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	You are here: Home > Population Monitoring		Population Monitoring and Radionuclide Decorporation Following a Radiological or Nuclear Incident (NCRP Report No. 166, 2011) NEW! Nuclear Detonation Scarce Resources Working Group Publications, 3/2011 (HHS/ASPR) NEW! Response to a Nuclear Detonation: State and Local Medical Planners Playbook, 3/2011 (HHS/ASPR) NEW! Responding to a Radiological or Nuclear Terrorism Incident: A Guide for Decision Makers (NCRP Report No. 165, 2010) Management of Persons Contaminated With Radionuclides: Handbook (NCRP Report No. 161, Vol. I, 2008)    New Users: Where Do I Start? What's New on REMM? Emergency Contacts Patient Management Algorithms Dose Estimator for Exposure Dictionary Isotopes of Interest Countermeasures: Internal Contamination Countermeasures: Exposure Decontamination Procedures Acute Radiation Syndrome (ARS) Hematopoietic Subsyndrome Cutaneous Radiation Syndrome Manage ARS Subsyndromes Time/Dose Effects in ARS Time Phases of ARS Strategic National Stockpile Scarce Resources Triage Tool Multimedia Library Print Algorithms & Tables Download REMM (1/2012) Download Mobile REMM (1/2012)    AFRRI AHRQ CDC CRCPD DHS DOE EPA FDA HHS HPS   IAEA ICRP NCRP NRC OSHA REAC/TS RERF RITN UNSCEAR WHO
	Population Monitoring What is Population Monitoring? Summary Information Population Monitoring and Radionuclide Decorporation Following a Radiological or Nuclear Incident, (NCRP Report No. 166), National Council on Radiation Protection and Measurements, Bethesda, MD, 2011. Estimate of Lifetime Excess Risk of Fatal Cancer Due to Short-term Radiation An Introduction to the Estimation of Risks Arising from Exposure to Low Doses of Ionizing Radiation (HPA-RPD-055) (Health Protection Agency, June 2009) Population Monitoring in Radiation Emergencies: A Guide for State and Local Public Health Planner (PDF - 3.66 MB ) (HHS/CDC) BEIR VII: Health Risks from Exposure to Low Levels of Ionizing Radiation Estimates of Cancer Following Radiation Exposure Monitoring Recommendations for Specific Organs (To be included in a later version of REMM) Monitoring Recommendations by Isotope (To be included in a later version of REMM) Monitoring Recommendations for Whole-Body Exposure (To be included in a later version of REMM) What is Population Monitoring? Population monitoring is a process that begins soon after a radiation incident is reported and continues until all potentially affected people have been monitored and evaluated for Needed medical treatment The presence of radioactive contamination on the body or clothing The intake of radioactive materials into the body The removal of external or internal contamination (decontamination) The radiation dose received and the resulting health risk from the exposure Long-term health effects Adapted from Population Monitoring in Radiation Emergencies: A Guide for State and Local Public Health Planners (PDF - 3.60 MB) (Predecisional Draft, HHS/CDC/NCEH/Radiation Studies Branch, August 2007, page 5) top of page Summary Information Persons potentially or actually exposed to radiation during an emergency event should be registered for long-term monitoring and tracking. Individuals to be tracked include Actual victims documented to have been exposed or contaminated Individuals who think they may have been exposed or contaminated All responders Tracking and surveillance guidelines are directed by Isotopes responsible for the contamination Dose from exposure received by each victim Host factors that may modify expected outcomes Individuals to be tracked should be entered into the global database generated for each event. Tracking and surveillance may be required for many years, as radiation late effects may not appear for decades. Even those who survive Acute Radiation Syndrome effects may be at risk for delayed effects of acute radiation exposure. Within HHS, CDC has been given the responsibility for population monitoring after a mass casualty event. Their documents provide comprehensive guidance. Population Monitoring in Radiation Emergencies: A Guide for State and Local Public Health Planners (PDF - 3.60 MB) (Predecisional Draft, HHS/CDC/NCEH/Radiation Studies Branch, August 2007) CDC's Roles in the Event of a Nuclear or Radiological Terrorist Attack (HHS/CDC, May 2006) Population Monitoring After a Release of Radioactive Material (HHS/CDC, May 2006) Population Monitoring After a Release of Radioactive Material (PDF - 79 KB) (HHS/CDC, January 2005) Roundtable on Population Monitoring Following a Nuclear/Radiological Incident (PDF - 334 KB) (HHS/CDC, January 2005) Prototype for basic tracking information to be collected from each individual (responder, victim, citizen) associated with a radiological/nuclear event (PDF - 31 KB) (HHS/CDC) Population Monitoring and Radionuclide Decorporation Following a Radiological or Nuclear Incident, (NCRP Report No. 166) Detailed guidance about the development of radiological response plans for emergency responders and medical centers for Efficient screening of a population for internally-deposited radionuclides, including detection procedures/equipment, and levels of concern Decontamination procedures for populations Treatment with decorporation therapy: details Use of Clinical Decision Guides for specific radionuclides of concern for adults, pregnant women and children Scaling up response capacity and operating procedures to match the size of the event Other useful references about dose reconstruction Douple EB, Mabuchi K, Cullings HM, Preston DL, Kodama K, Shimizu Y, Fujiwara S, Shore RE. Long-term radiation-related health effects in a unique human population: lessons learned from the atomic bomb survivors of Hiroshima and Nagasaki. Disaster Med Public Health Prep. 2011 Mar;5 Suppl 1:S122-33. [PubMed Citation] Simon SL, Bailiff I, Bouville A, Fattibene P, Kleinerman RA, Lloyd DC, McKeever SWS, Romanyukha A, Sevan'kaev AV, Tucker JD, Wieser A. BiodosEPR-2006 consensus committee report on biodosimetric methods to evaluate radiation doses at long times after exposure. Radiation Measurements. 2007 Jul;42(6):948-71. Radiation Epidemiology Course, May 2007 (HHS/National Cancer Institute/Division of Cancer Epidemiology and Genetics) Radiation Health Effects (Radiation Effects Research Foundation, 2007) 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) UNSCEAR reports on late effects of radiation: cancer and other effects Effects of ionizing radiation: UNSCEAR 2006 Report Volume I Main text of the 2006 report to the General Assembly ( A/61/46 + Corr.1) Annex A - Epidemiological studies of radiation and cancer; and Annex B - Epidemiological evaluation of cardiovascular disease and other non-cancer diseases following radiation exposure. Volume II Annex C: Non-targeted and delayed effects of exposure to ionizing radiation Annex D: Effects of ionizing radiation on the immune system Annex E: Sources-to-effects assessment for radon in homes and workplaces Hereditary effects of ionizing radiation: UNSCEAR 2001 Report Introduction I: The Human Genome II: Mendelian Diseases III: Multifactorial Diseases IV: The Mutation Component for Genetic Diseases V: Cancer Predisposition, Radiosensitivity, and the Risk of Radiation-Induced Cancers VI: Other Relevant Studies VII: Concepts, Data and Analysis Used for the Estimation of Genetic Risks VIII: Risk Estimates Summary and Conclusions Report to the General Assembly (PDF - 119 KB) Hereditary effects of radiation (PDF - 2.12 MB) (156 pages) Sources and effects of ionizing radiation: UNSCEAR 2000 Report Report to the General Assembly (PDF - 192 KB) Scientific Annexes: Annex A: Dose assessment methodologies (PDF - 769 KB) (63 pages) Annex B: Exposures from natural radiation sources (PDF - 922 KB) (74 pages) Annex C: Exposures from man-made sources of radiation (PDF - 1.80 MB) (134 pages) Annex D: Medical radiation exposures (PDF - 2.07 MB) (203 pages) Annex E: Occupational radiation exposures (PDF - 2.09 MB) (158 pages) top of page Estimate of Lifetime Excess Risk of Fatal Cancer Due to Short-term Radiation Short-terma Whole-body Dose [rad (Gy)] Excess Lifetime Risk of Fatal Cancer due to Short-term Radiation Exposureb (%) 10 (0.1) 0.8 100 (1) 8 200 (2) 16 300 (3) 24c 600 (6) >40c 1,000 (10) >50c a Short-term refers to the radiation exposure during the initial response to the incident. b Lifetime risk to fatal cancer without radiation exposure is approximately 24%. Most cancers are not likely to occur until several decades after exposure; although leukemia has a shorter latency period (>5 y). c Applies to those individuals that survive the acute radiation syndrome. Adapted from Key Elements of Preparing Emergency Responders for Nuclear and Radiological Terrorism (NCRP Commentary No. 19), National Council on Radiation Protection and Measurements, Bethesda, MD, December 2005, page 29. Purchase required; see Free Overview (PDF - 219 KB). top of page BEIR VII: Health Risks from Exposure to Low Levels of Ionizing Radiation Estimated Risk of Cancer in 100 People from a Single Exposure of 100 mSv of Radiation In a lifetime, approximately 42 (solid circles) of 100 people will be diagnosed with cancer from causes unrelated to radiation. The calculations in this report suggest approximately one cancer (star) in 100 people could result from a single exposure 100 mSv of low linear energy transfer (low-LET) radiation. Adapted from BEIR VII: Health Risks from Exposure to Low Levels of Ionizing Radiation, (The National Academies, 2005, purchase required). See short summary of the report (PDF - 288 KB) (free). BEIR VII's Best Estimates of the Lifetime Attributable Risk (LAR) of Incidence and Mortality for All Solid Cancer and Leukemia per 100,000 Persons Exposed to 100 mSv   All solid cancer Leukemia Excess cases (including non-fatal cases) from exposure to 100 mSv Males Females Males Females 800 (400-1600) 1300 (690-2500) 100 (30-300) 79 (20-250) Number of cases in the absence of exposure 45,500 36,900 830 590 Excess deaths from exposure to 100 mSv 410 (200-830) 610 (300-1200) 70 (20-220) 50 (10-190) Number of deaths in the absence of exposure 22,100 17,500 710 530 The Table shows the estimated number of cancer cases and deaths expected to result in 100,000 persons (with an age distribution similar to that of the entire U.S. population) exposed to 100 mSv. The estimates are accompanied by 95% subjective confidence intervals shown in parentheses that reflect the most important uncertainty sources including statistical variation, uncertainty in adjusting risk for exposure at low doses and dose rates, and uncertainty in the method of transporting data from a Japanese to a U.S. population. For comparison, the number of expected cases and deaths in the absence of exposure is listed. Adapted from BEIR VII: Health Risks from Exposure to Low Levels of Ionizing Radiation, (The National Academies, 2005) top of page Estimates of Cancer Following Radiation Exposure Risk of Solid Cancer Following Radiation Exposure, Estimates for the UK population, see especially pages 198-211 (Health Protection Agency, August 2011) Risk of Leukaemia and Related Malignancies following Radiation Exposure: Estimates for the UK Population (Health Protection Agency, 2003) top of page Monitoring Recommendations for Specific Organs (To be included in a later version of REMM)   top of page Monitoring Recommendations by Isotope (To be included in a later version of REMM)   top of page Monitoring Recommendations for Whole Body Exposure (To be included in a later version of REMM)   top of page References Moulder JE. Report on an interagency workshop on the radiobiology of nuclear terrorism. Molecular and cellular biology dose (1-10 Sv) radiation and potential mechanisms of radiation protection (Bethesda, Maryland, December 17-18, 2001). Radiat Res. 2002 Jul;158(1):118-24. [PubMed Citation] Moulder JE. Post-irradiation approaches to treatment of radiation injuries in the context of radiological terrorism and radiation accidents: a review. Int J Radiat Biol. 2004 Jan;80(1):3-10. [PubMed Citation] Follow-up of delayed health consequences of acute accidental radiation exposure: Lessons to be learned from their medical management (IAEA-TECDOC-1300, Sponsored by IAEA and WHO, July 2002) (PDF - 1.46 MB)

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