Centers for Disease Control and Prevention
U.S. Department of Health and Human Services
August 2007
PREDECiSioNal DRaft

this planning guide is provided as a predecisional draft. Please send your comments

and suggestions to the Radiation Studies Branch at CDC via e-mail (rsb@cdc.gov)

or mail them to:


Radiation Studies Branch


Division of Environmental Hazards and Health Effects


National Center for Environmental Health


Centers for Disease Control and Prevention


1600 Clifton Rd, NE (MS-E39)


atlanta, Ga 30333

Electronic copies of this document can be downloaded from

http://emergency.cdc.gov/radiation/pdf/population-monitoring-guide.pdf
population monitoring in radiation emergencies:
a guide for state and local public health planners ii
population monitoring in radiation emergencies: a guide for state and local public health planners
acknowledgments
the Centers for Disease Control and Prevention (CDC) thanks the many individuals and
organizations that provided input to this document, including the office of the Secretary,
Department of Health and Human Services, and the Population Monitoring interagency Working
Group.
Representatives from the following agencies and organizations participated in the CDC
roundtable on population monitoring on January 1112, 2005, and many provided comments on
initial drafts of this document:

American Red Cross (ARC)

Armed Forces Radiobiology Research Institute (AFRRI)

Association of State and Territorial Health Officials (ASTHO)

Conference of Radiation Control Program Directors, Inc. (CRCPD)

Council of State and Territorial Epidemiologists (CSTE)

Columbia University, Center for International Earth Science Information Network

Pennsylvania State University, Milton S. Hershey Medical Center

Indian Health Services

International Atomic Energy Agency (IAEA)

National Association of County and City Health Officials (NACCHO)

New York City Dept. of Health and Mental Hygiene

Oak Ridge Institute for Science and Education (ORISE)

State of Arkansas Department of Health

State of California Department of Public Health

State of Georgia Division of Public Health, Emergency Medical Services (EMS)

State of Illinois Emergency Management Agency (IEMA)

State of Iowa Hygienic Laboratory Department of Health

State of Maine Health and Environmental Testing Laboratory

State of Washington Department of Health

Texas A&M University, Department of Nuclear Engineering

University of Alabama-Birmingham, School of Public Health

University of Georgia, Grady College of Journalism and Mass Communication

University of New Mexico Health Sciences Center, Department of Radiology iii
population monitoring in radiation emergencies: a guide for state and local public health planners

U.S. Army and Air National Guard

- 4
th
Weapons of Mass Destruction Civil Support Team (WMD-CST)

U.S. Department of Commerce, National Institute of Standards and Technology (NIST)

U.S. Department of Defense, Northern Command (NORTHCOM)

U.S. Department of Energy (DOE)

- National Nuclear Security Administration (DOE/NNSA)

- Nevada Operations Office (DOE/NV)

- Radiation Emergency Assistance Center/Training Site (REAC/TS)

U.S. Department of Health and Human Services (DHHS)

- Agency for Toxic Substances and Disease Registry (ATSDR)

- Centers for Disease Control and Prevention (CDC)

- Food and Drug Administration (FDA)

- Health Resources and Services Administration (HRSA)

- National Institute for Occupational Safety and Health (NIOSH)

- National Institutes of Health (NIH)

- Substance Abuse and Mental Health Services Administration (SAMHSA)

U.S. Department of Homeland Security (DHS)

- Metropolitan Medical Response System (MMRS)

- Emergency Preparedness and Response Directorate, Nuclear and Chemical


HazardsBranch

- Environmental Measurements Laboratory (EML)

U.S. Environmental Protection Agency (EPA)

- Office of Radiation and Indoor Air (ORIA)

- Radiation and Indoor Environments National Laboratory (R&IE)

- National Air and Radiation Environmental Laboratory (NAREL)

U.S. Nuclear Regulatory Commission (NRC)
acknowledgments

continued iv
population monitoring in radiation emergencies: a guide for state and local public health planners
CDC wishes to specifically thank the representatives from the following agencies and
organizations who participated in the
Population Monitoring Interagency Working Group
since November 2005 and have continued to provide valuable comments throughout this
process:

aRC

CRCPD

DHS

EPa

fDa

DoE/NNSa

NRC

oRiSE

REaC/tS

State of California, Department of Public Health
CDC also acknowledges the oak Ridge associated Universities (oRaU), oak Ridge institute for
Science and Education (oRiSE), for its assistance in preparing this document.
acknowledgments

continued v
population monitoring in radiation emergencies: a guide for state and local public health planners
table of contents
Introduction ................................................................................................................................1
Scope ..........................................................................................................................................2


States with Operating Nuclear Power Plants .........................................................................3
Guiding Principles .....................................................................................................................3
What Is Population Monitoring? ..............................................................................................5
What Radiation Incidents Should Be Addressed
in Your Emergency Plan? .........................................................................................................6
What Are the Roles and Responsibilities of Federal, State,
and Local Public Health Agencies? .........................................................................................7
What Are Key Considerations in Planning for Population Monitoring? ..............................8


The Objectives of Population Monitoring .........................................................................9



Identifying and Prioritizing Affected Population ..............................................................9

Special Populations ....................................................................................................10


Population Monitoring (the Initial Hours) ........................................................................ 11

Contamination Screening Criteria ..............................................................................14

Radiation Survey Methodology ..................................................................................14

Clothing Services .......................................................................................................15

Transportation Services ..............................................................................................15

Washing Facilities .......................................................................................................16

Registry ......................................................................................................................17

Collection of Biological Samples ................................................................................17

Worker Protection .......................................................................................................17 vi
population monitoring in radiation emergencies: a guide for state and local public health planners


Population Monitoring (Day 2 and Beyond) ....................................................................18

Setting Up Community Reception Centers .................................................................18

Practical Considerations for Reception Centers Operations ......................................21

Pets ............................................................................................................................22

Scaling for Size of incident .........................................................................................23

Monitoring for External Contamination and Conducting Decontamination ................. 23

Monitoring for Internal Contamination and Conducting Decontamination .................. 24


Laboratory Capabilities/Biodosimetry .............................................................................26

Psychosocial Issues .........................................................................................................27

Registry ..............................................................................................................................27

Dose Reconstruction ........................................................................................................29


Training...............................................................................................................................29
Communications ...............................................................................................................31
Who Can I Contact for Further Information About This Guide? .........................................32
appendices
A - Acronyms.................................................................................................................... a-1
B - Glossary ..........................................