Disaster medicine. Present status of medicine for emergent radiation exposure

Global and Japanese medical networks organized for the accidental emergent exposure are outlined, actual measures at Japanese accidents are summarized, and their present tasks/problems are discussed. ICRP issues comments concerning radiation protection based on scientific findings verified by UNSCEAR, where there are such international organizations for the emergent network as WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) and IAEA Response Assistance Network (RANET). Two Japanese facilities (National Institute of Radiological Sciences: NIRS, and Nagasaki University) are in REMPAN and 3 (NIRS, Japan Atomic Energy Agency and Hiroshima Univ.), in RANET. The Radiation Emergency Medicine Network Council (REMNC, founded in NIRS, 1997) plays the central role in Japanese networks, consisting from medical facilities in prefectures having the nuclear facility and in their neighboring areas. Those facilities are responsible for the primary, secondary and tertiary medicare of the emergent exposure: id est (i.e.), respectively; in/near the nuclear facility, in its infirmary and in the emergency evacuation site; for hospitalization; and for hospitalization with expertized treatment. At Tokai JCO criticality accident in Ibaraki prefecture (1999), 3 workers exposed to the high dose of neutron flux were rapidly carried into the tertiary facility NIRS according to the treatment planning by REMNC. At Fukushima Daiichi Nuclear Power Plant Accident in 2011, the tertiary NIRS, Hiroshima Univ., and secondary Fukushima Medical Univ. in REMNC mainly intervened various kinds of medicare as early as at the first stage. Hospitals in Tochigi prefecture neighboring to Fukushima had to face the emergency derived from the radioactive plume. Present tasks/problems posed by these accidents are two: reconsideration of disaster measures for the network like REMNC to spread defined areas and facilities in wider regions and smaller hospitals; and importance of 3 risk communications of crisis, care and consensus, for which raising manpower is now eagerly required. (T.T.)