ICRP Publication 96

Abstract - There is a need for professional advice on measures to be undertaken should a radiological attack occur. This report reaffirms the applicability of existing ICRP recommendations to such situations. It is mainly concerned with attacks involving 'radiological dispersion devices'. Many aspects of emergency scenarios after a radiological attack may be similar to those arising from radiological accidents, but there are also differences. For instance, a radiological attack would probably be targeted at a public area, possibly in an urban environment, where the presence of radiation is not anticipated and the dispersion conditions commonly assumed for emergencies in nuclear facilities may not be applicable. First responders and rescuers need to be adequately trained and have the proper equipment to identify radiation and radioactive contamination. Radiological protection specialists must be available to provide advice. It may be prudent to assume that radiological, chemical, and/or biological agents are involved until proven otherwise. This calls for an 'all-hazard' approach to the response.
The main aim must be to prevent acute health effects of a 'deterministic' nature and restrict the likelihood of late health effects of stochastic nature such as cancer and hereditary effects. A supplementary aim is to minimise environmental contamination and general disruption. Actions to avert exposures are much more effective than possible medical treatment after exposure has occurred.
Responders at recovery and restoration should be protected according to normal occupational standards and dose limits. This restriction may be relaxed for informed volunteers undertaking urgent rescue operations, and is not applicable for volunteered life-saving actions. However, specific protection measures are recommended for female workers who may be pregnant or nursing an infant.
The immediate countermeasures to protect the public in the rescue phase are primarily caring for people with traumatic injuries and controlling access. Subsequent actions include respiratory protection, personal decontamination, sheltering, iodine prophylaxis (if radioiodines are involved) and temporary evacuation. In the recovery phase, definitive relocation and resettlement may be needed in extreme cases. This phase may require restoration and cleanup, management of resulting radioactive waste, management of corpses containing significant amounts of radioactive substances, and dealing with long-term exposure caused by remaining radioactive residues.
The guidance is based solely on radiological protection considerations and should be seen as a decision-aiding tool to prepare for the aftermath of a radiological attack. It is expected to serve as input to a final decision-making process that may include other societal concerns, consideration of lessons learned in the past, and the participation of stakeholders.
A radiological attack could cause radioactive contamination of consumer goods such as water, food and other commodities. This possible outcome, however, is unlikely to lead to significant internal contamination of a large number of people due to the large amounts of radioactive material that would be required to reach high levels of contamination.
Intervention measures in the aftermath of the radiological attack should result in a systematic and flexible approach, taking into account the conditions and invoking actions as warranted by the circumstances. Many potential scenarios clearly cannot induce immediate severe radiation injuries. In order to prevent overreaction, radiological protection decisions must be proportional to the magnitude of the radiological attack.