Public health aspects of nuclear and radiological incidents.
Public health aspects of nuclear and radiological incidents.
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DOI：
10.5055/ajdm.2014.0170
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发表时间：
2014-01-01
影响因子：
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通讯作者：
Gill, Kimberly B
中科院分区：
文献类型：
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作者：
Katz, Seth K;Parrillo, Steven J;Gill, Kimberly B
辐射和核事故是低概率但风险很高的事件。可以采取措施，并已采取措施，限制或防止对公众的影响。然而，做好准备仍然是最大限度地减少发病率和死亡率的关键。事故可能与介入放射学或核医学中医院的辐射管理不当、工业或核电厂事故有关。本集团已采取安全及保安措施，以防止或减轻该等事件。尽管已作出努力加以防止，但也可能发生恐怖分子使用放射性散布装置等手段制造的事件。由于对这一领域的事情存在误解或缺乏正规教育，人们可能对辐射相关事件感到相当焦虑，甚至恐惧。多项研究评估了医疗保健提供者报告工作的意愿，将辐射列为将最大数量的工人留在家中的危险。即使不构成灾难的事件也会迅速失控，对社区资源造成相当大的需求。我们的社区将在未来面临这些威胁，医生和专职医疗人员有责任接受培训，并准备好照顾受影响的人。准备和应对此类事件所需的资源范围确实很大。它包括第一反应者和医生的协调努力，参与应对此类事件的国家机构的准备工作，以及个别社区的合作和团结。本文回顾了辐射或核事故对受影响人群的短期和长期影响的方法，特别关注医疗和公共卫生问题。报告还总结了我们目前有效应对能力的长处和短处，并提出了改进这些能力的建议。
Radiological and nuclear incidents are low probability but very high risk events. Measures can be, and have been, implemented to limit or prevent the impact on the public. Preparedness, however, remains the key to minimizing morbidity and mortality. Incidents may be related to hospital-based mis-administration of radiation in interventional radiology or nuclear medicine, industrial or nuclear power plant accidents. Safety and security measures are in place to prevent or mitigate such events. Despite efforts to prevent them, terrorist-perpetrated incidents with, for example, a radiological dispersal device (RDD) are also possible. Due to a misunderstanding of, or lack of, formal education regarding things in this realm, there can be considerable anxiety, even fear, about radiation-related incidents. Multiple studies evaluating healthcare provider willingness to report to work rank radiation as the hazard that will keep the largest number of workers at home. Even incidents that do not constitute a disaster can spiral out of control quite rapidly, placing considerable demands on community resources. Our communities will face these threats in the future and it is the responsibility of physicians and allied healthcare personnel to be trained and ready to care for those affected. The scope of resources needed to prepare for and respond to such incidents is indeed vast. It encompasses the coordinated effort of first responders and physicians, the preparedness of national agencies involved in responding to such events, and individual community cooperation and solidarity. This article reviews the approach to the short- and long-term effects of a radiological or nuclear incident on an affected population, with a specific focus on the medical and public health issues. It also summarizes the strengths and weaknesses of our current ability to respond effectively and makes recommendations to improve these capabilities.