Medical planning and response for a nuclear detonation: a practical guide.

This article summarizes major points from a newly released guide published online by the Office of the Assistant Secretary for Preparedness and Response (ASPR). The article reviews basic principles about radiation and its measurement, short-term and long-term effects of radiation, and medical countermeasures as well as essential information about how to prepare for and respond to a nuclear detonation. A link is provided to the manual itself, which in turn is heavily referenced for readers who wish to have more detail.

Assessment of (90)sr and (137)cs penetration into reinforced concrete (extent of "deepening") under natural atmospheric conditions.

When assessing the feasibility of remediation following the detonation of a radiological dispersion device or improvised nuclear device in a large city, several issues should be considered, including the levels and characteristics of the radioactive contamination, the availability of resources required for decontamination and the planned future use of the city's structures and buildings. Currently, little is known about radionuclide penetration into construction materials in an urban environment. Knowledge in this area would be useful when considering costs of a thorough decontamination of buildings, artificial structures and roads in an affected urban environment. Pripyat, a city substantially contaminated by the Chernobyl Nuclear Power Plant accident in April 1986, may provide some answers. The main objective of this study was to assess the depth of (90)Sr and (137)Cs penetration into reinforced concrete structures in a highly contaminated urban environment under natural weather conditions. Thirteen reinforced concrete core samples were obtained from external surfaces of a contaminated building in Pripyat. The concrete cores were drilled to obtain sample layers of 0-5, 5-10, 10-15, 15-20, 20-30, 30-40 and 40-50 mm. Both (90)Sr and (137)Cs were detected in the entire 0-50 mm profile of the reinforced cores sampled. In most of the cores, over 90% of the total (137)Cs inventory and 70% of the total (90)Sr inventory was found in the first 0-5 mm layer of the reinforced concrete. Strontium-90 ((90)Sr) had penetrated markedly deeper into the reinforced concrete structures than (137)Cs.

Prenatal radiation exposure: background material for counseling pregnant patients following exposure to radiation.

Fetal sensitivity to radiation-induced health effects is related to gestational age, and it is highly dependent on fetal dose. Typical fetal doses from diagnostic radiology are usually below any level of concern. Although rare, significant fetal radiation doses can result from interventional medical exposures (fluoroscopically guided techniques), radiation therapy, or radiological or nuclear incidents, including terrorism. The potential health effects from these large radiation doses (possibly large enough to result in acute radiation syndrome in the expectant mother) include growth retardation, malformations, impaired brain function, and neoplasia. If exposure occurs during blastogenesis (and the embryo survives), there is a low risk for congenital abnormalities. (In all stages of gestation, radiation-induced noncancer health effects have not been reported for fetal doses below about 0.05 Gy [5 rad].) The additional risk for childhood cancer from prenatal radiation exposure is about 12% per Gy (0.12%/rad) above the background incidence.

Assessment of beta particle flux from surface contamination as a relative indicator for radionuclide distribution on external surfaces of a multistory building in Pripyat.

Several issues should be considered when assessing the feasibility of remediation following the detonation of a radiological dispersion device (e.g., dirty bomb) or improvised nuclear device in a large city. These issues include the levels and characteristics of the radioactive contamination, the availability of resources required for decontamination, and the planned future use of the city's structures and buildings. Presently, little is known about the distribution, redistribution, and migration of radionuclides in an urban environment. However, Pripyat, a city substantially contaminated by the Chernobyl Nuclear Power Plant accident in April 1986, may provide some answers. The main objective of this study was to determine the radionuclide distribution on a Pripyat multistory building that had not been decontaminated and, therefore, could reflect the initial fallout and its further natural redistribution on external surfaces over 23 y. The seven-story building selected was surveyed from the ground floor to the roof on horizontal and vertical surfaces along seven ground-to-roof transections. Some results from this study indicate that the upper floors of the building had higher contamination levels than the lower floors. Consequently, the authors recommend that thorough decontamination should be considered for all the floors of tall buildings (not just lower floors).

Acute radiation syndrome: assessment and management.

Primary care physicians may be unprepared to diagnose and treat rare, yet potentially fatal, illnesses such as acute radiation syndrome (ARS). ARS, also known as radiation sickness, is caused by exposure to a high dose of penetrating, ionizing radiation over a short period of time. The time to onset of ARS is dependent on the dose received, but even at the lowest doses capable of causing illness, this will occur within a matter of hours to days. This article describes the clinical manifestations of ARS, provides guidelines for assessing its severity, and makes recommendations for managing ARS victims.

Assessment of radionuclide databases in CAP88 mainframe version 1.0 and Windows-based version 3.0.

In this study the radionuclide databases for two versions of the Clean Air Act Assessment Package-1988 (CAP88) computer model were assessed in detail. CAP88 estimates radiation dose and the risk of health effects to human populations from radionuclide emissions to air. This program is used by several U.S. Department of Energy (DOE) facilities to comply with National Emission Standards for Hazardous Air Pollutants regulations. CAP88 Mainframe, referred to as version 1.0 on the U.S. Environmental Protection Agency Web site (http://www.epa.gov/radiation/assessment/CAP88/), was the very first CAP88 version released in 1988. Some DOE facilities including the Savannah River Site still employ this version (1.0) while others use the more user-friendly personal computer Windows-based version 3.0 released in December 2007. Version 1.0 uses the program RADRISK based on International Commission on Radiological Protection Publication 30 as its radionuclide database. Version 3.0 uses half-life, dose, and risk factor values based on Federal Guidance Report 13. Differences in these values could cause different results for the same input exposure data (same scenario), depending on which version of CAP88 is used. Consequently, the differences between the two versions are being assessed in detail at Savannah River National Laboratory. The version 1.0 and 3.0 database files contain 496 and 838 radionuclides, respectively, and though one would expect the newer version to include all the 496 radionuclides, 35 radionuclides are listed in version 1.0 that are not included in version 3.0. The majority of these has either extremely short or long half-lives or is no longer in production; however, some of the short-lived radionuclides might produce progeny of great interest at DOE sites. In addition, 122 radionuclides were found to have different half-lives in the two versions, with 21 over 3 percent different and 12 over 10 percent different.

Potential nuclear and radiological incidents: a summary for clinicians.

Most clinicians will go their entire career without seeing a patient who has been involved in a nuclear or radiological incident, and many health care professionals feel ill equipped to respond to such incidents. To add to this difficulty, the medical response that is most appropriate for such an event varies, depending on the type of incident. As part of an effort to address these and other challenges for the medical community, the Centers for Disease Control and Prevention has developed a quick-reference for clinicians (based on the consensus of numerous stakeholders) that summarizes the key differences between various types of potential nuclear and radiological incidents in relation to some key medical response concerns. This paper is not intended for a clinical audience, but rather presents the and describes the framework upon which the is based, providing the health physics community with a clinical perspective of these events.