Bundeswehr Institute of Radiobiology, Neuherberg Str. 11, 80937, Munich, Germany.
Mil Med Res. 2021 Dec 9;8(1):65. doi: 10.1186/s40779-021-00349-w.
In the case of a terrorist attack by a "dirty bomb", blast injuries, external irradiation and the incorporation of radioactivity are to be expected. Departing from information about the radiological attack scenario with cesium-137 in the U.S. National Scenario Planning Guide, we estimated the radiological doses absorbed. Similar calculations were performed for a smaller plume size and a detonation in a subway. For conditions as described in the U.S. scenario, the committed effective dose amounted to a maximum of 848 mSv, even for very unfavorable conditions. Red bone marrow equivalent doses are insufficient to induce acute radiation sickness (ARS). In the case of a smaller plume size, the ARS threshold may be exceeded in some cases. In a subway bombing, doses are much higher and the occurrence of ARS should be expected. The health hazards from a dirty bomb attack will depend on the location and the explosive device. The derived Haddon matrix indicates that preparing for such an event includes education of all the medical staff about radiation effects, the time lines of radiation damages and the treatment priorities. Further determinants of the outcome include rapid evacuation even from difficult locations, the availability of a specific triage tool to rapidly identify victims at risk for ARS, the availability of an antidote stockpile and dedicated hospital beds to treat seriously irradiated victims.
在遭受“脏弹”恐怖袭击的情况下，预计会出现爆炸伤、外照射和放射性物质摄入。我们根据美国国家情景规划指南中有关铯-137放射性袭击情景的信息，估算了吸收的放射性剂量。对于较小的烟羽规模和地铁爆炸情况，我们进行了类似的计算。在描述的美国情景条件下，即使在非常不利的情况下，承诺的有效剂量最高也达到 848 毫希沃特。红骨髓当量剂量不足以引起急性放射病（ARS）。在烟羽规模较小的情况下，在某些情况下可能会超过 ARS 阈值。在地铁爆炸中，剂量会更高，预计会出现 ARS。脏弹袭击造成的健康危害将取决于袭击地点和爆炸装置。推导的 Haddon 矩阵表明，为此类事件做准备包括对所有医护人员进行有关辐射效应、辐射损伤时间线和治疗优先级的教育。结果的进一步决定因素包括即使在困难的地点也要迅速撤离，是否有专门的分诊工具可以快速识别有发生 ARS 风险的受害者，是否有解毒剂储备以及专门的病床来治疗受严重辐射的受害者。
