash-off of cesium from surfaces is an ineffective process.

Emergency Exposure Situations: IAEA Safety Standards and Guidance

the Incident and Emergency centre (IEc) of the International Atomic Emergency Agency (IAEA) is the global focal point for preparedness and response to nuclear and radiological incidents and emergencies irrespective of their cause. In the area of preparedness the centre continuously works to develop standards and guidance for strengthening Member States' pre- paredness; practical tools and training programs to assist Member States in promptly applying the standards and guidance; and organizes a variety of training events and exercises. this paper provides an overview of the infor- mation presented in the IAEA Safety Standards and Guidance in the area of emergency preparedness and response.

The National Library of Medicine’s Disaster Information Management Research Center

The Disaster Information Management Research Center (DIMRC) develops and provides access to health information resources and technology for disaster preparedness, response, and recovery. DIMRC focuses on maintaining access to health information at all phases of disasters, developing innovative products and services for emergency personnel, conducting research to support disaster health information management, and collaborating with other agencies and communities. Several tools are available to help emergency responders in hazardous materials or chemical, biological, radiological, or nuclear incidents. Access to the literature is made available through PubMed and the Resource Guide for Disaster Medicine and Public Health, with links to online documents and resources from numerous organizations and government agencies. In addition, DIMRC supports the Disaster Information Specialist Program, a collaborative effort to explore and promote the role of librarians and information specialists in the provision of disaster-related information resources to the workforce and communities.

Is International Ocean Law Capable of Preventing or Mitigating the Impacts of Nuclear Disaster?

AbstractIn light of the Fukushima disaster, the global community must honestly and bravely consider whether existing international law is sufficient to protect the oceans from hazardous nuclear activities past, present, and future. If so, are these agreements, including conventions and treaties, adequate to clean-up existing problems, to safeguard against emerging risks, and to foster cooperation among nations? If not, what function, does ocean law serve? Assessing the efficacy of international law on state behavior with respect to real world outcomes is always challenging, but when dealing with nuclear activities the task is further complicated due to the unusual risk profile of catastrophic radiological incidents, the millennia-long risk of danger, the relative novelty of nuclear issues, and the scope of other activities that could also impact the ocean. Nevertheless, this task cannot be ignored. The oceans are a global commons filled with collective resources. Any meaningful discussion about the health of the seas and measures to protect them must take place on the international stage with due regard for the necessities and rights of all nations, as well as the natural environment. The international community must diligently collaborate to resolve issues surrounding nuclear activities that could impact the oceans. Yet, current international agreements that address nuclear pollution of the ocean are de facto judicially unenforceable and are often ignored when national self-interest is contrary to the agreement. Nevertheless, while not an effective legal mandate, ocean law does in some cases influence state actors to conform to international agreements (even when not bound to do so). Going forward, more research is necessary into the impacts of radiological pollution on the oceans to enable decision makers, like judicial tribunals, politicians, and NGOs, to effectuate and effectively enforce international ocean law with respect to nuclear issues.

Risk factors for parastomal hernia: based on radiological definition

PurposeThe aim of this study was to investigate the clinical and radiological incidence of parastomal hernia and to analyze the risk factors for parastomal hernia.MethodsWe reviewed retrospectively 108 patients with end colostomy from January 2003 to June 2010. Age, sex, surgical procedure type, body mass index (kg/m2), stoma size, and respiratory comorbidity were documented.RESULTSThere were 61 males (56.5%) and 47 females (43.5%). During an overall median follow-up of 25 months (range, 6 to 73 months), 36 patients (33.3%) developed a radiological parastomal hernia postoperatively and 29 patients (26.9%) presented with a clinical parastomal hernia. In multivariate analysis, gender (odds ratio [OR], 6.087; P = 0.008), age (OR, 1.109; P = 0.009) and aperture size (OR, 6.907; P < 0.001) proved to be significant and independent risk factors after logistic regression analysis.ConclusionThis study showed that the incidence of radiological parastomal hernia is higher than clinical parastomal hernia. Risk factors for parastomal hernia proved to be female, age, and aperture size.

Fukushima and the Future of Radiation Research

There are now a good deal of data, opinions and speculation regarding the multiple disaster incident in Japan that began March 11, 2011 (1–7). Worldwide attention has focused on the risks, benefits and consequences of potential exposure to and uses for radiation. This article presents personal observations from participation in the response to this incident and projections as to how this major radiological incident might impact the future of the Radiation Research Society, and the important positive contributions radiation sciences can make to society in general. This watershed incident has and will continue to have a profound impact on nuclear energy utilization and cancer care, and demonstrates the importance of sound scientific underpinnings for decisions regarding uses and risks of radiation. This paper emphasizes the societal benefit from broad based radiation research. This perspective on future directions for radiation research and biomedical research in general is that of a physician-scientist, radiation/medical oncologist in academia (Stanford 1975–1985 and Harvard 1985–1999) and government [National Cancer Institute (NCI) since 1999 and also Office of the Assistant Secretary for Preparedness and Response (ASPR) since 2004]. The perspective of the Fukushima experience is from 8 years as a subject matter expert within the all-hazard planning team at ASPR, including a 3-week deployment in the U.S. Embassy in Tokyo during the crisis. My opinion of the spectrum of opportunities for the Radiation Research Society are from: (a) having been active in outreach to the medically underserved both locally and internationally since I graduated from Yale Medical School including the New Haven riots of the late 1960s, (b) working with the National Coalition for Cancer Survivorship since the early 1990s (8), (c) having seen the enormous change in health care and in federally supported research programs over periods of substantial growth over the 1980s and 1990s, and (d) experiencing as a laboratory researcher and as an NCI program leader regarding the pushback against rising health care costs and the effects of flat investment in biomedical research that has been front-and-center for the last 10 years. Since this is a personal perspective and not a review paper, only a limited number of representative references from the literature are provided. Two quotations attributable to Yogi Berra, the former New York Yankee catcher (9) were used to frame this presentation at the 2012 Radiation Research Society meeting that are as true as they are humorous: