Disaster Medicine and Public Health Preparedness

Research Article

Improving Hospital Preparedness for Radiological Terrorism: Perspectives From Emergency Department Physicians and Nurses

Steven M. Becker c1 and Sarah A. Middleton


Background: Hospital emergency department (ED) clinicians will play a crucial role in responding to any terrorist incident involving radioactive materials. To date, however, there has been a paucity of research focusing specifically on ED clinicians’ perspectives regarding this threat.

Methods: At the request of the Centers for Disease Control and Prevention, researchers at the University of Alabama at Birmingham conducted a series of 10 focus groups (total participants, 77) with ED physicians and nurses at hospitals in 3 US regions. Participants considered a hypothetical “dirty bomb” scenario and discussed their perceptions, concerns, information needs, preferred information sources, and views of current guidance and informational materials.

Results: Study participants consistently expressed the view that neither EDs nor hospital facilities are sufficiently prepared for a terrorist event involving radioactive materials. Key clinician concerns included the possibility of the hospital being overwhelmed, safety of loved ones, potential staffing problems, readiness problems, and contamination and self-protection. Participants also expressed a need for additional information, strongly disagreed with aspects of current response guidance, and in some cases indicated they would not carry out current protocols.

Conclusions: This study is the first to examine the views, perceptions, and information needs of hospital ED clinicians regarding radiological terrorism. As such, the findings may be useful in informing current and future efforts to improve hospital preparedness. (Disaster Med Public Health Preparedness. 2008;2:174–184)

(Received November 05 2007)

(Accepted April 03 2008)

Key Words

  • radiological terrorism;
  • hospital preparedness;
  • disaster management


c1 Address correspondence and reprint requests to Dr Steven M. Becker, Department of Environmental Health Sciences, University of Alabama at Birmingham School of Public Health, 1665 University Blvd, Room 530, Birmingham, AL 35294-0022(e-mail: smbecker@uab.edu).

Dr Becker is Associate Professor and Vice Chair, Department of Environmental Health Sciences, University of Alabama at Birmingham School of Public Health, and Ms Middleton is Program Manager, Neurology Division, Department of Pediatrics, University of Alabama at Birmingham School of Medicine.