Exercise prepares public health and partners to respond to a radiological emergency

In Brief

The New York State Department of Health led a cross-jurisdictional exercise to examine its response to a radiological threat in summer 2009. The Empire 09 exercise involved testing myriad strategies to respond to two "dirty bombs" (Radiological Dispersal Devices) within New York's capital city of Albany.

Background

New York State public health agencies are currently developing programs and strategies to address the threat of radiation emergencies. Release of radioactive particles can be accidental or intentional. Although radiation preparedness is not a required public health activity, many state health departments expect to take a lead role in communicating with the public, determining whether protective pharmaceutical countermeasures are needed, and screening and analyzing samples from people and the environment for potential contamination. Additionally public health agencies may find themselves responsible for helping to monitor long-term health effects in the affected community.

The New York State Department of Health led a cross-jurisdictional exercise to examine its response to a radiological threat in summer 2009. The Empire 09 exercise involved testing myriad strategies to respond to two "dirty bombs" (Radiological Dispersal Devices) within New York's capital city of Albany.

The practice

The Empire 09 exercise required 18 months of planning and took place over a three-day period. Responders from more than 30 federal, state, and local agencies gathered at 13 different locations in Albany to participate in a coordinated response to a simulated dirty bomb scenario. Hosted by the New York State Disaster Preparedness Commission and sponsored by the U.S. Department of Energy/National Nuclear Security Administration (DOE/NNSA), Empire 09 involved personnel from the federal government, the state governments of New York and Vermont, Albany county and city agencies, and agencies in nearby Rensselaer County. Participants included approximately 660 exercise players/responders, 150 evaluators, 65 foreign observers, and 52 domestic VIPs.

Empire 09 consisted of three phases:

  1. The first 48 hours after detonation of two dirty bombs containing radioactive material
  2. Field operations occurring up to 120 hours after detonation
  3. A governmental transfer of authority and plans to monitor long-term health effects.

The goals of phases 1 and 2 were to coordinate between multiple agencies and levels of government to determine the type of radioactive particles contained in the bombs, evaluate the radiation's immediate effect on public health, assess environmental contamination, and evaluate damage to infrastructure.

Much of the Empire 09 exercise focused on how to provide care for people subject to mandatory or voluntary evacuation. One of public health's key activities for determining how to screen, treat, and communicate with the public involved setting up a Community Reception Center (CRC) for people who had potentially been exposed to radiation. During the drill, evacuation was mandated in downtown Albany, stretching across the Hudson River to areas in Rensselaer County. Planners established a CRC in a vacant building on the State Campus to monitor the health of evacuees.

The CRC was jointly established by radiation control and public health agencies, with significant assistance from environmental health staff, state and local emergency response organizations, the Medical Reserve Corps, local HAZMAT teams, law enforcement, and volunteers. Local and State health departments and radiation control partnered to offer expertise and experience in setting up the CRC, collecting urine samples to evaluate whether people had been internally contaminated and were in need of protective countermeasures, establishing a method for tracking long-term health effects in exposed people, and quickly preparing and distributing health education to the public. Sections included screening areas where exposed people could be assessed using hand-held monitors or walk-through portal monitors, a special needs area for people with animals and/or health issues, decontamination areas for showering and changing clothes, and stations where evacuees could fill out forms and receive information.

A streamlined process assured the separation of contaminated people and materials from those who had showered, put on clean clothes, and been externally assessed for radioactive particles. Staff screened all people for alpha-particle and gamma radiation with a hand-held radiation detector before asking them to walk through the full-body portal monitor.

After people were assessed for external contamination, staff assisted people who had special needs and guided people who had not showered to an area where they could shower and change clothes. Decontaminated people were asked to fill out a survey describing their exposure to the dirty bombs, their location at the time of the event (indoors, outdoors), and the length of time they were exposed. Based on this information, they could potentially be asked to undergo medical screening for internal contamination (e.g., urinalysis). People dropped off their forms at a station for "clean" materials, and behavioral health counselors were also made available at this point.

Public health and radiation control partners planned the exercise for 18 months, including time spent administering training on how to conduct field sampling and surveying. Planning staff also developed a variety of materials related to running the CRC, including job action sheets, message maps, laboratory protocols, victim scripts, and other infrastructural protocols. Having different types of expertise available at the CRC contributed to a comfortable, safe, and reassuring experience for the public. Additionally, public health's experience with setting up Points of Dispensing (PODs) contributed to a smooth CRC operation.

Results

Collaboration between more than 30 agencies in multiple jurisdictions led to a streamlined exercise of health capabilities for a topic still relatively new to public health preparedness. More than a year of planning and developing tools, culminating in a three-day exercise, gave agencies the significant strategies and resources to keep their communities safe in event of a radiation emergency.

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