Transcript International co-operation for medical assistance

INTERNATIONAL CO-OPERATION FOR
MEDICAL PREPAREDNESS AND RESPONSE TO
RADIATION EMERGENCIES
Module XXIII
Radiation accidents
1944-2001
1944-2001 420 radiation accidents leading to
significant overexposure of at least one person [when
E>0.25 Sv, Hskin>6 Sv, or Hother organ>0.75 Sv]
 Of 3000 overexposed persons, 133 fatalities
registered
 Fatalities include 28 operators and firemen who
died of acute radiation disease in Chernobyl
accident in April 1986

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Conventions for international
collaboration in radiation accidents

The basis for co-operation International Conventions (26
Sept 1986) on “Early notification of a nuclear accident”
and on “Assistance in case of a nuclear accident or
radiological emergency” prepared by IAEA in co-operation
with government experts of its 62 Member States and
representatives of 10 international organizations in AugustSeptember 1986

Conventions have 87 and 82 parties respectively, as of 1
March 2002. Besides three international organizations –
FAO, WHO & WMO – acceding to them, 84 and 79
Member States have, respectively, ratified them
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IACRNA
IAEA
IAEA
WHO
WMO
OCHA
FAO
NEA
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EC
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Emergency Response System (ERS) and
International Nuclear Event Scale (INES)

According to the Conventions Member States
provide the IAEA with immediate information on a
nuclear accident and
 mutually assist each other in case of a nuclear accident
or radiological emergency


The IAEA co-ordinates the ERS and has elaborated
the International Nuclear Event Scale, INES, used
for rating nuclear events in the early notification
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Responsibilities of IAEA

FOCAL POINT

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
NOTIFICATION
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Emergency Response System (ERS)
International Nuclear Event Scale (INES)
Inform States and organizations on accident
Notify upon request to minimize consequences
ASSISTANCE

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Disseminate information on resources, methods,
techniques, calculation of consequences
Transmit and co-ordinate assistance on request
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Co-operation of
IAEA with WHO

CO-OPERATION for
Application of Conventions
 Actions aimed at
 medical and public health response to
radiation emergency or nuclear accident
 medical preparedness and assistance


Joint publications and training activities

PARTICULAR RESPONSIBILITY of WHO
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Organize network of WHO Collaborating Centres,

Provide procedures for medical assistance
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International assistance in
medical response
Depends on
 number of exposed persons
 severity of exposure
 types of accidental exposure, which may be
 exposure of the public, workers, patients
 external exposure only
 external or internal radioactive contamination
 combination of external and internal exposure
 combination of radiation exposure and other
injuries
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REMPAN
Radiation emergency medical preparedness
and assistance network

For promotion of radiation emergency medical
preparedness and for practical assistance and
advice to countries in a case of overexposure
from any source of radiation, WHO established
REMPAN in 1988
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REMPAN
In March 2002
14 REMPAN centres in Armenia, Australia,
Finland, France (2), Germany, Japan, Russian
Federation (4), United Kingdom, Ukraine and
USA, and 2 liaison institutions in Brazil and
India.
These 16 institutions are located in 12 countries
on 4 continents
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Major roles of REMPAN in
radiation emergency

to provide assistance and advice in medical management of
exposed individuals

to provide medical team for on-site emergency treatment

to transfer (if possible and necessary) severely exposed
patients to collaborating centres for specialized medical
care

to assist with facilities and staff for medical investigations
and treatment
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Major roles of REMPAN in radiation
emergency
to assist in development of measures necessary to
limit health effects
 to follow up medical supervision and treatment
 to assist in developing procedures to strengthen
countries’ ability to manage such accidents
 to circulate information relating to medical
management of radiological accidents to Member
States

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Types of REMPAN assistance
Human resource specialists

Each WHO collaborating centre, including liaison
institutions, has a few dozen experts or more,
including many doctors. Other specialists are health
physicists, radiologists, radiochemists
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Types of REMPAN assistance

Recruitment of experts
WHO and IAEA invite experts from collaborating
centres and also from other institutions, if necessary
and requested by affected Member State
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Specialized teams
WHO (in co-operation with IAEA) can organize
multinational teams to render medical assistance on
site
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Types of REMPAN assistance

Equipment
Portable equipment for radiation monitoring of
humans and environmental objects for use on site
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Medical services
WHO collaborating centres can help with diagnosis,
prognosis, treatment and follow-up of persons exposed
to radiation and other accompanying factors - both in
affected country and at centres themselves
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Types of REMPAN assistance
Clothing

Special clothing for medical personnel
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Scientific services
Expertise may be provided for biological dose assessment
and reconstructing circumstances of overexposure (in cooperation with IAEA)

Transportation
WHO collaborating centres provide advice or render
practical assistance for transportation of affected persons
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Practical co-operation of IAEA, WHO, EC
and MSs in medical management of
radiation accidents
Notification - information on accident,
 Preparedness - plans for prevention &
diagnosis
 Intervention - actions for emergency aid,
treatment, decontamination,
decorporation
 Reparation - follow-up and rehabilitation,
 Training
- of medical staff in health effects of
radiation and radiopathology:
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training courses, symposia, fellowships
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Examples of
international co-operation

Numerous examples of joint assistance for
radiological accidents: most known cases are
Chernobyl and Goiania
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After Goiania accident of 1987, leading radiation
medicine scientists were recruited by IAEA and
WHO to provide medical and radiological
consultations on site
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Examples of
international co-operation
 International
studies on childhood thyroid
cancer in population affected by
Chernobyl radioiodine releases in iodine
deficient areas up to 500 km around NPP
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Dissemination of information
IAEA and WHO regularly
 organize
joint conferences
 prepare joint publications (also in co-operation
with other international organizations, such as EC,
UNSCEAR, OECD/NEA , ILO)
 present, discuss and disseminate information on
health effects of exposure to radiation
 publish lessons learned to prevent and better
manage radiological and nuclear accidents
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International co-operation for medical
management of radiation accident in Lia, JanFeb 2002
LIA
SANTREDIA
KAHISHI
ZUGDIDI
MATKOJI
POTI
LILO
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International collaboration to compile lessons
learned from medical management of recent
radiation accidents
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The 1st EAGM (Expert Advisory Group Meeting) on
medical follow-up of Georgian patients (soldiers)
accidentally exposed to radiation in Lilo conducted by
IAEA in Vienna in Sept 1999
Two joint IAEA-WHO expert meetings on medical
follow-up of six significant recent radiation accidents
at WHO-HQ (Geneva, 1-3 Oct 2001) and WHO/REMPAN
Centre (Ulm, 8-9 Nov 2001)
Joint technical document has been approved for
publication in 2002, to distribute to medical specialists
and institutions responsible for treatment of radiation
accident cases in Member States
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