Public Health Laboratories and Radiological Readiness

Abstract

<jats:title>ABSTRACT</jats:title><jats:p><jats:bold>Objective:</jats:bold> To document the ability of public health laboratories to respond to radiological emergencies.</jats:p><jats:p><jats:bold>Methods:</jats:bold> The Association of Public Health Laboratories developed, distributed, and analyzed two separate surveys of public health laboratories representing the 50 US states and major nonstate jurisdictions. The 2009 All-Hazards Laboratory Preparedness Survey examined overall laboratory capability and capacity, with a subset of questions on radiation preparedness. A 2011 survey focused exclusively on radiation readiness.</jats:p><jats:p><jats:bold>Results:</jats:bold> The 50 state and District of Columbia public health laboratories responded to the 2009 All-Hazards Laboratory Preparedness Survey, representing a 98% response rate. In addition to the above laboratories, environmental and agricultural laboratories responded to the 2011 Radiation Capabilities Survey, representing a 76% response rate. Twenty-seven percent of the All-Hazards Survey respondents reported the ability to measure radionuclides in clinical specimens; 6% reported that another state agency or department accepted and analyzed these samples via a radioanalytical method. Of the Radiation Capabilities Survey respondents, 60% reported the ability to test environmental samples, such as air, soil, or surface water, for radiation; 48% reported the ability to test nonmilk food samples; 47% reported the ability to test milk; and 56% reported sending data for drinking water to the Environmental Protection Agency.</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> Survey data reveal serious gaps in US radiological preparedness. In 2007, federal experts estimated it would take more than 4 years to screen 100 000 individuals for radiation exposure and 6 years to test environmental samples from a large-scale radiological emergency, relying on existing laboratory assets. Although some progress has been made since 2007, public health laboratory radiological test capabilities and capacities remain insufficient to respond to a major event. Adequate preparation requires significant new investment to build and enhance laboratory emergency response networks, as well as investments in the broader public health system in which public health laboratories function.</jats:p><jats:p>(<jats:italic>Disaster Med Public Health Preparedness</jats:italic>. 2011;5:213-217)</jats:p>

Slow Progress in Preparing for Radiological and Nuclear Emergencies

“…Only 17 (33%) of 51 respondents to the 2009 survey reported any ability to measure radionuclides in clinical specimens, and 3 (6%) of these indicated that a state agency or department other than the public health laboratory was responsible for testing. The 2011 Radiation Capability Survey solicited responses from environmental, agricultural, and public health laboratories in all 50 states, the District of Columbia, and Puerto Rico and reached similar conclusions 3. Just 26% of respondents reported the capability to test urine specimens for radionuclides, and only 14% reported the capability to test other clinical specimens.…”

“…The articles by Dainiak et al12 and survey report by Latshaw et al3 that appear in this issue of Disaster Medicine and Public Health Preparedness address the state of US preparedness for radiological and nuclear emergencies and should prompt deliberation about what can be done to improve it. Radiological and nuclear emergencies occur infrequently but have been associated with both immediate and long-term health consequences and psychological distress in affected populations 4567.…”

“…In 2009 and again in 2011, the Association of Public Health Laboratories distributed surveys (the first as part of an all-hazards survey) to state public health laboratories that assessed their radiation readiness. These surveys achieved high response rates (98% and 76%, respectively), so the results must be taken seriously 3. The data, unfortunately, are discouraging.…”

A portable real-time in situ gamma-ray analysis system

“…Sample preparation and data collection take substantial time from laboratory analysts and they are limiting factors for achieving rapid turnaround and high throughput analytical results. In addition to expertise shortage (The National Academies Press, 2012; Latshaw et al, 2011; Ware, 2002; Warwick et al), the technical difficulties and required financial resources for establishing and maintaining a radio-analytical laboratory are also limiting factors for achieving the needed capacity for emergency response to a radiological or nuclear incident. While gamma-ray analysis requires expertise, utilization of a portable analytical system will help to achieve the needed rapid turnaround and high throughput laboratory grade analytical results if the analytical system is built with such features that it allows field personnel to perform sample preparations and data collections.…”