Role of radiation emergency medicine: historical view-a perspective on the past, present, and future

The more science progresses, the more life and society change. Medicine also changes with the times and the culture. This is also true for radiation emergency medicine, which includes dose-assessment leading to diagnosis, treatment, medical follow-up and prognosis of persons who have developed acute injury or illness due to radioactive contamination or radiation exposure. Before the report of X-rays by Roentgen, there was evidence that X-rays had been emitted from the electrically excited Crookes tube and that skin injury had been caused by the X-rays. Thus, the history of radiation and its exposure started before Roentgen. During the early stage of radiation use, people were simply exposed to radiation but were unaware of any danger. Radioactive materials were found soon after Roentgen's report, and contamination with these materials occurred. Together with the development of science and technology, sophisticated radiation devices were produced, and the use and application of radiation became much enhanced. New radionuclides were found one after another, leading to identification of different qualities of radiation. Development of nuclear physics allowed people to artificially produce radionuclides and to construct a nuclear reactor. After World War II, nuclear power plants were constructed, and related facilities such as nuclear fuel processing, reprocessing and spent fuel storage facilities were built. If radiation accidents or events occur at such facilities, radiation exposure with thermal or chemical burns could occur. Together with the expansion of globalism in the world and division in the society, there are now increasing concerns regarding the malicious usage of radiation by radiological dispersal devices (RDDs) including a dirty bomb. Upon detonation of RDDs, blast and thermal injuries with radiation exposure could be caused. In the present society, the natures of exposure to radiation and contamination with radioactive materials have become much more complicated. Not even mentioning the atomic bomb, the detonation of RDDs also necessitates scenarios of medical responses to complicated injuries and the involvement of numbers of people. This article looks back at the history of radiation and addresses the medical responses to radiation injuries that change with the times.