About the REMM Dose Estimator for Exposure

  • The REMM Dose Estimator for Exposure provides three methods for estimating an individual's radiation dose
    • Time to onset of vomiting
    • Lymphocyte depletion kinetics
    • Dicentric Chromosome Assay: blood samples should be sent to a reference laboratory.
      See Warning: cautions and limitations for laboratory contacts
  • Where do the algorithms come from?
    • The vomiting tool and the lymphocyte depletion kinetics tools use algorithms developed by AFRRI for their Biodosimetry Assessment Tool (BAT) program.
      • BAT was originally designed to provide diagnostic information to Federal health care providers responsible for managing radiation casualties.
      • The REMM Dose Estimator for Exposure includes only parts of the much larger BAT tool.
        • Permission to use components of the BAT program on REMM was graciously provided by the Department of Defense and AFRRI.
      • Publications about the BAT program have been provided by AFRRI. (PDF - 20 KB)
  • The REMM Dose Estimator for Exposure assumes the following about a victim
    • Radiation exposure to the whole body or a major portion of the body
    • Radiation exposure during one event over a "short" period of time (minutes to hours), as with a radiation accident or terrorist event
  • New biodosimetry laboratory methods with faster throughput and better accuracy are under development.1
  • Other methods are used for estimating dose long after the event has occurred.2
  • Table of existing and developing techniques for assessment of radiation exposure levels: High dose radiation effects and tissue injury, Report of the Independent Advisory Group on Ionising Radiation, Table 4.4, page 41 (Health Protections Agency, UK)
  • What should you do when there are conflicting dose estimates?3
    • Use the highest dose estimate to plan initial treatment.
    • Consider a patient's signs and symptoms as indicators of dose
    • Modify the dose estimate and treatment plan as additional clinical and laboratory data become available over time.
  • Before using any of the tools provided in the REMM Dose Estimator for Exposure, clinicians should read and understand each of the 3 Warning and Caution statements.
References
  1. Alexander GA, et al., BiodosEPR-2006 Meeting: Acute dosimetry consensus committee recommendations on biodosimetry applications in events involving uses of radiation by terrorists and radiation accidents. (PDF - 518 KB) Radiat Meas. 2007 July;42(6-7):972-96.
  2. 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)
  3. Lloyd DC, Edwards AA, Moquet JE, Guerrero-Carbajal YC. The role of cytogenetics in early triage of radiation casualties. Appl Radiat Isot 2000 May;52(5):1107-12. [PubMed Citation]

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