Title: INTERNATIONAL COOPERATION FOR MEDICAL PREPAREDNESS AND RESPONSE TO RADIATION EMERGENCIES
1INTERNATIONAL CO-OPERATION FOR MEDICAL
PREPAREDNESS AND RESPONSE TO RADIATION
EMERGENCIES
2Radiation accidents 1944-2001
- 1944-2001 420 radiation accidents leading to
significant overexposure of at least one person
when Egt0.25 Sv, Hskingt6 Sv, or Hother organgt0.75
Sv - Of 3000 overexposed persons, 133 fatalities
registered - Fatalities include 28 operators and firemen who
died of acute radiation disease in Chernobyl
accident in April 1986
3Conventions for international collaboration in
radiation accidents
- The basis for co-operation International
Conventions (26 Sept 1986) on Early notification
of a nuclear accident and on Assistance in case
of a nuclear accident or radiological emergency
prepared by IAEA in co-operation with government
experts of its 62 Member States and
representatives of 10 international organizations
in August-September 1986 - Conventions have 87 and 82 parties respectively,
as of 1 March 2002. Besides three international
organizations FAO, WHO WMO acceding to
them, 84 and 79 Member States have, respectively,
ratified them
4IACRNA
IAEA
IAEA
WMO
WHO
OCHA
FAO
EC
NEA
5Emergency Response System (ERS) and
International Nuclear Event Scale (INES)
- According to the Conventions Member States
- provide the IAEA with immediate information on a
nuclear accident and - mutually assist each other in case of a nuclear
accident or radiological emergency - The IAEA co-ordinates the ERS and has elaborated
the International Nuclear Event Scale, INES, used
for rating nuclear events in the early
notification
6Responsibilities of IAEA
- FOCAL POINT
- Emergency Response System (ERS)
- International Nuclear Event Scale (INES)
- NOTIFICATION
- Inform States and organizations on accident
- Notify upon request to minimize consequences
- ASSISTANCE
- Disseminate information on resources, methods,
techniques, calculation of consequences - Transmit and co-ordinate assistance on request
7Co-operation of IAEA with WHO
- CO-OPERATION for
- Application of Conventions
- Actions aimed at
- medical and public health response to radiation
emergency or nuclear accident - medical preparedness and assistance
- Joint publications and training activities
- PARTICULAR RESPONSIBILITY of WHO
- Organize network of WHO Collaborating Centres,
- Provide procedures for medical assistance
8International assistance in medical response
- Depends on
- number of exposed persons
- severity of exposure
- types of accidental exposure, which may be
- exposure of the public, workers, patients
- external exposure only
- external or internal radioactive contamination
- combination of external and internal exposure
- combination of radiation exposure and other
injuries
9REMPAN
- Radiation emergency medical preparedness and
assistance network -
- For promotion of radiation emergency medical
preparedness and for practical assistance and
advice to countries in a case of overexposure
from any source of radiation, WHO established
REMPAN in 1988
10REMPAN
- In March 2002
- 14 REMPAN centres in Armenia, Australia,
Finland, France (2), Germany, Japan, Russian
Federation (4), United Kingdom, Ukraine and USA,
and 2 liaison institutions in Brazil and India. - These 16 institutions are located in 12 countries
on 4 continents
11Major roles of REMPAN in radiation emergency
- to provide assistance and advice in medical
management of exposed individuals - to provide medical team for on-site emergency
treatment - to transfer (if possible and necessary) severely
exposed patients to collaborating centres for
specialized medical care - to assist with facilities and staff for medical
investigations and treatment
12Major roles of REMPAN in radiation emergency
- to assist in development of measures necessary to
limit health effects - to follow up medical supervision and treatment
- to assist in developing procedures to strengthen
countries ability to manage such accidents - to circulate information relating to medical
management of radiological accidents to Member
States
13Types of REMPAN assistance
-
- Human resource specialists
- Each WHO collaborating centre, including liaison
institutions, has a few dozen experts or more,
including many doctors. Other specialists are
health physicists, radiologists, radiochemists -
14Types of REMPAN assistance
- Recruitment of experts
- WHO and IAEA invite experts from collaborating
centres and also from other institutions, if
necessary and requested by affected Member State - Specialized teams
- WHO (in co-operation with IAEA) can organize
multinational teams to render medical assistance
on site
15Types of REMPAN assistance
- Equipment
- Portable equipment for radiation monitoring of
humans and environmental objects for use on site
- Medical services
- WHO collaborating centres can help with
diagnosis, prognosis, treatment and follow-up of
persons exposed to radiation and other
accompanying factors - both in affected country
and at centres themselves
16Types of REMPAN assistance
- Clothing
- Special clothing for medical personnel
- Scientific services
- Expertise may be provided for biological dose
assessment and reconstructing circumstances of
overexposure (in co-operation with IAEA) - Transportation
- WHO collaborating centres provide advice or
render practical assistance for transportation of
affected persons
17Practical co-operation of IAEA, WHO, EC and MSs
in medical management of radiation accidents
- Notification - information on accident,
- Preparedness - plans for prevention
diagnosis - Intervention - actions for emergency aid,
treatment, decontamination,
decorporation - Reparation - follow-up and rehabilitation,
- Training - of medical staff in health effects
of - radiation and radiopathology
- training courses, symposia, fellowships
18Examples of international co-operation
- Numerous examples of joint assistance for
radiological accidents most known cases are
Chernobyl and Goiania - After Goiania accident of 1987, leading radiation
medicine scientists were recruited by IAEA and
WHO to provide medical and radiological
consultations on site
19Examples of international co-operation
- International studies on childhood thyroid cancer
in population affected by Chernobyl radioiodine
releases in iodine deficient areas up to 500 km
around NPP
20Dissemination of information
- IAEA and WHO regularly
- organize joint conferences
- prepare joint publications (also in co-operation
with other international organizations, such as
EC, UNSCEAR, OECD/NEA , ILO) - present, discuss and disseminate information on
health effects of exposure to radiation - publish lessons learned to prevent and better
manage radiological and nuclear accidents
21International co-operation for medical management
of radiation accident in Lia, Jan-Feb 2002
LIA
SANTREDIA
KAHISHI
ZUGDIDI
MATKOJI
POTI
LILO
22 International collaboration to compile lessons
learned from medical management of recent
radiation accidents
- The 1st EAGM (Expert Advisory Group Meeting) on
medical follow-up of Georgian patients (soldiers)
accidentally exposed to radiation in Lilo
conducted by IAEA in Vienna in Sept 1999 - Two joint IAEA-WHO expert meetings on medical
follow-up of six significant recent radiation
accidents at WHO-HQ (Geneva, 1-3 Oct 2001) and
WHO/REMPAN Centre (Ulm, 8-9 Nov 2001) - Joint technical document has been approved for
publication in 2002, to distribute to medical
specialists and institutions responsible for
treatment of radiation accident cases in Member
States