Development of an enhanced operational capacity for a laboratory using triage-mode based biodosimetry

In case of an accidental or malevolent radiological event involving a large number of potential victims, fast and correct classification in terms of level of exposure is of utmost importance, not only for those that require specific medical treatment, but also for those that were not exposed. Our goal was to develop a system allowing to classify as many potential victims as possible in our laboratory by using the reference cytogenetic biodosimetry assay.

A system was created with a theoretical classification of 320 individuals 13 days after sample reception by using a triage-mode dicentric chromosome assay (DCA). After preliminary tests to verify the system logistics and equipment, a partial-capacity exercise was performed, where 120 blood samples were irradiated with 6 MV X-rays at doses ranging from 0 to 4.5 Gy. Operators were asked to treat and analyze the blindly coded samples by applying specific protocols and to respect an established deadline.

Deployment of the system was successful and pre-planned logistics were applied as instructed. Classification results were compiled with a strict time limit and following previous developments, 3 radiation exposure grading scales of 5, 4 and 3 classes were applied. Correct classification ranged from 85 to 92%, depending on the grading scale used.

This partial-capacity exercise contributed to validate the newly developed organizational system, showing promising results. Points of improvement were clearly identified, and current efforts are focused toward maximizing the correct classification percentage and testing the maximal capacity of the system.