4.3 Article

ASSESSMENT OF BIODOSIMETRY METHODS FOR A MASS-CASUALTY RADIOLOGICAL INCIDENT: MEDICAL RESPONSE AND MANAGEMENT CONSIDERATIONS

期刊

HEALTH PHYSICS
卷 105, 期 6, 页码 540-554

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HP.0b013e31829cf221

关键词

biodosimetry; cytogenetics; dose assessment; emergency planning

资金

  1. Intramural NIH HHS [Z99 CA999999] Funding Source: Medline

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Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual's radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual's dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a standalone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, the authors reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point.

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