Radiologic Terrorism - PowerPoint PPT Presentation

1 / 23
About This Presentation
Title:

Radiologic Terrorism

Description:

Priority evacuation protocols for pregnant women, infants and pre-pubertal children ... Am J Med 1993;94(5):524-532. [Review] Nagataki S, Yamashita S, Eds. ... – PowerPoint PPT presentation

Number of Views:21
Avg rating:3.0/5.0
Slides: 24
Provided by: thomasp
Category:

less

Transcript and Presenter's Notes

Title: Radiologic Terrorism


1
Radiologic Terrorism
  • Radiation Exposure
  • Dirty Bombs
  • Atomic Bombs
  • Five decades after the first atomic bomb
  • Terrorist atomic bomb
  • Nuclear Power Plants
  • Three Mile Island accident 1978 in PA
  • Chernobyl accident, April 26, 1986, in the
    Ukrainian SSR
  • Management of pregnant women and children

2
Radiologic Terrorism
  • Radiation Exposure
  • Dirty Bombs
  • Atomic Bombs
  • Five decades after the first atomic bomb
  • Terrorist atomic bomb
  • Nuclear Power Plants
  • Three Mile Island accident 1978 in PA
  • Chernobyl accident, April 26, 1986, in the
    Ukrainian SSR
  • Management of pregnant women and children

3
(No Transcript)
4
(No Transcript)
5
Accident at Chernobyl
  • Saturday, April 26, 1986 at 012348
  • Chornobyl Nuclear Power Plant, Ukraine, USSR
  • Total Radioactivity Released by the accident
  • 50-100 x 106 Ci
  • Total Radioactivity Released into Belarus
  • 70 35-70 x 106 CI
  • Radioactive Materials Released by the Accident
  • I, Cs, Sr, Co, Xe, Kr, Pu, etc.
  • Williams D. Science and society Cancer after
    nuclear fallout lessons from
  • the Chernobyl accident. Nature Reviews Cancer
    20022543-549 (01 Jul).

6
(No Transcript)
7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
Populations at High Risk for Thyroid Neoplasia
from Exposure to Radiation
  • Fetus after 12 weeks of gestation in April 1986.
  • Number of cases dramatically decreased after
    2000.
  • Children ages lt 6 years in April, 1986.
  • Children ages 0 to 1 year have the highest risk.
  • Children living in areas with iodine deficiency.
  • Greater radioiodine uptake increases the dose of
    radiation exposure to the thyroid gland.
  • Children exposed to gt 1 cGy of radiation.
  • Rapid thyroid growth in young children occurs
    with chromosomal rearrangements (PTC1 and PTC3).

11
The Carcinogenic Effects of Radiation
  • The isotopes of iodine-131, -132, -133
  • Chronic exposure to Cesium-137
  • Higher tissue exposure to radiation occurs in
    those tissues that concentrate iodine
  • Thyroid ? ? incidence of adenoma, carcinoma
  • Breast ? ? incidence of carcinoma
  • Salivary gland
  • Gastric mucosa

12
Iodine Prophylaxis in Poland
  • Radiation detected 36 hours after initial
    release.
  • KI distribution began in the PM on day 3.
  • 10.5 million doses of KI given to children
  • 7 milion doses of KI given to adults
  • Exposure to radioiodines in infants age lt 1 year
  • gt 50 mSv (5 Rem) if unprotected from radioiodine
  • lt 50 mSv when protected by KI substituted milk
  • KI caused 40 reduction in Rem dose to thyroid.
  • With early prophylaxis, 60-70 reduction in
    Rem dose primarily because inhaled 131I is
    blocked.
  • Incidence of 0.2 for medically significant, but
    not serious side effects.

13
Radiologic Terrorism
  • Radiation Exposure
  • Dirty Bombs
  • Atomic Bombs
  • Five decades after the first atomic bomb
  • Terrorist atomic bomb
  • Nuclear Power Plants
  • Three Mile Island accident 1978 in PA
  • Chernobyl accident, April 26, 1986, in the
    Ukrainian SSR
  • Management of pregnant women and children

14
Management of Pregnant Women and Children Exposed
to Radiation
  • Evacuation
  • Priority evacuation protocols for pregnant women,
    infants and pre-pubertal children
  • Evacuation to an identified location at least 50
    miles from the source of radiation
  • Potassium Iodide
  • KI tablets or liquid administered on notification
    by authorities of the possibility of radiation
    exposure.
  • Dose schedules and negligible toxicity

15
Evacuation of Pregnant Women and Children Exposed
to Radiation
  • Priority Evacuation
  • Priority identification signs should be provided
    to pregnant women and families of infants and
    pre-pubertal children to display on the
    windshield for priority rapid HOV-lane
    emergency evacuation.
  • Evacuation routes should be defined in advance.
  • Distance from Radiation Source
  • The radiation plume travels in the direction and
    at the speed of the prevailing winds.
  • Biologically significant radiation exposure may
    occur 100-200 miles from the source depending
    upon the atmospheric conditions.

16
Management of Pregnant Women and Children Exposed
to Radiation
  • Evacuation
  • Priority evacuation protocols for pregnant women,
    infants and pre-pubertal children
  • Evacuation to an identified location at least 50
    miles from the source of radiation
  • Potassium Iodide
  • KI tablets or liquid administered on notification
    by authorities of the possibility of radiation
    exposure.
  • Dose schedules and negligible toxicity

17
KI Therapy for Pregnant Women and Children
Exposed to Radiation
  • Potassium Iodide for Radioiodine Exposure
  • Pre-packaged, pre-distributed KI tablets or
    liquid should be readily available in homes,
    schools, day care centers and nurseries near
    reactors.
  • On notification by authorities of the possibility
    of radiation exposure, parents should give or
    have given authorization to dispense KI if
    authorities declare a radiation-exposure
    emergency.
  • KI toxicity
  • Negligible, minor side effects, and rare in
    children.

18
Potassium Iodide Doses
  • AAP Committee on Environmental Health. Pediatrics
    20031111459

19
KI Therapy for Pregnant Women and Children
Exposed to Radiation
  • Potassium Iodide for Radioiodine Exposure
  • Pre-packaged, pre-distributed KI tablets or
    liquid should be readily available in homes,
    schools, day care centers and nurseries near
    reactors.
  • On notification by authorities of the possibility
    of radiation exposure, parents should give or
    have given authorization to dispense KI if
    authorities declare a radiation-exposure
    emergency.
  • KI toxicity
  • Negligible except in very rare cases of iodinism.

20
Potassium Iodide Safety
  • KI toxicity
  • Acute poisoning is uncommon
  • Hypersensitivity reactions are rare, but
    dangerous
  • Angioedema and laryngeal edema
  • Serum-sickness-like reactions
  • fever, lymphadenitis, arthralgia, arthritis
  • Chronic exposure
  • Iodism (parotid pain and swelling) skin rashes
  • Goiter and primary hypothyroidism on occasion at
    any age
  • Contraindicated during pregnancy and infancy
  • High dose KI as treatment of Sporotrichosis
  • Children 50 mg/dose tid ? by 50 mg/dose daily
  • Children 150-500 mg/dose up to 500-750 mg tid
  • Older Child 250 mg tid Maximum 1-2
    grams/dose tid

21
Management of Children Exposed to Ionizing
Radiation
  • Preparation Supplies of KI, infant formula,
    powered milk
  • Evacuation routes and locations
  • Emergency battery operated communications
  • Radios
  • Cellular telephones
  • Priority Evacuation
  • Defined routes HOV Routes
  • Priority evacuation Identification on vehicles
  • Potassium iodide
  • Priority 1 pregnant women and infants
  • Priority 2 young children
  • Monitor TSH in infants and pregnant women

22
Radiologic Terrorism Bibliography
  • Williams, Dillwyn. Science and society Cancer
    after nuclear fallout lessons from the
    Chernobyl accident. Nature Reviews Cancer
    20022543-549 (01 Jul). Review
  • CDC www.bt.cdc.gov/radiation
  • AAP Policy Statement. Radiation disasters and
    children. Pediat 2003111(6)1455-1466.
  • Mettler FA, Voelz GL. Major radiation exposure
    what to expect and how to respond. NEJM
    20023461554-1561.
  • www.atomicarchives.com/Example/ExampleStart.shtml
  • Nauman J, Wolff J. Iodide prophylaxis in Poland
    after the Chernobyl reactor accident Benefits
    and risks. Am J Med 199394(5)524-532. Review
  • Nagataki S, Yamashita S, Eds. Nagasaki Symposium
    Radiation Human Health, Elsevier, 1996, p xii.

23
(No Transcript)
Write a Comment
User Comments (0)
About PowerShow.com