Public Health Response to the Fukushima Dai’ichi Nuclear Crisis Baltimore-Washington Chapter, HPS Annual Meeting May 11,

1. Public Health Response to the Fukushima Dai’ichi Nuclear CrisisBaltimore-Washington Chapter, HPSAnnual MeetingMay 11, 2012 CAPT Michael A. Noska, M.S. US Public Health Service Senior Advisor for Health Physics US Food and Drug Administration

2. Scope of Presentation • Domestic interagency response • Joint Forces (Force protection) • International (including gov’t → gov’t and support of US citizens in Japan) • Food Safety Assessments

3. CONUS Response • All key rad agencies activated EOCs (2-3 shifts per day) • Federal Radiological Preparedness Coordinating Committee (FRPCC) • National Security Staff • Interagency Task Groups • DOE: NARAC/IMAAC • Advisory Team

4. The Advisory Team for the Environment, Food and Health The mission of the A-Team is to provide coordinated advice and recommendations to the State, Coordinating Agency, and DHS concerning environmental, food, and health matters. Membership is comprised principally of : and other Federal agencies as needed

5. Advisory Team Duties Overview Advisory Team provides recommendations in matters related to Environmental assessments (field monitoring) required for developing recommendations; Protective Action Guides and their application to the emergency; Protective Action Recommendations using data and assessments from FRMAC;

6. Advisory Team Duties Overview (cont.) Recommendations to prevent or minimize exposure through the ingestion pathway from contaminated milk, food, and water; Recommendations regarding the disposition of contaminated livestock, poultry, and foods; Recommendations for minimizing losses of agricultural resources;

7. Advisory Team Duties Overview (cont.) Guidance on availability of clean food, animal feed, and water supply inspection programs to assure wholesomeness; Recommendations on relocation, reentry, and other radiation protection measures prior to recovery; Recommendations for recovery, return, and cleanup issues;

8. Advisory Team Duties Overview (cont.) Estimated effects of radioactive releases on human health and the environment; Recommendations on the use of medical countermeasures (e.g., thyroid blocking agents, chelators, etc.); Health and safety advice or information for the public and for emergency workers; and Other matters as requested by Incident Command, the coordinating agency, or State and local agencies.

9. Domestic Issues Addressed • Modeling of potential plumes and water currents • Contamination of imported products • Import Bulletins and Alerts • Monitoring guidance • Potential contamination of domestic products • Food, milk, water • Seafood • Medical Countermeasures

10. Operation Tomodachi • USA Public Health Command • USA Vet Command • PACOM • USFJ • DTRA, AFRRI, AFRAT • DOE/FRMAC

11. The “Health Team” • HHS response based on request from US Ambassador to Japan • Mission: Provide health advice and support to Embassy staff and families, American citizens living in Japan, US military and families and the Government of Japan. • “Health Team” deployed 3/15/11 as part of DART: • Rad SME/Medical planner from HHS/ASPR • SNS expert from CDC • Risk communicator from CDC • DoD Liaison (PACOM) • Second deployment 3/29/11: • Health Physicist (food and water) from FDA • Health Physicist (risk assessor) from NCI • Third deployment 5/9/11

12. Major Activities • Collaboration with interagency representatives at Embassy (NRC, DOE, USDA, DoD) • Consultation with Embassy staff, including health, security and safety • Daily briefings at Embassy • Data interpretation (food, water, air) • PARs/Travel Advisories • Meetings with GoJ representatives • Outreach

13. We’re Not Alone NIPH TEPCO MHLW JAEA NISA MAFF JA FSC MEXT NSC METI

14. Major Activities • Collaboration with interagency representatives at Embassy (NRC, DOE, USDA) • Consultation with Embassy staff, including health, security and safety • Daily briefings at Embassy • Data interpretation (food, water, air) • PARs/Travel Advisories • Meetings with GoJ representatives • Outreach

15. Outreach • Four Sessions: • US Embassy • American Chamber of Commerce in Tokyo • American Citizens (at ACCJ twice) • Topics: • Radiation basics • Food and water protection • Radiation risk • http://japan2.usembassy.gov/e/acs/tacs-health.html

16. Food Safety Assessment • FDA PAGs/DILs • Codex • Japanese approach • Other assessments

17. FDA Guidelines (1998) DIL (Bq/kg) = PAG (mSv) f*Intake (kg)*DC (mSv/Bq) PAG: 5 mSv CEDE or 50 mSv CDE f: fraction of food supply contaminated, 30 or 100% Intake: Annual consumption based on total diet DC: Dose conversion factors from ICRP 56, NRPB

18. Derived Intervention Levels (Bq/kg)

19. Codex Alimentarius (2010) E = GL(A) * M(A) * eing(A) * IPF E: mean internal dose of public (mSv) GL(A): guideline level (Bq/kg) M(A): age-dependent food consumption (kg) eing(A): age-dependent ingestion coefficient (mSv/Bq) IPF: import/production factor (unitless) (Comparable to f in DIL equation) Based on 1 mSv PAG (annual) (Codex Standard 193-1995)

20. Guideline Levels (Bq/kg)

21. Japanese Index Levels • Based on 5/50 mSv PAG • Assume food contaminated at 50 or 100% • Different food classes • Dose distributed over all food classes for Cesium • 30% of PAG for I-131 distributed to thyroid

22. Index Levels (Bq/kg)

23. Summary

24. Revised Japanese Standards

25. Assessment for Rice Planting • Operational Guidelines Taskgroup • RESRAD-RDD • Japanese data on root transfer factors • National data on Japanese consumption • ICRP 72 DCFs • Cs-137: 5.4 E5 Bq/m2 Sr-90: 2.5 E5 Bq/m2 • Japanese levels = 1000-5000 Bq/kg soil

27. Acknowledgements • Health Team • Norm Coleman, MD, PhD (NCI/HHS-ASPR) • Steve Simon, PhD (NCI) • CAPT Tom Bowman, MS, USPHS (CDC) • Ms. Jana Telfer, MS (CDC) • CAPT Michele Hancock, MD, USN (PACOM) • CAPT Joe Hughart, USPHS (USAID/DART) • NRC, DOE, DoD, USDA, Embassy Staff • Government of Japan