Local Public Health Preparedness for Radiological and Nuclear Incidents

Why We Did This Study

According to the 2010 National Security Strategy, the American people face no greater or more urgent danger than a terrorist attack with a nuclear weapon. If State and local public health officials do not plan for such incidents, local public health departments will not be adequately prepared to quickly respond and protect the public. Although the Nuclear Regulatory Commission requires nuclear powerplants to have emergency plans for their facilities and the immediate surrounding area, no Federal entity requires States or localities to have public health emergency plans for nonpowerplant radiological and/or nuclear (RN) incidents, such as a terrorist attack.

How We Did This Study

Using information requests and conducting document reviews, we determined the extent to which 40 localities from the Nation's most populous metropolitan statistical areas (referred to as the "selected localities") used local risk assessments to prioritize planning for RN incidents. We also determined whether the selected localities planned for RN incidents by engaging in five RN-specific public health planning areas; coordinating with Federal, State, and local partners; and using Federal guidance sources.

What We Found

Thirty-six of the forty selected localities had conducted risk assessments, but RN-specific public health planning did not always correspond to localities' prioritized threats. For example, of the four localities that categorized RN incidents as a high-priority threat, only one had RN-specific plans. Twenty-one of the forty selected localities conducted RN-specific public health planning in at least one of the five public health areas of responsibility we examined, but planning in the five areas varied. Localities also varied in the extent to which they coordinated with Federal, State, and local partners for RN-specific public health planning. Most State and local officials were aware of Federal guidance sources available to aid RN-specific public health planning, but requested more comprehensive and specific planning tools.

What We Recommend

Our report made four recommendations to CDC. First, work with selected localities to more closely align their incident-specific planning with risk assessments. Second, provide more specific guidance outlining the public health areas of responsibility to include in RN-incident planning. Third, provide more guidance on coordination with other entities for RN-incident planning. Finally, provide more training to selected localities about the unique aspects of an RN incident not addressed in all-hazards planning. CDC agreed with all four of our recommendations.