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Pediatric Terrorism and Disaster Preparedness

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

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Chapter 6. Radiological and Nuclear Terrorism (continued)

Bibliography

Radiological Threats

American Academy of Pediatrics Committee on Environmental Health. Policy statement: radiation disasters and children. Pediatrics 2003;111(6):1455-66.

Glasstone S, Dolan P, eds. The Effects of Nuclear Weapons, 3rd ed. Washington, DC: U.S. Department of Defense and the Energy Research and Development Administration; 1977.

National Council on Radiation Protection and Measurements. NCRP Report No. 65, Management of Persons Accidentally Contaminated with Radionuclides Bethesda, MD: National Council on Radiation Protection and Measurements; 1979.

National Council on Radiation Protection and Measurements. NCRP Report No. 138, Management of Terrorist Events Involving Radioactive Material. Bethesda, MD: National Council on Radiation Protection and Measurements; 2001.

Sullivan JP, Bunker RJ, Lorelli, EJ, et al, eds. Jane's Unconventional Weapons Response Handbook, 1st ed. Alexandria, VA: Jane's Information Group; 2002.

United States Army Center for Health Promotion and Preventive Medicine. The Medical NBC Battlebook, USACHPPM Tech Guide 244. Aberdeen Proving Ground, MD: United States Army Center for Health Promotion and Preventive Medicine; August 2002.

Historical Overview

Adams RE, Bromet EJ, Panina N, Golovakha D, Goldgaber D, Gluzman S. Stress and well-being in mothers of young children 11 years after the Chornobyl nuclear power plant accident. Psychol Med 2002;32:143-56.

American Academy of Pediatrics Committee on Environmental Health. Policy statement: radiation disasters and children. Pediatrics (6)111;1455-66.*

Armed Forces Radiobiology Research Institute. Medical Management of Radiological Casualties, Handbook, 2nd ed. Bethesda, MD: Armed Forces Radiobiology Research Institute. April 2003. Available at: http://www.ntis.gov/products/mmrc.asp. Accessed August 18, 2006.

Centers for Disease Control and Prevention. Emergency Preparedness and Response. Frequently Asked Questions (FAQs) About Dirty Bombs Available at: http://www.bt.cdc.gov/radiation/dirtybombs.asp. Accessed August 1, 2006.

Collins DL, de Carvalho A. Chronic stress from the Goiania 137Cs radiation accident. Behav Med 1993;18:149-57.

Radiation Effects Research Foundation. Acute death due to radiation. Hiroshima and Nagasaki, Japan: Radiation Effects Research Foundation. Available at: http://www.rerf.or.jp/eigo/radefx/early/death.htm. Accessed August 1, 2006.

Hall, Eric. Radiobiology for the Radiologist, 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2000.

International Atomic Energy Agency. The Radiological Accident in Goiania. Vienna, Austria: International Atomic Energy Agency. 1988. Available at http://www-pub.iaea.org/MTCD/publications/PDF/Pub815_web.pdf. Accessed August 2, 2006.

Larin V. Mayak's walking wounded. Bull Atomic Scientists 1999;55(5):20-7. Available at: http://www.thebulletin.org/article.php?art_ofn=so99larin. Accessed August 18, 2006.

Likhtarev IA, Kovgan LN, Jacob P, Anspaugh LR. Chernobyl accident: retrospective and prospective estimates of external dose of the population of Ukraine. Health Phys 2002;82:290-303.

Medical Research Council. The Hazards to Man of Nuclear and Allied Radiations. London: His Majesty's Stationery Office; 1956.

Merke DP, Miller RW. Age differences in the effects of ionizing radiation. In: Guzelian PS, Henry CJ, Olin SS, eds. Similarities and Differences Between Children and Adults: Implications for Risk Assessment. Washington, DC: International Life Sciences Institute; 1992:139-49.

Miller RW. Delayed effects of external radiation exposure: A brief history. Radiation Res 1995;144:160-95.

Muirhead CR. Cancer after nuclear incidents. Occup Environ Med 2001;58:482-7.

National Academy of Sciences. The Biological Effects of Atomic Radiation, Summary Reports. Washington, DC: National Academy of Sciences-National Research Council;1956.

National Council on Radiation Protection and Measurements. Management of Terrorist Events Involving Radioactive Material. NCRP Report No. 138. Bethesda, MD: National Council on Radiation Protection and Measurements; 2001.

Niefert A. Case Study: Accidental Leakage of Cesium-137 in Goiania, Brazil, in 1987. Huntsville, AL: Camber Corporation; 1999. Available at http://www.nbc-med.org/SiteContent/MedRef/OnlineRef/CaseStudies/csgoiania.html. Accessed August 18, 2006.

NOVA. Dirty Bomb, Chronology of Events. Public Broadcasting Service; February, 2003.

O'Neill K. The Nuclear Terrorist Threat. Washington, DC: Institute for Science and International Security;1997. Available at http://www.isis-online.org/publications/terrorism/threat.pdf. Accessed August 18, 2006.

Public Health Strategies for Protecting the Thyroid with Potassium Iodide in the Event of a Nuclear Incident. A symposium of the American Thyroid Association, Feb 28, 2003, Washington, DC, sponsored by the Johns Hopkins University School of Medicine in conjunction with the ATA.

Talbott EO, Youk AO, McHugh KP, et al. Mortality among the residents of the Three Mile Island accident area: 1979-1992. Environ Health Perspect 2000;108:545-52.

Manhattan Engineer District of the United States Army. Chapter 10, Total Casualties. In: The Atomic Bombings of Hiroshima and Nagasaki by the Manhattan Engineer District of the United States Army June 29, 1946. New Haven, CT: The Avalon Project at Yale Law School: Documents in Law, History, and Diplomacy; 2003.

U.S. Department of Energy. Advisory Committee on Human Radiation Experiments—Final Report. Washington, DC: U.S. Department of Energy; October, 1995. Available at: http://www.eh.doe.gov/ohre/roadmap/achre/report.html. Accessed August 18, 2006.

U.S. Food and Drug Administration, Center for Drug evaluation and Research. Guidance Document: Potassium Iodide as a Thyroid Blocking Agent in Radiation Emergencies. Available at http://www.fda.gov/cder/guidance/4825fnl.htm. Accessed Nov 9, 2003.

U.S. Nuclear Regulatory Commission. Fact Sheet on Dirty Bombs, March 2003. Available at http://www.nrc.gov/reading-rm/doc-collections/fact-sheets/dirty-bombs.html. Accessed Dec 9, 2003.

U.S. Nuclear Regulatory Commission. Fact Sheet on the Accident at Three Mile Island. Available at http://www.nrc.gov/reading-rm/doc-collections/fact-sheets/3mile-isle.html. Accessed Nov 9, 2003.

Weinberg AD, Kripalani S, McCarthy PL, Schull WJ. Caring for survivors of the Chernobyl disaster. What the clinician should know. JAMA 1995;274:408-12.


* This document was the source for a large volume of material cited in this chapter.


Physical Principles of Ionizing Radiation

Hall, Eric J. Radiobiology for the Radiologist, 5th ed. Lippincott-Raven, Philadelphia, 2000.

Turner, James E. Atoms, Radiation, and Radiation Protection, 2nd ed. Wiley-Interscience, New York, 1995.

Radiation Biology and Dosimetry

Anno GH, Baum SJ, Withers HR, Young RW. Symptomatology of acute radiation effects in humans after exposure to doses of 0.5-30 Gy. Health Physics 1989;56(6):821-38.

Armed Forces Radiobiology Research Institute. Medical Management of Radiological Casualties—Handbook, 2nd ed. AFRRI, 2003.

Armed Forces Radiobiology Research Institute. Biodosimetry Assessment Tool (BAT). Bethesda, MD.

Baranov AE, Densow D, Fliedner TM, et al. Clinical Pre-Computer: Performa for the International Computer Database for Radiation Exposure Case Histories. Berlin: Springer-Verlag, 1994.

Goans RE, Holloway EC, Berger ME, Ricks RC. Early dose assessment following severe radiation accidents. Health Physics 1997;72:513-18.

Goans RE, Holloway EC, Berger ME, Ricks RC. Early dose assessment in criticality accidents. Health Physics 2001;81(4):446-9.

Goans RE. Clinical care of the radiation-accident patient: patient presentation, assessment, and initial diagnosis. The Medical Basis for Radiation-Accident Preparedness. Ricks RC, Berger ME, O'Hara FM, Jr, eds. Washington, DC: The Parthenon Publishing Group. 2002;11-22.

International Atomic Energy Agency. Cytogenetic Analysis for Radiation Dose Assessment—A Manual. Technical Report Series No. 405, IAEA, Vienna, 2001.

International Atomic Energy Agency. Diagnosis and Treatment of Radiation Injuries, Safety Reports Series No. 2. Vienna, Austria: International Atomic Energy Agency; 1998.

International Atomic Energy Agency. Generic Procedures for Medical Response During Nuclear and Radiological Emergency. Vienna, Austria: International Atomic Energy Agency; April 2005. Available at: http://www-pub.iaea.org/MTCD/publications/PDF/EPR-MEDICAL-2005_web.pdf. Accessed August 2, 2006.

Lloyd DC, Edwards AA, Moquet JE, Guerrero-Carbajal YC. The role of cytogenetics in early triage of radiation casualties. Appl Radiat Isotopes 2000;52:1107-12.

Lniecki J, Bajerska A, Adryszek C. Chromosomal aberrations in human lymphocytes irradiated in vitro from donors (males and females) of varying ages. Int J Radiat Biol 1971;19:349-60.

Prasanna PGS, Loats H, Gerstenberg HM, et al. AFRRI's Gamma-ray, X-ray, and Fission-neutron Calibration Curves for the Lymphocyte Dicentric Assay: Application of a Metaphase Finder System. Armed Forces Radiobiology Research Institute Special Publication, 2002.

Prasanna PGS, Subramanian U, Greenhill RG, et al. Cytogenetic Biodosimetry Strategy for Potential Radiation Mass Casualties. In: Radiation Safety Aspects and Emergency Response, Proceedings of the Health Physics Society Midyear Topical Meeting on Homeland Defense and Emergency Response, 36th Health Physics Society Topical Meeting, 2003. 218-23.

Sine RC, Levine IH, Jackson WE, et al. Biodosimetry assessment tool: A postexposure software application for management of radiation accidents. Mil Med 2001;166(12):85-7.

Voisin P, Barquinero F, Blakely B, Lindholm C, et al. Towards a standardization of biological dosimetry by cytogenetics. Cell Mol Biol 2002;48: 501-4.

Medical Diagnosis

Armed Forces Radiobiology Research Institute. Medical Management of Radiological Casualties Handbook. Bethesda, MD: Military Medical Operations, Armed Forces Radiobiology Research Institute; April 2003.

External Contamination

Armed Forces Radiobiology Research Institute. Medical Management of Radiological Casualties Handbook, 2nd ed. Armed Forces Radiobiology Research Institute, Bethesda, MD. April 2003.

Radiation Emergency Assistance Center/Training Site (REAC/TS). Oak Ridge, TN: Oak Ridge Institute for Science and Education. Available at http://orise.orau.gov/reacts. Accessed August 1, 2006.

Internal Radionuclide

Armed Forces Radiobiology Research Institute. Medical Management of Radiological Casualties Handbook, 2nd ed. Armed Forces Radiobiology Research Institute, Bethesda, MD. April 2003.

Gusev IA, Guskova AK, Mettler FA, eds. Medical Management of Radiation Accidents, 2nd ed. Boca Raton, FL: CRC Press; 2001.

National Council on Radiation Protection and Measurements. Report No. 65, Management of Persons Accidentally Contaminated With Radionuclides. Bethesda, MD: National Council on Radiation Protection and Measurements;1979.

Radiation Detection, Personal Protective Equipment (PPE), Monitoring, and Decontamination

National Institute for Occupational Safety and Health. Respirators. Available at: http://www.cdc.gov/niosh/npptl/. Accessed August 18, 2006.

Radiation Emergency Assistance Center/Training Site. Guidance for Radiation Accident Management, Detection. Available at: http://orise.orau.gov/reacts/guide/detect.htm. Accessed August 1, 2006.

Radiation Emergency Assistance Center/Training Site. Guide for Radiation Accident Management. Available at: http://orise.orau.gov/reacts/rad-incident-response.htm. Accessed August 1, 2006.

U.S. Department of the Navy. Bureau of Medicine and Surgery Instruction 6470,10A. Initial Management of Irradiated or Radioactively Contaminated Personnel. Washington, DC: U.S. Department of the Navy; December 1998.

Medical Treatment: Issues Unique to Pediatrics

American Academy of Pediatrics Work Group on Disasters. Psychosocial Issues for Children and Families in Disasters: A Guide for the Primary Care Physician. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, National Mental Health Information Center; 1995.

American Academy of Pediatrics Committee on Environmental Health. Risk of ionizing radiation exposure to children: a subject review. Pediatrics 1998;101:717-9.

American Academy of Pediatrics Committee on Environmental Health. Policy statement: radiation disasters and children. Pediatrics 2003;111(6):1455-66.

Cronkite EP, Conrad RA, Bond VP. Historical events associated with fallout from Bravo Shot—Operation Castle and 25 Y of medical findings. Health Phys 1997:73(1):176-86.

Fliedner T, Friesecke M, Beyrer K (eds). Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. Oxford: British Institute of Radiology; 2001.

Miller RW. Special susceptibility of the child to certain radiation-induced cancers. Environ Health Perspect 1995;131(6):41-4.

Moysich KB, Menezes RJ, Michalek AM. Chernobyl-related ionizing radiation exposure and cancer risk: an epidemiological review. Lancet Oncol 2002;3(5):269-79.

National Council on Radiation Protection and Measurements. Management of Terrorist Events Involving Radioactive Material, NCRP Report No. 138. Bethesda, MD: National Council on Radiation Protection and Measurements: 2001.

National Council on Radiation Protection and Measurements. Radiation Protection in Pediatric Radiology, NCRP Report No. 68. Washington, DC: National Council on Radiation Protection and Measurements; 1981.

Pacini F, Vorontsova T, Molinaro E, et al. Thyroid consequences of the Chernobyl nuclear accident. Acta Paediatr Suppl 1999;433:23-7.

Rutherford MW, Seward JP. Radiation injuries and illnesses in pediatric emergency medicine. Clin Ped Emerg Med 2001;2:141-51.

Sugar M. Children in a disaster: an overview. Child Psychiatry Hum Dev 1989;19:163-79.

Sutow WW, Conard RA. Effects of ionizing radiation in children. J Peds 1965;67(4):658-72.

Medical Treatment: Acute Radiation Syndrome

Brook I, Elliott TB, Ledney GD, Knudson GB. Management of postirradiation sepsis. Mil Med 2002;167(2 Suppl):105-6.

Brook I, Walker RI, MacVittie TJ. Effect of antimicrobial therapy on bowel flora and bacterial infection in irradiated mice. Int J Radiat Biol Stud Phys Chem Med 1988;53:709-16.

Dainiak N, Waselenko JK, Armitage JD, MacVittie TJ, Farese AM. The hematologist and radiation casualties. Hematology 2003:473-96.

Farese AM, Hunt P, Grab LB, MacVittie TJ. Combined administration of recombinant human megakaryocyte growth and development factor and granulocyte colony-stimulating factor enhances multilineage hematopoietic reconstitution in nonhuman primates after radiation-induced marrow aplasia. J Clin Invest 1996; 97:2145-51.

Fliedner T, Friesecke M, Beyrer K, eds. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. Oxford: British Institute of Radiology; 2001.

Gunn V, Nechyba C, eds. The Harriet Lane Handbook: A Manual for House Officers Mosby; 2002.

Hall EJ. Acute effects of total-body irradiation. In: Radiobiology for the Radiologist. Philadelphia: Lippincott Williams and Wilkins; 2000.

Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002:15(34):730-51.

Maekawa K. Overview of medical care of highly exposed victims in the Tokaimura accident. In: The Medical Basis for Radiation-Accident Preparedness: The Clinical Care of Victims. New York: Parthenon; 2002.

Medical Economics, ed. Physicians' Desk Reference, 59th ed. Montvale, NJ: Thomson PDR, 2005.

Medical Preparedness and Response Sub-Group, Department of Homeland Security Working Group on Radiological Dispersal Device Preparedness. December 9, 2003. Available at: http://www1.va.gov/emshg/docs/Radiological_Medical_Countermeasures_Indexed-Final.pdf. Accessed August 18, 2006.

Nash RA, Schuening FG, Seidel K, et al. Effect of recombinant canine granulocyte-macrophage colony-stimulating factor on hematopoietic recovery after otherwise lethal total body irradiation. Blood 1994;83:1963-70.

National Council on Radiation Protection and Measurements. Management of Terrorist Events Involving Radioactive Material, NCRP Report No. 138. Bethesda, MD: National Council on Radiation Protection and Measurements: 2001.

Patchen ML, Brook I, Elliott TB, Jackson WE. Adverse effects of pefloxacin in irradiated C3H/HeN mice: correction with glucan therapy. Antimicrob Agents Chemother 1993;37:1882-9.

Wade JC, Rubenstein EB. NCCN Fever and Neutropenia Practice Guidelines Panel: Fever and neutropenia. Cancer Cntl 2001;8(6 Suppl 2):16-21.

Waselenko JK, MacVittie TJ, Blakely WF, et al. Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med 2004;140(12):1037-51 and W-64 to W-67.

Medical Treatment: Internal Contamination

American Academy of Pediatrics Committee on Environmental Health. Policy statement: radiation disasters and children. Pediatrics 2003;111(6):1455-66.

Armed Forces Radiobiology Research Institute. Medical Management of Radiological Casualties, 2nd ed. Bethesda, MD: Armed Forces Radiobiology Research Institute; April 2003.

Guskova AK, Gusev IA. Medical aspects of the accident at Chernobyl. In: Gusev IA, Guskova AK, Mettler FA. Medical Management of Radiation Accidents. Washington, DC: CRC Press; 2001.

International Atomic Energy Agency. The Radiological Accident in Goiania. Vienna, Austria: International Atomic Energy Agency; 1988. Available at: http://www-pub.iaea.org/MTCD/publications/PDF/Pub0815_web.pdf. Accessed May 31, 2004.

Medical Economics, ed. Physicians' Desk Reference. Montvale, NJ: Thomson PDR; 2003.

National Council on Radiation Protection and Measurements. NCRP Report No. 65, Management of Persons Accidentally Contaminated with Radionuclides, Bethesda, MD: National Council on Radiation Protection and Measurements;1979.

National Research Council. Distribution and Administration of Potassium Iodide in the Event of a Nuclear Incident. Washington, DC: National Academy Press; 2004.

Radiation Emergency Assistance Center/ Training Site (REAC/TS). Managing Radiation Emergencies: Guidance for Hospital Medical Management Oak Ridge, TN: Oak Ridge Institute for Science and Education. Available at: http://orise.orau.gov/reacts/guide/manage.htm. Accessed August 2, 2006.

Radiation Emergency Assistance Center/ Training Site (REAC/TS). Zn-DTPA Informational Material. Oak Ridge, TN: Oak Ridge Institute for Science and Education; 2002. Available at: http://orise.orau.gov/reacts/zinc-dtpa.htm. Accessed August 2, 2006.

U.S. Food and Drug Administration, Center for Drug Evaluation and Research. Calcium-DTPA and Zinc-DTPA. Available at: http://www.fda.gov/cder/drug/infopage/DTPA/default.htm. Accessed August 22, 2006.

U.S. Food and Drug Administration, Center for Drug Evaluation and Research. Home Preparation Procedure for Emergency Administration of Potassium Iodide Tablets to Infants and Small Children. Last updated March 6, 2006. Available at http://www.fda.gov/cder/drugprepare/kiprep.htm. Accessed August 2, 2006.

U.S. Food and Drug Administration, Center for Drug Evaluation and Research. Prussian Blue for Treatment of Internal Contamination with Thallium or Radioactive Cesium, Oct 2003. Available at http://www.fda.gov/cder/drug/infopage/prussian_blue/default.htm. Accessed August 22, 2006.

U.S. Food and Drug Administration, Department of Health and Human Services. Guidance for industry on prussian blue for treatment of internal contamination with thallium or radioactive cesium. Federal Register 2003; 68(23):5645-8.

U.S. Government, Public Law 107-188, June 12, 2002. Public Health Security and Bioterrorism Preparedness and Response Act of 2002, Section 127. Potassium Iodide.

Verger P, Aurengo A, Geoggroy B, LeGuen B. Iodine kinetics and stable iodine prophylaxis after intake of radioactive iodine: a review. Thyroid 2001;11(a):353-60.

World Health Organization. Guidelines for Iodine Prophylaxis Following Nuclear Accidents: Update 1999. Geneva, Switzerland: WHO; 1999.

Surgical Issues

Barabanova AV. Local Radiation Injury. In: Gusev D, Guskova AK, Mettler FA, eds. Medical Management of Radiation Accidents, 2nd ed. 2001; CRC Press, Washington DC: p. 221-32.

Bushberg JT. Health Physics Society, Emergency Department Management of Radiation Casualties, 5 October 2004. Available at: http://hps.org/hsc/documents/emergency.ppt. Accessed August 22, 2006.

Delanian S, Porcher R, Balla-Mekias A, Lefaix J. Randomized, placebo-controlled trial of combined pentoxifylline and tocopherol for regression of superficial radiation-induced fibrosis. J Clin Oncol 2003;21(13):2545-50.

Gusev IA, Guskova AK, Mettler FA. Medical Management of Radiation Accidents, 2nd ed. 2001; CRC Press, Washington DC; 76.

Hall EJ. Radiobiology for the Radiologist. New York, New York: Lippincott Williams & Wilkins, 2000; 343, 536

McClain DE, Benson KA, Ejnik J, et al. Health effects of embedded depleted uranium. Military Medicine 2002;167(2 Suppl):117-19.

Medical Management of Radiological Casualties Handbook, 2nd ed. Armed Forces Radiobiology Research Institute, Bethesda, MD; April 2003;36-7.

Peter RU, Gottlober P. Management of cutaneous radiation injuries: diagnostic and therapeutic principles of the cutaneous radiation syndrome, Military Medicine 2002:167(2 Suppl):110-12.

Peter RU. The cutaneous radiation syndrome. In: MacVittie TJ, Weiss JF, Browne D. Advances in the Treatment of Radiation Injuries. Advances in the Biosciences Tarrytown, NY: Pergamon;1996;94:237-40.

Followup Care

American Academy of Pediatrics Committee on Environmental Health Radiation disasters and children. Policy statement: radiation disasters and children. Pediatrics 2003:111:1455-66.

Bauer AJ, Tuttle RM, Francis G. Thyroid nodules and thyroid carcinoma in children. In: Pescovitz O, Eugster E (eds) Pediatric Endocrinology: Mechanisms, Manifestations, and Management Philadelphia, PA: Lippincott Inc; 2004; 522-47.

Drozd VM, Astachova LN, Polyanskaya ON, et al. Characteristics of thyroid ultrasound pictures in children with nodular thyroid changes effected by radionuclides. Bildgebung 1995;62:236-41.

Gharib H. Changing concepts in the diagnosis and management of thyroid nodules. Endocrinol Metab Clin North Am 1997;26:777-800.

Hall E. Radiobiology for the Radiologist, 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins. 2000; 162.

Howard JE, Vaswani A, Heotis P. Thyroid disease among the Rongelap and Utirik population—an update. Health Phys 1997;73:190-8.

Hung W. Solitary thyroid nodules in 93 children and adolescents. a 35-year experience. Horm Res 1999;52:15-8.

Nikiforov YE, Koshoffer A, Nikiforova M, Stringer J, Fagin JA. Chromosomal breakpoint positions suggest a direct role for radiation in inducing illegitimate recombination between the ELE1 and RET genes in radiation-induced thyroid carcinomas. Oncogene 1999;18:6330-4.

Poth M. Thyroid cancer in children and adolescents. In: Wartofsky L (ed). Thyroid Cancer: A Comprehensive Guide to Clinical Management. Towota, NJ: Humana Press; 2000; 121-8.

Preston DL, Shimizu Y, Pierce DA, Suyama A, Mabuchi. K. Studies of mortality of atomic bomb survivors. Report 13: solid cancer and noncancer disease mortality: 1950-1997. Radiat Res 2003;160:381-407.

Robbins RJ, Chon JT, Fleisher M, Larson SM, Tuttle RM. Is the serum thyroglobulin response to recombinant human thyrotropin sufficient, by itself, to monitor for residual thyroid carcinoma? J Clin Endocrinol Metab 2002;87:3242-7.

Schlumberger MJ. Diagnostic follow-up of well-differentiated thyroid carcinoma: historical perspective and current status. J Endocrinol Invest 1999;22:3-7.

Shore RE. Issues and epidemiological evidence regarding radiation-induced thyroid cancer. Radiat Res 1992;131:98-111.

Sklar CA, Mertens AC, Mitby P, et al. Risk of disease recurrence and second neoplasms in survivors of childhood cancer treated with growth hormone: a report from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab 2002;87:3136-41.

Tuttle RM, Becker DV. The Chernobyl accident and its consequences: update at the millennium. Semin Nucl Med 2000;30:133-40.

U.S. Food and Drug Administration, Center for Drug Evaluation and Research 2002. Guidance for Industry: KI in Radiation Emergencies—Questions and Answers. Available at: http://www.fda.gov/cder/guidance/5386fnl.htm. Accessed August 24, 2006.

Welch Dinauer CA, Tuttle RM, Robie DK, et al. Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults. Clin Endocrinol (Oxf) 1998;49:619-28.

Environmental Issues

Bromet EJ. Psychological Effects of Radiation Casualties. In: Effects of Ionizing Radiation: Atomic Bomb Survivors and Their Children (1945-95). Washington, DC: John Henry Press, 1998; 288-9. Available at: http://books.nap.edu/catalog/5805.html. Exit Disclaimer Accessed August 24, 2006.

Cordesman AH. Terrorism, Asymmetric Warfare, and Weapons of Mass Destruction, Defending the U.S. Homeland. Westport, CN: Praeger Publishers; 2002.

Eisenbud M, Gesell T. Environmental Radioactivity, from Natural, Industrial, and Military Sources, 4th ed. San Diego: Academic Press;1997;108, 415-18, 530-31.

Health Physics Society. Guidance for Protective Actions Following a Radiological Terrorist Event, Position Statement of the Health Physics Society. Adopted Jan 2004. Available at: http://www.hps.org/documents/RDDPAGs.pdf. Accessed August 2, 2006.

International Atomic Energy Agency. The Radiological Accident in Goiania. Vienna, Austria: International Atomic Energy Agency. 1988. Available at http://www-pub.iaea.org/MTCD/publications/PDF/Pub815_web.pdf. Accessed August 2, 2006.

International Atomic Energy Agency, IAEA-TECDOC-1388, Feb 2004.

National Council on Radiation Protection and Measurements. Management of Terrorist Events Involving Radioactive Material, NCRP Report No. 138, Bethesda, MD: National Council on Radiation Protection and Measurements; 2001.

Nuclear Regulatory Commission Web site, Fact Sheet on the Accident at Three Mile Island. Available at http://www.nrc.gov/reading-rm/doc-collections/fact-sheets/3mile-isle.html. Accessed August 2, 2006.

U.S. Army Center for Health Promotion and Preventive Medicine. Medical NBC Battlebook Section 3-4 to 3-6, Aug 2002.

U.S. Dept of Health and Human Services, Food and Drug Administration, 13 Aug 1998. Accidental Radioactive Contamination of Human Food and Animal Feeds: Recommendations for State and Local Agencies, August 13, 1998. Available at: http://www.fda.gov/cdrh. Accessed August 24, 2006.

U.S. Dept of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research. Guidance, Potassium Iodide as a Thyroid Blocking Agent in Radiation Emergency, Dec 2001. Available at: http://www.fda.gov/cder/guidance/4825fnl.htm. Accessed August 2, 2006.

U.S. Environmental Protection Agency. Manual of Protective Action Guides and Protective Actions for Nuclear Incidents. Washington, DC: U.S. Environmental Protection Agency; EPA 400-R-92-001; May 1992. Available at: http://www.epa.gov/radiation/docs/er/400-r-92-001.pdf. Accessed August 2, 2006.

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