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

Published online by Cambridge University Press:  04 April 2013

C. Norman Coleman*
Affiliation:
Office of the Assistant Secretary for Preparedness and Response, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
Daniel J. Blumenthal
Affiliation:
National Nuclear Security Administration, Department of Energy, Washington, DC, USA
Charles A. Casto
Affiliation:
Nuclear Regulatory Commission, Rockville, Maryland, USA
Michael Alfant
Affiliation:
American Chamber of Commerce in Japan, Tokyo, Japan
Steven L. Simon
Affiliation:
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
Alan L. Remick
Affiliation:
National Nuclear Security Administration, Department of Energy, Washington, DC, USA
Heather J. Gepford
Affiliation:
Nuclear Regulatory Commission, Rockville, Maryland, USA
Thomas Bowman
Affiliation:
Division of the Strategic National Stockpile, Centers for Disease Control and Prevention, Atlanta, GA, USA
Jana L. Telfer
Affiliation:
Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
Pamela M. Blumenthal
Affiliation:
Department of Housing and Urban Development, Washington, DC, USA
Michael A. Noska
Affiliation:
Food and Drug Administration, Silver Spring, Maryland, USA
*
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).

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)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

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