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After Fukushima: Managing the Consequences of a Radiological Release

Image of Report Cover: After Fukushima: Managing the Consequences of a Radiological Release
Joe Fitzgerald, Samuel B. Wollner, Amesh A. Adalja, Ryan Morhard, Anita J. Cicero, Thomas V. Inglesby
Date posted:
March 07, 2012
Publication type:

Biosecur Bioterror 2012;10(2):228-236

Mary Ann Liebert, Inc.
Open access
See also:

The mission of the Center for Biosecurity’s After Fukushima project is to assess U.S. policies and plans for consequence management to reduce public exposure to radiation following a nuclear power plant accident and offer recommendations for strengthening those efforts.

Executive Summary

Analysis and Workshop

The Center reviewed the events surrounding the response to the Fukushima Daiichi nuclear power plant accident in light of current U.S. government policies and practices, and performed a comprehensive review of the published literature and key U.S. government documents. We then identified and interviewed more than 90 domestic and international experts in federal, state, and local governments, industry, and academia. Interview findings informed a working group meeting that convened 20 experts. The following represents the key issues, findings, and recommendations based on the synthesis of the results from the Center’s efforts.


Emergency Planning Zones and Protective Action Guidelines: Following the Fukushima Daiichi accident, the Japanese government concluded that the country’s existing framework for offsite emergency response—the Emergency Planning Zone (EPZ) structure—proved inadequate to guide evacuation decisions. Japanese officials have since reevaluated the EPZs and are planning to expand the size of planning zones to account for large-scale contamination events, with the expectation that such changes will improve timely decision making during a crisis. In the U.S., each nuclear reactor is surrounded by 2 circular planning zones: the Plume Exposure Pathway EPZ, covering a 10-mile radius around the reactor, and the Ingestion Exposure Pathway EPZ, which encompasses a 50-mile radius surrounding each reactor. Within these areas, state and local governments take predetermined specific preparedness precautions, including emergency exercises, community-wide public education programs, and possibly the predistribution of potassium iodide (KI).

Protective Action Guidelines (PAGs) were developed by the U.S. Environmental Protection Agency (EPA) to help state and local authorities make radiation protection decisions. The PAG manual currently provides advice for the early and intermediate phases of an accident based on levels of anticipated radiation exposure. The U.S. PAG manual differs from protective guides used by the international community, known as Operational Intervention Level (OIL), which are defined as the values of environmental measures of radiation, like radiation dose measurements, above which specific actions should be taken in emergency situations. OILs differ from PAGs in that they do not depend on projected dose calculations. Instead, they recommend actions based on real-time measurements, often using on-the-ground field measurements, possibly allowing for a faster response. The U.S. should reevaluate the relative balance of PAGs and OILs used in response planning to a nuclear power plant (NPP) radiological release given the disruptions to the radiation monitoring systems witnessed in Japan.

Potassium Iodide (KI) Policy: Potassium iodide (KI) is an over-the-counter medical countermeasure that can diminish the uptake of radioactive iodine by the thyroid gland and prevent thyroid cancer in children and developing fetuses. That KI has no value in protecting adults from cancer is well known by professionals and backed by scientific data.

U.S. federal policy recommends that states consider stockpiling and distributing KI as an adjunct to evacuation, which is the single most important protective measure available. Of 35 U.S. states that lie within the 10-mile EPZ of a nuclear power plant, 24 states predistribute KI as part of their emergency planning, and 9 do not. The experience with Fukushima provided some foreshadowing of possible U.S. demand for KI: As the plume of radioisotopes released from the Japanese power plant blew across the Pacific, many in the U.S. began to demand KI.

Communications and Public Health Education: Ionizing radiation ranks near the top of the public’s list of most feared threats. When a mass radiation event occurs, the public fear factor and low baseline knowledge about radiation create a major communications challenge. Federal communication efforts are further complicated by the need to coordinate information and messages from many agencies. The CDC, DOE, EPA, FEMA, HHS, NRC, and the White House were all included in the domestic response to the Fukushima accident. In contrast to the nuclear power plant accidents at Three Mile Island and Chernobyl, the Fukushima Daiichi accident has highlighted the new challenges of communicating with the public in the "information era" of 24-hour news cycles and social media outlets.

In the absence of consistent, trustworthy messaging from government authorities, members of the public may act in ways that put them in harm’s way. Without guidance from the government, residents of the town of Namie in Fukushima prefecture evacuated north, into the plume, believing that the winter winds would be blowing south. In later phases of the accident, the Japanese government struggled to communicate the relative risks of radiation exposure as residents of contaminated areas returned to their properties. Radiation education has since become a part of elementary education; the Japanese government has distributed textbooks to schools throughout the affected region.

Reentry and Recovery Policy: Prior to the Fukushima accident, planning for nuclear accidents in Japan had not taken into account the possibility of wide-scale contamination, major socioeconomic impact, and the possibility that large numbers of people would be displaced for extended periods of time, and perhaps indefinitely. The experience with that accident has raised questions about recovery from mass radiological events in which the health effects of residual ionizing radiation can be less threatening than the enormous socioeconomic impact of widespread contamination itself. The challenge is to define the acceptable level of post-accident population risk from radiation exposure.

Twenty years ago, the EPA published the PAGs as the official decision-making document to be followed during a radiological emergency. The PAGs establish principles for early and intermediate-phase response, but the agency deferred writing its chapter on the late phase, or recovery phase, to a later date. In January 2011, the EPA distributed a "significantly revised version" of the late-phase PAGs to the interagency working group for review. Until that review is completed and late-phase PAGs are published, there will not be clear federal policy for recovery and reentry after a nuclear accident.


1. The U.S. should evaluate the adequacy of current Emergency Planning Zones. In light of the Fukushima experience, the U.S. EPZ system should be carefully assessed to determine the following: Are planning zone distances sufficient to accommodate the potential radiation hazards posed by multiple units of a power plant, spent fuel storage, and the possibility of extended releases? Is the existing decision-making process during plant emergency conditions sufficiently timely and dynamic to be effective for conditions identified at Fukushima? Do we have sufficiently robust radiation measurement and modeling systems in place to monitor radiation threats in the aftermath of a large-scale accident? Would those systems still be functioning despite large-scale power loss or other disruption? Do current nuclear plant safety goals adequately reflect the socioeconomic impact of a wide-scale contamination event? Answers to these questions should guide future evaluations of U.S. EPZs.

2. The U.S. should improve the emergency exercise process for commercial nuclear power plants to make exercises more realistic and address a broader range of scenarios. Emergency exercises need to challenge participants with both expected and unexpected scenarios, including ones that may involve protracted releases and longer-term response. Currently, due to regulatory consequences, domestic commercial nuclear power plants are unable to exercise to failure. No-fault tabletop exercises should become part of the exercise process. Other good options to increase preparedness include regional exercises (eg, Liberty RadEx) that can accommodate a number of agencies and states on a periodic basis.

3. U.S. federal policy should downplay use of KI and emphasize evacuation. A major concern is that KI instills a false sense of security among the population and that demand for KI might delay evacuation. For states that have already committed to KI distribution, it would be extremely difficult to move away from that position without a substantial investment in public education. Given the likelihood that plans to provide (or predistribute KI) in the event of a nuclear accident will continue, it is paramount that the most important emergency response message is always: "Evacuate first—do not waste precious time looking for KI or waiting for it."

4. The U.S. government should expand preevent education and improve postevent communication. Community resilience to radiological threats in the U.S. would benefit from preevent education and postevent communication efforts that provide straightforward and actionable protective advice to the public. Public communication efforts must use all available media outlets and remain consistent across all levels of government—federal, state, and local. Ongoing federal agency efforts to understand how to educate the public before and during a crisis are important and should be supported. Furthermore, a nuclear power plant accident and a subsequent radiological release is both a technological and public health disaster. Given public concerns about the health effects of ionizing radiation, it seems important to include a health expert in the federal messaging approach alongside a nuclear regulatory official. In the future, it would be wise for the NRC and the CDC to consider jointly addressing the public about the threats posed by a compromised nuclear power plant and its public health consequences.

5. The U.S. should articulate a clear plan for recovery after a large-scale accident. With a late-phase protective action guide pending for the past 20 years, and little planning and exercising being conducted for the recovery phase, a serious gap exists in planning for U.S. recovery following a nuclear power plant accident. The consequence of continued inaction could be misdirection, delays, and confusion, as has been demonstrated in Japan, where the public struggles to recover lives and livelihoods. The U.S. government should publish a late-phase PAG to guide recovery planning and response, articulate its approach for recovering from a major radiological release, and develop guidance to aid state and local authorities in dealing with their responsibilities for mitigating exposure, managing decontamination and cleanup, and resettling displaced populations. This emerging set of benchmarks needs to be exercised periodically in a manner that does not detract from current emergency preparedness obligations at nuclear power plants.

6. The U.S. should take steps to sustain professional radiological expertise in the public sector. A number of actions can be taken to ensure a sustained supply of this essential expertise for federal and local governments. First, the federal government once offered graduate school grants and traineeships to encourage entry by nuclear safety and health physics graduates into the public sector—that can be reinstated with relative ease and with little budgetary burden. Second, existing resources can be leveraged better to provide support where needed and, in a major emergency, shared across agencies and between geographical areas. Finally, a means to convey the experience possessed by the existing cadre of radiological response professionals should be created through a mentoring program or other participatory means by which their knowledge can be captured for their successors.

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