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The human casualties from simulated nuclear detonation scenarios in New Delhi, India are analyzed, with a focus on the distribution of casualties in urban environments and the theoretical application of a nuclear-specific triage system with significant innovation in interdisciplinary disaster management applicable generally to urban nuclear detonation medical response. Model estimates of nuclear war casualties employed ESRI’s ArcGIS 9.3, blast and prompt radiation were calculated using the Defense Nuclear Agency’s WE program, and fallout radiation was calculated using the Defense Threat Reduction Agency’s (DTRA’s) Hazard Prediction and Assessment Capability (HPAC) V404SP4, as well as custom GIS and database software applications. ESRI ArcGISTM programs were used to calculate affected populations from the Oak Ridge National Laboratory’s LandScanTM 2007 Global Population Dataset for areas affected by thermal, blast and radiation data. Trauma, thermal burn, and radiation casualties were thus estimated on a geographic basis for New Delhi, India for single and multiple (six) 25 kt detonations and a single 1 mt (1000 kt) detonation. Major issues related to the emergency management of a nuclear incident are discussed with specific recommendations for improvement. The consequences for health management of thermal burn and radiation patients is the worst, as burn patients require enormous resources to treat, and there will be little to no familiarity with the treatment of radiation victims. Of particular importance is the interdisciplinary cooperation necessary for such a large-scale emergency response event, which would be exemplified by efforts such as the application of a Nuclear Global Health Workforce.

In the U.S., migration has been documented to affect the prevalence of infectious disease. As a mitigation entity, border security has been recorded by numerous scholarly works as being essential to the support of the health of the U.S. population. Consequently, the lack of current health care monitoring of the permeable U.S. border places the U.S. population at risk in the broad sectors of infectious disease and interpersonal violence. Visualizing border security in the context of public health mitigation has significant potential to protect migrant health as well as that of all populations on both sides of the border. Examples of how commonly this philosophy is held can be found in the expansive use of security-focused terms regarding public health. Using tools such as GIS to screen for disease in people before their entrance into a nation would be more efficient and ethical than treating patients once they have entered a population and increased the impact on the healthcare system. (Disaster Med Public Health Preparedness. 2018;12:554–562)

The public perception that there is no hope for surviving a nuclear attack has been an impediment to planning for the aftermath of such disasters. The perception is unjustified, but it shows how im...

This study argues that any nuclear weapon exchange or major nuclear plant meltdown, in the categories of human systems failure and conflict-based crises, will immediately provoke an unprecedented public health emergency of international concern. Notwithstanding nuclear triage and management plans and technical monitoring standards within the International Atomic Energy Agency and the World Health Organization (WHO), the capacity to rapidly deploy a robust professional workforce with the internal coordination and collaboration capabilities required for large-scale nuclear crises is profoundly lacking. A similar dilemma, evident in the early stages of the Ebola epidemic, was eventually managed by using worldwide infectious disease experts from the Global Outbreak Alert and Response Network and multiple multidisciplinary WHO-supported foreign medical teams. This success has led the WHO to propose the development of a Global Health Workforce. A strategic format is proposed for nuclear preparedness and response that builds and expands on the current model for infectious disease outbreak currently under consideration. This study proposes the inclusion of a nuclear global health workforce under the technical expertise of the International Atomic Energy Agency and WHO’s Radiation Emergency Medical Preparedness and Assistance Network leadership and supported by the International Health Regulations Treaty. Rationales are set forth for the development, structure, and function of a nuclear workforce based on health outcomes research that define the unique health, health systems, and public health challenges of a nuclear crisis. Recent research supports that life-saving opportunities are possible, but only if a rapidly deployed and robust multidisciplinary response component exists. (Disaster Med Public Health Preparedness. 2016;10:129–144)

Background Instability in the global geopolitical climate and the continuing spread of nuclear weapons and increase in their lethality has made the exchange of nuclear weapons or a terrorist attack upon a nuclear power plant a serious issue that demands appropriate planning for response. In response to this threat, the development of a nuclear global health workforce under the technical expertise of the International Atomic Energy Agency and the World Health Organization Radiation Emergency Medical Preparedness and Assistance Network has been proposed. Main body of the abstract As the largest component of the global healthcare workforce, nurses will play a critical role in both the leadership and health care effectiveness of a response to any public health emergency of international concern (PHEIC) resulting from the unprecedented numbers of trauma, thermal burn, and radiation affected patients that will require extensive involvement of the nursing professional community. Short conclusion Lives can and will be saved if nurses are present. The clinical care of radiation contaminated patients (e.g. radiation burns, fluid management, infection control), thermal burn patients, and other health system response activities such as community screening for radiation exposure, triage, decontamination, administration of medical countermeasures and the provision of supportive emotional and mental health care will be overwhelmingly nurse intensive.

On January 13, 2018, Hawaii experienced an erroneous alert that falsely warned of an imminent ballistic missile strike. Rather than focus on the inconvenience caused by the false alert, we used reporting of the event to identify the missing elements that would characterize a system that could save lives by alerting and informing the public in a nuclear detonation. These include warnings that contain essential information rather than directing recipients to secondary sources; a system that issues alerts directly from federal agencies that will have the earliest warning; a robust multimodal alerting system that can deliver messages before and after the detonation; and swift activation of federal agencies immediately upon warning.

Major challenges and crises in global health will not be solved by health alone; requiring rather a multidisciplinary, evidence-based analytical approach to prevention, preparedness and response. One such potential crisis is the continued spread of nuclear weapons to more nations concurrent with the increased volatility of international relations that has significantly escalated the risk of a major nuclear weapon exchange. This study argues for the development of a multidisciplinary global health response agenda based on the reality of the current political analysis of nuclear risk, research evidence suggesting higher-than-expected survivability risk, and the potential for improved health outcomes based on medical advances. To date, the medical consequences of such an exchange are not credibly addressed by any nation at this time, despite recent advances. While no one country could mount such a response, an international body of responders organized in the same fashion as the current World Health Organization’s global health workforce initiative for large-scale natural and public health emergencies could enlist and train for just such an emergency. A Nuclear Global Health Workforce is described for addressing the unprecedented medical and public health needs to be expected in the event of a nuclear conflict or catastrophic accident. The example of addressing mass casualty nuclear thermal burns outlines the potential triage and clinical response management of survivors enabled by this global approach.

Objective: A predictive system was developed and tested in a series of exercises with the objective of evaluating the preparedness and effectiveness of the multiagency response to food terrorism attacks. Design: A computerized simulation model, Risk Reduction Effectiveness and Capabilities Assessment Program (RRECAP), was developed to identify the key factors that influence the outcomes of an attack and quantify the relative reduction of such outcomes caused by each factor. Setting: The model was evaluated in a set of Tabletop and Full-Scale Exercises that simulate biological and chemical attacks on the food system. Participants: More than 300 participants representing more than 60 federal, state, local, and private sector agencies and organizations. Results: The exercises showed that agencies could use RRECAP to identify and prioritize their advance preparation to mitigate such attacks with minimal expense. RRECAP also demonstrated the relative utility and limitations of the ability of medical resources to treat patients if responders do not recognize and mitigate the attack rapidly, and the exercise results showed that proper advance preparation would reduce these deficiencies. Conclusions: Using computer simulation prediction of the medical outcomes of food supply attacks to identify optimal remediation activities and quantify the benefits of various measures provides a significant tool to agencies in both the public and private sector as they seek to prepare for such an attack.

ObjectiveWe designed and conducted a regional full-scale exercise in 2007 to test the ability of Atlanta-area hospitals and community partners to respond to a terrorist attack involving the coordinated release of 2 dangerous chemicals (toluene diisocyanate and parathion) that were being transported through the area by tanker truck.MethodsThe exercise was designed to facilitate the activation of hospital emergency response plans and to test applicable triage, decontamination, and communications protocols. Plume modeling was conducted by using the Defense Threat Reduction Agency’s (DTRA) Hazard Prediction and Assessment Capability (HPAC) V4 program. The scenario went through multiple iterations as exercise planners sought to reduce total injuries to a manageable, but stressful, level for Atlanta’s health care infrastructure.ResultsAtlanta-area hospitals rapidly performed multiple casualty triage and were able to take in a surge of victims from the simulated attack. However, health care facilities were reticent to push the perceived manageable numbers of victims, and scenarios were modified significantly to lower the magnitude of the simulated attack. Additional coordination with community response partners and incident command training is recommended. Security at health care facilities and decontamination of arriving victims are two areas that will require continued review.ConclusionAtlanta-area hospitals participated in an innovative regional exercise that pushed facilities beyond traditional scopes of practice and brought together numerous health care community response partners. Using lessons learned from this exercise coupled with subsequent real-world events and training exercises, participants have significantly enhanced preparedness levels and increased the metropolitan region’s medical surge capacity in the case of a multiple casualty disaster. (Disaster Med Public Health Preparedness. 2015;9:681–689)

The objective of this investigation was to elucidate the effects of route of exposure and oral dosage regimen on the toxicokinetics (TK) of 1,1-dichloroethylene (DCE). Fasted male Sprague-Dawley rats that inhaled 100 or 300 ppm for 2 h absorbed total systemic doses of (10 or 30 mg/kg DCE, respectively. Other groups of rats received 10 or 30 mg/kg DCE by intravenous injection, bolus gavage (by mouth), or gastric infusion (g.i.) over a 2-h period. Serial microblood samples were taken from the cannulated, unanesthetized animals and analyzed for DCE content by gas chromatography to obtain concentration versus time profiles. Inhalation resulted in substantially higher peak blood concentrations and area under blood-concentration time curves (AUC(0)(2)) than did gastric infusion of the same dose over the same time frame at each dosage level, although inhalation (AUC(0)(infinity)) values were only modestly higher. Urinary N-acetyl-beta-D-glucosaminidase (NAG) and gamma-glutamyltranspeptidase (GGT) activities were monitored as indices of kidney injury in the high-dose groups. NAG and GGT excretion were much more pronounced after inhalation than gastric infusion. Administration of DCE by gavage also produced much higher Cmax and AUC(0)(2) values than did 2-h g.i., although AUC(0)(infinity) values were not very different. The 30 mg/kg bolus dose produced marked elevation in serum sorbitol dehydrogenase, an index of hepatocellular injury. Administration of this dose by inhalation and gastric infusion was only marginally hepatotoxic. These findings demonstrate the TK and target organ toxicity of DCE vary substantially between different exposure routes, as well as dosage regimens, making direct extrapolations untenable in health risk assessments.

Nuclear reactor accidents and the threat of nuclear terrorism have heightened the concern for adverse health risks associated with radiation poisoning. Potassium iodide (KI) is the only pharmaceutical intervention that is currently approved by the Food and Drug Administration for treating (131)I(-) exposure, a common radioactive fission product. Though effective, KI administration needs to occur prior to or as soon as possible (within a few hours) after radioactive exposure to maximize the radioprotective benefits of KI. During the Chernobyl nuclear reactor accident, KI was not administered soon enough after radiation poisoning occurred to thousands of people. The delay in administration of KI resulted in an increased incidence of childhood thyroid cancer. Perchlorate (ClO(4)(-)) was suggested as another pharmaceutical radioprotectant for 131I- poisoning because of its ability to block thyroidal uptake of iodide and discharge free iodide from the thyroid gland. The objective of this study was to compare the ability of KI and ammonium perchlorate to reduce thyroid gland exposure to radioactive iodide (131I-). Rats were dosed with 131I- tracer and 0.5 and 3 h later dosed orally with 30 mg/kg of either ammonium perchlorate or KI. Compared to controls, both anion treatments reduced thyroid gland exposure to 131I- equally, with a reduction ranging from 65 to 77%. Ammonium perchlorate was more effective than stable iodide for whole-body radioprotectant effectiveness. KI-treated animals excreted only 30% of the (131)I(-) in urine after 15 h, compared to 47% in ammonium perchlorate-treated rats. Taken together, data suggest that KI and ammonium perchlorate are both able to reduce thyroid gland exposure to 131I- up to 3 h after exposure to 131I-. Ammonium perchlorate may offer an advantage over KI because of its ability to clear 131I- from the body.

Background: Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Public Health Preparedness and Disaster Response convened an expert working group (EWG) to review extant competencies and achieve consensus on an educational framework and competency set from which educators could devise learning objectives and curricula tailored to fit the needs of all health professionals in a disaster.Methods: The EWG conducted a systematic review of peer-reviewed and non–peer reviewed published literature. In addition, after-action reports from Hurricane Katrina and relevant publications recommended by EWG members and other subject matter experts were reviewed for congruencies and gaps. Consensus was ensured through a 3-stage Delphi process.Results: The EWG process developed a new educational framework for disaster medicine and public health preparedness based on consensus identification of 7 core learning domains, 19 core competencies, and 73 specific competencies targeted at 3 broad health personnel categories.Conclusions: The competencies can be applied to a wide range of health professionals who are expected to perform at different levels (informed worker/student, practitioner, leader) according to experience, professional role, level of education, or job function. Although these competencies strongly reflect lessons learned following the health system response to Hurricane Katrina, it must be understood that preparedness is a process, and that these competencies must be reviewed continually and refined over time. (Disaster Med Public Health Preparedness. 2008;2:57–68)

The summer of 2006 in northern Israel served as the battleground for the second war against Hezbollah based along Israel’s border with southern Lebanon. Western Galilee Hospital (WGH), which is located only 6 miles from the Lebanese border, served as a major medical center in the vicinity of the fighting. The hospital was directly impacted by Hezbollah with a Katyusha rocket, which struck the ophthalmology department on the 4th floor. WGH was able to utilize a 450-bed underground facility that maintained full hospital functionality throughout the conflict. In a major feat of rapid evacuation, the entire hospital population was relocated under the cover of darkness to these bunkers in just over 1 hour, thus emptying the building prior to the missile impact. Over half of the patients presenting during the conflict did not incur physical injury but qualified as acute stress disorder patients. The particulars of this evacuation remain unique owing to the extraordinary circumstances, but many of the principles employed in this maneuver may serve as a template for other hospitals requiring emergency evacuation. Hospital functionality drastically changed to accommodate the operational reality of war, and many of these tactics warrant closer investigation for possible implementation in other conflict zones. (Disaster Med Public Health Preparedness. 2016;10:152–156)

Tritium ((3)H) may enter the environment from human activities, particularly at production, processing, or waste storage sites such as the Department of Energy's Savannah River Site, a former nuclear production facility in South Carolina. Understanding the dynamics and potential adverse effects of tritium in exposed organisms is critical to evaluating risks of tritium releases at such sites. Previous studies estimated the biological half-life of tritium in mice to be approximately 1.13 d; however, these laboratory studies were not conducted under environmentally realistic conditions. In this study, designed to be more representative of environmental exposure, mice were allowed to drink water containing tritium (activity about 300 Bq/ml) for a period of 2 wk. The induction of oxidative stress from tritium exposure was evaluated by comparing the activities of antioxidant enzymes (catalase, glutathione peroxidase, and superoxide dismutase) in exposed and control mice. From this experiment, the biological half-life of tritium was determined to be 2.26 +/- 0.04 d, almost double previous estimates. While positive controls (x-ray irradiated mice) showed responses in antioxidant enzyme activity, there was no indication of oxidative stress induction in mice exposed to tritium at this concentration.

New methods are being employed on the Department of Energy’s Savannah River Site to deal with the disposal of tritium, including the irrigation of a hardwood/pine forest with tritiated water from an intercepted contaminant plume to reduce concentrations of tritium outcropping into Fourmile Branch, a tributary of the Savannah River. The use of this system has proven to be an effective means of tritium disposal. To evaluate the impact of this activity on terrestrial biota, rodent species were captured on the tritium disposal site and a control site during two trapping seasons in order to assess tritium exposure resulting from the forest irrigation. Control site mice had background levels of tritium, 0.02 Bq/mL, with disposal site mice having significantly higher tritium concentrations, meanZ 34.86 Bq/mL. Whole body tritium concentrations of the mice captured at the disposal site were positively correlated with tritium application and negatively correlated with precipitation at the site. 2005 Elsevier Ltd. All rights reserved.

Indicators of oxidative stress response were compared to radionuclide concentrations in rodents from highly contaminated sites around the Chornobyl Nuclear Power Plant, Ukraine, and uncontaminated reference areas. Three rodent species-Apodemus agrarius, Apodemus sylvaticus, and Clethrionomys glareolus (n = 121)-were collected from contaminated sites within the 10-km exclusion zone surrounding the Chornobyl Nuclear Power Plant and from uncontaminated reference areas in northern Ukraine. Liver samples were analyzed for superoxide dismutase (SOD) and catalase (CAT) activities, and muscle samples were analyzed for radiocesium activity. Superoxide dismutase and catalase activities differed significantly between reference and contaminated groups only for A. agrarius, and activities were lower in contaminated animals relative to those from reference sites. The SOD activity did not differ among species collected in reference areas. Among contaminated groups, A. agrarius had a significantly lower SOD activity than the other two species. Among reference groups, CAT activity for C. glareolus was significantly lower than for the other two species. Very high muscle radiocesium activities (up to 60,000 Bq/g) were found in rodents from contaminated areas, while the references for each species were at or below background. Clethrionomys glareolus had significantly higher muscle radiocesium concentrations than the other species collected at contaminated sites. There were no significant correlations between either SOD or CAT activities and muscle radiocesium concentrations for contaminated or reference animals in any species. There are significant interspecies differences in oxidative enzyme activities in rodents with lifetime exposure at highly radioactive contaminated sites. However, internal radiocesium concentration is not a sensitive predictor of these oxidative stress responses in individuals.

Free-ranging mammals near the Chornobyl nuclear reactor are experiencing substantial radiation dose rates from intramuscular concentrations of 134137Cs and skeletal 90Sr. Radiocesium concentrations averaged 3,200 Bq/g of dry muscle, compared to a mean of 297 Bq 90Sr/g in bone for mammals in the Exclusion Zone, a region of restricted human activity surrounding the reactor. Estimates of dose rates from intramuscular sources of radiocesium averaged 2.4 mGy/d within 8 km of the reactor and ranged as high as 60 mGy/d. Overall dose rates from internal 90Sr for mammals in the Exclusion Zone averaged 1.0 mGy/d, although doses to specific tissues are likely much higher. Mammals captured 30 km southeast of the reactor averaged only 2 Bq/g of muscle and were receiving an average of 1.4 μuGy/d from internal radiocesium. Dramatic variation exists in the spatial pattern of radiocesium in areas immediately surrounding the reactor and within and between remediated and unremediated regions. The variance of 90Sr for taxa among sites was significantly less than that for 134137Cs. Thermoluminescent dosimeters placed on free-ranging mice showed that dose rates from external sources of radiation were much greater than the dose rates from internal sources of radiocesium. Estimated dose rates in very small areas of the Chornobyl region exceed those reported to impede reproductive success in mammals.

1,1,1-Trichloroethane (TRI) is a commonly used industrial solvent with a considerable potential for inhalation abuse. Previous studies in our laboratory and elsewhere have shown that this agent exerts a suppressant effect on operant responding, as well as a number of additional neurobehavioral effects that are similar to those of central nervous system (CNS) depressant drugs. In an effort to provide information relevant to potential mechanisms involved in the behavioral effects and abuse potential of TRI, the present study evaluated the acute effects of this agent on the activity of the hypothalamo-pituitary-adrenal (HPA) axis . Male Sprague-Dawley rats were exposed to 3500 or 5000 ppm TRI by inhalation for 10 or 30 min. Following exposure, plasma levels of adrenocorticotropic hormone (ACTH) and corticosterone and levels of ACTH and corticotropin-releasing factor (CRF) in three brain regions--hypothalamus, hippocampus, and frontal cortex--were determined by selective radioimmunoassays. Levels of TRI in the three brain regions as well as blood were measured by headspace gas chromatography to determine the target tissue concentrations responsible for neuroendocrine changes. Uptake of TRI in blood and all brain regions was very rapid, with stable concentrations apparently achieved within 10 min and maintained for 30 min. During this time course, a significant decrease in plasma corticosterone was produced at 30 min but no significant change in plasma ACTH was observed with 3500 ppm TRI. However, after exposure to 5000 ppm, both plasma ACTH and plasma corticosterone were significantly reduced at 10 and 30 min. ACTH levels in the three brain regions were not significantly changed by TRI, while hypothalamic CRF was significantly increased during exposure to 3500 ppm. However, hypothalamic concentrations of CRF declined following 30 min at 3500 ppm and were not significantly changed by 5000 ppm. This complexity of effects on the regulation of HPA axis activity likely precluded the establishment of consistent relationships between changes in hormonal levels and blood or regional brain concentrations of the inhalant. However, these actions of TRI were strikingly similar to those previously reported for the benzodiazepines.

The central nervous system is the principal target of 1,1,1-trichloroethane (TRI), and several studies of this volatile solvent have demonstrated effects on learned animal behaviors. There have been few attempts, however, to quantitatively relate such effects to blood or target organ (brain) solvent concentrations. Therefore, Sprague-Dawley rats trained to lever-press for evaporated milk on a variable interval 30-s reinforcement schedule were placed in an operant test cage and exposed to clean air for 20 min, followed by a single concentration of TRI vapor (500-5000 ppm) for 100 min. Additional rats were exposed to equivalent TRI concentrations for 10, 20, 40, 60, 80, or 100 min to determine blood and brain concentration vs. time profiles. Inhalation of 1000 ppm slightly increased operant response rates, whereas 2000, 3500, and 5000 ppm decreased operant response rates in a concentration- and time-dependent manner. Accumulation of TRI in blood and brain was rapid and concentration dependent, with the brain concentration roughly twice that of blood. Plots of blood and brain TRI concentrations against operant performance showed responding in excess of control rates at low concentrations, and decreasing response rates as concentrations increased. Linear regression analyses indicated that blood and brain concentrations, as well as measures of time integrals of internal dose, were strongly correlated with operant performance. Neurobehavioral toxicity in laboratory animals, as measured by changes in operant performance, can therefore be quantitatively related to internal measures of TRI exposure to enhance its predictive value for human risk assessment.

Samples of fish and sediments collected from waters within 10 km of the Chernobyl Nuclear Power Plant were analysed for radiocaesium and other atmospherically transported pollutants (lead (Pb) and mercury (Hg)) were measured in fish tissues. For comparison, fish muscle was also sampled from a less-contaminated area of the Kiev Reservoir and from a hatchery in Kiev. In sediments, 137Cs was the major gamma-emitting isotope, with concentrations of over 100 Bq g−1 in canals adjacent to the reactor and in ponds that were downwind during the accident. The radiocaesium distributions appeared non-normal, were very patchy and could vary by over 100% in samples collected metres to tens of metres apart. Fish muscle radiocaesium from ponds within 10 km of the power plant was in the range of 6–192 Bq g−1. The fish muscle radiocaesium concentrations were highest in ponds from the downwind sites and were correlated with the sediment radiocaesium concentrations. The lead and mercury concentrations in fish were relatively low (medians

Flow cytometric (FCM) analysis was used to assess the potential impact of chronic radionuclide exposure in fish populations inhabiting contaminated sites in the vicinity of the Chernobyl nuclear accident. Four species of fish, channel catfish (Ictalurus punctatus), crucian carp (Carassius carassius), carp (Cyprinus carpio) and tench (Tinca tinca), were collected within a 10 km radius of the Chernobyl Nuclear Power Plant and compared with 'control' populations from two uncontaminated locations far removed from the plant. Assays of whole blood, as well as separate erythrocyte and leukocyte components, revealed aneuploid-like patterns in the DNA histograms of some fish, as well as widened G0/G1 peaks. None of the fish collected from the uncontaminated sites demonstrated these kinds of changes in their DNA histograms. Increases in the coefficient of variation (CV) of the G0/G1 peak, indicating abnormal DNA distributions, were observed in several of the fish from Chernobyl relative to the control populations. Cell cycle perturbation in fish from the contaminated sites was also detected, with a higher percentage of cells in G2/M phase relative to the controls. Leukocytes proved more sensitive than erythrocytes, as they displayed a larger number of abnormal DNA histograms. Variations in the cellular DNA content similar to those reported here have been shown for other vertebrate species exposed to radiation and other genotoxic agents in laboratory and field settings.

Beginning approximately 4 years after the Chernobyl nuclear accident a steady increase in the incidence of thyroid cancer was observed in children and adolescents of the Bryansk Oblast, which received the highest level of radionuclide contaminants in Russia. We examined the spatial relationship between the residence location of patients with identified thyroid cancer (0-18 years old at the time of the accident) and a number of geographic parameters to better account for the etiology of thyroid cancer spatial distribution. Geographic parameters analyzed included spatial distribution of 137Cs and 131I in soil, population demographics, measurements and reconstructions. of absorbed thyroid 131I doses in the population, and maps of major transportation arteries. An interesting finding is the lack of a consistent correlation between the spatial distribution of radionuclides in the soil and thyroid cancer incidence. Instead, most of the thyroid cancer cases were diagnosed in settlements situated on major railways and roads. Correlating population with thyroid cancer cases and transportation arteries reveals a much higher cancer rate on or near major roads and railways than at a distance from them, again independent of radionuclide soil concentration. There are other important factors, of course, that must be considered in future evaluations of this phenomenon. These include the influence of iodine endemic zones, genetic predisposition to thyroid cancer, and duration of residence time in contaminated areas. The feasibility of radionuclide transport on railways and roads is discussed, together with the vectors for transfer of the contaminants to the human population. Developing a model to reconstruct the radiation dose to the thyroid over time in this geographic region is proposed in light of the impact of transportation arteries. Specific studies are outlined to provide the data necessary to develop this model as well as to better characterize the feasibility and scientific validity of the contribution to human health effects of this transport factor. Transport factor refers to the transport of radionuclides on transportation arteries and the transfer of these agents to the human population residing in the vicinity of these arteries. If the impact on thyroid cancer of the transport of radionuclides on major railways and roads is indeed significant, a major reappraisal of the risk of large-scale radioactive release into the environment is necessary.

A design feature of most dose-response studies involving schedule-controlled operant behavior is the repeated administration of different doses of the test substance to the same experimental animal. Repeated dosing raises the question of whether or not an animal's initial exposure to a chemical agent alters its behavioral response to subsequent exposures. To address this question, a dose-response curve for the effect of inhaled 1,1,1-trichloroethane (TRI) on the rate of lever-pressing for milk delivery was generated with repeatedly exposed rats (i.e., a within-subject design) and compared to dose-response data obtained from rats receiving a single inhalation exposure to TRI (i.e., a between-group design). Relative to that generated with singly exposed rats, the dose-response curve generated by repeated exposure was shifted to the left. This suggests that the behavioral effects of rate-decreasing concentrations of TRI are augmented by previous exposures. This residual effect is apparently not due to the accumulation of pharmacologically active substances or to the development of an aversion to responding, since TRI is rapidly eliminated following exposure and solvent-free responding was unaffected 24 h postexposure. Instead, the results of this study support the well-established belief that an animal's response to a drug or chemical agent can be modified by its prior behavioral and exposure history. Thus, comparisons of single and repeated exposures may be necessary for fully accurate interpretations of the behavioral consequences of solvent exposure.

Largemouth bass (Micropterus salmoides) were collected from locations with and without documented histories of pollution in Georgia and South Carolina. Whole blood samples were collected from over 3,000 bass and analyzed by flow cytometry to measure changes in cellular DNA content and cell cycle distribution. The coefficient of variation (CV) of the cell cycle phase G0/G1 peak was used as a measure of variation in DNA content within an individual. The mean CV varied significantly among locations, and some locations with known chemical or radioactive contaminants had higher CVs. Plotting the frequency distribution of CV values for each site revealed greater skewness and kurtosis in most locations with known contaminants. In each case, a right skewness indicated higher proportions of bass with unusually high CV in these locations. Aneuploid-like patterns were detected in the DNA histograms of five fish, all from locations with histories of contamination. The percentage of cells distributed among phases of the cell cycle (G0/G1, S, and G2/M) varied significantly among locations, but there was no apparent relationship to contaminant distribution. Differences in CV and frequency of aneuploids among sites with and without histories of pollution were generally small, but increased variation in DNA content may be associated with contaminant exposure at some locations.

It is possible that a substantial portion of orally administered volatile organic chemicals (VOCs) may volatilize within the warm environment of the gastrointestinal (GI) tract and escape via the esophagus before being absorbed. The objective of this study was to test this hypothesis with a representative VOC., 1,1,2-trichloroethylene (TCE). Upon hepatic portal vein (PV) injection, complete systemic absorption of TCE was assumed. Thus, exhaled TCE after PV injection should originate only from pulmonary exhalation. In contrast, TCE volatilized in the gut may also contribute to the amounts of TCE exhaled by orally (PO) dosed animals. Male Sprague-Dawley rats (320–380g) were given 8 or 16 mg TCE/kg bw in an aqueous Alkamuls® emulsion (RhonePoulenc, Cranbury, New Jersey). For the PO groups both doses were given by gavage, and for the PV groups the lower dose was injected into the PV as a bolus and the higher dose given as a 20 mm infusion. Serial blood samples were taken from an indwelling carotid arterial cannula and analyzed for their TCE content by headspace gas chromatography (GC), so that the areas-under-blood-concentration-versus-time curves (AUCs) could be determined. Serial exhaled air samples were collected from a sampling port in a miniaturized one-way breathing valve and TCE measured by GC analysis to delineate exhaled breath concentration-versus-time-curves (EAUCs). Exhaled breath levels of TCE paralleled blood levels of TCE throughout the monitoring periods. Evidence against the aforementioned hypothesis was provided by comparison of ratios of blood AUCs and exhaled breath EAUCs: values for ratios of AUCpo/AUCpv and EAUCpo/EAUCpv were the same, as were EAUC/AUC ratios for the PO and PV groups. The EAUCs in the PO groups should have been higher, had there been substantial extrusion of volatilized TCE from the GI tract.

Blood from approximately 400 crucian carp, Carassius carassius, from 12 ponds in the Ukraine, was analysed by flow cytometry to assess the possible relationships between chronic contaminant exposure and variation in the cellular DNA content. The ponds were located 20--30 km from Chernobyl in areas that received 3.7 × 1010--3.7 × 1011 Bq 137Cs km-2 after the 1986 nuclear accident, as well as other radioactive and chemical contaminants. The fish populations consisted of both diploid and triploid individuals and the ploidy varied between ponds. Analysis of whole blood revealed aneuploid-like patterns in the DNA histograms of some fish, as well as hyperdiploid shoulders of the G0/G1 peak. The coefficient of variation (CV) of the G0/G1 peak has previously been employed to assess the variability in the DNA content of cells within individuals. The CV of individual fish varied between and within locations and very large CVs were found for some individuals. In some fish, DNA histograms showed a typical diploid or triploid cell population together with a smaller haploid population. Variations in the cellular DNA content similar to those reported here have been associated with exposure to radiation and other genotoxic agents in laboratory and field studies. However, the abnormalities we observed were not correlated with known contaminant distributions. While further work is needed, particuarly in areas with substantially higher levels of radioactivity, these results suggest that the Chernobyl accident may have long-term genetic consequences for wild organisms inhabiting contaminated areas

Whole body concentrations of radiocesium ( 137 Cs) were determined for 772 mosquitofish ( Gambusia holbrooki ) collected from three locations on the Pond B reservoir of the US Department of Energy's Savannah River Site in July and November 1991, and February and April 1992. Seasonal, site-, and sex-related differences in 137 Cs concentrations were tested for significance, and results compared with those reported for mosquitofish collected from the same locations in April 1987. Results from 1991 to 1992 showed that 137 Cs concentrations were higher in mosquitofish collected in February for both sexes at all sites. After accounting for differences in body size, males generally had higher concentrations than females across seasons and sites. Site-related differences were not the same as those found in April 1987. Results from the present study suggest that 137 Cs concentrations in mosquitofish undergo a seasonal cycling pattern, and that caution should be used when interpreting data collected from a single season, year or sex.

The explosion of the Chernobyl Nuclear Power Plant resulted in some of the most radioactively contaminated habitats on earth. Despite evacuation of all human inhabitants from the most contaminated areas, animals and plants continue to thrive in these areas. This study examines the levels of contamination and genetic damage associated with radiocesium in catfish (Ictalurus punctatus) from the cooling pond and a control site. In general, catfish from the cooling pond exhibit greater genetic damage, and the amount of damage is related to the concentration of radiocesium in individual fish. Genetic damage is primarily in the form of DNA strand breaks, with few micronuclei being observed in contaminated fish. The possible roles that acclimation and adaption play in the response to high levels of radiation exposure are discussed.

Previous studies have indicated that human exposure to perchloroethylene (PCE) produces subtle behavioral changes and other neurological effects at concentration at or below the current occupational exposure limit. Since comparable effects in animals may be reflected by changes in schedule-controlled operant behavior, the ability of orally administered PCE to alter fixed-ratio (FR) responding for a food reward was investigated in male Sprague-Dawley rats. Furthermore, since behavioral effects of solvents are likely to be more closely related to blood or target tissue (i.e, brain) concentrations than administered dose, the relationship between the pharmacokinetic distribution of PCE and its effects on operant responding was also evaluated. Rats trained to lever-press for evaporated milk on an FR-40 reinforcement schedule were gavaged with 160 or 480 mg/kg PCE and immediately placed in an operant test cage for 90 min. Separate animals gavaged with equivalent doses of PCE were used to determine profiles of blood and brain concentrations versus time. Perchloroethylene produced changes in responding that varied not only with dose but also among animals receiving the same dose. Changes in the response rates of rats receiving 160 mg/kg PCE were either not readily apparent, restricted to the first 5 min of the operant session, or attributable to gavage stress and the dosing vehicle. However, 480 mg/kg produced either an immediate suppression of responding for 15-30 min before a rapid recovery to control rates or a complete elimination of lever-pressing for the majority of the operant session. Although the two doses of PCE produced markedly different effects on operant behavior during the first 30 min of exposure, differences in brain concentrations of PCE were minimal. Furthermore, the majority of animals receiving 480 mg/kg PCE fully recovered from response suppression while blood and brain levels of the solvent continued to rise. Thus, relationships between blood and brain PCE levels and performance impairment were not discernible over the monitored time course. Since the rapid onset of response suppression suggests that the precipitating event occurs within the first few minutes of exposure, it is possible that altered responding is related to the rate of increase in blood or brain concentrations rather than the absolute solvent concentrations themselves. The relationship between the pharmacokinetic distribution of solvents and their effects on the central nervous system is obviously complex and may involve acute neuronal adaptation as well as the dynamics of solvent distribution among the various body compartments.

The Chernobyl disaster in 1986 involved the largest airborne release of radioactivity in history, more than 100 times as much radioactivity as the Hiroshima and Nagasaki atomic bombs together. The resulting emergency response, administrative blunders, and subsequent patient outcomes from this large-scale radiological disaster provide a wealth of information and valuable lessons for those who may find themselves having to deal with the staggering consequences of nuclear war. Research findings, administrative strategies (successful and otherwise), and resulting clinical procedures from the Chernobyl experience are reviewed to determine a current utility in addressing the appropriate protocols for a medical response to nuclear war. As various myths are still widely associated with radiation exposure, attention is given to the realities of a mass casualty medical response as it would occur with a nuclear detonation.(Disaster Med Public Health Preparedness. 2012;6:330-334)