A unique Institute of Railway Hygiene was created 70 years ago in Russia, one of the major railway countries in the world. Since then the Institute's staffers have carried out huge work on improvement of railway workers' health, prevention of their exposure to noise, unfavorable microclimate, vibration and other occupational hazards. Significant contribution into the world occupational hygiene was made by such Institute's professionals as S.F. Kazansky, P.I. Nikitin, A.M. Volkov and others.
The authors emphasize the need in coordination when conducting expert examinations in investigation of accidents with a great number of victims. Coordination is of special importance for combined application of molecular-genetic technologies and standard forensic medical investigations. The experience in experts cooperation in investigation of terroristic bombing in Moscow underground on February 6, 2004, according to algorithm of combined use of conventional forensic medical methods and innovating techniques of molecular-genetic identification for personal identification of dead bodies in accidents with a great number of victims is demonstrated.
In a previous study the knowledge and views of nursing students on how they thought nurses, both in their professional role and as private persons, should act at a disaster site were evaluated. In the present study the practical functional role and experiences of nurses (n = 16) in two major disaster situations (one 'load and go' and one 'stay and play' type of emergency situation) were assessed from personal interviews along a standardized questionnaire. Nurses more routinely involved in emergency care and nurses with no or limited previous practical experience of disaster nursing were included in the study. Leadership-type actions, i.e. a systematic way of attempting to survey and to comprehend the situation, what has happened, and how many injured there may be at the site of the accident, were reported by most of the experienced nurses, while inexperienced nurses were involved mainly in the immediate care of injured according to directions given by more experienced members of the emergency team. Readiness for action, reflected by having a feeling of being prepared for work at the disaster site, was experienced more often by nurses with considerable previous experience of disaster nursing than by nurses with limited experience. Negative experiences, such as feelings of being insufficient, of unreality, mental strain, and problems in understanding the organization, were commonly mentioned by the inexperienced nurses. The present study stresses the importance, for all types of nurses, of more systematic training in disaster nursing.
[Activity of the Irkutsk district public health authorities with regard to the medical-sanitary service to construction workers of the Baikal-Amur railroad].
Sixty-six passengers surviving a collision of two trains were investigated concerning relevant background data, degree of personal injury, experience of a threat to life, symptoms and problems immediately after the accident, and thoughts about difficulty in coping. The most obvious impact on the survivors was the experience of being close to death. One result of this was that they developed a new coping strategy to minimize emotional pain. Some survivors also suffered problems of "re-living" the accident. This is important for the coping process. The process includes psychological integration of the accident as an important life event. The findings indicate that "re-living" of the accident through nightmares and intrusive thoughts is responsible for problems in carrying out ordinary tasks. The observations are in accordance with those made after other types of accidents and disasters.
Beginning approximately 4 years after the Chernobyl nuclear accident a steady increase in the incidence of thyroid cancer was observed in children and adolescents of the Bryansk Oblast, which received the highest level of radionuclide contaminants in Russia. We examined the spatial relationship between the residence location of patients with identified thyroid cancer (0-18 years old at the time of the accident) and a number of geographic parameters to better account for the etiology of thyroid cancer spatial distribution. Geographic parameters analyzed included spatial distribution of 137Cs and 131I in soil, population demographics, measurements and reconstructions. of absorbed thyroid 131I doses in the population, and maps of major transportation arteries. An interesting finding is the lack of a consistent correlation between the spatial distribution of radionuclides in the soil and thyroid cancer incidence. Instead, most of the thyroid cancer cases were diagnosed in settlements situated on major railways and roads. Correlating population with thyroid cancer cases and transportation arteries reveals a much higher cancer rate on or near major roads and railways than at a distance from them, again independent of radionuclide soil concentration. There are other important factors, of course, that must be considered in future evaluations of this phenomenon. These include the influence of iodine endemic zones, genetic predisposition to thyroid cancer, and duration of residence time in contaminated areas. The feasibility of radionuclide transport on railways and roads is discussed, together with the vectors for transfer of the contaminants to the human population. Developing a model to reconstruct the radiation dose to the thyroid over time in this geographic region is proposed in light of the impact of transportation arteries. Specific studies are outlined to provide the data necessary to develop this model as well as to better characterize the feasibility and scientific validity of the contribution to human health effects of this transport factor. Transport factor refers to the transport of radionuclides on transportation arteries and the transfer of these agents to the human population residing in the vicinity of these arteries. If the impact on thyroid cancer of the transport of radionuclides on major railways and roads is indeed significant, a major reappraisal of the risk of large-scale radioactive release into the environment is necessary.
