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 from information about the radiological attack scenario with cesium-137 in the U.S.National Scenario Planning Guide,we estimated the radiological doses absorbed.Similar calculations were performed for a smaller plume size and a detonation in a subway.For conditions as described in the U.S.scenario,the committed effective dose amounted to a maximum of 848 mSv,even for very unfavorable conditions.Red 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 cases.In a subway bombing,doses are much higher and the occurrence of ARS should be expected.The health hazards from a dirty bomb attack will depend on the location and the explosive device.The 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 priorities.Further 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.

Follow-up of two victims of a 60Co-source radiation accident in 1986, Kaifeng, Henan Province, China

Objective:To explore the late effects of acute radiation exposure through the follow-up of two victims of a 60Cosource radiation accident,who suffered moderate acute radiation sickness of bone marrow type.Methods:On May 26,1986,a power failure occurred suddenly at an irradiation plant in Kaifeng,Henan Province,China,during which two workers at the site,named Liang and Yan,accidentally entered the 60Co-source irradiation cell in service.Long-term medical observations were carried out on them following the accident.Results:The late effects of the accident on Liang and Yan were observed.The main manifestations of Liang were hypomnesia and visual impairment.A typical radiation-induced cataract developed 2 years after exposure.Local cutaneous radiation injury and resultant five operations were performed within a period of five years after exposure.The decrease in the number and low viability of his sperms was found 1 year after exposure.The decrease in his leukocytes and platelets occurred during 1–5 years after exposure.He died from intrahepatic cholangiocarcinoma 21 years after exposure.For Yan,the main manifestations included headache,dizziness,fatigue,insomnia,and susceptibility to cold just after exposure.She had intermittent menolipsis at age 41.The leukocytes was fluctuating in the range of(3.1–3.9)109/L 14–24 years after exposure.A decrease in estradiol(reproductive hormone)and an increase in follicle-stimulating hormone were observed.Thyroid nodules were detected by thyroid ultrasound 21 years after exposure.She died from acute myeloid leukemia(AML)32 years after exposure.Conclusions:Follow-up of victims exposed to a high activity radiation source should focus on the organs sensitive to radiation and on the radiation-induced carcinogenesis.