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Diagnostic Criteria for Assessment by General Practitioners of Patients Injured in Radiation Incidents and Cases of Radiological Terrorism

Published online by Cambridge University Press:  10 August 2017

Vili Zahariev  and
Nikolai Hristov
Vili Zahariev
Affiliation:
Department of Preventive Medicine, Medical University – Sofia, Sofia, Bulgaria
Nikolai Hristov*
Affiliation:
Department of Social Medicine, Medical University – Sofia, Sofia, Bulgaria
*
Correspondence and reprint requests to Nikolai Hristov, Department of Preventive Medicine, Medical University – Sofia, 8 Byalo more Str., 1527 Sofia, Bulgaria (e-mail: [email protected]).
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Abstract

The general practitioner is an important figure in the provision of medical care during radiation incidents and cases of radiological terrorism. Knowing the nature of the radiation injury is essential for correct diagnosis and treatment. Insufficient knowledge of most physicians, and of general practitioners in particular, on the clinical manifestation of radiation injuries is the reason such conditions remain unrecognized and improperly treated. We suggest some simple diagnostic criteria for assessment of the injured by general practitioners, based on the results of our own studies and on the recommendations of prominent international organizations. (Disaster Med Public Health Preparedness. 2018;12:507–512)

Keywords

general practitionersradiation incidentsdiagnostic criteriamedical care provision
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 4 , August 2018 , pp. 507 - 512
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

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References

1. Bui, E, Joseph, B, Rhee, P, Diven, C, Pandit, V, Brown, CV. Contemporary management of radiation exposure and injury. J Trauma Acute Care Surg. 2014;77(3):495-500.Google Scholar
2. International Atomic Energy Agency. Generic procedures for assessment and response during a radiological emergency. IAEA, Vienna; 2000.Google Scholar
3. Muller, K, Meineke, V. Advances in the management of localized radiation injuries. Health Phys. 2010;98(6):843-850.Google Scholar
4. Pham, MH, Yu, C, Rusch, M, Holloway, C, Chang, E, Apuzzo, ML. Evolving societal risks and necessary precautions in the age of nuclear power and therapeutic radiation: an American perspective. World Neurosurg. 2014;82(6):1060-1070.Google Scholar
5. Andrew Karam P. Radiological terrorism, Department of Biological Sciences, Rochester Institute of Technology; 2005.Google Scholar
6. Bushberg, JT, Buddemeier, BR, Lanza, JJ, et al. Responding to a Radiological or Nuclear Terrorism Incident: A Guide for Decision Makers, NCRP Report No. 165, 2010, Bethesda, MD.Google Scholar
7. Blumenthal, DJ, Bader, JL, Christensen, D, et al. A sustainable training strategy for improving health care following a catastrophic radiological or nuclear incident. Prehosp Disaster Med. 2014;29(1):80-86.Google Scholar
8. Bunn, M, Morozov, Y, Mowatt-Larrsen, R, et al. The U.S.-Russia Joint Threat Assessment of Nuclear Terrorism. Report for Belfer Center for Science and International Affairs, Harvard Kennedy School, Institute for U.S. and Canadian Studies, Cambridge, MA, June 6, 2011.Google Scholar
9. Dodgen, D, Norwood, AE, Becker, SM, Perez, JT, Hansen, CK. Social, psychological, and behavioral responses to a nuclear detonation in a US city: implications for health care planning and delivery. Disaster Med Public Health Prep. 2011;5(suppl):S54-S64.Google Scholar
10. ICRP. Protecting people against radiation exposure in the event of a radiological attack. ICRP Publication 96, 2006;1-110.Google Scholar
11. Christensen, DM, Parrillo, SJ, Glassman, ES, Sugarman, SL. Management of ionizing radiation injuries and illnesses, part 2: nontherapeutic radiologic/nuclear incidents. J Am Osteopath Assoc. 2014;114(5):383-389.Google Scholar
12. Christensen, DM, Iddins, CJ, Sugarman, SL. Ionizing radiation injuries and illnesses. Emerg Med Clin North Am. 2014;32(1):245-265.Google Scholar
13. Emergency Preparedness in Response to Terrorism, NRC, August 23, 2011, USNRC, Washington, DC.Google Scholar
14. Acton, JM, Rogers, MB, Zimmerman, PD. Beyond the dirty bomb: re-thinking radiological terror. Survival. 2007;49(3):161-168.Google Scholar
15. Poston, JW, Abdelnour, C, Ainsworth, J. Management of Terrorist Events Involving Radioactive Material, NCRP Report No. 138, 2001, Bethesda, MD.Google Scholar
16. Wiley, AL. REAC/TS, Radiation Emergency Response & Training Capabilities. ASTRO Refresher Course, November 7, 2006.Google Scholar
17. International Agency for Atomic Energy. Dosimetric and medical aspects of the radiological accident in Goiania in 1987, IAEA-TECDOC-1009, IAEA, Vienna, 1998.Google Scholar
18. International Agency for Atomic Energy. The radiological accident in Goiania, STI/PUB/815, IAEA, Vienna, 1988.Google Scholar
19. Nénot, J-C. Radiation accidents over the last 60 years. J Radiol Prot. 2009;29(3):301-320.Google Scholar
20. UN nuclear regulatory commission. Sources and Effects of Ionizing Radiation, Report to General Assembly with Annexes. New York: UN Publication; 2000.Google Scholar
21. IAEA and WHO. The Radiological Accident in Lilo. International Atomic Energy Agency, Vienna, 2000.Google Scholar
22. Buyan, G, Ganpolat, C, Cosset, JM, et al. The Radiological Accident in Istanbul, International Atomic Energy Agency, Vienna, 2000.Google Scholar
23. Bottolier-Depois, JF, Berger, ME, Caceres, E, et al. The Radiological Accident in Yanango, International Atomic Energy Agency, Vienna, 2000.Google Scholar
24. IAEA and WHO. Generic procedures for medical response during a nuclear or radiological emergency, EPR-MEDICAL, Vienna, 2005.Google Scholar
25. Sugarman, SL, Goans, RE, Garrett, S, Livingston, GK. The Medical Aspects of Radiation Incidents, Radiation Emergency Assistance Center/Training Site (REAC/TS), 2011, Oak Ridge, TN.Google Scholar
26. Fliedner, TM, Dörr, D, Meineke, V. Multi-organ involvement as a pathogenetic principle of the radiation syndromes: a study involving 110 case histories documented in search and classified as the bases of haematopoietic indicators of effect. Br J Radiol. Suppl, 2005;27:1-8.Google Scholar
27. Fliedner, TM, Friesecke, I, Beyrer, K. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. London: British Institute of Radiology; 2001.Google Scholar
28. Fliedner, TM, Meineke, V, Dainiak, N, Gourmelon, P, Akashi, M. Radiation-Induced Multi-Organ Involvement and Failure: A Challenge for Pathogenetic, Diagnostic and Therapeutic Approaches and Research. London and Oxford: BIR; 2004.Google Scholar
29. Gorin, NC, Fliedner, TM, Gourmelon, P, et al. Consensus conference on European preparedness for haematological and other medical management of mass radiation accidents. Ann Hematol. 2006;85(10):671-679.Google Scholar
30. Christensen, DM, Iddins, CJ, Parrillo, SJ, Glassman, ES, Goans, RE. Management of ionizing radiation injuries and illnesses, part 4: acute radiation syndrome. J Am Osteopath Assoc. 2014;114(9):702-711.Google Scholar
31. IAEA and WHO. Diagnosis and Treatment of Radiation Injuries. Safety Reports Series No.2, Vienna, 1998.Google Scholar
32. IAEA and WHO. Training for radiation emergency preparedness and response, EPR MEDICAL, 2002. www-pub.iaea.org/.Google Scholar
33. International Agency for Atomic Energy. Manual for First Responders to a Radiological Emergency, IAEA, 2006. www-pub.iaea.org/.Google Scholar
34. Berger, ME, Leonard, RB, Ricks, RC, Wiley, AL, Lowry, PC, Flynn, DF. Hospital Triage in the First 24 Hours after a Nuclear or Radiological Disaster. Radiation Emergency Assistance Center/Training Site (REAC/TS), 2011.Google Scholar
35. Bland, SA. Mass casualty management for radiological and nuclear incidents. J R Army Med Corps. 2004;150(3)Suppl 1:27-34.Google Scholar
36. Dainiak, N, Gent, RN, Carr, Z, et al. Literature review and global consensus on management of acute radiation syndrome affecting nonhematopoietic organ systems. Disaster Med Public Health Prep. 2011.Google Scholar
37. Gussev, IA, Gusskova, AK, Mettler, FA. eds. Medical Management of Radiation Accident, 2nd edition. Roca Ralton, FL: CRC Press; 2001.Google Scholar
38. IAEA and WHO. Medical Preparedness and Response for a Nuclear or Radiological Emergency, Vienna, 2014.Google Scholar
39. Kuniak, M, Azizova, T, Day, R, et al. The Radiation Injury Severity Classification system: an early injury assessment tool for the frontline health-care provider. BJR. 2008;81(963):232-243.Google Scholar
40. Turai, I, Veress, K. Radiation accidents: occurrence, types, consequences, medical management, and the lessons to be learned. Central Eur J Occup Environ Med. 2001;7:3-14.Google Scholar
41. Guskova, AK, Baranov, AY, Barabanova, AV. Diagnosis, clinical picture and therapy of acute radiation disease in victims of the accident at the Chernobyl nuclear power station. Ther Arch. 1989;61(1):95-103.Google Scholar
42. Brenner, DJ, Chao, NJ, Greenberger, JS, et al. Are we ready for a radiological terrorist attack yet? Report from the Centers for Medical Countermeasures Against Radiation Network. Int J Radiat Oncol Biol Phys. 2015;92(3);504-505.Google Scholar
43. Avetisov, GM. Importance of injury signs and indices in prehospital triage of nonuniformly irradiated patients. Prehosp Disast Med. 2001;16(2):S14.Google Scholar
44. Koenig, KL, Goans, RE, Hatchett, RJ, et al. Medical treatment of radiological casualties: current concepts. Ann Emerg Med. 2005;45(6):643-652.Google Scholar
45. Bargues, L, Donat, N, Jault, P, Leclerc, T. Burns care following a nuclear incident. Ann Burns Fire Disasters. 2010;23(3):160-164.Google Scholar
46. Guskova, AK. Local radiation injury in the population: diagnosis and treatment VCMK “Zashita”, Moscow, 2001.Google Scholar
47. Michael Leiter – U.S. Counterterror Chief. “Dirty Bomb” as much a risk as biological weapon, February 11, 2011.Google Scholar
48. ICRP Publication 90. Biological effects after prenatal irradiation (embryo and fetus). Ann ICRP. 2003;33(1-2).Google Scholar
49. Committee of the Biological Effects of Ionizing Radiation. Health Effects of Exposure to Low Levels of Ionizing Radiation. US National Academy of Sciences, National Research Council. Washington, DC: National Academy Press; 2005.Google Scholar
50. International Atomic Energy Agency. Development of an extended framework for emergency response criteria. TECDOC-1432, International Atomic Energy Agency, Vienna, 2005.Google Scholar
51. Olkin, AH, Moore, AV, Amis, S, et al. Disaster Preparedness for Radiology Professionals. Response to Radiological Terrorism. ©2002 American College of Radiology, 2002, Reston, VA.Google Scholar
52. Donnelly, EH, Smith, JM, Farfan, EB, Ozcan, I. Prenatal radiation exposure: background material for counseling pregnant patients following exposure to radiation. Disaster Med Public Health Prep. 2011;5(1):62-68.Google Scholar
53. Douple, EB, Mabuchi, K, Harry, MC, et al. Long-term radiation-related health effects in a unique human population: lessons learned from the atomic bomb survivors of Hiroshima and Nagasaki. Disaster Med Public Health Prep. 2011;5(1):S122-S133.Google Scholar
54. Higson, DJ, Boreham, DR, Brooks, AL, Luan, Y-C. Effects of low doses of radiation: joint statement from the following participants at the 15th Pacific Basin Nuclear Conference, October 2006, Dose Response, 2007; 5(4):259-262.Google Scholar
55. ICRP Publication 99. Low-dose extrapolation of radiation-related cancer risk. Ann ICRP. 2005;35(4):1-140.Google Scholar
56. Luckey, TD. Biological effects of ionizing radiation: a perspective for Japan. J Am Physicians Surgeons. 2011;16(2):45-46.Google Scholar
57. Report of the United Nations Scientific Committee on the Effects of Atomic Radiation –“Summary of low-dose radiation effects on health”, 2010. www.unscear.org/unscear/en/publications.Google Scholar
58. Tubiana, M. Dose-effect relationship and estimation of the carcinogenic effects of low doses of ionizing radiation: the joint report of the Acadamie des Sciences (Paris) and of the Acadamie Nationale de Medecine. Int J Radiat Oncol Biol Phys. 2005;63(2):317-319.Google Scholar
59. US Nuclear Regulatory Commission (NRC), Radiation Exposure and Cancer, March 31, 2011.Google Scholar
60. Ware, WR. Low-dose radiation exposure and risk of cancer. Int Health News. November 2008. http://www.yourhealthbase.com/radiation_and_cancer_risk.htmGoogle Scholar