Background: ICRP recommendations need to be made fit for purpose for the response to a nuclear or radiological emergency. While the System of Radiological Protection has performed well to meet its primary objective ‘to contribute to an appropriate level of protection for people…’ in normal, routine activities (planned exposure situations), the System has failed in its objective related to protection of the people in emergency exposure situations. This is evident from the excess deaths, increases in morbidity (e.g., diabetes, heart diseases) and other severe effects (e.g., mental, economic, social) observed after the Fukushima Daiichi nuclear power plant accident. These adverse effects resulted from protective actions taken to avert radiation exposure, consistent with international recommendations, even though the radiation health effects avoided are negligible and not discernible. These actions were therefore not justified based on the hazard to health from radiation exposure. Too much emphasis is given to protection of people from the radiation, without due consideration to the impact of the protective action. Thus justification – to do more good than harm – is not being realised. The principle of justification has not been thoroughly or correctly considered before, in part because no tools were provided to allow the risk of protective actions to be put in perspective, so our analysis will provide a technical basis for the development of such tools.
Methods: Meta-analysis of more than 600 papers focusing on protective actions and non-radiological health effects for different disasters (including nuclear and natural disasters). Analysis in terms of absolute risk (cases per 1000) of the health effects resulting from protective actions and radiation health effects from the averted dose based on the LNT fatal risk coefficient of 5% per Sv.
Results: Preliminary results are presented. We estimate approximately 15 excess early deaths per 1000 among the general population and 30 among those in long term care facilities following dislocations resulting from protective actions, while only 1 hypothetical excess radiation-induced cancer (late) death per 1000 would be averted if protective actions are taken at 20 mSv total effective dose – a criterion used in many countries for implementation of protective actions.
Conclusions: Implementing protective actions can result in more excess deaths than assumed to result from the radiation expose averted. Such negative impacts to the health of people must be accounted for in the System of Radiological Protection and recommendations concerning their application, or they are failing to protect people effectively.
Keywords: mergencies; Protective actions; Justification; Averted dose; Emergency exposure situation
Thanks, I enjoyed your presentation, and your clever title :). We addressed this issue in ICRP Publication 146 RP of People and the Environment in the Event of a Large Nuclear Accident, based primarily on experience from Chernobyl and Fukushima. However, we did not go into detail about decision aiding tools like the one you presented. These are essential for decision makers, and work to develop and use them should be encouraged.
However, at the moment a decision needs to be made, it can be difficult to know what dose might be averted. Decision makers will be faced with great uncertainty, especially early on when information is scarce. A tool like what you presented can help them understand impacts of an action like relocation, but the impacts of not relocating won't be well known until later.
Thank you very much Christopher to you and ICRP for giving me the opportunity to present my research. It's very true that dealing with uncertainty is a major challenge for decision makers in NPP emergencies. It's also difficult to communicate this uncertainty and present complex information in an understandable and useful way. I hope this tool is a first step and welcome feedback and comments from other colleagues about this issue.
An excellent and thought provoking presentation. I hadn't seen rates put to the harm of protective actions in this way before.
Many thanks Keith for your comment. I will soon be submitting my work to a journal for publishing (hopefully!) and would be happy to share with you the basis for my analysis.
Jessica, I've been thinking a bit more about your presentation. We see evidence of reduced life quality in those caught up in nuclear emergencies. But what causes it? The deaths of frail and elderly people during or shortly after an uncomfortable evacuation are easy to assign to the evacuation but otherwise it is more difficult.
If healthy people are evacuated but returned to their homes within days, do they suffer reduced life quality? If so, is this due in some way to the trauma of the evacuation itself or due to long term mistrust of their now slightly radioactive environment or due to a reduction in the standard of living due to reduction of economic activity in their area?
If it is the long-term effects that are causing the long-term health effects then we might want to retain the protective actions but provide better long-term care and counselling for those involved.