Chapter 18
Radiological Assessment and Public
Health Response
Radiological assessment is the process of determining the amount of radiation exposure a person has received or, in the case of internal radioactivity, the amount of
radiation exposure they are likely to receive in the future from the radioactivity in
their bodies. The simplest and most accurate form of radiological assessment occurs
when the person being assessed was wearing a dosimeter and it can be confirmed
that there was no intake of radioactivity. Unfortunately, this does not happen often.
In the initial hours following any sort of radiological event it will be important to
be able to determine who is likely to survive their radiation exposure, who is likely to
survive with suitable care, and who cannot be saved. With limited medical resources,
this process of triage will help to focus attention and resources on those most likely
to benefit from that attention; to make the transition from patient-centered medicine
(trying to save every single patient arriving at the hospital) to community-centered
medicine (spending the most time on those patients who will benefit most from the
attention to save the greatest number of lives). Here, too, radiological assessment
plays a huge role; unless we have some way of understanding how much radiation a
patient has received (or is likely to receive) we cannot properly address the needs of
the patient or the needs of the public as a whole.
Over the longer term, radiological assessment continues to play a role, especially with regards to adjudicating future compensation claims, just as assessments
of exposure to airborne contaminants have been used to help determine whose lung
disease might have been due to their presence in Lower Manhattan on September
11, 2001 [13]. Similarly, in the longer-term aftermath of a radiological or nuclear
attack it will be helpful to have a rough guess as to the numbers of cancers and other
radiation-related injuries that might arise over the years (Fig. 18.1).
One concept that can be useful is that of the Clinical Decision Guideline (CDG)
first developed by the National Council on Radiation Protection and Measurements
[8, 9]. As defined by NCRP, an intake of 1 CDG will expose the person affected to a
committed (e.g. over the next 50 years) whole-body radiation exposure of 250 mSv;
© Springer Nature Switzerland AG 2021
P. A. Karam, Radiological and Nuclear Terrorism,
Advanced Sciences and Technologies for Security Applications,
https://doi.org/10.1007/978-3-030-69162-2_18
221
Radiological Assessment and Public
Health Response
Radiological assessment is the process of determining the amount of radiation exposure a person has received or, in the case of internal radioactivity, the amount of
radiation exposure they are likely to receive in the future from the radioactivity in
their bodies. The simplest and most accurate form of radiological assessment occurs
when the person being assessed was wearing a dosimeter and it can be confirmed
that there was no intake of radioactivity. Unfortunately, this does not happen often.
In the initial hours following any sort of radiological event it will be important to
be able to determine who is likely to survive their radiation exposure, who is likely to
survive with suitable care, and who cannot be saved. With limited medical resources,
this process of triage will help to focus attention and resources on those most likely
to benefit from that attention; to make the transition from patient-centered medicine
(trying to save every single patient arriving at the hospital) to community-centered
medicine (spending the most time on those patients who will benefit most from the
attention to save the greatest number of lives). Here, too, radiological assessment
plays a huge role; unless we have some way of understanding how much radiation a
patient has received (or is likely to receive) we cannot properly address the needs of
the patient or the needs of the public as a whole.
Over the longer term, radiological assessment continues to play a role, especially with regards to adjudicating future compensation claims, just as assessments
of exposure to airborne contaminants have been used to help determine whose lung
disease might have been due to their presence in Lower Manhattan on September
11, 2001 [13]. Similarly, in the longer-term aftermath of a radiological or nuclear
attack it will be helpful to have a rough guess as to the numbers of cancers and other
radiation-related injuries that might arise over the years (Fig. 18.1).
One concept that can be useful is that of the Clinical Decision Guideline (CDG)
first developed by the National Council on Radiation Protection and Measurements
[8, 9]. As defined by NCRP, an intake of 1 CDG will expose the person affected to a
committed (e.g. over the next 50 years) whole-body radiation exposure of 250 mSv;
© Springer Nature Switzerland AG 2021
P. A. Karam, Radiological and Nuclear Terrorism,
Advanced Sciences and Technologies for Security Applications,
https://doi.org/10.1007/978-3-030-69162-2_18
221