NEUTRON DOSE ASSESSMENT USING SAMPLES OF HUMAN BLOOD AND HAIR

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.

Nuclear and Radiological Emergencies: Biological Effects, Countermeasures and Biodosimetry

Atomic and radiological crises can be caused by accidents, military activities, terrorist assaults involving atomic installations, the explosion of nuclear devices, or the utilization of concealed radiation exposure devices. Direct damage is caused when radiation interacts directly with cellular components. Indirect effects are mainly caused by the generation of reactive oxygen species due to radiolysis of water molecules. Acute and persistent oxidative stress associates to radiation-induced biological damages. Biological impacts of atomic radiation exposure can be deterministic (in a period range a posteriori of the event and because of destructive tissue/organ harm) or stochastic (irregular, for example cell mutation related pathologies and heritable infections). Potential countermeasures according to a specific scenario require considering basic issues, e.g., the type of radiation, people directly affected and first responders, range of doses received and whether the exposure or contamination has affected the total body or is partial. This review focuses on available medical countermeasures (radioprotectors, radiomitigators, radionuclide scavengers), biodosimetry (biological and biophysical techniques that can be quantitatively correlated with the magnitude of the radiation dose received), and strategies to implement the response to an accidental radiation exposure. In the case of large-scale atomic or radiological events, the most ideal choice for triage, dose assessment and victim classification, is the utilization of global biodosimetry networks, in combination with the automation of strategies based on modular platforms.

Early-response multiple-parameter biodosimetry and dosimetry: risk predictions

The accepted generic multiple-parameter and early-response biodosimetry and dosimetry assessment approach for suspected high-dose radiation (i.e. life-threatening) exposure includes measuring radioactivity associated with the exposed individual (if appropriate); observing and recording prodromal signs/symptoms; obtaining serial complete blood counts with white-blood-cell differential; sampling blood for the chromosome-aberration cytogenetic bioassay using the 'gold standard' dicentric assay (premature chromosome condensation assay for exposures >5 Gy photon acute doses equivalent), measurement of proteomic biomarkers and gene expression assays for dose assessment; bioassay sampling, if appropriate, to determine radioactive internal contamination; physical dose reconstruction, and using other available opportunistic dosimetry approaches. Biodosimetry and dosimetry resources are identified and should be setup in advance along with agreements to access additional national, regional, and international resources. This multifaceted capability needs to be integrated into a biodosimetry/dosimetry 'concept of operations' for use in a radiological emergency. The combined use of traditional biological-, clinical-, and physical-dosimetry should be use in an integrated approach to provide: (a) early-phase diagnostics to guide the development of initial medical-management strategy, and (b) intermediate and definitive assessment of radiation dose and injury. Use of early-phase (a) clinical signs and symptoms, (b) blood chemistry biomarkers, and (c) triage cytogenetics shows diagnostic utility to predict acute radiation injury severity.

Retrospective physical dosimetry in the Czech Republic: an overview of already established methods and recent research

PURPOSE

The threat of serious radiation exposures to members of the public from radiological incidents and nuclear events has led to intensive study of a number of emergency dosimetry techniques for purposes of triage. As such, a national laboratory of retrospective dosimetry was established in our institute. The purpose of this work is to provide a summary of the well-established and already implemented retrospective physical dosimetry techniques based on thermoluminescence (TL), optically stimulated luminescence (OSL) and neutron activation including their specifics. Moreover, we present some new results of the experimental work, in which we compared dosimetry potential of various dental repair materials and human teeth.

MATERIALS AND METHODS

At first, an overview of already established retrospective physical retrospective methods including their main features was compiled. As regards recent research, an experimental comparative study was performed under defined conditions. The materials used were aliquots prepared from both pure and repaired teeth and aliquots of unused dental ceramics of known type. Following irradiation, we compared TL and OSL curves of the materials. We also compared dosimetry characteristics of OSL signal as reproducibility, dose dependence and fading.

RESULTS

After irradiation, the teeth aliquots of dental enamel and dentin exhibited very low OSL and TL signals compared with aliquots containing some dental repair materials or aliquots of pure dental ceramics. With a few exceptions, the OSL signal of dental enamel and dentin aliquots irradiated to 2 Gy was hardly distinguishable from OSL signal corresponding to unirradiated aliquots. In contrast, aliquots of teeth containing some dental repair material and aliquots of pure dental ceramics provided a well reproducible OSL signal exhibiting linear dose response. All the materials tested exhibited a significant fading of the OSL signal. The loss of OSL signal during the first 24 hours after irradiation was from 20 to 99% of its original value obtained immediately after the irradiation.

CONCLUSIONS

The already established physical methods of retrospective dosimetry use a spectrum of verified materials and techniques for dose assessment in the aftermath of serious radiological incidents and nuclear events. In the comparative study, we found that the dosimetry potential of teeth in natural state is much worse compared to teeth repaired with dental ceramics or dental cement fillings. Teeth restored with dental repair materials exhibited relatively favorable dosimetry characteristics. However, they can be usable for a dose reconstruction only on condition that the main practical problems connected with fading and optical bleaching were solved.