Infrastructure to support ultra high throughput biodosimetry screening after a radiological event

Abstract

Purpose: After a large-scale radiological event, there will be a pressing need to assess, within a few days, the radiation doses received by tens or hundreds of thousands of individuals. This is for triage, to prevent treatment locations from being overwhelmed, in what is sure to be a resource limited scenario, as well as to facilitate dose-dependent treatment decisions. In addition there are psycho-social considerations, in that active reassurance of minimal exposure is a potentially effective antidote to mass panic, as well as long-term considerations, to facilitate later studies of cancer and other long-term disease risks.

Materials and methods: As described elsewhere in this issue, we are developing a Rapid Automated Biodosimetry Tool (RABiT). The RABiT allows high throughput analysis of thousands of blood samples per day, providing a dose estimate that can be used to support clinical triage and treatment decisions.

Results: Development of the RABiT has motivated us to consider the logistics of incorporating such a system into the existing emergency response scenarios of a large metropolitan area. We present here a view of how one or more centralized biodosimetry readout devices might be incorporated into an infrastructure in which fingerstick blood samples are taken at many distributed locations within an affected city or region and transported to centralized locations.

Conclusions: High throughput biodosimetry systems offer the opportunity to perform biodosimetric assessments on a large number of persons. As such systems reach a high level of maturity, emergency response scenarios will need to be tweaked to make use of these powerful tools. This can be done relatively easily within the framework of current scenarios.

Keywords:

• Disaster management
• radiation triage
• high throughput biodosimetry
• accidents – radiation

Acknowledgements

Development of the RABiT prototype and collection kit was supported by grant number U19 AI067773, the Columbia Center for High-Throughput Minimally Invasive Radiation Biodosimetry, the National Institute of Allergy and Infectious Diseases/National Institutes of Health.

Declaration of interest:

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of National Institute of Allergy and Infectious Diseases, the National Institutes of Health or the New York City Department of Health and Mental Hygiene. The concepts discussed here do not necessarily reflect current planning for emergency response at local or national levels.