Population Monitoring
Summary Information
- Persons potentially or actually exposed to radiation during an emergency event should be registered for long-term monitoring and tracking.
- Individuals to be tracked include
- Actual victims documented to have been exposed or contaminated
- Individuals who think they may have been exposed or contaminated
- All responders
- Tracking and surveillance guidelines are directed
by
- Isotopes responsible for the contamination
- Exposure dose received by each victim
- Host factors that may modify expected outcomes
- Individuals to be tracked should be entered into the global database generated for each event.
- Tracking and surveillance may be required for many years, as radiation late effects may not appear for decades.
- Even those who survive Acute Radiation Syndrome effects may be at risk for delayed effects of acute radiation exposure.
- Within HHS, CDC has been given the responsibility for population monitoring after a mass casualty event.
- Population Monitoring in Radiation Emergencies: A Guide for State and Local Public Health Planners (PDF - 3.60 MB) (Predecisional Draft, HHS/CDC/NCEH/Radiation Studies Branch, August 2007)
What's in this document?
- Introduction
- Scope
- States with Operating Nuclear Power Plants
- Guiding Principles
- What is Population Monitoring?
- What Radiation Incidents Should be Addressed in Your Emergency Plan?
- What Are The Roles and Responsibilities of Federal, State, and Local Public Health Agencies?
- What Are Key Considerations in Planning for Population Monitoring?
- The Objectives of Population Monitoring
- Identifying and Prioritizing Affected Population
- Population Monitoring (the Initial Hours)
- Contamination Screening Criteria
- Radiation Survey Methodology
- Clothing Services
- Transporation Services
- Washing Facilities
- Registry
- Collection of Biological Samples
- Worker Protection
- Population Monitoring (Day 2 and Beyond)
- Setting up Community Reception Centers
- Practical Considerations for Reception Centers Operations
- Pets
- Scaling for Size of Incident
- Monitoring for External Contamination and Conducting Decontamination
- Monitoring for Internal Contamination and Conducting Decontamination
- Laboratory Capabilities/Biodosimetry
- Psychosocial Issues
- Registry
- Dose Reconstruction
- Training
- Communications
This planners' guide is specifically intended for public health and emergency preparedness personnel involed in planning for response to a radiation emergency.
The following two assumptions are made:
- The incident does not involve biological or chemical agents. In such a case, radiation issues may be overshadowed by more immediate health concerns related to those chemical or biological agents.
- The local response infrastructure is relatively intact.
This document does not address environmental monitoring, assessment, or remediation.
- CDC's Roles in the Event of a Nuclear or Radiological Terrorist Attack (HHS/CDC, May 2006)
- Population Monitoring After a Release of Radioactive Material (HHS/CDC, May 2006)
- Population Monitoring After a Release of Radioactive Material (PDF - 79 KB) (HHS/CDC, January 2005)
- Roundtable on Population Monitoring Following a Nuclear/Radiological Incident (PDF - 334 KB) (HHS/CDC, January 2005)
- Prototype for basic tracking information to be collected from each individual (responder, victim, citizen) associated with a radiological/nuclear event (PDF - 31 KB) (HHS/CDC)
- Simon SL, Bailiff I, Bouville A, Fattibene P, Kleinerman RA, Lloyd DC, McKeever SWS, Romanyukha A, Sevan'kaev AV, Tucker JD, Wieser A. BiodosEPR-2006 consensus committee report on biodosimetric methods to evaluate radiation doses at long times after exposure. Radiation Measurements. 2007 Jul;42(6):948-71.
- Radiation Epidemiology Course, May 2007 (HHS/National Cancer Institute/Division of Cancer Epidemiology and Genetics)
- Radiation Health Effects (Radiation Effects Research Foundation, 2007)
- Radiation Dosimetry Monograph: "Applications of Dosimetry in Radiation Epidemiology" (Radiation Research, July 2006, Volume 166, Number 1. Special Supplement) (HHS/National Cancer Institute/Division of Cancer Epidemiology and Genetics)
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Estimate of Lifetime Excess Risk of Fatal Cancer Due to Short-term Radiation
Short-term Whole-body Dose
[rad (Gy)] |
Excess Lifetime Risk of Fatal Cancer due to Short-term
Radiation Exposure (%) |
|---|
| 10 (0.1) |
0.8 |
| 100 (1) |
8 |
| 200 (2) |
16 |
| 300 (3) |
24 |
| 600 (6) |
>40 |
| 1,000 (10) |
>50 |
a Short-term refers to the radiation exposure during the initial response to the incident.
b Lifetime risk to fatal cancer without radiation exposure is approximately 24%.
Most cancers are not likely to occur until several decades after exposure; although leukemia has a shorter latency period (>5 y).
c Applies to those individuals that survive the acute radiation syndrome.
Adapted from
Key Elements of Preparing Emergency Responders for Nuclear and Radiological Terrorism (NCRP Commentary No. 19, December 2005, purchase required; see Free Overview (PDF - 219 KB), page 29)
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BEIR VII: Health Risks from Exposure to Low Levels of Ionizing Radiation
Estimated Risk of Cancer in 100 People from a Single Exposure of 100 mSv of Radiation
In a lifetime, approximately 42 (solid circles) of 100 people will be diagnosed with cancer from causes unrelated to radiation. The calculations in this report suggest approximately one cancer (star) in 100 people could result from a single exposure 100 mSv of low linear energey transfer (low-LET) radiation.
Adapted from BEIR VII: Health Risks from Exposure to Low Levels of Ionizing Radiation, (PDF - 166 KB) The National Academies, 2005
BEIR VII's Best Estimates of the Lifetime Attributable Risk (LAR) of Incidence and Mortality for All Solid Cancer and Leukemia per 100,000 Persons Exposed to 100 mSv
| |
All solid cancer |
Leukemia |
|---|
Excess cases (including non-fatal cases) from exposure to 100 mSv |
Males | Females |
Males | Females |
800
(400-1600) | 1300
(690-2500) |
100
(30-300) | 79
(20-250) |
| Number of cases in the absence of exposure |
45,500 | 36,900 |
830 | 590 |
| Excess deaths from exposure to 100 mSv |
410
(200-830) | 610
(300-1200) |
70
(20-220) | 50
(10-190) |
| Number of deaths in the absence of exposure |
22,100 | 17,500 |
710 | 530 |
- The Table shows the estimated number of cancer cases and deaths expected to result in 100,000 persons (with an age distribution similar to that of the entire U.S. population) exposed to 100 mSv.
- The estimates are accompanied by 95% subjective confidence intervals shown in parentheses that reflect the most important uncertainty sources including statistical variation, uncertainty in adjusting risk for exposure at low doses and dose rates, and uncertainty in the method of transporting data from a Japanese to a U.S. population.
- For comparison, the number of expected cases and deaths in the absence of exposure is listed.
Adapted from BEIR VII: Health Risks from Exposure to Low Levels of Ionizing Radiation, (PDF - 166 KB) The National Academies, 2005
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Monitoring Recommendations for Specific Organs
(To be included in Version 2 of REMM)
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Monitoring Recommendations by Isotope
(To be included in Version 2 of REMM)
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Monitoring Recommendations for Whole Body Exposure
(To be included in Version 2 of REMM)
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