Long-Term Health Monitoring of
Populations Following a
Nuclear or Radiological Incident
in the United States
PROCEEDINGS OF A WORKSHOP
Ourania Kosti, Rapporteur
Nuclear and Radiation Studies Board
Division on Earth and Life Studies
THE NATIONAL ACADEMIES PRESS
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This activity was supported by Award No. 200-2011-338807/75D30118F00072 with the Department of Health and Human Services’ Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-49263-8
International Standard Book Number-10: 0-309-49263-7
Digital Object Identifier: https://doi.org/10.17226/25443
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Copyright 2019 by the National Academy of Sciences. All rights reserved.
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. Long-Term Health Monitoring of Populations Following a Nuclear or Radiological Incident in the United States: Proceedings of a Workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25443.
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WORKSHOP PLANNING COMMITTEE1
JONATHAN E. FIELDING, Chair, University of California, Los Angeles, Fielding School of Public Health
BETSY T. KAGEY, Georgia Department of Public Health, Atlanta, Georgia (retired)
MEGHAN MCGINTY, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
STEPHEN MUSOLINO, Brookhaven National Laboratory, Upton, New York
BROOKE ROGERS, King’s College London, United Kingdom
LORNA THORPE, New York University Langone Heath, New York, New York
TENER VEENEMA, Johns Hopkins University School of Nursing, Baltimore, Maryland
OURANIA KOSTI, Study Director
TONI GREENLEAF, Administrative and Financial Associate
DARLENE GROS, Senior Program Assistant
JORGE MENDOZA-TORRES, Senior Research Librarian
1 The National Academies of Sciences, Engineering, and Medicine’s workshop planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
NUCLEAR AND RADIATION STUDIES BOARD
GEORGE APOSTOLAKIS, Chair, Massachusetts Institute of Technology
JAMES A. BRINK, Vice-Chair, Massachusetts General Hospital
SALLY A. AMUNDSON, Columbia University Irving Medical Center
STEVEN M. BECKER, Old Dominion University
AMY J. BERRINGTON DE GONZÁLEZ, National Cancer Institute
PAUL T. DICKMAN, Argonne National Laboratory
TISSA H. ILLANGASEKARE, Colorado School of Mines
BONNIE D. JENKINS, The Brookings Institution
ALLISON M. MACFARLANE, The George Washington University
NANCY JO NICHOLAS, Los Alamos National Laboratory
R. JULIAN PRESTON, Environmental Protection Agency
HENRY D. ROYAL, Washington University School of Medicine
WILLIAM H. TOBEY, Harvard University
SERGEY V. YUDINTSEV, Russian Academy of Sciences
CHARLES D. FERGUSON, Director
JENNIFER HEIMBERG, Senior Program Officer
OURANIA KOSTI, Senior Program Officer
TONI GREENLEAF, Administrative and Financial Associate
LAURA D. LLANOS, Administrative and Financial Associate
DARLENE GROS, Senior Program Assistant
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
C. NORMAN COLEMAN, National Cancer Institute
TED LAZO, Nuclear Energy Agency
ANGELA LEEK, Iowa Department of Public Health
OLEG MURAVOV, Agency for Toxic Substances and Disease Registry
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by PAUL A. LOCKE, Johns Hopkins Bloomberg School of Public Health. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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1.3 Background Information and Context
1.3.1 Radiation Health Effects
1.3.2 Impacts of Nuclear and Radiological Incidents
1.3.3 Radiation Dose Reconstruction
2 PLANNING FOR A RADIATION REGISTRY
2.2 Defining the Purpose of a Registry
2.3 Agreeing on Roles and Responsibilities
2.4 Linking Immediate Response to Long-Term Follow-Up
2.4.1 Capturing Basic Information Early
2.4.2 Screening for Radiation Contamination and Assessing Exposure
2.5 Implementing Radiation Dose Threshold as a Registry Inclusion Criterion
2.5.2 Practice with Other Registries
2.6.2 Screening for Psychological Effects
2.7 Preparing for Long-Term Communications
2.7.2 During-Event Communication
2.7.3 Communication During Recovery
Acronyms and Abbreviations
|ARS||acute radiation syndrome|
|ASPR||Assistant Secretary for Preparedness and Response|
|ATSDR||Agency for Toxic Substances and Disease Registry|
|CDC||Centers for Disease Control and Prevention|
|CRC||Community Reception Center|
|DHS||Department of Homeland Security|
|EPA||Environmental Protection Agency|
|ESF||Emergency Support Function|
|FEMA||Federal Emergency Management Agency|
|GSR||General Safety Requirements|
|HHS||Department of Health and Human Services|
|HIPAA||Health Insurance Portability and Accountability Act|
|IAEA||International Atomic Energy Agency|
|IARC||International Agency for Research on Cancer|
|IND||improvised nuclear device|
|LSS||Life Span Study|
|NACCHO||National Association of County & City Health Officials|
|NCRP||National Council on Radiation Protection and Measurements|
|RABiT||Rapid Automated Biodosimetry Tool|
|RDD||radiological dispersal device|
|REAC/TS||Radiation Emergency Assistance Center/Training Site|
|RERF||Radiation Effects Research Foundation|
|RITN||Radiation Injury Treatment Network|
|TMT||Triage Monitoring and Treatment|
|WHO||World Health Organization|