Models of caregiving in nuclear accidents. Enrico M. Staderini

1. Models of caregiving in nuclear accidents. Enrico M. Staderini

2. Radioactivity safety and security Models of caregiving in nuclear accidents Enrico M. Staderini Haute Ecole d'Ingénierie et de Gestion du Canton de Vaud – HES-SO Western Switzerland University of Applied Sciences Route de Cheseaux, 1 CH-1400 Yverdon les Bains (Vaud) Switzerland enrico.staderini@heig-vd.ch

3. Radioactivity safety and security • Not so long time ago, radioactive elements were considered curative…

4. Radioactivity safety and security Ouch! Those cosmic rays are killing me… • Now radioactivity is considered with a bit too much attention…

5. Radioactivity safety and security • An incredibly complicated problem

6. Radioactivity safety and security • Place of accident • nuclear power plant / military facility • possibly restricted access • hospital/research nuclear facility • neighbouring (isolated-populated area) • pre-existent health facilities • pre-existent nuclear accident health care facilities (included accident plans) •  Efficacy of health care to affected people

7. Radioactivity safety and security • irradiation vs. contamination • kind of irradiation/contamination • released activity • physical/biological behaviour of radioactive contaminant • biological effects of irradiation •  Seriousness of health consequences in the short or long period •  Need for evacuating people

8. Radioactivity safety and security • number of affected people • professional people • general population •  Level and efficacy of health care •  Level of problems in evacuating people

9. Radioactivity safety and security • affected area • confined area • open area • accessible / not accessible area • limited / unlimited area •  Possibility of delivering health care on site •  Need of evacuating people

10. Radioactivity safety and security • affected resources and infrastructures • water supply • food supply • health care facilities • roads • telecommunication systems •  Decision about area extension or number of people to evacuate •  Problems in alerting or caring for the affected population

11. Radioactivity safety and security • what’s the difference between an accident and a disaster? • number of people affected • area extension affected • infrastructures affected • time required to restore to normality • costs to restore to normality

12. Radioactivity safety and security • what are the differences between a nuclear disaster and a “conventional” disaster? • increased / unpredictable risk for caregivers and rescuers • more difficult rescue operations (due to increased level of safety required) • longer time consequences • higher psychological impact on populations and the general public

13. Radioactivity safety and security • how telemedicine can help in the case of a nuclear disaster or a nuclear accident?

14. Radioactivity safety and security • prerequisite for telemedicine is a telecommunication infrastructure • use existing infrastructure (if it survived the accident) • fast deploy new infrastructure (mobile phone base stations) • one way communication (alerting, counselling, giving evacuation directions) • two way communication (caring and specific help) •  Plan ahead!!!

15. Radioactivity safety and security • If a thing may go wrong it will go. • (Murphy’s rule)

16. Radioactivity safety and security • What may go wrong: • (never an exhaustive list)

17. Radioactivity safety and security • telecommunication facilities destroyed • electric power discontinued • emergency power not available or not usable • telecommunication facilities contaminated • telecommunication facilities not reachable • people trapped under rubbles (or within shelters) • shortage / unavailability of technical personnel • common people not able to establish a link • long range telecommunication systems not available (satellite TV broadcasting may be) • shortage / unavailability of health personnel • aged people with cognitive problems

18. Radioactivity safety and security • Any good news? • No.

19. Radioactivity safety and security • a general purpose telecommunication alert system still unavailable in most countries (at best they still rely on sirens) • a general (robust) telemedicine infrastructure are still unavailable as well • robust emergency plans for the general population are still based on eighteen century demography • standards for telemedicine operation still missing despite the number of mobile phones is approaching that of the population on the planet • still not addressing the cognitive performances of the general population

20. Radioactivity safety and security • So what? • Only good news: • We know the risks!

21. Radioactivity safety and security • “Perhaps radium has something to do with these troubles, but it cannot be affirmed with certainty.” • From the letter of Marie Sklodowska Curie to her sister Bronya (November 1920) • Marie Curie died of aplastic anemia on July 4th 1934. • Her papers from the 1890s are still considered too dangerous to handle, even her cookbook is highly radioactive. They are kept in lead-lined boxes, and those who wish to consult them must wear protective clothing.

22. Radioactivity safety and security Thanks for your attention Enrico M. Staderini Haute Ecole d'Ingénierie et de Gestion du Canton de Vaud – HES-SO Western Switzerland University of Applied Sciences Route de Cheseaux, 1 CH-1400 Yverdon les Bains (Vaud) Switzerland enrico.staderini@heig-vd.ch