NACCT Platform Abstracts 2012 - The American Academy of Clinical ...

236
Surveillance for Radiation Exposures Using the National Poison Data System
Arthur Chang 1 , Royal Law 1 , Colleen Martin 1 , Alvin Bronstein 2 , Kendra Grande 3 , Karen Simone 4 , Martin Caravati 5 , Joshua
Schier 1
1 Centers for Disease Control and Prevention, Atlanta GA USA
2 Rocky Mountain Poison and Drug Center, Denver CO USA
3 Thomson Reuters, Denver CO USA
4 Northern New England Poison Center, Portland ME USA
5 Utah Poison Control Center, Salt Lake City UT USA
Background: Since 2010, the Centers for Disease Control and Prevention (CDC) and the American Association of Poison
Control Centers (AAPCC) have conducted surveillance for exposures to radiation and radioactive materials reported from all
57 US Poison Centers (PCs) using the National Poison Data System (NPDS). CDC, AAPCC and Poisindex® Thomson
Reuters, recently implemented improvements to the NPDS radiation coding structure to enhance its utility for public health
surveillance. Our objective is to describe results from this surveillance and associated radiation incidents during a one-year
period.
Methods: We analyzed all PC calls from September 1, 2010 to September 1, 2011 that met our case definition: human
exposure calls with any of the following NPDS codes: “miscellaneous non-radiopharmaceutical isotopes”, “miscellaneous
radiopharmaceuticals”, or “ionizing radiation”. Exclusion criteria were: exposure calls about substances such as “radon”,
“radon gas”, “non-ionizing radiation”, “smoke detectors” or calls with outcomes of “confirmed non-exposure” or “adverse
reaction”. Using NPDS data, CDC staff reviewed each call meeting this definition. CDC and AAPCC staff also contacted the
regional PC to obtain further information and confirm exposures. When multiple reported exposures clustered in space and
time were detected, news stories in the public media were also monitored for associated radiation incidents.
Results: During the study period, a total of 186 calls met the case definition. 51 of these were associated with 3 radiological
incidents reported in the public media and one anti-terrorism exercise. The incidents included a radiation exposure from
industrial radiography which led to the temporary closure of a hospital (n=4; 8%), a transportation accident involving potential
radioactive contamination to several medical personnel (n=11; 22%), the Fukushima Daiichi Japan nuclear reactor disaster
(n=10; 20%) and a regional radiation anti-terrorism exercise involving a cesium radiological dispersal device (n=26; 50%).
The remaining 135 calls were single person exposures and were not followed by the regional PC.
Conclusion: During a one-year period, our case definition detected 51 calls associated with four radiation incidents. These
incidents were of potential public health significance because they involved multiple persons and had the potential to cause
widespread public concern. Similar surveillance strategies for detecting and tracking future radiological incidents using NPDS
may be helpful to regional PCs and their public health partners.