A new publication from the American College of Radiology could be the most useful book of the year.
Far more chilling than anything novelist Stephen King could
conceive is the latest publication from the American College of
Radiology (ACR): Disaster Preparedness for Radiology Professionals,
Response to Radiological Terrorism. Published just prior to the
headlines about the arrest of a US citizen and a fuzzy plot to
detonate a bomb spiked with radioactive materials on US soil, the
matter-of-fact, 38-page guide is intended to provide a quick
reference in the event of a radiation disaster. As stated in the
preface: "A radiation disaster is a possibility for which we must
be prepared. Radiologists, radiation oncologists, and medical
physicists will play a vital role as responders and as sources of
accurate information for patients, the public, and the medical
community."
In stepping up to publish this primer, the ACR has taken a
proactive stance in preparing health care for a radiation disaster,
and the College, along with the committee that produced this
document, led by Arl Van Moore, MD, should be applauded for
assuming responsibility on behalf of its specialty to collect the
resources necessary for organizing and managing a response to this
potential threat. Moore acknowledged Harvey L. Neiman, MD, who was
just named the first physician executive director of the College,
for his leadership in convening the task force. As custodians of
diagnostic and therapeutic radiation, radiologists, radiation
oncologists, and radiological physicists are the default experts on
radiation exposureor will be perceived as such. This book should
top the summer reading list for every radiologist, oncologist,
radiology administrator, and radiological physicist in the
country.
This primer is not meant to sit on a shelf. It begins with a
checklist of 10 basics of response, preceded with the caveat that
only advance planning will ensure an appropriate response. It is
divided into12 chapters under the heading Radiation Incidents, and
also includes a section on radiological findings associated with
biological and chemical terrorist agents. Many tables, several
appendices, and additional resources are included. As the ACR notes
on its Disaster Preparedness web page, the primer is a "living
document" that will be updated as new information becomes
available. It can be downloaded at www.acr.org, and is not yet available
in print form.
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What is also implied by this primer and recent events is the
need to limit access to those areas in the hospital where radiation
sources used in medical diagnosis and therapy can be found. Though
it is unlikely that a bomb laced with the radioisotopes available
in the average hospital would result in significant
radiation-related mortality or morbidity, the fact that the
manufacture of such a threat could be on the agenda of a criminal
who converted to Islam in prison underscores the need for
preparedness. According to an article in the Wall Street Journal,1
the threat of what the primer refers to as a radiation dispersal
device (RDD) was not taken seriously in the past by nuclear and
defense experts because the act of making and carrying them would
eventually kill the perpetrators by exposing them to a suicidal
dose of radiation. "One of the things that's changed since
September 11 is the thought that death for the terrorist is part of
the plan," Matthew Bunn, a nuclear expert and assistant director of
the Science, Technology and Public Policy Program at Harvard
University's John F. Kennedy School of Government, told the
Journal.
In the event of a terrorist attack on US soil involving ionizing
radiation or even an RDD, radiology departments will be called on
to treat both the victims of the fallout and the terror itself:
that is, fear of radiation exposure. The information and resources
to develop a clear plan to treat victims and limit exposure and
panic are available in this publication.
Cheryl Proval
cproval@medpubs.com
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