Responding to a radiological or nuclear terrorism incident : a guide for decision makers.

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii 1. Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 2. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 2.1 Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 2.2 Target Audiences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 2.3 Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 2.4 Report Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 2.5 Quantities and Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 2.6 Types of Radiological or Nuclear Terrorism Incidents . . . .7 2.6.1 Radiological Terrorism Incidents . . . . . . . . . . . . . .7 2.6.1.1 Radiological Dispersal Device . . . . . . . 9 2.6.1.2 Radiation Exposure Device . . . . . . . . 11 2.6.1.3 Deliberate Contamination of Food, Water or Consumables. . . . . . . . . . . . 12 2.6.1.4 Dispersal of Radioactive Material from Fixed Radiological or Nuclear Facilities or Materials in Transit . . . . . . . . . . . .12 2.6.2 Improvised Nuclear Device . . . . . . . . . . . . . . . . . .12 3. Key Radiation Protection Principles . . . . . . . . . . . . . . . . . .15 3.1 Establishment of Control Zones . . . . . . . . . . . . . . . . . . . . .15 3.1.1 Defining the Hot Zone . . . . . . . . . . . . . . . . . . . . . .16 3.1.2 Defining the Dangerous-Radiation Zone . . . . . . .17 3.2 Protecting People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 3.2.1 Recommendations for Members of the General Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 3.2.2 Recommendations for Emergency Responders . .20 3.2.3 Recommendations for Public Health and Medical System Personnel . . . . . . . . . . . . . . . . . . . . . . . . .23 3.2.4 Building Design and Construction . . . . . . . . . . . .23 3.2.5 Building Ventilation Systems . . . . . . . . . . . . . . . .24 4. Response-Plan Development and Implementation . . . . . .25 4.1 Federal Guidance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 4.2 Roles and Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . .27 4.3 Response-Plan Requirements . . . . . . . . . . . . . . . . . . . . . . .30 vi / CONTENTS 4.3.1 Hazard Evaluations . . . . . . . . . . . . . . . . . . . . . . . 32 4.3.2 Decontamination of Members of the General Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 4.3.3 Control of Doses to Emergency Responders . . . . 34 4.3.4 Training and Exercises . . . . . . . . . . . . . . . . . . . . 34 4.4 Providing Information to Members of the General Public 36 4.4.1 Preincident Public Information Program . . . . . . 37 4.4.2 Preparing for Post-Incident Messages . . . . . . . . 38 4.5 Mutual-Aid Agreements . . . . . . . . . . . . . . . . . . . . . . . . . . 40 4.6 International Agreements . . . . . . . . . . . . . . . . . . . . . . . . . 40 5. Radiological Terrorism Incident . . . . . . . . . . . . . . . . . . . . . 43 5.1 Radiological Terrorism Incident Response Plan . . . . . . . . 43 5.2 Radiological Terrorism Incident Hazard Zones . . . . . . . . 45 5.3 Protective Actions for Emergency Responders and Members of the General Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 5.3.1 Sheltering versus Evacuation in the Emergency Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 5.3.2 Postemergency-Phase Protection of Members of the General Public . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 5.3.3 Improvised Respiratory Protection . . . . . . . . . . . 47 5.3.4 Management of Concerned Citizens . . . . . . . . . . 47 5.3.5 Protection of Emergency Responders . . . . . . . . . 48 5.4 Triage for Inhaled Radionuclides . . . . . . . . . . . . . . . . . . . 49 5.5 Management of the Crime Scene . . . . . . . . . . . . . . . . . . . 50 6. Nuclear Terrorism Incident . . . . . . . . . . . . . . . . . . . . . . . . . . 51 6.1 Hazard Analysis and Zones . . . . . . . . . . . . . . . . . . . . . . . . 55 6.2 Response-Plan Considerations . . . . . . . . . . . . . . . . . . . . . 57 6.3 Public Information Program to Improve Response to a Nuclear Terrorism Incident . . . . . . . . . . . . . . . . . . . . . . . . 61 6.3.1 Preincident Public Information Program . . . . . . 61 6.3.2 Preparing for Post-Incident Messages . . . . . . . . 62 6.4 Protective-Action Recommendations Specific to a Nuclear Terrorism Incident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 6.5 Planning for the Protection of Emergency Responders After a Nuclear Terrorism Incident . . . . . . . . . . . . . . . . . 67 6.6 Nuclear Terrorism Incident Recommendations for Emergency Responders . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 6.7 Considerations for Downwind Populations at Long Distances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 7. Preparing the Public-Health and Medical System Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 7.1 Public-Health and Medical Preparedness Overview . . . . 73 CONTENTS / vii 7.2 Hospital Preparedness . . . . . . . . . . . . . . . . . . . . . . . . . . . .76 7.3 Reception Centers Other Than Hospitals . . . . . . . . . . . . .82 7.4 Triage Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87 7.5 Treatment Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 7.5.1 Medical Treatment of Victims . . . . . . . . . . . . . . . .90 7.5.2 Radiological Assessment of Patients . . . . . . . . . .92 7.5.3 Management of Individuals at Community Reception Centers . . . . . . . . . . . . . . . . . . . . . . . . .93 7.5.4 Management of Individuals at Alternative Medical Treatment Sites . . . . . . . . . . . . . . . . . . . . . . . . . . .94 7.5.5 Diagnosis of Early Health Effects and Assessment of Internal Contamination . . . . . . . . . . . . . . . . . . . .94 7.5.6 Hospital Management of Radiation Casualties . .95 7.5.7 Use of Countermeasures . . . . . . . . . . . . . . . . . . . .95 7.5.8 Medical Follow-Up of Individuals Exposed to Ionizing Radiation . . . . . . . . . . . . . . . . . . . . . . . . .96 7.6 Decontamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96 7.7 Bioassays for Internal Contamination and Biodosimetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102 7.7.1 Bioassays for Internal Contamination . . . . . . . .102 7.7.2 Biodosimetry . . . . . . . . . . . . . . . . . . . . . . . . . . . .107 7.8 Population Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . .108 7.9 Handling Contaminated Waste . . . . . . . . . . . . . . . . . . . .110 7.10 Handling Contaminated Deceased Persons . . . . . . . . . . .112 7.11 Recruitment and Credentialing of Supplementary Personnel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115 Appendix A. Employer and Emergency Responder Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119 Appendix B. Public Information Statements . . . . . . . . . . . . .124 B.1 In the Event of a Radiological Dispersal Device . . . . . . .124 B.2 In the Event of an Improvised Nuclear Device . . . . . . . .128 Appendix C. Key Decisions for Federal Decision Makers (as they relate to international conventions and agreements) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134 C.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134 C.2 Notification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 C.2.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 C.2.2 Key Decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 C.3 Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137 C.3.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137 C.3.2 Key Decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . .137 C.4 Radioactive-Waste Management . . . . . . . . . . . . . . . . . . .138 viii / CONTENTS C.4.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 C.4.2 Key Decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Appendix D. Controlling Consumer Products — Food, Water, etc. (international implications) . . . . . . . . . . . . . . . . . . . . . 141 D.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 D.2 Radiation Protection Considerations . . . . . . . . . . . . . . . 142 D.3 International Intergovernmental Agreements . . . . . . . 143 D.3.1 Nonedible Consumer Products . . . . . . . . . . . . . 143 D.3.2 Edible Consumer Products (other than drinking water) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 D.3.3 Drinking Water . . . . . . . . . . . . . . . . . . . . . . . . . . 145 D.4 Dealing with Consumer Products After Radiological or Nuclear Terrorism Incidents . . . . . . . . . . . . . . . . . . . . . . 146 D.5 Handling Situations Involving “Hot Particles” . . . . . . . . 147 Appendix E. Resources of the U.S. Department of Energy . 149 E.1 Radiological Assistance Program . . . . . . . . . . . . . . . . . . 149 E.2 Consequence Management Home Team . . . . . . . . . . . . . 150 E.3 Consequence Management Response Team Phase I . . . 150 E.4 Consequence Management Response Team Phase II . . 151 E.5 Consequence Management Response Team- Augmentation/ Federal Radiological Monitoring and Assessment Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 E.6 Aerial Measuring System . . . . . . . . . . . . . . . . . . . . . . . . 152 E.7 National Atmospheric Release Advisory Center . . . . . . 152 E.8 Radiation Emergency Assistance Center/Training Site 152 Appendix F. Decontamination of People . . . . . . . . . . . . . . . . . 153 F.1 Instructions on How to Perform Decontamination at Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 F.2 Instructions to Members of the General Public Waiting for Decontamination at the Scene of an Incident . . . . . . 154 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Abbreviations and Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 The NCRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 NCRP Publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194