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Medical Lessons Learned From Chernobyl Relative to Nuclear Detonations and Failed Nuclear Reactors

Published online by Cambridge University Press:  08 April 2013

Abstract

The Chernobyl disaster in 1986 involved the largest airborne release of radioactivity in history, more than 100 times as much radioactivity as the Hiroshima and Nagasaki atomic bombs together. The resulting emergency response, administrative blunders, and subsequent patient outcomes from this large-scale radiological disaster provide a wealth of information and valuable lessons for those who may find themselves having to deal with the staggering consequences of nuclear war. Research findings, administrative strategies (successful and otherwise), and resulting clinical procedures from the Chernobyl experience are reviewed to determine a current utility in addressing the appropriate protocols for a medical response to nuclear war. As various myths are still widely associated with radiation exposure, attention is given to the realities of a mass casualty medical response as it would occur with a nuclear detonation.

(Disaster Med Public Health Preparedness. 2012;6:330-334)

Type
Review Article
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2012

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References

REFERENCES

1.Goans, RE ed. Medical Management of Radiological Casualties. 3rd ed. Bethesda, MD: Armed Forces Radiobiology Research Institute; 2009.Google Scholar
2.Dallas, CE. Nuclear detonation. In: Keyes, C, Pepe, P, Swienton, R, Schwartz, R, eds. Medical Response to Terrorism. New York, NY: Lippincott; 2004: 174185.Google Scholar
3.Swienton, RMarkenson, D, eds. Basic disaster life support. In: Nuclear and Radiological Events. Chicago, IL: American Medical Association; 2011.Google Scholar
4.Office of Science and Technology Policy, Executive Office of the President. Planning Guidance for Response to a Nuclear Detonation. 2nd ed. Washington, DC: Federal Emergency Management Agency; June 2010.Google Scholar
5.Holloway, HCNorwood, AEFullerton, CSEngel, CC JrUrsano, RJ. The threat of biological weapons: prophylaxis and mitigation of psychological and social consequences. JAMA. 1997;278(5)425427.Google Scholar
6.World Health Organization. Health Effects of the Chernobyl Accident and Special Health Care Programmes: Report of the UN Chernobyl Forum Expert Group “Health.”. Geneva, Switzerland: World Health Organization; 2006.Google Scholar
7.Litcher, LBromet, EJCarlson, G, et alSchool and neuropsychological performance of evacuated children in Kyiv 11 years after the Chornobyl disaster. J Child Psychol Psychiatry. 2000;41(3):291299.Google Scholar
8.Bar Joseph, NReisfeld, DTirosh, ESilman, ZRennert, G. Neurobehavioral and cognitive performances of children exposed to low-dose radiation in the Chernobyl accident: the Israeli Chernobyl Health Effects Study. Am J Epidemiol. 2004;160(5)453459.Google Scholar
9.Castronovo, FP Jr.Teratogen update: radiation and Chernobyl. Teratology. 1999;60(2):100106.Google Scholar
10.Dolk, HNichols, R; EUROCAT Working Group. Evaluation of the impact of Chernobyl on the prevalence of congenital anomalies in 16 regions of Europe. Int J Epidemiol. 1999;28(5)941948.Google Scholar
11.Kolominsky, YIgumnov, SDrozdovitch, V. The psychological development of children from Belarus exposed in the prenatal period to radiation from the Chernobyl atomic power plant. J Child Psychol Psychiatry. 1999; 40(2):299305.Google Scholar
12.Nyagu, AILoganovsky, KNLoganovskaja, TK. Psychophysiologic after-effects of prenatal irradiation. Int J Psychophysiol. 1998;30(3)303311.CrossRefGoogle Scholar
13.Kulakov, VISokur, TNVolobuev, AI, et alFemale reproductive function in areas affected by radiation after the Chernobyl power station accident. Environ Health Perspect. 1993; 101(suppl 2):117123.Google Scholar
14.Yablokov, AV. 5. Nonmalignant diseases after the Chernobyl catastrophe. Ann N Y Acad Sci. 2009;1181:58160.Google Scholar
15.Wertilecki, W. Malformations in a Chernobyl-impacted region. Pediatrics. 2010; 125(4):e837e843.Google Scholar
16.Williams, DBaverstock, K. Chernobyl and the future: too soon for a final diagnosis. Nature. 2006;440(7087):993994.CrossRefGoogle ScholarPubMed
17.De Wals, PDolk, H. Effects of the Chernobyl radiological contamination on human reproduction in western Europe. Prog Clin Biol Res. 1990;340C:339346.Google Scholar
18.Rojas-Burke, J. Scientists report surprise findings of thyroid cancer following Chernobyl. J Nucl Med. 1992;33:2324, 32–33.Google ScholarPubMed
19.Knudsen, LB. Legally induced abortions in Denmark after Chernobyl. Biomed Pharmacother. 1991;45(6):229231.CrossRefGoogle ScholarPubMed
20.Irgens, LMLie, RTUlstein, M, et alPregnancy outcome in Norway after Chernobyl. Biomed Pharmacother. 1991;45(6)233241.Google Scholar
21.Spinelli, AOsborn, JF. The effects of the Chernobyl explosion on induced abortion in Italy. Biomed Pharmacother. 1991;45(6)243247.Google Scholar
22.Czeizel, AE. Incidence of legal abortions and congenital abnormalities in Hungary. Biomed Pharmacother. 1991;45(6):249254.Google Scholar
23.Trichopoulos, DZavitsanos, XKoutis, CDrogari, PProukakis, CPetridou, E. The victims of Chernobyl in Greece: induced abortions after the accident. Br Med J (Clin Res Ed). 1987;295(6606):1100.Google Scholar
24.United Nations Security Committee on the Effects of Atomic Radiation. Scientific Annexes C,D, and E. Vol 2. New York, NY: United Nations; 2011. Sources and Effects of Ionizing Radiation: 2008 Report to the General Assembly with Scientific Annexes.Google Scholar
25.World Health Organization. Chernobyl: the true scale of the accident: 20 years later a UN report provides definitive answers and ways to repair lives. Geneva, Switzerland: World Health Organization; September 5, 2005. http://www.who.int/mediacentre/news/releases/2005/pr38/en/index.html.Google Scholar
26.Williams, ED. Effects on the thyroid in populations exposed to radiation as a result of the Chernobyl accident. In: One Decade After Chernobyl. Vienna, Austria: International Atomic Energy Authority; 1996:207230.Google Scholar
27.Ron, ELubin, JHShore, RE, et alThyroid cancer after exposure to external radiation: a pooled analysis of seven studies. Radiat Res. 1995;141(3):259277.Google Scholar
28.Williams, D. Radiation carcinogenesis: lessons from Chernobyl. Oncogene. 2008;27(suppl 2):S9S18.CrossRefGoogle ScholarPubMed
29.Cockerham, LGWalden, TLDallas, CEMickley, GALandauer, MR. Ionizing radiation. In: Hayes, AW, ed. Principles and Methods of Toxicology. 5th ed. Boca Raton, FL: CRC Press; 2007:897982.Google Scholar
30.Howe, GR. Leukemia following the Chernobyl accident. Health Phys. 2007;93(5):512515.Google Scholar
31.Moysich, KBMenezes, RJMichalek, AM. Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review. Lancet Oncol. 2002;3(5):269279.CrossRefGoogle ScholarPubMed
32.Sali, DCardis, ESztanyik, L, et alCancer consequences of the Chernobyl accident in Europe outside the former USSR: a review. Int J Cancer. 1996;67(3)343352.Google Scholar
33.Walker, RICerveny, TJ eds. Medical Consequences of Nuclear Warfare: Textbook of Military Medicine. Falls Church, VA: US Army Office of the Surgeon General; 1989.Google Scholar
34.Flynn, DFGoans, RE. Nuclear terrorism: triage and medical management of radiation and combined-injury casualties. Surg Clin North Am. 2006;86(3):601636.Google Scholar
35.Nesterenko, VBNesterenko, AVBabenko, VIYerkovich, TVBabenko, IV. Reducing the 137Cs-load in the organism of “Chernobyl” children with apple-pectin. Swiss Med Wkly. 2004;134(1–2):2427.Google Scholar
36.Verzijl, JMWierckx, FCHennen, LAvan Dijk, AGlerum, JH. The influence of extracorporeal clearance techniques on elimination of radiocesium after internal contamination. Health Phys. 1995;69(4):521529.Google Scholar
37.Musolino, SVHarper, FT. Emergency response guidance for the first 48 hours after the outdoor detonation of an explosive radiological dispersal device. Health Phys. 2006;90(4):377385.Google Scholar
38.Oak Ridge Institute for Science and Education. The Medical Aspects of Radiation Incidents. Oak Ridge, TN: Oak Ridge Institute for Science and Education; 2010.Google Scholar
39.Dallas, CEBell, WC. Prediction modeling to determine the adequacy of medical response to urban nuclear attack. Disaster Med Public Health Prep. 2007;1(2):8089.Google Scholar
40.Medvedev, Z. The Legacy of Chernobyl. New York, NY: WW Norton & Co; 1990.Google Scholar
41.Becker, SM. Communicating risk to the public after radiological incidents. BMJ. 2007;335(7630):11061107.CrossRefGoogle Scholar