Predictability of Acute Radiation Injury Severity

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Slide 1 : Predictability of Acute Radiation Injury Severity Tamara V. Azizova, Sergey V. Osovets, Richard D. Day, Maria B. Druzhinina, Margarita V. Sumina, Valentina S. Pesternikova, Igor I. Teplyakov, Aimin Zhang, Michael Kuniak, Evgeny K. Vasilenko, Niel Wald, David M. Slaughter, Nadezhda D. Okladnikova, Laura Cassidy Schall Southern Urals Biophysics Institute, Ozyorskoe shosse 19, Ozyoursk, Chelyabinsk region, 456780 Russia; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261; Mayak Production Association, Ozyorsk, Chelyabinsk region, 456780 Russia; McClellan Nuclear Radiation Center, University of Pittsburgh, Pittsburgh, PA 15261
Slide 2 : Mayak Production Association (Mayak) PA, the first Russian nuclear enterprise located in the Southern Urals, was commissioned in June 1948. It included facilities necessary for weapons-grade plutonium production, e.g. industrial reactors, a radiochemical plant, and a plutonium production plant.
Slide 3 : Due to the early lack of experience in operating nuclear facilities and the short time allowed by the government to accomplish weapons-grade plutonium production, 19 radiation accidents occurred during the start-up and early operations of Mayak PA, in the period from 1948 to 1958. They resulted in acute gamma-neutron or gamma exposures of 59 involved individuals who developed acute radiation syndrome (ARS). Of the 19 radiation accidents, three (15 March 1953; 22 April 1957; 2 January 1958) were associated with spontaneous criticality events producing high gamma and neutron exposures of nuclear workers (McLaughlin et al. 2000).
Slide 4 : The primary medical and dosimetric data were utilized to establish the ARS clinical-dosimetry database. Database structure is presented in the next slide.
Slide 5 :
Slide 6 : In the Mayak worker cohort, 59 ARS patients, including 10 females, were diagnosed during 1950 - 1958.
Slide 7 : Distribution of Mayak PA workers with ARS (1948-1958) in accordance with ARS injury severity classification of Guskova-Baysogolov
Slide 8 : Mean (median) absorbed external doses at radiation accident
Slide 9 : Key clinical symptoms and signs of the ARS prodromal phase
Slide 10 : Time- dependence of vomiting on absorbed acute dose (* = two patients): Log10 (T) = (0.67 ± 0.08) – (0.78 ± 0.09) × Log10 (D), R2 = 0.7, where Log10 (T) is decimal logarithm of the vomiting onset; T is the vomiting onset (h); Log10 (D) is decimal logarithm of absorbed acute dose; and D is absorbed acute dose (Gy).
Slide 11 : Dependence of neutrophil counts on absorbed acute dose within the first hours after exposure (* = two patients): Neutrophils = (4.94 ± 0.66) + (4.66 ± 0.67) × Log 10 (D), R2 = 0.7, where Neutrophils is the neutrophil count (× 109 L-1); Log10 (D) is the decimal logarithm of absorbed acute dose; and D is absorbed acute dose (Gy).
Slide 12 : Dependence of lymphocytes on absorbed acute dose on the third day after exposure : Lymphocytes = (1.12 ± 0.09) – (0.61 ± 0.08) × Log10 (D), R2 = 0.7, where Lymphocytes is the lymphocyte count (× 109 L-1); Log10 (D) is decimal logarithm of absorbed acute dose; and D is absorbed acute dose (Gy).
Slide 13 : The onset of agranulocytosis depending on the ARS severity
Slide 14 : Conclusion Results of the analysis of clinical data on 59 ARS patients from Mayak PA confirmed the possibility of acute absorbed dose estimation and prediction of injury severity within the first hours or days after acute exposure using the following clinical symptoms and signs: onset of vomiting; neutrophil count in the peripheral blood within the first 2-3 hours after acute exposure; lymphocyte count in the peripheral blood within the first 24 - 48 hours after acute exposure.

 


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