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Biodosimetry
Effective medical management for suspected radiation overexposure necessitates the
recording of dynamic medical data and the measurement of level of injury using
appropriate radiation bioassays. Biodosimetric assays can provide diagnostic information
to the attending physician, as well as an estimate of the dose for personnel radiation
protection records. Radiation biodosimetry usually encompasses multiple parameters,
including the following:
• Radioactivity measurements and monitoring of the exposed individual.
• Observation and recording of prodromal signs/symptoms and erythema.
• Complete blood counts with WBC differential.
• Chromosome-aberration cytogenetic bioassay, using the “gold standard” dicentric
assay for dose assessment.
• Bioassay sampling (if appropriate) to determine radioactivity contamination.
• Other available approaches.
The biological response to an absorbed dose of ionizing radiation should be assessed to
predict the medical consequences. Physical dosimeters (e.g., film badges) may
misrepresent the actual radiation dose and may not be available in a radiological accident
or terrorism incident. Multiparameter dose assessments represent the current approach on
which to base medical treatment and management decisions. Radiation syndromes are
generally characterized into three phases: prodromal, manifest, and latent. The early or
prodromal signs and symptoms will be emphasized later in this chapter.
Medical recording. Radiation-induced signs, symptoms, and erythema should be
recorded during the course of medical management for radiation casualties to help triage
patients and to guide medical management of casualties. Default standard mechanisms
and procedures include recording of medical data by the respective medical responders
and health care providers.
Additional medical guidance available to first responders and health care providers
includes the following:
• International Atomic Energy Agency’s (IAEA) Generic Procedures for Medical
Response during Nuclear and Radiological Emergency (http://wwwpub.iaea.org/MTCD/publications/PDF/EPR-MEDICAL-2005_web.pdf).
• Armed Forces Radiobiology Research Institute’s (AFRRI) radiation casualty
management software application (i.e., Biodosimetry Assessment Tool or BAT),
which was developed for radiation casualty management. It is distributed to
authorized users who have access to the AFRRI Web site.
The BAT software application equips health care providers with diagnostic information
(e.g., clinical signs and symptoms, physical dosimetry, etc.) relevant to the management
of radiation casualties. Designed primarily for prompt use after a radiation incident, the
program facilitates the collection, integration, and archiving of data obtained from
exposed individuals. Data collected in templates are compared with established radiation
dose responses obtained from the literature to provide multiparameter dose assessments.
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