Awareness and preparedness level of medical workers for radiation and nuclear emergency response.

Radiological science and nuclear technology have made great strides in the twenty-first century, with wide-ranging applications in various fields, including energy, medicine, and industry. However, those developments have been accompanied by the inherent risks of exposure to nuclear radiation, which is a source of concern owing to its potentially adverse effects on human health and safety and which is of particular relevance to medical personnel who may be exposed to certain cancers associated with low-dose radiation in their working environment. While medical radiation workers have seen a decrease in their occupational exposure since the 1950s thanks to improved measures for radiation protection, a concerning lack of understanding and awareness persists among medical professionals regarding these potential hazards and the required safety precautions. This issue is further compounded by insufficient capabilities in emergency response. This highlights the urgent need to strengthen radiation safety education and training to ensure the well-being of medical staff who play a critical role in radiological and nuclear emergencies. This review examines the health hazards of nuclear radiation to healthcare workers and the awareness and willingness and education of healthcare workers on radiation protection, calling for improved training programs and emergency response skills to mitigate the risks of radiation exposure in the occupational environment, providing a catalyst for future enhancement of radiation safety protocols and fostering of a culture of safety in the medical community.

A comprehensive review of dose limits, triage systems and measurement tools for consequence management of nuclear and radiological emergencies.

During a radiological or nuclear emergency, occupational workers, members of the public, and emergency responders may be exposed to radionuclides, whether external or internal, through inhalation, ingestion, or wounds. In the case of internalized radiation exposure, prompt assessment of contamination is necessary to inform subsequent medical interventions. This review assembles the constituent considerations for managing nuclear and radiological incidents, focused on a parallel analysis of the evolution of radiation dose limits - notably in the emergency preparedness and response realm - alongside a discussion of triage systems and in vivo radionuclide detection tools. The review maps the development of international and national standards and regulations concerning radiation dose limits, illuminating how past incidents and accumulated knowledge have informed present emergency preparedness and response practices, specifically for internalized radiation. Additionally, the objectives and levels of radiation triage systems are explored in-depth, along with a global survey of practices and protocols. Finally, this review also focuses on in vivo detection systems and their capacities for radionuclide identification, prioritizing internalized gamma-emitting isotopes due to their broader relevance. Collectively, this study comprehensively addresses the intricacies of triage management following radiation emergencies, emphasizing the imperative for enhanced standardization and continued research in this critical domain.

The difficulty of nuclear emergency prevention measures during natural disasters: ongoing challenges in Japan.

It is crucial to anticipate nuclear emergency scenarios and implement effective measures. Japan's climate and topography make it vulnerable to natural disasters; thus, it is necessary to address compounding and cascading disaster scenarios involving the simultaneous occurrence of natural and nuclear disasters. On 1 January 2024, an earthquake hit the Noto region of Ishikawa Prefecture, resulting in damage to the area around the Shika Nuclear Power Plant, located 90 km from the epicenter. This earthquake revealed that, in the event of a complex disaster, it is possible that residents living within 30 km of the Shika Nuclear Power Plant will be completely unprepared for a nuclear disaster. In the event of a complex disaster, it is crucial to implement appropriate countermeasures while balancing responses to both nuclear and natural disasters and optimizing radiation disaster prevention measures.

Gold leaf electrochemical flow cell for determination of iodide in nuclear emergency tablets.

This work introduces an innovative gold-leaf flow cell for electrochemical detection in flow injection (FI) analysis. The flow cell incorporates a hammered custom gold leaf electrochemical sensor. Hammered gold leaves consist of pure gold and are readily available in Thailand at affordable prices (approximately $0.085 for a sheet measuring 40 mm × 40 mm). Four sensing devices can be made from a single sheet of this gold leaf, resulting in a production cost of approximately $0.19 per sensor. Each electrochemical sensor has the gold leaf as the working electrode, together with a printed carbon strip, and a printed silver/silver chloride strip as the counter and reference electrodes, respectively. Initial investigations using cyclic voltammetry of a standard 1000 µmol L⁻1 iodide solution in 60 mmol L⁻1 phosphate buffer (PB) solution at pH 5, demonstrated performance comparable to that of a commercial screen-printed gold electrode. The hammered gold leaf electrode was then installed in a commercial flow cell as part of an FI system. A sample or standard iodide solution (100 µL) is injected into the first carrier stream of phosphate buffer (PB) solution, which then merges to mix with the second stream of the same buffer solution before flowing into the flow cell for amperometric detection of iodide. The optimized operating conditions include a fixed potential of +0.39 V (vs Ag/AgCl), and a total flow rate of 3 mL min⁻1. A linear calibration is obtained in the concentration range of 1 to 1000 µmol L⁻1 I- with a typical equation of µA = (0.00299 ± 0.00004) × (µmol L-1 I-) + (0.021 ± 0.020), and R2 = 0.9994. Analysis of iodide using this gold leaf-FI system is rapid with sample throughput of 86 samples h⁻1 and %RSD of a sample of 100 µmol L⁻1 I⁻ of 1.2 (n = 29). The limit of detection, (calculated as 2.78 × SD of regression line/slope), is 27 µmol L⁻1 I-. This method was successfully applied to determine iodide in nuclear emergency tablets.

Applicability of Scoring Calyculin A-Induced Premature Chromosome Condensation Objects for Dose Assessment Including for Radiotherapy Patients.

As an extension to a previous study, a linear calibration curve covering doses from 0 to 10 Gy was constructed and evaluated in the present study using calyculin A-induced premature chromosome condensation (PCC) by scoring excess PCC objects. The main aim of this study was to assess the applicability of this PCC assay for doses below 2 Gy that are critical for triage categorization. Two separate blind tests involving a total of 6 doses were carried out; 4 out of 6 dose estimates were within the 95% confidence limits (95% CL) with the other 2 just outside. In addition, blood samples from five cancer patients undergoing external beam radiotherapy (RT) were also analyzed, and the results showed whole-body dose estimates statistically comparable to the dicentric chromosome assay (DCA) results. This is the first time that calyculin A-induced PCC was used to analyze clinical samples by scoring excess objects. Although dose estimates for the pre-RT patient samples were found to be significantly higher than the mean value for the healthy donors and were also significantly higher than those obtained using DCA, all these pre-treatment patients fell into the same category as those who may have received a low dose (<1 Gy) and do not require immediate medical care during emergency triage. Additionally, for radiological accidents with unknown exposure scenario, PCC objects and rings can be scored in parallel for the assessment of both low- and high-dose exposures. In conclusion, scoring excess objects using calyculin A-induced PCC is confirmed to be another potential biodosimetry tool in radiological emergency particularly in mass casualty scenarios, even though the data need to be interpreted with caution when cancer patients are among the casualties.

On the value and costs of protective actions in a nuclear emergency.

This paper reviews the current orthodoxy for the prompt application of shelter and evacuation advice in the event of a nuclear emergency in the light of the reassessment of the perceived costs and benefits of these protective actions that followed the Fukushima event. In particular, it discusses the mechanisms and criteria for the withdrawal of protective action advice or their continuation for more than a few hours and their impact on public perception. It suggests that lack of thought given to this area may lead to protective actions being kept in place for longer than necessary leading to more harm than good. It also considers the language used to recommend protective actions and to modify them as the event unfolds. Would over strong language used at the start of the event to encourage compliance contribute to public concerns later? Finally, the report poses some discussion points.

Implications of the evacuation of hospitalized patients in a nuclear emergency.

In the accident at the Fukushima Daiichi nuclear power station following the Great East Japan Earthquake and tsunami, more than 50 hospital patients died during or soon after evacuation, primarily owing to the interruption of necessary medical care. To prevent the occurrence of such losses in the future, the focus of evacuation decisions should be on the health status of individual patients and not on currently evaluated non-human aspects such as the geophysical conditions and the status of the accident facility. This brief research report provides a conceptual basis considering the principle of justification for making more appropriate decisions on the evacuation of hospitalized patients by balancing radiological risks and evacuation-induced health risks. This research report is expected to foster discussions among stakeholders on how to protect vulnerable people more appropriately in nuclear emergencies.

Construction and reflections on UAV airborne monitoring technology system for nuclear emergency / 中国辐射卫生

With the development and utilization of nuclear energy, the safe operation of nuclear facilities has become a social issue of great concern. China attaches great importance to nuclear emergency plan and the construction of legal, institutional, and mechanism systems. Among them, the emergency preparedness and response of airborne monitoring for nuclear emergency is one of the important components of the national nuclear emergency system. The technology system of airborne monitoring for nuclear emergency is being developed and combines the advantages of manned aircraft and unmanned aerial vehicle (UAV) airborne monitoring. In recent years, UAVs with different loads and types have been developed, with diversified sizes and types of detectors carried by UAVs. The research on UAV airborne monitoring techniques for nuclear emergency has been continuously deepened and improved, and the technical system of airborne monitoring for nuclear emergency has been developed at the same time. The construction of UAV airborne monitoring technology system for nuclear emergency is discussed from the perspectives of monitoring equipment and technology, emergency response plan, emergency monitoring and evaluation, monitoring standards, emergency personnel, emergency support, and training and exercise. The UAV is a rapidly developing aircraft. With the continuous improvement in UAV performance and the continuous innovation and development of nuclear emergency airborne monitoring technology, the UAV airborne monitoring technology system for nuclear emergency will be constantly improved and developed towards networking, intelligence, and standardization.

A reflection on medical treatment of radionuclide-contaminated wounds during medical response to nuclear emergencies / 中国辐射卫生

Radionuclide-contaminated wounds are common in medical response to nuclear emergencies, which have different manifestations in different types of accidents. Medical treatment is the key part of the response. Based on the drill experience gained from medical response to nuclear emergencies, the authors summarize the research advances in radionuclide-contaminated wounds in recent years, mainly involving the biokinetic characteristics, medical response, surgical debridement, and prevention and treatment of internal contamination of radionuclide-contaminated wounds; the authors summarize the key points of technical operations and provide suggestions on improvements in the drills. The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge; emergency response, surgical debridement, and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations. However, targeted improvements are needed to achieve desired effects in the drills.

Research progress of imaging flow cytometry in automatic analysis of radiation biodosimetric indicators / 中国辐射卫生

@#A large number of people would be exposed to irradiation in large-scale nuclear and radiation accidents or nuclear terrorist attacks. Therefore, it is urgent to establish rapid and high-throughput biodosimetry for in triage, providing a basis for emergency management. Imaging flow cytometry (IFC) possesses the high through put advantages of traditional flow cytometry and the sensitivity and specificity of microscope, and has a good application prospect in the research and development of rapid, automated, and high-throughput biological dose estimation technology. This article reviews the application progress of IFC in biodosimetry, and provides a reference for the development of biological dose estimation and detection equipment for large-scale nuclear and radiation accidents.

Long-term care issues in a municipality affected by the great East Japan earthquake: A case of Katsurao Village, Fukushima prefecture.

Information regarding the proposed measures addressing long-term care problems during disasters at a municipal level is scarce. Thus, this study reviewed the long-term care insurance measures taken in the Katsurao Village after the Fukushima nuclear accident and summarized the measures that municipalities can take against such issues in the future.

Development of a gamma ray dose rate calculation and mapping tool for Lagrangian marine nuclear emergency response models.

This paper presents the development and testing of a gamma radiation dose rate calculation model for the marine environment, and evaluates the potential use for such a model in both short term nuclear emergency response management and emergency response planning. This is believed to be the first implementation of a full field gamma radiation mapping model (including air attenuation and buildup) to be incorporated within a Lagrangian marine dispersion model. Calculated surface gamma ray dose rates for nine generic release scenarios are presented and used to undertake an emergency countermeasure optioneering assessment.

A simulation system of radiation field and its detection for nuclear and radiological emergency preparedness and response training.

Appropriate training of the related personnel is one of the most important aspects in nuclear and radiological emergency preparedness and response. The use of simulation training could provide the trainees learning experience of a lifelike, hands-on scenario without associated radiation safety restrictions. In this study, we established a radiation field simulation system that includes two separate parts. For small-area radiation field simulation, a set of simulation sources and detectors was designed based on ultra wide band distance measurement technology. For large-area field simulation, a Gaussian plume model was used to simulate the dispersion of released radioactive aerosols and calculate the consequent radiation field. Also, a Global Position System positioning and wireless transmission technique was used for simulation instruments' data acquisition. This system could create a verisimilar but also safe and radiation-free environment and can be used in the training of nuclear emergency first responders, rescue teams or radiation protection personnel.

Improving the estimation accuracy of multi-nuclide source term estimation method for severe nuclear accidents using temporal convolutional network optimized by Bayesian optimization and hyperband.

During a nuclear accident, estimating the source terms using environmental measurements is vital for emergency decision-making. In this study, we propose a forecasting model based on a temporal convolutional network to estimate the release rates of seven radionuclides (Kr-88, Te-132, I-131, Xe-133, Cs-137, Ba-140, and Ce-144) based on off-site sequential gamma dose rates and meteorological monitoring data. To determine the best structure of the neural network, Bayesian optimization and hyperband (BOHB) was used on the hyperparameters of the model to reduce the testing loss. Additionally, a gradient boosting regression model was used to predict missing gamma dose rates to ensure the model offers a relatively reliable estimate under certain circumstances. The international radiological assessment system (InterRAS) was used to generate datasets for model training and testing. The results showed that the optimal hyperparameters selected by BOHB can reduce the valid loss of the model to 0.0153, and the mean absolute percentage error of prediction for the seven radionuclides was below 12%, three of which (Kr-88, Te-132, Cs-137) reached 8% at 10 h. When the first and second time-steps of the data were missing, the mean absolute percentage error of the prediction for all radionuclides was less than 30% after using a gradient boosting regression.

Impact of metaverse on radiation medicine field / 中华放射医学与防护杂志

Metaverse is a reality-connected parallel universe created by human beings by the aid of various techniques including virtue reality, augmented reality, mixed reality, 5G, artificial intelligence, blockchain, and so on. It provides immersive user experience and brings disruptive changes to social networking, games, medicine, education, etc. The application of metaverse in radiation medicine has not been reported yet, but with the increasingly prominent role of radiation medicine in the fields of disease diagnosis and treatment, nuclear energy safety, and manned space exploration, it can be predicted that metaverse will promote the development of radiation medicine. This paper reviews the possible influence of metaverse on the development of radiation medicine field, and suggests China start the creation and application of radiomediverse, a metaverse for radiation medicine, as soon as possible.

Organization and thinking of provincial-level on-sit and off-sit joint exercises for nuclear emergency / 中国辐射卫生

By reviewing the organization and implementation of “Hongsha-2021” Guangxi nuclear emergency joint exercises, this article summarizes the experience in the organization process and puts forward some thoughts and suggestions in order to improve the depth of provincial-level on-site and off-site joint exercises for nuclear emergency at nuclear power plants and further enhance the emergency response capacity of nuclear emergency organizations at all levels.

Protocol for sampling and analysis of food and agricultural produces consequent to a nuclear accident in India.

Nuclear accidents, despite having an extremely low probability of occurrence, could cause uncontrolled release of radioactive elements (fission and activation products) into the environment, and may ultimately lead to contamination of food products. Such a scenario requires extraordinary measures for control of food, which might be contaminated to a level not suitable for human consumption. Agricultural products (which include grain crops, vegetable, fruits, dairy, meat, eggs and poultry) pass through a series of local, district and state level markets to finally reach consumers. An effective intervention at different stages of distribution by targeted sampling and analysis of suspected (contaminated) foodstuffs will substantially reduce the chances of contaminated food to reach the public. At the same time, it will also ensure food security of the people without imposing unreasonable restrictions in market flow. This can also help in getting the farmers adequately compensated. This paper presents a protocol for sampling and analysis suitable for India, considering the diversity with respect to climate, soil type, land use, crop pattern, population density, etc. The paper also provides an estimate of infrastructure requirement to carry out environmental monitoring following the emergency with respect to human resources and instruments. The paper proposes to use the national web portal for collection of data pertaining to crop pattern, land use and market flow. A web-based decision support system (Web-DSS) on a GIS platform, for sampling, analysis and display of data online would enhance the transparency of decision being taken and enable the administrators to effectively monitor the work flow, details of sample collection, analysis and effective use of human and other resources.

Monitoring in animal breeding in response to nuclear or radiological emergencies: Chernobyl experience.

The main techniques of animal product sampling used in different time periods after the Chernobyl accident are summarised and lessons learned from this analysis are presented. It was shown that simple instruments for measurement γ-radiation in the environment can also be effectively implemented for measurement of γ-emitters in animal products even though these were not originally developed to measure radioactivity in food. The lessons learned related to the major tasks of the monitoring such "what to sample", "where to sample" and "when to sample". The role and example of application of supplementary data on radionuclide of concern properties for sampling planning are also discussed. Based on the statistical analysis of the data obtained in the affected settlement it was shown that radionuclide concentration in the animal products can be fitted by the log-normal distributions whilst the dispersion of the logarithms of the activity 137Cs concentrations in milk is not dependent on the local settlement specific factors. Based on these findings the novel approach for justification of the number of samples that should to be taken to obtain the GM estimate with predefined precision for given variability of the data is suggested.

Multi-nuclide source term estimation method for severe nuclear accidents from sequential gamma dose rate based on a recurrent neural network.

When severe nuclear accidents at nuclear power plants release radioactive material into the atmosphere, the source term information is typically unknown. Estimating the emission rate of radionuclides is essential to assess the consequences of the accident before adequate decision-making can be performed. A recurrent neural network-based model, optimized with the Bayesian method, is proposed to estimate the emission rates of multi-nuclides using off-site sequential gamma dose rate monitoring data. Compared with the existing method that is based on least squares, this new model does not require a priori information and the complicated and time-consuming process of conducting atmospheric dispersion simulations following a nuclear accident, which is conducive to a faster response. Six typical radionuclides (Sr-91, La-140, Te-132, Xe-133, I-131, and Cs-137) were set as mixed source terms, combined with meteorological parameters, and input into the International Radiological Assessment System for simulation to generate data sets for model training. The results indicate that with the input of data describing the sequential gamma dose rate, the accuracy of the nuclide emission rates estimated by this new method is continuously improved, with a mean absolute percentage error for Te-132 of below 7% over 10 h.

Radiation Emergency Readiness Among US Medical Toxicologists: A Survey.

INTRODUCTION: Large scale radiologic and nuclear disasters are rare; however, recent events such as the Fukushima Daiichi nuclear reactor emergency in Japan and current global political tensions have highlighted the need for health-care providers with expertise in managing radiation injuries. Medical Toxicologists have the ability to collaborate with other specialists in filling this critical role. METHODS: We conducted a cross-sectional survey to assess the attitudes, experiences, and knowledge of medical toxicologists through the assistance of the American College of Medical Toxicology. RESULTS: The survey was completed by 114 medical toxicologists during the enrollment period. Medical toxicologists who had a willingness to participate in radiologic or nuclear emergencies or who had taken care of patients contaminated with radioactive material were more likely to perform well on the knowledge assessment. CONCLUSION: We identified that there is a group of medical toxicologists who have the willingness, experience, and knowledge to help manage patients in the event of a radiologic or nuclear emergency.