It is essential to identify improved capabilities to accurately identify, confirm, and/or quantify radiological exposure and injury in order to inform critical triage, diagnosis, and treatment decisions. Herein the authors report characteristic requirements and potential Concepts of Operations (CONOPS) for biodosimetry tools employed in operational environments. While similar significant efforts have been completed in this area for the U.S. civilian sector, limited perspectives are published in the peer-reviewed literature regarding the use of radiological diagnostic technologies in deployed military medical treatment settings. Two radiological exposure scenarios were developed to clarify the diagnostic performance criteria and identify capability gaps. The emerging technology areas associated with radiation exposure diagnostics were reviewed and assessed to gauge their suitability in supporting triage, treatment, and return to duty decisions within the military medical support system.
Assessment of the health risk from exposure to aerosols of depleted uranium (DU) is an important outcome of the Capstone aerosol studies that established exposure ranges to personnel in armored combat vehicles perforated by DU munitions. Although the radiation exposure from DU is low, there is concern that DU deposited in the body may increase cancer rates. Radiation doses to various organs of the body resulting from the inhalation of DU aerosols measured in the Capstone studies were calculated using International Commission on Radiological Protection (ICRP) models. Organs and tissues with the highest calculated committed equivalent 50-y doses were lung and extrathoracic tissues (nose and nasal passages, pharynx, larynx, mouth, and thoracic lymph nodes). Doses to the bone surface and kidney were about 5 to 10% of the doses to the extrathoracic tissues. Organ-specific risks were estimated using ICRP and U.S. Environmental Protection Agency (EPA) methodologies. Risks for crewmembers and first responders were determined for selected scenarios based on the time interval of exposure and for vehicle and armor type. The lung was the organ with the highest cancer mortality risk, accounting for about 97% of the risks summed from all organs. The highest mean lifetime risk for lung cancer for the scenario with the longest exposure time interval (2 h) was 0.42%. This risk is low compared with the natural or background risk of 7.35%. These risks can be significantly reduced by using an existing ventilation system (if operable) and by reducing personnel time in the vehicle immediately after perforation.
Depleted uranium (DU) intake rates and subsequent dose rates were estimated for personnel entering armored combat vehicles perforated with DU penetrators (level II and level III personnel) using data generated during the Capstone DU Aerosol Study. Inhalation intake rates and associated dose rates were estimated from cascade impactors worn by sample recovery personnel and from cascade impactors that served as area monitors. Ingestion intake rates and associated dose rates were estimated from cotton gloves worn by sample recovery personnel and from wipe-tests samples from the interior of vehicles perforated with large-caliber DU munitions. The mean DU inhalation intake rate for level II personnel ranged from 0.447 mg h(-1) based on breathing zone monitor data (in and around a perforated vehicle) to 14.5 mg h(-1) based on area monitor data (in a perforated vehicle). The mean DU ingestion intake rate for level II ranged from 4.8 mg h(-1) to 38.9 mg h(-1) based on the wipe-tests data including surface-to-glove transfer factors derived from the Capstone data. Based on glove contamination data, the mean DU ingestion intake rates for level II and level III personnel were 10.6 mg h(-1) and 1.78 mg h(-1), respectively. Effective dose rates and peak kidney uranium concentration rates were calculated based on the intake rates. The peak kidney uranium concentration rate cannot be multiplied by the total exposure duration when multiple intakes occur because uranium will clear from the kidney between the exposures.
Risks to personnel engaged in military operations include not only the threat of enemy firepower but also risks from exposure to other hazards such as radiation. Combatant commanders of the U.S. Army carefully weigh risks of casualties before implementing battlefield actions using an established paradigm that takes these risks into consideration. As a result of the inclusion of depleted uranium (DU) anti-armor ammunition in the conventional (non-nuclear) weapons arsenal, the potential for exposure to DU aerosols and its associated chemical and radiological effects becomes an element of the commanders' risk assessment. The Capstone DU Aerosol Study measured the range of likely DU oxide aerosol concentrations created inside a combat vehicle perforated with a DU munition, and the Capstone Human Health Risk Assessment (HHRA) estimated the associated doses and calculated risks. This paper focuses on the development of a scientific approach to adapt the risks from DU's non-uniform dose distribution within the body using the current U.S. Department of Defense radiation risk management approach. The approach developed equates the Radiation Exposure Status categories to the estimated radiological risks of DU and makes use of the Capstone-developed Renal Effects Group as a measure of chemical risk from DU intake. Recommendations are provided for modifying Army guidance and policy in order to better encompass the potential risks from DU aerosol inhalation during military operations.
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