78
8 Societal Impact of a Radiological Attack
of the existing scientific and medical literature showed “…no evidence to support
changing the conclusions (that) no effects are expected at chronic dose rates below
0.1 milligrays per hour or at acute doses below 1 gray to the most highly exposed
individuals in the exposed population” [14].
8.2.2 Contamination
Contamination of medical equipment and facilities might also play a role in public
health in the aftermath of a radiological attack. New York and other cities have realized the difficulty of attempting to confine the public to the immediate vicinity of the
attack, releasing them only after checking them for contamination, and emergency
responders are trained to take critically injured victims directly to the hospital without
stopping to decontaminate them first. While this approach is likely to save the most
lives, it also means that ambulances, emergency rooms, trauma bays, and operating
rooms are likely to be contaminated and to require decontamination before they can
be used to treat non-radiological patients. Decontamination resources (personnel,
contractors, and equipment) are likely to be inadequate to address the city’s decontamination needs; those hospitals with an in-house radiation safety program (typically
large research hospitals) will likely be able to perform their own decontamination
but smaller hospitals, urgent care centers, and clinics might be unable to see patients
for a few to several weeks unless they receive permission to continue operating or
unless they can install coverings on floors, furniture, and equipment to contain the
contamination.
Yet another public health impact to consider regards the reproductive effects of a
radiological attack. While the developing fetus is remarkably resistant to the effects
of radiation exposure ([15], [24]) this is not widely known among members of the
public nor among medical personnel; as a result it is not uncommon for pregnant
women to be advised to have a therapeutic abortion following even relatively minor
exposures to medical radiation [16]; this author has direct experience working with
patients whose physicians have advised a therapeutic abortion following diagnostic
x-rays that produced far too little radiation exposure to interfere with fetal development. In an article published by the Society of Nuclear Medicine about one year
after the Chernobyl accident [17] the author states “According to the IAEA, an
estimated 100,000–200,000 wanted pregnancies were aborted in Western Europe
because physicians mistakenly advised patients that the radiation from Chernobyl
posed a significant health risk to unborn children.”
In the aftermath of a radiological attack, public health officials should expect an
increase in the numbers of women seeking abortions and a decrease in births as a
result of fear on the part of the parents and lack of information on the part of their
physicians. This can be addressed in part by developing and distributing fact-based
information resources for physicians and pregnant women both.
8 Societal Impact of a Radiological Attack
of the existing scientific and medical literature showed “…no evidence to support
changing the conclusions (that) no effects are expected at chronic dose rates below
0.1 milligrays per hour or at acute doses below 1 gray to the most highly exposed
individuals in the exposed population” [14].
8.2.2 Contamination
Contamination of medical equipment and facilities might also play a role in public
health in the aftermath of a radiological attack. New York and other cities have realized the difficulty of attempting to confine the public to the immediate vicinity of the
attack, releasing them only after checking them for contamination, and emergency
responders are trained to take critically injured victims directly to the hospital without
stopping to decontaminate them first. While this approach is likely to save the most
lives, it also means that ambulances, emergency rooms, trauma bays, and operating
rooms are likely to be contaminated and to require decontamination before they can
be used to treat non-radiological patients. Decontamination resources (personnel,
contractors, and equipment) are likely to be inadequate to address the city’s decontamination needs; those hospitals with an in-house radiation safety program (typically
large research hospitals) will likely be able to perform their own decontamination
but smaller hospitals, urgent care centers, and clinics might be unable to see patients
for a few to several weeks unless they receive permission to continue operating or
unless they can install coverings on floors, furniture, and equipment to contain the
contamination.
Yet another public health impact to consider regards the reproductive effects of a
radiological attack. While the developing fetus is remarkably resistant to the effects
of radiation exposure ([15], [24]) this is not widely known among members of the
public nor among medical personnel; as a result it is not uncommon for pregnant
women to be advised to have a therapeutic abortion following even relatively minor
exposures to medical radiation [16]; this author has direct experience working with
patients whose physicians have advised a therapeutic abortion following diagnostic
x-rays that produced far too little radiation exposure to interfere with fetal development. In an article published by the Society of Nuclear Medicine about one year
after the Chernobyl accident [17] the author states “According to the IAEA, an
estimated 100,000–200,000 wanted pregnancies were aborted in Western Europe
because physicians mistakenly advised patients that the radiation from Chernobyl
posed a significant health risk to unborn children.”
In the aftermath of a radiological attack, public health officials should expect an
increase in the numbers of women seeking abortions and a decrease in births as a
result of fear on the part of the parents and lack of information on the part of their
physicians. This can be addressed in part by developing and distributing fact-based
information resources for physicians and pregnant women both.