title: The Internet's role in a biodosimetric response to a radiation mass casualty event.
abstract: Response to a large-scale radiological incident could require timely medical interventions to minimize radiation casualties. Proper medical care requires knowing the victim's radiation dose. When physical dosimetry is absent, radiation-specific chromosome aberration analysis can serve to estimate the absorbed dose in order to assist physicians in the medical management of radiation injuries. A mock exercise scenario was presented to six participating biodosimetry laboratories as one individual acutely exposed to Co under conditions suggesting whole-body exposure. The individual was not wearing a dosimeter and within 2-3 h of the incident began vomiting. The individual also had other medical symptoms indicating likelihood of a significant dose. Physicians managing the patient requested a dose estimate in order to develop a treatment plan. Participating laboratories in North and South America, Europe, and Asia were asked to evaluate more than 800 electronic images of metaphase cells from the patient to determine the dicentric yield and calculate a dose estimate with 95% confidence limits. All participants were blind to the physical dose until after submitting their estimates based on the dicentric chromosome assay (DCA). The exercise was successful since the mean biological dose estimate was 1.89 Gy whereas the actual physical dose was 2 Gy. This is well within the requirements for guidance of medical management. The exercise demonstrated that the most labor-intensive step in the entire process (visual evaluation of images) can be accelerated by taking advantage of world-wide expertise available on the Internet.
authors.affiliation: *Oak Ridge Associated Universities, REAC/TS, P.O. Box 117, Oak Ridge, TN, 37831; †Applied Research Associates, Arlington, VA, 22203; ‡Health Canada, Consumer and Clinical Radiation Protection Bureau, Ottawa, ON K1A 1C1, Canada; §Bundesamt fuer Strahlenschutz, 85764 Neuherberg, Germany; **Institute of Radiation Emergency Medicine, Hirosaki University, 036-8564, Hirosaki, Japan; ††Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire OX11 0RQ, UK; ‡‡Autoridad Regulatoria Nuclear (ARN), Av. Del Libertador 8250, C1429BNP, Buenos Aires, Argentina.
authors.forename: S L
authors.initials: SL
authors.lastname: Sugarman
authors.forename: G K
authors.initials: GK
authors.lastname: Livingston
authors.forename: D L
authors.initials: DL
authors.lastname: Stricklin
authors.forename: M G
authors.initials: MG
authors.lastname: Abbott
authors.forename: R C
authors.initials: RC
authors.lastname: Wilkins
authors.forename: H
authors.initials: H
authors.lastname: Romm
authors.forename: U
authors.initials: U
authors.lastname: Oestreicher
authors.forename: M A
authors.initials: MA
authors.lastname: Yoshida
authors.forename: T
authors.initials: T
authors.lastname: Miura
authors.forename: J E
authors.initials: JE
authors.lastname: Moquet
authors.forename: M
authors.initials: M
authors.lastname: Di Giorgio
authors.forename: C
authors.initials: C
authors.lastname: Ferrarotto
authors.forename: G A
authors.initials: GA
authors.lastname: Gross
authors.forename: M E
authors.initials: ME
authors.lastname: Christiansen
authors.forename: C L
authors.initials: CL
authors.lastname: Hart
authors.forename: D M
authors.initials: DM
authors.lastname: Christensen
mesh_terms: D001681:Biological Assay / Q000379:methods*; D002478:Cells, Cultured; D002869:Chromosome Aberrations / Q000528:radiation effects*; D002877:Chromosomes, Human / Q000235:genetics / Q000528:radiation effects*; D003037:Cobalt Radioisotopes / Q000009:adverse effects; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020407:Internet / Q000706:statistics & numerical data*; D007753:Laboratories / Q000592:standards*; D008214:Lymphocytes / Q000528:radiation effects; D054527:Mass Casualty Incidents / Q000517:prevention & control*; D008677:Metaphase / Q000528:radiation effects; D011832:Radiation Injuries / Q000175:diagnosis* / Q000235:genetics / Q000517:prevention & control; D018788:Radioactive Hazard Release / Q000517:prevention & control; D011874:Radiometry
chemical_list: D003037:Cobalt Radioisotopes