The difficulty of nuclear emergency prevention measures during natural disasters: ongoing challenges in Japan.

It is crucial to anticipate nuclear emergency scenarios and implement effective measures. Japan's climate and topography make it vulnerable to natural disasters; thus, it is necessary to address compounding and cascading disaster scenarios involving the simultaneous occurrence of natural and nuclear disasters. On 1 January 2024, an earthquake hit the Noto region of Ishikawa Prefecture, resulting in damage to the area around the Shika Nuclear Power Plant, located 90 km from the epicenter. This earthquake revealed that, in the event of a complex disaster, it is possible that residents living within 30 km of the Shika Nuclear Power Plant will be completely unprepared for a nuclear disaster. In the event of a complex disaster, it is crucial to implement appropriate countermeasures while balancing responses to both nuclear and natural disasters and optimizing radiation disaster prevention measures.

JRODOS customization for Pakistan and assessment of the consequences of a hypothetical nuclear accident.

Since the Chernobyl disaster in 1986, decision support systems and modelling tools have been utilized in response to nuclear and radiological emergencies. The java-based real-time online decision support system (JRODOS) is a decision support tool that can be utilised in response to an emergency in managing off-site radiological consequences. This article documents the customization and use of JRODOS for Pakistan. JRODOS was tailored to the local Pakistan conditions, and a case study of a theoretical nuclear power plant accident was used to assess JRODOS's feasibility as a decision support tool. A worst-case probabilistic accident scenario was used to identify zones and areas where urgent protective actions, early protective actions and food restriction and other response actions could be required. The areas and distances identified for the implementation of protective and response actions for such a hypothetical accident were found to be in agreement with the emergency planning zones and distances suggested by the International Atomic Energy Agency (IAEA). Additionally, the implications of meteorological and source term input parameters on predicting the radiation doses to members of the public were investigated. It was identified that the output of such tools strongly depends on the availability and accuracy of the input parameters, such as radioactive release and meteorological data. Limitations and uncertainties associated with these tools need to be considered in deciding on protective and other response actions in response to a nuclear accident. As established by the IAEA, protective and other response actions need to be applied on a graded approach, taking into account the protection strategy and uncertainties and limitations in the available information and criteria, based on the conditions at the facility and off-site.

Chemical, biological, radiological, and nuclear mass casualty medicine: a review of lessons from the Salisbury and Amesbury Novichok nerve agent incidents.

On March 4, 2018, two casualties collapsed on a park bench in Salisbury, Wiltshire, UK. They were later discovered to have been the victims of an attempted murder using the Soviet-era Novichok class of nerve agent. The casualties, along with three further critically ill patients, were cared for in Salisbury District Hospital's Intensive Care Unit. Before the COVID-19 pandemic, the Salisbury and Amesbury incidents were the longest-running major incidents in the history of the UK National Health Service. This narrative review seeks to reflect on the lessons learned from these chemical incidents, with a particular focus on hospital and local organisational responses.

A simulation system of radiation field and its detection for nuclear and radiological emergency preparedness and response training.

Appropriate training of the related personnel is one of the most important aspects in nuclear and radiological emergency preparedness and response. The use of simulation training could provide the trainees learning experience of a lifelike, hands-on scenario without associated radiation safety restrictions. In this study, we established a radiation field simulation system that includes two separate parts. For small-area radiation field simulation, a set of simulation sources and detectors was designed based on ultra wide band distance measurement technology. For large-area field simulation, a Gaussian plume model was used to simulate the dispersion of released radioactive aerosols and calculate the consequent radiation field. Also, a Global Position System positioning and wireless transmission technique was used for simulation instruments' data acquisition. This system could create a verisimilar but also safe and radiation-free environment and can be used in the training of nuclear emergency first responders, rescue teams or radiation protection personnel.

Estimation and sensitivity analysis of operational intervention levels for the early phase of radiological emergencies involving radioactive releases.

Radiological emergencies involving any likely atmospheric release of radioactive material in the public domain are quite a challenge to respond to and manage. Such conditions require a quick and confident response. One such response involves using pre-planned operational intervention levels (OILs) to trigger certain protective actions or groups of actions. OILs are typically derived for nuclear emergencies, whose values cannot always be directly used in a radiological incident. Therefore, in this study, OILs were derived for the early phase of a radiological emergency involving ground- and skin-deposition exposure scenarios. The methodology is an adaptation of an internationally recommended method for nuclear emergencies, with modifications to suit radiological incidents. The derived OILs for the radiological emergency were compared against the internationally recommended values to attest their adaptability. Nominal range sensitivity analysis was performed over 14 factors used in the methodology, which provided broad insights into their influence. Moreover, exhaustive sampling of the extreme values of these factors helped to derive operational margins for the OILs to cover all possible scenario variations. Based on this analysis, generic OILs for the early phase of a radiological emergency are proposed, such that the projected doses are well below the respective generic criteria, ensuring justification on radiological grounds.

Responding to radiation accidents: what more do we need to know?

A short review of the various types of radiation incidents and accidents that have occurred is used to provide a context for discussing the findings on medical management of the victims of such incidents and accidents reported in a recent Special Issue of the Journal of Radiological Protection. The review demonstrates that accidents and incidents giving rise to high radiation doses may involve over-exposure of a single individual, a few individuals, or very large numbers. In general, these exposures will be relatively short-term, ranging from a few seconds to a few days, but chronic situations resulting in high exposures can occur. Some of these exposures may be highly localised, whereas others may result in almost uniform whole-body irradiation. This diversity of situations means that it is not feasible to have a single protocol for the diagnosis and treatment of over-exposed individuals. If the over-exposures are limited to one or a few individuals, these can be addressed on a case-by-case basis. However, where large numbers have been exposed or may have been exposed, there is a need to implement a rapid and effective system of triage. Furthermore, this system is likely to have to be implemented by individuals who have little or no direct experience of radiation-induced injuries. For those individuals who may have been significantly exposed, the key consideration is not to determine the radiation dose that they have received, but to establish their present clinical status and how it is likely to develop with time. There is at most a very limited role for bone-marrow transplantation in the treatment of acute radiation syndrome, whereas there are good arguments for administering various treatments to boost bone marrow function together with other supportive interventions, e.g. in control of infections and handling both fluid loss and bleeding. However, there is concern that the focus to date has been only on the licencing of drugs related to the management of haematopoietic effects. Although a great deal is known about the diagnosis and treatment of injuries arising from high dose exposures, this knowledge is biased towards situations in which there is relatively uniform, external whole-body exposure. More attention needs to be given to assessing the implications of various inhomogeneous exposure regimes and to developing medical countermeasures optimised for addressing the complex, multi-organ effects likely to arise from such inhomogeneous exposures.

Guidelines for first responders based on results from deploying a mockup radiological dispersal device.

During the past 7th Security Framework Program the European Commission funded a research project called CATO (CBRN Crisis management, Architectures, Technologies and Operational procedures) to develop a prototype decision support system for crisis management in addition to providing a suite of guidelines for first responders and incident commanders when dealing with chemical, biological, radiological or nuclear incidents. In order to derive these guidelines a proof-of-concept experiment was setup during which several passive agent (Stable CsCl) dispersions with improvised explosive devices and vehicle-borne improvised explosive devices were carried out. Each dispersion was thoroughly characterised by a number of monitoring devices, including high-volume air samplers and size-segregated air samplers. All environmental and forensic samples were collected by the UK counter terrorism police, following strict labelling and chain-of-custody protocols. The samples were analysed at the Belgian Nuclear Research Center suing the k0 method for instrumental neutron activation technique. A full consequence assessment analysis was carried out assuming that the observed concentration of Cs-133 in samples was Cs-137 instead and use was made of the specific activity of Cs-137. Due to the sensitivity of the information the European Commission classified this research. The resulted reported on in this work have been unclassified and are released to assist emergency planners and first responders to take the necessary precautions. The results indicate that, up to distances of 50 m from ground zero radiation levels will be considerable and therefore live-saving actions must be performed by fire/rescue wearing full protective gear. In addition, low-wind conditions will favor a long airborne residence time and therefore the use of full-face protective gear is a must. In order to protect first responders, a radiation protection specialist is to determine how long people can enter and remain in the contaminated area. The recovery of evidence in the case of a car-bomb will be hard or even impossible due to the high level of radioactive material remaining inside the vehicle.

Communicating Geographical Risks in Crisis Management: The Need for Research.

In any crisis, there is a great deal of uncertainty, often geographical uncertainty or, more precisely, spatiotemporal uncertainty. Examples include the spread of contamination from an industrial accident, drifting volcanic ash, and the path of a hurricane. Estimating spatiotemporal probabilities is usually a difficult task, but that is not our primary concern. Rather, we ask how analysts can communicate spatiotemporal uncertainty to those handling the crisis. We comment on the somewhat limited literature on the representation of spatial uncertainty on maps. We note that many cognitive issues arise and that the potential for confusion is high. We note that in the early stages of handling a crisis, the uncertainties involved may be deep, i.e., difficult or impossible to quantify in the time available. In such circumstance, we suggest the idea of presenting multiple scenarios.

GIS-Based Integration of Social Vulnerability and Level 3 Probabilistic Risk Assessment to Advance Emergency Preparedness, Planning, and Response for Severe Nuclear Power Plant Accidents.

In the nuclear power industry, Level 3 probabilistic risk assessment (PRA) is used to estimate damage to public health and the environment if a severe accident leads to large radiological release. Current Level 3 PRA does not have an explicit inclusion of social factors and, therefore, it is not possible to perform importance ranking of social factors for risk-informing emergency preparedness, planning, and response (EPPR). This article offers a methodology for adapting the concept of social vulnerability, commonly used in natural hazard research, in the context of a severe nuclear power plant accident. The methodology has four steps: (1) calculating a hazard-independent social vulnerability index for the local population; (2) developing a location-specific representation of the maximum radiological hazard estimated from current Level 3 PRA, in a geographic information system (GIS) environment; (3) developing a GIS-based socio-technical risk map by combining the social vulnerability index and the location-specific radiological hazard; and (4) conducting a risk importance measure analysis to rank the criticality of social factors based on their contribution to the socio-technical risk. The methodology is applied using results from the 2012 Surry Power Station state-of-the-art reactor consequence analysis. A radiological hazard model is generated from MELCOR accident consequence code system, translated into a GIS environment, and combined with the Center for Disease Control social vulnerability index (SVI). This research creates an opportunity to explicitly consider and rank the criticality of location-specific SVI themes based on their influence on risk, providing input for EPPR.

Guidance on prevention of unintended and accidental radiation exposures in nuclear medicine.

Nuclear medicine (NM) procedures for diagnosis and treatment of disease are performed routinely in hospitals throughout the world. These involve preparation and administration to patients of pharmaceuticals labelled with radioactive material. The International Atomic Energy Agency (IAEA) and the World Health Organisation highlighted the need for improvement in prevention of medical radiation incidents and accidents in the Bonn Call-for-Action in 2012. An IAEA Technical Meeting was held on prevention of unintended exposures and accidents in NM in 2018 to address the issue. Exposures can take place at any time when radioactive material is being produced and used, and the risk continues after procedures have been completed. Thus there is potential for staff or members of the general public to be exposed, as well as patients. This paper sets out guidelines for incident prevention based on presentations and discussions at the meeting, and review of reports from the literature. It deals with potential incidents in in-house radionuclide production, radiopharmaceutical preparation, administration to patients, and following a procedure, as well as aspects in management of radioactive materials. Special attention has been paid to therapeutic procedures, as these have the potential to cause more harm to patients from erroneous administrations, including tissue reactions from extravasation of radiopharmaceutical, and could lead to significant contamination events. Administration of NM therapy is generally contraindicated in pregnancy. Identification of any patient who may be pregnant is crucial and it might be necessary to verify this with a pregnancy test for patients within the age band considered to be fertile. Inclusion of NM therapy incidents in the IAEA automated reporting system SAFRON is recommended. In summary, the paper aims to highlight errors that could occur during different phases of NM procedures in order to aid prevention of incidents. The value of periodic audit in evaluating systems in place on a regular basis is emphasised. Approaches to incident investigation and follow-up are described, and the need to ensure corrective action is taken to address any deficiencies stressed.

Unintended and accidental medical radiation exposures in radiology: guidelines on investigation and prevention.

This paper sets out guidelines for managing radiation exposure incidents involving patients in diagnostic and interventional radiology. The work is based on collation of experiences from representatives of international and national organizations for radiologists, medical physicists, radiographers, regulators, and equipment manufacturers, derived from an International Atomic Energy Agency Technical Meeting. More serious overexposures can result in skin doses high enough to produce tissue reactions, in interventional procedures and computed tomography, most notably from perfusion studies. A major factor involved has been deficiencies in training of staff in operation of equipment and optimization techniques. The use of checklists and time outs before procedures commence, and dose alerts when critical levels are reached during procedures, can provide safeguards to reduce the risks of these effects occurring. However, unintended and accidental overexposures resulting in relatively small additional doses can take place in any diagnostic or interventional x-ray procedure and it is important to learn from errors that occur, as these may lead to increased risks of stochastic effects. Such events may involve the wrong examinations, procedural errors, or equipment faults. Guidance is given on prevention, investigation, and dose calculation for radiology exposure incidents within healthcare facilities. Responsibilities should be clearly set out in formal policies, and procedures should be in place to ensure that root causes are identified and deficiencies addressed. When an overexposure of a patient or an unintended exposure of a foetus occurs, the foetal, organ, skin, and/or effective dose may be estimated from exposure data. When doses are very low, generic values for the examination may be sufficient, but a full assessment of doses to all exposed organs and tissues may sometimes be required. The use of general terminology to describe risks from stochastic effects is recommended rather than the calculation of numerical values, as these are misleading when applied to individuals.

The assessment of the ionizing radiation dose received by patients during some diagnostic X-ray examinations carried out on the basis of the working procedures in the health care entities

Background: X-ray examination is a popular and universally used injury and disease diagnostic method. A distinctive X ray examination feature is that it can be done quickly which is extremely important in case of the need for rapid diagnosis of patients in life threatening condition. Another advantage of the X-ray examinations is also relatively low cost of carry. However, X-ray examination involve adverse health effects. During the examination the patient is subjected to ionizing radiation that might have impact on his health. Objective: The aim of this study has been to determine and assess the size of the entrance surface doses (ESD) received by patients during selected X-ray examinations performed on the basis of the medical working procedures available in healthcare entities in Masovian Voivodeship in Poland. Materials and Method: The examinations were conducted for 71 X-ray units located in the Masovian Voivodeship. Measurements of doses received by the patients were based on our own validated test methods. Results: It was found that the range applied to the high voltage in healthcare entities does not always coincide with the values specified in the standard procedures. It was found in the skull projection radiography AP and LAT that the recorded values were from range 60 to 82 kV (the average value of 74 kV) while in accordance with a standard procedure they should be in the range from 65 to 75 kV. Only in case of cervical spine radiography in the AP projection, the LAT exposure conditions were matching with the standard obligatory procedures in Poland. The consequence of selecting exposure conditions are significant differences in the size of the doses the patient receive during the same medical procedures. The greatest range of ESD doses was found during radiography of the thoracic spine in the projection AP and LAT. The projection LAT measured values were in the range of 523 to 10550 µGy (average value 2175 µGy). Conclusions: It is necessary to update immediately the standard procedures and to develop detailed guidelines for the preparation of working procedures in X-ray rooms.

Derivation of risk indices and analysis of variablility for the management of incidents involving the transport of nuclear materials in the Northern Seas.

The transport of nuclear or radioactive materials and the presence of nuclear powered vessels pose risks to the Northern Seas in terms of potential impacts to man and environment as well socio-economic impacts. Management of incidents involving actual or potential releases to the marine environment are potentially difficult due to the complexity of the environment into which the release may occur and difficulties in quantifying risk to both man and environment. In order to address this, a state of the art oceanographic model was used to characterize the underlying variability for a specific radionuclide release scenario. The resultant probabilistic data were used as inputs to transfer and dose models providing an indication of potential impacts for man and environment This characterization was then employed to facilitate a rapid means of quantifying risk to man and the environment that included and addressed this variability. The radionuclide specific risk indices derived can be applied by simply multiplying the reported values by the magnitude of the source term and thereafter summing over all radionuclides to provide an indication of total risk.

[The morbidity and mortality of residents of Kazakhstan exposed to radiation impact and their posterity].

The most part of population exposed to radiation and their offspring residing in territories bordering upon the Semipalatinsk nuclear testing area represent objects of studying aged 40 years and older because the age is the factor decreasing health indices at the expense of natural gerontological processes. In these conditions, additional radiation exposition, besides radiological biological effects, plays the role ofpotentiation of common biological and environmental risk factors. From the archives of research institute of radiation medicine and ecology the primary medical documents were retrieved containing information about established diagnoses of individuals included into elaboration of epidemiological statistical analysis of dynamics of morbidity of persons in 2008-2012. Within the same period, the acts-certificates of causes of death of specific persons included into study groups were retrieved. It is established that in 8 classes of diseases in the main group and in 5 classes of diseases in comparison group significant exceeding of average annual indices of prevalence of diseases as compared with control group was established. The common prevalence of diseases in the main group comprised 3147.5 cases, in the comparison group - 2615.6 cases and in control group - 2203.8 cases per 1000 of population (RR=1.42;1.19; p<0.05;0.05). The indices of total mortality in the main group comprised 1887.3 cases, in the comparison group - 1531.2 cases and in control group - 1155.1 cases per 100 000 of population (RR=1.58;1.36; p<0.05;0.05). Among persons in the main group in 7 classes of diseases and in the comparison group in 5 classes of diseases significant exceeding of indices of mortality was registered over same indices in control group was registered as causes of death.

A review of post-nuclear-catastrophe management.

The purpose of this paper is to make radioactive risk more generally understandable. To that end, we compare it to smoking tobacco. Further, we show that the concept of loss of life expectancy permits a quantitative comparison between various aggressions. The demystification of radioactive risk should lead to basic changes in post-catastrophe management, allowing victims to choose whether or not to leave contaminated areas. A less emotional appreciation of radioactive risks should lead to the adaptation of legal practices when dealing with probabilistic situations.

All You Need to Know as an Authorized User.

OBJECTIVE: The purpose of this article is to review the training requirements for practicing nuclear radiology, the scope of licensing, how to start a new practice, and the key concepts an authorized user needs to know for responsible use of radiopharmaceuticals. CONCLUSION: Physicians responsible for the daily operations of nuclear medicine clinics often find the regulations concerning the safe handling and administration of radiopharmaceuticals daunting. Even experienced authorized users have concerns about handling many new therapeutic agents. Those studying for certifying and subspecialty examinations or for maintenance of certification for the American Board of Nuclear Medicine and the American Board of Radiology must clearly understand the overall process for becoming an authorized user.