O planejamento e preparo da resposta médica a acidentes radiológicos e nucleares : a importância da inclusão das forças armadas na resposta médica

Abstract

The increasing use of radioactive sources in medicine, research projects and industry and the recent acknowledgement of nuclear power plants as a secure and clean alternative of energy production is pushing the International Atomic Energy Agency to review and elaborate some plans and new safeguards in order to reduce the risk of an accident. Moreover, the last terrorist attacks turned the possibility of mass and environmental casualties as a consequence of a nuclear or radiological event more probable than ever, which make urgent the necessity of actions to strengthen the international preparedness and response system for these situations as well as to reduce the gaps and regional discrepancies. In Brazil, the response to nuclear accidents is coordinated by the Protection System for the Brazilian Nuclear Program (SIPRON) and the response to radiological events is a National Civil Defense responsibility. The Nuclear Energy National Commission is the public organ that coordinates the radioprotection actions and nuclear security and elaborates the safeguards and the national response preparedness. However, although great improvements have been done in the national response since the Goiania accident, very few gains have been achieved in medical planning and preparedness. The country neither have a global medical response nor a consensus protocol for medical procedures in case of a nuclear or radiological accident. The management of patients suffering from radiation injury is highly complex and needs a specialized multi-disciplinary health team. Lessons learned from Goiania accident showed that, in Brazil, a military organization, with its well defined hierarchical structure, have the ideal qualifications to implement a medical response to nuclear and radiological accidents all over the national territory. The objective of this work is, by describing the complexity of planning and preparedness response for nuclear and radiological accidents, analyse the national response and show how important the inclusion of Armed Forces in the overall medical response would be.