Radiological Emergency Preparedness- an Analysis of Interviews With Israeli Experts

Introduction: Radiological and nuclear emergencies can occur as a result of a nuclear facility accident/attack, due to mishap while working with or transporting nuclear materials, and due to intentional attacks with improvised or military-grade nuclear devices or with radiation dispersal devices, “dirty bomb.” While rare, such incidents present significant challenges to healthcare providers in the pre-hospital and hospital arenas. As part of a collaborative research project, data-driven recommendations regarding the required medical and emergency agency preparedness were sought. Methods: An initial research stage included interviews with three leading Israeli experts on radiation/nuclear risk assessment and preparedness. The two lead Israeli researchers conducted these. The interviews were conducted with predefined open-ended questions and analyzed using qualitative research methods. Results: The three subject experts included: A former head of the Israeli Atomic agency, a senior advisor to the Israeli Ministry of Health on hospital emergency management and CBRNE, and the Israeli national EMS CBRNE specialist. Major themes identified in these interviews included: differences in risk assessment between the U.S. and Israel, with the Israeli experts focusing on the risk of a radiation dispersal device attack on a stadium,/mall, or a strategic facility. The experts stressed that even a low casualty event of this type might have far-reaching psychological and economic repercussions. Prehospital and hospitals must prepare for a high number of worried-well and public panic. All emphasized the importance of first responder training and radiation identification capacities. Two pointed to the importance of risk and event communications targeting the general public and healthcare personnel. Conclusion: Experts from three levels: the national level tasked with risk assessments and national preparedness guidelines, the Ministry of Health and hospital preparedness management, and national EMS CBRNE management. Similar themes were identified regarding risk assessment, major challenges, and required interventions.