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Nuclear Power Plant / Nuclear Reactor Emergencies

General Information


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Emergency Planning and Response


  • The Emergency Planning Zone (EPZ)
    • Definition: the area surrounding a nuclear power plant for which plans required by the NRC have been made in advance to ensure that prompt and effective actions are taken to protect the health and safety of the public in case of an incident
    • The Nuclear Regulatory Commission (NRC) has described 2 EPZs
      • Plume Exposure Pathway EPZ: within a 10 mile (16.1 km) radius of the nuclear power plant where potential exposure could be from any or all of the following sources
        • Whole-body external exposure to gamma radiation from the passing plume and from deposited material
        • Thyroid exposure through inhalation from the passing plume
        • Committed effective dose equivalent exposure to other critical organs through inhalation
      • Ingestion Exposure Pathway EPZ: within a 50 mile (80.5 km) radius of the nuclear power plant where potential exposure could be from any or all of the following sources
        • Ingestion of contaminated water or foods, such as milk, fresh vegetables, and aquatic foodstuffs, may result in increased risk of radiation-induced cancer to the thyroid, bone marrow, and other organs
  • Generalized Protective Action Areas for Nuclear Power Plant Incident
    Generalized protective action areas for nuclear power plant incident

    (Source: EPA PAG Manual 2017 (PDF - 1.48 MB), See Figure 4-1, page 54. See also entire PAG Manual section on Intermediate Phase: Relocation and Dose Reduction)

  • If a release of radioactivity occurs, response managers will recommend public health protective actions. Depending on the circumstances, these actions could include
    • Evacuation from areas at risk of being significantly contaminated by the plume
    • Sheltering-in-place (intake ventilation off, windows closed) to avoid the radioactive plume
    • Interdiction of contaminated or potentially contaminated food
    • Use of medical countermeasures
  • If a serious release of radioactivity occurs, there is likely to be a window of time before it starts, so that the response plan can be implemented.
  • Radioisotopes released into the air after an incident could contain alpha, beta and gamma radiation
  • Workers close to the reactor could be affected by
    • External exposure to highly radioactive materials within the reactor
    • External contamination by radioactivity released and dispersed locally in the plume
    • Internal contamination by radioactivity released, dispersed locally, and then ingested, inhaled, and/or incorporated
  • The general public could be affected by
  • Routine preparedness signs in regions potentially at risk after a nuclear power plant incident might look something like the one below which was photographed in Solomons Island, Maryland, September 2016
    Nuclear power plant warning sign

Selected key documents

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Radioisotopes in the Plume and Recommendations for Potassium Iodide Countermeasure


  • Radioiodines
    • Can travel over long distances in air after release and settle to the ground
    • Can be inhaled or ingested from the water supply or food chain except for foodstuffs that were encapsulated/sealed/canned prior to the event
    • Primary health threat from a release is likely to be from radioiodines and I-131 particularly, although other radioiodine isotopes are possible.
    • Heath effects
      • No short term acute health effects
      • Potential longer term health effects could develop if there is sufficient internal contamination and incorporation of radioiodine by the thyroid gland. These late effects could include
        • Hypothyroidism, with special consequences in infants and children
        • Thyroid cancer, particularly in younger individuals
      • Radioiodine is not concentrated in organs other than the thyroid.
    • Prophylaxis (before the exposure) and treatment (after the exposure) to radioactive iodine
      • Administration of non-radioactive potassium iodide (KI) or other iodine substances blocks the thyroid from accumulating radioactive iodine, thereby minimizing/avoiding subsequent risks.
      • KI is most effective if given a few hours before exposure, but it is also effective if given within several hours after exposure.
      • The need for prophylaxis and/or treatment with KI will be determined by officials managing the event, and instructions to the general public will be given based on the assessment of risk.
      • KI should be taken only on the advice of emergency management officials, public health officials, or a personal physician.
    • Time Line of Potassium Iodide Distribution Policies in the US
  • Other radioisotopes might be released, with possible health effects only if an individual receives a high enough dose
  • Monitoring radionuclides in drinking water and food: routinely and after a release

Figure 1. Internal Exposure to Iodine-131 Through Ingestion

Internal Exposure to Iodine-131 Through Ingestion

Adapted from Radioactive Iodine (I-131) and Thyroid Cancer — An Education Resource (PDF - 791 KB) (HHS/National Cancer Institute/Division of Cancer Epidemiology and Genetics)

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Responder Willingness to Serve During Radiation Disasters



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References


General information

  1. Radiation Monitoring for Protection of the Public after Major Releases of Radionuclides in the Environment, Journal of the ICRU Report 92: 2015;15(1-2):1-244.
  2. The Science of Responding to a Nuclear Reactor Accident: Summary of a Symposium (National Academies Press, 2014)
  3. Coleman CN, Blumenthal DJ, Casto CA, Alfant M, Simon SL, Remick AL, Gepford HJ, Bowman T, Telfer JL, Blumenthal PM, Noska MA, Recovery and Resilience After a Nuclear Power Plant Disaster: A Medical Decision Model for Managing an Effective, Timely, and Balanced Response, Dis Med Pub Health Prep 2013;7(2),2013. [PubMed Citation]
  4. Zwolinski LR, Stanbury M, Manente S. Nuclear power plant emergency preparedness: results from an evaluation of Michigan's potassium iodide distribution program. Disaster Med Public Health Prep. 2012 Oct;6(3):263-9. [PubMed Citation]
  5. Christodouleas JP, Forrest RD, Ainsley CG, Tochner Z, Hahn SM, Glatstein E. Short-Term and Long-Term Health Risks of Nuclear-Power-Plant Accidents. N Engl J Med. 2011 Jun 16;364(24):2334-41. [PubMed Citation]

Reviews

  1. Lancet series of 14 articles about historical radiation incidents including weapons testing, nuclear detonations and power plant incidents: Japan: from Hiroshima and Nagasaki to Fukushima
    • To coincide with 70th anniversary of the atomic bombs in Hiroshima and Nagasaki, on July 31, 2015, Lancet published 14 articles about the enduring radiological, nuclear and psychological impact of radiation disasters.
    • The excellent series also provides information about public health planning to manage potential future disasters. The goal is to protect the millions of people who live in areas surrounding the 437 nuclear power plants that are in operation worldwide.
    • Citation: Lancet August 2015; 386(9992):405-500. Some, but not all articles, are free.

Guidance documents about nuclear power plant operations and accidents

  1. Program Manual, Radiological Emergency Preparedness, (DHS/FEMA P-1028, December 2019)
  2. Agreement State Program Administered by the US Nuclear Regulatory Commission
  3. IAEA Operational Interventional Levels (OILs) for Reactor Emergencies (PDF - 4.57 MB) (IAEA, 2017)
  4. Actions to Protect the Public in an Emergency due to Severe Conditions at a Light Water Reactor (IAEA, 2013)
  5. The Science of Responding to a Nuclear Reactor Accident: Summary of a Symposium (National Academies Press, 2014)
  6. Contamination Monitoring Guidance for Portable Instruments Used for Radiological Emergency Response to Nuclear Power Plant Accidents (PDF - 233 KB) (FEMA, October 2002)
  7. Nuclear Materials Quick Links (NRC)

Guidance documents about managing internal contamination

  1. Braverman ER, Blum K, Loeffke B, Baker R, Kreuk F, Yang SP, Hurley JR. Managing terrorism or accidental nuclear errors, preparing for iodine-131 emergencies: a comprehensive review. Int J Environ Res Public Health. 2014 Apr 15;11(4):4158-200. [PubMed Citation]
  2. Management of Persons Contaminated with Radionuclides: Scientific and Technical Bases (NCRP Report No. 161, Volume II), National Council on Radiation Protection and Measurements, Bethesda, MD, 2010.
  3. Management of Persons Contaminated With Radionuclides: Handbook (NCRP Report No. 161, Volume I), National Council on Radiation Protection and Measurements, Bethesda, MD, 2008.
  4. Management of Persons Accidentally Contaminated with Radionuclides (NCRP Report No. 65), National Council on Radiation Protection and Measurements, Bethesda, MD, 1980. [This document has been superseded by NCRP 161.]
  5. Dose assessment of inhaled radionuclides in emergency situations (Public Health England [PHE], formerly Health Protection Agency [HPA]/United Kingdom and Treatment Initiatives After Radiological Accidents (TIARA) project/European Commission, August 2007)
  6. Exposure of the American People to Iodine-131 from Nevada Nuclear Bomb Tests, Review of the National Cancer Institute Report and Public Health Implications (IOM/NRC, 1999)

History of radiation incidents

Fukushima

  1. Health consequences of Fukushima: 10 years towards recovery (WHO REMPAN Webinar - 23 March 2021) (YouTube: 2:02:19) Watch video
  2. Lancet series of 14 articles about historical radiation incidents including weapons testing, nuclear detonations and power plant incidents: Japan: from Hiroshima and Nagasaki to Fukushima
    • To coincide with 70th anniversary of the atomic bombs in Hiroshima and Nagasaki, on July 31, 2015, Lancet published 14 articles about the enduring radiological, nuclear and psychological impact of radiation disasters.
    • The excellent series also provides information about public health planning to manage potential future disasters. The goal is to protect the millions of people who live in areas surrounding the 437 nuclear power plants that are in operation worldwide.
    • Citation: Lancet August 2015; 386(9992):405-500. Some, but not all articles, are free.
  3. Developments Since the 2013 UNSCEAR Report on the Levels and Effects of Radiation Exposure Due to the Nuclear Accident Following the Great East-Japan Earthquake and Tsunami, A 2015 White Paper to Guide the Scientific Committee's Future Programme of Work. (UNSCEAR)
  4. Fukushima—Five Years After: Thyroid Cancer (PDF - 199 KB) (NCRP, November 16, 2016, The Boice Report #52)
  5. Hasegawa A, Ohira T, Maeda M, Yasumura S, Tanigawa K. Emergency Responses and Health Consequences after the Fukushima Accident; Evacuation and Relocation. Clin Oncol (R Coll Radiol). 2016 Apr;28(4):237-44. [PubMed Citation]
  6. IAEA information on Fukushima Nuclear Accident (IAEA)
  7. The Science of Responding to a Nuclear Reactor Accident: Summary of a Symposium (National Academies Press, 2014)
  8. Tominaga T, Hachiya M, Tatsuzaki H, Akashi M. The accident at the Fukushima Daiichi Nuclear Power Plant in 2011. Health Phys. 2014 Jun;106(6):630-7. [PubMed Citation]
  9. Kondo H, Shimada J, Tase C et al. Screening of Residents Following the Tokyo Electric Fukushima Daiichi Nuclear Power Plant Accident. Health Phys. 2013 Jul;105(1):11-20.
  10. Gonzalez AJ, Akashi M, Boice JD Jr, Chino M, Homma T, Ishigure N, Kai M, Kusumi S, Lee JK, Menzel HG, Niwa O, Sakai K, Weiss W, Yamashita S, Yonekura Y. Radiological protection issues arising during and after the Fukushima nuclear reactor accident. J Radiol Prot. 2013 Sep;33(3):497-571. [PubMed Citation]
  11. The International Workshop on Radiation and Thyroid Cancer (NEA/CRPPH/R(2014)3), Organization for Economic Co-operation and Development, Nuclear Energy Agency, Tokyo, Japan, February 2014.
    • What is known today about thyroid cancer and radiation
    • What has been learned from past nuclear and radiological accidents
    • What actions have and are being taken to assess the potential for thyroid cancer in Fukushima and Japan from the Fukushima accident
    • Relevant aspects of stakeholder involvement and planned activities
  12. EPA Information and Resources (EPA)
  13. Levels and effects of radiation exposure due to the nuclear accident after the 2012 great east-Japan earthquake and tsunami. UNSCEAR 2013 Report to the General Assembly ,Volume I, Scientific Annex A. See chapter III (page 6-12) for excellent UNSCEAR summary report on the levels and effects of radiation exposure due to the nuclear accident after the 2011 great east-Japan earthquake and tsunami.
  14. UNSCEAR Press Briefing on Fukushima, May 31, 2013, YouTube video. Scientific discussion begins at 4 min 45 secs. Watch video
  15. Health Physics News, The Boice Report #11, Aprils 2013: Summary of the NCRP February 2013 Fukushima Conference (PDF - 155 KB)
  16. Gonzalez A, Akashi M, Boice JD, et al. Radiological protection issues arising during and after the Fukushima nuclear reactor accident. J Radiol Prot. 2013 Jun 27;33(3):497-571. [PubMed Citation]
  17. Acton JM, Hibbs, M. Why Fukishima was Preventable, Carnegie Endowment for International Peace, 2012
  18. Wilson T, Chang F, Berro A, et al. US screening of international travelers for radioactive contamination after the Japanese nuclear plant disaster in March 2011. Disaster Med Public Health Prep. 2012 Oct;6(3):291-6. [PubMed Citation]
  19. Akiba S. Epidemiological studies of Fukushima residents exposed to ionising radiation from the Fukushima Daiichi Nuclear Power Plant prefecture--a preliminary review of current plans. J Radiol Prot. 2012 Mar;32(1):1-10. [PubMed Citation]
  20. Fukushima Nuclear Reactor Radiation Crisis: A National Review of the U.S. Domestic Public Health and Medical Response (PDF - 1.01 MB) (Association of State and Territorial Heath Officials, May 2012)
  21. The Journal of Radiological Protection published a special subsection of the March 2012 issue with 22 excellent articles on the Japanese Fukushima nuclear power plant incident (based on the September 2011 International Expert Symposium in Fukushima: Radiation and Health Risks) J Radiol Prot. 2012 Jun;32(1) (special section)
  22. Becker SM. Learning from the 2011 Great East Japan Disaster: insights from a special radiological emergency assistance mission. Biosecur Bioterror. 2011 Dec;9(4):394-404. [PubMed Citation]
  23. Fukushima Daiichi nuclear disaster (Wikipedia)
  24. ICRP publications about Fukushima incident (ICRP)
  25. Whitcomb RC Jr, Ansari AJ, Buzzell JJ, McCurley MC, Miller CW, Smith JM, Evans DL. A public health perspective on the U.S. response to the Fukushima radiological emergency. Health Phys. 2015 Mar;108(3):357-63. [PubMed Citation]

Chernobyl

  1. Gilbert W. Beebe Symposium on 30 Years after the Chernobyl Accident: Current and Future Studies on Radiation Health Effects (National Academy of Sciences (NAS), Nov 1-2, 2016, 12 web cast lectures and pdfs of slides)
  2. IAEA information about the Chenobyl accident (IAEA)
  3. Balonov MI. On protecting the inexperienced reader from Chernobyl myths. J Radiol Prot. 2012 Jun;32(2):181-9. Epub 2012 May 8. [PubMed Citation]
  4. Thomas GA (ed.), The Radiobiological Consequences of the Chernobyl Accident 25 Years On - April 2011, Clin Oncol (R Coll Radiol). 2011 May;23(4):229-308. (Note: All 11 articles in this issue are on this topic.)
  5. Balonov MI. The Chernobyl Forum: major findings and recommendations. J Environ Radioact. 2007;96(1-3):6-12. [PubMed Citation]
  6. Health Effects of the Chernobyl Accident and Special Health Care Programmes (PDF - 923 KB) (WHO, 2006)
  7. Chernobyl disaster (Wikipedia)
  8. See also: History of Radiation Incidents

CDC/ATSDR

  1. Potassium Iodide (CDC, March 17, 2011)
  2. Radiation and Potassium Iodide (CDC, March 18, 2011)
  3. Case Studies in Environmental Medicine (CSEM): Radiation Exposure from Iodine 131, Course SS3117. (HHS/ATSDR, November 2002)

FDA

  1. Frequently Asked Questions on Potassium Iodide (KI) (March 18, 2011, HHS/FDA)
  2. Guidance: Potassium Iodide as a Thyroid Blocking Agent in Radiation Emergencies (PDF - 40 KB) (HHS/FDA, December 2001)
  3. Other KI resources including information for infants and small children (HHS/FDA)

Nuclear Regulatory Commission

  1. Consideration of Potassium Iodide in Emergency Planning
  2. Backgrounder on Emergency Preparedness at Nuclear Power Plants
  3. Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants (NUREG-0654/FEMA-REP-1)
  4. Student's Corner - Nuclear Reactors
  5. Operating Nuclear Power Reactors (by Location or Name)

Other Agencies

  1. Medical Effectiveness of Iodine Prophylaxis in a Nuclear Reactor Emergency Situation and Overview of European Practices (PDF - 717 KB) (European Commission, Directorate-General for Energy Directorate D - Nuclear Energy Unit D4, Radiation Protection No. 165, 2010)
  2. Distribution and Administration of Potassium Iodide in the Event of a Nuclear Incident (Committee to Assess the Distribution and Administration of Potassium Iodide in the Event of a Nuclear Incident, National Research Council, 2004)
  3. Federal Policy on Use of Potassium Iodide (KI) (PDF - 43 KB) (DHS/FEMA document, published in Federal Register January 10, 2002)
  4. Guidelines for Iodine Prophylaxis following Nuclear Accidents (PDF - 96 KB) (WHO, 1999)

Pediatric issues

  1. Pediatric Counter-terrorism Measures (HHS/FDA, 2/2010) See KI information.
  2. American Academy of Pediatrics Committee on Environmental Health. Radiation disasters and children. Pediatrics. 2003 Jun;111(6 Pt 1):1455-66. [PubMed Citation]

National Council on Radiation Protection and Measurements (NCRP)

  1. Population Monitoring and Radionuclide Decorporation Following a Radiological or Nuclear Incident (NCRP Report No. 166), National Council on Radiation Protection and Measurements, Bethesda, MD, 2011.
  2. Responding to a Radiological or Nuclear Terrorism Incident: A Guide for Decision Makers (PDF - 1.61 MB) (NCRP Report No. 165), Bethesda, MD, 2010.
  3. Management of Persons Contaminated with Radionuclides: Scientific and Technical Bases (NCRP Report No. 161, Volume II), Bethesda, MD, 2010.
  4. Management of Persons Contaminated With Radionuclides: Handbook (NCRP Report No. 161, Volume I), Bethesda, MD, 2008.
  5. Management of Persons Accidentally Contaminated with Radionuclides (NCRP Report No. 65), Bethesda, MD, 1980. [NCRP 65 has been superseded by NCRP 161.]
  6. Cesium-137 in the Environment: Radioecology and Approaches to Assessment and Management (NCRP Report No. 154), Bethesda, MD, 2006.
  7. Risk to the Thyroid from Ionizing Radiation (NCRP Report No. 159), Bethesda, MD, 2008.

Exposure Assessment Considerations

  1. Guidelines for exposure assessment in health risk studies following a nuclear reactor accident. Bouville A, Linet MS, Hatch M, Mabuchi K, Simon SL. Environ Health Perspect. 2014 Jan;122(1):1-5. [PubMed Citation]
  2. Kondo H, Shimada J, Tase C et al. Screening of Residents Following the Tokyo Electric Fukushima Daiichi Nuclear Power Plant Accident. Health Physics 2013 July;105(1):11-20.