Medical response to radiation incidents and radionuclear threats

doi:10.1136/bmj.328.7439.568

BMJ 2004;328:568-572 (6 March), doi:10.1136/bmj.328.7439.568

Clinical review

Medical response to radiation incidents and radionuclear threats

István Turai, medical officer¹, Katalin Veress, senior lecturer², Bengül Günalp, associate professor³, Gennadi Souchkevitch, deputy director⁴

¹ Department of Protection of the Human Environment, World Health Organization, Geneva 27, CH-1211, Switzerland, ² Department of Public Health, Semmelweis University, Budapest, Hungary, ³ Department of Nuclear Medicine, Gülhane Medical Academy, Ankara, Turkey, ⁴ Institute of Pathology and Pathophysiology, Moscow, Russia

Correspondence to: I Turai Turaii@who.int

Events that expose people to radiation are rare, but the threatof radiation injury is increasing. Doctors should know how torecognise and manage suspected exposure or contamination

The first 150 words of the full text of this article appear below.

Introduction

After the attacks of 11 September 2001, use of sources of radiationby terrorists with the potential to cause human damage has becomea greater threat.^1-4 Various professionals have discussed whethermalevolent use of these sources could result in radiation sicknessor radiation injuries on a large scale and the possible results.^5-7Radiation sickness is the acute or delayed consequences of exposureof the whole body or a large part to high doses of ionisingradiation capable of causing a set of non-specific clinicalsymptoms and haematological changes. Radiation injury is theacute or delayed consequences of exposure of a small part ofthe body to high doses of ionising radiation capable of causingburns or other localised organ pathology—for example,cataract, hypothyreosis, and pneumonia.

Responses to recent incidents involving radiation indicate thatmost general practitioners are uncertain about the health consequencesof exposure to ionising radiation and the medical . . . [Full text of this article]

Methods

Global statistics and main causes of radiation accidents

Typical exposure scenario of recent radiation accidents

Radiation sickness

Early clinical symptoms
Differential diagnosis

Radiation injury of the skin

Clinical suspicion

Early management of contaminated patients

Strategy and safety aspects of the medical response to radiation injuries

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Response to radiation incidents and radionuclear threats: Medical treatment should be given only when safe to do so: Jonathan R Benger
BMJ 2004 328: 1074. [Extract] [Full Text] [PDF]

Response to radiation incidents and radionuclear threats: Other threats may be more serious: John R Buscombe
BMJ 2004 328: 1074. [Extract] [Full Text]

Response to radiation incidents and radionuclear threats: Renunciation of nuclear weapons could lessen the threat: Douglas Holdstock and Elizabeth Waterston
BMJ 2004 328: 1074. [Extract] [Full Text]

"Doctor, come quickly. There's been a nuclear incident": Richard Smith
BMJ 2004 328: 0. [Extract] [Full Text] [PDF]

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Cordes, N, Meineke, V (2005). Modification of the cellular radiation survival and proliferation response by cell-matrix interactions: implications for integrin targeting in therapeutic approaches for radiation accident patients. Br. J. Radiol. Supplement_27: 152-156 [Abstract] [Full text]
Benger, J. R (2004). Response to radiation incidents and radionuclear threats: Medical treatment should be given only when safe to do so. BMJ 328: 1074-1074 [Full text]
Buscombe, J. R (2004). Response to radiation incidents and radionuclear threats: Other threats may be more serious. BMJ 328: 1074-1074 [Full text]
Holdstock, D., Waterston, E. (2004). Response to radiation incidents and radionuclear threats: Renunciation of nuclear weapons could lessen the threat. BMJ 328: 1074-1074 [Full text]

Rapid Responses:

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