'Dirty' Bombs Scare More Than Scar

Experts say psychological damage from such threats much more dangerous

WEDNESDAY, June 19, 2002 (HealthDayNews) -- While the threat of terrorists attacking the United States with radioactive materials is real, experts say the possibility causes more psychological damage than physical harm.

Recent news that an American citizen is accused of plotting with Al Qaeda to plant a "dirty bomb" -- a combination of conventional explosives and radioactive materials -- in this country has only intensified those fears.

However, the possibility of such an attack may cause more panic and shock than deaths or injuries, say experts who attended a special Society of Nuclear Medicine session in Los Angeles.

"I think our biggest concern is that the risk from radiation is often overstated," says Dr. Henry D. Royal, a professor of radiology at Washington University in St. Louis and vice president-elect of the society.

"A terrorist attack involving radioactive materials is going to have its greatest effect through the social-psychological effect as opposed to real physical harm," Royal says. He was one of the presenters at a special session on terrorism and radioactive materials at the society's annual meeting, which ends tomorrow.

With almost any type of attack using radioactive materials -- the exception being a nuclear weapon -- it's hard to imagine more people being killed than the number who died at the World Trade Center in New York, Royal says.

"We should try to get it right. We should try not to overstate the risk, and not understate the risk," he says.

It's vital to understand the facts about radiation exposure, probable types of attacks, and to have detailed response plans to such attacks, Royal says.

Proper awareness and preparation are crucial to countering the natural panic, uncertainty, and fear that may follow a radioactive attack and possibly threaten efforts to rescue and treat injured people.

Royal says health-care professionals and the public have many misconceptions about the health risks of radiation.

One is that people injured or affected by such attacks will be extremely radioactive. In the majority of such cases, the amount of radiation a contaminated victim would emit is less than the amount emitted by a person who's had a typical nuclear medicine procedure, such as positron emission tomography (PET), Royal says.

Another misconception is that treating someone with radioactive contamination requires extraordinary precautions, greater than those needed to deal with chemical or biological agents. Royal says that's not the case.

"I've spent a lot of time educating health-care professionals in what to do in taking care of patients contaminated with radioactive material, and most of the time they're just amazed to hear that it's really a simple problem to deal with," Royal says.

Radioactive dirt is no different than regular dirt in such cases, he says.

"If you were to imagine that a patient was covered with sewerage and you did whatever you would do if they were covered with sewerage, you would do exactly the right thing for radioactive dirt," Royal says.

It's far less dangerous than something like the Sarin nerve gas used in an attack on a Tokyo subway in March 1995. The attack left 11 people dead and 5,500 injured.

"When those patients were brought to the emergency room, about 60 percent of the emergency room staff got sick because some of the Sarin that was in the clothes of the victims affected the emergency room staff," Royal says.

It's difficult for him to imagine a situation where radiation or radioactive contamination on patients would create anything other than a nuisance problem for medical staff.

"So, it's very important that the medical staff know that so that they don't get distracted by the radiation aspect of the event and they take care of patients the way they know how to take care of patients," Royal says.

This is a new issue for most health-care workers and it's essential to make them understand this is a problem they can deal with, he stresses.

That includes paramedics and other emergency crews who would be first to respond to something such as a "dirty bomb".

"The risk to a first responder from radiation is going to be much less than the risk from lots of other hazards that they normally deal with," Royal says.

Rescuing people from a wrecked vehicle that's leaking gas is probably more hazardous than dealing with radioactivity. Rescue crews can use radiation detectors to determine whether it's safe for them to go into an area to extract or treat victims of a radioactive attack, Royal says.

Fellow presenter Jonathan Links, a professor of environmental sciences at Johns Hopkins School of Public Health who's working with Baltimore officials on a radiologic terror preparedness plan, agrees.

"In truth, unless you get your hands on a pretty significant nuclear device, the actual physical risk from air/water poisoning or a "dirty bomb" is actually relatively small. It's not going to be thousands and thousands of people dying of radiation poisoning. That would require significant amounts of radioactivity," Links says.

The expertise of nuclear medicine professionals would be invaluable in the event of any radiologic attack, he says.

"It is absolutely natural that nuclear medicine professionals, by virtue of their training, background and experience, are going to be part of the mix of responding to any terrorist incident involving radioactive materials," Links says.

They'd be able to rapidly assess the actual level of physical risk posed by radiation.

And nuclear medicine specialists should be included in all hospital plans to treat victims of a radiologic attack because of their knowledge of radiation issues, such as skin and clothing contamination.

"I think it's absolutely critical and they need to be fully integrated in any emergency medical planning," Links says.

What To Do

For more information about radiation health effects, go to this site about Chernobyl, the crippled nuclear reactor in Ukraine. For more about nuclear medicine, visit the Society of Nuclear Medicine.

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