The EPR Center for Viable Systems, Dartmouth Medical School, Hanover, NH 03755, USA.
Health Phys. 2010 Feb;98(2):95-108. doi: 10.1097/HP.0b013e3181b8cffd.
Recognition is growing regarding the possibility that terrorism or large-scale accidents could result in potential radiation exposure of hundreds of thousands of people and that the present guidelines for evaluation after such an event are seriously deficient. Therefore, there is a great and urgent need for after-the-fact biodosimetric methods to estimate radiation dose. To accomplish this goal, the dose estimates must be at the individual level, timely, accurate, and plausibly obtained in large-scale disasters. This paper evaluates current biodosimetry methods, focusing on their strengths and weaknesses in estimating human radiation exposure in large-scale disasters at three stages. First, the authors evaluate biodosimetry's ability to determine which individuals did not receive a significant exposure so they can be removed from the acute response system. Second, biodosimetry's capacity to classify those initially assessed as needing further evaluation into treatment-level categories is assessed. Third, we review biodosimetry's ability to guide treatment, both short- and long-term, is reviewed. The authors compare biodosimetric methods that are based on physical vs. biological parameters and evaluate the features of current dosimeters (capacity, speed and ease of getting information, and accuracy) to determine which are most useful in meeting patients' needs at each of the different stages. Results indicate that the biodosimetry methods differ in their applicability to the three different stages, and that combining physical and biological techniques may sometimes be most effective. In conclusion, biodosimetry techniques have different properties, and knowledge of their properties for meeting the different needs for different stages will result in their most effective use in a nuclear disaster mass-casualty event.
人们越来越认识到，恐怖主义或大规模事故可能导致数十万人面临潜在的辐射暴露，而目前针对此类事件的评估指南存在严重不足。因此，迫切需要在事后进行生物剂量测定方法来估计辐射剂量。为了实现这一目标，剂量估计必须在个体水平上进行，及时、准确且合理地在大规模灾难中获得。本文评估了当前的生物剂量测定方法，重点关注它们在三个阶段估计大规模灾害中人类辐射暴露的优缺点。首先，作者评估了生物剂量测定法确定哪些个体没有受到明显暴露的能力，以便将其从急性反应系统中排除。其次，评估了生物剂量测定法将最初评估为需要进一步评估的个体分类到治疗水平类别的能力。第三，我们回顾了生物剂量测定法指导短期和长期治疗的能力。作者比较了基于物理和生物参数的生物剂量测定方法，并评估了当前剂量计的特性（容量、速度和获取信息的难易程度以及准确性），以确定在不同阶段最能满足患者需求的方法。结果表明，生物剂量测定方法在适用于三个不同阶段方面存在差异，并且结合物理和生物技术有时可能最有效。总之，生物剂量测定技术具有不同的特性，了解其在满足不同阶段不同需求方面的特性将有助于在核灾难大量伤亡事件中最有效地使用这些技术。
