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Acknowledgements
This material was developed by the Mid-Atlantic Center for Children’s Health & the Environment and funded under the cooperative agreement award number 1U61TS000237-04 from the Agency for Toxic Substances and Disease Registry (ATSDR).
Acknowledgement: The U.S. Environmental Protection Agency (EPA) supports the PEHSU by providing funds to ATSDR under Inter-Agency Agreement number DW-75-92301301. Neither EPA nor ATSDR endorse the purchase of any products or services mentioned in PEHSU materials.
Disasters and Children: Radiation Readiness Using an All-Hazards ApproachLaura Anderko PhD RN
1. List the exposure pathways from a radiation event
2. Outline strategies using an all-hazards approach to improve resiliency and recovery readiness
Learning Objectives
Fukushima Daiichi Nuclear Power Plant
YouTube
Presenter
Presentation Notes
Level 7 (the highest level) International Nuclear and Radiological Event Scale (INES) March 2011 Mortality: Over 22,000 persons 18,455 Direct Deaths(1) Causes (2) 92.5% (12,143) Drowning 4.4% (578) Crushed 1.1% (148) Burns 3,647 Associated Deaths (3) Morbidity (Injuries) 6,152 persons (1) death + missing. (March 10, 2016, National Police Agency: NPA) (2) National Police Agency, www.npa.go.jp/hakusyo/h23/honbun/pdf/05tokushu1.pdf (3) Dec. 2017, Reconstruction Agency (as of Sept 30) Destroyed health facilities* 78% (380) hospitals 31% (1,256) clinics 34% (903) dental clinics *completely/partially in 3 affected prefectures (MHLW, 2011) Health provider shortage 182.6 MDs per 100,000 population (41st/47), pre-disaster 178.7 MDs (44th/47), post-disaster (Japan’s average 226.5) Achievements: Established a high-quality ultrasound thyroid cancer test system & trained physicians and technicians (Fukushima Prefecture)
Over 1,000 disasters since 2007- not including tornadoes and earthquakes
Disasters in the US
6
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Nearly 26 million Americans impacted by Hurricanes Harvey, Irma, and Maria in fall 2017 AP: Benzene, vinyl chloride, butadiene and other known human carcinogens were among the dozens of tons of industrial toxic substances released into surrounding neighborhoods and waterways following Harvey’s torrential rains. In all, reporters catalogued more than 100 Harvey-related toxic releases — on land, in water and in the air. Most were never publicized, and in the case of two of the biggest ones, the extent or potential toxicity of the releases was initially understated. Only a handful of the industrial spills have been investigated by federal regulators, reporters found. Texas regulators say they have investigated 89 incidents, but have yet to announce any enforcement actions. Testing by state and federal regulators of soil and water for contaminants was largely limited to Superfund toxic waste sites. Based on widespread air monitoring, including flyovers, officials repeatedly assured the public that post-Harvey air pollution posed no health threat. But the U.S. Environmental Protection Agency official in charge now says these general assessments did not necessarily reflect local “hotspots” with potential risk to people. Regulators alerted the public to dangers from just two, well-publicized toxic disasters: the Arkema chemical plant northeast of Houston that exploded and burned for days, and a nearby dioxin-laden federal Superfund site whose protective cap was damaged by the raging San Jacinto River. Samuel Coleman, who was the EPA’s acting regional administrator during Harvey, said the priority in the immediate aftermath was “addressing any environmental harms as quickly as possible as opposed to making announcements about what the problem was.” https://www.apnews.com/e0ceae76d5894734b0041210a902218d Hurricane Harvey: Chemical exposures from flooded plant 13 Superfund sites inundated Doesn’t include tornadoes, earthquakes. Chemical exposures from Hurricane Harvey. In late August 2017 hurricane Harvey decimated Houston, the fourth-largest American city, flooding vast neighborhoods and releasing in excess of a million pounds of chemical pollutants. Thirteen EPA Superfund sites were inundated, with damage assessments underway. FSES, in conjunction with Texas A&M University, Baylor College of Medicine, The University of Texas School of Public Health and the NIEHS are deploying wristband passive samplers to residents of Houston involved in hurricane clean-up efforts. Data from these wristbands will inform studies of individual personal exposures during disaster recovery.
Are we prepared for a radiation event?
9
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Lessons from Fukushima
US Operating Commercial Nuclear Power Reactors
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There are maps (copyrighted) that show paths of tornadoes and seismic activity that are threats to the integrity of these plants.
Radiation: Exposure Pathways
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From: Wikimedia
All-Hazards Approach
EPA.gov
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Many hazards lead to similar impacts (center of diagram) “An approach for prevention protection mitigation response and recovery that addresses a full range of threats and hazards, including domestic terrorist attacks, natural and [human-caused] disasters, accidental disruptions, and other emergencies.” The Office of Public Health Preparedness and Response (PHPR) has primary oversight and responsibility for all programs that comprise CDC’s public health preparedness and response portfolio. Through an all-hazards approach to preparedness — focusing on threats from natural, biological, chemical, and radiological events — PHPR helps the nation prepare for and respond to urgent threats to the public’s health. PHPR carries out its mission by emphasizing accountability through performance, progress through public health science, and collaboration through partnerships. Mission Strengthen and support the nation’s health security to save lives and protect against public health threats.�
Based on:• Vulnerability• Capacity• Threats of exposure • Hazard characteristics Used for:• Risk assessment• Hazard Prevention• Risk Mitigation• Preparedness• Response
All Hazards Planning
Initial Shelter and Evacuation Message
Source: CDC
Medical Countermeasures (MCMs)
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Medical countermeasures, or MCMs, are FDA-regulated products (biologics, drugs, devices) that may be used in the event of a potential public health emergency stemming from a terrorist attack with a biological, chemical, or radiological/nuclear material, or a naturally occurring emerging disease. MCMs can be used to diagnose, prevent, protect from, or treat conditions associated with chemical, biological, radiological, or nuclear (CBRN) threats, or emerging infectious diseases. MCMs can include: Biologic products, such as vaccines, blood products and antibodies Drugs, such as antimicrobial or antiviral drugs Devices, including diagnostic tests to identify threat agents, and personal protective equipment (PPE), such as gloves, respirators (face masks), and ventilators Iodide has been used/recommeded in Japan
Joanna M. Prasher, PhDSenior Advisor for Medical CountermeasuresOffice of Public Health Preparedness and ResponseCenters for Disease Control and PreventionTelephone: 404-718-1020JPrasher@cdc.gov
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Information is needed to ensure effective use of medical countermeasures Radiation MCMs in the Strategic National Stockpile (SNS) Chelating or blocking agents Myeloid cytokines Suppies ot treat traumatic injuries (e.g., burns or lacerations) Antiemetics Antimicrobial agents Research question: Does sufficient information and clinical guidance exist to support immediate dispensing of SNS or commercially available radiation MCMs to the pediatric population in a radiation emergency?
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Community Reception Center (CRC)
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Webinars
Series of scientific webinars that provide a forum for discourse on scientific