Senior Leaders:
Information for Radiation Emergencies
- General Information
- Practical Guidance
- Communications Strategies
- Assessment of State and Local Laws Regarding Management of Persons During Radiation Incidents
- Emergency Declaration Authorities Across all States and DC
- Selected References
General Information
-
Issues for medical planning and response to a mass casualty
radiation incident will vary with
- Nature, severity, cause, and location of the radiation incident
- Agency in which the Leader is operating and its own rules and regulations
- Leadership role of the official
- Medical practice, standards of care, available assets, Concept of Operations, and liability issues are complex and each practitioner should consult with experts in his/her venue and organization.
- Methodologies for Evaluating and Grading Evidence: Considerations for Public Health Emergency Preparedness and Response: Proceedings of a Workshop—in Brief (NASEM, 2019)
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2017 – 2022 Health Care and Preparedness and Response
Capabilities
(PDF - 795 KB) (HHS/ASPR, November 2016)
- HHS/ASPR recognizes that there is shared authority and accountability for the health care delivery system's readiness that rests with private organizations, government agencies, and Emergency Support Function-8 (ESF-8, Public Health and Medical Services) lead agencies.
- Given the many public and private entities that must come together to ensure community preparedness, HCCs serve an important communication and coordination role within their respective jurisdiction(s).
Practical Guidance
- A Decision Makers Guide: Medical Planning and Response for a Nuclear Detonation (HHS/ASPR, November 2017)
- Coleman CN, Sullivan JM, Bader JL, Murrain-Hill P, Koerner JF, Garrett AL, Weinstock DM, Case C Jr, Hrdina C, Adams SA, Whitcomb RC, Graeden E, Shankman R, Lant T, Maidment BW, Hatchett RC. Public health and medical preparedness for a nuclear detonation: the nuclear incident medical enterprise. Health Phys. 2015 Feb;108(2):149-60. [PubMed Citation]
- 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]
- Koerner JF, Coleman CN, Murrain-Hill P, FitzGerald DJ, Sullivan JM. The medical decision model and decision maker tools for management of radiological and nuclear incidents. Health Phys. 2014 Jun;106(6):645-51. [PubMed Citation]
- Coleman CN, Adams S, Adrianopoli C, Ansari A, Bader JL, et al., Medical planning and response for a nuclear detonation: a practical guide. Biosecur Bioterror. 2012 Dec;10(4):346-71. [PubMed Citation]
- Medical Planning and Response Manual for a Nuclear Detonation Incident: a Practical Guide. (PDF - 7.7 MB) (October 2012, HHS)
Communications Strategies
- Leadership, Human Performance and Internal Communication in Nuclear Emergencies (IAEA, 2017)
- Improvised Nuclear Device Response and Recovery: Communicating in the Immediate Aftermath (US Government Interagency Nuclear Detonation Response Communications Working Group, April 2024)
- Communicating During and After a Nuclear Power Plant Incident (US Government Interagency Nuclear Detonation Response Communications Working Group, June 2013)
- Advising the public about radiation emergencies (NCRP Commentary No. 10), National Council on Radiation Protection and Measurements, Bethesda, MD, 1994.
- Zahringer M, Luff R, Schiesewitz M, Burbeck S, Hogg R. From dose rate to websites: making measurements accessible, understandable and helpful to the lay public. Radiat Prot Dosimetry. 2014 Aug;160(4):322-5. [PubMed Citation]
Assessment of State and Local Laws Regarding Management of Persons During Radiation Incidents
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Public Health Preparedness: Examination of Legal Language
Authorizing Responses to Incidents Involving Contamination
with Radioactive Material
(PDF - 670 KB) (HHS/CDC/RSB and CDC/ATSDR; CDC/Office for
State, Tribal, Local and Territorial Support; Legal
Preparedness Project: collaboration between CDC and NACCHO),
May 2014)
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Designed to answer 2 questions: Do states and select
jurisdictions...
- "Possess the authority to decontaminate persons contaminated with radioactive material?"
- "Have the authority to restrict the movement of persons contaminated with radioactive material? (e.g. quarantine)"
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Goals
- "Identify and categorize the current landscape of laws that may be available to decontaminate and restrict personal movement of persons contaminated or potentially contaminated with radioactivity"
- "Foster collaboration among stakeholders to enhance preparedness and response"
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Conducted a legal assessment of all fifty states, New
York City, Los Angeles, and Washington, D.C.
- Text, maps and tables show comparisons among these jurisdictions
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Designed to answer 2 questions: Do states and select
jurisdictions...
Emergency Declaration Authorities Across all States and DC
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Links to legal authorizations for each of the 50 states
and DC
(The Network for Public Health Law)
-
Table provides state statutory and regulatory
authorities for emergency declarations in all 50 U.S.
states and the District of Columbia including
- Emergency declarations, public health emergency declarations, and other types of declarations that may relate to the public's health.
-
Table provides state statutory and regulatory
authorities for emergency declarations in all 50 U.S.
states and the District of Columbia including
Selected References
NCRP
- Decision Making for Late-Phase Recovery from Major Nuclear or Radiological Incidents, (NCRP Report No. 175), National Council on Radiation Protection and Measurements, Bethesda, MD, 2014.
- Responding to a Radiological or Nuclear Terrorism Incident: A Guide for Decision Makers (PDF - 1.61 MB) (NCRP Report No. 165), National Council on Radiation Protection and Measurements, Bethesda, MD, January 2010.
- Key elements of preparing emergency responders for nuclear and radiological terrorism (NCRP Commentary No. 19), Bethesda, MD, December 2005. Purchase required.
Other
- Nuclear/Radiological Incident Annex to the Response and Recovery Federal Interagency Operations Plan (PDF - 3.38 MB) (US Government Interagency, 2023)
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Long-Term Health Monitoring of Populations Following a
Nuclear or Radiological Incident in the United States,
Proceedings of a Workshop
(NASEM, 2019)
- Reviews the process for preparing a radiation registry for monitoring long-term health effects of populations affected by a nuclear or radiological incident.
- Assesses existing information, useful practices, and tools for planning a radiation registry that will enhance incident monitoring and response methods.
- See REMM information about sample data elements useful in radiation incident registries
- PAG Manual: Protective Action Guides and Planning Guidance for Radiological Incidents, EPA-400/R-17/001 (PDF - 1.48 MB) (EPA, January 2017)
- Response and Recovery Knowledge Product: Key Planning Factors for Recovery from a Radiological Terrorism Incident (PDF - 7.48 MB) (DHS/FEMA, September 2012)
- Planning Guidance for Response to a Nuclear Detonation, Second edition, 6/2010 (PDF - 2.62 MB) (National Security Staff, Interagency Policy Coordination Subcommittee for Preparedness & Response to Radiological and Nuclear Threats)
- Emergency Responder Health Monitoring and Surveillance, A Guide for Key Decision Makers (PDF - 383 KB) (US Government Interagency group led by NIOSH and coordinated with the National Response Team, January 26, 2012) Note: this document includes radiation issues generically, but not specifically.
GAO Reports on Radiological and Nuclear Preparedness
- Nuclear Terrorism Response Plans: Major Cities Could Benefit from Federal Guidance on Responding to Nuclear and Radiologic Attacks. GAO-13-736 (U.S. Government Accountability Office, Sept 30, 2013)
- Emergency Preparedness - States Are Planning for Medical Surge, but Could Benefit from Shared Guidance for Allocating Scarce Medical Resources (PDF - 1.06 MB) (U.S. Government Accountability Office, June 2008)
- Hospital Preparedness: Most Urban Hospitals Have Emergency Plans but Lack Certain Capacities for Bioterrorism Response. GAO-03-924. (PDF - 2.04 MB) (US Government Accountability Office, August 2003)
US Military
- Chemical, Biological, Radiological, and Nuclear Consequence Management, Joint Publication 3-41 (PDF - 2.08 MB) (Joint US Military, Sept 9, 2016)
WHO
- WHO Guidance on Research Methods for Health and Disaster Risk Management (WHO 2018-2022 implementation)
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Sendai Framework for Disaster Risk Reduction 2015-2020
(WHO, 2015)
- WHO Technical Guidance Notes on Sendai Framework Reporting for Ministries of Health (WHO, Nov 2020)
- Hazard Definition and Classification Review (WHO/UNDRR, 2020)
- Health Emergency and Disaster Risk Management Framework (WHO, 2019)
- Ethics in Epidemics, Emergencies and Disasters: Research, Surveillance and Patient Care (WHO, 2015)
- UN Office for Disaster Risk Reduction (WHO/UNDRR)