Mass Casualties and Health Care Following the Release of Toxic Chemicals or Radioactive Material—Contribution of Modern Biotechnology

Nyberg, Ann Göransson; Stricklin, Daniela; Sellström, Åke

doi:10.3390/ijerph8124521

Cited by 14 publications

(5 citation statements)

References 62 publications

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“…Apart from the usual hazards related to transports, fires, chemical incidents etc., acts of terror as well as consequences of sudden climate changes and breakdown of critical infrastructure have emerged as potential causes of MCIs. Every emergency hospital is required to have a MCI/"disaster" plan, which can be activated to different levels of alert [10].. The level of alert can be one of the following:…”

Section: Settingmentioning

confidence: 99%

“…Due to chronic budgetary deficits in most emergency hospitals, investments in the maintenance of MCI preparedness may have received low priority. Until now it is unclear how healthcare budget constraints have affected the regional MCI preparedness [9,10]. The aim of this paper was to study surgical MCI preparedness in Swedish emergency care hospitals.…”

Section: Introductionmentioning

confidence: 99%

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Swedish emergency hospital surgical surge capacity to mass casualty incidents

Blimark

Örtenwall

Lönroth

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: In Sweden the surgical surge capacity for mass casualty incidents (MCI) is managed by county councils within their dedicated budget. It is unclear whether healthcare budget constraints have affected the regional MCI preparedness. This study was designed to investigate the current surgical MCI preparedness at Swedish emergency hospitals. Methods: Surveys were distributed in 2015 to department heads of intensive care units (ICU) and surgery at 54 Swedish emergency hospitals. The survey contained quantitative measures as the number of (1) surgical trauma teams in hospital and available after activating the disaster plan, (2) surgical theatres suitable for multi-trauma care, and (3) surgical ICU beds. The survey was also distributed to the Armed Forces Centre for Defence Medicine. Results: 53 hospitals responded to the survey (98%). Included were 10 university hospitals (19%), 42 county hospitals (79%), and 1 private hospital (2%). Within 8 h the surgical capacity could be increased from 105 to 399 surgical teams, while 433 surgical theatres and 480 ICU beds were made available. The surgical surge capacity differed between university hospitals and county hospitals, and regional differences were identified regarding the availability of surgical theatres and ICU beds. Conclusions: The MCI preparedness of Swedish emergency care hospitals needs further attention. To improve Swedish surgical MCI preparedness a national strategy for trauma care in disaster management is necessary.

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Section: Settingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Swedish emergency hospital surgical surge capacity to mass casualty incidents

Blimark

Örtenwall

Lönroth

et al. 2020

Scand J Trauma Resusc Emerg Med

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show abstract

“…Approximately 130,000 individuals were screened within the first days after discovery of the event, but only 20 of these people required hospitalization (2). In the case of an improvised nuclear device (IND) or “dirty bomb” in a major city, potentially hundreds of thousands of people would require screening to ensure appropriate treatment for exposed individuals, and to help reassure the “worried well” (3).…”

Section: Introductionmentioning

confidence: 99%

Global Gene Expression Response in Mouse Models of DNA Repair Deficiency after Gamma Irradiation

et al. 2018

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In the event of an improvised nuclear device or "dirty bomb" in a highly populated area, potentially hundreds of thousands of people will require screening to ensure that exposed individuals receive appropriate treatment. For this reason, there is a need to develop tools for high-throughput radiation biodosimetry. Gene expression represents an emerging approach to biodosimetry and could potentially provide an estimate of both absorbed dose and individual radiation-induced injury. Since approximately 2-4% of humans are thought to be radiosensitive, and would suffer greater radiological injury at a given dose than members of the general population, it is of interest to explore the potential impact of such sensitivity on the biodosimetric gene expression signatures being developed. In this study, we used wild-type mice and genetically engineered mouse models deficient in two DNA repair pathways that can contribute to radiation sensitivity to estimate the maximum effect of differences in radiosensitivity. We compared gene expression in response to a roughly equitoxic (LD) dose of gamma rays in wild-type C57BL/6 (8 Gy) and DNA double-strand break repair-deficient Atm (4 Gy) and Prkdc (3 Gy) mutants of C57BL/6. Overall, 780 genes were significantly differentially expressed in wild-type mice one day postirradiation, 232 in Atm and 269 in Prkdc. Upstream regulators including TP53 and NFκB were predicted to be activated by radiation exposure in the wild-type mice, but not in either of the DNA repair-deficient mutant strains. There was also a significant muting of the apparent inflammatory response triggered by radiation in both mutant strains. These differences impacted the ability of gene expression signatures developed in wild-type mice to detect potentially fatal radiation exposure in the DNA repair-deficient mice, with the greatest impact on Atm mice. However, the inclusion of mutant mice in gene selection vastly improved performance of the classifiers.

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“…Hence, there is a critical need for mass triage strategies determining the absorbed dose, which is a key parameter for appropriate medical treatment [3]. Without appropriate treatment, nearly all individuals exposed to more than 4 Gy would die within 30 days [4]–[6].…”

Section: Introductionmentioning

confidence: 99%

Influence of Free Radicals Signal from Dental Resins on the Radio-Induced Signal in Teeth in EPR Retrospective Dosimetry

et al. 2013

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In case of radiological accident, retrospective dosimetry is needed to reconstruct the absorbed dose of overexposed individuals not wearing personal dosimeters at the onset of the incident. In such a situation, emergency mass triage will be required. In this context, it has been shown that Electron Paramagnetic Resonance (EPR) spectroscopy would be a rapid and sensitive method, on the field deployable system, allowing dose evaluation of a great number of people in a short time period. This methodology uses tooth enamel as a natural dosimeter. Ionising radiations create stable free radicals in the enamel, in a dose dependent manner, which can be detected by EPR directly in the mouth with an appropriate resonator. Teeth are often subject to restorations, currently made of synthetic dimethacrylate-based photopolymerizable composites. It is known that some dental composites give an EPR signal which is likely to interfere with the dosimetric signal from the enamel. So far, no information was available about the occurrence of this signal in the various composites available on the market, the magnitude of the signal compared to the dosimetric signal, nor its evolution with time. In this study, we conducted a systematic characterization of the signal (intensity, kinetics, interference with dosimetric signal) on 19 most widely used composites for tooth restoration, and on 14 experimental resins made with the most characteristic monomers found in commercial composites. Although a strong EPR signal was observed in every material, a rapid decay of the signal was noted. Six months after the polymerization, the signal was negligible in most composites compared to a 3 Gy dosimetric signal in a tooth. In some cases, a stable atypical signal was observed, which was still interfering with the dosimetric signal.

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Mass Casualties and Health Care Following the Release of Toxic Chemicals or Radioactive Material—Contribution of Modern Biotechnology

Cited by 14 publications

References 62 publications

Swedish emergency hospital surgical surge capacity to mass casualty incidents

Swedish emergency hospital surgical surge capacity to mass casualty incidents

Global Gene Expression Response in Mouse Models of DNA Repair Deficiency after Gamma Irradiation

Influence of Free Radicals Signal from Dental Resins on the Radio-Induced Signal in Teeth in EPR Retrospective Dosimetry

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