Radiological/Nuclear Incident Response
For more than 25 years, the Oak Ridge Institute for Science and Education (ORISE) has provided the U.S. Department of Energy (DOE) with a comprehensive capability to respond effectively to medical emergencies involving radiological or nuclear materials.
An Emergency Response Asset
ORISE's Radiation Emergency Assistance Center/Training Site (REAC/TS) is a deployable DOE National Nuclear Security Agency (NNSA) asset, on call 24/7 to offer its expertise on managing the medical component of a radiation incident.
Additionally:
- REAC/TS is identified in Section 501 of the Homeland Security Act of 2002 as a response organization and member of DOE's Nuclear Incident Response Team.
- REAC/TS is identified in DOE Order 5530 as the organization that provides medical assistance to DOE's Accident Response Group and the Federal Radiological Monitoring and Assessment Center (FRMAC).
Personnel
REAC/TS has developed an interdisciplinary radiation emergency medical response approach that integrates medicine with health physics. This enables rapid dose assessment, radiological and medical triage, diagnosis, and medical management during a radiation emergency.
REAC/TS maintains specialized response teams to ensure our readiness to respond. Each team consists of a physician, nurse/paramedic, and a health physicist—all cross-trained in the details of managing a radiation emergency.
Our response teams are equipped with state-of-the-art medical equipment that can be transported to a site or used in our unique facility in Oak Ridge, Tenn., located adjacent to the Methodist Medical Center. The staff are equipped to perform at REAC/TS:
- medical and radiological triage
- decontamination
- diethylenetriaminepentaacetic acid (DTPA) and Prussian Blue therapy for specific radiological materials
- diagnostic and prognostic assessments of radiation-induced injuries
- biological and radiological dose estimates by methods that include cytogenetic analysis, bioassay, and in vivo counting.
A cytogenetics biodosimetry laboratory as well as several health physics laboratories are also located on the ORISE campus. Cytogenetics biodosimetry can be used for determining the radiation doses to victims.
A World Health Organization Collaborating Center
To offer a comprehensive response capability, REAC/TS also maintains collaborative working relationships with national and international radiological emergency response professionals. Specifically, REAC/TS works closely with the International Atomic Energy Agency (IAEA) as well as the World Health Organization (WHO).
REAC/TS was designated a WHO Collaborating Center for Radiation Emergency Assistance in 1980. REAC/TS responds to international incidents as part of WHO's Radiation Emergency Medical Planning & Assistance Network (REMPAN).
In this role, we hold several responsibilities that further enhance our expertise:
- Provides direct or consultative services to foreign governments at the request of WHO and the International Atomic Energy Agency in the event of an actual radiation incident
- Serves as a focal point for advice and possible medical care in cases of human radiation exposure
- Facilitates the establishment of a network of available equipment and staff specializing in human radiopathology
- Assists in the development of medical emergency plans to address large-scale radiation incidents
- Develops and carries out coordinated studies on human radiopathology and appropriate epidemiologic studies
- Assists in the preparation of relevant documents and guidelines
Radiation Accident Registries
REAC/TS maintains a Radiation Accident Registry System that consists of the following components:
- the U.S. Radiation Accident Registry
- the Diethylenetriaminepentaacetic Acid (DTPA) User Registry
- the Prussian Blue Registry
- a Foreign Accident Registry
Data from the registry system is used:
- to determine the efficacy of treatment protocols
- to monitor trends in morbidity and mortality
- as a database for follow-up of accident survivors.
National Exercises
As a deployable DOE response asset, REAC/TS participates in all national exercises where the simulated terrorist attack involves a radiological weapon of mass destruction. REAC/TS staff provide the expertise on the medical management of the victims.
Example exercises include:
- TOPOFF IV (2006)
- Diligent Warrior (2004)
- TOPOFF II (2003)
- Savannah River Injection Pathway (2002)
Response Examples
As an international expert in managing radiation accidents, REAC/TS has been called to respond to the following accidents:
- diagnostic evaluation of 10 persons following rupture of an iridium-192 source in Venezuela
- onsite health physics assistance following leakage of a radium-226 implant source at a hospital in Kingston, Jamaica
- assistance to the Government of Mexico through medical consultations, cytogenetic dosimetry, and accident follow-up after a cobalt-60 therapy unit accident in Cuidad Juarez, Mexico
- medical consultation, radiological monitoring, cytogenetic dosimetry, and assistance in establishing patient follow-up in the cesium-137 accident in Goiânia, Brazil.
- medical consultation and assistance following a serious injury from an iridium-192 industrial radiography source in Peru
- medical and health physics consultation following a criticality event in Japan
REAC/TS was also immediately deployed following the Sept. 11, 2001, terrorist attacks on the United States as part of DOE's Consequence Management Response Team. The team stood ready to respond in the event that additional terrorist acts immediately following Sept. 11 involved nuclear materials.
