Radiation Environment and Medicine 2022 Vol.11, No.1 25–33

ReportCytogenetic Biodosimetry in Radiation Emergency Medicine:
1. Blood Collection and Its Management
Yohei Fujishima1, Yu Abe2, Valerie Goh Swee Ting3, Ryo Nakayama1, 4, Kai Takebayashi1, 4,
Akifumi Nakata5, Kentaro Ariyoshi6, Mai Tran Thanh7, Kosuke Kasai4, Hiroyuki Hanada8,
Mitsuaki A. Yoshida1, 9, Katsuhiro Ito8* and Tomisato Miura1**
Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine,
Hirosaki University, 66-1 Hon-cho, Hirosaki, Aomori 036-8564, Japan2
Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University,
1-12-4 Sakamoto, Nagasaki, Nagasaki 852-8523, Japan3
Department of Radiobiology, Singapore Nuclear Research and Safety Initiative, National University of Singapore,
1 Create Way, Singapore 138602, Singapore
4
Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences,66-1 Hon-cho, Hirosaki, Aomori 036-8564, Japan
5
Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 15-4-1, Maeda 7-jo, Teine-ku, Sapporo, Hokkaido 006-8585, Japan
6
Center for Integrated Science and Humanities, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
7
Biodosimetry Group, Centre of Radiation Technology and Biotechnology, Dalat Nuclear Research Institute,
1 Nguyen Tu Luc, Ward 8, Dalat City, Lamdong Province, Vietnam
8
Advanced Emergency and Critical Care Center, Hirosaki University Hospital, Hirosaki University,
53 Hon-cho, Hirosaki, Aomori 036-8563, Japan
9
Institute of Chromosome Life Science, 11-5-409, Fukuokachuo 2-Chome, Fujimino-shi, Saitama 356-0031, Japan
1

Received 21 October 2021; revised 19 November 2021; accepted 1 December 2021

Dose assessment is very important to triage exposed patients and to carry out efficient medicalcare and treatment in radiation emergency medicine. In cytogenetic biodosimetry, peripheral bloodcollected from exposed patients must be cultured to induce chromosome-analyzable metaphases
in peripheral lymphocytes. Medical institutions that accept exposed patients must understandthe time of blood sampling, choice of anticoagulant, temperature conditions for blood storage
according to the type of anticoagulant and the method of blood transportation to the laboratory
for biodosimetry. However, as medical institutions tend to have insufficient understanding on
blood collection and shipment required for biodosimetry, this information must be provided toaid in reliable dose estimation. In addition, dose assessment requires some basic information frompatients such as age, gender, smoking history, alcohol intake, underlying medical conditions andprevious radiation exposures including occupational and medical exposure. The medical institution
should also be prepared to provide such information to the biodosimetry laboratory. This article
provides a summary of essential information from blood collection to blood transportation carriedout by medical institutions for cytogenetic biodosimetry.
Key words: cytogenetic biodosimetry, blood collection, timing, anticoagulant, storage, shipment*Katsuhiro Ito: Advanced Emergency and Critical Care Center, Hirosaki University Hospital, Hirosaki University, 53 Hon-cho, Hirosaki, Aomori 036-8563, Japan
E-mail: itohkcck@hirosaki-u.ac.jp**Tomisato Miura: Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine, Hirosaki University, 66-1 Hon-cho, Hirosaki, Aomori
036-8564, Japan
E-mail: tomisato@hirosaki-u.ac.jp
Copyright © 2022 by Hirosaki University. All rights reserved.

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Yohei Fujishima et al./ Radiation Environment and Medicine 2022 Vol.11, No.1 25–33

1．Introduction
In radiation emergency medicine, it is necessary toestimate radiation dose in order to triage exposed patientsand to formulate a treatment plan. In dose assessment,
the patient is first classified into roughly estimateddose categories based on the prodromal symptoms of
the patient1, 2). Furthermore, the exposed dose can be
estimated by physical methods if internal and/or external
radioactive contamination occurs. However, in the case of
external exposures by ionizing radiation such as X-rays
or gamma rays, as there are no residual radioactive
substances in the exposed patient, the absorbed dose isestimated based on biological reactions in the humanbody. This form of biological dose assessment is known
as biodosimetry.
In addition to monitoring blood cell counts in peripheral
blood of exposed patients 2, 3), biomarkers such as
C-reactive protein (CRP) and salivary α -amylase (sAA)
can also be used for biodosimetry4). However, as these
endpoints show individual differences even without
radiation exposure5), accurate dose assessment can bedifficult.
The most reliable endpoint in biodosimetry is thefrequency of chromosome aberrations. In the processof repairing double-stranded DNA break induced byradiation, chromosome aberrations such as dicentricchromosomes, ring chromosomes and chromosomet r a ns l oc a t ions c a n oc c ur d ue t o c h r omosom e
recombination errors6). As these chromosome aberration
frequencies positively correlate with absorbed dose,absorbed dose can be easily calculated from a doseresponse curve. The dicentric chromosome assay, whichuses the frequency of dicentric chromosomes as an
endpoint, has been the international gold standard forbiodosimetry for about 70 years7).
Cells used for chromosome analysis are generally
peripheral blood lymphocytes, more specifically T
cells. Chromosomes cannot be directly observed inlymphocytes after blood collection because lymphocytes
do not undergo cell division in peripheral blood. Peripheral
blood lymphocytes therefore require stimulation andculture under appropriate conditions to induce cell
division for analyzable metaphase chromosomes. Pleaserefer to other articles in the “Biodosimetry in Radiation
Emergency Medicine” series for more information.
In order to culture blood for chromosome aberration
analysis, peripheral blood is collected using an appropriate
anticoagulant at an acceptable timing. Collected bloodis stored under recommended conditions according to
the type of anticoagulant used. The blood must then be
sent to the biodosimetry laboratory as needed. Moreover,patient information is also required for reliable dose
assessment. Communication between medical institutions

handling radiation exposed patients and biodosimetrylaboratories is thus essential. Details regarding bloodcollection and its management for biodosimetry involving
medical institutions and biodosimetry laboratories can befound in this article.
2. Timing of blood collection
It is highly likely that the exposed patient will not beevenly exposed to external radiation (i.e. partial bodyradiation). Likewise, the circulating blood in the bodywill not be uniformly exposed. For example, if the patientwas exposed to a radiation source on the right side, theabsorption rate will differ depending on the radiation
quality, but the absorbed dose on the left side will belower than that on the right side. Tamura et al. collected
peripheral blood from patients after gamma-ray therapy
and analyzed a temporal change of the frequency ofchromosome aberrations. Chromosome aberrationpositive cells peaked after 6 hours. After 20 hours,
chromosome aberration-positive cells reached the samelevel as 20 minutes after exposure6, 8). In biodosimetry, as
whole-body exposure dose is estimated from a very small
portion of circulating peripheral blood, the patientʼs bloodis advised to be collected after the blood in the body is
sufficiently mixed and homogeneous. For this reason, it isrecommended to collect peripheral blood 24 hours afterradiation exposure in radiation emergency medicine.
In addition, the dicentric chromosome found in exposed
patients is an unstable chromosome abnormality. Its
biological half-life is estimated to be 14 to 18 months9, 10).
Therefore, the frequency of dicentric chromosomes
gradually decreases with increasing time from theaccidental exposure. Brewen et al. reported that
unstable chromosome aberrations (dicentric and ring
chromosomes) did not change in peripheral blood
lymphocytes of patients who were systemically exposed
to radiation accidents until 32 days after exposure11).
Estimated doses derived from the reduced dicentricchromosome frequency will be lower than the original
exposed dose, resulting in an underestimation of thepatientʼs dose. Therefore, it is recommended that bloodshould be drawn from patients within 28 days of exposurefor dicentric chromosome assay6).
On the other hand, radiation-sensitive lymphocytes can
immediately decrease in high-dose exposed patients. In
the JCO Tokai-mura criticality accident, peripheral blood
lymphocyte counts of the two workers who died fromhigh-dose exposures were 684 cell/µl (3%) and 127 cells/µl(1%), respectively, 2–3 hours after the exposure12). Patients
exposed to high doses may not have sufficient peripheral
blood lymphocytes for chromosome aberration analysis
after 24 hours. If high-dose exposure of 4–5 Gy or higher
is suspected from prodromal symptoms, peripheral blood

Yohei Fujishima et al./ Radiation Environment and Medicine 2022 Vol.11, No.1 25–33

for biodosimetry should be drawn as soon as possible.
For patients who require a blood transfusion, blood forbiodosimetry must be collected prior to the transfusion.
However, if the patientʼs condition is serious and it
is determined that blood collection is difficult, bloodcollection is not necessary and should not be forced.
3. Acquisition of basic information and consent
In biodosimetry with chromosome aberration analysis,
it is necessary to obtain information of exposed patientssuch as age, gender, smoking history, alcohol intake,medication intake, underlying medical conditions andprevious radiation exposures such as radiotherapy,
X-ray diagnosis and nuclear medicine13). An example ofa questionnaire is shown in the Appendix. This basic
information may affect the frequency of chromosome
aberrations and dose estimation, depending on the typeof chromosome abnormality used as an endpoint. It isnecessary to record the information obtained from theexposed patient or his/her family in a standardized
format and share it with the biodosimetry laboratory.
In addition, in order to learn from the mistakes ofpast radiation-related accidents, it is also important todisclose this information including estimated exposure
doses. As the estimated dose is part of the diagnosis, thepatientʼs and familyʼs consent is required for information
disclosure. It should be noted that in the case of an
occupational accident, the consent of the employer is also
required.
4. Anticoagulants
In specimen collection f or clinical use, various
anticoagulants and blood collection tubes are used
depending on the examination purpose. The International
Council for Hematology Standardization recommends
et hy lenediaminet et raacet ic acid (EDT A ) as an
anticoagulant for blood cell count measurement andblood cell morphology examination on blood smears14).
On the other hand, in critical care, which requires rapid
tests, blood is collected using heparin as an anticoagulant
for blood gas test and electrolyte test, and blood cellcount is measured using the leftover blood. These same
blood tests are likely to be used in radiation emergency
medicine. In addition, serum or plasma can also be used
for biomarker measurement.
Heparin is the preferred anticoagulant in chromosome
aberration analysis. Heparin does not have a direct
anticoagulant effect, but it binds to the endogenous
anticoagulant factor, antithrombin, to form a complex.
This in turn enhances the activity of antithrombin,inhibits the activity of thrombin and blood coagulation
factor X, and suppresses blood coagulation15-17). Low

27

temperature conditions are not recommended forheparin blood storage because antithrombin activity
decreases and partial blood coagulation occurs under low
temperature conditions18).
Heparin also allows lymphocyte proliferation to occur
in peripheral blood cultures as it does not affect calcium
ions necessary for cell division19-22). In contrast, EDTA
chelates calcium ions in the culture medium required
for lymphocyte proliferation. Lymphocyte cell division
is unable to be effectively induced and thus affects thenumber of analyzable metaphases for biodosimetry(Fig. 1)18). If EDTA blood only is available for biodosimetry,the medical institution which collected the blood must
inform the biodosimetry laboratory that EDTA was used
as an anticoagulant.
5. Blood volume
The amount of blood used for chromosome aberration
analysis depends on the culture method and the numberof assays. For example, whole blood cultures use 0.5–1.2
ml of blood, whereas peripheral blood mononuclear cell
(PBMC) cultures use about 3 ml of blood. More bloodis required if various cytogenetic assays are performed
together with the dicentric chromosome assay, such as
the premature chromosome condensation (PCC) assay
and the cytokinesis-block micronucleus (CBMN) assay. In
addition, if the initial blood culture fails for some reason,
the stored leftover blood is re-cultured. Considering thesefactors, it is thus recommended to collect about 10 ml ofperipheral blood.
As heparin blood is used for blood gas test, electrolyte
test and blood cell count measurement in critical care
medicine, it is also possible to use the leftover blood after
clinical analysis for biodosimetry. When storing leftover
blood, bacterial contamination should be avoided as muchas possible.
6. Blood storage
As described above, when heparin is used as an
anticoagulant, low temperature conditions may cause
partial blood coagulation due to incomplete coagulation(Fig. 2)18). When the number of lymphocytes requiredfor blood culture decreases, a sufficient number of
metaphases for chromosome analysis cannot be obtained.
In exposed patients, blood clots may become larger andlymphocyte depletion may be even more pronounced. It
is thus highly recommended to store heparin blood at
18–24 °C 23). Blood temperature control in cold regions is
also essential. Based on the authorsʼ previous experiences,
partial coagulation was seen in blood exposed to low
ambient temperature ( <5 °C) and made chromosome
analysis difficult.

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Yohei Fujishima et al./ Radiation Environment and Medicine 2022 Vol.11, No.1 25–33
A

B

Fig. 1. Effect of temperature, storage time, anticoagulant type and radiation dose on mitotic index. Mitotic index was analyzed inblood cultured for 48 hours after storing them in different time periods and conditions. (A) 0 Gy; (B) 3 Gy of X-ray (150 kVp, 20 mA,
with 0.5 mm Al, and 0.3 mm Cu filters, 1.0 Gy/min). Data is represented as Mean±SD. (Data was modified from Fujishima et al.18)).

On the other hand, EDTA blood can be stored from4°
C to room temperature. Refrigerated storage is highly
recommended if it is not used immediately after bloodcollection. When EDTA is used as an anticoagulant,even if blood is stored in a refrigerator at 4 °C , bloodcoagulation is not affected18, 23). Furthermore, even when
the EDTA blood stored in a refrigerator is cultured,
the frequency of cell division was equivalent to that ofheparin blood when EDTA was removed by washing
before blood culture (Fig. 1B)18).
It should also be noted that blood is an infectious
specimen. Proper understanding of blood-borne infectious
diseases and their countermeasures and appropriate blood
storage procedures is advised.
7. Blood shipment
Transportation of blood obtained from exposed patients
to biodosimetry laboratories requires special care intemperature control and handling of blood as an infectious
specimen. In the case of heparin blood, it is necessary
to maintain the temperature at 18 to 24 °C using
temperature controlled packaging6, 23). When transporting
EDTA blood, refrigerator packs can be added to maintaina low temperature. Temperatures should not be too
low such that the blood becomes frozen. If possible, atemperature logger may be added in the shipment torecord the temperature inside the packaging during thedelivery.
In addition, human blood is classified as a UN
standard category B biological substance. It must be
shipped in triple packaging using Category B UN
standard containers (UN3373) in accordance with WHO

guidelines, “UN3373: Guidance on Transport Regulations
for Infectious Substances”24). The primary receptacleis the closed blood collection tube. Next, the primary
receptacle is wrapped in sufficient absorbent material andpacked in a leak-proof secondary package. Lastly, it isplaced in an outer container that protects against impact
during transportation (Fig. 3). It is also advisable to use
temperature controlled packaging that complies with UN
and WHO standards.
If blood samples need to be transported to thebiodosimetry lab via air, X-ray security checks must
be avoided to prevent any unnecessary radiation
exposure which could affect the true dose estimate.
The outer packaging should be labelled with “Do not
X-ray”. If possible, a piece of X-ray film, a standard
thermoluminescent dosimeter (TLD) or an opticallystimulated luminescence (OSL) monitoring badge could
be included in the package to indicate possible X-ray
exposure.
8. Conclusion
For biodosimetry in radiation emergency medicine, greatcare must be taken in blood sample timing, anticoagulant
selection and blood temperature control according to
the type of anticoagulant used. It is also necessary tocomply with international guidelines for blood shipment
and transportation as human blood is an infectious
biological specimen. In addition, as basic information
on exposed patients is essential for dose estimation, it isnecessary to standardize a recording format and establish
an information sharing system with each institution.
Furthermore, in order to prevent future accidents basedYohei Fujishima et al./ Radiation Environment and Medicine 2022 Vol.11, No.1 25–33
A

29

B

Fig. 2. Microscopic observations of May-Grünwald and Giemsa-stained blood smears. (A) 0 Gy-irradiated blood; (B) 3 Gy-irradiatedblood. Scale bars represent 20 µm. Partial blood coagulation was only observed in Li-heparin blood stored at 4 °C (Data was modified
from Fujishima et al. 18)).

Fig. 3. Example of triple packaging used for blood transport for biodosimetry. Modified from WHO Guidance on regulations for
the Transport of Infectious Substances24).

on the lessons learned from the exposure accident, it isdesirable to disclose information related to the accident,
including the exposure dose. Please note that informed
consent from exposed individual and employer (if needed)
is required for information disclosure.
We hope that this article will help medical professionals
involved in radiation emergency medicine understandbiodosimetry.

Point 1. Time of blood collection
Blood collection period: 24 hours to 28 days
• If fatal high-dose exposure is suspected, bloodshould be drawn as soon as possible.
• For patients who require blood transfusion, draw
blood before blood transfusion.
• Blood collection should not be forced if the patientʼs medical condition is serious.

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Yohei Fujishima et al./ Radiation Environment and Medicine 2022 Vol.11, No.1 25–33

Point 2. Acquisition of basic information andinformed consent• It is essential to collect and share basic informationfrom exposed patients for dose assessment.
•

It is necessary to obtain patientʼs consent to disclosethe estimated dose.

Point 3. Anticoagulant• Heparin is t he pref erred ant icoa gulant inbiodosimetry.
• If EDTA blood is only available, be sure to indicatethat blood was collected with EDTA.
Point 4. Blood volume• If possible, collect 10 ml of blood from each patient.
• As blood leftover from blood tests can also be used
for biodosimetry, store the leftover blood awayfrom contamination.
Point 5. Blood storage• Blood must be treated aseptically to avoid
contamination.
• The storage temperature of heparin blood is 18 to
24 °C.
* Do not expose to cold conditions.
• EDTA blood can be stored at low temperatures of 4°
C.
* Do not freeze the blood.
• Blood is a potentially infectious substance. Pleasehandle with care.
Point 6. Blood shipment• Maintain recommended temperature using
temperature controlled packaging.
• Blood is classified in biological substance Category
B and transported in triple packaging according toUN and WHO standards (UN3373).
• To a void airport securit y check, the outer
packaging must be labelled with “Do not X-ray”. A
piece of X-ray film, a standard thermoluminescentdosimeter ( TLD) or an optically stimulated
luminescence (OSL) monitoring badge could also
be included in the package.
Conflict of Interest
The authors declare that they have no conflict ofinterests.

2.

Waselenko JK, MacVittie TJ, Blakely WF, Pesik N, Wiley AL,
Dickerson WE, et al. Strategic National Stockpile Radiation
Working Group. Medical management of the acute radiation
syndrome: recommendations of the Strategic National Stockpile
Radiation Working Group. Ann Intern Med. 2004;140(12):1037–51.

3.

IAEA, WHO. Diagnosis and Treatment of Radiation Injuries.
Vienna: International Atomic Energy Agenvy; 1998. 49p. Safety
Reports Series No. 2.

4.

Blakely WF, Port M, Abend M. Early-response multiple-parameterbiodosimetry and dosimetry: Risk predictions. J Radiol Prot. inpress.

5.

Blakely WF, Ossetrova NI, Whitnall MH. Multiple parameterradiation injury assessment using a nonhuman primate radiation
model-biodosimetry applications. Health Phys. 2010;98:153–9.

6.

IAEA. Cytogenetic Dosimetry: Applications in Preparedness forand response to radiation emergencies. Vienna: International
Atomic Energy Agency; 2011.

7.

Blakely WF, Carr Z, Chu MC, Dayal-Drager R, Fujimoto K,
Hopmeir M, et al. WHO 1st Consultation on the Developmentof a Global Biodosimetry Laboratories Network for Radiation
Emergencies (BioDoseNet). Radiat Res. 2009;171(1):127–39.

8.

Tamura H, Sugiyama Y, Sugahara T. Changes in the number ofcirculating lymphocytes with chromosomal aberrations following
a single exposure of the pelvis to gamma-irradiation in cancer
patients. Radiat Res. 1974;59(3):653–7.

9.

Bauchinger M, Schmid E, Braselmann H. Time-course oftranslocation and dicentric frequencies in a radiation accident
case. Int J Radiat Biol. 2001;77(5):553–7.

10.

Cho MS, Lee JK, Bae KS, Han EA, Jang SJ, Ha WH, et al.
Retrospective biodosimetry using translocation frequency in astable cell of occupationally exposed to ionizing radiation. J Radiat
Res. 2015;56(4):709–16.

11.

Brewen JG, Preston RJ, Littlefield LG. Radiation-induced humanchromosome aberration yields following an accidental whole-body
exposure to 60Co-rays. Radiat Res. 1972;49(3):647–56.

12.

Akashi M, Hirama T, Tanosaki S, Kuroiwa N, Nakagawa K, Tsuji
H, et al. Initial symptoms of acute radiation syndrome in the JCO
criticality accident in Tokai-mura. J Radiat Res. 2001;42:S157–66.

13.

ISO. Radiation protection ̶ Performance criteria for laboratories
performing cytogenetic triage for assessment of mass casualties
in radiological or nuclear emergencies ̶ General principles
and application to dicentric assay. Switzerland: International
Organization for Standardization; ISO Standard No. 21243:2008.

14.

England JM, Rowan RM, Assendelft OW, Bull BS, Coulter W,
Fujimoto K, et al. Recommendations of the International Council
for Standardization in Haematology for ethylenediaminetetraacetic
acid anticoagulation of blood for blood cell counting and sizing.
International Council for Standardization in Haematology: Expert
Panel on Cytometry. Am J Clin Pathol. 1993;100(4):371–2.

15.

Biggs R, Denson K W, A kman N, Borrett R, Hadden M.
Antithrombin 3, antifactor Xa and heparin. Br J Haematol.
1970;19(3):283–305.

16.

Gitel SN, Stephenson RC, Wessler S. In vitro and in vivo
correlation of clotting protease activity: effect of heparin. Proc Natl
Acad Sci USA. 1977;74(7):3028–32.

17.

Barrow RT, Parker ET, Krishnaswamy S, Lollar P. Inhibition by
heparin of the human blood coagulation intrinsic pathway factor X
activator. J Biol Chem. 1994;269(43):26796–800.

18.

Fujishima Y, Kanahama S, Hagino S, Natsubori S, Saito H,
Azumaya A, et al. Influence of anticoagulants and storage
temperatures on blood counts and mitotic index of blood
samples collected for cytogenetic biodosimetry. Int J Radiat Biol.
2019;95(2):186–92.

19.

Jaffe LF. Calcium explosions as triggers of development. Ann N Y

References
1.

Fliedner TM, Friesecke I, Beyrer K. Medical management ofradiation accidents-manual on the acute radiation syndrome.
London: British Inst. of Radiology, 2001.

Yohei Fujishima et al./ Radiation Environment and Medicine 2022 Vol.11, No.1 25–33
Acad Sci. 1980;339:86–101.
20.

21.

Rabinovitch PS, June CH, Grossmann A, Ledbetter JA.
Heterogeneity among T cells in intracellular free calcium
responses after mitogen stimulation with PHA or anti-CD3.
Simultaneous use of indo-1 and immunofluorescence with flow
cytometry. J Immunol. 1986;137(3):952–61.
Watman NP, Crespo L, Davis B, Poiesz BJ, Zamkoff KW.
Differential effect on fresh and cultured T cells of PHA-inducedchanges in free cytoplasmic calcium: relation to IL-2 receptor
expression, IL-2 production, and proliferation. Cell Immunol. 1988;
111(1):158–66.

31

22.

Modiano JF, Kelepouris E, Kern JA, Nowell PC. Requirement
for extracellular calcium or magnesium in mitogen-induced
activation of human peripheral blood lymphocytes. J Cell Physiol.
1988;135(3):451–8.

23.

Freise KJ, Schmidt RL, Gingerich EL, Veng-Pedersen Widness
PJA. The effect of anticoagulant, storage temperature and dilution
on cord blood hematology parameters over time. Int J Lab
Hematol. 2009;3(5):496–504.

24.

WHO. Guidance on regulations for the transport of infectious
substances 2021-2022: applicable as from 1 January 2021. Geneva;
World Health Organization; 2021.

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Appendix

Sample QuestionnaireThis questionnaire form has been modified from ISO 21243:2008

Exposure Information for Chromosome Aberration Analysis(TO BE FILLED OUT BY THE REQUESTOR)I,(Name), born

(dd/mm/yy) consent to giving a blood

sample for the purpose of estimating chromosome aberrations induced by exposure to ionizing
radiation.
Signature

Blood collection
Blood taken by:
Laboratory name:
Telephone number:
E-mail:Fax:@

Date and time of blood taken:(dd/mm/yy)

Type of anticoagulant:

Exposure Data:
1.

Radiation Worker

Non-Radiation Worker

2. Date and time of overexposure:(dd/mm/yy - time)

3. Place:

Company:

3. Brief description of overexposure:
4.

Whole body exposure
Dose value:

Partial body exposure

Internal contamination

Part of body:

Nuclide:Dose value:

Dose value:

How was this dose value obtained?
5. Type of radiation:

X-ray

Energy:γ

Origin:αOrigin:Neutrons

Origin:Energy:Electrons

Origin:Energy:Appendix. Sample questionnaire for chromosome aberration analysis (adapted from ISO 21243:2008)13).

Yohei Fujishima et al./ Radiation Environment and Medicine 2022 Vol.11, No.1 25–33

Patient Data
1. Age:Gender:2. Previous exposure through medical practice:
Radiation therapy

Date:Part of body:

X-ray diagnoses

Date:Part of body:

Nuclear medicine

Date:

Part of body:

2. Illness within the last 4 weeks before taking the blood sample:

3.

Intake of medication (fill in if applicable)
Name of medication:

Dose:

Duration:

4. Smoker:

No

Yes

Number / day

5. Alcohol intake:

No

Yes

Volume / day

Hepatitis B

Hepatitis C

6. Other known diseases:
HIV
Other diseases:

Results of chromosomal analysis to be sent to:Name:
Address:

Telephone number:
E-mail:Fax:@

Appendix. Sample questionnaire for chromosome aberration analysis (adapted from ISO 21243:2008)13).

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