Follow-Up and Medical Treatment of Radiation Accident Victims of the 1997 Lilo Accident: Implications for Radiation Accident Medical Management

H.D. Dorr1; T.M. Fliedner2; and V. Meineke3 (1Institute of Radiobiology, German Armed Forces, Munich, Germany; 2Radiation Medicine Research Group, Faculty of Medicine, University of Ulm, Germany; 3Director, Institute of Radiobiology German Armed Forces, Munich, Germany)

In December 2003 two of the 11 radiation accident victims of the 1997 Lilo accident were medically treated and followed up in the Bundeswehr Hospital / Ulm in cooperation with the Bundeswehr Institute of Radiobiology and the WHO REMPAN (Radiological Emergency Medical Preparedness and Assistance Network) center, University of Ulm, Germany. Beside the medical treatment several special diagnostic procedures (dicentric chromosomes assay, quantification of gene expression, comet assay) were performed to investigate the long term effects on the cellular and molecular level. The effectiveness of multidisciplinary international cooperation in the field of radiation accident medical management is shown. Moreover the important role of telemedicine expert consultation as a means of both rapid expert consultation worldwide and a tool for a follow-up of treatment of radiation accident victims is illustrated. The case of the follow-up investigation in the Lilo patients underlines one important fact. The described clinical as well as molecular biological findings show that even years after accidental radiation exposure changes on the molecular level can be noticed in those patients. These patients therefore are a high risk collective for the development of late effects up to cancer and for this reason need a life long follow-up. Concepts for this specific task of a long term follow-up of radiation victims need to be developed.

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