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Advanced
Training Course on Radiation Emergency Medical Preparedness and
Assistance |
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| Theodor M.
Fliedner (Director)
Radiation Medicine Research Group and WHO Collaborating Center for Radiation Accident Management, ICAS-Secretariat
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The newly
established International Center for Advanced Studies in
Health Sciences and Services at the University of Ulm is
preparing for 2003 or 2004 (depending on financial support from
the European Commission) an Advanced Training Course
focusing on Novel Medical Approaches in Radiation Accident
Management.
This course is prompted by the observation that larger or
smaller radiation accidents are likely any time and anywhere in
Europe. Particularly, the enlargement of the European
Communities and the fact of open borders with unlimited
desirable and undesirable movements of people increases the
probability of radiation accidents in the European region. They
may be caused (increasingly observed) by radiation sources that
are unrecognised when they are found in metal scrap places or
used in criminal actions. Of course not only the built-up of
nuclear facilities but also their maintenance as well as their
removal carry a definite risk of radiation emergencies with
potential health consequences.
It is also recognised that the medical profession across Europe
is usually not updated in the recent approaches that have been
developed to recognise, to diagnose and to treat radiation
medical emergencies. Therefore, this course is specifically
designed for medical doctors who carry responsibility in the
area of radiation emergency planning and response action or who
might become engaged in the medical handling of radiation
accident victims. The present worldwide radiation emergency
experience will be reviewed, the most recent diagnostic
approaches discussed as well as therapeutic options outlined.
Practical laboratory exercises will be performed to provide
participants with up-to-date techniques. It can be anticipated
that the participation in the course will be recognised by a
certificate of the European Accreditation Council for Continuing
Medical Education (EACCME).
Session I of this course is directed to an overview on radiation
accident developments in the last 20-25 years. An update
will be made as to the "classical" acute
radiation syndrome. Thereafter, radiation accident experience
will be presented and discussed after chronic or protracted
radiation exposure. On this basis a large segment will be
devoted to predominantly skin exposure as well as exposure by
radionuclide contamination or incorporation.
Session II will deal with the medical management of radiation
emergencies. This includes organisational and institutional
prerequisites and the available international as well as
national networks for help in case of radiation emergencies.
Most of the European countries do have such national networks.
It will be of interest to compare the potentialities of these
networks to deal with recent development in radiation accident
management. Also the potentialities of worldwide networks, such
as established by the World Health Organization, will be
discussed.
In Session III the pathophysiology of the response of the
organism in case of acute, protracted or chronic radiation
exposure will be discussed and updated. The haematopoietic
system, the skin, the gastrointestinal tract as well as the
neurovascular system are the most critical organs in dealing
with accidentally radiation-exposed persons.
Session IV will discuss the most recent diagnostic approaches
to radiation emergencies. It is pointed out that a
west-European consortium supported by the European Communities
developed the "METREPOL" approach (Medical Treatment
Protocols for Radiation Accident Victims as a Basis for a
Computerised Guidance System). On this basis, a grading code for
the severity of damage of the organism was developed on the
basis of indicators of radiation exposure, effects and repair.
Also the response of the blood cell forming tissues will be
discussed to assess the severity of effect. Furthermore, the
role of cytogenetic indicators will be demonstrated and
discussed in depth.
Session V will deal with therapeutic options for the acute
radiation syndrome, for the chronic radiation syndrome, for skin
lesions, for options in radionuclide contamination and for
treatment options after incorporation of radionuclides.
In Session VI there will be practical exercises in order to
understand what indicators are available to determine radiation
exposure at the molecular level, the cellular level, the
cell system level and the organ system level. In this context,
use will be made of the SEARCH database (System for Evaluation
and Archiving of Radiation Accidents based on Case Histories).
This is a database containing more than 800 case histories of
radiation accidents since 1945. The use of this database will
provide valuable information for teaching purposes as well as
for comparing new radiation accident case developments with
historical ones. In the practical exercises, decontamination and
decorporation approaches will be reviewed.
It is hoped that the European Late Effects Project Group will
support such a course and will particularly support its funding
by the European Communities.
For
further Information
Prof. Dr. Theodor M. Fliedner
Director, Radiation Medicine Research Group and WHO
Collaborating Center for Radiation Accident Management
ICAS-Secretariat
University of Ulm
Helmholtzstrasse 20
D-89081 Ulm
GERMANY
Phone: +49-731-500-22900/-22901
Fax: +49-731-500-22902
e-mail: theodor.fliedner@medizin.uni-ulm.de