Korea has advanced nuclear and radioisotope industry, and it is urgent to establish a national system to countermeasure the radiation accidents and preparedness for radiation emergency medical management. The Government opened the National Radiation Emergency Medical Center (NREMC) in the Korea Institute of Radiological and Medical Sciences (KIRAMS) in 2002, and the NREMC is setting up a radiation emergency medical preparedness and assistance network in nationwide. On April 30, 2003 the special law was proposed for the physical protection of nuclear facilities and emergency response against radiological accidents, which includes medical preparedness and management. Detailed guidelines for this law is being prepared by the Ministry of Science and Technology (MOST), and will be take effect in February 2004. Per this guideline, regional emergency medical centers will be appointed by the MOST, and the NREMC will operate this national system including education of the medical personnel.
Education ; Emergencies* ; Jurisprudence ; Korea ; Medical Assistance* ; Radioactive Hazard Release

PURPOSE: The aim of this study was to evaluate the characteristics of Emergency Medical Service (EMS) provider responded chemical, biological, radiological, and nuclear (CBRN) incidents in Korea. METHODS: Nationwide EMS rescue records from Jan 2012 to Dec 2014 were analyzed. All EMS rescue records were integrated according to the unique accident ID. Cases related to animal rescue, hive removal, and suicide-related were excluded. CBRN-associated keywords were extracted by literature review and pilot survey. In-depth review of cases containing CBRN-associated keywords in the activity summary were conducted by trained emergency medical technicians, and predefined information was abstracted. Descriptive analyses were performed to characterize the EMS provider responded CBRN incidents. RESULTS: A total of 1,571,293 cases were included, and 1,335,205 cases had a unique accident ID; 515,417 cases were excluded because of their association with animal rescue, hive removal, and suicide attempts; 19,663 cases contained CBRN-associated keywords in the activity summary, and in-depth review identified 1,862 cases as CBRN incidents. Among them 1,856 cases were chemical incidents, and 6 cases were radiological incidents; 144 cases were resulted to victims. In chemical incidents, ammonia, hydrogen chloride, sulfuric acid, hydrogen fluoride, and nitric acid were the top 5 toxic substances. In chemical incidents with victims, the proportion of explosion/implosion, and suffocation in sealed space was more prevalent than chemical incidents without victims. Median scene time of all CBRN incidents was 41 minutes (interquartile range 18.0-57.0). CONCLUSION: We evaluated the characteristics of CBRN incidents responded by EMS in Korea.
Ammonia ; Animals ; Asphyxia ; Biohazard Release ; Chemical Hazard Release ; Emergencies* ; Emergency Medical Services* ; Emergency Medical Technicians ; Humans ; Hydrochloric Acid ; Hydrofluoric Acid ; Korea ; Nitric Acid ; Radioactive Hazard Release ; Suicide ; Sulfur

Radiation disasters have a potential to cause a widespread feeling of destruction of safety in life and severe and complicated psychiatric problems to individuals and community. When a radiation accident occurs, it is essential to recognize the importance of psychosocial issues and to focus on the mental health aspect of victims. A radiation accident can produce profound psychological impacts at all levels of society, affecting individuals, families, communities, and the nation as a whole. These psychological effects may create longer-term problems, and the social stigma can be powerful and pervasive. The "post-traumatic stress reaction" has a broad range of disturbances from hyperarousal to psychiatric disorders, and can produce a marked deterioration in the quality of life. The strategy of the continuing care has been modest, based on promoting the victims' self-esteem and ability to cope with the disaster, while providing both social and life support. Rapid and appropriate intervention containing 'information management' is essential to prevent the progression of psychiatric disorders. Consideration of psychosocial factors needs to be an integral part of domestic preparedness efforts including multidimensional approach (planning, education, training, forum, and response operations). Therefore mental health care should be incorporated into the global strategy for victims' care, and this has to be done at a very early stage after the accident.
Disasters ; Education ; Humans ; Information Management ; Mental Health ; Psychology ; Quality of Life ; Radioactive Hazard Release* ; Social Stigma

The ARS(Acute Radiation Syndrome) develops, within 60 days after exposure to ionising radiation with typical clinical signs and symptoms as a function of time. The interactions and combined effects of radiation-induced damage to different organ systems are diverse and not yet fully understood. Therefore, when accidental exposure to ionising radiation is documented or suspected, guidance for immediate diagnostic procedures and specialised care are required to handle the complexity of the ARS. The following four organ systems, Neurovascular system (N), Hematopoietic system (H), Cutaneous system (C) and Gastrointestinal system (G) are considered to be of critical significance for the development of ARS and should therefore receive special attention in the medical management of radiation accident cases. The Assessment of the severity of damage, Decision on the kind of hospitalisation, Provision of appropriate therapeutic interventions and Evaluation of the patient's prognosis must be considered in the management of a patient after a radiation accident. When significant levels of radioactive materials are incorporated, pathological consequences may ensue, making emergent treatment particularly important. However, this should not take priority over treatment of life threatening conditions and of acute injuries. Following medical stabilization, careful radiological assessment can be performed to determine the presence of both external and internal contamination. It is important to note that 1) contaminated patients do not represent a direct hazard to health care providers and 2) lifesaving procedures should not be delayed regardless of the level of contamination.
Acute Radiation Syndrome* ; Health Personnel ; Hematopoietic System ; Humans ; Prognosis ; Radioactive Hazard Release

While the use of radioactive materials around the world offers a wide range of benefits in medicine, industry and research, radiation accidents also occur in world-wide. The objective of this article is to provide useful information about radiation accidents to the medical personnel. For this, I attempted to document the circumstances leading to the accident and the subsequent medical treatment and health consequences of the victims. Radiation accidents described in this article are Chernobyl nuclear power plant accident, nuclear weapon accident in bikini atoll, major industrial accidents (Ir-192 Peruvian accident, Ir-192 internal contamination accident in Korea, Tokaimura accident in Japan) and Cs-137 contamination accident in Brazil. After reviewing major radiation accidents, I summarized the lessons to be learned from these accidents and presented the helpful institutes that can offer useful helps when radiation accident occurs.
Academies and Institutes ; Accidents, Occupational ; Brazil ; Korea ; Nuclear Power Plants ; Radioactive Hazard Release* ; Weapons

Humans ; Radiation Injuries ; drug therapy ; prevention & control ; Radiation, Nonionizing ; Radiation-Protective Agents ; therapeutic use ; Radioactive Hazard Release ; prevention & control

Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation.
DNA Damage/drug effects ; Environmental Exposure ; Humans ; Leukemia/epidemiology/etiology ; Neoplasms, Radiation-Induced/epidemiology ; *Radiation Dosage ; Radiation Tolerance ; *Radiation, Ionizing ; Radioactive Hazard Release ; Risk

Although ionizing radiation is known to induce cellular senescence in vitro and in vivo, its long-term in vivo effects are not well defined. In this study, we examined the prolonged expression of senescence markers in mice irradiated with single or fractionated doses. C57BL/6 female mice were exposed to 5 Gy of gamma-rays in single or 5, 10, 25 fractions. At 2, 4, and 6 months after irradiation, senescence markers including mitochondrial DNA (mtDNA) common deletion, p21, and senescence-associated beta-galactosidase (SA beta-gal) were monitored in the lung, liver, and kidney. Increases of mtDNA deletion were detected in the lung, liver, and kidney of irradiated groups. p21 expression and SA beta-gal staining were also increased in the irradiated groups compared to the non-irradiated control group. Increases of senescence markers persisted up to 6 months after irradiation. Additionally, the extent of mtDNA deletion and the numbers of SA beta-gal positive cells were greater as the number of radiation fractions increased. In conclusion, our results showed that ionizing radiation, especially that delivered in fractions, can cause the persistent upregulation of senescence marker expression in vivo. This should be considered when dealing with chronic normal tissue injuries caused by radiation therapy or radiation accidents.
Aging ; Animals ; Cell Aging ; DNA, Mitochondrial ; Female ; Humans ; Kidney ; Liver ; Lung ; Mice ; Radiation, Ionizing ; Radioactive Hazard Release ; Up-Regulation ; beta-Galactosidase

Chernobyl Nuclear Accident ; Humans ; Japan ; epidemiology ; Neoplasms, Radiation-Induced ; etiology ; mortality ; Nuclear Warfare ; Radiation Dosage ; Radiation Injuries ; etiology ; mortality ; Radioactive Hazard Release ; Risk ; Ukraine ; epidemiology

Radiation risk has become well known through epidemiological studies of clinically or occupationally exposed populations, animal experiments, and in vitro studies; however, the study of radiation related or induced disease has been limited in Korea. This study is to find the level of occupational radiation exposure for various kinds of accidents, compensated occupational diseases, related studies, and estimations on future occupational disease risks. Research data of related institutions were additionally investigated. About 67% of 62,553 radiation workers had no exposure or less than 1.2 mSv per year. The 5 reported cases on radiation accident patients in Korea occurred during nondestructive testing. According to the recent rapid increase in the number of workers exposed to radiation, a higher social recognition of cancer, and an increasing cancer mortality rate, it is expected that occupational disease compensation will rapidly increase as well. Therefore, it is important to develop scientific and objective decision methods, such as probability of causation and screening dose in the establishment of an exposure and health surveillance system.
Female ; Humans ; Male ; Neoplasms, Radiation-Induced/*epidemiology ; Nuclear Power Plants ; Occupational Diseases/*epidemiology/etiology ; Occupational Exposure ; Radiation Injuries/*epidemiology ; *Radiation, Ionizing ; Radioactive Hazard Release/*statistics & numerical data ; Republic of Korea/epidemiology