Global & Disaster Medicine

Archive for the ‘Nuclear-Radiation-Contamination’ Category

Hidden Sealed Radioactive Source (Radiological Exposure Device) in Train Car – Illustration

Hidden sealed radioactive source in metro car: 150 Ci iridium source under seat

150 Ci Iridium-192 Source Under Seat

Ci = Curie; R = Roentgen; Γ constant = 4.69 R-cm2/mCi-hr.

Note: This graphic describes radiation exposure rate (in air) in units of R/Hr. For gamma radiation, this is roughly equivalent to a radiation absorbed dose rate in units of cGy/hour, which must also take into account any shielding present, e.g., material in the seats in this example.


REMM: External Contamination: Wound Contamination with Radioactive Shrapnel – Animation

Contamination - Full Body

 

External Contamination: Wound Contamination with Radioactive Shrapnel – Animation

Contamination


Chernobyl: In villages as much as 140 miles from the Chernobyl nuclear plant, radioactivity readings in milk are up to five times the Ukranian government’s official limit for adults, and more than 12 times the limit for children.

NY Times

 


Pluristem Therapeutics Inc, a developer of placenta-based stem cell products, said the FDA has cleared the emergency use of its therapy to treat acute radiation exposure in a nuclear event.

Reuters

“…..Pluristem said it will start preparations to keep an emergency stock of PLX-R18 on hand for use in such events.

Full approval of the drug will depend on the results of a Phase III clinical trial…..”

 

 


Medical countermeasures (MCMs) to treat patients with radiation-induced myelosuppression following a radiological/nuclear incident

FDA

MCMs to treat patients with radiation-induced myelosuppression following a radiological/nuclear incident (H-ARS)

Myelosuppression occurs when radiation damages the bone marrow. Suppression of the bone marrow blocks the production of blood cells. There are FDA-approved products that can help patients with H-ARS by facilitating recovery of bone marrow cells that develop into white blood cells, including neutrophils, which help fight off infections.

FDA-approved products that may be used to treat adult and pediatric patients acutely exposed to myelosuppressive doses of radiation, a condition known as Hematopoietic Syndrome of Acute Radiation Syndrome, or H-ARS:


FDA approves Leukine for Acute Radiation Syndrome

FDA

 
Adds to the country’s available treatments in the event of radiological or nuclear emergency
On March 29, 2018, the FDA approved use of Leukine (sargramostim) to increase survival in adult and pediatric patients acutely exposed to myelosuppressive doses of radiation (Hematopoietic Syndrome of Acute Radiation Syndrome, or H-ARS).

Myelosuppression occurs when radiation damages the bone marrow. Suppression of the bone marrow blocks the production of blood cells. Leukine can help patients with H-ARS by facilitating recovery of bone marrow cells that develop into white blood cells that help fight off infections.

Leukine was shown to increase survival when administered up to 48 hours after total body irradiation exposure at doses expected to be fatal to 50% of those exposed subjects under conditions of minimal supportive care.

Leukine is the third FDA-approved medical countermeasure (MCM) that is indicated to increase survival in patients exposed to myelosuppressive doses of radiation. It was approved by FDA based on efficacy studies in animals (under the Animal Rule), as efficacy studies in humans could not be ethically conducted. Leukine was originally approved in 1991 and was originally indicated to shorten time to neutrophil recovery and to reduce the incidence of severe and life-threatening infections following induction chemotherapy in adult patients 55 years and older with acute myeloid leukemia (AML), and subsequently approved for several oncology-related indications.

The most commonly reported side effects associated with Leukine injections are fever, injection site reactions, and shortness of breath.

Other products from a similar pharmacological class and approved for the same indication are:


Flash of light? Mushroom cloud? Expert advice is: “Don’t run. Get inside.”

Campus Safety

Shelter?

  • Concrete and brick buildings.  A home basement OK too.
  • Avoid structures made of wood and plaster:  No protection
  • Go deep. Underground areas or the center of a tall building;

Then what?

  • Stay inside for at least 24 hours. Radiation levels are extremely dangerous after a detonation, but levels decrease rapidly.
  • Tune in to the news

 


38 Minutes

NY Times

“…..The Federal Communications Commission said on Sunday that its initial investigation of the mistaken alert had concluded that Hawaii did not have “reasonable safeguards or process controls in place” in its emergency notification process. The alert was sent to cellphones across Hawaii on Saturday morning when a state employee pushed the wrong button in the midst of a shift-change safety drill. It then took 38 minutes for the agency to withdraw the alert.

The prospect of a battery of investigations by state and federal lawmakers, with public testimony about the timeline of events, suggested that the alert would probably be a dominant subject in Hawaii life for months to come…..

As officials tried to reconstruct exactly what happened on Saturday, a spokesman for the Pacific Command in Hawaii said the military had moved quickly to push back against the Hawaii state alert as soon as it was known to be incorrect.

“Upon confirming yesterday’s message was a false alarm, Uspacom Public Affairs worked quickly to inform the public through traditional and social media channels,” Cmdr. David Benham, a military spokesman, said in an email Sunday, using an acronym for the Pacific Command. “We will use this as an opportunity to improve our internal processes as well as coordination with State authorities. “

The Pacific Command first told Hawaii media that there was no approaching ballistic missile at 8:23 a.m. — about 13 minutes after Hawaii sent out the alert………”

Hawaii sector


A false alarm in Hawaii: 38 minutes elapsed before emergency systems sent a second message announcing the mistake. Many more mistakes could “domino” in a 1/2 minute — like nuclear war!

NY Times

 


PHEMCE High-Priority Threats

PHEMCE High-Priority Threats

The PHEMCE will continue to address MCM needs to protect against high-priority threats for which the Secretary of Homeland Security made a determination pose a material threat sufficient to affect national security or PHEMCE leadership determines to have the potential to threaten national health security.

This year, the PHEMCE added three chemical agents (chlorine, phosgene, and vesicants); otherwise, the high-priority threats are unchanged from those listed in the 2016 PHEMCE SIP. The PHEMCE high-priority threats are (in alphabetical order by threat area):

Biological Threats

  • Bacillus anthracis (anthrax)* and
  • Multi-drug resistant B. anthracis (MDR anthrax)*
  • Burkholderia mallei (glanders)* and
  • Burkholderia pseudomallei (melioidosis)*
  • Clostridium botulinum toxin (botulism)*
  • Ebola virus (Ebola hemorrhagic fever)*
  • Emerging infectious diseases4
  • Francisella tularensis (tularemia)*
  • Marburg virus (Marburg hemorrhagic fever)*
  • Pandemic influenza
  • Rickettsia prowazekii (typhus)*
  • Variola virus (smallpox)*
  • Yersinia pestis (plague)*
  • Chemical Threats
  • Acetylcholinesterase inhibitor nerve agents*
  • Chlorine5
  • Cyanide salts (potassium and sodium cyanide)*
  • Hydrogen cyanide*
  • Phosgene5
  • Vesicants*
  • Radiological* and Nuclear* Threats(*) indicates threats identified under the following authorities related to MCMs: (1) emergency use authorities that rely on section 564(b)(1)(D) of the Federal Food, Drug, and Cosmetic Act (FD&C Act); (2) priority review vouchers PRVs) under section 565A of the FD&C Act;6 and, (3) procurements of security countermeasures under section 319F-2 of the PHS Act.

 

4 EIDs continue to remain a high-priority threat for the PHEMCE. The PHEMCE developed a risk assessment framework to assess whether specific emerging pathogens should be included explicitly as a high-priority threat. These pathogens may be included if PHEMCE leadership determines they have the potential to affect national health security.

5 The PHEMCE added additional chemical threat agents to the high-priority threat list after considering multiple factors, including recent reported intentional use of agents as weapons, accidental releases, availability of agents in industry, and health impacts of exposure.

6 It is possible that a drug product meeting the requirements of section 565A (material threat MCM priority review vouchers (PRVs)) also may meet the requirements of section 524 of the FD&C Act (which enables sponsors of certain tropical disease applications to receive PRVs). However, under section 565A(e), the same application is not permitted to receive more than one voucher. U.S. Food & Drug Administration (2017). Tropical Disease Priority Review Voucher Program. https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cder/ucm534162.htm and U.S. Food & Drug Administration (2017). 21st Century Cures Act: MCM-Related Cures Provisions. https://www.fda.gov/EmergencyPreparedness/Counterterrorism/MedicalCountermeasures/MCMLegalRegulatoryand PolicyFramework/ucm566498.htm#prv.


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