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Estimation of radiation-induced health hazards from a“dirty bomb”attack with radiocesium under different assault and rescue conditions

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Military Medical Research 2022年第1期9卷 106-125页

作者： Alexis Rump Stefan Eder Cornelius Hermann Andreas Lamkowski Patrick Ostheim Michael Abend Matthias Port Bundeswehr Institute of Radiobiology Neuherberg Str.1180937 MunichGermany

In the case of a terrorist attack by a“dirty bomb”,blast injuries,external irradiation and the incorporation of radioactivity are to be *** from information about the radiological attack scenario with cesium-137 in the *** Scenario Planning Guide,we estimated the radiological doses *** calculations were performed for a smaller plume size and a detonation in a *** conditions as described in the ***,the committed effective dose amounted to a maximum of 848 mSv,even for very unfavorable *** bone marrow equivalent doses are insufcient to induce acute radiation sickness(ARS).In the case of a smaller plume size,the ARS threshold may be exceeded in some *** a subway bombing,doses are much higher and the occurrence of ARS should be *** health hazards from a dirty bomb attack will depend on the location and the explosive *** derived Haddon matrix indicates that preparing for such an event includes education of all the medical staff about radiation effects,the time lines of radiation damages and the treatment *** determinants of the outcome include rapid evacuation even from difficult locations,the availability of a specific triage tool to rapidly identify victims at risk for ARS,the availability of an antidote stockpile and dedicated hospital beds to treat seriously irradiated victims.

关键词： Medical NRBC protection Terrorism Radiological emergency dirty bomb Combined injuries Triage Acute radiation sickness Radionuclide incorporation

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Preparing for a “dirty bomb” attack: The optimum mix of medical countermeasure resources

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Military Medical Research 2021年第3期8卷 336-351页

作者： Alexis Rump Patrick Ostheim Stefan Eder Cornelius Hermann Michael Abend Matthias Port Bundeswehr Institute of Radiobiology Neuherberg Str.n80937 MunichGermany

Background: In radiological emergencies with radionuclide incorporation, decorporation treatment is particularly effective if started early. Treating all people potentially contaminated("urgent treatment") may require large antidote stockpiles. An efficacious way to reduce antidote requirements is by using radioactivity screening equipment. We analyzed the suitability of such equipment for triage purposes and determined the most efficient mix of screening units and antidote daily ***: The committed effective doses corresponding to activities within the detection limits of monitoring portals and mobile whole-body counters were used to assess their usefulness as triage tools. To determine the optimal resource mix, we departed from a large-scale scenario(60,000 victims) and based on purchase prices of antidotes and screening equipment in Germany, we calculated efficiencies of different combinations of medical countermeasure resources by data envelopment analysis. Cost-effectiveness was expressed as the costs per life year saved and compared to risk reduction opportunities in other sectors of society as well as the values of a statistical ***: Monitoring portals are adequate instruments for a sensitive triage after cesium-137 exposure with a high screening throughput. For the detection of americium-241 whole-body counters with a lower daily screening capacity per unit are needed. Assuming that 1% of the potentially contaminated patients actually need decorporation treatment, an efficient resource mix includes 6 monitoring portals and 25 mobile whole-body counters. The optimum mix depends on price discounts and in particular the fraction of victims actually needing treatment. The costeffectiveness of preparedness for a "dirty bomb" attack is less than for common health care, but costs for a life year saved are less than for many risk-reduction interventions in the environmental ***: To achieve economic efficiency a high daily screening ca

关键词： Radiological emergency dirty bomb Medical countermeasures Radionuclide incorporation Decorporation treatment Screening Efficiency Data envelopment analysis

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