Researchers Review Risks Tied to Nuclear Accidents

Review outlines short- and long-term risks of radiation exposure after nuclear reactor accident

THURSDAY, April 21 (HealthDay News) -- In a new article, researchers review the short- and long-term health risks associated with nuclear power plant accidents in light of the recent earthquake in Japan that caused substantial damage to a nuclear plant. The article has been published online April 20 in the New England Journal of Medicine.

In the wake of the 9.0 magnitude earthquake that struck Japan on March 11, John P. Christodouleas, M.D., M.P.H., of the University of Pennsylvania in Philadelphia, and colleagues analyzed the mechanisms and major short- and long-term health risks of radiation exposure to put the emergency at the Japan plant into the context of the extensive literature on nuclear reactor accidents. The investigators briefly discuss the accidents at Three Mile Island in Pennsylvania in 1979 and Chernobyl in the Ukraine in 1986.

The investigators review the clinical consequences of radiation exposure, including DNA damage and short-term and long-term effects on all organ systems as well as radiation-induced sickness. Radiation-induced sickness can be categorized into three phases: prodrome, latency, and illness, with treatment based on the estimated dose of radiation exposure. Among those exposed to modest whole-body radiation doses of 2 Gys, symptomatic control of nausea and vomiting should be the focus, the authors write. However, among those exposed to more than 2 Gys of radiation, treating the consequences of bone marrow depletion should be the key focus, including managing infections, using hematopoietic growth factors, and considering bone marrow transplantation. The investigators also discuss how radiation exposure may be associated with increased long-term cancer risks.

"Because nuclear-reactor accidents are very rare events, few medical practitioners have direct experience in treating patients who have been exposed to radiation or in the overall public health response," the authors write. "A critical component of the response, with respect to both treatment of individual patients and interaction with the community, is clear communication about exposure levels and corresponding risk, with an eye toward widespread public apprehension about acute radiation sickness and long-term cancer risks."

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