-
氚是氢的同位素之一,也是氢发生核聚变反应的重要核素之一。近年来,随着核能的不断发展,在核电厂的运行、乏燃料后处理、放射性同位素的生产、核潜艇动力的研究过程中和核退役设施中,氚的释放越来越多,其均存在潜在的氚泄露风险。此外,核电站发生事故时还会导致更多的氚排放到环境中[1]。近年来,日本福岛核事故产生的大量含氚放射性污水的排放[2-4]使公众对氚的辐射效应及辐射防护、氚的应急等相关问题更加关注。中国的核安全白皮书[5]指出,要提升我国核与辐射事故的应急能力。核与辐射事故的医学应急是国家核应急的重要组成部分,一旦发生严重的核与辐射事故,应将公众的健康放在第一位[6],首先抢救放射损伤或受伤人员,其次维护国家的财产安全[7]。做好核与辐射事故应急的准备与响应工作的重要性日益突出[8],核应急作为核辐射纵深防御的最后一道屏障[9],是一项社会系统工程,其涉及面广、社会影响大、敏感度高。涉氚事故的医学应急可参考核与辐射事故的医学应急,应有充分的组织准备、应急预案、周密的应急行动计划及平时的培训演练。
本文针对涉氚事故的发生特点,结合相关法律法规的规定,对涉氚事故医学应急三级救援体系、涉氚事故受照人员的医学管理及心理援助等方面进行分析,期望对今后涉氚事故的医学应急与管理提供建设性的意见。
涉氚事故的医学应急与管理
Medical emergency and management of tritium-related accidents
-
摘要: 近年来,氚的辐射效应受到广泛关注。涉氚事故的医学应急是一项对专业技术要求较高、涉及面广、社会影响范围大的工作。我国核与辐射相关法律法规对于突发事件应急有完善的应急制度与救援管理方案。笔者结合氚放射事故发生的特点和法律法规相关规定,对涉氚事故的医学应急三级救援体系、涉氚事故受照人员的医学管理及心理援助等方面进行分析,以期为涉氚事故的医学应急与管理提供建设性意见。Abstract: In recent years, the radiation effects of tritium have received widespread attention. Medical emergency to tritium-related accidents is a task with high requirements for specialized technology, wide coverage and wide impact. China's nuclear and radiation-related laws and regulations for emergency have a perfect emergency system and rescue management program. The author combines the characteristics of tritium radiation accidents and the relevant provisions of laws and regulations to analyze the three-level rescue system for medical emergency to tritium accidents, the medical management of tritium accidents and the psychological assistance of the illuminated personnel, etc., in order to put forward constructive opinions for the medical emergency and management of tritium-related accidents.
-
Key words:
- Tritium /
- Medical emergency /
- Medical management /
- Psychological assistance
-
[1] Zhao C, Wang G, Zhang M, et al. Transport and dispersion of tritium from the radioactive water of the Fukushima Daiichi nuclear plant[J]. Mar Pollut Bull, 2021, 169: 112515. DOI: 10.1016/j.marpolbul.2021.112515. [2] Men W. Discharge of contaminated water from the Fukushima Daiichi nuclear power plant accident into the Northwest Pacific: what is known and what needs to be known[J]. Mar Pollut Bull, 2021, 173: 112984. DOI: 10.1016/j.marpolbul.2021.112984. [3] Kaizer J, Kontuľ I, Povinec PP. Impact of the Fukushima accident on 3H and 14C environmental levels: a review of ten years of investigation[J/OL]. Molecules, 2023, 28(6): 2548[2023-08-07]. https://www.mdpi.com/1420-3049/28/6/2548. DOI: 10.3390/molecules28062548. [4] 吕德胜. 日本不顾国际社会反对正式批准核废水排海计划[J]. 雷锋, 2022, 8(8): 68. DOI: 10.19564/j.cnki.leifeng.2022.08.017.
Lyv DS. Japan formally approves nuclear wastewater discharge plan despite international opposition[J]. Leifeng, 2022, 8(8): 68. DOI: 10.19564/j.cnki.leifeng.2022.08.017.[5] 中华人民共和国国务院新闻办公室. 中国的核安全[N]. 人民日报, 2019-09-04(017).
The Information Office of the State Council of the People's Republic of China. China's nuclear safety [N]. People's Daily, 2019-09-04 (017).[6] 王睿昊, 刘玉龙. 核与辐射事故应急的医疗计划[J]. 辐射防护通讯, 2018, 38(2): 44−45. DOI: 10.3969/j.issn.1004-6356.2018.02.010.
Wang RH, Liu YL. Medical plan for nuclear and radiation accident emergency response[J]. Radiat Prot Bull, 2018, 38(2): 44−45. DOI: 10.3969/j.issn.1004-6356.2018.02.010.[7] 王川, 马志刚, 袁添鸿. 福岛核电站事故对我国核电发展的启示[J]. 工业安全与环保, 2014, 40(2): 83−85. DOI: 10.3969/j.issn.1001-425X.2014.02.026.
Wang C, Ma ZG, Yuan TH. The enlightenment of Fukushima nuclear power plant accident to China's nuclear power development[J]. Ind Saf Environ Prot, 2014, 40(2): 83−85. DOI: 10.3969/j.issn.1001-425X.2014.02.026.[8] 白光, 刘玉龙, 曹毅, 等. 提高我国核与辐射突发事件医学应急救援水平的思考[J]. 辐射防护通讯, 2020, 40(4/5): 7−10, 21. DOI: 10.3969/j.issn.1004-6356.2020.04.003.
Bai G, Liu YL, Cao Y, et al. Thoughts on improving nuclear and radiation emergency medical rescue in China[J]. Radiat Prot Bull, 2020, 40(4/5): 7−10, 21. DOI: 10.3969/j.issn.1004-6356.2020.04.003.[9] 中华人民共和国国家核事故应急协调委员会. 国家核应急预案[EB/OL]. (2013-06-30) [2023-08-07]. https://www.gov.cn/yjgl/2013-07/09/content_2443474.htm.
National Nuclear Accident Emergency Coordinating Committee of the People's Republic of China. National Nuclear Emergency Response Plan [EB/OL]. (2013-06-30)[2023-08-07]. https://www.gov.cn/yjgl/2013-07/09/content_2443474.htm.[10] 中华人民共和国国务院. 中华人民共和国突发事件应对法[EB/OL]. (2007-08-30) [2023-08-07]. https://www.gov.cn/ziliao/flfg/2007-08/30/content_732593.htm.
The State Council of the People's Republic of China. Law of the People's Republic of China on Emergency Response [EB/OL]. (2007-08-30) [2023-08-07]. https://www.gov.cn/ziliao/flfg/2007-08/30/content_732593.htm.[11] 中华人民共和国国务院. 放射性同位素与射线装置安全和防护条例[M]. 北京: 中国法制出版社, 2005.
The State Council of the People's Republic of China. Regulations on the safety and protection of radioisotopes and radiation devices[M]. Beijing: China Legal Publishing House, 2005.[12] 中华人民共和国卫生部. 国家突发公共事件医疗卫生救援应急预案[EB/OL]. (2006-02-26) [2023-08-07]. https://www.gov.cn/yjgl/2006-02/26/content_211628.htm.
Ministry of Health of the People's Republic of China. National emergency plan for medical and health rescue in public emergencies [EB/OL]. (2006-02-26) [2023-08-07]. https://www.gov.cn/yjgl/2006-02/26/content_211628.htm.[13] 中华人民共和国卫生部. 卫生部核事故和辐射事故卫生应急预案[EB/OL]. (2009-10-27)[2023-08-07]. https://www.gov.cn/govweb/zwgk/2009-10/27/content_1450118.htm.
Ministry of Health of the People's Republic of China. Emergency plan for nuclear and radiological accidents of the Ministry of Health[EB/OL]. (2009-10-27)[2023-08-07]. https://www.gov.cn/govweb/zwgk/2009-10/27/content_1450118.htm.[14] 中华人民共和国卫生和计划生育委员会. WS/T 467-2014 核和辐射事故医学响应程序[S]. 北京: 中国标准出版社, 2015.
National Health and Family Planning Commission of the People's Republic of China. WS/T 467-2014 Procedures for medical response during a nuclear or radiological accident[S]. Beijing: Standards Press of China, 2015.[15] 中华人民共和国卫生和计划生育委员会应急办. 全国医疗机构卫生应急工作规范(试行)[EB/OL]. (2015-10-28)[2023-08-07]. http://www.nhc.gov.cn/yjb/s7859/201511/8b520f79cba04976bd563ab22bd0fc69.shtml.
Emergency Office of the National Health and Family Planning Commission of the People's Republic of China. National health emergency response work specifications for medical institutions (Trial)[EB/OL]. (2015-10-28)[2023-08-07]. http://www.nhc.gov.cn/yjb/s7859/201511/8b520f79cba04976bd563ab22bd0fc69.shtml.[16] 游振根. 关于消防部队核与辐射事故应急救援力量建设问题的思考[J]. 城市建设理论研究(电子版), 2012, (7): 1−7.
You ZG. Reflections on the construction of emergency rescue forces for nuclear and radiation accidents in fire fighting forces[J]. Urban Constr Theory Res (Electron Ed), 2012, (7): 1−7.[17] Okada S, Momoshima N. Overview of tritium: characteristics, sources, and problems[J]. Health Phys, 1993, 65(6): 595−609. DOI: 10.1097/00004032-199312000-00001. [18] 周文明, 古晓娜, 郝杰. 两种氚化水内照射剂量估算方法比较[J]. 中国工业医学杂志, 2022, 35(3): 282−284. DOI: 10.13631/j.cnki.zggyyx.2022.03.032.
Zhou WM, Gu XN, Hao J. Comparison of two methods for estimating the dose of internal irradiation in deuterated water[J]. Chin J Ind Med, 2022, 35(3): 282−284. DOI: 10.13631/j.cnki.zggyyx.2022.03.032.[19] Higley K, Real A, Chambers D. ICRP publication 148: radiation weighting for reference animals and plants[J]. Ann ICRP, 2021, 50(2): 9−133. DOI: 10.1177/0146645319896548. [20] Johnson KC, Rouleau J. Temporal trends in Canadian birth defects birth prevalences, 1979-1993[J]. Can J Public Health, 1997, 88(3): 169−176. DOI: 10.1007/BF03403882. [21] 黄彦君, 陶云良, 上官志洪. 氚对公众的健康影响及风险评估[J]. 中华放射医学与防护杂志, 2012, 32(4): 431−435. DOI: 10.3760/cma.j.issn.0254-5098.2012.04.028.
Huang YJ, Tao YL, Shangguan ZH. Public health effects and risk assessment of tritium[J]. Chin J Radiol Med Prot, 2012, 32(4): 431−435. DOI: 10.3760/cma.j.issn.0254-5098.2012.04.028.[22] Chen WB, Li HW, Wang KZ, et al. Medical treatment and dose estimation of a person exposed to tritium[J/OL]. Dose Response, 2019, 17(4): 1559325819880670[2023-08-07]. https://journals.sagepub.com/doi/full/10.1177/1559325819880670?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org. DOI: 10.1177/1559325819880670. [23] 陈炜博, 刘玉龙, 卞华慧, 等. 1例氚内污染人员的剂量估算与医学处理[J]. 中国卫生检验杂志, 2015, 25(12): 1952−1955.
Chen WB, Liu YL, Bian HH, et al. The dose estimation and the medical treatment of one person with tritium internal contamination[J]. Chin J Health Lab Technol, 2015, 25(12): 1952−1955.[24] 刘玉龙, 陈炜博, 卞华慧, 等. 1例小剂量氚水体内污染人员的医学观察及处理[C]//中华医学会灾难医学分会第三届年会暨城市安全与灾难医学救援国际高峰论坛论文集. 上海: 中华医学会, 世界灾难与急救医学会, 2015: 25-26.
Liu YL, Chen WB, Bian HH, et al. Medical observation and management of a case of small-dose tritium water internal contamination in a person[C]//Proceedings of the Third Annual Meeting of the Disaster Medicine Branch of the Chinese Medical Association and International Summit Forum on Urban Safety and Disaster Medical Rescue. Shanghai: Chinese Medical Association, World Society for Disaster and Emergency Medicine, 2015: 25-26.[25] 刘玉龙, 马楠. 核能运转中氚的防护[J]. 中国辐射卫生, 2021, 30(3): 386−390. DOI: 10.13491/j.issn.1004-714X.2021.03.025.
Liu YL, Ma N. Tritium protection in the operation of nuclear energy[J]. Chin J Radiol Health, 2021, 30(3): 386−390. DOI: 10.13491/j.issn.1004-714X.2021.03.025.[26] Pédehontaa-Hiaa G, Holstein H, Mattsson S, et al. Tritium in urine from members of the general public and occupationally exposed workers in Lund, Sweden, prior to operation of the European Spallation Source[J]. J Environ Radioact, 2020, 213: 106141. DOI: 10.1016/j.jenvrad.2019.106141. [27] 李圣日, 崔凤梅, 刘玉龙, 等. 氚水致癌、致突变和致畸效应研究进展[J]. 辐射防护通讯, 2019, 39(5): 32−35. DOI: 10.3969/j.issn.1004-6356.2019.05.005.
Li SR, Cui FM, Liu YL, et al. Advances in research on carcinogenic, mutagenic and teratogenic effects of tritiated water[J]. Radiat Prot Bull, 2019, 39(5): 32−35. DOI: 10.3969/j.issn.1004-6356.2019.05.005.[28] Balonov MI, Muksinova KN, Mushkacheva GS. Tritium radiobiological effects in mammals: review of experiments of the last decade in Russia[J]. Health Phys, 1993, 65(6): 713−726. DOI: 10.1097/00004032-199312000-00009. [29] United Nations Scientific Committee on the Effects of Atomic Radiation. Sources, effects and risks of ionizing radiation, UNSCEAR 2020/2021 Report Volume II. Scientific Annex B -levels and effects of radiation exposure due to the accident at the Fukushima Daiichi Nuclear Power Station: implications of information published since the UNSCEAR 2013 Report[M]. New York: United Nations Publication, 2021. [30] 潘自强. 切尔诺贝利和福岛核事故对人体健康影响究竟有多大?[J]. 中国核电, 2018, 11(1): 11−14. DOI: 10.12058/zghd.2018.01.011.
Pan ZQ. How much impact of Chernobyl and Fukushima nuclear accidents on human health[J]. China Nucl Power, 2018, 11(1): 11−14. DOI: 10.12058/zghd.2018.01.011.[31] Matsunaga H, Orita M, Iyama K, et al. Intention to return to the town of Tomioka in residents 7 years after the accident at Fukushima Daiichi Nuclear Power Station: a cross-sectional study[J]. J Radiat Res, 2019, 60(1): 51−58. DOI: 10.1093/jrr/rry094. [32] Eyrolle F, Ducros L, Le Dizès S, et al. An updated review on tritium in the environment[J]. J Environ Radioact, 2018, 181: 128−137. DOI: 10.1016/j.jenvrad.2017.11.001. [33] International Atomic Energy Agency. Lessons learned from the response to radiation emergencies (1945-2010)[M]. Vienna: International Atomic Energy Agency, 2012.
计量
- 文章访问数: 1441
- HTML全文浏览量: 1101
- PDF下载量: 8