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Modeling the Optimum Prussian Blue Treatment for Acute Radiation Syndrome Following 137Cs Ingestion

Adams, Tim G.; Casagrande, Rocco1

doi: 10.1097/HP.0000000000000966

Accidents or radiological attacks may lead to ingestion of 137Cs by large numbers of the public. This work models the efficacy of Prussian blue, the medical countermeasure for internal contamination with 137Cs, to prevent acute radiation syndrome as a function of the duration of treatment and the time that treatment starts after uptake. Risk of acute radiation syndrome is modeled using the International Commission on Radiological Protection’s acute radiation hazard model. Dose rates to target organs from 137Cs ingestion were based on the data published by the US Environmental Protection Agency and the retention of 137Cs in the reference man. Modeling found that treatment is most effective if begun within 15 d of ingestion, and the course length should be at least 75 d to mitigate cancer risk and 290 d to mitigate fatalities due to acute radiation syndrome. Both of these course lengths are much longer than the minimum Prussian blue treatment regimen of 30 d. Extending the treatment time for contaminated individuals would increase demand for Prussian blue following an accident or attack and in turn, would require a larger stockpile of Prussian blue to meet demand. Not enough data is available to determine if this longer treatment time would lead to adverse medical outcomes due to the toxicity of the treatment itself.

1Gryphon Scientific LLC., Takoma Park, MD.

The authors declare no conflicts of interest.

For correspondence contact Tim G. Adams, 6930 Carroll Ave, #810, Takoma Park, MD 20912, or email at

(Manuscript accepted 31 July 2018)

© 2019 by the Health Physics Society