Experience gained from involvement in a number of emergency response activities since September 2001 in Texas indicated that the likely roles of statewide medical reserve corps units typically included aspects such as crowd control, registration and tracking, and information management. The need for training specifically focused on these likely roles became apparent. A novel field training exercise was developed that specifically focused on these likely roles. The exercise centered on a scenario involving the surreptitious placement of radioactivity in high traffic areas across the country, resulting in the contamination of large numbers of individuals. Because the source of the contamination was unknown, surge capacity contamination screening and data collection centers became necessary. Feedback collected from drill participants was measured to be overwhelmingly positive, with the vast majority of participants indicating a marked improvement in their understanding of their likely roles in a disaster of this type. The approach used in this training effort may be of use to other disaster surge capacity organizations as part of their strategic planning efforts as a means of ensuring that individuals involved in response activities possess familiarity with their likely roles during a wide scale public health disaster event.

To assist in providing comprehensive surveillance for potential health and safety hazards, simple assessments of physical, chemical, and biological safety concerns were incorporated into traditional radiation safety facility surveys for a biomedical research and clinical care facility for a 1-y period. Customized training was provided to radiation safety staff members concerning each of the hazard areas identified and a brief checklist was developed. During the 1-y period 802 laboratory and clinic surveys were performed, and of the 372 safety issues noted by the staff, approximately 55% were identified as not related to traditional health physics surveillance activities. The utilization of these simple safety audit tools as part of a routine radiation safety surveillance program can serve as a cost effective way to assist in maintaining a teaching, research, and clinical environment that is free from a variety of recognized hazards.

Experience gained during a field training exercise with a Medical Reserve Corps unit on the screening of large groups of individuals for possible contamination with radioactive material revealed that while exercise participants were generally attentive to the proper use of protective equipment and detectors, they tended to overlook important basic risk communications aspects. For example, drill participants did not actively communicate with the persons waiting in line for screening, a step which would provide re-assurance, possibly minimize apprehension, and would clarify expectations. When questioned on this issue of risk communication, drill participants were often able to craft ad hoc messages, but the messages were inconsistent and likely would not have significantly helped diminish anxiety and maintain crowd control. Similar difficulties were encountered regarding messaging for persons determined to be contaminated, those departing the screening center, and those to be delivered to the media. Based on these experiences, the need for a suggested list of risk communication points was identified. To address this need, a set of risk communication templates were developed that focused on the issues likely to be encountered in a mass screening event. The points include issues such as the importance of remaining calm, steps for minimizing possible intake or uptake, considerations for those exhibiting acute injuries, expected screening wait times, the process to be followed and the information to be collected, the process to be undertaken for those exhibiting contamination, and symptoms to watch for after departure. Drill participants indicated in follow-up discussions that such pre-established risk communication templates would serve to enhance their ability to assist in times of emergency and noted the potential broader applicably of the approach for use in responses for other disasters types as well.

Routine radiation safety surveys are a required part of every institutional radiation protection program. Although mandated by regulation, surveys are really performed to help clinicians and researchers establish and maintain radiologically-safe working and learning environments. In some cases, however, the priorities established by a radiation protection program may not coincide with the needs perceived by the institution's workers, leading to possible alienation, dissatisfaction, and non-compliance with policies, procedures, and regulations. To determine if a typical survey program was perceived as providing a good or valued service to workers, a simple questionnaire was created and utilized for a 6-mo period The results obtained from this targeted assessment tool indicate that the radiation safety survey services were perceived as useful by most of the workers. In addition, the actual process of comment solicitation provided a positive feedback mechanism from the service recipients to the radiation safety staff, managers, committee members, and institution administrators.

Compaction has been suggested as an interim processing method for infectious waste. Compaction greatly reduces the volume of waste at the site of generation and produces a more stable package for handling, shipment, and treatment. Preliminary studies have also indicated that when partially compacted waste is burned in an incinerator, the performance of the incineration unit is enhanced. Compaction is not currently used in institutions because the process may lead to the release of infectious aerosols, which could pose a significant hazard to healthcare workers. To determine if bacterial releases can be adequately controlled by a compaction device specially designed and constructed for the task, a prototype infectious waste compactor was challenged by compressing waste containing known quantities of indicator bacteria. Samples were collected to monitor bacterial releases and surface contamination. The data collected from this initial evaluation document that indicator bacteria were released from the unit. Modifications to the design and operation of a compactor of this type are proposed as suggestions that may improve system performance with regard to the health and safety of workers. A critical review of the experimental procedure used in this study is also included for the benefit of any future studies.