Disaster Medicine and Public Health Preparedness

Original Research

Recovery and Resilience After a Nuclear Power Plant Disaster: A Medical Decision Model for Managing an Effective, Timely, and Balanced Response

C. Norman Colemana1a2 c1, Daniel J. Blumenthala4, Charles A. Castoa5, Michael Alfanta6, Steven L. Simona3, Alan L. Remicka4, Heather J. Gepforda5, Thomas Bowmana7, Jana L. Telfera8, Pamela M. Blumenthala9 and Michael A. Noskaa10

a1 Office of the Assistant Secretary for Preparedness and Response, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

a2 Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

a3 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

a4 National Nuclear Security Administration, Department of Energy, Washington, DC, USA

a5 Nuclear Regulatory Commission, Rockville, Maryland, USA

a6 American Chamber of Commerce in Japan, Tokyo, Japan

a7 Division of the Strategic National Stockpile, Centers for Disease Control and Prevention, Atlanta, GA, USA

a8 Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA

a9 Department of Housing and Urban Development, Washington, DC, USA

a10 Food and Drug Administration, Silver Spring, Maryland, USA

Abstract

Resilience after a nuclear power plant or other radiation emergency requires response and recovery activities that are appropriately safe, timely, effective, and well organized. Timely informed decisions must be made, and the logic behind them communicated during the evolution of the incident before the final outcome is known. Based on our experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, we propose a real-time, medical decision model by which to make key health-related decisions that are central drivers to the overall incident management. Using this approach, on-site decision makers empowered to make interim decisions can act without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Ongoing assessment, consultation, and adaption to the changing conditions and additional information are additional key features. Given the central role of health and medical issues in all disasters, we propose that this medical decision model, which is compatible with the existing US National Response Framework structure, be considered for effective management of complex, large-scale, and large-consequence incidents. (Disaster Med Public Health Preparedness. 2012;0:1-10)

(Online publication April 04 2013)

Key Words

  • nuclear power plant;
  • disaster resilience;
  • disaster recovery;
  • medical decision model

Correspondence

c1 Address correspondence and reprint requests to C. Norman Coleman, MD, 9609 Medical Center Drive, Room 3W102, Rockville, MD 20850 (e-mail ccoleman@mail.nih.gov).