Rump Alexis, Stricklin Daniela, Lamkowski Andreas, Eder Stefan, Port Matthias
Bundeswehr Institute of Radiobiology, Munich, Germany.
Applied Research Associates Inc., Arlington, USA.
Drug Res (Stuttg). 2018 Feb;68(2):89-99. doi: 10.1055/s-0043-119793. Epub 2017 Oct 16.
In the case of an attack by a "dirty bomb" with cesium-137 there is a risk of internal contamination. The excretion of cesium-137 can be enhanced by Prussian Blue (PB), and thus the committed effective dose be reduced. We analyzed the benefit and costs of PB decorporation treatment. We simulated the reduction of the radiological dose by PB treatment after cesium-137 incorporation by inhalation. The saving of life time was quantified using the monetary "value of a statistical life" (VSL). Treatment costs were based on the market price of PB in Germany. Moreover we considered the holding costs of stockpiling. The benefit of PB treatment increases with its duration up to about 90 days. If treatment initiation is delayed, the maximum achievable benefit is decreased. For a VSL of 1.646 million €, the net benefit of a 90-days treatment started 1 day after the incorporation remains positive up to a stockpiling duration of 10 years. If starting PB treatment as late as the 180th day after incorporation, the costs will surpass the benefit. We conclude that a prompt decision making and early treatment initiation greatly impacts on the medical but also economic efficiency of a PB treatment.
在遭遇含有铯 - 137的“脏弹”袭击时，存在内部污染的风险。普鲁士蓝（PB）可促进铯 - 137的排泄，从而降低待积有效剂量。我们分析了PB促排治疗的效益和成本。我们模拟了吸入铯 - 137后通过PB治疗降低放射剂量的情况。使用货币化的“统计生命价值”（VSL）对节省的寿命进行了量化。治疗成本基于PB在德国的市场价格。此外，我们还考虑了储存成本。PB治疗的效益随治疗持续时间增加，最长可达约90天。如果延迟开始治疗，可实现的最大效益会降低。对于VSL为164.6万欧元的情况，在摄入后1天开始的90天治疗，其净效益在储存期长达10年时仍为正值。如果在摄入后第180天才开始PB治疗，成本将超过效益。我们得出结论，迅速决策并尽早开始治疗对PB治疗的医学和经济效率都有重大影响。
