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Bioterrorism: Part 4 -
Information on Public Health Response to a Radiological or Nuclear
Emergency
This
is an official CDC Health Update
Distributed via Health Alert Network
December 31, 2003, 19:35 EST (7:35 PM EST)
CDCHAN-00180-03-12-31-UPD-N
Update
on Public Health Precautions related to Orange Threat Level:
Part 4
(Information
on Public Health Response to a Radiological or Nuclear Emergency)
In preparation for any possible public health emergency related
to the current orange (high) threat level, the Centers for Disease
Control and Prevention is disseminating a series of notices on potential
hazards. This is the fourth in a series of four updates.
This message focuses on public health roles and responsibilities
in the event of a radiation or nuclear emergency.
During an orange (high) alert public health agencies should be prepared
to respond to a terrorist event involving radiation or nuclear weapons.
In the event of a terrorist attack involving radiation or
nuclear weapons, the Department of Homeland Security would be the
lead federal agency responding. However, local and state public
health agencies would be among the first called upon to protect
public health.
Information on Public Health Response to a
Radiological or Nuclear Emergency
During an orange (high) alert public health agencies and clinicians
should be prepared to respond to a terrorist event involving radiation
or nuclear weapons. Local and state health and radiation control
officials would be the first called upon to respond to protect the
public’s health. The Centers for Disease Control and Prevention
(CDC) will be ready to support the states in such an event.
There are several possible scenarios for a radiological terrorist
emergency. Radioactive material could be introduced into the food
or water supply. A “silent source” of radiation could be placed
where people could be exposed (under a subway seat, in a food mall,
etc). Conventional weapons could be used to widely disperse
radio active materials (“dirty bomb”).
A nuclear facility, nuclear waste facility or nuclear reactor could
be destroyed by an airplane crash or an explosion. A small nuclear
device could be detonated resulting in physical devastation similar
to the World Trade Center on September 11, 2001. For information
about the types and scope of injuries related to these types of
scenarios, please see: http://www.bt.cdc.gov/radiation/emergencyfaq.asp.
An emergency involving radiation would include special challenges
for public health responders and clinicians. Treatment of casualties
is more difficult because of the contamination and the complications
associated with other trauma. People who were not wounded in an
immediate attack could still be harmed by exposure to radiation.
The debris from the event and other normally harmless materials
will be contaminated with radiation. The affected area may be much
larger than the immediate scene of the crime.
The radiological threat, invisible and uncertain in terms of long-term
health impacts, will cause considerable public fear and concern.
Finally, the incident will be difficult to manage until appropriate
monitoring equipment and well-trained technical individuals are
available.
Public Health Roles and Responsibilities
In a radiological or nuclear emergency, a broad public health
response involving state, local, and Federal public health agencies
will be required. If required, the Department of Energy will
establish a Federal Radiological Monitoring and Assessment Center
to coordinate the development of radiation monitoring data for use
by decision makers.
CDC may also join the Food and Drug Administration, the U.S. Department
of Agriculture, and the U.S. Environmental Protection Agency to
form an Advisory Team for Environment, Food, and Health to assist
state and local decision makers. Public health activities
that may be required, depending upon the magnitude the event, include
the following:
Support
the deployment of the Strategic National Stockpile through the
Department of Homeland Security
Conduct
field investigations and monitoring of people
Conduct
surveillance and epidemiological studies
Establish
an exposure registry and monitor long-term impacts
Provide
advice on medical treatment and decontamination methods for people
potentially exposed to radioactive materials
Develop
criteria for entry and operations in the “hot zone,” the area
contaminated with radioactive materials
Implement
guidance for medical interventions and recommendations
Implement
disease control and prevention measures
Assist
in establishing and implementing protective action guidelines
for both responders and members of the public
Assist
decision makers in making appropriate evacuation and relocation
decisions
Evaluate
the health and medical impact on the public and emergency personnel
of the event
Provide
communication with the public, policy makers, and the media. For
CDC information for the public on radiation and nuclear emergencies,
see http://www.bt.cdc.gov/radiation/index.asp#public.
Because
these activities will require a collaborative public health effort,
state and local health officials may wish to visit CDC’s website
at http://www.bt.cdc.gov/radiation/index.asp
to obtain more information about radiological events and emergency
preparedness.
The Federal Response Plan and the Federal Radiological Emergency
Response Plan provide information about how federal agencies will
coordinate their support for state and local officials.
State and local public health
authorities should contact their state radiation control program
director for assistance in responding to a radiological or nuclear
emergency in their jurisdiction.
Contact information for state radiation control program directors
can be found at http://www.crcpd.org/
For further medical guidance, contact the Radiological Emergency
Assistance Center/Training Site, or REAC/TS.
Additional
medical guidance can be found at the Department of Homeland Security’s
Report on Medical Treatment of Radiological Casualties. The
DHS treatment guidelines can be found at www1.va.gov/emshg/docs/Radiologic_Medical_Countermeasures_051403.pdf
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