Pediatric Considerations Before, During, and After Radiological or Nuclear Emergencies

Pediatric Medical Countermeasures: Antidotes and Cytokines for Radiological and Nuclear Incidents and Terrorism

The war in Ukraine raises concerns for potential hazards of radiological and nuclear incidents. Children are particularly vulnerable in these incidents and may need pharmaceutical countermeasures, including antidotes and cytokines. Searches found no published study comparing pediatric indications and dosing among standard references detailing pediatric medications for these incidents. This study addresses this gap by collecting, tabulating, and disseminating this information to healthcare professionals caring for children. Expert consensus chose the following references to compare their pediatric indications and dosing of medical countermeasures for radiation exposure and internal contamination with radioactive materials: Advanced Hazmat Life Support (AHLS) for Radiological Incidents and Terrorism, DailyMed, Internal Contamination Clinical Reference, Medical Aspects of Radiation Incidents, and Medical Management of Radiological Casualties, as well as Micromedex, POISINDEX, and Radiation Emergency Medical Management (REMM). This is the first study comparing pediatric indications and dosing for medical countermeasures among commonly used references for radiological and nuclear incidents.

Radiation Injuries: Acute Radiation Syndrome in Children

The conflict in Ukraine has raised the specter of radiological and nuclear incidents, including fighting at the Zaporizhzhia nuclear plant, the largest nuclear powerplant in Europe; concerns that a radiological dispersion device ("dirty bomb") may be used; and threats to deploy tactical nuclear weapons. Children are more susceptible than adults to immediate and delayed radiation health effects. This article reviews the diagnosis and treatment of acute radiation syndrome. Although definitive treatment of radiation injuries should involve consultation with specialists, nonspecialists should learn to recognize the distinctive signs of radiation injury and make an initial assessment of severity of exposure. [Pediatr Ann. 2023;52(6):e231-e237.].

Drinking Water From Private Wells and Risks to Children

Drinking water for >23 million US households is obtained from private wells. These wells can become contaminated by chemicals, naturally occurring toxic substances, or pathogenic organisms that can cause illness in children. Although the US Environmental Protection Agency and most states offer some guidance for the construction, maintenance, and testing of private wells, most states only regulate the construction of new private water wells. With few exceptions, well owners are responsible for their own wells after the initial construction. Children may also drink well water at childcare or when traveling. This policy statement provides recommendations for the inspection, testing, and remediation of private wells to provide safe drinking water for children.

Lessons from Fukushima: Potassium Iodide After a Nuclear Disaster

ABSTRACT

The release of radioactive iodine after a nuclear disaster, such as those that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan 10 years ago and Three Mile Island in Pennsylvania in 1979, increases thyroid cancer risk among people who are exposed. Certain populations are especially vulnerable, including pregnant and breastfeeding women, children, and neonates. Potassium iodide (KI) can effectively block radioactive iodine from being absorbed by the thyroid gland if taken immediately after a radiation release. This article examines lessons learned from Fukushima to enhance disaster readiness and nursing actions. Nurses should be directly involved in vulnerability assessments, emergency planning, and in ensuring the availability, accessibility, and distribution of KI within U.S. nuclear power plant emergency planning zones before a crisis occurs.

Usefulness of the whole-body counter for infants and small children (BABYSCAN) as a risk communication tool after the Fukushima Daiichi nuclear power plant incident

Responding to the radiation-related concerns of parents/guardians with infants/small children is an important public health issue for regional recovery after radioactive contamination. This study summarizes the results of a systematic internal contamination screening of infants/small children, aged 0-6 years, using BABYSCAN and individual counselling sessions with physicians about radiation concerns from 2014 to 2018 in Minamisoma City. Of 3,114 participants, no one was found to have internal contamination with radioactive caesium with a detection limit of 50 Bq/body. The questionnaire survey showed a decreasing trend of concerns about food contamination and playing outside as possible causes of internal contamination over time. Because people's concerns were diverse in counselling sessions, individual responses are required. This study showed that examinations using BABYSCAN provide an opportunity for direct dialogue between the parents/guardians of infants/small children and experts. This can be considered a model case for risk communication conducted by the local government after a radioactive contamination incident.

Rights, justice, and equity: a global agenda for child health and wellbeing

Worldwide challenges to child health and wellbeing are rapidly becoming existential threats to children and childhood. Inequities, armed conflict and violence, nuclear proliferation, forced migration, globalisation, and climate change are among the global issues violating children's rights to optimal survival and development. Child rights-based approaches will be required to enhance the response to the civil-political, social, economic, and cultural determinants of these global child health issues. In this Viewpoint, we present a global agenda for child health and wellbeing as a blueprint for the practice of paediatrics and child health in the domains of clinical care, systems development, and policy formulation. This global agenda is grounded in the principles of rights, justice, and equity and can address the root-cause determinants of health. The 30th anniversary of the UN Convention on the Rights of the Child is a relevant moment to recommit to shared goals for children's health and wellbeing.