Nuclear and radiological emergencies: Building capacity in medical physics to support response

Reduction of pTau and APP Levels in Mammalian Brain After Low-Dose Radiation

“…iatrogenic origins, nuclear accidents, war/terrorist attacks) resulting in a drastic reduction of either survival or long-term quality of life. The detrimental effects of brain radiation exposure might occur despite the implementation of preventative measures (as in the clinical setting) or prophylactic protocols (as after radiation contamination due to nuclear disaster or attack) 1,2 . While most radiation research investigations focus on minimizing long-term neurological consequences in the context of speci c radiotherapy protocols (for example, using low-dose fractionated radiation for primary brain tumors) or on looking for prophylactic tools to minimize systemic injurious effects of radiation (e.g.…”

“…Radiation-induced brain injury due to fractionated or single dose radiotherapy can generate a complex series of acute [1][2][3] and chronic changes 4,5 , where the resulting clinical severity and therapeutic outcomes depend on the nature of the brain pathology involved (primary brain tumor vs. brain metastases), general medical conditions (older vs. younger patients), radiation techniques used (fractionated vs. single dose), requirement of isolated or combined chemotherapy+radiotherapy (isolated radiotherapy vs. antiblastic+radiation therapy), and total dose of γ-rays administered (low-vs. high-dose).…”

EFOMP policy statement 16: The role and competences of medical physicists and medical physics experts under 2013/59/EURATOM

“…Examples are Article 63 regarding accidental and unintended exposures 13 and Article 64 on estimates of population doses from medical exposures. 14 Other articles in other chapters also offer opportunities e.g., Chapter IX Article 96 on notification and recording of significant events. 15 MPP are ideally placed to liaise with radiation protection authorities in such situations.…”

“…Because of these reasons MPP should look beyond the directive for further guidance. Many organizations (e.g., IAEA, ICRP, EFOMP, AAPM) produce excellent documents which can be used by MPP to develop their role [13,14]. MPP are also very well-positioned to contribute to the ISO 9000 and ISO 17025 accreditation of medical organizations.…”

“…(a) all reasonable measures are taken to minimise the probability and magnitude of accidental or unintended exposures of individuals subject to medical exposure; (b) for radiotherapeutic practices the quality assurance programme includes a study of the risk of accidental or unintended exposures; (c) for all medical exposures the undertaking implements an appropriate system for the record keeping and analysis of events involving or potentially involving accidental or unintended medical exposures, commensurate with the radiological risk posed by the practice; (d) arrangements are made to inform the referrer and the practitioner, and the patient, or their representative, about clinically significant unintended or accidental exposures and the results of the analysis; (e) (i) the undertaking declares as soon as possible to the competent authority the occurrence of significant events as defined by the competent authority; (ii) the results of the investigation and the corrective measures to avoid such events are reported to the competent authority within the time period specified by the Member State; (f) mechanisms are in place for the timely dissemination of information, relevant to radiation protection in medical exposure, regarding lessons learned from significant events. 14 Article 64 Estimates of population doses "Member States shall ensure that the distribution of individual dose estimates from medical exposure for radiodiagnostic and interventional radiology purposes is determined, taking into consideration where appropriate the distribution by age and gender of the exposed". 15 Article 96 Notification and recording of significant events "Member States shall require the undertaking to: (a) implement, as appropriate, a recording and analysis system of significant events involving or potentially involving accidental or unintended exposures; (b) promptly notify the competent authority of the occurrence of any significant event resulting or liable to result in the exposure of an individual beyond the operational limits or conditions of operation specified in authorising requirements with regard to occupational or public exposure or as defined by the competent authority for medical exposure, including the results of the investigation and the corrective measures to avoid such events".…”