Hotlines for information:
• CDC at
800-CDC-INFO
• 1-800-BE-READY
• The Conference of Radiation Control Program Directors at 502-227-4543
• The Nuclear Regulatory Commission Office of Public Affairs
can be contacted at 301-415-8200
• The Federal Emergency Management Agency (FEMA) can be reached
at 202-646-4600
• The Radiation Emergency Assistance Center/Training Site at
865-576-3131
• The U.S.
Department of Energy (DOE) at 800-DIAL-DOE
SHOWER AND SHELTER
-
WHAT TO DO AT
HOME AFTERWARDS
This information
is from peer reviewed medical journals.
"The public
response should be “shelter and shower.” Sheltering (particularly
at home) is prudent early in a radiologic event, because families
congregate at home and showers, clean clothing, food, and water are
available. Sheltering also provides authorities time to assess the
situation more completely. Evacuation might be indicated later for
people in some locations, depending on the specific situation and
the extended dose estimates. In other locations, remaining sheltered
may result in lower radiation exposure." (Flynn D., 2006)
"Exposed
skin and hair should be cleansed with soap and water repeatedly..."(Udeani
J., 2002)
"Removing
clothing alone can decrease external radioactive contamination by
90%.
Washing with soap
and lukewarm or room-temperature water is effective and removes another
90% of contamination (about 99% of the total is removed after both
steps have been performed)." (Flynn D., 2006)
Medications to
take within 4 hours: Potassium Iodide
If you do not
have the pill now- home remedy (not proven)
Radiation
Emergencies -
what to do from
the CDC
Pueblo.gov
information on Nuclear and Radiological Attacks - what to do before,
during & after
What
to do in case of nuclear threat 1-800-BE-READY
What
to do if there is a radiation threat or 'dirty bomb'
How
You Can Limit Contamination
What
you can do - preparation
Sheltering
in Place during a Radiation Emergency
Types
of disasters from FEMA
Nuclear
emergency: What would you do?
NIMS-
National Incident Management System
State
by state emergency management offices (FEMA) phone numbers
Health Concerns
Acute
Radiation Syndrome
THE
TREATMENT OF BURNS - Atomic Bombing: How to Protect Yourself
"The first
thing to remember about a burn, no matter how severe or slight, or
what the cause, is to keep it from getting infected. In other words,
keep germs out, just as you are careful to keep germs out of an open
cut or other wound...In case of an atom bomb attack, and often in
other cases of burn injuries, it may not be possible to get the victim
to medical aid very quickly. In such a case, put a sterile dressing
on the burn to cover it and protect it both from the air and from
germs."
Mass
Casualties: Burns- not related to radiation but intersects
Journal articles
Nuclear terrorism:
triage and medical management of radiation and combined-injury casualties.
(includes abstract) Flynn DF; Surgical Clinics of North America, 2006
Jun; 86 (3): 601-36.
link
- This link will work if you are logged into your local public or
school library database. Full text likely available.
Quote: "This
article addresses the medical effects of nuclear explosions and other
forms of radiation exposure, assessment of radiation dose, triage
of victims, definitive treatment of radiation and combined-injury
casualties, and planning for emergency services after a terrorist
attack involving a nuclear device. It reviews historical events of
mass radiation-induced casualties and fatalities at Hiroshima, Chernobyl,
and Goiania, and discusses various scenarios for nuclear terrorism."
The first phase
of treatment in a hospital:
"During the
first 72 hours the initial phase of treatment will be directed toward
treatment of trauma and burns, external decontamination, and very
early initiation of potassium iodide, where appropriate. After detonation
of a nuclear weapon, most casualties will be combined-injury patients.
Emergency surgical care involves resuscitation, control of hemorrhage,
and minimization of sepsis with débridement techniques."
Decontamination
instructions:
"Removing
clothing alone can decrease external radioactive contamination by
90%.
Washing
with soap and lukewarm or room-temperature water is effective and
removes another 90% of contamination (about 99% of the total is removed
after both steps have been performed).
Soap emulsifies and dissolves most contaminants. Wounds and body orifices
usually are decontaminated first. Wounds should be rinsed with saline.
To prevent cross-contamination, wounds and burns should be covered
with waterproof dressings before the skin is decontaminated. Abrasions
and lacerations usually are relatively easy to decontaminate. Stubborn
contamination may be excised from lacerations. Puncture wounds, most
often on the hands, are sometimes difficult because of poor access
to the contaminants and difficulty in determining the degree and depth
of contamination. Irrigation with standard water picks may be successful.
Burns should be rinsed gently with water and cleared of debris. In
patients whose burns cannot be completely decontaminated, most of
the contamination will remain in the burn eschar when it sloughs.
Some patients may have imbedded metal fragments (shrapnel). When metallic
shrapnel is removed, it should be evaluated for radioactivity and
either shielded or placed in a safe location. Potentially radioactive
fragments should be handled with forceps, not with gloved hands. Contaminated
wastewater can be released into sewers without restriction. For intact
skin, a wet washcloth and basin (with or without a low-velocity, low-volume
water spray) may be used to remove a significant amount of superficial
contamination. Gentle brushing may help remove contamination from
the skin, but care should be taken not to damage the skin, because
some contamination could be absorbed through injured skin. Experience
has shown that shampoo can be effective for skin decontamination in
addition to soap, if soap alone is inadequate. On some occasions,
povidone-iodine can be used as an antiseptic-germicide on the intact
skin. It has the added benefit of nonradioactive iodine absorption
through intact skin to block the thyroid partially when there is internal
contamination from radioactive iodine-131. Hair can be decontaminated
with any commercial shampoo. Cutting or clipping the hair, if appropriate,
can remove contaminants, but cutting the eyebrows should be avoided,
because they may not grow back. Fingernails and toenails should be
checked and cut if necessary."
"DECONTAMINATION
TEAM DRESS:
Caregivers should
follow strict isolation-type procedures (universal precautions). Barrier
clothing is worn, including cap, mask, eye protection, gown, gloves,
and shoe covers. All seams and cuffs should be secured with masking
tape. Ideally, a dosimeter should be worn at the collar level. A complete
surgical scrub suit ideally would include a plastic apron or waterproof
gown for use when washing contaminated patients and double gloves,
with the inner gloves taped to the scrub suit, to prevent cross contamination,
because glove changes may be necessary."
"The decontamination-treatment
area for those injured needs to be delineated and, if possible, established
in an area away from the main flow of emergency department activity,
near a separate emergency department entrance. It should be appropriate
for both emergency medical care and decontamination, with access to
water. Ideally, the floor should be covered and with taped-down nonskid
plastic sheets (however, butcher's paper or other appropriate covering
may be substituted)."
"Skin decontamination
needs to be done early because reducing the time radioisotopes remain
in direct contact with the skin lessens the severity of the radiation
burn that develops later [5], [16]. In contrast to thermal burns,
which appear almost immediately, the development of radiation burns
takes weeks to evolve fully."
"Infections
are a major cause of mortality in the irradiated host because of immunosuppressive
effects that result from declining lymphohematopoietic elements secondary
to radiation-induced bone marrow aplasia (reversible or irreversible).
After wounds or burns have been débrided, topical antibiotics
should be used, and the wound should be covered with nonadherent dressings."
SHOWER AND SHELTER
- WHAT TO DO AT HOME
"Massive
amounts of contamination are injected into the lower atmosphere, producing
a downwind radioactive plume containing radioactive dust and particles.
Prolonged contact with fallout on the skin can result in serious skin
damage plus increased whole-body dose. Therefore, the public response
should be “shelter and shower.” Sheltering (particularly
at home) is prudent early in a radiologic event, because families
congregate at home and showers, clean clothing, food, and water are
available. Sheltering also provides authorities time to assess the
situation more completely. Evacuation might be indicated later for
people in some locations, depending on the specific situation and
the extended dose estimates. In other locations, remaining sheltered
may result in lower radiation exposure."
Management of
nuclear casualties. (includes abstract) Udeani JC; Topics in Emergency
Medicine, 2002 Jun; 24 (2): 40-6, 79-82. Link
- This
link will work if you are logged into your local public or school
library database. Full text likely available.
Quote: "Radioactive
agents pose a significant threat to the efficient operation of any
emergency department and challenge the ability of emergency physicians
to provide lifesaving patient care. A well-planned, organized system
of triage and hospital preparedness is critical. All health care providers
involved in the early treatment of these patients must understand
the clinical presentations, treatment options, and preventive measures
to prevent further contamination of other individuals. This article
reviews some of the important concepts in management of nuclear catastrophes"
"Four mechanisms
ofinjury are implicated in
trauma caused by explosions. Primary blast
injuries are the direct effects of rapid increases
in atmospheric pressure causing barotrauma.
Most of the primary blast wave
injuries tend to affect areas of tissue-fluid/
gas interface and result in most on-scene
deaths.^'' The most common organ affected is
the ear (tympanic membrane rupture). Patients
with ruptured tympanic membranes
have been exposed to pressures usually exceeding
15 psi.^"'' In a case series of 647 survivors
of bombings in Israel from 1994 to
1996, 29.8% of them had blast injuries; of
those injuries, 89.6% had tympanic membrane
injuries.^ The most common injury to the tympanic
membrane involves a linear tear to the
inferior portion of the eardrum.
Primary blast injuries to the lung produce
the most profoimd and serious life-threatening
problems to victims. Tliese injuries result from
a rapid increase in intrathoracic pressures. Victims
may suffer from a whole range of problems
including pneumothoraces, contusions,
subpleural petechiae, and parenchymal hemorrhages.
In addition, local disruption of blood
vessels in close proximity to air-filled spaces
may cause a bronchopleural fistula. Arterial air
embolism to the brain or heart may be the
most common cause of rapid death in initial
survivors of blast injuries.*' Blast injuries to the
howel involve mechanisms similar to pulmonary
injuries. Hematomas, petechiae, and
perforation are commonly encountered.*'"
Secondary' blast injuries are penetrating
trauma induced by flying debris. The blast
wind, which immediately follows the blast
wave, is a displacement of air that accelerates
debris. Tertiary injuries occur when the victim
is propelled by blast wind."^ Blunt and penetrating
traumas account for most of these injuries
and are usually seen in victims close to
the blast. Finally, quaternary' blast injuries are
miscellaneous blast events that include exposure
to toxic gases, radiation, bums, and crush
injuries sustained from collapsing buildings."
"Exposed
skin and hair should be cleansed
with soap and water repeatedly until the
dosimeter readings are minimal."
Harrison TW.
Gustafson EM. Dixon JK. Radiologic emergency: protecting schoolchildren
& the public. [Journal Article, CEU, Exam Questions, Pictorial,
Review] American Journal of Nursing. 2003 May; 103(5): 41-50. (35
ref)
AN: 2003080375.
Quotes:
'Public tap water would probably be safe to use during the first few
hours after a radioactive release because it would be in underground
pipes that had not yet been contaminated. It should be collected and
stored in clean containers.'
'A full discussion of sheltering considerations in a variety of emergencies
and disasters is contained in the FEMA publication Are You Ready?
A Guide to Citizen Preparedness, available online at www.fema.gov/areyouready
., a few points of which should be emphasized. Existing and prospective
shelters should be identified in advance. In a radiologic emergency,
again, the best shelter would be determined by the nature of the event,
the distance from the source of contamination, and many other factors.
If an explosion of a nuclear device, dirty bomb, or compromised reactor
core were imminent, finding shelter below ground to protect against
explosion would be best (should there happen to be warning in advance
of such an event). However, if the hazard consists of airborne contaminants
only, people should not go to basement areas or to the top floor of
a building because radioactive contaminants settle on the ground and
on roofs. Rooms and other spaces above ground provide better shelter—preferably
interior halls or rooms without windows or ventilation open to the
outside, such as air conditioners and fireplaces. Otherwise, windows,
vents, air conditioning, fireplaces, and all other routes by which
outside air might enter the shelter should be closed and sealed, if
possible.'
A review of triage
and management of burns victims following a nuclear disaster. Kumar
P; Burns (03054179), 1994 Oct; 20 (5): 397-402. Link-
This link will work if you are logged into your local public or school
library database.
Disaster triage
of massive casualties from thermonuclear detonation. (includes abstract)
Laurent CL; Journal of Emergency Nursing, 1990 Jul-Aug; 16 (4): 248-51.
Link
- This link will work if you are logged into
your local public or school library database.
Medications
to help
Potassium
Iodide (KI)- buy
it here
DTPA
Prussian
Blue
Neupogen
More about potassium
Iodide:
"These numbers
represent the best current thinking in terms of daily dosage of potassium
iodide to protect the thyroid, said Dr. David Orloff of the Food and
Drug Administration. He emphasized that the overall benefits of protective
KI far exceed the risks of overdosing, especially in children.
* Adults (older
than 18 years): 130 mg
* Pregnant or
lactating women: 130 mg
* Newborns (up
to 1 month old): 16 mg
* Infants (aged
1 month to 3 years): 32 mg
* Children 3-18
years: 65 mg *
* Teens weighing
more than 150 pounds should take the adult dosage.
Source: "Potassium
Iodide as a Thyroid Blocking Agent in Radiation Emergencies,"
www.fda.gov/cder/guidance/4825fnl.htm
Patients can buy
Iosat at www.anbex.com.
Information about
KI is available from the FDA at www.fda.gov/cder/drugprepare/KI_Q&A.htm."
(Splete, H., 2003)
How it works
(in layman's terms)
"Experts
agree that radioactive iodine and cesium, commonly used in cancer
therapy and industrial radiography, are the most likely ingredients
of a dirty bomb. How to minimize the damage? Start by wearing a mask--the
thicker, the better. Then pop these chemical cures.
POTASSIUM IODIDE
The thyroid is the only organ that collects iodine, so strike first.
"Each thyroid cell is a parking lot with a specific number of
spaces," explains Andrew Karam, Ph.D., a founding member of the
Health Physics Society's Homeland Security Committee who, while in
the navy's nuclear-power program, was contaminated 30 times. "If
you put stable iodine in there first, you block the radioactive stuff."
Potassium iodide is available online at KI4U.com. Take up to 130 milligrams
(mg) as soon as you can after the blast.
PRUSSIAN BLUE
Cesium likes to attack blood cells. Don't let it. This iron compound
binds to the radioactive particles and escorts them out of the body
through urine. (The urine turns blue, which would be cool under different
circumstances.) Take 1 to 2 mg twice a day for up to 3 weeks after
exposure, says Karam." (Schipper, D., 2005)
"Can I give
it to my pets?
There have been
no studies concerning animals and the administration of Potassium
Iodide for radiation emergencies. Like humans, animals do not normally
have any allergic reaction to limited doses of Potassium Iodide. For
animals with no known iodine allergies (ask your vet) it is a relatively
safe drug. If you wish to administer it to your pet, follow the human
dosage amounts listed below in the "What is the dosage?"
info and give the appropiate dosage based upon weight. For instance,
the dosage for a 2-year-old child would be 32mg (1/4 tablet). If an
average 2-year-old weighs 25 -30 lbs., a dog weighing the same would
take the same dosage, 32mg (1/4 tablet). If a 2-week-old infant weighs
on average 9 pds., then you would give a 9 pound cat/dog 16mg (1/8
tablet). Crush it up and put it in their food. Please consult with
a vet in advance to make sure your pet can safely take Potassium Iodide
(found in table salt, fish oil, kelp, daily vitamins, etc.)"
preparedness.com
If you do not
have the pills now -home remedies
and myth
busters
"Researchers
at Pennsylvania State University's medical center in Hershey have
stumbled onto what may be an effective home remedy to prevent serious
radioactive contamination of the thyroid gland from iodine-131 emitted
in the event of a major nuclear plant mishap. They swab the skin
with a tincture of iodine...the effective dose in rats suggests
human skin swabbing need only cover an area the size of a hand or
scraped knee" (Science News, 1985) link
to article This article is
discussed by it's author here.
The followup study done in 1989 stated "Topical application of
tincture of iodine (I) was found to be effective in blocking the thyroid
uptake of orally administered 131I in humans." Depending on the
amount and the person. (Miller, K., 1989) link
to article
Though I cannot
vouch for these sources they are online webpages stating topical iodine
is helpful for radiation.
"And lacking
an oral source of iodine, applying 2 percent tincture of iodine to
the skin works almost as well. Painting iodine on the abdomen in a
4 x 8 inch patch blocks thyroidal radioiodine uptake by 95 to 99 percent.
" Google
scholar article, also mentioned in this masters
of nursing paper
"If no tablets
available, you can topically (on the skin) apply an iodine solution,
like tincture of iodine or Betadine, for a similar protective effect.
Iodine solutions are NEVER to be ingested or swallowed, and should
not be used if allergic to iodine."
"It is poisonous
to ingest (drink/swallow) elemental iodine, iodine tablets (widely
sold for water purification), tincture of iodine, or Povidone-iodine
solutions (like the Betadine® brand solution). They are all both
ineffective for thyroid-blocking and very dangerous, perhaps even
fatal to have a child drink any of them.
However, there
has been some promising research, though, with both humans and dogs
into topically (on the skin) applied Povidone-Iodine (10%) solution
(such as Betadine® or Povidex® solutions), and also with tincture
of iodine, to test the absorption rates of iodine directly, and safely,
through the skin." ki4u
Some websites
also claim:
"If no tablets
available, you can topically (on the skin) apply an iodine solution,
like tincture of iodine or Betadine, for a similar protective effect.
(WARNING: Iodine solutions are NEVER to be ingested or swallowed.)
For adults, paint 8 ml of a 2 percent tincture of Iodine on the abdomen
or forearm each day, ideally at least 2 hours prior to possible exposure.
For children 3 to 18, but under 150 pounds, only half that amount
painted on daily, or 4 ml. For children under 3 but older than a month,
half again, or 2 ml. For newborns to 1 month old, half it again, or
just 1 ml. (One measuring teaspoon is about 5 ml, if you don't have
a medicine dropper graduated in ml.) If your iodine is stronger than
2%, reduce the dosage accordingly. Absorption through the skin is
not as reliable a dosing method as using the tablets, but tests show
that it will still be very effective for most. Do not use if allergic
to iodine." nukalert
FOODS
"DO NOT MAKE
A FUTILE, HARMFUL ATTEMPT TO EAT ENOUGH IODIZED SALT TO RESULT IN
THYROID BLOCKING. Iodized salt contains potassium iodide, but in such
a low concentration that it is impossible to eat enough iodized salt
to be helpful as a blocking agent." OISM
"Certain
foods contain substances which are metabolized to 5-vinyloxazolidine-2-thione
and thiocyanate. 5-Vinyloxazolidine-2-thione and thiocyanate may compete
with iodide and negatively affect the iodine status of the thyroid
gland and may cause hypothyroidism. These food substances are called
goitrogens and are found in foods such as cassava and such cruciferous
foods as cabbage, Brussels sprouts, broccoli, cauliflower and rutabaga.
Certain flavonoids may have goitrogenic activity. C-gluosylflavones
such as vitexin, which are found in millet, have been found to inhibit
thyroid peroxidase activity. The soybean isoflavones genistein and
daidzein have also been found to inhibit thyroid peroxidase."
VITAMINS that
help with radiation
Bairati I (2005).
Randomized trial of antioxidant vitamins to prevent acute adverse
effects of radiation therapy in head and neck cancer patients. (includes
abstract) Journal of Clinical Oncology, Aug 20; 23 (24):
5805-13.
This article cites:
.# The alpha-tocopherol,
beta-carotene lung cancer prevention study: Design, methods, participant
characteristics, and compliance—The ATBC Cancer Prevention Study
Group. Ann Epidemiol 4:1-10, 1994[Medline]
# Omenn GS, Goodman GE, Thornquist MD, et al: Risk factors for lung
cancer and for intervention effects in CARET, the Beta-Carotene and
Retinol Efficacy Trial. J Natl Cancer Inst 88:1550-1559, 1996[Abstract/Free
Full Text]
# Ferreira PR, Fleck JF, Diehl A, et al: Protective effect of alpha-tocopherol
in head and neck cancer radiation-induced mucositis: A double-blind
randomized trial. Head Neck 26:313-321, 2004[CrossRef][Medline]
# Mills EE: The modifying effect of beta-carotene on radiation and
chemotherapy induced oral mucositis. Br J Cancer 57:416-417, 1988[Medline]
# Sanchiz F, Milla A, Artola N, et al: Prevention of radioinduced
cystitis by orgotein: A randomized study. Anticancer Res 16:2025-2028,
1996[Medline]
# Metz JM, Smith D, Mick R, et al: A phase I study of topical Tempol
for the prevention of alopecia induced by whole brain radiotherapy.
Clin Cancer Res 10:6411-6417, 2004[Abstract/Free Full Text]
# Halperin EC, Gaspar L, George S, et al: A double-blind, randomized,
prospective trial to evaluate topical vitamin C solution for the prevention
of radiation dermatitis: CNS Cancer Consortium. Int J Radiat Oncol
Biol Phys 26:413-416, 1993[Medline]
Bairati I, Meyer F, Gélinas M, et al: Randomized trial of antioxidant
vitamins to prevent acute adverse effects of radiation therapy in
head and neck cancer patients. J Clin Oncol 23:5805-5813, 2005
(1985). Tincture
of iodine keeps radiation away. (possible home remedy in event of
nuclear plant mishap). Science News. Dec 7, 128 p360(1).
link
to article
Miller, K.L. (1989).
Effectiveness of skin absorption of tincture of I in blocking radioiodine
from the human thyroid gland. Health Physics [Health Phys],
56 (6), pp. 911-4. link
to article
Splete, H. (2003).
Handling a nuclear incident: potassium iodide. (Some Regional Distribution
Plans in Place). Internal Medicine News, 36 (8). p8(1).
Schipper, D.
(2005). Pills that protect you.(Cesium and Potassium iodide in radiography).
Men's Health, 20 (7). p138.
Randomized trial
of antioxidant vitamins to prevent acute adverse effects of radiation
therapy in head and neck cancer patients. (includes abstract) Bairati
I; Journal of Clinical Oncology, 2005 Aug 20; 23 (24): 5805-13. (journal
article - clinical trial, research, tables/charts) PMID: 16027437
CINAHL AN: 2009157768
Spare tactics: advances in radiation therapy include techniques that
help keep surrounding tissue healthy. Kinsley M; Nursing Spectrum
-- New York & New Jersey Edition, 2006 Aug 14; 18A (17): 10-1.
(journal article - pictorial) CINAHL AN: 2009273549
Check emergency
department victims for radiation... Koenig KL, Goans RE, Hatchett
RJ et al. Medical treatment of radiological casualties: current concepts.
Ann Emerg Med 2005;45:643-52. Casavant MJ; Annals of Emergency Medicine,
2006 Jan; 47 (1): 120-1. (journal article - commentary, letter, response)
PMID: 16387228 CINAHL AN: 2009111238
Books
Rose, K. (2001).
One nation underground : the fallout shelter in American culture,
New York : New York University Press.
UA927 .R67 2001
Couch, D. &
Boswell J., (2003). U.S. Armed Forces Nuclear, Biological and
Chemical Survival Manual, New York, NY : Basic Books.
"Curling
up in a basement corner after a nuclear blast, for example, can cut
your radiation dose by a factor of ten (provided you are outside the
"100 percent lethality " zone), while heavy clothing and
a wet cloth over the nose and mouth help protect in a chemical or
biological strike. After an attack, most fallout/toxins/spoors can
be washed off, preferably with diluted bleach. And do use that duct
tape."
Russian threat
perceptions and plans for sabotage against the United States :
hearing before the Military Research and Development Subcommittee
of the Committee on Armed Services, House of Representatives, One
Hundred Sixth Congress, first session, hearing held October 26, 1999.
Publisher: Washington : U.S. G.P.O. : For sale by the U.S. G.P.O.,
Supt. of Docs., Congressional Sales Office, 2000.
Hoffman, Bruce
(1986). Terrorism in the United States and the potential threat
to nuclear facilities; prepared for the U.S. Department of Energy,
Santa Monica, CA : Rand.
Gordin, M. (2007).
Five days in August : how World War II became a nuclear war.
Princeton, N.J. : Princeton University Press.
Subject: Hiroshima-shi (Japan) History Bombardment,
1945.
Nagasaki-shi (Japan) History Bombardment, 1945.
Atomic bomb United States History.
World War, 1939-1945 Japan.
Capitulations, Military Japan History 20th century.
D767.25.H6 G67 2007
Keep out of trouble:
Waiting for the end of the world [by] Richard Ross [book review]
Bowerman, Clare.
Blueprint (London, England), no. 222, pp. 62, Aug 2004
Photo book of atomic bomb shelters around the world.
Photo book of
atomic bomb shelters around the world.
Survival city:
adventures among the ruins of atomic America, by T. Vanderbildt
Farish, Matthew.
Environment and planning D, society & space, vol. 21, no. 1, pp.
127-129, Feb 2003
Shelters against
explosions of nuclear and other non conventional warfare
Dannish, Sami A.; Golam, Mohammad A.
International journal for housing science and its applications, vol.
17, no. 3, pp. 163-171, 1993
Before the nuclear
dust settles
Luder, Owen
Building, vol. 251, no. 33, pp. 21, Aug 1986
Search terms:
Air raid shelters -- 20th century -- United States Atomic bombs and
bombing, fallout shelter*, Bunkers -- United States, Air raid shelters
-- Conservation and restoration, Air
raid shelters -- Research, Air
raid shelters
A compilation
of quotes from other, mostly government sites.
How You Can Limit
Contamination
Since radiation cannot be seen, smelled, felt, or tasted, people at
the site of an incident will not know whether radioactive materials
were involved. You can take the following steps to limit your contamination.
1. Get out of the immediate area quickly. Go inside the nearest safe
building or to an area to which you are directed by law enforcement
or health officials.
2. Remove the outer layer of your clothing. If radioactive material
is on your clothes, getting it away from you will reduce the external
contamination and decrease the risk of internal contamination. It
will also reduce the length of time that you are exposed to radiation.
3. If possible, place the clothing in a plastic bag or leave it in
an out-of-the-way area, such as the corner of a room. Keep people
away from it to reduce their exposure to radiation. Keep cuts and
abrasions covered when handling contaminated items to avoid getting
radioactive material in them.
4. Wash all of the exposed parts of your body using lots of soap and
lukewarm water to remove contamination. This process is called decontamination.
Try to avoid spreading contamination to parts of the body that may
not be contaminated, such as areas that were clothed.
5. After authorities determine that internal contamination may have
occurred, you may be able to take medication to reduce the radioactive
material in your body.
http://www.bt.cdc.gov/radiation/contamination.asp
Sheltering in place
The terrorist events of 2001 made many people wonder about the possibility
of a terrorist attack involving radioactive materials. People who
live near but not in the immediate area of the attack may be asked
to stay home and take shelter rather than try to evacuate. This action
is called “sheltering in place.” Because many radioactive
materials rapidly decay and dissipate, staying in your home for a
short time may protect you from exposure to radiation. The walls of
your home may block much of the harmful radiation. Taking a few simple
precautions can help you reduce your exposure to radiation. The Centers
for Disease Control and Prevention has prepared this fact sheet to
help you protect yourself and your family and to help you prepare
a safe and well-stocked shelter.
Preparing a Shelter in Your Home
The safest place in your home during an emergency involving radioactive
materials is a centrally located room or basement. This area should
have as few windows as possible. The further your shelter is from
windows, the safer you will be.
Preparation is the key. Store emergency supplies in this area. An
emergency could happen at any time, so it is best to stock supplies
in advance and have everything that you need stored in the shelter.
Every 6 months, check the supplies in your shelter. Replace any expired
medications, food, or batteries. Also, replace the water in your shelter
every 6 months to keep it fresh.
Make sure that all family members know where the shelter is and what
it is for. Caution them not to take any items from that area. If someone
“borrows” items from your shelter, you may find that important
items are missing when they are most needed.
If you have pets, prepare a place for them to relieve themselves in
the shelter. Pets should not go outside during a radiation emergency
because they may track radioactive materials from fallout into the
shelter. Preparing a place for pets will keep the radioactive materials
from getting inside the shelter.
Preparing Emergency Supplies
Stock up on supplies, just as you would in case of severe weather
conditions or other emergencies. Following is a list of things to
consider when preparing your emergency kit.
• Food with a long shelf life—Examples of this include
canned, dried, and packaged food products. Store enough food for each
member of the household for at least 3 days.
• Water—In preparation for an emergency, purchase and
store bottled water or simply store water from the tap. Each person
in the household will need about 1 gallon per day; plan on storing
enough water for at least 3 days.
• A change of clothes and shoes—Check clothing every 6
months and remove clothes that no longer fit or are unsuitable for
seasonal weather. Remember to include underwear, socks, sturdy shoes
or work boots, and winter or summer clothes as needed.
• Paper plates, paper towels, and plastic utensils—Store
disposable dishware and utensils because you will not have enough
water to wash dishes and because community water sources may be contaminated.
• Plastic bags—Because you may not be able to leave your
shelter for several days, you will need to collect your waste in plastic
bags until it can be removed.
• Bedding—Store sheets, blankets, towels, and cots for
use during the time that you cannot leave your shelter.
• Battery-operated radio and batteries—Electrical power
may not be on for several days. A battery-operated radio will allow
you to listen to emergency messages.
• Medicines—Have 2-3 days’ dose of your current
prescription medicines in a childproof bottle for your shelter medical
kit; label with the name and expiration date of the medicine. (Discuss
with your doctor the best way to obtain this small amount of extra
medicine.) Be sure to check medicines in your kit every 6 months to
make sure they are not past the expiration date.
• Toiletries—Keep a supply of soap, hand sanitizer, toilet
paper, deodorant, disinfectants, etc.
• Flashlight and batteries—Electrical power may be out
for several days. A flashlight will help you see in your shelter.
• A telephone or cell phone—Although cell phone or ground
phone service may be interrupted, there is still a chance that you
will be able to use a phone to call outside for information and advice
from emergency services.
• Extra eyeglasses or contact lenses and cleaning supplies.
• Duct tape and heavy plastic sheeting—You can use these
items to seal the door to your shelter and to seal any vents that
open into your shelter for a short period of time if a radiation plume
is passing over.
• Pet food, baby formula, diapers, etc.—Don’t forget
the other members of your family. If you have an infant, store extra
formula and diapers. If you have pets keep a 3-day supply of pet food.
• First aid kit—You can purchase a first-aid kit or prepare
one yourself. Be sure to include the following items:
o Sterile adhesive bandages
o Sterile gauze pads in 2 inch and 4 inch sizes
o Adhesive tape
o Sterile rolled bandages
o Scissors
o Tweezers
o Needle
o Thermometer
o Moistened towelettes
o Antiseptic ointment
o Tube of petroleum jelly or other lubricant
o Soap or hand sanitizer
o Latex or vinyl gloves
o Safety pins
o Aspirin or aspirin free pain reliever
o Antidiarrhea medication
o Laxatives
o Antacids for stomach upset
o Syrup of ipecac to cause vomiting if advised by the Poison Control
Center
o Activated charcoal to stop vomiting if advised by the Poison Control
Center
• Games, books, and other entertainment—Because you may
be in your shelter for several days, keep items on hand to occupy
your family during that time. Children are likely to get bored if
they have to stay in one place for long periods. Think of activities
that they will enjoy doing while in the shelter—finger painting,
coloring, playing games, etc.
Tips before Entering a Shelter
If you are outside when the alert is given, try to remove clothing
and shoes and place them in a plastic bag before entering the house.
During severe weather, such as extreme cold, remove at least the outer
layer of clothes before entering the home to avoid bringing radioactive
material into your shelter. Leave clothing and shoes outside. Shower
and wash your body with soap and water. Removing clothing can eliminate
up to 90% of radioactive contamination. By taking this simple step,
you will reduce the time that you are exposed and also your risk of
injury from the radiation.
Before entering the shelter, turn off fans, air conditioners, and
forced-air heating units that bring air in from the outside. Close
and lock all windows and doors, and close fireplace dampers.
When you move to your shelter, use duct tape and plastic sheeting
to seal any doors, windows, or vents for a short period of time in
case a radiation plume is passing over (listen to your radio for instructions).
Within a few hours, you should remove the plastic and duct tape and
ventilate the room. Suffocation could occur if you keep the shelter
tightly sealed for more than a few hours.
Keep your radio tuned to an emergency response network at all times
for updates on the situation. The announcers will provide information
about when you may leave your shelter and whether you need to take
other emergency measures.
http://www.bt.cdc.gov/radiation/shelter.asp
How Can I Protect Myself During a Radiation Emergency?
• After a release of radioactive materials, local authorities
will monitor the levels of radiation and determine what protective
actions to take.
• The most appropriate action will depend on the situation.
Tune to the local emergency response network or news station for information
and instructions during any emergency.
• If a radiation emergency involves the release of large amounts
of radioactive materials, you may be advised to “shelter in
place,” which means to stay in your home or office; or you may
be advised to move to another location.
• If you are advised to shelter in place, you should do the
following:
o Close and lock all doors and windows.
o Turn off fans, air conditioners, and forced-air heating units that
bring in fresh air from the outside. Only use units to recirculate
air that is already in the building.
o Close fireplace dampers.
o If possible, bring pets inside.
o Move to an inner room or basement.
o Keep your radio tuned to the emergency response network or local
news to find out what else you need to do.
• If you are advised to evacuate, follow the directions that
your local officials provide. Leave the area as quickly and orderly
as possible. In addition –
o Take a flashlight, portable radio, batteries, first-aid kit, supply
of sealed food and water, hand-operated can opener, essential medicines,
and cash and credit cards.
o Take pets only if you are using your own vehicle and going to a
place you know will accept animals. Emergency vehicles and shelters
usually will not accept animals.
http://www.bt.cdc.gov/radiation/emergencyfaq.asp
Nuclear terrorism:
triage and medical management of radiation and combined-injury casualties.
(includes abstract) Flynn DF; Surgical Clinics of North America, 2006
Jun; 86 (3): 601-36.
link - This link will work if you are logged into your local public
or school library database. Full text likely available.
Quote: "This article addresses the medical effects of nuclear
explosions and other forms of radiation exposure, assessment of radiation
dose, triage of victims, definitive treatment of radiation and combined-injury
casualties, and planning for emergency services after a terrorist
attack involving a nuclear device. It reviews historical events of
mass radiation-induced casualties and fatalities at Hiroshima, Chernobyl,
and Goiania, and discusses various scenarios for nuclear terrorism."
The first phase of treatment in a hospital:
"During the first 72 hours the initial phase of treatment will
be directed toward treatment of trauma and burns, external decontamination,
and very early initiation of potassium iodide, where appropriate.
After detonation of a nuclear weapon, most casualties will be combined-injury
patients. Emergency surgical care involves resuscitation, control
of hemorrhage, and minimization of sepsis with débridement
techniques."
Decontamination instructions:
"Removing clothing alone can decrease external radioactive contamination
by 90%.
Washing with soap and lukewarm or room-temperature water is effective
and removes another 90% of contamination (about 99% of the total is
removed after both steps have been performed). Soap emulsifies and
dissolves most contaminants. Wounds and body orifices usually are
decontaminated first. Wounds should be rinsed with saline. To prevent
cross-contamination, wounds and burns should be covered with waterproof
dressings before the skin is decontaminated. Abrasions and lacerations
usually are relatively easy to decontaminate. Stubborn contamination
may be excised from lacerations. Puncture wounds, most often on the
hands, are sometimes difficult because of poor access to the contaminants
and difficulty in determining the degree and depth of contamination.
Irrigation with standard water picks may be successful. Burns should
be rinsed gently with water and cleared of debris. In patients whose
burns cannot be completely decontaminated, most of the contamination
will remain in the burn eschar when it sloughs. Some patients may
have imbedded metal fragments (shrapnel). When metallic shrapnel is
removed, it should be evaluated for radioactivity and either shielded
or placed in a safe location. Potentially radioactive fragments should
be handled with forceps, not with gloved hands. Contaminated wastewater
can be released into sewers without restriction. For intact skin,
a wet washcloth and basin (with or without a low-velocity, low-volume
water spray) may be used to remove a significant amount of superficial
contamination. Gentle brushing may help remove contamination from
the skin, but care should be taken not to damage the skin, because
some contamination could be absorbed through injured skin. Experience
has shown that shampoo can be effective for skin decontamination in
addition to soap, if soap alone is inadequate. On some occasions,
povidone-iodine can be used as an antiseptic-germicide on the intact
skin. It has the added benefit of nonradioactive iodine absorption
through intact skin to block the thyroid partially when there is internal
contamination from radioactive iodine-131. Hair can be decontaminated
with any commercial shampoo. Cutting or clipping the hair, if appropriate,
can remove contaminants, but cutting the eyebrows should be avoided,
because they may not grow back. Fingernails and toenails should be
checked and cut if necessary."
"DECONTAMINATION TEAM DRESS:
Caregivers should follow strict isolation-type procedures (universal
precautions). Barrier clothing is worn, including cap, mask, eye protection,
gown, gloves, and shoe covers. All seams and cuffs should be secured
with masking tape. Ideally, a dosimeter should be worn at the collar
level. A complete surgical scrub suit ideally would include a plastic
apron or waterproof gown for use when washing contaminated patients
and double gloves, with the inner gloves taped to the scrub suit,
to prevent cross contamination, because glove changes may be necessary."
"The decontamination-treatment area for those injured needs to
be delineated and, if possible, established in an area away from the
main flow of emergency department activity, near a separate emergency
department entrance. It should be appropriate for both emergency medical
care and decontamination, with access to water. Ideally, the floor
should be covered and with taped-down nonskid plastic sheets (however,
butcher's paper or other appropriate covering may be substituted)."
"Skin decontamination needs to be done early because reducing
the time radioisotopes remain in direct contact with the skin lessens
the severity of the radiation burn that develops later [5], [16].
In contrast to thermal burns, which appear almost immediately, the
development of radiation burns takes weeks to evolve fully."
"Infections are a major cause of mortality in the irradiated
host because of immunosuppressive effects that result from declining
lymphohematopoietic elements secondary to radiation-induced bone marrow
aplasia (reversible or irreversible). After wounds or burns have been
débrided, topical antibiotics should be used, and the wound
should be covered with nonadherent dressings."
SHOWER AND SHELTER - WHAT TO DO AT HOME
"Massive amounts of contamination are injected into the lower
atmosphere, producing a downwind radioactive plume containing radioactive
dust and particles. Prolonged contact with fallout on the skin can
result in serious skin damage plus increased whole-body dose. Therefore,
the public response should be “shelter and shower.” Sheltering
(particularly at home) is prudent early in a radiologic event, because
families congregate at home and showers, clean clothing, food, and
water are available. Sheltering also provides authorities time to
assess the situation more completely. Evacuation might be indicated
later for people in some locations, depending on the specific situation
and the extended dose estimates. In other locations, remaining sheltered
may result in lower radiation exposure."
Management of nuclear casualties. (includes
abstract) Udeani JC; Topics in Emergency Medicine, 2002 Jun; 24 (2):
40-6, 79-82. Link - This link will work if you are logged into your
local public or school library database. Full text likely available.
Quote: "Radioactive agents pose a significant threat to the efficient
operation of any emergency department and challenge the ability of
emergency physicians to provide lifesaving patient care. A well-planned,
organized system of triage and hospital preparedness is critical.
All health care providers involved in the early treatment of these
patients must understand the clinical presentations, treatment options,
and preventive measures to prevent further contamination of other
individuals. This article reviews some of the important concepts in
management of nuclear catastrophes"
"Four mechanisms ofinjury are implicated in
trauma caused by explosions. Primary blast
injuries are the direct effects of rapid increases
in atmospheric pressure causing barotrauma.
Most of the primary blast wave
injuries tend to affect areas of tissue-fluid/
gas interface and result in most on-scene
deaths.^'' The most common organ affected is
the ear (tympanic membrane rupture). Patients
with ruptured tympanic membranes
have been exposed to pressures usually exceeding
15 psi.^"'' In a case series of 647 survivors
of bombings in Israel from 1994 to
1996, 29.8% of them had blast injuries; of
those injuries, 89.6% had tympanic membrane
injuries.^ The most common injury to the tympanic
membrane involves a linear tear to the
inferior portion of the eardrum.
Primary blast injuries to the lung produce
the most profoimd and serious life-threatening
problems to victims. Tliese injuries result from
a rapid increase in intrathoracic pressures. Victims
may suffer from a whole range of problems
including pneumothoraces, contusions,
subpleural petechiae, and parenchymal hemorrhages.
In addition, local disruption of blood
vessels in close proximity to air-filled spaces
may cause a bronchopleural fistula. Arterial air
embolism to the brain or heart may be the
most common cause of rapid death in initial
survivors of blast injuries.*' Blast injuries to the
howel involve mechanisms similar to pulmonary
injuries. Hematomas, petechiae, and
perforation are commonly encountered.*'"
Secondary' blast injuries are penetrating
trauma induced by flying debris. The blast
wind, which immediately follows the blast
wave, is a displacement of air that accelerates
debris. Tertiary injuries occur when the victim
is propelled by blast wind."^ Blunt and penetrating
traumas account for most of these injuries
and are usually seen in victims close to
the blast. Finally, quaternary' blast injuries are
miscellaneous blast events that include exposure
to toxic gases, radiation, bums, and crush
injuries sustained from collapsing buildings."
"Exposed skin and hair should be cleansed
with soap and water repeatedly until the
dosimeter readings are minimal."
Phone numbers:
Where can I get more information?
For more information about radiation and emergency response, see the
Centers for Disease Control and Prevention's website at http://www.bt.cdc.gov
or contact the following organizations:
• CDC at 800-CDC-INFO
• 1-800-BE-READY
• World Health Organization, Radiation and Environmental Health
Unit at www.who.int/ionizing_radiation/en
• The Conference of Radiation Control Program Directors at 502-227-4543
• The Environmental Protection Agency, Radiological Emergency
Response Team
• The Nuclear Regulatory Commission Office of Public Affairs
can be contacted at 301-415-8200
• The Federal Emergency Management Agency (FEMA) can be reached
at 202-646-4600
• The Radiation Emergency Assistance Center/Training Site at
865-576-3131
• The U.S. National Response Team
• The U.S.
Department of Energy (DOE) at 800-DIAL-DOE
Frequently Asked
Questions About a Nuclear Blast
Radiation Emergency Instructions for Individuals & Families
With the recent threats of terrorism, many people have expressed concern
about the likelihood and effects of a nuclear blast. The Centers for
Disease Control and Prevention (CDC) has developed this fact sheet
to describe what happens when a nuclear blast occurs, the possible
health effects, and what you can do to protect yourself in this type
of emergency.
What is a nuclear blast?
A nuclear blast, produced by explosion of a nuclear bomb (sometimes
called a nuclear detonation), involves the joining or splitting of
atoms (called fusion and fission) to produce an intense pulse or wave
of heat, light, air pressure, and radiation. The bombs dropped on
Hiroshima and Nagasaki, Japan, at the end of World War II produced
nuclear blasts.
When a nuclear device is exploded, a large fireball is created. Everything
inside of this fireball vaporizes, including soil and water, and is
carried upwards. This creates the mushroom cloud that we associate
with a nuclear blast, detonation, or explosion. Radioactive material
from the nuclear device mixes with the vaporized material in the mushroom
cloud. As this vaporized radioactive material cools, it becomes condensed
and forms particles, such as dust. The condensed radioactive material
then falls back to the earth; this is what is known as fallout. Because
fallout is in the form of particles, it can be carried long distances
on wind currents and end up miles from the site of the explosion.
Fallout is radioactive and can cause contamination of anything on
which it lands, including food and water supplies.
What are the effects of a nuclear blast?
The effects on a person from a nuclear blast will depend on the size
of the bomb and the distance the person is from the explosion. However,
a nuclear blast would likely cause great destruction, death, and injury,
and have a wide area of impact.
In a nuclear blast, injury or death may occur as a result of the blast
itself or as a result of debris thrown from the blast. People may
experience moderate to severe skin burns, depending on their distance
from the blast site. Those who look directly at the blast could experience
eye damage ranging from temporary blindness to severe burns on the
retina. Individuals near the blast site would be exposed to high levels
of radiation and could develop symptoms of radiation sickness (called
acute radiation syndrome, or ARS). While severe burns would appear
in minutes, other health effects might take days or weeks to appear.
These effects range from mild, such as skin reddening, to severe effects
such as cancer and death, depending on the amount of radiation absorbed
by the body (the dose), the type of radiation, the route of exposure,
and the length of time of the exposure.
People may experience two types of exposure from radioactive materials
from a nuclear blast: external exposure and internal exposure. External
exposure would occur when people were exposed to radiation outside
of their bodies from the blast or its fallout. Internal exposure would
occur when people ate food or breathed air that was contaminated with
radioactive fallout. Both internal and external exposure from fallout
could occur miles away from the blast site. Exposure to very large
doses of external radiation may cause death within a few days or months.
External exposure to lower doses of radiation and internal exposure
from breathing or eating food contaminated with radioactive fallout
may lead to an increased risk of developing cancer and other health
effects.
How can I protect my family and myself during a nuclear blast?
In the event of a nuclear blast, a national emergency response plan
would be activated and would include federal, state, and local agencies.
Following are some steps recommended by the World Health Organization
if a nuclear blast occurs:
If you are near the blast when it occurs:
• Turn away and close and cover your eyes to prevent damage
to your sight.
• Drop to the ground face down and place your hands under your
body.
• Remain flat until the heat and two shock waves have passed.
If you are outside when the blast occurs:
• Find something to cover your mouth and nose, such as a scarf,
handkerchief, or other cloth.
• Remove any dust from your clothes by brushing, shaking, and
wiping in a ventilated area, however, cover your mouth and nose while
you do this.
• Move to a shelter, basement, or other underground area, preferably
located away from the direction that the wind is blowing.
• Remove clothing since it may be contaminated; if possible,
take a shower, wash your hair, and change clothes before you enter
the shelter.
If you are already in a shelter or basement:
• Cover your mouth and nose with a face mask or other material
(such as a scarf or handkerchief) until the fallout cloud has passed.
• Shut off ventilation systems and seal doors or windows until
the fallout cloud has passed. However, after the fallout cloud has
passed, unseal the doors and windows to allow some air circulation.
• Stay inside until authorities say it is safe to come out.
• Listen to the local radio or television for information and
advice. Authorities may direct you to stay in your shelter or evacuate
to a safer place away from the area.
• If you must go out, cover your mouth and nose with a damp
towel.
• Use stored food and drinking water. Do not eat local fresh
food or drink water from open water supplies.
• Clean and cover any open wounds on your body.
If you are advised to evacuate:
• Listen to the radio or television for information about evacuation
routes, temporary shelters, and procedures to follow.
• Before you leave, close and lock windows and doors and turn
off air conditioning, vents, fans, and furnace. Close fireplace dampers.
• Take disaster supplies with you (such as a flashlight and
extra batteries, battery-operated radio, first aid kit and manual,
emergency food and water, nonelectric can opener, essential medicines,
cash and credit cards, and sturdy shoes).
• Remember your neighbors may require special assistance, especially
infants, elderly people, and people with disabilities.
Is a nuclear bomb the same as a suitcase bomb?
The ?suitcase? bombs that have been described in new stories in recent
years are small nuclear bombs. A suitcase bomb would produce a nuclear
blast that is very destructive, but not as great as a nuclear weapon
developed for strategic military purposes.
Is a nuclear bomb the same as a dirty bomb?
A nuclear blast is different than a dirty bomb. A dirty bomb, or radiological
dispersion device, is a bomb that uses conventional explosives such
as dynamite to spread radioactive materials in the form of powder
or pellets. It does not involve the splitting of atoms to produce
the tremendous force and destruction of a nuclear blast, but rather
spreads smaller amounts radioactive material into the surrounding
area. The main purpose of a dirty bomb is to frighten people and contaminate
buildings or land with radioactive material.
Would an airplane crash in a nuclear power plant have the same effect
as a nuclear blast?
While a serious event such as a plane crash into a nuclear power plant
could result in a release of radioactive material into the air, a
nuclear power plant would not explode like a nuclear weapon. There
may be a radiation danger in the surrounding areas, depending on the
type of incident, the amount of radiation released, and the current
weather patterns. However, radiation would be monitored to determine
the potential danger, and people in the local area would be evacuated
or advised on how to protect themselves.
Do I need to take potassium iodide (KI) if there is a nuclear blast?
Local emergency management officials will tell people when to take
KI. If a nuclear incident occurs, officials will have to find out
which radioactive substances are present before recommending that
people take KI. If radioactive iodine is not present, then taking
KI will not protect people. If radioactive iodine is present, then
taking KI will help protect a person's thyroid gland from the radioactive
iodine. Taking KI will not protect people from other radioactive substances
that may be present along with the radioactive iodine.
http://www.bt.cdc.gov
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