DOE OSTI2017
Many casualties of the Hiroshima and Nagasaki atomic bombs, and many of the firefighters who first responded to the Chernobyl nuclear power plant accident, became ill with acute radiation syndrome (ARS). Most of the people who do not recover from ARS will die within a few weeks to a few months after exposure, with the primary cause of death being the destruction of the body's bone marrow (BM). This is exemplified by the Chernobyl firefighters, the majority of whom received whole body doses between 0.8 and 10 Gy, and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) final report on the disaster concluded that the underlying cause of death of all 28 firefighters who succumbed to ARS was from bone marrow failure. BM is comprised of hematopoietic stem cells (HSCs) which are responsible for the constant renewal of blood cells. Due to their high rate of proliferation, HSCs are especially vulnerable to ionizing radiation, but are endowed with remarkable regenerative potential. Owing to their central role in blood production, lethal irradiation of HSCs leads to death from severe anemia, infection and internal bleeding. This relationship between high doses of radiation and HSC apoptosis has led to the use of HSC transplantation as a life-saving intervention in cases of acute exposure. This is demonstrable in medical practice, where thousands of individuals have undergone supra-lethal Total Body Irradiation (TBI) for purposes of cancer therapy, and were rescued by well-matched BM transplantation. Indeed, life-threatening damage may be reversed by BM transplantation in individuals receiving doses of radiation of up to 10 Gy. At doses > 10 Gy, damage to gastrointestinal (GI) tissue may become a limiting factor in survival. Remarkably, in the common procedure of BM transplantation, the number of HSCs extracted from a single active BM site containing less than 5% of the donor's BM tissue is sufficient to support the complete reconstitution of the HSC compartment in a lethally irradiated recipient. This capacity of BM to expand and replenish is due to the high regenerative potential of the HSCs it harbors. In contrast to mature blood cells, which are dispersed throughout the body, HSCs are confined to the bones, allowing for effective targeted shielding. This has been confirmed in several animal models, where sparing the HSC-rich area of a subject receiving otherwise full-body irradiation is sufficient to support hematopoietic functions and allow survival. Approximately 48% of the human body's active BM is contained within the lumbar vertebrae and the pelvic region. This high concentration of BM makes the pelvic region an ideal area to shield for preventing the serious hematopoietic effects of radiation exposure. Stem-cell rich tissues like active BM are also more sensitive to the stochastic effects (i.e. cancer) of radiation exposure. The high amount of BM in the pelvic region, combined with the presence of the sensitive gastrointestinal system and female gonads in this same area of the body allows for the possibility of significantly reducing stochastic effects of radiation by limiting radiation exposure to this vital area. Thus, shielding this region holds great promise for both acute and protracted exposures. Thus, a specialized radiation shielding device for the protection of active BM concentrations is presented here. This belt-like selective shielding device focuses on the protection of BM that is present in the pelvis and hip bones, protecting the medullary volume from which BM is commonly extracted for transplantation (i.e. the iliac bones) while allowing relatively unhindered movement of the wearer. In order to optimize the use of shielding materials towards the protection of active BM, the shielding uniquely brings into account the natural shielding properties of human tissue, with thickness being inversely related to the thickness and radiation attenuation of the underlying tissue at each point surrounding the area being protected. The findings resulting from both experimental and simulation testing of this selective shielding device are presented here.
61 RADIATION PROTECTION AND DOSIMETRY↗