Preparing for the Next Public Health Crisis

Establishing a Public Health Response Plan to 

Address Threats Such as the Gulf Oil Disaster

SOURCE: AP/Patrick Semansky

Workers clean up the gulf shore. The BP disaster reiterates 

why we need to better manage the short- and long-term 

responses required to address the public health threats 

such disasters pose whether they are manmade or due 

to natural causes.

By Ellen-Marie Whelan, Lesley Russell | July 12, 2010

Read the full report (pdf)

Download the executive summary (pdf)

Download the report to mobile devices and e-readers from Scribd

Video: The BP Oil Disaster and Public Health

We’ve all seen pictures of the dreadful and continuing aftermath of the explosion on the Deepwater Horizon oil well in the Gulf of Mexico. The environmental cleanup and the economic consequences of this will last far into the future, and it’s hard to imagine that the time will come when fumes from oil, chemicals, and burning no longer pollute the air, oceans aren’t covered with sheets of oil, beaches aren’t stained with tar, and marshes aren’t clogged with residues. But with hard work that will eventually be the case. At that point the Unified Command—which was established under U.S. Coast Guard leadership to manage the response to this disaster—will fold, the cleanup workers will go home, and the raft of workers brought in from diverse agencies as part of the emergency response will be pulled back to deal with other more urgent tasks.

But health threats from the oil spill may linger unseen, perhaps for more than a generation. And we will not be fully prepared to address the public health problems that arise in the future unless there is an effective and coordinated handover of responsibilities for protecting public health from the emergency response agencies to agencies with the capability and capacity for long-term monitoring and management. Federal agencies have been pulled in as needed in the gulf spill response, but it’s not clear that the Health and Human Services response has been synchronized from the top to ensure effective delivery and coordination.

In short, the spill reiterates why we need to better manage the short- and longterm responses required to address the public health threats such disasters pose whether they are manmade or due to natural causes.

No systematic long-term monitoring and oversight was put in place with the Exxon Valdez spill in 1989, and now we wonder what we missed. Several studies following the Prestige oil spill off the coast of Spain in 2002 indicate that some respiratory problems in cleanup workers didn’t show up until years after the spill. Additionally, evidence suggests DNA damage occurred to these workers that could lead to cancers and alterations in hormone status.

The responsibility for both the immediate and long-term responses can only be led by the administration from the highest levels. This is not an appropriate role for corporations, which cannot be trusted to put the long-term interests and needs of the affected communities ahead of their business concerns. The BP oil spill is a clear example of why we cannot allow the very corporation that caused the problem in the first place to be trusted with monitoring its potential health effects. The protection of public health has always been a key responsibility of the federal government, and we have previously called for the federal government to takeover this responsibility with respect to the gulf oil spill.

The gulf oil crisis reminds us that it is essential to have a response plan that is activated early and can continue into the future for as long as needed.

This is not the first time the nation has faced such a crisis, and it won’t be the last. We have faced public health threats from the World Trade Center attack on 9/11, Hurricane Katrina, and the Exxon Valdez oil spill, and from infectious agents such as SARS, Avian flu, and H1N1 flu that fortunately did not reach crisis proportions but could have. The responses, while effective, have not been always been well coordinated. The Government Accountability Office in 2008 identified important lessons from the WTC response that could help develop responder health programs in the event of a future disaster, but the GAO recommendations have not been fully addressed.

The gulf oil crisis reminds us that it is essential to have a response plan that is activated early and can continue into the future for as long as needed. We need to establish an architecture complete with clear lines of responsibilities and acknowledged trigger points for action. It should facilitate the involvement of the appropriate federal health agencies in addressing a potential public health emergency— from watchful waiting to emergency response to long-term monitoring and management.

We do not need a new entity to put this system in place. Government has the expertise among the many HHS agencies to handle any given public health emergency, but different players may be called on at different times depending on the event. This transfer of responsibilities will occur mostly between HHS agencies, but it may also involve nonhealth agencies as well. Obviously this is now the case with the gulf oil crisis, but it could occur with other incidents as well. With a large-scale infectious agent attack, for example, medication may need to be delivered to the homes of many affected Americans, and it has been suggested that the U.S. Postal Service could fill this role since they know how to get parcels to nearly every U.S. home.

We propose that a single, high-ranking HHS official be designated to launch and oversee the coordinated response plan implemented whenever a situation arises that can threaten public health. We recommend this leadership role go to the assistant secretary for health, or ASH. The ASH should have responsibility for determining when and how the response to a public health threat moves into the initial emergency phase and when it transitions to a long-term monitoring and management phase. The ASH would have responsibility for ensuring—in conjunction with other federal, state, and local agencies, academics, and the private sector—that needed services are delivered and information is collected, and that data, information, and resources are transferred to the responsible HHS agency or agencies.

This approach does not require new agencies or significant new authorities. But it will require the following:

• Clarification of roles and responsibilities of all agencies and offices involved
• Robust surveillance systems with standardized data that can analyze information collected from a variety of sources
• Sufficient financial resources and the appropriate workforce to develop capacity and maintain long-term monitoring systems
• Mechanisms in place to address ongoing medical needs for individuals affected by the crisis
• A financial infrastructure to assure funding is available for immediate and longer-term health needs

This paper looks at the issues that must be addressed in the immediate (emergency) response situation to facilitate the eventual handover to a long-term monitoring and management system, what that system should incorporate, how to trigger the emergency response and the long-term monitoring phase, and how the different agencies should work together in a seamless fashion. But first, it examines how our current system lacks an overall plan to maximize the contribution of all available agencies and organize the strongest possible public health response.

Read the full report (pdf)

Download the executive summary (pdf)

Download the report to mobile devices and e-readers from Scribd

Video: The BP Oil Disaster and Public Health

U.S. health-care system unprepared for major nuclear emergency, officials say

By Sheri Fink, Thursday, April 7, 12:40 PM

U.S. officials say the nation’s health system is ill-prepared to cope with a catastrophic release of radiation, despite years of focus on the possibility of a terrorist “dirty bomb” or an improvised nuclear device attack.

A blunt assessment circulating among American officials says, “Current capabilities can only handle a few radiation injuries at any one time.” That assessment, prepared by the Department of Homeland Security in 2010 and stamped “for official use only,’’ says “there is no strategy for notifying the public in real time of recommendations on shelter or evacuation priorities.”

The Homeland Security report, plus several other reports and interviews with almost two dozen experts inside and outside the government, reveal other gaps that might increase the risks posed by a nuclear accident or terrorist attack.

One example: The U.S. Strategic National Stockpile stopped purchasing the best-known agent to counter radioactive iodine-induced thyroid cancer in young people, potassium iodide, about two years ago and designated the limited remaining quantities “excess,” according to information provided by the U.S. Centers for Disease Control and Prevention to ProPublica. Despite this, the CDC Web site still lists potassium iodide as one of only four drugs in the stockpile specifically for use in radiation emergencies.

The drug is most effective when administered before or within hours of exposure. The decision to stop stockpiling it was made, in part, because distribution could take too long in a fast-moving emergency, one official involved in the discussions said. The interagency group that governs the stockpile decided that “other preparedness measures were more suitable to mitigate potential exposures to radioactive iodine that would result from a release at a nuclear reactor,” a CDC spokesperson said in an e-mail to ProPublica.

Japan’s ongoing nuclear crisis might prompt officials to revisit that conclusion. With radiation levels higher than expected outside the evacuation zones in some areas, the Japanese government recently asked the United States for potassium iodide. The federal government agreed to send some of its dwindling stockpile of the liquid version used in children or adults, which is due to reach its expiration date within about a year. The government is “finalizing the paperwork,” according to an official with the U.S. Department of Health and Human Services.

Another example: Although hospitals near nuclear power plants often drill for radiological emergencies, few hospitals outside of that area practice such drills. Most medical personnel are untrained and unfamiliar with the level of risk posed by radiation, whether it is released from a nuclear power plant, a “dirty” bomb laced with radioactive material or the explosion of an improvised nuclear weapon.

Many states don’t have a basic radiation emergency plan for communicating with the public or responding to the health risks. Even something as fundamental as the importance of sheltering inside sturdy buildings to avoid exposure to radioactive fallout from a nuclear explosion — which experts say could determine whether huge numbers of people live or die — hasn’t been communicated to the public.

Recently the White House and other federal officials concerned about deficiencies in public readiness met with experts to explore what might be done to make nuclear events more survivable. “The bottom line is that the citizenry are not prepared at all,” said Michael McDonald, president of Global Health Initiatives, who participated in White House and congressional briefings.

The Department of Homeland Security report acknowledges that officials are poorly prepared to communicate with the public and that the current organization of medical care “does not support the anticipated magnitude of the requirements” following an attack with an improvised nuclear device. It says the United States has “limited” treatment options for radiation exposure and notes that staff and materials aren’t in place to carry out mass evacuations after a large-scale release of radiation. “The requirements to monitor, track, and decontaminate large numbers of people have not been identified,” the report said.

Underlying the preparedness problems is the need for additional research. It isn’t known, for example, how a nuclear blast and electromagnetic pulse would affect modern communications infrastructure, or to what extent modern buildings can protect people from nuclear blast, heat and radiation effects.

A report prepared last year by the Council on State and Territorial Epidemiologists was equally pessimistic about U.S. readiness. Based on surveys of public health officials in 38 states, it concluded that “in almost every measure of public health capacity and capability, the public health system remains poorly prepared to adequately respond to a major radiation emergency incident.” Forty-five percent of the states surveyed had no radiation plan at all for areas outside federally mandated nuclear power plant emergency zones. Almost 85 percent of the officials said their states couldn’t properly respond to a radiation incident because of inadequate planning, resources, staffing and partnerships.

More troubling was the fact that the situation hadn’t improved since a similar survey was taken in 2003. “Most of those comparisons appear to indicate either the same poor level of preparedness and planning or a decline in capacity,” the report said.

The nation’s investment in emergency preparedness seems likely to decrease rather than increase, experts say, because of massive federal and state deficits.

President Obama’s proposed budget would cut funding for a federal hospital preparedness program by about 10 percent. The release of proposed federal regulations that would require hospitals to meet emergency management standards has been delayed.

“If the public isn’t demanding that we be better prepared, the politicians won’t put the money in for us to be better prepared and the regulators” won’t require it, said Arthur Cooper, a professor of surgery at Columbia University and director of trauma and pediatric surgical services at Harlem Hospital Center. “It all begins with the public knowing this is a problem that’s got to be solved and it’s worth spending some money and effort to try to be prepared in a real way.”

Hospital preparedness

In the days after nuclear fuel at Japan’s Fukushima power plant began to overheat, the greatest threat to one hospital within 50 miles of the plant wasn’t radiation, but fear. Many staff members had fled, and government emergency workers hadn’t delivered food and medicine needed for the 120 patients. Masaru Nakayama, director of Kashima Hospital in Iwaki, Japan, said it took time to convince people that the area around the hospital was in fact safe.

Yet in national surveys, U.S. hospital workers have expressed fears similar to those of Nakayama’s staff, saying they would be less willing to report to work for a radiological or nuclear incident than for other types of emergencies. They also said they feel unprepared for the work they would be required to do, even though the risk of radiation exposure from treating contaminated patients outside the danger zone is considered negligible when workers are properly trained and wear protective equipment.

“The level of education for disasters across the board in American hospitals is really pretty terrible,” Cooper said. “People don’t have a good sense of how to focus on any disaster, let alone a radiation disaster. Radiation adds a level of complexity that most folks aren’t prepared to face.”

Cooper said hospital drills have improved in recent years, “but they occur far too seldom and they end far too quickly and they’re far too superficial to really prepare a hospital for a major disaster.”

“Shutting down part of the hospital’s work for a period of time to conduct a full-scale exercise, that’s daunting for a hospital,” he said. “Trying to ‘do the right thing’ and provide employees with in-depth disaster education across the board is not something they’re going to do unless it becomes a major regulatory mandate.”

William Fales, an associate professor of emergency medicine at Michigan State University and a regional medical director in southwest Michigan, said he has yet to see a hospital outside of a nuclear reactor’s emergency planning zone conduct a drill for a nuclear or radiological emergency.

In the courses Fales teaches for medical professionals, he has seen firsthand what little baseline knowledge many of them have. In one exercise they are treating mock bombing victims when they are suddenly told that the explosive was a dirty bomb packed with radioactive material. Typically they drop everything, run the patients outside and decontaminate them. But that reflects a lack of knowledge of a basic principle — that medical workers should treat a patient’s life-threatening traumatic injuries from a bomb blast before worrying about radiological decontamination.

“It’s amazing,” Fales said. “It’s a knee-jerk reaction because they hear the word ‘radiation.’ ... Imagine what would happen if, God forbid, we had a real terrorist bombing and a rumor started on TV that it was a dirty bomb. How many potentially salvageable trauma patients would be compromised by that reaction?”

Health workers made a different mistake at a recent radiation emergency conference sponsored by the CDC. When a workshop leader in a white decontamination suit asked nurses to practice cutting the garments off a mock contamination patient, one volunteer slid the scissors quickly from ankle to torso. That could send radioactive debris flying, the leader warned. The more careful approach took about two minutes—a long time if hundreds are awaiting assistance.

Knowing when a patient has been contaminated versus exposed to radiation is an important distinction that is acquired with simple training. “If you put a chicken in a microwave and cook it, it comes out a rubbery chicken, but it doesn’t come out contaminated,” Fales said. “It’s been irradiated, but it’s not radioactive.”

Fales said few participants in his training courses think about doing a quick survey with a radiation detector to verify the existence of contamination. At many hospitals, most workers don’t even know where the Geiger-Müller counter is kept.

Facing a worst-case emergency

The American Medical Association devoted the March issue of its journal, Disaster Medicine and Public Health Preparedness, to the No. 1 scenario on the federal government’s list of 15 planning scenarios for emergency preparedness: a nuclear explosion equivalent to the force of a 10-kiloton trinitrotoluene (TNT) blast on a major population center.

Using Washington as an example, one study estimated that 180,000 hospital beds could be needed after such a detonation and that 61,000 of those patients could require intensive care. But Washington typically has only about 1,000 vacant beds — and there are only about 9,400 vacant intensive care unit beds in the entire United States.

After a nuclear blast, hospitals probably would fill with trauma patients. Later, others would arrive with acute radiation syndrome, which can take days to manifest and affects multiple organ systems. Without supportive care, about 50 percent of people exposed to 3.5 Gray, a measure of radiation dose, would die. Proper care would almost double the exposure level at which 50 percent would survive, but only a small fraction of American medical professionals have training and expertise in treating radiation injury.

Given that not enough beds would be available, hospitals and first responders would have to choose which patients to save. Authors of the journal articles recommend basing those decisions in part on how much radiation exposure patients have received and treating only those with a reasonable chance of surviving. “It’s very hard to turn someone away who needs medical care who comes to your hospital,” Cooper said. “I don’t think any American hospital is prepared to do this kind of triage.”

The staff would be hampered by a shortage of the laboratory equipment needed to help evaluate so many patients, a lack of approved devices to rapidly quantify the level of radiation exposure and a lack of approved medicines to counter the cellular effects of radiation. About $200 million in federal funding has been invested since 2008 to develop diagnostics and treatments, but HHS officials say most are still years away from approval.

Even getting the protective measures that do exist, including potassium iodide, where they are needed is a challenge. Michigan has developed a round-the-clock dispatch system with ready-to-go medical packs designed for a range of emergencies and stored at 16 sites around the state. Four of those sites stock radiological countermeasures.

“We think we’re one of the few states that’s really designed a statewide system that can deliver these countermeasures,” Fales said. In the case of one particularly expensive drug provided by the federal government, “my sense is in a lot of states it’s sitting in a warehouse in the state capital, hopefully secure and warm. On a Saturday night if something goes boom in a location on another side of the state, how long will it take to get it to where it’s needed?”

Improving future response

One of the top priorities in preparing for a major nuclear disaster is readying ordinary citizens for the role they will have to play. “The common misperception is any nuclear blast means everybody’s vaporized,” McDonald said. “That’s just wrong.”

But experts say the government has done little to educate the public about its responsibilities.

When police and fire departments have run nuclear exercises in conjunction with federal authorities, “they haven’t included the public,” McDonald said. “They’ve basically treated it like a classified event.”

The motivation might be to safeguard the public from fear and panic, McDonald said, but “it does almost no good for the federal government to be talking about this with the top officers and not have the public understand what to do.” Although government Web sites including ready.gov and cdc.gov contain useful preparedness information, there is no single Web site the public can turn to for up-to-the-minute public health information in disasters.

One of the crucial things the public must know is when to evacuate and when to shelter underground or in a heavily constructed building. Yet making decisions on sheltering and evacuation and communicating those decisions to the public is precisely what the Homeland Security report found government agencies aren’t inadequately prepared to do.

Sheltering in place could make a major difference in how many people live or die, because the danger of fallout decreases rapidly as radioactive elements decay and debris is dispersed. The dose rate drops 90 percent every seven hours.

“You can’t wait until the event to put out this information,” said James James, director of the American Medical Association’s Center for Public Health Preparedness and Disaster Response.

Many experts predict that without more education, people probably would flee as many are doing in Tokyo and as many Americans did after the Three Mile Island nuclear accident in 1979. An estimated 144,000 people — many times more than the number advised to do so — needlessly left the area because of fear and inadequate information.

“Such an exodus would extend panic and devastation far beyond the locus of the event, draining food, water, medicines, gasoline and other resources from surrounding communities and potentially causing gridlock that would severely compromise many elements of the official disaster response,” according to a modeling study published by University of Chicago researcher Michael Meit and colleagues in the same issue of the journal.

Not knowing what to do would be especially harmful to those who are least likely to be able get out of harm’s way: children and the elderly, people with disabilities, and patients with chronic illnesses requiring regular treatment. The federal government enacted a number of reforms after elderly and disabled people died after Hurricane Katrina. But those reforms aren’t necessarily reflected in critical front-line emergency plans. A federal court in California recently found the city of Los Angeles violated the Americans with Disabilities Act and other laws for failing to consider the needs of the disabled in its emergency response plans.

Eric Toner, a senior associate at the University of Pittsburgh Medical Center’s Center for Biosecurity in Baltimore, said the key to protecting as many people as possible during an emergency is offering them frank communication about what is known and unknown.

“Nature abhors a vacuum. If credible officials aren’t out there constantly, that void will get filled with people who don’t know what they’re talking about or have different agendas.”

Still, there is no guarantee the public will act on information once they get it. Several years ago Michigan, like many other states, sent vouchers for potassium iodide to people living within a 10-mile radius of a nuclear power plant. The goal was to give them the medication free of charge from local pharmacies, so they wouldn’t risk their lives searching for the drug in an emergency, when they should be sheltering in place or evacuating.

But only about 6 percent of the residents picked up their allotted supply, said Fales, the Michigan regional medical director, a rate that’s similar to some other states. “So much for pre-event planning,” he concluded.

FROM NEI: Nuclear Power Plant Security

Nuclear Power Plant Security

View this fact sheet in printer-friendly PDF

Key Facts

• The defense-in-depth philosophy used in the construction and operation of nuclear power plants provides high levels of protection for public health and safety.
• The U.S. Nuclear Regulatory Commission holds nuclear power plants to the highest security standards of any American industry. The industry meets or exceeds these requirements in all areas. As a result, America’s nuclear power plants are our nation’s most protected and secure industrial assets. Well-armed and highly trained security forces protect every U.S. nuclear facility. These forces are routinely drilled and tested to ensure their readiness.
• Since Sept. 11, 2001, security provisions at nuclear power plants have been strengthened. The NRC has issued new security requirements for nuclear plant sites, and all U.S. plants have met these requirements.
• As part of 2005 comprehensive energy legislation, Congress required that the NRC officially increase security requirements. The bill also mandated background checks on nuclear power plant workers and allowed guards to use more advanced weaponry.
• The industry has added about 3,000 officers and upgraded physical security over the past four years. The industry has spent an additional $1.5 billion on security since September 2001.
• The industry coordinates with the NRC, Department of Homeland Security (DHS) and intelligence agencies on the assessment of potential threats and the specific actions by industry security forces in the event of a credible threat against a commercial nuclear facility.
• All commercial nuclear plants have emergency response procedures and contingency plans in the event of a plant accident or terrorist event. These procedures are evaluated every three years during extensive drills involving plant personnel and local police, fire and emergency management organizations. NRC and Federal Emergency Management Agency (FEMA) expert teams evaluate these drills.

Plant Security Meets All Federal Requirements
The nuclear energy industry is one of the few industries whose security program is regulated by the federal government. The NRC’s requirements for nuclear power plant security are predicated on the need to protect the public from the possibility of exposure to radioactive releases caused by acts of sabotage. Intelligence information and incidents around the world are analyzed to ensure plant protection regulations are updated to reflect potential threats.

The NRC’s security regulations are designed to ensure the industry’s security force can protect against a range of threats. The threat against which the industry must defend is characterized as a suicidal, well-trained paramilitary force, armed with automatic weapons and explosives, and intent on forcing its way into a nuclear power plant to commit radiological sabotage. Such a force may have the assistance of an “insider,” who could pass along information and help the attackers. The presumed goal of such an attack would be the release of radioactive material from the plant.

The NRC’s “design basis threat” provides a foundation for developing defensive response strategies that cover a variety of situations. The NRC determines the design basis threat using technical studies and information received from intelligence experts and federal law enforcement agencies. It is reviewed by the agency twice a year.

Since Sept. 11, 2001, the NRC has twice raised the threat level against which nuclear plants must provide protection. In doing so, the NRC has assumed an increased number of possible attackers and weapons capabilities.

Congress also responded to public concern over nuclear plant security by including in the Energy Policy Act of 2005 several provisions that increase security requirements or capabilities. As part of the bill, the NRC was directed to increase officially the scope of the design basis threat. It also requires plants to fingerprint and conduct background checks of their employees. The bill also allowed the NRC to mandate certain advanced weaponry for plant guards. In addition, the bill increased federal penalties for sabotage and for bringing unauthorized weapons on to a nuclear power plant site.

Many industry security elements are considered “safeguards” information, which means they are controlled on a “need-to-know” basis. Clearly, plant protection capabilities and response strategy should be controlled and protected from public disclosure to avoid compromises that might benefit a potential adversary.

Defense-in-Depth Against Potential Threats
The FBI considers security forces and infrastructure at nuclear power plants formidable and considers nuclear power plants difficult to penetrate. In addition, the defense-in-depth features that protect the public from radiological hazard in the event of a reactor incident also protect the plant’s fuel and related safety systems from attempted sabotage. The design of each plant emphasizes the reliability of plant systems, redundancy and diversity of key safety systems, and other safety features to prevent incidents that could pose a threat to public health and safety.

Steel-reinforced concrete containment structures protect the reactor. Redundant safety and reactor shutdown systems have been designed to withstand the impact of earthquakes, hurricanes, tornadoes and floods. Areas of the plant that house the reactor and used reactor fuel also would withstand the impact of a wide-body commercial aircraft, according to peer-reviewed analyses by the Electric Power Research Institute, a Palo Alto, Calif.-based research organization. Plant personnel are trained in emergency procedures that would be used to keep the plant safe from a sabotage attempt.

A two-day national security exercise conducted by the Center for Strategic and International Studies (CSIS) in 2002 found that nuclear power plants would be less attractive targets to terrorist organizations because of the industry’s robust security program. The exercise was designed to explore difficulties and reveal vulnerabilities that might arise if the nation were faced with a credible, but ambiguous, threat of a terrorist attack on American soil.

“Silent Vector” was developed and produced by CSIS in partnership with the ANSER Institute for Homeland Security and the Oklahoma City National Memorial Institute for the Prevention of Terrorism. Potential targets included refineries, large liquefied natural gas or liquefied petroleum gas storage operations, pipeline infrastructure, petroleum terminals, nuclear power plants, chemical operations, and dams.

CSIS President John Hamre said that nuclear power plants “are probably our best-defended targets. There is more security around nuclear power plants than anything else we’ve got. … One of the things that we have clearly found in this exercise is that this is an industry that has taken security pretty seriously for quite a long time, and its infrastructure, especially against these kinds of terrorist threats, is extremely good.”


Security Increased Since Sept. 11, 2001
Immediately after the events of Sept. 11, 2001, security at every nuclear power plant was placed on its highest level of alert. Nuclear plant security now is consistent with DHS threat levels.

As a result, access to the plants is more strictly controlled, the defensive perimeters have been extended and reinforced, and security forces and capabilities have been augmented. Further, coordination with law enforcement, the intelligence community and the military has been enhanced. At some plants, these efforts have been supplemented by National Guard, U.S. Coast Guard, state police or other forces.

In 2002, the NRC formalized many of the enhancements to security that the industry already had implemented. The agency subsequently issued new requirements further restricting access authorization.

In 2003, the NRC issued rules limiting the working hours of security personnel and requiring increased training, including weapons proficiency. All plants met these requirements in 2004.

As a result of these mandates, each nuclear plant site has spent an average of nearly $70 million for physical improvements to improve security. In addition, the industry’s total guard force was increased by approximately 60 percent.

Site Security Measures
All commercial nuclear plants have established extensive security measures. Plant operators and the NRC inspect these measures and test them in drills to uncover any weakness. Security measures include:

• physical barriers and illuminated detection zones
• approximately 8,000 well-trained and well-equipped armed security officers at 64 sites who are on duty all day, every day
• surveillance and patrols of the perimeter fence
• intrusion detection aids (including several types of detection fields, closed-circuit television systems and alarm/alert devices)
• bullet-resisting barriers to critical areas
• a dedicated contingency response force.
  

All threats will be countered with dedicated, tactically trained, well-armed security officers who collectively determine the nature of a threat, assess its magnitude and take aggressive steps to deter the threat.

Controlled Access
Access to a nuclear power plant requires passage through a larger “owner-controlled area” surrounding the plant.

Access to an interior fenced area—the protected area, where the reactor building is located—is controlled by security officers and physical barriers. Vehicle barriers and/or other physical boundaries ensure the protected area of the plant cannot be breached by a direct vehicular assault or by detonation of a vehicle bomb. All vehicles, personnel and material entering the protected area first must be thoroughly inspected by security officers to ensure that no weapons, explosives or other such items are brought onto the plant site.

Access to the “protected area” of the plant is controlled through the use of physical barriers, intrusion detection equipment, closed-circuit surveillance equipment, a designated isolation zone and exterior lighting.

Access to the inner areas of the plant where vital equipment is located also is controlled through the use of physical barriers, locked and alarmed doors, and card-reader or hand geometry access control systems.

The barriers are substantial enough to effectively delay entry to allow for an effective armed response by plant security forces. Within the protected zone, access to all vital areas of the plant is even more secure. This access may be controlled by a security officer or provided by computer-controlled “key-card” access systems. Plant employees must have a documented need prior to gaining access to each vital area, and their movements are tracked by key-card access points throughout the vital area.

Reactor Operators Act in Concert With Security
Reactor operators train frequently to be sure they can respond to a range of unusual events. Plant operators have emergency procedures in place specifically for security situations, including automatic shutdown of the reactor in the event of an attack. Emergency planning and public notification systems support protection of public health and safety. The NRC periodically evaluates these plans during exercises or drills, which also may involve local police, fire and emergency management organizations.

Protecting Against An Insider Threat
All nuclear power plants have programs that reduce the potential for threats from plant personnel, or “insiders.” These include authorization criteria for those allowed unescorted access to the plant’s protected area and “fitness-for-duty” programs to deter drug and alcohol abuse.

Strong behavioral observation programs are in place requiring personnel to be trained to observe and report behavior that may be a potential threat to the normal operation of a nuclear power plant. In addition, many companies provide teamwork development programs that promote commitment and accountability in the work force.

Access Authorization
Before new nuclear plant employees or contractor employees are allowed unescorted access to the protected area, they must pass several evaluations and background checks to determine whether they are trustworthy and reliable. These include drug and alcohol screening, psychological evaluations, a check with former employers, education records, criminal histories (through the FBI) and credit histories.

Fitness-for-Duty Programs
Companies that operate nuclear power plants demand and ensure that personnel perform their duties in a safe, reliable and trustworthy manner, and are not under the influence of legal or illegal substances, or mentally or physically impaired from other causes, that would adversely hinder their ability to competently perform their duties. Employees who have unescorted access to the plant’s protected area must maintain their fitness-for-duty. The NRC requires companies to conduct random drug and alcohol testing on their employees. At least half of all employees are tested annually.

Behavioral Observation
Employees with unescorted plant access are subject to continual behavioral observation programs. This observation is conducted by personnel who have been trained to do so. The purpose is to detect individual behavioral changes that, if left unattended, could lead to acts detrimental to public safety. Employees are offered counseling if they have job performance problems or exhibit unusual behavior. Similarly, anyone who appears to be under the influence of drugs or alcohol is immediately removed from the work area for evaluation.

Further Improvement Through Coordination
The nuclear energy industry recognizes that there is a theoretical possibility of an attack beyond the capabilities of plant security. In such cases, plant personnel would help respond in coordination with local, state and federal authorities. Nuclear plants are pursuing several different efforts to facilitate better coordination between the facilities and local, state and federal entities.

The nuclear energy industry is the first industrial sector to participate in the DHS Comprehensive Review Program. The comprehensive reviews examine every element of the critical infrastructure, including a thorough security assessment. DHS provides recommendations on additional measures that can be taken to protect against and mitigate possible terrorist attacks.

During these comprehensive reviews, a multidisciplinary team spends a week reviewing a site’s vulnerabilities and security plans and also spends three to five days at the site interacting with security personnel, emergency planning and response staff, and state and local law enforcement and emergency responders. All nuclear power plants are expected to complete comprehensive reviews by July 2007.

The industry is fully committed to working with all levels of government to provide the best security possible to deter an attack and to respond forcefully and swiftly should one occur. The industry must always satisfy the security requirements imposed by the NRC. It is working constantly to improve security at nuclear plants through training, drills and exercises; implementation of new technology; and cooperation with government entities such as DHS, the FBI and local law enforcement.

relevant links:

• U.S. Nuclear Regulatory Commission
• U.S. Environmental Protection Agency
• National Council on Radiation Protection and Measurements
• Federal Emergency Management Agency
• Health Physics Society
• NEI Public Bookmarks