Potential applications of biomarkers of radiation exposure in nuclear terrorism events

Terrorists attacks involving radioactive materials are raising an increasing concern in the public. Physical dosimetry will be incomplete or absent in a terrorist radiological attack, and it will be necessary to resort to biological indicators of exposure for the assessment of dose and risk to the exposed population. The current status of biological dosimetry techniques is reviewed in this paper. It is shown that reliable estimates can be achieved in the high dose-range (1-20 Gy), whereas large uncertainties will be associated to estimates of radiological exposures at doses below 0.5 Gy, especially when internal contamination is involved. Cytogenetic techniques are recommended for acute exposure to moderate or high doses. Novel molecular methodologies show promise as screening and clinical diagnostic tools at low-doses, but they require further development and validation studies. The automation potential of these methods is also discussed.