410 likes | 677 Views
How to Educate a Diverse Population?. Health officersEnvironmental health specialistsEmergency Response groupsInfection control professionalsEpidemiologists. Health educatorsHigher education professionalsMental Health respondersVolunteer disaster response groupsEmployees of industrial facili
E N D
1. Radiological Preparedness Case Studies: Training for Accidents & Dirty Bombs Carl Schopfer
Carl.Schopfer@UMDNJ.edu
2. How to Educate a Diverse Population? Health officers
Environmental health specialists
Emergency Response groups
Infection control professionals
Epidemiologists Health educators
Higher education professionals
Mental Health responders
Volunteer disaster response groups
Employees of industrial facilities
Law enforcement
3. Various Training Approaches Didactic Training
Web-Based Courses
Distance Education Modules
Lectures, Seminars & Workshops
Case-Based Curriculum Development
Use for students with diverse learning levels
Allow students to focus on different aspects
Emphasizes skills over facts learned
Advantage for adult students
Rated high for future relevance and skills
4. Why Study Accidents to Prepare for Terror? Fortunately, no radiological attacks
..Yet
Major accidents involve several groups:
Governments
Emergency Services
Public
Outside Technical Experts
Media
Healthcare Community
These groups interact in complex ways
There is a need for quick & accurate response
5. Case Study - Three Mile Island Learn the rationale for a KI distribution plan and the risks and benefits of implementation
Describe on what points to counsel patients and public about radiation risk
Understand the concepts behind the terms radiation exposure, absorbed dose, dose equivalent, collective DE
Identify reliable sources of information
Identify populations at risk
6. Case study - Chernobyl Describe how to identify acute radiation syndrome
Distinguish between external and internal contamination
Learn the basics of management of radiological casualties
Identify specialized state and federal radiation response resources
Advice to give on monitoring and decontamination of people, equipment, property and the environment
7. Case Study - Goiania Describe how the public should be informed of hazardous areas, and of protective actions
How to address protection of the water and food supply
How to address mass concern, mental health and behavioral health issues
Explain the basics of radiation background
Distinguish between external and internal contamination
Describe how clean is clean, and what is a safe dose level
8. What is the Terror Threat? Radiological Dispersion Device (RDD)
Dirty Bomb - conventional explosive disperses material
Doesnt have heat, blast, prompt radiation effects of nuclear bomb
Covert Placement or Dispersal
Placement of high-intensity source
Simple contamination or poisoning
Sabotage of Nuclear Power, Transport or Storage Facility
Improvised Nuclear Device or Actual Weapon
Suitcase Nukes
Use of fissile material to initiate fission reaction
Other device to disperse radioactive material
9. Radiological & Nuclear Weapons Availability Nuclear Weapons require resources of a nation
Is high tech, but accomplished in 1945
Can be stolen, perhaps bypass safeguards
Would not have to be high-yield
RDD the Next Best Thing
Considered in WWII and tested by Iraq in 1980s
Military an area denial weapon
Simple construction, deployment
Simple Dispersal or Placement
Sabotage or Outright Attack
10. Weapons of Mass Destruction Attractive to Terrorists
Have a high effect / resource ratio
Use target organization resources against itself
Can be done covertly, making deterrence difficult
CBRNE are scary and useful against soft targets
RDDs and Nuclear Attacks
Nuclear weapon large loss of life, physical damage and economic impact, and long-term radioactive contamination
RDDs potentially economic impact, and long-term radioactive contamination
11. Radiological Terrorist Events: Izmailovo Park, Moscow Chechen insurgents place a dynamite/radiocesium device which did not explode (1996)
Argun, Chechnya Suspected Chechen rebels deploy an explosive mine with unidentified radioactive material (1998)
Chicago, USA Jose Padilla arrested on suspicion of planning to build and detonate a dirty bomb (2002)
Herat, Afghanistan British Intelligence & weapons researchers conclude Al Qaeda succeeded in constructing a small dirty bomb (2003)
12. Radiological Accidents Windscale, U.K. (1957):
Palomares, Spain (1966)
Three Mile Island, USA (1979)
Goiania, Brazil (1987)
Chernobyl, USSR (1986)
Tomsk, USSR (1993)
Tokaimura, Japan (1999)
13. Radiological Dispersion Device The Department of Defense definition:
"any device, including any weapon or equipment, other than a nuclear explosive device, specifically designed to employ radioactive material by disseminating it to cause destruction, damage, or injury by means of the radiation produced by the decay of such material.
Radiation presence may not be immediately obvious
Unless strong source, prompt radiation injury unlikely
Significant contamination of people and environment
14. Preparing for a Radiological Attack Enhance awareness of acute radiation symptoms and treatment among healthcare providers
Educate first responder and healthcare providers on contamination and low-level radiation issues.
Provide basic detection capability for security organizations and first responders.
Identify State & Federal Support capabilities, clarify responsibilities
Stockpile radiation exposure antidotes.
Prepare educational materials to inform the public during and after an attack
15. Radiation Physics Basics Ionizing but a relatively weak carcinogen and mutagen
Comprised of particulate & electromagnetic radiation
a alpha b beta g gamma x x-rays n neutron
Measures of radiation exposure
Exposure, absorbed dose, dose equivalent
Internal versus External Exposure
Time, Distance, Shielding
16. Radiation Background Several sources
Cosmic
Terrestrial
Anthropogenic
17. RDD Likely Impacts Expected to be terror and an expensive clean-up
Contamination of Victims & Environment
Effect on Emergency Response
Societal Effects
Possible Benefits!?
18. Contamination - Victims and Environment Likely to have zero to small number of fatalities within the immediate deployment area
Injuries from blast effects
most significant
Stress-related injuries
Moderate to wide-spread contamination
19. Effect on Emergency Response Immediate, radiation-related health effects unlikely
Depends on size of RDD, location, conditions
Assessment of high radiation level can be made quickly
Concern: radioactive contamination may slow response
Most important: Treat conventionally wounded first
Decontaminate later
Protect sensitive populations
Public Health Sector Preparedness
Prevent worried well from impacting system
Triage where necessary
20. Societal Effects Potential for initial public panic
Concern whether large-scale relocation needed
Economic Impact
Potentially enormous, both business and personal
Protracted societal distraction
Political capital expended on clean-up priorities
Large governmental clean-up costs
Health Effects
Psychological effects
Increased cancer risk
Long-term environmental monitoring
21. Possible Benefits!? Force resolution of radioactive waste clean-up and disposal issues, including driving down disposal costs
Educate lay public about radiation risk
Tighter hazardous materials controls reduce accidents
Hormesis?!
22. Post-Event Clean-Up Possible to clean-up to pre-event levels?
Probably not
But health can be protected
Economic costs and use restrictions
23. Radioactive Material Characteristics Detection
Cannot detect with senses
Requires specialized equipment and training
Physical form
Initially, an airborne solid, dust or gas.
Will adhere to surfaces, may dissolve in water.
May re-suspend over time
Persistence
Depends on the half-life
Environmental transport depends on chemistry, but also physical factors
Both dilution and bio-concentration
24. Radioisotope Candidates 137Cs
60Cu
192Ir
226Ra
241Am
239Pu
Uranium
3H
Irradiators & industrial sources
Irradiators
Irradiators & industrial sources
Irradiators & industrial sources
Industrial sources
Industrial sources
Industrial sources
Research, medical, consumer
25. Health Effects Cannot feel or sense an exposure of any magnitude
Acute Radiation Syndrome
LD50 approx 300 rad (3Gy) adult, untreated
Latency period - characteristic of radiation-induced carcinogenesis
Low level exposure - increased risk of cancer
26. Acute Effects Acute Radiation Syndrome (ARS)
Nausea, vomiting and diarrhea
Cataracts
Hair loss
LD50 approx 300 rad (3Gy) adult, untreated
Loss of white blood cells
Radiation cataracts (lens opacity)
Death
27. Low Level Effects Genetic Effects
Cancer risks among the atomic-bomb survivors
Site-specific cancer deaths
Leukemia risks among atomic-bomb survivors
Benign tumors: uterus, parathyroid, thyroid
Deaths due to non-cancer disease
Effect on cholesterol levels, fertility, growth
Chromosome aberrations in white blood cells
Mutation in blood cells
Effects upon the immune system
Psychological effects
Hormesis
28. How To Know When an RDD is Used? Unexplained deaths of otherwise healthy individuals, ARS symptoms
Suspicious explosion or fire, forensics
Detection by emergency services
Intelligence services
Specialized detection equipment, monitoring stations
Announcement or claim of perpetrators
29. Treatment Guidelines Acute NCRP65
AFRRI Biodosimetry Assessment Tool
VA Pocket Card
31. Patient Management and Treatment Low Level Exposures
Treat life-threatening conditions FIRST
Remove Clothing
Decontaminate
Copious water with mild soap
Do not use abrasives or brushes
32. Healthcare Personnel Protection Triage and admitting may need PPE
Unless patients are very hot, exposure to providers should be minimal
See: webcast available on the CDC website
Response to Nuclear and Radiological Terrorism
33. Radiation Detection Environmental Monitors
Site/Station Monitors
Portable Equipment
Radiation Safety Departments
Laboratories
34. Technical Assistance RAP map
35. Selected References NCRP Report 138, Management of Terrorist Events Involving Radioactive Material
NCRP Report 65 Management of Persons Accidentally Contaminated with Radionuclides
Google it!
37. Internet Resources (1) National Safety Council, Environmental Health Center. Link for radiation at:
http://www.nsc.org/ehc/rad/radbroch.htm
Centers for Disease Control, Emergency Preparedness & Response, Radiation Emergencies
http://www.bt.cdc.gov/radiation
Radiation Emergency Assistance Center/Training Site
http://www.orau.gov/reacts
38. Internet Resources (2) Department of Homeland Security
http://www.ready.gov/radiation.html
American College of Radiology
Disaster Preparedness for Radiology Professionals: Response to Radiological Terrorism
http://www.acr.org/departments/educ/disaster_prep/disaster-planning.pdf
39. Internet Resources (3) howstuffworks
http://science.howstuffworks.com/dirty-bomb.htm
Radiation Effects Research Foundation
http://www.rerf.or.jp
Health Physics Society
http://www.hps.org
International Atomic Energy Agency
http://www.iaea.org
40. Internet Resources (4) Armed Forces Radiobiology Research Institute
http://www.afrri.usuhs.mil
Virtual Naval Hospital
Initial Management of Irradiated or Radioactively Contaminated Personnel
http://www.vnh.org/BUMEDINST6470.10A/TOC.html
41. Other Resources RAND http://www.rand.org
Other Sources of Information
OHSA, DOE, EPA, NRC
State Health and Environment Depts.
Academic Centers for Public Health Preparedness
42. Thank you! The New Jersey Center for Public Health Preparedness at UMDNJ
www.NJCPHP.org
email: Carl.Schopfer@UMDNJ.edu