Importance of Information Sharing on Radiation Dose for Adequate Management of Medical Assistant Team in Nuclear Disasters

Abstract

Large scale and complex disasters, including nuclear accidents, entail evacuation of a large population comprising tens of millions of people. It could be expected to take several days for such large scale evacuation. In particular, individuals such as inpatients and people living in nursing homes are vulnerable when disaster strikes and they may face the risk of death by involved in a traffic jam without medical care for a long time. In the event of a nuclear disaster, it is necessary to ensure that an adequate number of medical response teams are deployable to secure safe transport of patients, staff, and equipment to an alternative location. Therefore, in the present study a questionnaire survey was carried out to investigate awareness for a radiation emergency medicine among 733 disaster medical assistant teams (DMATs) who were designated by medical institutions nationwide. Many of the teams that were hesitant to serve on the frontline declared their willingness to be deployed if other teams have already measured the radiation dose. This suggests the importance of timely sharing of information on radiation dose to ensure that a sufficient number of medical response teams are deployable. Although some teams are equipped with a conventional dosimeter, it is unlikely that it will be designated as a standard portable device for DMATs due to various issues such as cost, maintenance, and size. Many teams showed great interest in the ultra-compact dosimeter instead.

As we experienced in the wake of the Fukushima Daiichi nuclear disaster, detailed data by measurement of air dose rate was not obtained in the aftermath of the disaster when confusion still prevails. Although a DMAT uses Emergency Medical Information System (EMIS) to share various types of information on radiation dose, it may take a considerable number of days for the group to receive data compiled by other institutions. In addition, it is expected that during the first few days following the disaster, there may be only a few locations available for captured data. It is difficult for the DMTAs to decide whether they should serve in the frontline because of uncertainty in measurements of air dose rate and risks for radiation exposure; therefore, it is likely that they will decline. By the time the data is made available, intervention by medical personnel may not be needed anymore. Certainly, the safety of medical response teams must be a priority. Yet, timely sharing of data on radiation doses is crucial to facilitate swift hospital evacuation and, simultaneously, to ensure the safety of medical response team members. Data exchange among medical response teams would enable more precise measurement of radiation levels, but compilation of analogue data will require much time and energy.

As part of this study, we also evaluated the usefulness of a new ultra-compact portable dosimeter on a trial basis in the Fukushima Prefecture. Once connected to a smartphone, the device works in conjunction with an application software and continues to take and store measured results automatically as digital data. It is also possible to visualize the measurements by automatically importing them to an enlargeable map for real-time information sharing. We concurrently used conventional dosimeters to capture data for comparison. The figures were more or less the same and credible; it was believed that the new device could appropriately replace the older one.

As the discussion above attests, information dissemination on correct knowledge of radiation and timely sharing of data on radiation doses are required to ensure that enough medical response teams are deployable in the event of large scale and complex disasters.