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

In the case of a terrorist attack by a "dirty bomb", blast injuries, external irradiation and the incorporation of radioactivity are to be expected. Departing f...     

急性核辐射对人的远期效应

内容仅涉及事故性急性核辐射的远期效应:1.日本原爆幸存者(包括宫内受照者约2800名)的流行病学调查结果,归纳为强关联、弱关联和无关联的远期效应。在第8～15孕周阶段接受1Gy照射的胎儿,约有43%会发生智力发育延迟,为受照0.01Gy以下的对比组危险度的50倍以上。对原爆人群各部位癌症的相对、绝对和归因危险作了介绍。对原爆幸存者受照射后怀孕所生子女(1946年5月以后出生),用(1)不利的妊娠结果、(2)死亡事件、(3)携带有性染色体异常儿童的频率、(4)携有由于基因突变引起的血液蛋白电泳变异体儿童的频率等遗传学指标提示,近爆心(<2000m)幸存者(>1Gy)所生儿童与远离爆心组(0.01～0.09Gy)相比,仅仅是预期趋势上有差别,实际上未发现有统计学意义的差异。即使如此,这两组儿童间的差异用上述4个指标中的前3个观察结果,估计了加倍剂量,平均数是1.56Sv,但是有争议。2.马绍尔群岛放射性落下灰受照居民医学随访近况,甲状腺疾病发病率高,而在日本原爆幸存者中则未见类似情况,估计与马绍尔群岛居民甲状腺因摄入放射性碘而照射量较大有关。3.日本福隆丸号渔民受落下灰照射后远后效应资料。4.美国Y-12工厂共8名受照者的远后效应:4例有放射性白内障,1998年时仅活存3例。5.前苏联切尔诺贝利核电站事故中急性放射病(ARS)病人远后效应:2例Ⅲ度ARS病人分别于照后第6年和第9年发生骨髓增生异常综合征(MDS)引起死亡,1例Ⅰ度ARS病人也于照后第9年诊断为MDS,另一例Ⅱ度ARS病人照后第11年发生急性单核细胞白血病。6.巴西137Cs事故5年后远期效应。     

The pipe bomb: a modern terrorist weapon

The use of pipe bombs by terrorist organisations around the world has risen dramatically. The pipe bomb is simple and easy to make and details of bomb construction are freely available from the Internet. Components can be found in most hardware stores and thus give little forensic information. Despite the increasing use of pipe bombs, clinicians may be unfamiliar with the type of injuries they cause. This paper describes two incidents of pipe bomb explosions and illustrates the type of injuries sustained by both terrorists and victims.     

城市核与辐射恐怖事件的辐射影响预测软件

目的 为更加直观了解核与辐射恐怖事件在城市地区的辐射影响范围,开发可将预测结果直接显示在城市电子地图上的系统软件.方法 针对放射性物质散布、脏弹袭击、辐射设施爆炸或纵火袭击3种场景,采用高斯扩散模型,预测污染物在大气中的扩散与沉降.结合相应的剂量转换因子,估算"代表人"的内、外照射剂量.集成计算系统与Mapinfo(R)地理信息系统,将相应的预测结果直观显示于城市电子地图.结果 该软件可实现预测结果在城市电子地图上的直接显示.其预测结果与国外类似软件Hotspot(R)的计算结果比较,对于主要污染区域的预测范围基本一致,事故下风向区域等剂量曲线位置偏差小于0.2 km.结论 研制出的软件系统能对城市核与辐射恐怖事件的辐射影响进行早期预测,为城市的应急响应提供参考,具有一定的实用价值.

Abstract：

Objective To develop a new software system that cau directly display the predicted results on an electronic map,in order to get a directly perceived understanding of the affected areas of nuclear and radiological terrorism events in city areas.Methods Three scenarios of events including spreading radioactive materials, dirty bomb attack,and explosion or arson attacks on the radiation facilities were assumed.Gaussian diffusion model was employed to predict the spread and deposition of radioactive pollutants,and both the internal and external doses were estimated for the representative person by using the corresponding dose conversion factors.Through integration of the computing system and Mapinfo geographic information system(GIS),the predicted results were visually displayed on the electronic maps of a city.Results The new software system could visually display the predicted results on the electronic map of a city, and the predicted results were consistent with those calculated by the similar software Hotspot(R)The deviation between this system and Hotspot was less than 0.2 km for predicted isoplethic curves of dose rate downwind.Conclusions The newly developed software system is of the practical value in predicting the effects of nuclear and radiological terrorism events in city areas.     

城市核与辐射恐怖事件的辐射影响预测软件

目的 为更加直观了解核与辐射恐怖事件在城市地区的辐射影响范围,开发可将预测结果直接显示在城市电子地图上的系统软件.方法 针对放射性物质散布、脏弹袭击、辐射设施爆炸或纵火袭击3种场景,采用高斯扩散模型,预测污染物在大气中的扩散与沉降.结合相应的剂量转换因子,估算"代表人"的内、外照射剂量.集成计算系统与Mapinfo(R)地理信息系统,将相应的预测结果直观显示于城市电子地图.结果 该软件可实现预测结果在城市电子地图上的直接显示.其预测结果与国外类似软件Hotspot(R)的计算结果比较,对于主要污染区域的预测范围基本一致,事故下风向区域等剂量曲线位置偏差小于0.2 km.结论 研制出的软件系统能对城市核与辐射恐怖事件的辐射影响进行早期预测,为城市的应急响应提供参考,具有一定的实用价值.     

云爆弹/温压弹的杀伤因素及杀伤特点的研究进展

云爆弹装填液体炸药,主要杀伤隐蔽目标,也能规模化杀伤地面目标.温压弹装填温压炸药,其爆炸威力不仅比液态炸药更强,杀伤效果也更可靠,被视为云爆弹的提高型.云爆弹/温压弹的主要杀伤因素有冲击波、高温、低氧和有毒有害气体,如不预置,则破片少见.主要杀伤特点是冲击波损伤重、烧伤重、密闭空间内人员损伤重、低氧窒息重、复合伤多.现...     

水下冲击波与空气冲击波对生物内脏损伤效应的对比研究

目的对比研究水下冲击波与空气冲击波对生物内脏的损伤效应，为其防治提供一定的依据。方法用1000g TNT分别进行水下和空气中爆炸，压力传感器测定冲击波的物理参数，包括峰值压力、正向持续时间和冲量。取成年杂种犬26只，其中水下爆炸20只，空气中爆炸6只，分别用1000g TNT进行水下和空气中爆炸，观察伤后6h动物存活情况和病理形态学改变。结果水下冲击波的峰值压力明显高于空气冲击波的峰值压力，尽管正向持续时间比空气冲击波短，但冲量仍明显大于空气冲击波。生物效应的测定结果表明，水下冲击波引起的死亡率高（50％），致死边界远（距爆心12．5m），肺和腹腔脏器损伤的发生率高，且伤情严重，而空气冲击波引起的损伤轻微，仅个别动物有轻微肺损伤，未见动物死亡。结论同质量TNT水下和空气中爆炸，水下冲击波的峰值压力和冲量明显高于空气冲击波，对生物的杀伤效应也明显强于空气冲击波，肺和腹腔脏器的损伤是早期救治的重要环节。     

Occupational radiation exposure: population studies

Occupational exposure to ionizing radiation in the medical setting differs from the acute exposure received by survivors of atomic bomb blasts. Yet, atomic bomb survivors' disease and mortality outcomes have been the standard data source on the effects of ionizing radiation on humans. Therefore, the prevailing estimated risks of ionizing radiation may not apply to radiologic technologists and other medical radiation workers. Carefully designed epidemiological trials provide evidence that helps determine the strength of association between exposure and onset of disease in selected populations. This article reviews radiation effects, explains some basic design concepts of epidemiologic trials and surveys the epidemiology literature related to radiation exposure to humans, with special attention to radiology staff.     

An autopsy case related to a terrorist attack using a ball-bearing bomb

We encountered an autopsy case related to a terrorist attack using a ball-bearing bomb. The decedent was a 51-year-old male without significant medical histories. During dinner in a restaurant, the perpetrator suddenly exploded a ball-bearing bomb, the blast from which blew the victim off his chair. The victim was found to be unresponsive, and pronounced dead. X-ray photographs taken before autopsy revealed six spherical shadows. Three penetrating wounds in the head, one in the neck and chest, and two in the left upper arm were observed in vivo. Six projectiles recovered from the body were identified as ball-bearings, one of which traveled through the midbrain, diencephalon, and left temporal lobe. Although blast injuries and penetrating wounds are often combined in bomb attack victims, penetrating brain injury would be the cause of death in this case. Lethal injuries to major organs can thus occur even though the destructive force of a ball-bearing bomb is weak. X-ray films were informative for detecting the ball-bearings in this case, suggesting that autopsy imaging is essential in cases of terrorism victims.     

Chernobyl retrospective

On April 28, 1986 heavy radioactive fallout from an unknown source was reported from Sweden. Later, it was discovered that two days earlier, a nuclear power reactor at Chernobyl, in the Soviet Union, had exploded releasing an enormous cloud of effluent containing 40 million Ci of 131I, 3 million Ci of 137Cs, and 50 million Ci of xenon radioisotopes. This far exceeded the 15 Ci of 131I escape in the notorious Three Mile Island accident. Chernobyl reactor IV, of an antiquated design, was a graphite-moderated reactor which suffered a steam explosion when the operating staff attempted an experiment involving preservation of safety functions during a planned shutdown. Following the explosion, a fire started in the graphite core which required ten days to control. Thirty-one persons died, two in the initial explosion and 29 of various combinations of thermal and radiation burns, and gamma irradiation. Existing emergency plans were invoked involving treatment on the scene and evacuation of seriously injured patients to a special hospital in Moscow, as well as to nearby Kiev. Later, 135,000 residents of the immediate neighborhood were surveyed and evacuated after fallout radiation levels began to rise. Fallout patterns around Europe and the northern hemisphere were closely tracked. Consequences of the accident in human and monetary terms will require years of evaluation. Although the United States has no power reactors of the Chernobyl type, the country does have a radiation disaster management plan, often rehearsed at the state level. As a consequence of Chernobyl certain international agreements dealing with radiation disaster information and management have been forged.     

Therapy for prevention and treatment of skin ionizing radiation damage: a review

Abstract

Radiologic accidents or terrorist acts involving radioactive material, as well as radiation exposure in medical or industrial procedures are potential sources of risk for human health. All these risks share a common element, exposure to ionizing radiation. The extent of ionizing radiation injury will depend on a number of independent variables such as dose, type of radiation and tissue, etc. As a result of ionizing radiation exposure, biological effects can take place in acute or long-term manner. As in the case of other self-renewing tissues (e.g. hematopoietic system and intestinal epithelium), skin is also extremely sensitive to ionizing radiation. In this way, appropriate management of radiation skin effects might improve the therapeutic benefit of medical radiation therapy, as well as reduce the mortality associated with any radiological incident (e.g. accident or terrorist attack). For this reason, current and potential future treatment approaches for skin radiation injury are reviewed in this work. Unfortunately, there is no sufficient evidence for establishing a standard treatment to prevent or mitigate radiation-induced cutaneous injury. Thus, continued research is necessary to achieve effective therapies to address this important health problem.     

Radiation decontamination unit for the community hospital

"Freestanding" radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstruction. Because of the development of nuclear power plants in relatively remote areas and widespread transportation of radioactive materials it is important for hospitals and physicians to be prepared to handle radiation accident victims. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Ridge Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. It is important that the team leader be knowledgeable in radiation accident management and have personnel trained in radiation accident management as members of this team. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important. Periodic drills are necessary for this mobilization and the smooth operation of the unit.     

Implications of ICRP 60 and the patient directive 97/43 Euratom for nuclear medicine.

The Council of the European Union has completely renewed the framework regarding radiation protection by adopting 2 directives: Directive 97/43 Euratom lays down the general principles of the radiation protection of individuals undergoing exposure to ionizing radiations related to medical exposures, as a supplement of Directive 96/29 Euratom laying down the basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionizing radiations. Member States shall bring into force the laws, regulations and administrative provisions necessary to comply with these two directives before 13 May 2000. Since medical applications represent the largest man-made sources of radiation exposure for the European population and exposure to low levels of ionizing radiations has become a sensitive issue for the public, the nuclear medicine community is concerned by the set of European legislation which appear to be more restrictive than the previous one. It is based on the scientific knowledge concerning radiation protection as expressed in particular in Recommendation No. 60 of the International Commission on Radiological Protection. In this paper, the directives are carefully analyzed and evaluated in terms of their potential impact on nuclear medicine practice.     

Significance of beta-radiation skin burns in Chernobyl patients for the theory and practice of radiopathology

In the year 1986 the Clinical Department of the Institute of Biophysics of the Ministry of Health of the USSR was the main specialized center in the country for the treatment of radiation disease. More than 300 people involved into the Chernobyl nuclear power plant accident were submitted to a specialized clinical observation, and the acute radiation syndrome (ARS) was diagnosed in 115 of the patients. The author of the article worked as a chief of surgical team responsible for the radiation burns treatment.     

Radiation injuries from military and accidental explosions: a brief historical review

Nuclear radiation was discovered in the late 1800s. Advances in nuclear physics split the atom to herald the atomic age soon afterward. Now, a century later, health care providers remain acutely aware that nuclear hazards may present instantly and unexpectedly, with devastating and massive results. This article highlights known radiation injuries from military and accidental explosions. This information is critical for the preparedness of health care providers in view of aging nuclear power plants, potential industrial and medical accidents, and the buildup of military weapons by other countries.     

田湾核电站周围居民核电站认知调查

目的 调查核电站周围公众对核电站的认知和态度,了解影响公众对核电站认知和态度的因素。方法 按照居住地距连港市田湾核电站的距离,将调查对象分为4层:0km～, 4km～, 8km～和 30km～50km。用问卷调查的方式调查了田湾核电站周围50km内的常住居民共计1408人。调查问卷共37个问题,包括个人基本情况、对辐射相关知识的了解、对常见工业设施和核电站的环境影响评价、对核电站的认知和态度及其影响因素等信息。用ordinal logistic模型进行多因素回归分析。结果 调查对象中91.18%的人听说过核电站,35.36%的人对切尔诺贝利核电站事故有所了解,71.05%的人认为核电站对环境没有负面影响,37.03%的人认为核电站是安全的,74.27%的人认为我国有必要发展核电站,63.29%的人支持当地发展核电站。回归分析表明:受教育程度高、男性、认为当地政府处理突发事件能力强、家庭年收入高、认为本地区建核电站对自己有经济好处是影响调查对象对核电站认知和态度的正向因素,而认为核电站对环境有影响和担心核电站对健康有影响是负向因素。调查对象对核电站的负向态度(否定或不支持)与距离核电站的距离的关系曲线呈右侧拖尾倒置"U"型。结论 受教育程度、性别、家庭年收入和预期经济回报等是影响公众对核电站认知和态度的主要因素,为了提高公众对核电的接受性,需要针对重点人群和主要影响因素做更多工作。     

Computed tomography and patient risk: Facts,perceptions and uncertainties

Since its introduction in the 1970s, computed tomography (CT) has revolutionized diagnostic decision-making. One of the major concerns associated with the widespread use of CT is the associated increased radiation exposure incurred by patients. The link between ionizing radiation and the subsequent development of neoplasia has been largely based on extrapolating data from studies of survivors of the atomic bombs dropped in Japan in 1945 and on assessments of the increased relative risk of neoplasia in those occupationally exposed to radiation within the nuclear industry. However, the association between exposure to low-dose radiation from diagnostic imaging examinations and oncogenesis remains unclear. With improved technology, significant advances have already been achieved with regards to radiation dose reduction. There are several dose optimization strategies available that may be readily employed including omitting unnecessary images at the ends of acquired series, minimizing the number of phases acquired, and the use of automated exposure control as opposed to fixed tube current techniques. In addition, new image reconstruction techniques that reduce radiation dose have been developed in recent years with promising results. These techniques use iterative reconstruction algorithms to attain diagnostic quality images with reduced image noise at lower radiation doses.     

辐射引起的电子自旋共振信号在回顾剂量学中的应用

辐射可以激发某些材料以及生物样品产生自由基,电子自旋共振(ESR)波谱仪可以检测到这些自由基信号,而信号的强度与受到电离辐射的剂量相关。利用牙齿的ESR波谱估算核事故的辐射剂量是一种经典的方法。近年来,很多学者研究了指(趾)甲、头发、手机屏幕等易获取材料的ESR波谱与辐射剂量的关系。该文从这些材料的背景信号、剂量学的线性关系、探测下限以及信号的稳定性等方面进行综述,以期为核事故的剂量估算提供更好的依据。