US/European Consensus On Preparedness For Large Scale Nuclear Accidents Or Terrorist Activity Discussed

Main Category: Bio-terrorism / Terrorism
Also Included In: Aid / Disasters;  Public Health
Article Date: 03 Apr 2009 - 0:00 PDT

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Eminent European and American Oncologists gathered today to discuss the state of EU/US preparedness in the case of a nuclear incident. Prof. Ray Powles chaired the meeting organized by the Nuclear Accident Committee (NAC) of the European Group for Blood and Marrow Transplantation (EBMT). He raised the alarm that the threat of a nuclear-related incident is real and terrorist activity from disaffected groups is broadening. Participants questioned whether the medical community was ready.

With extensive experience in the field of Bone Marrow Transplantation and of the use of high levels of radiation for treating patients, the EBMT has shown great commitment in their work to prepare Europe for this type of threat. EBMT has funded research, organised extensive training programmes to build a prepared medical taskforce, and strived to harmonize guidelines at a European level to ensure a unified response in the case of such an incident occurring. The EBMT Board established the NAC in response to the 9/11 disaster to oversee this important work.

However, aligned practices at a European level are not enough and Ray Powles, Professor of Haemato-Oncology at Parkside Oncology Clinic in London, stressed the importance of international cooperation in terms of research, training and treatment. He stated, "research and expertise across the Atlantic have focused on different scenarios and can therefore be complementary to European approaches. We have a lot to gain by exchanging knowledge and practices. Building a strong alliance would be essential in the case of a nuclear accident."

During the first US/European Consultation Workshop on transatlantic cooperation in the medical management of radiation accident victims, held at Ulm University in Germany, participants insisted on the need to compare approaches to assess the extent of damage after exposure to ionizing radiation, commonly called "clinical triage". Dr Bhawna Sirohi, Consultant Medical Oncologist at Addenbrooke's Hospital in Cambridge, explained that in case of a large scale accident, the "triage" process is crucial in order to give optimal treatment to casualties. She stressed that more research needs to be done in order to develop more accurate tools to measure the amount of ionizing radiation dose received by a patient. "We would need to save time and be able to detect very rapidly the victims in need of acute care". Dr Sirohi went on to underline that diagnosis guidelines are different across the Atlantic: "The EBMT has developed METREPOL, a clinical assessment tool while in the US there is a greater emphasis on using laboratory methods to determine the dose received by individuals." METREPOL was most recently discussed at a WHO conference in Geneva (March 16-18, 2009) where further efforts were made to harmonize diagnosis and therapy of acute radiation syndrome worldwide.

Prof. Ted Fliedner, Director, Radiation Medicine Research Group in Ulm, Germany, raised the importance of training medical staff and assistance professions in diagnostic and therapeutic needs after accidental whole body radiation exposure. The concept of extending some basic education as provided by RITN (Radiation Injury Treatment Network) with the availability of just-in-time up-to-date information for medical staff was favourably received. "Too few medical workers in Europe are properly trained today" pointed out Prof. Fliedner.

As far as research is concerned, there was a strong consensus to consider the formation of research networks not only with laboratories from the United States and from Europe but from the worldwide scientific community. This network would include accident registries and databases of patient case histories as a basis for further clinical and preclinical research.

The progression of work in this field has created a paradigm shift in thinking; where as we once believed if a massive irradiation incident occurred, there is nothing we could do, and today, informed clinicians and scientists now agree hundreds, maybe thousands of lives could be saved by careful selection of the right people to receive relatively standard curative treatment that is given routinely to patients with Leukemia. The challenge is a rapid, logistic organization of trained individuals in a well rehearsed pan-European network .This is what the EBMT is geared to deliver.

About the European Group for Blood and Marrow Transplantation

Bone marrow or stem cell transplantation is often the only curative treatment for different malignant diseases and is currently performed on more than 50,000 patients worldwide each year. The European Group for Blood and Marrow Transplantation (EBMT) as the leading non-profit, scientific society representing 527 transplant centres in and outside Europe, promotes all activity aiming to improve stem cell transplantation or cellular therapy. This includes registering all the activity relating to stem cell transplants with a view to improving treatment outcomes for patients. EBMT has set standards for indication and treatment for malignant and non-malignant diseases, along with running training programmes for continual professional development. These are continually audited and updated. EBMT is also responsible for accrediting the transplant centres based on their performance and data reporting.

Source
European Group for Blood and Marrow Transplantation