A PARTICIPATIVE AND ITERATIVE APPROACH

1. HANDBOOK« Practical radiation protection and monitoring for people living in long-term contaminated territories »SAGE Workshop - 14 March 2005

2. A PARTICIPATIVE AND ITERATIVE APPROACH • 4 Stakeholder groups (F, UK, D, BY) - Health Professionals, - Teachers, - NGOs’ Representatives (from regions confronted to problems of radiological/chemical pollution and risks), - Firemen, - Students, -Specialists of radiological measurements - Representatives of Safety/Radiological Protection/Environment Authorities, etc. • Topic: “Implementation and dissemination of a practical radiation protection culture in Western European countries for helping in the management of long term contaminated territories”. Focus on radiological monitoring & health professionals - Identification of concerns and questions, - Propositions of answers, for tools to be used or developed, for a new organization of the society capable to handle the situation at the local level in a sustainable manner. • Iterative process between all groups - to advise, to complement and adjust the content of the handbook (> 12 meetings)  Handbook(working document to be discussed with you)

3. WHY SUCH A HANDBOOK ? • To answer - trying to avoid expert wording - some of the legitimate questions asked by people who are living in a territory (after an accident which has led to long term radiological consequences), • To give elements allowing to consider more objectively a situation that implies radiological risks ; to allow people to act and behave with a better knowledge of this situation, • To reinforce the long-term citizen vigilance (by proposing new organizations, means, and tools).

4. PREREQUISITES ON THE CONTENT • NO FALSELY REASSURING REMARKS (« Life is not worse in this context than elsewhere, no problem ! ») • NO EXCESSIVELY FRIGHTENING WORDS ( The objective was not to elaborate a « survival handbook ») • DOESN’T CLAIM FOR EXHAUSTIVENESS (!?) (typically: « Everything is inside... ») • DOESN’T CLAIM FOR OMNISCIENCE (!?) (typically: « All what you wanted to know... ») • NO BIAS (TOWARDS OR AGAINST...) (« We can assure you that you can stay living here! ») or, on the contrary, (« If I were you, I’d go elsewhere! ») • NO FATALISM, AND AUTHORITARIAN PRESCRIPTIONS (« You have no choice now, do this and that! »)

5. A HANDBOOK, FOR WHOM? (1) • FOR EVERYONE because fundamental questions are the same everywhere • Is the environment contaminated? • How am I exposed? • How to know if I am irradiated ? • Are the food products contaminated? • How to know if my foodstuffs are contaminated? • Am I contaminated myself? What about my children? Is it serious? • What to measure to know whether I am contaminated? • Will the situation change? When? • Who can explain to me the radiological situation, answer my questions and propose possible actions? • What can I do by myself to improve the radiological situation in my house, my garden, the foodstuffs that I or my family eat?

6. A HANDBOOK, FOR WHOM? (2) • FOR THOSE WHO MAKE RADIOLOGICAL MEASUREMENTS • What kind of devices are (easily) adapted? (irradiation, contamination of the environment, foodstuffs, individuals) • How to monitor and describe plainly a radiological situation? (137Cs ≠ 90Sr ≠ 241Am, ...) (seasons’ effect) (local variations) (...) • How to inform the public? • When and how to alert people? • FOR HEALTH PROFESSIONALS • Become privileged interlocutors for many people with regard to their health concerns • FOR HP AND SAFETY AUTHORITIES • A new organisation of the society and new roles in post-accidental situations - impact the legal framework - reinforce the need to educate and train professionals • Need to developed new tools (especially at the local level)

7. STRUCTURE OF THE HANDBOOK • General Questions • Who can answer? • How to monitor the situation? • How to interpret measurements results? • How to improve the radiological situation? • Annex: Radioactivity

8. ANSWERS TO GENERAL QUESTIONS • Presentation, in simple words, of the transfers of the radioactivity into the environment, exposures routes and, means to measure individual doses: • ingestion of contaminated foodstuffs is emphasized, • irradiation, inhalation are presented but are less important in a long-term perspective. • Basic role of local health professionals and specialists of radiological measurements in educating and informing people about the encountered risks •  NEED TO HAVE A COMMON LANGUAGE

9. THE ROLE OF LOCAL HEALTH PROFESSIONALS • Listen to and help people in expressing their concerns regarding to the radioactivity • Answer the questions posed • Propose actions in specific circumstances, especially if they detect critical situation s(radiological and health problems) • Propose possible day-to-day actions that reduce the individual risk of contamination  Tatiana Kotlabai’s presentation, tomorrow.

10. THE ROLE OF LOCAL HEALTH PROFESSIONALS • Regarding to radiological protection, the education and training of health professionals is really insufficient today (medical doctors and practitioners, occupational and school doctors, nurses, veterinarian) • Need of tools helping them in interpreting rapidly Whole Body Measurements (Bq/kg  mSv/y) and their evolution with time. (ex. CORPORE for 137Cs)

11. THE ROLE OF MEASUREMENTS SPECIALISTS • They are not necessarily all professionals; after a specific training, everybody can become a radiametrist (cf. Belarus experience), • However, hospitals and radiation protection institutes have also important roles (for example, to perform Whole Body Measurements or to measure specific radionuclides, which both are often impossible to do with simple and cheap techniques), • Belarus experience shows that to be credible all these specialists must be located very close to the affected population:  complementary roles (pluralism) of local NGOs and decentralized representations of national institutes and authorities is a key factor for the confidence in the measurements

12. THE ROLE OF MEASUREMENTS SPECIALISTS • Immediate communication of measurements results : • to the individuals • at the local level • at the national level • Alert (eg. if contamination levels of several products from a specific location are high, if consumed products by a family are contaminated, if results of Whole Body Measurements are high, etc)

13. LOCAL STAKEHOLDER ADVISORY BOARD  Need to have a local point of information which collects, centralises and diffuses all data measurements and co-ordinates actions: “the Local Stakeholder Advisory Board” - to elaborate contamination maps of the villages (food products, fields, forests, etc), and statistical results of Whole Body Measurements (evolution with time, seasonal factors), - to exchange information between all stakeholders (networking), - to publish information in local journals, and to relay it towards national institutes.

14. INDIVIDUAL RADIATION PROTECTION BOOKLET  Need to create anIndividual (or Family) Radiation Protection Booklet - to register individual/family data (Whole Body Measurements, food products measured by the radiametrist, irradiation levels in the house and garden, etc), - to help in exchanging information between measurements specialists, health professionals and the individuals.

15. MEASUREMENTS TOOLS AND INTERPRETATION OF RESULTS • Chapter 4 of the handbook presents all available measurements tools and for what kind of measurements they are useful (ambient dose rates,foodstuffs contamination, body contamination) • however, the work is incomplete because focussed on 137Cs, only. • Chapter 5 of the handbook presents several examples of interpretation of results of measurements (external and internal dose calculations in real situations) • here again, the work is incomplete because focussed on 137Cs, only.

16. INTERPRETATION OF RESULTS AND CORRECTIVE ACTIONS • Chapter 5 of the handbook gives also « reference situations » that may allow people to put the measurements results (eg. ambient dose rates, contamination of products, body contamination) into perspective with levels observed in normal situation (before an accident). • Regulatory limits in Western Europe (eg. radioactivity concentration in food products) are also given: it must be pointed out that the existing limits are not adapted to situations where people eat everyday low contaminated foodstuff products (chronic contamination). • Chapter 6 of the handbook proposes some means (corrective actions) that allow to reduce external or internal exposures: • at home, • in the garden, • in the allotment, • in the forest.

17. CONCLUSIONS • The co-development process of the handbook was appreciated whatever the origin of participants (however, their participation does not imply necessarily a full agreement on the content) ( testimony of a member of the French Stakeholders’ Group) • Great interest, especially for health professionals, to continue to develop the handbook (the work is not finished!) ( experience with the Belarusian leaflet for young mothers) • Identification of a lack of a common language between “radiation protection experts”, the professionals and population , as well as tools and structures for informing dialogues and debates (“piloting tools”) • Everybody agree to go further and to try to apply (to customize) the handbook in more specific contexts, and at regional or local levels)