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Health Effects of Embedded Depleted Uranium Fragments (Armed Forces Radiobiology Research Institute Workshop, 15 November 1996)
During Operation Desert Storm (ODS) friendly-fire incidents resulted in patients wounded from embedded fragments of depleted uranium (DU) metal. Existing fragment removal
guidelines dictated fragments be left in place unless they were a present or future threat to health. An Armed Forces Radiobiology Research Institute (AFRRI) 1993 review of the potential health effects of allowing DU fragments to remain in place found no compelling evidence to warrant a change in the fragment removal policies. However, sufficient uncertainties existed concerning the health effects of embedded DU fragments to warrant implementation
of both patient follow-up and toxicological research programs. The Department of Veterans Affairs (DVA) is conducting a joint DoD/DVA patient
monitoring effort; and the DoD is funding a DU research program at AFRRI and at the Inhalation Toxicology Research Institute (ITRI). A meeting of these groups was held at AFRRI 15 November 1996 to review research efforts to date. This
report is a summary of the eight research efforts presented at the workshop.
Armed Forces Radiobiology Research Institute (U.S.)
1998-06
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Proceedings: Triage of Irradiated Personnel (Armed Forces Radiobiology Research Institute Workshop, 25-27 September 1996)
The workshop, "Triage of Irradiated Personnel," sponsored by the U.S. Army Office of the Surgeon General, was conducted at the Armed Forces Radiobiology Research Institute (AFRRI) on September 25-27, 1996. This workshop focused on a reassessment of the radiation medicine section of Chapter 4, Medical Aspects of Nuclear, Biological and Chemical Warfare, of Army Field Manual 8-10-7: Health
Service Support in a Nuclear, Biological and Chemical Environment. Sixty-five speakers and guests
from the United States, Germany, Netherlands, Canada, United Kingdom, and France addressed the three issues: (1) operational effectiveness of exposed personnel with and without other injuries who receive medical care in Army echelon I and echelon II
medical facilities, (2) operational effectiveness of personnel with multiple exposures (assuming a previous total dose of
Armed Forces Radiobiology Research Institute (U.S.)
1998-03
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Toxicological Evaluation of Depleted Uranium in Rats: Six-Month Evaluation Point
The use of depleted uranium (DU) munitions during Desert Storm resulted in a unique type of battlefield casualty, DU shrapnel wounds. The toxicity associated with embedded DU may differ significantly
from other metals or other routes of uranium administration. This is a 6-month interim report of an 18- month study that is designed to assess the toxicity of implanted DU pellets. This study evaluates kidney, behavioral, and neural toxicity associated with intramuscularly
implanted DU pellets (1-mm x 2-mm) and assesses tissues for histological changes and for uranium content. Rats were assigned to five experimental groups: 1) a non-implanted sham surgical control group, 2) rats implanted with 20 tantalum (Ta) to control for fragment implantation, 3) rats implanted with low-doseDU (4DU and 16 Ta pellets), 4) rats implanted with medium-doseDU(10DU and 10 Ta pellets), and 5) rats implanted with high-dose DU (20 DU pellets). Uranium levels were high and dose-dependent in the kidney, urine, and bone. Despite high uranium levels in the kidney, no renal toxicity was evident. Between 23-26 weeks body
weight in high-DU dose animals was significantly lower than controls. Unexpectedly, uranium was found in the brain of DU-implanted animals. No
behavioral neurotoxicity was evident. Excitability of hippocampal neurons was reduced in the highDU dose animals at 6 months. These data suggest that at the 6-month time point, renal toxicity may be less of
a hazard than anticipated.While these results indicate that toxicity is not evident at 6 months with exposure
to embedded DU, there is a need to further investigate long-term effects in light of the high levels accumulated in some body tissues.
Armed Forces Radiobiology Research Institute (U.S.)
Pellmar, T. C. (Terry C.); Hogan, J. B.; Benson, K. A. . . .
1998-02
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AFRRI's Gamma-Ray, X-Ray, and Fission-Neutron Calibration Curves for the Lymphocyte Dicentric Assay: Application of a Metaphase Finder System
This paper reports dose-response or calibration curves of measured dicentric yields following exposure to 250-kVp x rays, 60Co gamma rays,
and fission neutrons, whose radiation qualities have been measured at AFRRI (Bethesda, MD) in terms of their microdosimetric parameters. In addition, we compare these dose response calibration curves with similar studies from other laboratories. Estimating radiation dose by chromosome aberration analysis requires time-demanding and labor-intensive scoring by expert cytogeneticists. Our attempt to decrease cytogenetic scoring time in biodosimetric assessment for radiation accidents is addressed by the use of satellite scoring stations used in conjunction with an automated metaphase finder.
Armed Forces Radiobiology Research Institute (U.S.)
Prasanna, P. G. S.; Loats, Harry; Gerstenberg, H. M. . . .
2002-05
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Medical Management of Radiological Casualties Handbook: First Edition
The purpose of this handbook is to provide concise supplemental reading material for the Medical Effects of Ionizing Radiation Course, which is the only course in the Department of Defense for training health care professionals in the management of uncontrolled ionizing radiation exposure. As U.S. forces deploy to areas devastated by civil war and factional strife, unmarked radioactive material will be encountered in waste dumps, factories, abandoned medical clinics, and nuclear fuel facilities. Medical providers must be prepared to adequately treat injuries complicated by ionizing radiation exposure and radioactive contamination. To that end, the theory and treatment of radiological casualties is taught in the Medical Effects of Ionizing Radiation Course offered by the Armed Forces Radiobiology Research Institute at Bethesda, Maryland.
Armed Forces Radiobiology Research Institute (U.S.)
Jarrett, David G.
1999-12
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Terrorism with Ionizing Radiation General Guidance: Pocket Guide
This 2 sided pocket guide includes the following information for radiation terrorism: confirmation of cases; decontamination considerations; treatment considerations; institutional reporting; public health reporting; diagnosis alerts; understanding exposure; and a table outline of acute radiation syndrome. The following web sites are for VA access card and DoD access cards respectively: http://www.oqp.med.va.gov/cpg/cpg.htm; http://www.cs.amedd.army.mil/qmo
Armed Forces Radiobiology Research Institute (U.S.)
2002-05-16
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Population Health in Regions Adjacent to the Semipalatinsk Nuclear Test Site
The crucial fact documented in this report is that the health of the people in the regions surrounding
the test site was poor. The authors compiled data relating to incidences not only of neoplastic diseases but also cardiovascular diseases, infectious diseases, nervous system dysfunctions, etc. Heavily exposed settlements were compared with control villages. Of note, however, is that not one case of acute or chronic radiation sickness was detected. The report's importance is that it thoroughly addresses questions about the cause(s) of the populations severe health problems. The authors' careful analyses of factors associated with increased incidence and/or susceptibility to disease are described in detail.
Armed Forces Radiobiology Research Institute (U.S.)
Logachev, V. A., professor; Mikhalikhina, L. A.; Darenskaya, N. G. . . .
1998-09
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Chronic Radiation Sickness Among Techa Riverside Residents
In 1994 the Armed Forces Radiobiology Research Institute published a contract report entitled "Analysis
of Chronic Radiation Sickness Cases in the Population of the Southern Urals." The principal author of both reports was Dr. Mira M. Kossenko of
the Urals Research Center for Radiation Medicine (URCRM, formerly Branch 4 of the Institute of Biophysics of the Ministry of Health of the USSR). The first report documented the extent of radiation
exposure along the Techa river and gave an overview of the health effects of this exposure on the
population. There were 940 individuals diagnosed with CRS; of this large group, 66 met the criteria of a dose of at least one gray received over three years, no concurrent disease with symptoms similar to CRS, and signs and symptoms as described by Guskova and Baysogolov. In this report the dynamics of CRS, its clinical course, and the long-term outcomes for patients with this disease are described in much greater detail. Once the patient was removed from exposure, the course of CRS stabilized. Most patients eventually recovered, with the time to recovery
being inversely related to the total dose received. Severity of symptoms was directly related to dose. A significantly increased percentage of
patients died from leukemia or other blood dyscrasias and solid tissue neoplastic diseases compared to a control group. However, except for early deaths resulting from malignancies, there was no life span shortening. Today there are no patients who have CRS; all have either recovered completely (the majority), at least stabilized, or have died.
Armed Forces Radiobiology Research Institute (U.S.)
Kossenko, Mira M.; Nikolayenko, Lidiya A.; Yepifanova, Svetlana B. . . .
1998-02
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Animal Studies of Residual Hematopoietic and Immune System Injury From Low Dose/Low Dose Rate Radiation and Heavy Metals
It is clear that there is an adaptive response to low dose rate exposures. However, as the authors of this report describe, recovery of marrow precursor cells after a second exposure may be incomplete. This could be due to any combination of factors such as persistent deficiency of stem cells, accelerated cell cycling of marrow precursors leading to increased ratios of S-phase populations among stem cells, shortened lifespans of immature erythroid and myeloid cells, and others. Part of the problem in studying the effects of damage repair after low dose exposures is that the damage is minimal, and detection of changes accordingly is difficult. More research needs to be carried out in this field. One unique feature of this report is the combination of radiation effects with those from the heavy metals cadmium and lead. These metals, both marrow-toxic and immunotoxic in their own right, affect the outcomes of radiation exposures even at low doses and low dose rates. Particularly in situations involving radiation contamination from occupational accidents or environmental releases, one may expect to seldom encounter victims adversely affected by radiation alone. A host of other physicochemical agents, ranging from metals such as these to solvents and other substances, are likely to be present. The authors' findings regarding the additive and/or synergistic effects of simultaneous or nearly simultaneous exposure to radiation and toxic metals are important for this reason. We trust that readers of this work will find their approach and findings stimulating and useful for their own understanding and efforts.
Armed Forces Radiobiology Research Institute (U.S.)
Yagunov, A.S.; Tokalov, S.V.; Chukhlovin, A.B. . . .
1998-09
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Chemical Protection Against X-Ray, Gamma, and Neutron Radiation
Experiments in mice showed that intraperitoneal (i.p.) injection of unithiol (sodium salt of 2,3-
dimercapto-l-propanesulfonic acid) diminished toxicity of several aminothiol radioprotectors, increasing
the LD50 of cystamine by 40% and aminoethanisothiuronium bromide hydrobromide (AET) by 64%. The optimum ratio for the doses is 0.5 molar equivalent of unithiol per radioprotective thiol. A new radioprotector (mixed disulfide of cysteamine and unithiol--MDCU) has a weak toxicity: the LD50 is 750 mg/kg i.p. The use of unithiol makes it possible to increase the dose of the SH-radioprotectors, enhancing the dose reduction factor (DRF) of cystamine and AET by 30% for x-ray irradiation. A somewhat lesser effect is observed with fission neutron
irradiation. The DRF of MDCU is equal to 1.6 for x-ray irradiation and is 1.1 for neutron irradiation. The mechanism of antitoxic action of unithiol could not be detected in Chinese hamster fibroblasts. It may be caused by the competition of unithiol and the SH-radioprotectors for certain, as yet undetermined,
biochemical structures in brain neurons. It is also possible that unithiol may decrease penetration
of SH-radioprotectors into the brain.
Armed Forces Radiobiology Research Institute (U.S.)
Grachev, Sergeĭ (Sergeĭ Anatolʹevich)
1997-12
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Retrospective Reconstruction of Radiation Doses of Chernobyl Liquidators by Electron Paramagnetic Resonance
Accurate, reliable dose reconstruction is a critical component in the epidemiological followup of liquidators. Dosimetry of teeth by electron paramagnetic resonance (EPR) is a state-of-the-art laboratory technique that is key to this effort. The Scientific Center of Radiation Medicine (SCRM) has developed and refined this technique in order to meet the practical demands of large-scale epidemiological followup of the Chernobyl liquidators. Independent analysis using similar technology was performed by investigators at the University of Utah and showed good correlation with the SCRM results. The lower limit of detection for reliable dose reconstruction was 100 mGy. Techniques were applied to samples from approximately 135 liquidators involved in cleanup activities within the first 2 years after the Chernobyl accident in 1986. Mean dose was 287 mGy, geometric mean was 205 mGy, and median dose value was 200 mGy. The reconstructed dose values range from 30 to 2220 mGy. Correlation of results between the two institutions was generally within 17%. This report also addresses some confounding factors (previous medical x-ray exposures, ultraviolet light effects on anterior teeth, nonlinearity of dose response curves below 100 mGy) and how to deal with them.
Armed Forces Radiobiology Research Institute (U.S.)
Chumak, Vadim V.; Likhtarev, I.; Sholom, Sergey S. . . .
1997-12
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Armed Forces Radiobiology Research Institute [website]
This is the website for the Armed Forces Radiobiology Research Institute [AFFRI] at the Uniformed Services University. "The AFRRI mission is to preserve and protect the health and performance of U.S. military personnel through research and training that advance understanding of the effects of ionizing radiation. This mission includes education and training to maintain a pool of qualified radiation biologists; and basic and applied research to identify and perform early development of measures to prevent, assess and treat radiation injury. AFRRI research thrusts include medical countermeasures, diagnosis of injury (biodosimetry), low dose/low dose rate/late effects, internalized radionuclides, and combined injury."
Armed Forces Radiobiology Research Institute (U.S.)
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Medical Management of Radiological Casualties Handbook [Online Third Edition]
This document provides guidance on identifying the type of radiation involved and estimating victims' exposure after a nuclear or radiological event. This handbook can help emergency responders and medical professionals who may have minimal knowledge of the effects of ionizing radiation on the human body.
Armed Forces Radiobiology Research Institute (U.S.)
2010-06
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Second Edition: Medical Management of Radiological Casualties Handbook
"This handbook provides concise supplemental reading material for the Medical Effects of Ionizing Radiation Course, which is presented by the Armed Forces Radiobiology Research Institute several times each year and is the only graduate-level course in the Department of Defense for training health care professionals in the management of uncontrolled ionizing radiation exposure."
Armed Forces Radiobiology Research Institute (U.S.)
2003-04
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Medical Management of Radiological Casualties
Medical defense against radiological warfare is one of, the least emphasized segments of modern medical education., Forty years of nuclear-doomsday predictions made, any realistic preparation for radiation casualty management, an untenable political consideration. The end of the, Cold War has dramatically reduced the likelihood of strategic, nuclear weapons use and thermonuclear war. LLIS Core Capability: HazMat; Military; Hazmat
Armed Forces Radiobiology Research Institute (U.S.)
2003-04-01?
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TRIAGE of Irradiated Personnel
AERRI [Armed Forces Radiobiology Research Institute] was tasked by the Army Office of the Surgeon General to answer operational questions concerning three issues related to the triage of irradiated personnel deployed forward. These issues, and the workshop participants' consensus responses, are: (1) Effects of radiation injuries on exposed personnel, assuming Level I and Level II medical care and facilities. Individuals receiving over 1.5 Gy should be evacuated; those receiving less than this amount may return to duty. Even at this level, 30% of exposed personnel may be too ill to return to duty. Those who recover will experience varying degrees of persistent fatigue and weakness. Dose assessment at this level is best served by physical dosimetry. (2) Describe these effects in previously exposed personnel. Physical dosimetry is required for personnel who are at risk of a second exposure; no animal model completely predicts the effects of either protracted or multiple radiation exposure in humans. Fatigue and weakness in multiply exposed personnel will be cumulative.
Armed Forces Radiobiology Research Institute (U.S.)
1996-09-25
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Medical Recording Tools for Biodosimetry in Radiation Incidents
"NATO Standardization Agreement (STANAG) 2474, entitled 'Determination and Recording of Ionizing Radiation Exposure For Medical Purposes,' calls for thorough medical recording in radiation exposure incidents. There are also U.S. Specific Military Requirements (SMR) to 'Identify or develop and validate viable low-cost field biodosimetry' (FY01/02), on converting the 'Biological Assessment Tool' (BAT) to a handheld computer device (FY03/04), and 'Field Radiological Biodosimetry' (FY05/06). BAT output has been accepted as a requirement for the Theater Functional Working Group Integrated Process Team (TFWG IPT) for incorporation into deployment medical database, and has been used in radiological exercises. To meet all these requirements, the Armed Forces Radiobiology Research Institute (AFRRI) has prepared a CD-ROM package entitled 'Radiation Biological Dosimetry Tools for Emergency Responders.' This collection includes three subsets of medical assistance tools: 1. Casualty Management Guidance includes the 'Terrorism with Ionizing Radiation Guidance Pocket Guide' and the 'Medical Management of Radiological Casualties Handbook,' both of which were previously available in hard copy and can now be downloaded as PDF (portable document format) files from the CD-ROM. 2. Medical Data Forms include AFRRI adaptations and expansions of previous military forms to include applicability to civilians and youth. The 'AFRRI Adult/Pediatric Field Medical Record' was adapted from the U.S. Army's Field Medical Card."
Armed Forces Radiobiology Research Institute (U.S.)
Jackson, W. E.; Salter, C. A.; Levine, I. H.
2005
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Combined Injury: Radiation in Combination with Trauma, Infectious Disease, or Chemical Exposures
"In an accident, a terrorist attack, or an act of war, radiation exposures are likely to be confounded by other injuries, diseases, and toxic chemicals. In this chapter we will review the current status of the research on combined injuries. Although the term 'combined injury' has often been used strictly to refer to radiation in combination with traumatic injuries, we will use it to encompass any combined exposure: radiation with a burn, wound, infection, or chemical contact. Past experiences have shown us that with a nuclear detonation traumatic injuries such as burns and wounds will occur in combination with radiation exposure. Disruption of the public health infrastructure with a nuclear or radiological attack can increase the risk of communicable disease. The source of infection could be endemic opportunistic pathogens or an intentionally dispersed biological warfare agent. Chemical releases from local industrial or storage facilities or by chemical weapons can also complicate radiation injury in an actual event. Trauma, pathogens, and chemicals will all exacerbate the biomedical consequences of irradiation. To be fully prepared for a nuclear or radiological event, it will be important to understand the potential interactions, medical consequences, and treatment options when combined effects are encountered."
Armed Forces Radiobiology Research Institute (U.S.)
Ledney, G. D.; Pellmar, T. C. (Terry C.)
2005
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Medical Management of Radiological Casualties Handbook: Second Edition
This handbook provides concise supplemental reading material for the Medical Effects of Ionizing Radiation Course, which is presented by the Armed Forces
Radiobiology Research Institute several times each year and is the only graduate-level course in the Department of Defense for training health care professionals in the management of uncontrolled ionizing radiation exposure.
Armed Forces Radiobiology Research Institute (U.S.). Military Medical Operations Office
2003-04
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Anthrax of the Gastrointestinal Tract
"When swallowed, anthrax spores may cause lesions from the oral cavity to the cecum. Gastrointestinal anthrax is greatly underreported in rural disease-endemic areas of the world. The apparent paucity of this form of anthrax reflects the lack of facilities able to make the diagnosis in these areas. The spectrum of disease, ranging from subclinical infection to death, has not been fully recognized. In some communitybased studies, cases of gastrointestinal anthrax outnumbered those of cutaneous anthrax. The oropharyngeal variant, in particular, is unfamiliar to most physicians. The clinical features of oropharyngeal anthrax include fever and toxemia, inflammatory lesion(s) in the oral cavity or oropharynx, enlargement of cervical lymph nodes associated with edema of the soft tissue of the cervical area, and a high case-fatality rate. Awareness of gastrointestinal anthrax in a differential diagnosis remains important in anthrax-endemic areas but now also in settings of possible bioterrorism."
Armed Forces Radiobiology Research Institute (U.S.). Military Medical Operations Office
Sirisanthana, Thira; Brown, Arthur E., 1945-
2002-07
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Medical Management of Radiological Casualties: Fourth Edition - July 2013
"This handbook addresses medical management of casualties in the first 72 hours of a radiation event. The most important consideration in the medical evaluation of a radiation event is the relative magnitude of the situation and the resources needed to address the emergency. In many cases, order of magnitude estimates of the scale of the event will be sufficient for emergency response. 'Small-scale' events are those occurring in laboratories, hospitals, etc., involving small amounts of radionuclides with the potential exposure and/or contamination of one or a few individuals. 'Large-scale' events are those involving relatively large quantities of radionuclides and the potential exposure or contamination of large numbers of people, e.g., terrorist attacks with radiological weapons, nuclear weapons detonation, and large-scale nuclear power plant disasters. High-level external ionizing radiation poses the greatest danger to living organisms. Low levels of internal or external contamination generally pose very low risk. A site known to be radiologically contaminated should be surveyed before entering, and responders should be advised to limit their time in high dose-rate areas. There is generally no hazard associated with handling a radiologically contaminated casualty. See the 'Decontamination' tab."
Armed Forces Radiobiology Research Institute (U.S.). Military Medical Operations Office
2013-07
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Radiation Dose Assessments for Fleet-Based Individuals in Operation Tomodachi, Revision 1
"This report provides the radiation dose assessments for the Department of Defense fleet-based population of interest that was potentially exposed to radioactive fallout resulting from the Fukushima Daiichi nuclear power station units' radiological releases that followed the earthquake and tsunami on March 11, 2011. The associated Department of Defense disaster relief operation to the citizens of Japan was entitled, 'Operation Tomodachi.' Finalized radiation dose assessments for the population of interest have been loaded into an Operation Tomodachi Registry, which will support public inquiries."
United States. Defense Threat Reduction Agency; Armed Forces Radiobiology Research Institute (U.S.)
Marro, Ralph; McKenzie-Carter, Michael; Rademacher, Steven . . .
2014-04
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