On any given day of the week public health professionals must be prepared to respond to any form of emergency. With the varying threats evolving in intensity and modality every year, heavy stress is placed on public health responders to have the knowledge and skill to neutralize the dangers. These threats range from new diseases, injuries from new technology and, on a very bad day, terrorist attacks and bombings. One of the scariest health concerns for the public health community is a nuclear radiological threat. Actions to neutralize the effects of a nuclear radiological event must be made thoroughly and quickly. Of largest and immediate concern are containment, treatment application, safe removal, and safe clean-up. Other varying concerns are training and protecting public health responders from the nuclear threat and having the right equipment for the job. This is a very large public health concern and needs to be in the forefront for all communities.
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The Centers for Disease Control (CDC) (2018) defines public health as “the science of protecting and improving the health of people and their communities.” The CDC works diligently “promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases” (Centers for Disease Control [CDC], 2018). Public health is a concern for everyone whether one lives in a large, popular metropolitan area or lives alone on 500 acres of land.
Public health responders are all the personnel assigned the task of looking after all public health concerns for a population. This includes doctors, nurses, first responders, and even the people that implement public health policy. When an individual receives a flu shot, or visits their physician, they are in contact with a public health responder. The next time you have to dial 9-1-1, think about the first responders that are directly related to public health. The importance of personnel doing these jobs is invaluable to a communities’ overall health.
What has become common place in this country, and many other countries around the world, are nuclear power plants. There are over 450 active nuclear power plants operating worldwide – with more being built or expanded upon right now. That includes the ninety-nine power plants that are currently operating in the United States. These power plants are producing approximately 19 percent of all the electrical power for the country. In the recent past, nuclear power was an intimidating idea to many, but with new technologies and containment, nuclear power plants mostly operate safely and efficiently around the world.
One of the largest nuclear disasters in world history was the reactor explosion at the Chernobyl nuclear power plant. Within three months of this nuclear disaster, thirty people died either from the explosion or from acute radiation syndrome (ARS) (Acute radiation syndrome [ARS], n.d.). The type of radiation and threat that is caused by a nuclear power plant can be the same as other radiological materials, but, depending on how the incident happens; the intensity of the threat can vary dramatically.
Evaluation of the radioactive material and harm reduction is the first step in assessing the threat level of a nuclear disaster. Identifying where the hazard is coming from makes a difference to how the threat will be approached. If it was a dirty bomb, responders must identify the center of the radiation. This can make containment challenging for first responders when the center of the radiation is difficult to pin-point. The same happens when it is a nuclear power plant; you might not know what happened and the cause of the damage. The only good thing about a power plant is it is in a set location, so at least you know where the radiation is coming from and can make a judgment call about where to direct evacuating personal depending on fall out and prevailing winds. So what do we do if this happens again? What did we learn from the Chernobyl incident?
The first step in a nuclear disaster is containment, which helps contain the spread of radiation to the area surrounding the power plant. The United States Nuclear Regulatory Commission (NRC) states that “primary reactor containment means the structure or vessel that encloses the components of the reactor coolant pressure boundary and serves as an essentially leak-tight barrier against the uncontrolled release of radioactivity to the environment” (Nuclear Regulatory Commission [NRC], 2017). These containments are typically a domed structure made of steel-reinforced concrete designed with the capability of being sealed off and made air tight. This capability is important because air tight buildings prevent contaminates from leaking out of the power plant facility in the event of a radiological emergency. If everything goes as planned and designed, the containment structure will be effective in stopping any leakage into the environment. This containment is also designed for the safe decommissioning and removal of the nuclear power plant and fuel sources.
Understanding the different types of radiation created by a nuclear reaction is important because if you don’t understand what they do and how they can be stopped, many of the fail-safes plans will be useless. There are four different types of radiation and each has their own characteristics. Alpha radiation is heavy and extremely short-ranged. The benefit of alpha’s short-range is – unless you are very close to the reaction – alpha radiation will not penetrate the epidermis.
Beta radiation is light and short-ranged. Beta radiation can be discouraged from penetrating skin with the deterrent of clothing or taking shelter. For alpha and beta radiation, seeking shelter or getting behind something solid will protect you from these types of radiation.
Health physics society (2016) explains that gamma and x-ray radiation are “highly penetrating electromagnetic radiation and are called penetrating radiation.” Out of the four types of radiation, gamma and x-ray pose the largest threat to humans in the event of a nuclear disaster. Gamma radiation infiltrated pop cultural awareness with Marvel’s superhero the Incredible Hulk. All of Hulk’s strength and healing abilities came from gamma radiation.
There are several things that you can do to protect yourself in the event of a nuclear disaster. Military training teaches the importance of time, distance, and shielding. The longer it has been since the radiation event, the less likely you are to be exposed. Nuclear radiation has a high decay rate that can lessen its effects. That is why people can safely return to Chernobyl, as long as it is not for a long period of time. Distance means that the further away you are, the safer you will be. This plays a factor by the density of the radiation, the further you are from the center of the radiation the more spread out the radiation becomes and less harmful. Shielding is what was discussed for alpha and beta radiation; anything from you clothing to a solid structure will help shield your body from radiation. This also is applied for gamma and x-ray. Even though they are penetrating radiation they are still stopped depending on the thickness of the material and its density. That is why nuclear power plants use concrete and steel, both materials are very dense and can stop radiation from penetrating through. This is also why we as a nation store nuclear material underground, this stop the transmission of radiation from the source. Now with a clear understand of radiation and what it can do we should be able to protect ourselves better.
Not all radiation is harmful to humans; we are exposed to radiation every day. The largest source of radiation that humans exposed to comes from our sun. It is also needed for a healthy lifestyle; exposure to the sun in small amounts helps our body produce vitamin D. Your body needs vitamin D help with calcium absorption and in turn helps with strong bones. But like most things now days, too much of a good thing can be bad for you. This is why we can get a sun burn from staying out in the sun for too long without protection, the same thing with radiation from a nuclear power plant meltdown.
One of the active contributors to the number of deaths from the Chernobyl nuclear disaster was the number of people that were exposed to high levels of radiation which in turn contributed to them being diagnosed with acute radiation syndrome (ARS). ARS is the result of exposure to huge quantities of radiation, and was the main cause of death from the Chernobyl nuclear disaster. Rare events such as specific radiation bio-medical therapies, accidents and nuclear explosions can be the cause of ARS. ARS effects can be severe, affecting the bodies’ “hematologic, gastrointestinal, and central nervous system-cardiovascular forms; its clinical manifestations are divided into prodromal, latent, overt, and recovery stages.” (Farlex Partner Medical Dictionary, 2012).
There are several things we can do to treat personal that are diagnosed with ARS, though once exposed to the amount of radiation it takes to develop ARS, all outcomes are questionable. Treatment of ARS should focus on the “prevention of further contamination of the radiation, treat fatal injuries, reduce symptoms, and control pain” (Syndromes pedia, 2016). Symptoms of ARS include diarrhea, nausea, body-aches, and vomiting, and can also affect the effective functioning of white blood cells and bone marrow (Syndromes pedia, 2016).
Treatments shown to be effective on ARS symptoms and effects are “potassium iodide, Prussian blue, and diethylenetriamine pentaacetic acid” and application efficacy is dependent on which type of radiation the individual was exposed (Syndromes pedia, 2016). Individuals who are exposed to high-does radiations, the chance of recovery is little and could die within a few days or weeks (Syndromes pedia, 2016). After reading some of the treatment options for treating ARS, preventative measures are the most effective safety plan.
Nuclear Regulatory Commission (NRC) and Federal Emergency Management Agency (FEMA) have a general nuclear disaster preparedness plan.
FEMA “This SOG should be used when a natural or man-made disaster causes damage or alters the emergency response infrastructure around an NRC-licensed NPP to the extent that the damage raises serious questions about the continued adequacy of offsite EP. Moreover, these guidelines apply when a NPP is shut down or operating. If FEMA determines that there is a compromise of “reasonable assurance,” the FEMA Region and FEMA REP Program will coordinate with OROs and the NRC to determine necessary actions to ensure the continued protection of public health and safety.” The key take away is the continued protection of public health and safety.
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According to NRC, “Our emergency preparedness programs enable emergency personnel to rapidly identify, evaluate, and react to a wide spectrum of emergencies, including those arising from terrorism or natural events such as hurricanes. Our incident response program integrates the overall NRC capabilities for the response and recovery of radiological incidents and emergencies involving facilities and materials regulated by the NRC or an Agreement State.”
Between FEMA and the NRC a plan is place and it also monitors not just nuclear but other facilities that have hazardous materials.
Understanding weather patterns helps predict fallout movements, aiding in determining which direction to evacuate public health responder personnel towards safety. The factors affecting determination are based off of the intensity of the initial incident and the quantity of radiation leaking from the detonation site. If the purpose is to protect our public health responders during a nuclear disaster, then we need to understand where the threat is coming from and where it is going. One of the most dangerous aspects of a nuclear disaster is radioactive fallout. Fallout is “the slow descent of minute particles of debris in the atmosphere following an explosion, especially the descent of radioactive debris after a nuclear explosion” (Fallout, n.d.). These minute particles can be influenced by the weather, moving over great distances and have the potential to cause more damage than the explosion itself.
Two other concerns in the event of a nuclear threat are nuclear weapons and the uncontrolled spread of radioactive materials. Nuclear weapons have been under development since the early 1900s. The United States was able to successful test its first bomb in 1945. Shortly thereafter the world watched as the United States used the first nuclear bomb on the Japanese city of Hiroshima. In Hiroshima alone, 75,000 people were killed by the actual bomb, but a total of 200,000 Japanese lives were lost due to the bomb and radiation poisoning (New Internationalist, 2008).
Nuclear weapons pose such a threat to the world’s health that the United Nations proposed a ban in 2017 for full nuclear disarmament. Out of the 123 states in the United Nations, 122 states voted in favor of full nuclear disarmament. This is a strong step in the right direction to remove this threat of nuclear weapons for the world and public health responders.
The next area of concern is radioactive materials. There is a laundry list of radioactive materials that can cause harm to humans. A lot of radioactive materials can be used for the good of mankind such as nuclear medicine. Fully enriched uranium is the preferred material used in large nuclear weapons. The reason it is preferred is because of its half-life, over a billion years. A half-life is the amount of time it takes for “half the nuclei in a sample of a specific isotopic species to undergo radioactive decay” (Half-life, 2011).
To put in simple terms: how long will it take before the material itself is no longer radioactive? The NRC is responsible for keeping track and tracking radioactive materials in the United States. “The NSTS is a major security initiative of the NRC. This highly secure, accessible and easy-to-use computer system tracks high-risk radioactive sources from the time they are manufactured or imported through the time of their disposal or export, or until they decay enough to no longer be of concern. This website has been developed to provide our stakeholders with the current status of program activities, tools and resources to aid in using the system, and mechanisms to provide direct feedback to us.” (NRC, 2017). This states that the NRC has a tracking system for all controlled radioactive materials as well as tracking the licensing and licensees for all radioactive material.
The last threat to public health responders comes from using radioactive materials to make what is called a dirty bomb. The NRC states “A “dirty bomb” is one type of a radiological dispersal device, also called an RDD that combines conventional explosives, such as dynamite, with radioactive material. The terms dirty bomb and RDD are often used interchangeably. Most RDDs would not release enough radiation to kill people or cause severe illness. The conventional explosive itself would be more harmful to individuals than the radioactive material. However, depending on the situation, an RDD explosion could create fear and panic, contaminate property, and require potentially costly cleanup” (NRC, 2018). These are simply made and cost effect bombs for terrorist to make and use. It only requires you to place a radioactive material around a bomb, it doesn’t even have to be a fusion reaction, and have it explode, and then you can spread the radioactive material having it cause harm to personal and property in the area of the explosion. With the explanation of a dirty bomb coming from the NRC and the NRC is responsible for the tracking of radioactive materials, which leaves the question, where would you get radioactive materials to make a dirty bomb. The NRC further explains “Radioactive materials are routinely used at hospitals, research facilities, industrial activities, and construction sites. These radioactive materials are used for such purposes as diagnosing and treating illnesses, sterilizing equipment, and inspecting welding seams. The NRC together with the “agreement States,” (who also regulate radioactive material), administers more than 22,000 licenses of such materials (NRC, 2018). The vast majority of these materials are not useful in an RDD (NRC, 2018).
Keeping public health responders safe during a nuclear disaster begins with proper training and obtaining the proper equipment to neutralize threats and exposure. Some disasters have been compounded by first responders not wearing the correct safety gear. In 2011, Japan had a nuclear power plant core meltdown. The United States Navy sent ships equipped with a radiological alpha/beta detector to aid in the disaster by monitoring the coast of Japan for radiation. Alpha and beta radiation does not travel that far, however, the more dangerous gamma and x-ray types do. As a result, U.S. Navy personnel were exposed to gamma and x-ray radiation. Training and the right equipment (gamma probe), would have prevented excessive radiological exposure to U.S. Navy sailors.
Public health responders play a very important part of our communities and our community’s health as well as having a vital role in a nuclear disaster. This role is only going to grow with the steadily increasing number of nuclear power plants in the country around the world. Some of the key points are first responders must be properly trained and prepared with all of the right equipped to step up to the plate in the event of a nuclear disaster. One thing that might ad public health responders in the future is further developments in the containment and safety of a nuclear power plant. Public health responders have to have a good understanding of all national and state regulation put down by FEMA and the NRC as well as a good understanding of the preparedness plan.
References
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- CDC Foundation. (2018, October 21). What is Public Health? Retrieved from https://www.cdcfoundation.org/what-public-health
- Fallout. (n.d.). In American Heritage® Dictionary of the English Language, Fifth Edition. (2011). Retrieved October 22, 2018 from https://www.thefreedictionary.com/fallou
- FEMA. (2018, August 17). Assessment of Offsite Emergency Preparedness Infrastructure and Capabilities Following an Incident in the Vicinity of a U.S. Nuclear Regulatory Commission Licensed-Nuclear Power Plant. Retrieved from https://www.fema.gov/media-library-data/1537195353987-869b5b423aa582bddc3e7db893e5761f/2018_FEMA_REP_PCA_DIR_SOG.pdf
- Half-life. (n.d.). In American Heritage® Dictionary of the English Language, Fifth Edition. (2011). Retrieved October 22 2018 from https://www.thefreedictionary.com/half-life
- Health Physics Society. (2016, June 17). What Types of Radiation are There? Retrieved from http://hps.org/publicinformation/ate/faqs/radiationtypes.html
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- The Internationalist. (2008, June 02). Nuclear weapons: a history. Retrieved from https://newint.org/features/2008/06/01/nuclear-weapons-history/
- United States Nuclear Regulatory Commission. (2017, August 29). Appendix J to Part 50—Primary Reactor Containment Leakage Testing for Water-Cooled Power Reactors. Retrieved from https://www.nrc.gov/reading-rm/doc-collections/cfr/part050/part050-appj.html
- United States Nuclear Regulatory Commission. (2017, August 22). National Source Tracking System. Retrieved from https://www.nrc.gov/security/byproduct/ismp/nsts.html
- United States Nuclear Regulatory Commission. (2018, May 25). Backgrounder on Dirty Bombs. Retrieved from https://www.nrc.gov/reading-rm/doc-collections/fact-sheets/fs-dirty-bombs.html
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