Health workers fear nuclear terrorism

Follow standard precautions, decontaminate pts

Hospitals and public health agencies should prepare for the unique features of radiological terrorism, such as mass casualties with blast injuries combined with burns, the Centers for Disease Control and Prevention (CDC) recommends. In guidance posted on its bioterrorism web site on Dec. 31, 2003, the CDC emphasized health care workers may be particularly fearful of radiation incidents and possible exposures.

"While patient care is a top hospital priority, it is vital that hospital personnel are protected from injury and disease while doing their job," the CDC added. "During a mass casualty radiological event, it is likely that hospital personnel will be concerned about radiation contamination. To alleviate their concern, hospital personnel should be educated about the potential health effects resulting from radiation exposure, learn what personal protective equipment they will need for precautionary measures and be trained so they can respond effectively to a radiological incident."

Standard (universal) precautions as practiced with any other mass casualty incidents (trauma, chemical, biological, etc.) generally is sufficient for protection from radioactive contamination. In a particular note about use of masks, the CDC said surgical masks should be adequate if N95 respirators are not available. The respirators should be available in hospitals because they already are recommended for health care worker protection against severe acute respiratory syndrome, TB, and certain other infectious diseases.

"Experience in human decontamination indicates that careful procedures for removing clothing and decontaminating patients prevents aerosolization of radioactive particles, and dosimetry of health care workers using surgical masks has not found evidence of contamination," the CDC stated.

(Editor’s note: To see Interim Guidelines for Hospital Response to Mass Casualties from a Radiological Incident, go to: www.bt.cdc.gov/radiation/pdf/MassCasualtiesGuidelines.pdf.)