Preparedness and Training are Key in Radiological Incident Mitigation

Radiation. The mere mention of the word tends to conjure up images of mushroom clouds, Hiroshima and Three Mile Island. To many, it is an even bigger concern today with the threat of an Iranian nuclear program and terrorists using radiological dispersal devices or RDD's. Rumors of missing "briefcase nukes" from former Soviet arsenals and Osama bin Laden's attempts to acquire one of these weapons only make these concerns larger.

What many people fail to realize is that we are surrounded by radiation every day. No matter where we go, we are surrounded by small amounts of radiation called "background radiation". Radioactive sources travel up and down our highways every day. Even if you don't have a nuclear power plant in your jurisdiction, chances are you have a nuclear medicine department in a local hospital or clinic. Many construction firms use radiological sources to check welds in steel or thicknesses in concrete or asphalt as quality assurance measures.

With so many radiological sources around us, how can we be sure we are able to handle a radiological emergency? The answer lies in two areas, preparedness and training.

Preparedness - Knowing your District

Preparedness begins with conducting a hazard and vulnerability assessment. While the threat of a terrorist using a "dirty bomb" is a possibility, the obvious sources cannot be overlooked. This segment of preparedness is known as preplanning. First, what businesses in your jurisdiction use radiological sources? Many jurisdictions may assume they are safe because they are not located near a nuclear power plant. This assumption can have life and death consequences as radiological sources are much closer than many think.

Larger hospitals have nuclear medicine departments that utilize radioactive sources for medical screenings and cancer treatments. Smaller hospitals, clinics, dentists and veterinarians also maintain x-ray machines utilizing radioactive sources. Engineering and construction firms use radioactive sources in order to X-ray welds for quality assurance and asphalt and concrete roadways to search for voids and to ensure the proper thicknesses have been poured. These occupancies are subject to the same fires and explosions as any other structure. The radiation component makes the response much more difficult in these cases.

Another overlooked possible radiation hazard is the transportation sector. There are over three million shipments of radioactive materials annually. These shipments run the gamut from low level radioactive sources found in smoke detectors to high level radioactive waste such as spent fuel rods from nuclear reactors. Unlike other hazardous materials, where the container size and shape is an instant clue to the contents, this is not always the case with radioactive materials. Low level radioactive material can be shipped in innocuous cardboard boxes with nothing more that a small sticker or placard indicating the contents. High level radioactive materials are shipped in large steel casks that are unmistakable.

Low level radioactive material may be found on almost any street in any jurisdiction. It may be carried by private couriers, messengers, UPS, Fed Ex, etc. Depending on the amount of radiation present, the vehicles may or may not be placarded, but the boxes always will. Certain government shipments of "critical components" or weapons grade material are a special case altogether. Not only are the containers and vehicles unmarked, but they are also escorted by armed Federal Marshals in the vehicle and also in chase vehicles leading and following the transport vehicle. first responders walking up to one of these vehicles that has been involved in any kind of incident may find themselves being watched from behind the barrel of an automatic weapon. The time to find out about this situation is not when it happens, but beforehand through the preplanning process, particularly when shipments such as these travel along predetermined routes.

Once these sources of radioactive material in the jurisdiction have been identified, both in fixed structures and transportation corridors, relationships must be built and maintained with these companies and individuals. Fixed facilities must be visited by members of the fire department who would be called upon to respond to an incident there. This applies to regular line companies, chief officers and the hazardous materials response team. These visits serve many purposes. first responders get to know the facility personnel and the facility personnel get to know the first responders. This way, each knows what the other is capable of when an emergency happens. This knowledge may save precious time and lives and time should an incident occur.

The hazmat team will also gain first hand knowledge as to the radioactive materials present, their half lives and hazards associated with them. If unable to deal with these materials, the hazmat team should be able to take this information and purchase the necessary protective equipment, monitors, etc. in order to mitigate any incident they find at the facility in question. The facility or company in question may be able to provide this equipment (and any associated training) to the fire department free of charge. In times of increasingly tight budgets, assets like this cannot be ignored.

Training for All Responding Agencies

Training of personnel is also an important part of preparedness. Training is not just for the fire department or hazmat team, but also law enforcement agencies and EMS providers. Radiation training is important simply because of the stigma that radiation carries. Many aggressive hazmat technicians and specialists would much rather deal with any manner of toxic industrial materials or chemical warfare agents simply because they don't understand radiation. Training and experience will help to alleviate this apprehension and misunderstanding.

It is impossible to determine who will be first on scene of any emergency. For this reason, all first responders must have radiation training to at least the awareness level at a bare minimum. hazmat team members must receive specialized training in radiation incident response and mitigation.

While training for first responders is certainly important, there comes a point when an incident escalates to the point where it grows beyond the control of local resources and specialized Federal assets must be called in. The availability of these assets must be known before the incident happens as opposed to scrambling around looking for assistance after the incident starts.

Response Implications & Decontamination

Radioactive materials are grouped along with all other hazardous materials according to the Department of Transportation hazard classes. Radiation has one implication that the others do not, it is invisible. When a firefighter responds to a dwelling fire, they can see the flames, smell the smoke and feel the heat. A hazardous materials specialist can see the vapor cloud from a leak or see the contents of a spill on the ground. Radiation is colorless, odorless and tasteless. It can only be confirmed through the use of specialized monitoring devices.

It is very possible that a first responder may come into contact with a radioactive material before they are aware of the danger. This makes response to a radiation incident, either intentional or accidental in nature, unique among all emergencies encountered. Depending upon the strength of the source encountered, the duration of exposure and how close the individual was, symptoms of exposure may not manifest themselves for days, weeks or even longer. This is completely different from exposure to toxic chemicals where patients may become symptomatic within seconds of exposure.

Decontamination procedures present a unique set of circumstances for radiological responses. In chemical emergencies, it is often said that the solution to pollution is dilution. Simply put, by applying enough water to a given amount of product, it is diluted to the point that it no longer is considered dangerous. This is not the case with a radiological material. A radioactive material's danger lies in its half life, or the amount of time it takes for a given material to lose half of its radioactive activity. This half life can range from a few hours for sources used for medicinal treatments to millions of years for spent nuclear fuel.

In regular chemical emergencies, all runoff from decontamination operations is contained and disposed of as hazardous waste. In a large scale weapons of mass destruction attack involving chemical weapons, this practice would be impossible given the fact that hundreds and possibly thousands of victims may have to be decontaminated. The water runoff will find its way into the nearest storm sewer. Both the EPA and USAMRIID have declared this an acceptable practice as long as life safety is the primary concern. This practice would be unacceptable when dealing with a radioactive material as the contamination is not diluted by water, but merely spread. This would lead to the cross contamination downstream of storm sewers, retention ponds and storm water treatment facilities.

Mass Decontamination Factors

Decontamination of large numbers of people is a problem that is difficult to overcome, if not impossible. Most decontamination procedures are geared towards decontaminating hazmat team members and a few casualties. While many jurisdictions have been utilizing grant money to purchase mass decontamination equipment and trailers, the equipment is not the issue. The issue is time and time is the enemy.

The most effective way to terrorize a large amount of people is to detonate a radiological dispersal device in a large venue containing hundreds or thousands of people. Examples include a crowded shopping mall, the Super Bowl or the Daytona 500 just to name a few. Once word spreads that radioactive material is involved, there is a good possibility that a panic may ensue. Even those who were no where near the initial detonation will demand to be decontaminated. first responders will have no choice but to decontaminate everyone involved. This will serve to prevent cross contamination by ensuring that only clean patients are transported to receiving hospitals. This will prevent contamination of those transport vehicles and local emergency rooms. Decontamination will also provide a certain amount psychological comfort to those affected.

The sheer numbers involved in this process is staggering. Highly trained and well practiced jurisdictions may be able to decontaminate a few hundred an hour. While this may seem acceptable, this becomes a tedious process if several thousand victims or potential victims involved. It may take 12-18 hours to adequately decontaminate the entire affected population. This is a labor intensive process requiring frequent relief of first responders wearing personal protective equipment, including self-contained breathing apparatus or air purifying respirators. This process becomes even more difficult if many victims are seriously wounded and must be carried out of the hot zone.

Requiring exposed victims to wait 12-18 hours to be decontaminated will create problems of epic proportions in addition to logistical nightmares. Where will several thousand people be kept while waiting their turn to be decontaminated? This may not be an issue at the Daytona 500, but it will be a problem at Times Square on New Year's Eve. What will the victims use for bathroom facilities? The largest concern, often overlooked, is food and drink.

When a natural disaster occurs or a large fire displaces residents, one of the first things seen is a wagon from the Red Cross or Salvation Army that provides rudimentary food and drink to those displaced persons (and first responders as well). This must not be allowed in cases where victims may be contaminated with a radioactive material. Surface contamination is bad enough, but can be removed with standard decontamination techniques such as rinsing with soap and water. Internal contamination is much more serious and more difficult to remove or deal with.

Internal contamination requires medical treatment to remediate. It occurs when a radioactive material enters the body through inhalation, ingestion, injection and absorption. Alpha radiation is stopped by unbroken skin. Beta radiation can be stopped by thick clothing (such as turnout gear). Only gamma and neutron radiation can permeate shielding and pass through the body. External alpha and beta contamination can enter the body through broken skin, inhalation or ingestion if someone eats or drinks with contaminated hands. For this reason, it is absolutely imperative that no one eat or drink until they have been decontaminated.

Since radiation cannot be detected by the senses, each victim will have to be screened with a radiation detector prior to their being transported. This also applies to all first responders involved in the incident, especially those actively engaged in search and rescue, firefighting, EMS and decontamination operations. All apparatus leaving the immediate area will also have to be screened. As with decontamination itself, this screening process will be lengthy and labor intensive. Jurisdictions will have no choice but to activate mutual aid pacts early in the process to bring additional local responders into the event. State and Federal resources will also have to be requested early in order to being them into action as soon as possible.

Air Monitoring for Spread of Radiation

Air monitoring will be critical. Atmospheric monitoring will determine hot, warm and cold zones and their required personal protective equipment. The highest levels of protection will be required in the hot zone with decreasing levels of protection being required in the warm and cold zones. Area surveys will need to be conducted in order to find safe means of ingress and egress into the affected area for ambulances, fire apparatus, heavy equipment, etc. The command post, staging areas, triage centers, etc. will all have to be verified as uncontaminated prior to their being used.

Radiation also presents a unique situation for first responders. Air currents will dilute a gas until it is rendered virtually harmless. These same air currents will spread radioactive contamination or fallout if a radiological dispersal device or thermonuclear weapon is used. This contamination may travel for tens or hundreds of miles depending on the ambient weather conditions. This problem is even more complex if a thermonuclear device is used. While this is a worst case scenario with the least likelihood of occurrence, it cannot be ignored.

A thermonuclear detonation will create a mushroom cloud traveling thousands of feet into the atmosphere. (Think of the photos of Hiroshima, Nagasaki, or the atmospheric testing done in the 1950's to put this in a visual perspective.) Winds vary in speed and direction depending on their height. While most responders to chemical emergencies are only concerned with areas downwind, this is not the case with a thermonuclear event. Radioactive contamination may be spread in a full 360-degree arc in an irregular pattern. To adequately predict where this contamination will spread, highly specialized Federal assets will be required.

The Aerial Measuring System (AMS) flies fixed wing aircraft and helicopters equipped to detect radioactive contamination on the ground. It can also measure airborne contamination as well. These aircraft are also equipped with photographic equipment designed to provide high resolution aerial pictures of the incident location.

The Atmospheric Release Advisory Capability (ARAC) provides predictions of the spread of contamination through the atmosphere. This system is quite similar to the CAMEO/ALOHA/MARPLOT suite used by the majority of hazmat Teams. The difference is in the size of the computer capacity needed. This advanced capacity is required to due the three dimensional quality of upper atmosphere air currents as opposed to the relatively stable lower atmospheric air currents that are used to predict the downwind footprints of more common hazardous materials spills. ARAC can also be used to track large scale chemical releases and natural disasters such as volcanic ash eruptions. Initial results can be available to first responders on scene usually less than one hour after the first numbers are provided.

The Nuclear Emergency Support Team (NEST) may be the biggest asset to first responders in the field in the event of nuclear terrorism. The NEST has the ability to search for and identify radioactive materials, including individual isotopes. NEST specialists are also able to identify and render safe Improvised Nuclear Devices (IND's), Radiological Dispersal Devices (RDD's) and actual thermonuclear warheads and other nuclear weapons. Local Explosive Ordnance Disposal units (commonly referred to as "bomb squads") do not have the unique training or experience required to deal with these types of weapons.

Working with Media Agencies to Prevent Misinformation

Media cooperation will be critical in any kind of radiation event. As stated previously, the mere mention of radiation is enough to cause grave concerns (no pun intended). The outcry over the way the incident at Three Mile Island was handled is an excellent example. Getting all types of media (radio, television and print) on your side from the beginning is paramount. The way to do this is by being up front with the media from the start. This can be accomplished by holding regularly scheduled press briefings. This was very effective in the wake of the Oklahoma City bombing. Remember, first responders want the proper information relayed to the public, not sensationalized information designed to enhance media ratings. The best way to do this is to cooperate as much as possible with media requests for information and interviews from the start. In a case such as this, the media can be a trusted ally in helping to protect the public.

The final response implication may the most critical, that of long term recovery. Unlike chemical spills, where decontamination activities can return an area to pre-spill conditions relatively quickly, radioactive contamination and fallout may render areas uninhabitable for months or years. This may be acceptable for out of the way locations such as the Nevada Test Site, but it is unacceptable for most any other location. Consider if you will the detonation of a small nuclear weapon on Wall Street. With stock trading ground to a halt and financial records in disarray, the possibilities boggle the mind. It is one thing to decontaminate people, equipment and vehicles, but how would a jurisdiction decontaminate several square blocks or high-rise buildings? Real estate values would plummet. Officials and radiation specialists could talk until they were blue in the face about how safe the area was and point to their atmospheric monitoring results, but would that be enough to make a population believe them?

Long term monitoring of all victims and response personnel would also have to occur. To this day, the survivors of Hiroshima and Nagasaki are being medically monitored as are their children and grandchildren. The same situation is being faced today by the survivors of 9/11 with what is being commonly referred to as "WTC Cough". No one knows what the long term implications will be from that day. We have 60 years of data on what the medical complications are arising from exposure to high levels of radioactivity. The costs of medical monitoring and treatment for what may be literally thousands of victims and responders would be astronomical.

The chances of a large scale radioactive event occurring in any jurisdiction are relatively small. The chances of a small scale radioactive event occurring in the same jurisdiction are more likely. Compared to the possibly of other hazardous materials events, radiation incidents are of the "high risk, low probability" category. Preparing for the small scale events may make the response to the large scale event just that much easier. Failures of imagination can no longer be accepted. The events of September 11, 2001 will forever remind us of that.

Mark Schmitt began his fire service career in 1992 as a volunteer firefighter with the Rivera Beach Volunteer Fire Company in Anne Arundel County, Maryland while pursuing a degree in Fire Protection Engineering at the University of Maryland College Park. After volunteering for three years, he decided a career change was in order and opted for becoming a full-time firefighter instead. After filing applications with several departments, he was hired by the Greensboro Fire Department in North Carolina and completed Recruit School in October 1997.

Upon completion of Recruit School, he was assigned to Engine 15 for 18 months until he was assigned to Truck 11 of the Hazardous Materials Team in April 1999 after being promoted to Firefighter II. Hazardous Materials Team assignments have included tours with Engine 19 and Quint 11, Engine 15 and Engine 11. Mark is also a member of North Carolina's Hazardous Materials Regional Response Team 5 (RRT 5), which provides hazardous materials response capabilities for 14 counties in central North Carolina. RRT 5 also responds statewide if required for large hazardous materials emergencies and natural disasters.

Weapons of Mass Destruction are his main area of interest. He has attended numerous WMD related courses in Socorro, NM, Ft. McClellan, AL, Aberdeen Proving Ground, MD, Elko, NV, Dugway Proving Ground, UT and Mercury, NV. He also serves on several committees relating to hazardous materials including North Carolina's Technical Advisory Group for the Hazardous Materials Regional Response Teams and the Greensboro Fire Department's Hazardous Materials Training Committee. Other areas of interest include chemical research and rail cars. Mark also serves as the Lead Instructor for Weapons of Mass Destruction and Hazardous Materials Operations for the Greensboro Fire Department's Recruit Training Academy.

Mark holds an Associate of Arts Degree in Fire Protection Technology from Guilford Technical Community College and a Bachelor of Science Degree in Fire Safety Engineering Technology from the University of North Carolina at Charlotte. He is a Fire Service Instructor III with qualifications in Firefighter I&II, Hazardous Materials Awareness and Operations. He is also a certified instructor for the Department of Energy's Modular Emergency Response to Radiological Transportation Training Program. Other certifications include Firefighter II, Hazardous Materials Technician, Emergency Rescue Technician, Fire Department Safety Officer, Fire & Life Safety Educator, Emergency Medical Technician-Defibrillator and Fire Officer IV.