More caution needed than ever before, experts say
Risk managers may have thought about their facilities as potential targets of terrorists, but have you ever considered that you might be the source of nuclear material used in an attack? If you don’t act now to ensure you have strict security for nuclear material in use in your facility, there is a real chance that it could be stolen for use in a dirty bomb, the experts warn.
The security of nuclear material always has been a concern in health care, but that risk has grown much bigger since Sept. 11, 2001, says Dave McIntyre, a spokesman for the Nuclear Regulatory Commission in Washington, DC, which oversees security at health care facilities and any other setting in which radioactive materials are found.
"Before 9/11, the industry — and to a large extent, the agency — regarded the security of materials in a hospital or industrial setting as a matter of public health and safety primarily. In other words, you keep them locked up so that people aren’t exposed to them," he explains. "Since then, everyone has begun to think in terms of access as well to protect the materials from malevolent use."
The nuclear materials found in a health care setting have limited use for a terrorist. They cannot be used to make a nuclear bomb, but they can be used in a dirty bomb, which uses conventional explosives to disperse radioactive material across a wide area, explains Dan Hodges, a retired FBI agent and now consultant with OpSec Consultants in Nashville, TN. Even in that use, nuclear materials such as the iodine seeds used in prostate cancer treatment probably would produce limited harmful effects.
But the actual injuries from the material would not be the main focus of such a weapon anyway, he explains. Terrorists would be more interested in creating panic and fear among the population when word spreads that radioactive materials were spread by the bomb, he says. The actual injuries, limited as they may be, would be a secondary objective of the terrorists.
"So the fact that we’re not talking about a huge amount of material that could cause a lot of damage is really beside the point. Terrorists would want this material for the shock value, because they realize the value in that," he says. "That’s why it is so important to protect it, even if your scientists are telling you it wouldn’t be that useful to a terrorist. It would, just in a different way than they might mean."
Hodges says hospitals would be an attractive target for terrorists seeking to access such materials because, by their nature, they have lower security and easier access than many industrial sites with similar material.
A 2003 report from the CIA notes that al Qaeda and other terrorist groups are intent on using chemical, biological, and nuclear weapons, but it says that most attacks will be "small-scale, incorporating relatively crude delivery means and easily produced or obtained chemicals, toxins, or radiological substances." The report mentions that the material of interest to terrorists includes the cesium-137, strontium-90, and cobalt-60 used by health care providers.
In addition, the report notes that terrorists may be interested in obtaining biological materials from health care facilities for the same purpose — spreading them with the intent of creating panic, regardless of the actual health implications of such dispersal.
In 2002, the International Atomic Energy Agency addressed the problem of terrorists using stolen nuclear material, issuing a report that makes this statement: "Clearly, theft of radioactive sources is easiest from locations where security is weaker, such as at hospitals and universities. . . . There would appear to be a need for some increase in the level of physical security for desirable sources. It is also logical to promote the collection and removal of disused sources, especially those that are in vulnerable locations."
Terrorists could target site with bomb
The presence of radiological materials in your facility also could increase your risk as the target of a terrorist attack, cautions Fred Roll, president of the International Association for Healthcare Security and Safety in Glendale Heights, IL. Keeping in mind that terrorists strive for panic as much as a death toll, they may see your oncology lab or other area with radioactive materials as a good place to plant a conventional bomb.
While the blast may not actually release radioactive material from your equipment or storage, the fact that the bomb site contains radioactive material will add another level of panic to the incident, Roll explains.
"A small explosive device in a radiological storage area will cause contamination or at least an extreme level of concern about contamination," he says. "The first responders are going to go nuts, and the people who have to work there afterward are going to wonder about it."
That means extra precautions are necessary in any area containing radiological materials, Roll says. Most hospitals already have the material behind locked doors, but that might not be enough. The area should be considered security-sensitive, just like the emergency department and the newborn nursery, with similar surveillance and presence by security personnel, he says.
Roll says risk managers who have not reviewed their security for radioactive materials since Sept. 11, 2001, should conduct a thorough review in light of the new threats from terrorists. One thing to consider is how the material comes to your hospital and leaves again, which may require added security and procedures in other areas such as shipping.
"The truth is that we have terrorists out there and we don’t always know what they’re planning," Roll says. "It might seem like a stretch to think they would go after a hospital’s radioactive material, but a few years ago it was hard to imagine what they would do with our airlines."