Citation

Ingram RJ. Health Phys. 2018; 114(2): 208-213.

Copyright

(Copyright © 2018, Health Physics Society, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/HP.0000000000000757

PMID

30086017

Abstract

The emergency responder community trains for and responds to many types of incidents on a daily basis and has done so for years. This experience with fires, emergency medical calls, chemical spills, confined spaces, and other common calls for assistance has helped responders develop an understanding of the problems and a confidence in solving them. Radiation from an accidental release in a facility or during transportation, or from a terrorist incident that causes radioactive materials to be released from their containment vessel, remains a cause of concern and fear. Emergency responders are a segment of the general population and share some of the same fears of radioactive materials as the whole population. Radioactive material incidents are not a common 911 call type. Radiation training has been included in emergency responder training standards for several decades and covers a broad range of topics from simple awareness and recognition to technical knowledge of the materials, detection and identification capabilities, self-protection, medical effects, and countermeasures to overall public and environmental safety and health. The safety factor of the radiation community has been very good, but without the actual response confidence in handling previous incident releases, many responders remain fearful of radiation. A single source site where responders can post and read after-action reports on actual radiation incidents may help communicate health and safety information, building responder confidence. Competencies in standards do not always translate into compliance in training curriculum and exercises. The fire service has been the key local response agency to radiation accidents for many years and has developed training programs that meet the competencies found in 29 CFR 1910.120 [q], How to Determine What Training is Required for Emergency Response Team Members, and the National Fire Protection Associations Standard 472: Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents. The majority of fire service responders in the United States are volunteers who often make decisions on what they train for based on the time available and their areas' hazard assessment. This has often caused radiation training to be limited at best. Communicating timely and accurate hazards and risks associated with radiation threats and incidents may increase the amount and level of training in response to these types of incidents. Many law enforcement and emergency medical services and other key disciplines did not address these standards requirements prior to 9/11, as they were considered outside their "normal" mission space. The change in the mission space caused by the new threat of radiological terrorism has required additional training and equipment. This training has started but will take time to impact the entire responder community, it will require funding for the training and equipment, and most of all, sustainment. Communicating the broad scope of capabilities necessary to safely manage a radiation incident and the requirement for all agencies to be involved may support the effort to train these disciplines in their new mission space. The serious and much publicized radiological incidents that have occurred during the lifetime of many of today's responder community (Chernobyl, Fukushima, and Three Mile Island) have added to this fear within the responder community. The majority of today's responder communities are between 21 and 50 y of age. In studies conducted in recent years by federal agencies, it was identified that this group did not receive the basics of nuclear information provided to the U.S. population at the start of the Cold War and the fear of a nuclear war. These studies have identified the gap that exists in understanding basic radiation terminology, protective actions including sheltering-in-place, informed evacuation, public messaging, and others. Despite studies like this, federal, state, and local public officials have been slow to communicate emergency action plans to the public for radiological and nuclear incidents. Emergency management agencies at all levels have action plans for natural events such as hurricanes, tornadoes, and coastal storms, and now they are including biological incidents and active shooters. Nuclear and radiological incident plans and protective actions need to be included and communicated to members of the public (and responders) in all media streams. Several federal agencies have been tasked with radiological and nuclear mission space, but this appears to remain fragmented without an organizing agency. The Domestic Nuclear Detection Office (U.S. Department of Homeland Security) remains in a detection and prevention mission and has provided a good amount of equipment, training, and coordination, but primarily among law enforcement organizations. The Federal Emergency Management Agency remains in the response mission but has limited outreach to the majority of response organizations. The U.S. Department of Health and Human Services (Assistant Secretary for Preparedness and Response) has stepped up its efforts in medical countermeasures, surge capabilities, and support services. All of this information and support comes to the responder community separately, and it is left to the local-level planners to piece it together. It needs to be coordinated and communicated as one source. Communications remains the top challenge for the responder community as we look to the new administration for a plan for radiological and nuclear preparedness: communicating public messaging on radiation terminology, how members of the public can protect themselves and expected public agency actions; communicating a coordinated response plan that includes all levels and agencies; communicating the necessary training; andcommunicating the recovery actions that will have to take place.

Language: en