22.1 Public Health Concerns
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conditions such as asthma, interstitial lung diseases, upper airway hyperreactivity,
chronic obstructive pulmonary disease, and more [7, 17].
It is tempting to simply combine the lists of cancers that can be induced by radiation with those that can be caused by non-radiological airborne contaminants such as
silica dust or asbestos. Unfortunately, there is a great deal of overlap between these
lists; in the event of a radiological or nuclear attack it might be necessary to evaluate the probability of causation for both radiogenic and non-radiogenic cancers to
determine whether or not a particular cancer, or any other condition, is compensable.
This will add complexity to the evaluation process and might delay compensation
decisions. It might also require additional staff as there are few professionals who are
competent to assess both radiological and non-radiological exposure and probability
of injury from either or both of these.
22.1.4 Mental Health Issues
Long-term public health concerns must also include mental health concerns. There
have been a number of recognized post-September 11 mental health issues (e.g. [3,
12]), as well as observations made by the World Health Organization (WHO) among
those forcibly relocated following the Chernobyl accident, including:
• Acute stress disorder
• Adjustment disorder
• Anxiety disorder (not otherwise specified)
• Depression (not otherwise specified)
• Dysthymic disorder
• Generalized anxiety disorder
• Major depressive disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Substance abuse
• Suicide.
Many of these were also noted by the World Health Organization among survivors
of the Chernobyl reactor accident [18] and several are consistent with observations
made by the author and his teammates in the aftermath of the Fukushima accident
[1, 2]. Given that the post-Chernobyl mental health concerns continued for at least
20 years after that accident, public health officials should assume that they will remain
a concern for at least this long following a radiological or nuclear terrorist attack, as
well as lasting trauma of the terrorist attack itself (PTSD, hyperarousal, relationship
difficulties, etc.; [15]). It is also worth noting that the WHO also found evidence
of mental health problems among children of those who were evacuated, including
children who were not born until after the accident.
Thus, the health effects of a radiological or nuclear attack can last beyond the
generation involved in the attack; this, in turn, will require trained personnel to attend
275
conditions such as asthma, interstitial lung diseases, upper airway hyperreactivity,
chronic obstructive pulmonary disease, and more [7, 17].
It is tempting to simply combine the lists of cancers that can be induced by radiation with those that can be caused by non-radiological airborne contaminants such as
silica dust or asbestos. Unfortunately, there is a great deal of overlap between these
lists; in the event of a radiological or nuclear attack it might be necessary to evaluate the probability of causation for both radiogenic and non-radiogenic cancers to
determine whether or not a particular cancer, or any other condition, is compensable.
This will add complexity to the evaluation process and might delay compensation
decisions. It might also require additional staff as there are few professionals who are
competent to assess both radiological and non-radiological exposure and probability
of injury from either or both of these.
22.1.4 Mental Health Issues
Long-term public health concerns must also include mental health concerns. There
have been a number of recognized post-September 11 mental health issues (e.g. [3,
12]), as well as observations made by the World Health Organization (WHO) among
those forcibly relocated following the Chernobyl accident, including:
• Acute stress disorder
• Adjustment disorder
• Anxiety disorder (not otherwise specified)
• Depression (not otherwise specified)
• Dysthymic disorder
• Generalized anxiety disorder
• Major depressive disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Substance abuse
• Suicide.
Many of these were also noted by the World Health Organization among survivors
of the Chernobyl reactor accident [18] and several are consistent with observations
made by the author and his teammates in the aftermath of the Fukushima accident
[1, 2]. Given that the post-Chernobyl mental health concerns continued for at least
20 years after that accident, public health officials should assume that they will remain
a concern for at least this long following a radiological or nuclear terrorist attack, as
well as lasting trauma of the terrorist attack itself (PTSD, hyperarousal, relationship
difficulties, etc.; [15]). It is also worth noting that the WHO also found evidence
of mental health problems among children of those who were evacuated, including
children who were not born until after the accident.
Thus, the health effects of a radiological or nuclear attack can last beyond the
generation involved in the attack; this, in turn, will require trained personnel to attend