Nuclear reactor accidents: preparedness and medical consequences

Until the recent radiation accident at Chernobyl, USSR, the medical basis for managing the care of radiation accident victims was derived from relatively few events and patients (Lushbaugh et al, 1986). While a vast literature exists on experimental radiation biology of animals, extrapolations from the research laboratory to the clinical setting are not straightforward and must be tested for validity by actual medical experience at the bedside. Such testing has been accomplished to the extent possible by studying the medical histories of accidental radiation injury cases that recount the successes and failures in worldwide medical communities (Hubner & Fry, 1979). Medical case reports, records of accident investigations, and medical reviews of this human radiation experience have been gathered in many places for use in medical education and in planning national and community responses to nuclear and other kinds of radiation disasters. The extraordinarily rapid and thorough response by the medical emergency teams sent to Chernobyl from Kiev and Moscow after the explosion there demonstrated how well such plans based on human radiation accident experience can be carried out (Legasov, 1986). The excellence of this approach was also demonstrated well by the subsequent “up-to-theminute” therapy that the 203 seriously irradiated victims received at Moscow “Hospital No. 6” under the leadership of Soviet physicians, Drs Guskova, Baranov and Ilyin. It produced enviable medical successes since only 29 of the 203 seriously injured victims were lost (Legasov, 1986).