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Social, Psychological, and Behavioral Responses to a Nuclear Detonation in a US City: Implications for Health Care Planning and Delivery

  • Daniel Dodgen, Ann E. Norwood, Steven M. Becker, Jon T. Perez and Cynthia K. Hansen...
Abstract

A nuclear detonation in a US city would have profound psychological, social, and behavioral effects. This article reviews the scientific literature on human responses to radiation incidents and disasters in general, and examines potential behavioral health care provider (BHCP) contributions in the hours and days after a nuclear detonation. In the area directly affected by the blast, the immediate overarching goal of BHCP interventions is the support of lifesaving activities and the prevention of additional casualties from fallout. These interventions include 6 broad categories: promoting appropriate protective actions, discouraging dangerous behaviors, managing patient/survivor flow to facilitate the best use of scarce resources, supporting first responders, assisting with triage, and delivering palliative care when appropriate. At more distant sites, BHCP should work with medical providers to support hospitalized survivors of the detonation. Recommendations are also made on BHCP interventions later in the response phase and during recovery.

(Disaster Med Public Health Preparedness. 2011;5:S54-S64)

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Corresponding author
Correspondence: Address correspondence and reprint requests to Dr Daniel Dodgen, 330 C Street SW, Suite 5200, Washington, DC 20447 (e-mail: daniel.dodgen@hhs.gov).
References
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1.Buddemeier, BRReducing the Consequences of a Nuclear Detonation. Threats at Our Threshold: Securing and Defending the United States in the 21st Century.Livermore, CA: Lawrence Livermore National Laboratory; 2007.
2.Mlakar, PF, Corley, WG, Sozen, MA.The Oklahoma City bombing: analysis of blast damage to the Murrah Building. J Perform Constr Facil. 1998;12:113119.
3.Coleman, CN, Knebel, AR, Hick, JL.Scarce resources for nuclear detonation: project overview and challenges. Disaster Med Public Health Prep. 2011;5(Suppl 1)S13S19.
4.Caro, JJ, DeRenzo, EG, Coleman, CN.Resource allocation following a nuclear detonation incident: unaltered standards of ethical decision making. Disaster Med Public Health Prep. 2011;5(Suppl 1)S46S53.
5.Casagrande, R, Wills, N, Kramer, E.Using the model of resource and time-based triage (MORTT) to guide scarce resource allocation in the aftermath of a nuclear detonation. Disaster Med Public Health Prep. 2011;5(Suppl 1)S98S110.
6.DiCarlo, AL, Maher, C, Hick, JL.Radiation injury after a nuclear detonation: medical consequences and the need for scarce resources allocation. Disaster Med Public Health Prep. 2011;5(Suppl 1)S32S44.
7.Hick, JL, Weinstock, DM, Coleman, CN.Health care system planning for and response to a nuclear detonation. Disaster Med Public Health Prep. 2011;5(Suppl 1)S73S88.
8.Knebel, AR, Coleman, CN, Cliffer, KD.Allocation of scarce resources after a nuclear detonation: setting the context. Disaster Med Public Health Prep. 2011;5(Suppl 1)S20S31.
9.Murrain-Hill, P, Coleman, CN, Hick, JL.Medical response to a nuclear detonation: creating a playbook for state and local planners and responders. Disaster Med Public Health Prep. 2011;5(Suppl 1)S89S97.
10.Sherman, SE.Legal considerations in a nuclear detonation. Disaster Med Public Health Prep. 2011;5(Suppl 1)S65S72.
11.Management of Terrorist Events Involving Radioactive Material (Report No. 138).Bethesda, MD: National Council on Radiation Protection and Measurements; 2001.
12.Key Elements of Preparing Emergency Responders for Nuclear and Radiological Terrorism (Commentary No. 19.). Bethesda, MD: National Council on Radiation Protection and Measurements; 2005.
13.Becker, SM.Emergency communication and information issues in terrorist events involving radioactive materials. Biosecur Bioterror. 2004;2 (3):195207.
14.Becker, SM.Communicating risk to the public after radiological incidents. BMJ. 2007;335 (7630):11061107.
15.Becker, S.Preparing for terrorism involving radioactive materials: three lessons from recent experience and research. J Appl Secur Res. 2009;4:920.
16.Slovic, P.Perception of risk from radiation. Radiat Prot Dosimetry. 1996;68:165180.
17.Berry, LB, Jones, A, Powers, TMedia Interaction With the Public in Emergency Situations: Four Case Studies. A Report.Washington, DC: Federal Research Division, Library of Congress; 1999.
18.Petterson, J.Perception vs. reality of radiological impact: the Goiania model. Nucl News. 1988;31:8490.
19.Becker, SMPsychosocial effects of radiation accidents.In: Gusev IA, Guskova AK, Mettler FA, eds. Medical Management of Radiation Accidents. 2nd ed. Boca Raton, FL: CRC Press; 2001:519-525.
20.Buddemeier, BR, Dillion, MKey Response Planning Factors for the Aftermath of a Nuclear Detonation.LLNL-TR-410067. Livermore, CA: Lawrence Livermore National Laboratory. http://www.remm.nlm.gov/IND_ResponsePlanning_LLNL-TR-410067.pdf. Published August 2009. Accessed June 28, 2010.
21.Perry, RW, Lindell, MK.Preparedness for emergency response: guidelines for the emergency planning process. Disasters. 2003;27 (4):336350.
22.Auf der Heide, ECommon misconceptions about disasters: panic, the “disaster syndrome,” and looting.In: O’Leary MR, ed. The First 72 Hours: A Community Approach to Disaster Preparedness. Bloomington, IN: iUniverse; 2004: 340–380.
23.Gershon, RR, Qureshi, KA, Rubin, MS, Raveis, VH.Factors associated with high-rise evacuation: qualitative results from the World Trade Center Evacuation Study. Prehosp Disaster Med. 2007;22 (3):165173.
24.Tierney, KJStrength of a city: a disaster research perspective on the World Trade Center attack. http://essays.ssrc.org/sept11/essays/tierney.htm. Accessed January 18, 2010.
25.Drury, J, Cocking, C, Reicher, S.Everyone for themselves? A comparative study of crowd solidarity among emergency survivors. Br J Soc Psychol. 2009;48 (pt 3):487506.
26.Drury, J, Cocking, C, Reicher, S.The nature of collective resilience: survivor reactions to the 2005 London bombings. Int J Mass Emerg Disasters. 2009;27:6695.
27.Avdeyeva, TV, Burgetova, K, Welch, ID.To help or not to help? Factors that determined helping responses to Katrina victims. Anal Soc Issues Public Policy. 2006;6:159173.
28.Drury, J.Managing crowds in emergencies: psychology for business continuity. Business Continuity J. 2009;3:1424.
29.Rodriguez, H, Trainor, J, Quarantelli, EL.Rising to the challenges of a catastrophe: the emergent and prosocial behavior following Hurricane Katrina. Ann Am Acad Pol Soc Sci. 2006;604:82101.
30.Barsky, L, Trainor, J, Torres, MDisaster realities in the aftermath of Hurricane Katrina: revisiting the looting myth.2006. http://www.colorado.edu/hazards/qr/qr184/qr184.html. Published 2006. Accessed January 12, 2010.
31.Brezina, T, Kaufman, J.What really happened in New Orleans? Estimating the threat of violence during the Hurricane Katrina disaster. Justice Q. 2008;25:701.
32.Drury, J, Winter, G.Social identity as a source of strength in mass emergencies and other crowd events. Int J Ment Health. 2003;32:7793.
33.Nuclear Detonation Preparedness—Communicating in the Immediate Aftermath. Domestic Resilience Group.Washington, DC: IND Response Sub-IPC; 2010.
34.Hersey, JHiroshima.New York: Vintage Books; 1989.
35.Matsunari, Y, Nozawa, S, Sakata, K.Individual testimonies to nursing care after the atomic bombing of Hiroshima in 1945. Int Nurs Rev. 2008;55 (1):1319.
36.Hachiya, MHiroshima Diary: The Journal of a Japanese Physician, August 6–September 30, 1945.Chapel Hill: The University of North Carolina Press; 1995.
37.Becker, SMRisk communication and radiological/nuclear terrorism: perceptions, concerns and information needs of first responders, health department personnel, and healthcare providers.In: Johnson RH, ed. Radiation Risk Communication: Issues and Solutions. Madison, WI: Medical Physics Publishing; 2010:271-280.
38.Becker, SM, Middleton, SA.Improving hospital preparedness for radiological terrorism: perspectives from emergency department physicians and nurses. Disaster Med Public Health Prep. 2008;2 (3):174184.
39.Cone, DC, Cummings, BA.Hospital disaster staffing: if you call, will they come? Am J Disaster Med. 2006;1 (1):2836.
40.Dimaggio, C, Markenson, D, T Loo, G, Redlener, I.The willingness of U.S. Emergency Medical Technicians to respond to terrorist incidents. Biosecur Bioterror. 2005;3 (4):331337.
41.Lanzilotti, SS, Galanis, D, Leoni, N, Craig, B.Hawaii medical professionals assessment. Hawaii Med J. 2002;61 (8):162173.
42.Qureshi, K, Gershon, RR, Sherman, MF.Health care workers' ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005;82 (3):378388.
43.Planning Guidance for Response to a Nuclear Detonation.2nd ed. Washington, DC: Homeland Security Council, Interagency Policy Coordination Subcommittee for Preparedness and Response to Radiological and Nuclear Threats; 2010. http://hps.org/hsc/documents/Planning_Guidance_for_Response_to_a_Nuclear_Detonation-2nd_Edition_FINAL.pdf. Accessed February 7, 2011.
44.Coleman, CN, Weinstock, DM, Casagrande, R.Triage and treatment tools for use in a scarce resources-crisis standards of care setting following a nuclear detonation. Disaster Med Public Health Prep. 2011;5(Suppl 1)S111S121.
45.Steffen, SL, Fothergill, A.9/11 volunteerism: a pathway to personal healing and community engagement. Soc Sci J. 2009;46:2946.
46.Andrulis, DP, Siddiqui, NJ, Gantner, JL.Preparing racially and ethnically diverse communities for public health emergencies. Health Aff (Millwood). 2007;26 (5):12691279.
47.Hobfoll, SE, Watson, P, Bell, CC.Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry. 2007;70 (4):283315, discussion 316-369.
48.Hall, RC, Hall, RC, Chapman, MJ.Medical and psychiatric casualties caused by conventional and radiological (dirty) bombs. Gen Hosp Psychiatry. 2006;28 (3):242248.
49.Hall, RCW, Hall, RCW, Chapman, MJEmotional and psychiatric effects of weapons of mass destruction on first responders.In: Ursano RJ, Norwood AE, Fullerton CS, eds. Bioterrorism: Psychological and Public Health Interventions. Cambridge, UK: Cambridge University Press; 2004.
50.US Department of Health and Human Services. HHS Pandemic Influenza Plan Supplement 11: worforce support.Psychosocial consideration and information needs. http://www.hhs.gov/pandemicflu/plan/sup11.html. Accessed January 19, 2010.
51.Yzermans, CJ, Berg, VD, Dirkzwager, AJEPhysical health problems after disasters.In: Nuria Y, Galea S, Norris FH, eds. Mental Health and Disasters. Cambridge, UK: Cambridge University Press; 2009:67-93.
52.Ursano, RJ.Post-traumatic stress disorder. N Engl J Med. 2002;346 (2):130132.
53.Yehuda, R.Post-traumatic stress disorder. N Engl J Med. 2002;346 (2):108114.
54.Bromet, E, Parkinson, D, Dunn, L.Long-term mental health consequences of the accident at Three Mile Island. Int J Ment Health. 1990;19:4860.
55.Bromet, EJ, Havenaar, JMThe long-term mental health impacts of the Chernobyl accident.In: Neria Y, Galea S, Norris FH, eds. Mental Health and Disasters. Cambridge, UK: Cambridge University Press; 2009:441-453.
56.Havenaar, JM, Poelijoe, NW, Kasyanenko, AP, Van den Bout, J, Koeter, MW, Filipenko, VV.Screening for psychiatric disorders in an area affected by the Chernobyl disaster: the reliability and validity of three psychiatric screening questionnaires in Belarus. Psychol Med. 1996;26 (4):837844.
57.Wain, H, Grammer, GG, Stasinos, JPsychiatric intervention for medical and surgical patients following traumatic injuries.In: Ritchie EC, Watson PJ, Friedman MJ, eds. Interventions Following Mass Violence and Disasters: Strategies for Mental Health Practice. New York: Guilford Press; 2006:278-299.
58.Zatzick, D, Roy-Byrne, P.Developing high-quality interventions for posttraumatic stress disorder in the acute care medical setting. Semin Clin Neuropsychiatry. 2003;8 (3):158167.
59.Zatzick, D, Roy-Byrne, P, Russo, J.A randomized effectiveness trial of stepped collaborative care for acutely injured trauma survivors. Arch Gen Psychiatry. 2004;61 (5):498506.
60.Chernobyl's Legacy. Health, Environmental and Socio-Economic Impacts and Recommendations to the Governments of Belarus, the Russian Federation and Ukraine.2nd rev. ed. Vienna: Chernobyl Forum, International Atomic Energy Agency; 2005.
61.Zatzick, DF, Russo, J, Rajotte, E.Strengthening the patient-provider relationship in the aftermath of physical trauma through an understanding of the nature and severity of posttraumatic concerns. Psychiatry. 2007;70 (3):260273.
62.Bryant, RA, Harvey, AG, Dang, ST, Sackville, T, Basten, C.Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling. J Consult Clin Psychol. 1998;66 (5):862866.
63.Bryant, RA, Sackville, T, Dang, ST, Moulds, M, Guthrie, R.Treating acute stress disorder: an evaluation of cognitive behavior therapy and supportive counseling techniques. Am J Psychiatry. 1999;156 (11):17801786.
64.Watson, PJEarly intervention for trauma-related problems following mass trauma.In: Ursano RJ, Fullerton CS, Weisaeth L, eds. Textbook of Disaster Psychiatry. Cambridge, UK: Cambridge University Press; 2007:121-139.
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Disaster Medicine and Public Health Preparedness
  • ISSN: 1935-7893
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