14 Disaster Management of Radiological, Nuclear and Biological Disasters

Dr. Lubna Siddiqui

RATIONALE

In today’s scenario of modernization, the risk of chemical, biological, radiological & nuclear (CBRN) disasters are quite common. It is significant to note that CBRN threats are now a stern reality across the world and India, not being an exception, is equally prone to CBRN threats. In recent years, the incidents of CBRN attack by terrorists or extremist groups have increased manifolds not only in India but worldwide. The CBRN terrorism mainly focuses the vested propaganda/demands, because of the publicity of hatred and jingoism. Soft targets for such terrorist activities would include densely populated locations, crowded areas like fairs, religious congregations, entertainment clubs, rallies, mega cultural/sports events, etc. This particular module is totally focused on the radiological, nuclear and biological disasters. While the effects of radiological and nuclear cases are immediately known, the manifestations of bacteria, viruses or toxins, which are used as biological agent, may be immediate or delayed, depending upon the nature of the biological agent.

Nuclear and Radiological Emergency

India has traditionally been vulnerable to natural disasters on account of its unique geo climatic conditions. On the other hand, the country is equally vulnerable to various man-made disasters including radiological and nuclear emergencies. In recent years, the significant growth in the application of nuclear science and technology in the fields of power generation, medicine, industry, agriculture, research and defence has led to an increase in the risk of occurrence of Nuclear and Radiological emergencies.

Nuclear and Radiological Emergency situations may arise in a nuclear facility at the plant level leading to onsite or offsite emergency depending upon the extent of its impact on the surroundings. It may also take place while using radiation sources, either at Hospitals, Industries, Agriculture or Research Institutions due to loss or misplacement or due to faulty handling. The other events that can lead to Nuclear or Radiological Emergency in the public domain include accident of a vehicle carrying radioactive/nuclear material, due of an orphan source i.e. the source which is not under regulatory control or due to usage of radiation source/radioactive material in malevolent activities. Any radiation incident resulting in or having a potential to result in exposure and/or contamination of the workers or the public in excess of the respective permissible limits can lead to a nuclear/radiological emergency.

The main reason for any nuclear disaster is the extraordinary release of radioactive material or radiation either in the operation of nuclear reactors or other nuclear events like explosion of a Radiological Dispersion Device (RDD) or Improved Nuclear Device (IND) or explosion of nuclear weapon. It is accompanied with sudden release of harmful radiations or radiological materials or both together in the environment.

Sad memories of the use of nuclear weapons dropped on Hiroshima and Nagasaki in Japan (August 1945), and the wide publicity given to the reactor accidents at Three Mile Island (1979) in USA and Chernobyl in erstwhile USSR (1986), have strongly influenced the public perception of any nuclear or radiological emergency to be most often linked, erroneously though, to only these events.

However, one must be prepared to face nuclear/radiological emergencies of lower magnitudes and ensure that the impact of such an emergency (which, for a given magnitude, is likely to be much greater today because of higher population densities coupled with an enhanced urban infrastructure due to economic prosperity) is always kept under control. It may be noted that better infrastructure can be helpful during such incidences in terms of enhanced communication, transport and medical support.

The Indian Perspective on Radiological and Nuclear Emergencies:

For improving the quality of life in society, India has embarked upon a large programme of using nuclear energy for generating electricity. India has 20 plus power reactors and research reactors in operation along with five power reactors. It is also planned to explore setting up Thorium based reactors to meet its ever increasing energy needs. Further, the country utilises radioisotopes in a variety of applications in the non-power sector, viz., industry, agriculture, medicine, research, etc. Due to the inherent safety culture, the best safety practices and standards followed in these applications and effective regulation by the Atomic Energy Regulatory Board (AERB), the radiation dose to which the persons working in nuclear/radiation facilities are exposed to, is well within the permissible limits and the risk of its impact on the public domain is very low.

However, nuclear emergencies can still arise due to factors beyond the control of the operating agencies; e.g., human error, system failure, sabotage, earthquake, cyclone, flood, etc. Such failures, even though of very low probability, may lead to an on-site or off-site emergency. To combat this, a number of system upgrades have been planned to mitigate/prevent such emergencies. However, proper emergency preparedness plans must be in place so that there is minimum avoidable loss of life, livelihood, property and impact on the environment.

A brief summary of the radiological and nuclear accidents is given in the table below:

Further, the radiation releases due to any reason can be devastating – Chernobyl is a classic example to understand. With modern reactor design, a catastrophic release of radiation is highly unlikely, but nevertheless, there may be possibilities. This can happen due to factors beyond the control of the operating agencies e.g. human error, system failure, sabotage, earthquake, cyclone, flood and tsunami etc.

Emergency Preparedness for Nuclear Power Plants

Since the proper implementation of counter measures can significantly reduce the consequences of an emergency situation, it is mandatory for all nuclear facilities that there must be a comprehensive emergency preparedness plan. Prior to the issuance of a license for the operation of a nuclear facility, the AERB ensures that the facility has the Emergency Response Manuals for the three main types of emergencies, viz., plant, on-site and off-site, and that the plans are in place to handle these types of emergencies. The operators of nuclear facilities must make an assessment of the type and quantum of release of radioactivity under various accident conditions and the extent to which it can spread into the environment.

Plant Emergency

When the radiological consequences of an abnormal situation are expected to remain confined to the plant boundary or a section of the plant, it is described as a plant emergency. Nuclear facilities in the country already have the following provisions for the detection, classification, notification and mitigation of any emergency situation:

i) Emergency operating procedures for the assessment of an emergency condition and its mitigation.

ii) Pre-identification of any facility-specific, abnormal situation for classification of a plant and site emergency.

iii)  Facility-specific, approved nuclear emergency response plans specifying the jobs of all the functionaries who have been assigned roles during the emergency.

iv) Alerting the plant personnel by sounding the emergency siren and making an emergency announcement.

v) Adequate means for communicating a notification to the emergency response organisations at the facility, the district and state authorities, CMG of DAE and the central government authorities.

vi) Identified assembly locations for plant personnel and casual visitors for their accounting, and assessment of persons trapped in the radiological areas.

vii) Formation of rescue teams and activation of a treatment area and decontamination centre.

viii) Radiation survey around the plant and outside the plant and site boundaries.

ix) Assessment of wind speed, wind direction and the affected sector around the nuclear facility.

x) Whenever required, the nuclear facility is able to mobilise the services of the ambulance and paramedical staff at its site.

xi) Equipment and materials for handling a nuclear emergency are kept at a designated place of the nuclear facility and ERC (Emergency Response Centre).

On-Site Emergencies

An accidental release of radioactivity or the potential of release of activity extending beyond the plant, but confined to the site boundary, constitutes on site emergency condition. In addition to all the provisions applicable in a plant emergency, the following additional provisions are ensured:

i) Extensive radiological survey for an assessment of the radiological conditions within the site boundary of the nuclear facility.

ii) Suitable prophylaxis to be made available at all assembly areas for administration to plant personnel, in case the situation demands.

iii) Identification of temporary shelters within the facility/site for shifting plant personnel, in case required.

iv) Provision of a fleet of vehicles for evacuation of plant personnel from the site to a safer place.

v) Provision of fixed and portable contamination monitors to check contaminated personnel/vehicles leaving the site.

vi) On sensing the potential of release of radioactivity which can transgress into the public domain, the concerned district authorities are alerted to be on standby for emergency operations in the public domain.

vii) Radiological monitoring of the environment in the EPZ (16 km radius around the plant).

Off-Site Emergencies-

On recognising the potential for an uncontrolled release of radioactivity into the public domain, the concerned district authorities are alerted to be on standby for emergency response operations. In addition to all the provisions applicable in plant emergency and site emergency, the following additional provisions are to be ensured for handling a nuclear emergency in the public domain:

i. Pre-identification of plant conditions which can lead to an emergency in the public domain.

ii. An assessment of the radiological status at the site boundary and in the public domain.

For handling of an off-site emergency condition in Nuclear Plant, an off-site emergency committee is headed by the district magistrate of the concerned district and supported by the district sub-committee, which include chiefs of all public service departments relevant to emergency management in the district and also the Head of the Site Emergency Committee of the nuclear facility for technical advice. This committee takes decisions pertaining to the handling of a nuclear emergency outside the site boundary and ensures implementation of countermeasures such as sheltering, prophylaxis and evacuation and resettlement, including maintenance of law and order and civil amenities. All the activities pertaining to the handling of an off-site emergency are guided and coordinated from a pre-designated emergency response centre located outside the boundary of the nuclear facility. The information and broadcasting department of the district, in association with an authorised information officer, ensures the smooth flow of information to the media to avoid panic and spreading of rumours.

Preparedness at Nuclear Facilities

The probability of a major accident at nuclear facilities leading to the release of large quantities of radioactivity into the environment is always ensured to be negligibly small. However, even in the event of a major release into the environment, the prompt and effective implementation of countermeasures can reduce the radiological consequences for the public and the environment.

Preparedness for Nuclear/Radiological Emergencies

The handling of nuclear emergencies require coordination among different service groups of the nuclear facility. In the event of potential radiological consequences in the public domain, all the authorities at the three levels, i.e., district, state and central, would play a vital role and assist the offsite officials in effectively responding to and keeping the public informed on the precautions to be taken.

Major Responsibilities of Nuclear Power Plant Operators

This includes the arrangements required to promptly classify, mitigate the emergency, notify and recommend protective actions off the site consistent with international guidelines, protect those on site, obtain off-site assistance, conduct environmental monitoring of the affected area and assist off-site officials in keeping the public informed.

Major Responsibilities of Off-Site Officials

This includes the arrangements required to promptly implement protective actions and counter measures in the affected area.

Nodal Agency:

Department of Atomic Energy (DAE) is the nodal agency for providing the necessary technical inputs to the National or local authorities for responding to any nuclear or radiological emergency. The Ministry of Home Affairs (MHA) is the nodal ministry to coordinate with the various response agencies in the event of any nuclear or radiological disaster in the public domain. A Crisis Management Group (CMG) has been functioning since 1987 at DAE for this purpose. This Group is chaired by the Additional Secretary, DAE, and has on board expert members from different units of DAE and Atomic Energy Regulatory Board (AERB). Each Member has an alternate member and CMG is backed by resource agencies of various units of DAE.

Biological Disasters:

Biological disasters are the situations involving disease, disability or death on a large scale among humans, animals and plants due to toxins or disease caused by live organisms or their products. Such disasters may be natural in the form of epidemics or pandemics of existing, emerging or reemerging diseases and pestilences or man-made by the intentional use of disease causing agents in Biological Warfare (BW) operations or incidents of Bioterrorism (BT).

Biological disasters are causative of process or phenomenon of organic origin or conveyed by biological vectors, including exposure to pathogenic micro-organisms, toxins and bioactive substances that may cause loss of life, injury, illness or other health impacts, property damage, loss of livelihoods and services, social and economic disruption, or environmental damage. Examples of biological disasters include the outbreaks of epidemic diseases, plant or animal contagion, insect or other animal plagues and infestation.

Biological disasters may be in the form of:-

Epidemic affecting a disproportionately large number of individuals within a population, community, or region at the same time, examples being Cholera, Plague, Japanese Encephalitis (JE) – In India, the Gorakhpur and other regions are affecting due to the same drastically/ Acute Encephalitis Syndrome (AES); or,

Pandemic is an epidemic that spreads across a large region, that is, a continent, or even worldwide of existing, emerging or reemerging the diseases and pestilences, example being Influenza H1N1 (Swine Flu).

Causes of Biological Disasters:

 Biological disasters are caused by the epidemics, accidental release of virulent microorganism(s) or Bioterrorism (BT) with the use of biological agents such as anthrax, smallpox, etc. The existence of infectious diseases has been known among human communities and civilisations since the dawn of civilisation. Social upheavals caused by epidemics have contributed in shaping history over the ages. The mutual association of war, pestilence and famine was acknowledged and often attributed to divine influences, though a few keen observers realised that some infections were contagious. The development of bacteriology and epidemiology later, established the chain of infection. Along with nuclear and chemical agents, which are derived from technology, biological agents have been accepted as agents of mass destruction capable of generating comparable disasters.

Epidemics can result in heavy mortalities in the short term leading to a depletion of population with a corresponding drop in economic activity, e.g., the plague epidemics in Europe during the middle ages or the Spanish influenza between 1917–18. Infections like Tuberculosis (TB) might not kill in the short term but thrust nations towards socio-economic disasters. Another example is the Human Immunodeficiency Virus (HIV)/Acquired Immuno Deficiency Syndrome (AIDS) epidemic in Sub-Saharan Africa, that has wiped out the benefits of improved health care and decimated the productive segments of the society leading to economic stagnation and recession.

In recent decades, India has also experienced the footprints of biological disasters incidents in some parts. The outbreak of plague in Surat which was relatively small, disrupted urban activity in the city, generated an exodus and lead to a massive economic fallout. The ongoing human immunodeficiency virus/acquired immuno deficiency syndrome epidemic in different parts of the country is leading to the diversion of substantial resources. The spread of invasive weed Parthenium hysterophorus after its accidental introduction into India has had wide repercussions on human and animal health, apart from depleting the fodder output. Infectious agents are constantly evolving, often acquiring enhanced virulence or epidemic potential. This results in normally mild infections becoming serious. The outbreak of Chikungunya that started in 2005 is one such example. In recent times travelling has become easier. More and more people are travelling all over the world which exposes the whole world to epidemics. As our society is in a state of flux, novel pathogens emerge to pose challenges not only at the point of primary contact but in far removed locations. The increased interaction between humans and animals has increased the possibilities of zoonotic diseases emerging in epidemic form.

Theoretically any human, animal or plant pathogen can cause an epidemic or may be used as biological weapon. The deliberate intention/ action to cause harm defines a biological attack. Biological weapons are particularly attractive to terrorist groups because of ease of production and low cost. They have been termed as poor man’s nuclear bomb since it is estimated that a large scale operation may lead to huge tangible and intangible losses across the globe. Release of biological agent has not been successfully used by terrorists in India/ surroundings until now, but in the event of any successful attempt there will be severe disruption of governmental services and psychological mass reactions which will jeopardize normal life and create fear in the community.

Mitigation Measures:

The essential protection against natural and artificial outbreaks of disease (bioterrorism) will include the development of mechanisms for prompt detection of incipient outbreaks, isolation of the infected persons and the people they have been in contact with and mobilisation of investigational and therapeutic countermeasures. In the case of deliberately generated outbreaks (bioterrorism) the spectrum of possible pathogens is narrow, while natural outbreaks can have a wide range of organisms. The mechanism required however, to face both can be similar if the service providers are adequately sensitised.

Most of the outbreaks/epidemics reported in India are due to water-borne diseases, vector-borne diseases and vaccine preventable diseases. While National Vector Borne Diseases Control Programme (NVBDCP) is the key programme for prevention/ control of outbreak of epidemics of malaria, dengue, chikungunya etc, vaccines administered under UIP/EPI reduce the morbidity and mortality due to the diseases like measles, diphtheria, pertussis, poliomyelitis etc. Availability of safe water and adoption of the personal and domestic hygienic practices are important measures to prevent/control epidemics of water-borne diseases like cholera, viral hepatitis etc.

Nodal Agency:

The response to these challenges is coordinated by the nodal ministry—Ministry of Health and Family Welfare (MoH&FW) with inputs from the Ministry of Agriculture (MoA) for agents affecting animals and crops. Further, the support and input of other ministries like Ministry of Home Affairs (MHA), Ministry of Defence (MoD), Ministry of Railways (MoR) and Ministry of Labour and Employment (MoL&E) have their own medical care infrastructure with capability of casualty evacuation and treatment, have important role to play. With a proper surveillance mechanism and response system in place, epidemics can be detected at the beginning stage of their outbreak and controlled. Slowly evolving epidemics do not cause upheavals in society and will not come under the crisis management scenario usually. There may be specific situations when disaster response mechanism may be evoked, e.g., an outbreak of Plasmodium falciparum malaria erupting after an exceptionally wet season in a previously non-endemic region and epidemics occurring as a consequence of an attack of bioterrorism.

In India, Ministry of Health & Family Welfare is instrumental and responsible for implementation of various programmes on a national scale in the areas of prevention and control of major communicable diseases and promotion of traditional and indigenous systems of medicines. This ministry also assists states in preventing and controlling the spread of seasonal disease outbreaks and epidemics through technical assistance. It is actively involved in disease diagnosis during epidemics and outbreaks, operational research, manpower development, advisory role and other multifarious activities towards prevention and control of a cascade of epidemic prone disease of larger public health importance in collaboration with National Centre for Disease Control (formerly National Institute of Communicable Disease) and external organisations and institutes.

National Vector Borne Diseases Control Programme (NVBDCP) is the key programme for prevention/control of outbreaks/epidemics of malaria, dengue, chikungunya etc., vaccines administered to reduce the morbidity and mortality due to diseases like measles, diphtheria, pertussis, poliomyelitis etc. Two key measures to prevent/control epidemics of water-borne diseases like cholera, viral hepatitis etc. include making available safe water and ensuring personal and domestic hygienic practices are adopted.

It is impossible to always prevent epidemics, but its impact can always be mitigated by anticipating them and preparedness measures. Epidemic preparedness and response is a multisectoral and multi-agency activity. Health sector plays a lead role in preparing and executing the epidemic preparedness plan but need the expertise and support of other disciplines/sectors also. Planning process will inter alia require extensive review of health infrastructure, disease surveillance and response system, availability of laboratories, trained professionals, drugs, vaccines and equipment in the country, communication system, coordinating mechanism between different sectors and between the national and international agencies and legal issues.

Accordingly, Govt. of India launched Integrated Disease Surveillance Project (IDSP) in 2004 to strengthen capacity at state/district levels to detect and respond to the epidemics in early rising phase. Under the project, the district and states have been strengthened by providing additional technical manpower (epidemiologists, microbiologists, entomologists), training of rapid response teams for outbreak investigation and control, strengthening of laboratories for detection of organisms causing epidemic prone diseases, and establishment of IT network for data compilation, dissemination and analysis. The states are at varying stages of implementation.

The biological diseases/ outbreaks/epidemics in India are usually investigated by the district or state Rapid Response Teams. Several central/regional institutes like National Centre for Disease Control (formerly National Institute of Communicable Diseases), Delhi; National Institute of Virology, Pune; National Institute of Cholera and Enteric Diseases, Kolkata; Vector Control Research Centre, Puducherry and other ICMR institutes provide epidemiological, laboratory and entomological support to the states for investigation and control when the outbreaks/epidemics are widespread and states request for assistance. Also there is increasing collaboration with Department of Animal Husbandry in managing emerging zoonotic diseases such as avian influenza and Crimean Congo Hemorrhagic fever.

It is a fact that epidemics do not respect national borders. As international travel is easy, biological agents need to be tracked so that they do not enter new regions across the boundaries. This aspect has made international collaboration crucial for epidemic control. International organisations like the World Health Organization (WHO), Food and Agricultural Organization (FAO), Office International des Épizooties (OIE) as well as some national agencies with global reach, e.g., Center for Disease Control and Prevention (CDC), United States of America (USA) have an important role to play and cooperation with them is necessary.

Response Mechanism: To deal with any kind of biological, radiological, nuclear emergency situation in India, there are 12 NDRF Battalions (Bns) which are placed in all the zones of the country, as depicted below, according to the specific Area of Responsibility (AOR).

All the Battalions have specialized teams (sufficient manpower) equipped with modern devices, to address the biological, radiological, nuclear emergencies. In addition, States also have the well trained SDRF Teams in 21 States of India, to deal with such disasters.

The NDRF and SDRF may respond to any such emergency 24/7. Further, a national emergency number 1078 is also available for any kind of assistance, including the biological, radiological, nuclear accidents/ disasters.

References

• Biological Disaster Management Guidelines, National Disaster Management Authority, Govt. of India (NDMA), July 2008
• Nuclear and Radiological Disaster Management Guidelines, National Disaster Management Authority, Govt. of India (NDMA), February 2009
• Disaster Management in India, Ministry of Home Affairs, Government of India, (Supported by UNDP), 2011
• Training Module on Chemical Biological, Radiological and Nuclear Disaster Management, by MEDIPIET.
• National Disaster Management Plan (NDMP) , May 2016,  , National Disaster Management Authority, Govt. of India (NDMA)