CDC Grand Rounds: Radiological and Nuclear Preparedness

S Deitchman, MD; C Miller, PhD; RL Jones, PhD; RC Whitcomb Jr, PhD; JB Nemhauser, MD; J Halpin, MD; D Sosin, MD; T Popovic, MD, PhD; K Uranek, MD;

Disclosures

Morbidity & Mortality Weekly Report. 2010;59(36):1178-1181. 

In This Article

Abstract and Introduction

Introduction

Radiological and nuclear disasters are infrequent, but when they occur, they result in large and demonstrable health burdens. Several scenarios can result in the public's exposure to radiation. For example, radiation sources used in health care or other industries can be lost or misused. Incidents in the nuclear power industry, such as those at Chernobyl and Three Mile Island, require significant public health response. In addition, radiological terrorism can involve the use of a radiological dispersal device (RDD) or an improvised nuclear device (IND). State and local health agencies are expected to perform essential public health functions in response to any of these emergencies[1,2] (Box 1).

Recent events illustrate that the public health sector will be essential in a radiological or nuclear response. For example, in August 2004, the day before the Republican National Convention, the New York City Department of Health and Mental Health (DOHMH) responded to a radiation incident at a mid-town Manhattan post office. A radiation source failed to retract into its protective shielding, resulting in dangerously high radiation levels near the radiation source. Police and fire departments evacuated the building and closed off nearby streets. The DOHMH response included conducting extensive environmental surveys outside and throughout the building, assisting with shielding the source, conducting press conferences, providing approximately 2,000 copies of fact sheets to residents in nearby buildings, and conducting dose estimates for the contractor and postal service employees. It took over 24 hours to remove the radiation source safely. The public's maximal risk for exposure was less than that received from a single chest radiograph because of their distance from the radiation source.

When Aleksander Litvinenko died in London in 2006 from poisoning with the radioisotope polonium-210, public health agencies in the United States were affected. Polonium was spread to many places in London, potentially contaminating thousands of persons, including foreign visitors. In the United Kingdom, approximately 8,000 persons contacted public health authorities, and citizens from 52 countries potentially were involved, including 160 U.S. citizens. Approximately 20 U.S. state and local public health agencies worked with CDC to notify involved citizens and to coordinate laboratory testing.

These events demonstrate that 1) radiological incidents can happen at any time and any place, 2) state and local health agencies are involved in response and communication concerning health effects of radiation, 3) communication needs arise even when there is no public risk, 4) responses require coordination with multiple agencies, and 5) planning requires multiagency input.

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