Preparedness and Training are Key in Radiological Incident Mitigation

With so many radiological sources around us, how can we be sure we are able to handle a radiological emergency?

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.