MEDICAL RESPONSE STRATEGY Responders’ equipment and means of protection Dosimetric monitoring of responders The persons responding to a Radiological Emergency Situation (RES) take measures intended to prevent or reduce the risks associated with an RN situation. They are tasked with protecting the populations or helping to maintain the functioning of an uninterruptible activity of strategic importance. These tasks cannot be assigned to pregnant women, women who are breast-feeding, or young workers5. From the French labour law viewpoint, the RES responders are classified into two groups: • The first group (group 1) comprises the workers whose effective dose could exceed 20 mSv during the radiological emergency. These workers are volunteers. • The second group (group 2) comprises the workers whose effective dose could exceed 1 mSv but without exceeding 20 mSv (the SMUR personnel are classified in this group). Group 1 responders receive special training while group 2 responders are suitably informed of the health risks and the precautions to take when intervening in a radiological emergency situation. The French Labour Code obliges the use of dosimetric monitoring means that are appropriate for the radiological risk. • The group 1 responder are equipped with a passive dosimeter and an active dosimeter appropriate for the situation. Rescuers working in the danger zone must have real-time dosimetric monitoring equipment. • The group 2 responders are equipped with at least a passive dosimeter or, if the nature of the emergency situation does not permit this, their exposure is evaluated by any other appropriate method established by the employer with the support of the Institute of Radiation Protection and Nuclear Safety (IRSN). It may, for example, involve the use of an electronic dosimeter, collective dosimetry or an approach by calculation based on environmental measurements. The SMUR personnel have active dosimeters. Dosimetric monitoring is ensured by the RPE in collaboration with the occupational physician. • It concerns both external and internal exposure for the front-line responders (within the exclusion zone and the controlled zone4). For the second line (management of a potentially contaminated victim at the VAA, at the Advanced Medical Post (AMP) or in the healthcare facility), attention is focused on the monitoring or at least the evaluation of the internal exposure of the responders. • The dosimetric information, or failing this the dosimetric evaluation, is determining for the occupational physician responsible for setting up the post-incident monitoring. • At the end of the RES, the occupational physician prescribes all the examinations he/she considers appropriate for assessing the responders’ state of health. The occupational physician establishes a dosimetric assessment for each worker which is recorded in the occupational health medical record. Each worker having intervened in an RES is subject to the tightened monitoring measures applicable to workers classified in category A for at least five years following the RES, or during the period in which the received dose remains higher than one of the occupational exposure limits. 5. “Young workers” means workers aged from 16 to 18. 06 SHEET 26 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY
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