2016-07-14-世界卫生组织-An_update_of_the_WHO_BioDoseNet_11页_635kb

Summary of the WHO BioDoseNet: Developments Since Its Inception

Core Content

The World Health Organization (WHO) established the BioDoseNet (BDN) in 2007 to enhance international cooperation and capacity building in biodosimetry. The network aims to support the rapid assessment of radiation exposure during mass casualty events through the harmonization of protocols and techniques. A survey conducted in 2015 compared the capabilities of BDN laboratories with a similar survey from 2009, highlighting progress and changes in the field.

Main Objectives

• To provide mutual assistance during radiological emergencies.
• To standardize biodosimetry methods and improve global capacity.
• To enhance the ability of laboratories to quickly and accurately estimate radiation doses using biological methods.

Key Developments

Biodosimetry Methods

• Dicentric Chromosome Assay (DCA) remains the most widely used method, with almost all laboratories having developed calibration curves.
• Cytokinesis-Block Micronucleus (CBMN) assay and Premature Chromosome Condensation (PCC) are increasingly used, with γ-H2AX also gaining popularity.
• Fluorescence In Situ Hybridisation (FISH) and Electron Paramagnetic Resonance (EPR) are less common, with only a few laboratories reporting capacity for these techniques.
• Calibration curves have improved in number and quality, especially for low LET (Linear Energy Transfer) radiation.

Sample Processing and Triage

• Laboratories are better prepared for sample processing, with more established protocols for collection, shipping, and handling.
• The weekly capacity for DCA scoring remained relatively stable (from 53 to 52 samples/laboratory), but monthly capacity increased (from 170 to 200 samples/laboratory).
• The overall international capacity increased slightly from ~3000 samples/week to ~3200 samples/week and from ~10,000 to ~12,000 samples/month.

Human Resources and Staffing

• Most laboratories have trained staff for culturing, scoring, and data analysis.
• The average number of techniques available per laboratory increased from 2.6 to 2.9.
• The number of techniques with calibration curves increased from 1.9 to 2.8.

Quality Assurance and Control (QA/QC)

• QA/QC compliance improved, with about half of the laboratories now in compliance.
• ISO accreditation increased from 2 laboratories to 6, and national accreditation increased from 40% to almost 40%.
• Many laboratories follow ISO and IAEA guidelines without formal accreditation.

Experience with In Vivo Exposures

• 95% of laboratories reported some experience with in vivo exposures, compared to 80% in 2009.
• 71% had experience with accidental or suspected exposure cases, up from 65% in 2009.
• Cases included those from Fukushima, Bulgaria, Ecuador, El Salvador, Venezuela, and Peru.

Intercomparisons and Exercises

• Regular intercomparisons and exercises are essential for maintaining and validating biodosimetry capabilities.
• 17% of laboratories still do not participate in any intercomparisons, often due to being new or in resource-limited countries.
• Participation in national, regional, and international exercises increased, especially in Europe and Latin America.

Networks and Collaboration

• 66% of laboratories belong to at least one network, up from 58% in 2009.
• Renewable Network of Biodosimetry (RENEB) has grown significantly, with 19 laboratories now participating.
• WHO-Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) and IAEA-Response Assistance Network (RANET) have seen increased participation, especially RANET.
• The IAEA Coordinated Research Project (CRP) has played a key role in strengthening regional networks, including the Asian Network.

Conclusion

The WHO BioDoseNet has made significant progress since its inception in 2007, with improved standardization, increased awareness of shipping and QA/QC protocols, and enhanced collaboration between laboratories. While the DCA remains the dominant method, the field has expanded to include alternative techniques. However, the capacity for handling very large mass casualty events is still limited, and further efforts are needed to improve global readiness. The role of international networks and intercomparisons is crucial in ensuring consistent and reliable biodosimetry results across the globe.