Response to radiation incidents and radionuclear threats
http://www.100md.com
《英国医生杂志》
EDITOR—Benger's remarks give us an opportunity to re-emphasise one of the key messages of our article: saving the lives of patients with life threatening conditions should always have a priority, as providing emergency medical care for a patient contaminated with radioactive materials cannot pose a serious direct health risk to medical staff.
When workers at Chernobyl, who were in the reactor area at the time of the nuclear accident, were decontaminated, the medical staff at the site received less then 10 mGy of radiation.1 In view of a possible dose as low such as this, we refer to the handbook of the Armed Forces Radiobiology Research Institute, which says that surgical priorities for acute or life threatening injury must precede any treatment priority for associated radiation injury and that radiological decontamination should never interfere with medical care.2
We agree with Buscombe that radionuclear threats are of low probability and the radioactive materials used for making dirty bombs pose the highest threat to the terrorists themselves. Accepting that terrorist contamination of central water supply may lead to a serious threat in the affected population group via ingestion, however, we wish to underline that inhalation of radioactive aerosols produced by a radiological dispersion device seems to be the most probable contamination pathway. Although hospital sources and radioactive materials used in nuclear medicine are of less importance for terrorist use,3 the radio-therapy sources, when stolen and dismantled, may cause severe overexposure to people having direct contact with them, as we said in our paper.
We agree with Holdstock and Waterston that all efforts must be made for non-proliferation of nuclear weapons. The Comprehensive Nuclear-Test-Ban Treaty Organisation (CTBTO, Vienna, www.ctbto.org) is the specialised UN organisation in charge of and effectively performing the task of preventing proliferation of nuclear materials.
István Turai, medical officer
Department of Protection of the Human Environment, World Health Organization, CH-1211 Geneva 27, Switzerland turaii@who.int
Katalin Veress, senior lecturer
Department of Public Health, Semmelweis University, Budapest, Hungary
Bengül Günalp, associate professor
Department of Nuclear Medicine, Gülhane Medical Academy, Ankara, Turkey
Gennadi Souchkevitch, deputy director
Institute of Pathology and Pathophysiology, Moscow, Russia
Competing interests: None declared.
References
Mettler FA Jr, Voelz GL. Current concepts: major radiation exposure—what to expect and how to respond. N Engl J Med 2002;346: 1554-61.
Armed Forces Radiobiology Research Institute. Military medical operations. Medical management of radiological casualties. Handbook. 2nd ed. Bethesda, MD: AFRRI, 2003: 35, 53.
Hogan DE, Kellison T. Nuclear terrorism. Am J Med Sci 2002;323: 341-9.
When workers at Chernobyl, who were in the reactor area at the time of the nuclear accident, were decontaminated, the medical staff at the site received less then 10 mGy of radiation.1 In view of a possible dose as low such as this, we refer to the handbook of the Armed Forces Radiobiology Research Institute, which says that surgical priorities for acute or life threatening injury must precede any treatment priority for associated radiation injury and that radiological decontamination should never interfere with medical care.2
We agree with Buscombe that radionuclear threats are of low probability and the radioactive materials used for making dirty bombs pose the highest threat to the terrorists themselves. Accepting that terrorist contamination of central water supply may lead to a serious threat in the affected population group via ingestion, however, we wish to underline that inhalation of radioactive aerosols produced by a radiological dispersion device seems to be the most probable contamination pathway. Although hospital sources and radioactive materials used in nuclear medicine are of less importance for terrorist use,3 the radio-therapy sources, when stolen and dismantled, may cause severe overexposure to people having direct contact with them, as we said in our paper.
We agree with Holdstock and Waterston that all efforts must be made for non-proliferation of nuclear weapons. The Comprehensive Nuclear-Test-Ban Treaty Organisation (CTBTO, Vienna, www.ctbto.org) is the specialised UN organisation in charge of and effectively performing the task of preventing proliferation of nuclear materials.
István Turai, medical officer
Department of Protection of the Human Environment, World Health Organization, CH-1211 Geneva 27, Switzerland turaii@who.int
Katalin Veress, senior lecturer
Department of Public Health, Semmelweis University, Budapest, Hungary
Bengül Günalp, associate professor
Department of Nuclear Medicine, Gülhane Medical Academy, Ankara, Turkey
Gennadi Souchkevitch, deputy director
Institute of Pathology and Pathophysiology, Moscow, Russia
Competing interests: None declared.
References
Mettler FA Jr, Voelz GL. Current concepts: major radiation exposure—what to expect and how to respond. N Engl J Med 2002;346: 1554-61.
Armed Forces Radiobiology Research Institute. Military medical operations. Medical management of radiological casualties. Handbook. 2nd ed. Bethesda, MD: AFRRI, 2003: 35, 53.
Hogan DE, Kellison T. Nuclear terrorism. Am J Med Sci 2002;323: 341-9.