ASTRO Addresses Nuclear Radiologic Terrorism

Carolyn Vachani, MSN, RN, AOCN
OncoLink
Last Modified: October 6, 2002

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After the events of September 11, 2001, The American Society of Therapeutic Radiology and Oncology (ASTRO) Board of Directors put forth a mandate for training courses to prepare professionals for a radiologic terrorist event.  In response to the mandate, ASTRO has been working in conjunction with The American College of Radiology (ACR) and The American Association of Physicists in Medicine (AAPM) to develop a plan to increase disaster preparedness within the professional groups.  A lunch presentation held at the 44th Annual ASTRO meeting addressed what has been accomplished thus far and plans for the future.

Dr. Arl Van Moore, chairman of the ACR Disaster Planning Task Force, told attendees that the primary goal of the task force is to assist professionals in fulfilling the role they would undoubtedly be called upon to assume in the event of a disaster.  Radiation experts would be crucial to providing accurate, timely information to the public and the media.  Dr. Moore pointed out that The American Medical Association has been addressing disaster preparedness and bioterrorism, posting up to date information on their website, but has neglected to specifically discuss radiologic bioterrorism. 

A study, conducted by the Federation of American Scientists (FAS), concluded that radiologic attacks constitute a credible threat, and although some deaths may occur, the overriding goal of the terrorists is to create pandemonium and chaos, and that there would be large areas of contamination requiring cleanup, costing billions of dollars.  The group reported a need to train first responders, including hospital workers, emergency medical technicians, police, and fire fighters to deal with radiologic disasters.  Several pieces of legislation were recently passed to provide funding for much needed training, including The Public Health Security and Bioterrorism Preparedness and Response Act of 2002, signed by President Bush in June of 2002.

In response to the FAS study and assessed needs, the ACR Disaster Planning Task Force developed a primer for disaster preparedness, which is in its second edition and will be updated regularly.  The primer is available on both the ACR and ASTRO websites in PDF format.  In addition to the primer, the ACR website addresses physician and hospital preparedness, bioterrorism response aides, and federal and state resources.  Dr. Moore summed up his presentation by saying "a radiation disaster is a possibility for which we must be prepared".

James Smith, PhD, from the Centers for Disease Control (CDC), presented findings from a discussion group on hospital management of a radiological event.  The group of 40 invited participants included nurses, physicians, radiation safety professionals, and federal officials, among others.  Issues addressed by the group included triage, mental health concerns, community health, communication, training, and stockpiling of pharmaceuticals.  From these sessions, the CDC hopes to publish guidelines for hospital preparedness by the end of 2002. 

The Department of Defense has developed a biodosimetry assessment tool to be used in a radiologic emergency.  This tool is available on the Armed Forces Radiobiological Research Institute website.

Robert Ricks, PhD, Director of the World Health Organization's Collaborating Center for Radiation Emergency Assistance, suggested that terrorists would release biological agents without the use of an explosive device, therefore not attracting attention to the release.  In this situation, the attack may not be realized until people begin presenting to physicians offices and hospitals with complaints, when officials would put it all together.  Dr. Ricks discussed the management of patients after a radiation accident.  Like the other speakers, he emphasized that a radiation disaster is something for which we must be prepared.

Dr. Steven Leibel concluded the session by presenting ASTRO's goals for the future in relation to disaster preparedness.  These include developing a "frequently asked questions" document for radiation oncologists to use in response to public and media, continue to work with the ACR to update the primer, develop a one day course for radiation oncologists in disaster preparedness and offer these courses regionally.  In addition, the CDC is surveying the status of state disaster preparedness plans.

ASTRO, among other professional organizations, has felt the need to be better prepared for terrorist attacks in the wake of September 11th.  The collaboration of professional organizations is a step in the right direction, but there is much more to be done.  Professionals should check the websites of these organizations frequently for up to date information and guidance.  As one speaker stated, the best time to get prepared for an emergency is before, and not during the emergency.

Oncolink's ASTRO Coverage made possible by an unrestricted Educational Grant from Ortho Biotech.


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