Boston University Medical Campus
Nuclear Accident Preparedness Program

Introduction

Although radiation accidents occur infrequently, the world’s growing reliance on nuclear power and the industrial use of radioisotopes increase the likelihood that such accidents will occur. In the first hours following a radiation accident, local emergency response personnel will have to provide assistance to victims especially if the victims have sustained bodily injury. During the early phase of response, experienced personnel must also attempt to prevent further radiation exposure to all individuals in the affected area while attempting to predict the consequences of the release to people outside the local area. During the next phase of the response, local personnel must communicate with expert consultants and request the necessary resources to definitively manage the victims and the situation.

This document is intended to serve as a template and framework for local and national medical response personnel who are developing or revising their radiation accident plan. When the medical response plan is drafted or revised in each country, the planner should make sure that the revisions do not conflict with plans prepared by other responding organizations in that country. The International Atomic Energy Agency document “International Basic Safety Standards for Protection Against Ionizing Radiation and the Safety of Radiation Sources” addresses the allocation of responsibilities in an emergency exposure situation by the National Regulatory Authority to the organization that is expected to respond to the accident. This document is also intended to facilitate the cooperation of medical personnel from different countries in a given region who are confronted by a disaster of international magnitude. It is hoped that similarities between national plans will allow interregional exercises and cooperation following major radiation accidents.

This document was designed to highlight the essential elements that should be included in the medical portion of each country’s radiation emergency response plan. Selection of the essential elements has been based on lessons that have been learned from prior radiation accidents such as Chernobyl, Goiania and Three Mile Island. This plan was also designed to be consistent with the “Handling of Radiation Accidents by Emergency Personnel” curriculum developed by the Radiation Emergency Assistance Center/Training Site (REAC/TS), a training facility in Oak Ridge, Tennessee supported by the United States Department of Energy. It is understood that each local or national plan will have to address site specific needs. While it is important to study what has happened in the past, planners must try to anticipate what could happen in the future. The radiation emergency response plans that are developed from this document must prepare responders for any feasible occurrence from an accidental exposure to an industrial radiation source to core damage at a nuclear power plant.

The International Atomic Energy Agency (IAEA) TECDOC-953¹ identifies five emergency planning categories into which radiological accidents can be fit according to the magnitude and timing of the event. Planners should consider these five categories in preparing emergency medical response plans in the vicinity of the accident (on-site area) and in the area beyond the control of the facility (off-site area) where the accidental release or exposure has occurred. IAEA TECDOC-953 can be used by medical response personnel to assess the risks to victims and responders that are associated with the accident. In addition, IAEA TECDOC-955² should be used by medical response personnel in assessing the risk to victims and responders when a radiation accident occurs at a nuclear power plant. The IAEA TECDOC-955 document outlines the “technical procedures for determining protective actions for the public and controlling dose to emergency workers for accidents at a nuclear reactor.” Finally, it is hoped that this document will encourage radiation accident planners from the emergency medical community to access resources available from international resource agencies such as IAEA or the World Health Organization (WHO) when planning for or responding to radiation accidents³ .

¹ From reference 6 (pp. 10,11).

² From reference 5.

³ See Appendix 8.