The Radiation Emergency Assistance Center/Training Site (REAC/TS) Program

Background: REAC/TS program has been a significant part of DOE's radiation protection effort for almost 40 years. REAC/TS is funded by the DOE Office of Illness and Injury Prevention Programs and NNSA. REAC/TS is an essential component of the DOE Radiological Assistance Program (RAP), which will also supports the Department of Homeland Security in the event of a national radiological/nuclear emergency.

Worker Health and Safety: The safety and health of DOE workers benefit from the services provided by REAC/TS and the collaboration of REAC/TS staff with site medical staff through the Energy Facility Contractors Group (EFCOG).

Specific Areas of Support Include:

	Distribution of pentetate calcium trisodium (Ca-DTPA), pentetate zinc trisodium (Zn-DTPA), and Prussian Blue to co-investigator physicians at DOE sites. Distribution of DTPAs and Prussian Blue based on national need in the event of a radiological event/attack.
	Specialized training for DOE medical/technical staff. Besides on-site REAC/TS courses, instructors can travel to DOE sites to address specific training needs.
	Continuation of safety and efficacy studies on DTPAs and Prussian Blue. Annual reporting of experience and findings to co-investigators and interested parties, including the Food and Drug Administration (FDA).
	Maintenance of the REAC/TS Radiation Accident Registries and incorporation of new data to meet programmatic needs.
	State-of-the art advice and consultation in occupational/radiation medicine for clinical evaluation and treatment of radiation accident victims. Experienced personnel are available on a 24-hour basis to evaluate patients directly or in consultation with their physicians, to provide clinical care management, and medical follow-up.

Accomplishments: The following accomplishments (1976-present) illustrate the REAC/TS mission of assisting DOE sites in the area of occupational medicine, as well as their role in the world-wide emergency response community.

Training: Numbers trained in Oak Ridge: >2000 physicians; >1500 nurses; >1000 health physicists; >1400 other professionals.
- Numerous training activities throughout US for occupational medicine, emergency and other physicians, nurses, lawyers, and health physicists.
- Sponsored 4 major conferences on The Medical Basis for Radiation Accident Preparedness.
Radiation accident/incident assistance: calls for assistance: >2000;
biodosimetry and other dose estimates: >300; patients seen at REAC/TS: >200.
History of drug distribution to sites, etc.:
- Ca-DTPA and Zn-TPA provided to DOE facilities and public physicians for treatment of internal contamination with transuranic radioisotopes (Pu, Am and Cm) since late 70's as Investigational New Drug (IND).
- In 1993, FDA awards REAC/TS an IND for Prussian blue for treatment of cesium contamination given to REAC/TS and distribution to sites begins.
- Use of REAC/TS data by FDA to support national security needs: FDA used data from the REAC/TS DTPA Registry to determine safety and efficacy of DTPAs, allowing the drugs to be moved from IND status to New Drug category (NDA) and wider availability in 2003-4.
- Advised DOE on the use of other drugs for the protection/treatment of radiation injury.
National, international support and exercises:
- REAC/TS staff participates in many national committees and exercises related to emergency response.
- REAC/TS is a World Health Organization (WHO) Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) Center. - REAC/TS staff provides technical assistance and consultation to WHO and the International Atomic Energy Agency in technical and policy areas. Provided advice and consultation on accidents in Chernobyl and other Former Soviet Union, Brazil, Peru, Egypt, and Japan.