EIIP Virtual Forum Presentation — January 24, 2007

First Response to Radiological Emergencies
International Atomic Energy Agency (IAEA) Resources

Dr. Elena Buglova
Thomas McKenna
Incident and Emergency Centre
Department of Nuclear Safety and Security
International Atomic Energy Agency

Amy Sebring
EIIP Moderator

The following version of the transcript has been edited for easier reading and comprehension. A raw, unedited transcript is available from our archives. See our home page at http://www.emforum.org

[Welcome / Introduction]

Amy Sebring: Good morning/afternoon everyone. Thank you for joining us today. On behalf of Avagene and myself, welcome to the EIIP Virtual Forum! Our topic today is First Response to Radiological Emergencies: International Atomic Energy Agency (IAEA) Resources.

I believe this is a first for the Virtual Forum, in that our guests today are joining us from Vienna, Austria where it is 6:00 PM! We are especially delighted that they would take the time to be with us today to share this important information.

Now it is my pleasure to introduce today's guests. Dr. Elena Buglova has served since 1996 as the IAEA consultant in the medical management of radiation emergencies, and since 2002 has been a staff member of the IAEA. She participates in emergency missions to the countries requesting assistance in case of radiation emergency under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency, presents lectures at the training courses and workshops.

She is also a contributor to the IAEA publications (requirements, technical documents) in emergency preparedness and response, and is a Corresponding Member of the Task Group of the Committee 4 of the International Commission on Radiological Protection (ICRP) on application of the Commission's "Recommendations for the Protection of Populations" in the early phase of a nuclear accident or a radiological emergency.

We are also pleased to have Tom McKenna, who is assisting Dr. Buglova in the background. Tom is now a consultant, and worked from 1999 to 2006 at the IAEA where he also served on its emergency response team. Before joining the IAEA, Tom worked at the US Nuclear Regulatory Commission (NRC) for more than 19 years, where he managed part of the program that developed the technical tools, training, organizations and procedures used by the NRC for responding to emergencies.

Welcome to you both, and thank you for joining us today. I turn the floor over to Dr. Buglova to start us off please.


Elena Buglova: Thank you, we are very pleased with the opportunity to be with you today. We would like to start off with some background information on our organization and its mission. The International Atomic Energy Agency (IAEA) is the world's center of cooperation in the nuclear field. It was set up as the world's "Atoms for Peace" organization in 1957 within the United Nations family. The IAEA is headquartered in Vienna, Austria and has over 140 countries as Member States.

One of the IAEA's missions is to provide assistance to Member States (e.g. Georgia) during radiological emergencies and, when possible, collect the lessons learned during the response to these emergencies. On average the IAEA responds to about four radiological emergencies year.

This first slide shows the IAEA, with the support of France, conducting aerial surveys in Georgia to locate dangerous amount of radioactive material. Amy, slide 1 please.

[Slide 1]

This has included monitoring to locate dangerous amounts of radioactive material, coordination of the medical treatment of severe health effects of radiation exposure and recovery of dangerous amounts of radioactive material. In some cases this support has been proved in very remote areas under difficult conditions.

In addition, the IAEA has the mission to assist its Member States to develop the capability to response adequately to radiological emergencies. This assistance is based on the experience of the IAEA and its Member Sates in responding to radiological emergencies.

This experience shows that radiological emergencies continue to occur throughout the world in unexpected places - often involving lost, stolen, damaged, discarded or accidentally found sources. In recent years there has been increased concern about the possibility of emergencies resulting from the malicious use of radioactive material (e.g. radioactive dispersal devices (RDDs)).

As an example, this next slide shows some of the decontamination efforts that resulted from a container of radioactive caesium the size of a salt shaker being opened by someone who was not aware of the hazard. This accident resulted in 350 truck loads of radioactive waste. Amy, slide 2 please.

[Slide 2]

Experience also shows that even relatively minor radiological emergencies can have severe economic and psychological impact nationally and internationally. This is of particular concern if the initial response to these emergencies is not adequately handled and might result in: 1) the public and international bodies having an exaggerated perception of the severity of the risks, and 2) loss of trust in the ability of national officials to handle the response appropriately, which in turn may result in expensive, disruptive and inappropriate (e.g. unwarranted abortions) actions being taken. Past experience has clearly indicated that an inadequate response could greatly enhance public fear and thus the effectiveness of a terrorist attack.

In almost all radiological emergencies, first responders (i.e. police, fire fighters, medical) and local officials, supported by national officials, perform the initial response. The local and international media and thus the public gain their first impression of the severity of an emergency and of the adequacy of the national response.

Since radiological emergencies are very rare, local responders have little or no experience in dealing with them, which often leads to an inadequate response, which can have economic and psychological consequences that far exceed the radiological consequences. Consequently, the provision of guidelines on and basic training for preparedness for radiological emergencies is required in order for first responders and national officials to take the appropriate actions early in the event.

The level of preparedness required at the local and national levels in order to respond adequately to radiological emergencies is modest. First responders can recognize and adequately respond to a radiological emergency by following basic principles and using the tools and organizational structures they would normally use in response to a national disaster or situation involving any hazardous material.

National officials, as required by international requirements, should be able:

1) to promptly provide on-call advice to local officials
2) to dispatch an emergency team of radiation specialists to the scene
3) to arrange for treatment of a limited number of exposed/contaminated victims, and
4) to ensure that public information is coordinated and public concerns are addressed

These capabilities also only require modest preparations and will be adequate for the first few days following an emergency. If additional response capabilities are needed, assistance can be obtained through the IAEA.

The IAEA found that for many States the best approach for assisting them in developing an adequate response capability is to provide them with detailed practical procedures (and associated training) that can be readily adapted for local use. In recognition of this critical need, the IAEA development the "Manual for First Response to a Radiological Emergency". This Manual contains practical procedures for first responders (police, fire fighters, medical) and for the national bodies that would support the local response during the first few days following an emergency.

This material was developed in consideration of the lessons learned from past emergencies, using a collegial approach and drawing on the expertise of many international professionals from radiation protection, law enforcement and emergency services.

This Manual is the topic of the Virtual Forum today. In addition, the IAEA has developed training material on use of the Manual and has under development practical guidance for the radiological assessment in support of first responders entitled "Field Manual for Support During a Radiological Emergency," which should be published in late 2008.

The Manual was co-sponsored by the international organization for fire fighters (Comité technique international de prévention et d'extinction du feu (CTIF), the Pan American Health Organization (PAHO) and the World Health Organization (WHO).

The objective of the Manual is to provide practical guidance for the emergency service personnel who would initially respond at the local level, and the national officials who would support this early response. It does not address the response to emergencies involving facilities such as nuclear power plants for which specific emergency arrangements should have been developed and be in place.

In developing the Manual it was assumed that the first responders will use an organizational structure similar to the incident command system (ICS), directed by a single incident commander (IC). It is also assumed that the first responders have neither experience nor equipment to assess radiological hazards. Therefore the guidance in the Manual ensures that the public and responders are protected before there is any radiological monitoring or assessment.

The Manual covers the basic concepts and terms that must be understood to use the manual to include the hazards, how to protect the public and responders from these hazards and the lessons learned from past emergencies. The body of the Manual provides guidance for use by first responders in a form that can be easily converted for use by a response organization.

This includes action guides that are lists of tasks that should be performed by the incident commander and other members of the response (e.g. fire brigade). It also provides detailed instructions on how to perform various tasks such as assessment of the hazard, protection of responders and the public, decontamination of the public and responders, and the initial response of the local hospital.

Other information is provided in appendices and annexes to include:

1) sample media and public statements
2) a description of the arrangements that need to be in place to use this guidance effectively
3) answers to some of the frequently asked questions, and
4) a brief description of the basis for the radiological criteria used in this publication

The Manual has been tested during exercises, and training has been provided on its use to first responders from over 100 countries. The manual can be downloaded from the IAEA web site at http://www-ns.iaea.org/tech-areas/emergency/iec/publications.asp. In addition there is a version that can be used on line at: http://www-ns.iaea.org/tech-areas/emergency/emergency-response-actions.asp

We would like to conclude by sharing a couple of the highlights of the guidance, and hope that you will take the opportunity to review the complete contents in the future. The manual has been designed to be as concise as possible for practical use by responding organizations.

The first task is to determine if you have a possible radiological emergency. The Manual lists key indicators of radiological emergencies, for example, symptoms of radiation exposure such as burns with no apparent cause. Doctors are often the first people to recognize there is an emergency when they realize they are treating radiation injuries.

This next slide shows an example of the burns that resulted from carrying a dangerous radioactive source in a pocket. We see these types of injuries each year. Amy, slide 3 please.

[Slide 3]

Our next slide shows the recommended Incident Site layout, which will be familiar to those of you involved with planning for any hazardous material incident. Please note the area labeled "Inner Cordoned Area" also known as the Hot Zone. Amy, slide 4 please.

[Slide 4]

The next slide is a table of suggested initial radius distances, depending on the type of incident. The initial determination presumes that radiological monitoring is not immediately available. These initial distances can subsequently be adjusted based on measured dose rates when they become available. Amy, slide 5 please.

[Slide 5]

Next we would like to share a series of radiological response cards, found in Section D of the manual that can be replicated, laminated, and issued to first responder to provide a quick reference to basic response actions. The slides will show what is designed to be the front and back of a pocket card.

The first includes actions for the Incident Commander when responding to a general radiological emergency. Amy, slide 6 please.

[Slide 6]

The next response card includes basic actions appropriate for ALL first responders in a radiological emergency. Amy, slide 7 please.

[Slide 7]

Finally, a card for local hospital actions has also been developed. Amy, slide 8 please.

[Slide 8]

This concludes our prepared remarks, and we will be happy to respond to your questions and comments. We turn the floor back over to our Moderator to start us off.

Amy Sebring: Thank you very much Elena. Now, to proceed to your questions and comments.

[Audience Questions & Answers]

Deb Robinson: What kinds of training opportunities are being created in conjunction with the manual?

Elena Buglova: We have developed a set of training materials designed for a two week workshop. The workshop has been given to first responders in different regions of the world.

Rick Tobin: I've reviewed the document some time ago. It is very sound for the purpose it was prepared for; however, in some of my recent research I found some state and local officials who believed the guidance had direct application to response to a thermonuclear weapon attack. Nothing could be further from the truth. Were you aware of this misinterpretation of your guidance? Would you care to comment?

Elena Buglova: You are correct. The document does not apply to nuclear weapons.

Michael Ladouceur: Is there any guidance to determine "zone of influence", i.e. "orange zones" vs "red zones"? I am an environmental air scientist.

Elena Buglova: Experience shows during real emergencies that the most you will be able to do is have a single zone if you're lucky. Consequently the manual is built on just having a single zone.

Deb Robinson: Are there TTT (T3), a.k.a. Train the Trainer versions available, or are they strictly deliverables through your organization? And a follow up on a previous question, is it possible to extrapolate for weapons?

Elena Buglova: For TTT, we are conducting train the trainers workshops, which means participants of our workshops will be lecturers for follow-on training courses. Training materials are being prepared for printing and hopefully will be available soon. Concerning the use of the manual for nuclear weapons, the manual should not be used and cannot be extrapolated for this purpose.

Hal Heaton: How severely are the planned actions of first responders in entering an RDD zone compromised by the needs of forensic officials to leave the site alone in order to preserve evidence? How are those competing needs balanced?

Elena Buglova: This has to be handled within the incident command structure, i.e., by the incident commander, and this is explained in the manual. The material in the manual was put together by people experienced in these issues from various countries.

Greg Tillman: Where does a responder hear about these two-week training workshops that are given, and how does one get involved and where are they located?

Elena Buglova: It is important to note that these workshops are being given for IAEA Member States (countries) at their request.

Amy Sebring: Have you had any requests from the U.S. Elena?

Elena Buglova: No.

Robert A. Crutchfield: Maybe I missed it, but in delivering your training do you work through national governments, non-governmental organizations (NGOs), or both? In the U. S. for example it is often more effective to work through the various professional organizations than government channels.

Elena Buglova: IAEA has well-established channels with its Member States that are used for this purpose.

Michael Ladouceur: Can you estimate the percentage of municipalities / lower tier agencies that have adequate materiel resources for effective response? The low frequency of accidents/situations typically means low preparedness.

Elena Buglova: As indicated in our earlier remarks, we have found in many cases that local governments were not prepared and that was one of the primary purposes for developing the manual.

Rick Tobin: Will your workshops also touch on the sociological impacts of an RDD, and the concerns of the re-entering civilian population after recovery efforts? I believe many officials are truly unaware of the underlying concerns about radiation that the public holds deeply in their psyche. Even a small RDD may leave critical and expensive commercial areas as ghost towns simply out of fear, and not out of actual exposure issues based on measurements after decontamination is completed. Recovery after response can be very challenging. Your comment?

Elena Buglova: Yes, it is covered in a general way in the training, and the manual has been written in a way to help address some of these concerns. Take a look at the public information officer action guide and sample messages and answers. The next manual, which is under development, will address this in much more depth.

Lori Wieber: Are there any particular agencies or organizations with which you have worked in the United States? or how does the U.S. participate in the IAEA?

Elena Buglova: In developing the manual, the following organizations from the U.S. participated: Officials from Massachusetts, California, Washington State. EPA, CDC, AFRRI, and the Mayo Clinic all contributed. In addition we worked very closely with those who have responded to emergencies from all over the world.

Deb Robinson: Who makes these requests to your organization for a training event? Specifically, who or what are the channels if locals are interested in your training, and what are the costs of the program?

Elena Buglova: This must go through official channels, which we believe for the U.S is the Department of State’s Permanent Mission in Vienna.

Amy Sebring: Obviously we have great interest in the training today. You mentioned you hope to make the printed manuals available soon. Will they be made available through your Website?

Elena Buglova: We hope so.

Aadu Pilt:
Do I understand from Slide 4 that the inner cordoned area is greater than 0.3 micro sieverts per hour?

Elena Buglova: That applies to the area outside the inner cordoned area where the public will be processed.

Avagene Moore: Probably one of the toughest decisions for the Incident Commander is whether to recommend evacuation, "shelter in place", or some combination of both for public protection. Is there any rule of thumb?

Elena Buglova: Any guidance to first responders must be very simple. There is no time for any detailed analysis and all the information available will be very poor. The manual basically says that you should evacuate if you can, and if you can't -- you shelter.

Amy Sebring: Elena, how does your work at the IAEA relate to the guidance from the ICRP? What is the Task Group on application of the ICRP recommendations on public protection charged with exactly?

Elena Buglova: The ICRP is currently finalizing their main recommendations in parallel. The specific guidance on emergency preparedness and response needs to be updated. We are trying to make this update in line with developments in the IAEA; however, an emergency could happen tomorrow and we feel that it is important that we continue to develop the practical guidance that our experience indicates is needed by our member states.

Michael Ladouceur: The radius of evacuation sheet is detailed except for "fires". For chemical accidents this is typically handled by "cataloging" typical scenarios. Perhaps this may be of value since fires evoke a very dramatic public concern, which would be elevated in the context of RDD. Environmental agencies may be of value in fleshing this out.

Elena Buglova: Here again the guidance was intended to be very simple for use by the first responder. We assume that this first responder would then promptly get assistance from national or other specialists. The distances in the manual for fires were established to be consistent with the guidance for first responders in national and international guidance for dealing with transportation emergencies involving radioactive materials, to include fires.

Amy Sebring: With respect to an extreme life-saving situation, do you recommend using first responders who will volunteer, understanding the risks involved? If so, what guidance may be available to rapidly estimate and inform first responders what the health risk may be?

Elena Buglova: Guidance is given in note 33 page 41. [Workers shall be volunteers and be provided with information on the potential health consequences of exposure to allow them to make an informed decision. For example: 3000 mSv exposure could be life threatening, 500-1000 mSv can result in short term vomiting, reduction in sperm count and an increase in the chance (risk) of development of fatal cancer from the normal rate of about 25% to about 30%. Exposure in dose of 100 mSv will not result in any short term effects, but will result in small increase (about 0.5%) for the risk of development of fatal cancer.]

Hal Heaton: When triaging medical patients at an RDD scene, is an effort made to identify the particular agent used in the RDD and to decontaminate them, given that knowledge, before transporting them to local hospitals?

Elena Buglova: While making triage, the main question to answer is how to save the life. Our analysis indicates that just by following simple barrier methods (mask and gloves), people treating injured persons can protect themselves The same is true for the hospital. The real risk is from the injuries and not from the radioactive contamination. Analysis and experience has indicated that contamination is, in fact, not a major concern and can be easily handled.

Rick Tobin: Are you anticipating doing online training modules using both printed and video materials that can be used world wide? If yes, any timeline for when they would be ready and what site they would be provided through to the first responder community? What languages might they be developed in? (I would think English, Spanish, French, Russian and Mandarin would be needed.)

Elena Buglova: We plan to publish a CD first and then will plan for further developments. It will be developed in English, and hopefully translated into other U.N. languages. Some of our member states have translated the material themselves.

Amy Sebring: Would you like to put up some contact info where folks may follow up as needed?

Elena Buglova: My e-mail is [email protected] Tom’s is [email protected] And please refer to the website listed earlier.


Amy Sebring: That's all we have time for today. Thank you very much Elena and Tom for an excellent job. We hope you enjoyed the experience today. Please stand by just a moment while we make a couple of quick announcements.

The formatted transcript will be available later today. If you are not on our mailing list and would like to get notices of future sessions and availability of transcripts, just go to our home page to Subscribe.

If your organization is interested in becoming an EIIP Partner, please go to our home page and click on "Partnership for You"

Thanks to everyone for participating today. We stand adjourned but before you go, please help me show our appreciation to Elena and Tom for a fine job.