ML20027C403
| ML20027C403 | |
| Person / Time | |
|---|---|
| Site: | San Onofre  |
| Issue date: | 10/13/1982 |
| From: | Mcclung C FLEMMING, ANDERSON, MCCLUNG & FINCH, GALLAGHER, P.M., GUARD |
| To: | |
| References | |
| CLI-82-27, ISSUANCES-OL, NUDOCS 8210150490 | |
| Download: ML20027C403 (34) | |
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00CMETED USNRC 1 PHYLLIS GALLAGHER, Esq.
1695 West Crescent, Suite 222 '-
2 Anaheim, California 92801 T2 .CCI 14 P2 '25 3 Charles E. McClung, Esq FLEMING, ANDERSON, McCLUNG & FINCH 4 24012 Calle de la Plata, Suite 330 Laguna Hills, California 92653 5
6 Telephone: (714) 768-3601 7 Attorneys for Intervenors 8
9 10 UNITED STATES OF AMERICA NUCLEAR REGULATORY COMMISSION 11
)
12 In the Matter of ) Docket Nos.50-361 OL
) 50-362 OL 13 SOUTHERN CALIFORNI A EDISON )
14 )
(San Onofre Nuclear Generating )
15 Station, Units 2 and 3.) )
)
16 17 INTERVENORS' BRIEF REGARDING REOUIRED MEDICAL SERVICES FOR 18 THE GENERAL PUBLIC IN RESPONSE TO COMMISSION ORDER CLI-82-27 20 The Intervenors, Guard et al. hereby respectfully 21 submit their opening Brief with respect to the certified issues contained in the Commission's Order dated September 24, 1982 23 (CLI-82-27).
24 25 i
The Intervenors answer the two questions in the order 26 posed by the Commission in said Order.
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8210150490 821013 PDRADOCK05000g a
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I OUESTION PRESENTED NO. (1).
2 3 "(1) Does the phrase " contaminated 4 injured individuals" as used in 10 CFR 5 50.47(b)(12) reauire applicants for 6 nuclear power plants to provide 7 arrangements for medical services only 8 for members of the public who have 9 suffered traumatic injury and are also 10 contaminated with radiation?"
11 12 1 13 THE PHRASE " CONTAMINATED INJURED INDIVIDUALS" AS USED IN 10 CPR 50.47(b)(12) DOES NOT REFER ONLY TO THOSE 14 MEMBERS OF THE PUBLIC WHO HAVE SUFFERED TRAUMATIC INJURY BUT ALSO TO THOSE MEMBERS OF THE PUBLIC WHO HAVE 15 SUFFERED RADIATION INJURY.
16 17 The Intervenors feel that the short answer to the 18 Commission's first question regarding the precise meaning of the 19 above referenced regulation is: "no". The Intervenors completely 20 agree with the detailed and well reasoned opinion of the 21 Licensing Board in th'is case (LPB-82-39). Please refer to slip E2 opinion Page 24, et seg. Accordingly the Intervenors will not 23 reargue the same points made by the Licensing Board in that 24 decision herein.
25 26 The question posed turns on the meaning of the word 27 " injured" in the above quoted regulation. The positions of the 28 NRC Staff and the Applicants are correctly set forth in the
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i 1 Appeal Board decision denying our notion for a stay pending our 2 appeal (ALAB-680). The NRC Staff and the Applicants essentially 3 take the position (although the NRC's position is somewhat 4 unclear) that the word " injured" refers to traumatic, i.e.
5 non-radiation, injuries. The Appec2 Board appearn to favor this 6 view without citation of authority. The Intervenors have argued 7 throughout the Hearing process that the word " injured" in this 8 regulation refers not only to the traumatic, non-radiation type 9 injury, but to radiation injuries as well.
10 11 Although there is a difference of opinion among medical 12 experts the applicants' witness, Dr. Linnemann, in this pro-13 ceeding, who was presented as an expert in radiological medicine, 14 consistently made a distinction between those individuals who 15 were contaminated and those individuals who are irradiated and IE actually suffering physical harm. Mere contamination was said to 17 be something that could be washed off with soap and water, 18 whereas actual irradiation, viz, receiving whole body doses in
. 19 excess of 150 rem, was thought to be significant radiological 20 " injury" for which hospitalization and careful supervision would 21 -be appropriate. (Transcript at 7728,7767) 22 23 The phrase " contaminated injured individuals" would, 24 therefore, appropriately mean an individual who was contaminated 25 and also injured, either traumatically or because he had received 26 a life threatening dose of radiation.
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1 II 2 PEMA SUPPORTS THE READING OF THE INTERVENORS THAT
" INJURED" REFERS TO THOSE WITH RADIATION INJURY.
3 4
This position is supported by Federal Emergency 5
Management Agency (" FEMA"). FEMA provided evidence in this 6
proceeding by way of letters addressing the meaning of this 7
regulation and NUREG-0654. The letters are attached hereto as 8
Exhibit "B" and incorporated by reference herein. FEMA, co-9 author of NUREG-0654 which sets forth the guidelines for 10 implementing the cmergency planning regulations, interprets 11 NUREG-0654 to encompass medical arrangements for the general 12 public beyond those people who may be traumatically injured 13 during the radiological emergency.
14 15 The FEMA position clearly encompasses planning and 16 arrangements for medical services for those people who are 17 radiologically injured. Intervenors contend that FEMA's position 18 on this issue should be most persuasive authority because FEMA 19 has been given lead responsibility to develop off-site juris-20 i Ciction emergency response plannina by the Presidential Order of 21 December 7, 1979 (E.O. 12148) implementing the recommendations 22 contained in the Kemeny Report on Three Mile Island. The 23 Memorandum of Understanding between the NRC and FEMA provides 24 that FEMA will review the off-site jurisdiction plans and the 25 regulations 10 CFR 50.47(a) and (b) provide that FEMA will make 26 the review. The NRC staff essentially performs an appellate 27 function in reviewing FEMA's " Findings" which are to form a 28
i 1 " rebuttable presumption" in Licensing Board proceedings. It is, 2 therefore, respectfully submitted that the interpretation of FEMA 3 as to the NUREG-0654, although not dispositive to the issue with 4 respect to the NRC regulation, should be very persuasive to this 5 Commission as to not only what the regulation means in c 6 technical sense but what it should mean as a matter of public 7 policy.
8 9 III 10 NUREG-0654 SUPPORTS THE READING OF INTERVENORS THAT " INJURED" REFERS TO THOSE WITH RADIATION INJURY.
11 12 The view of FEMA and the Intervenors' is also supported 13 by specific reference to NUREG-0654. Exhibit "A" to this 14 pleading sets forth the specific references in NUREG-0654 in 15 their entirety which refer directly or indirectly to the pro-16 vision of off-site medical care for the general public. As can 17 be seen these cover a vast array of arrangements from the 18 identifying of resources (what the NRC Staff refers to as 19
" preplanning") to the setting forth of agreements between the 20 various private response organizations, to the planning and 21 implementing of procedures to call upon said resources in the 22 event of emergency, to the drilling and exercising of those 23 facilities. It is submitted that this large amount of regulatory 24 language would not have been used if the regulations meant only 25 to protect those who were traumatically injured and also con-26 taminated in the event of emergency. This is because the 27 traumatically injured, as set forth in the evidence of this 28 e
l 1 proceedinq and as quoted by the Appeal Board, would be a very 2 small number indeed, perhaps no more than 25. (ALAB-680 Slip 3 Opinion at 18) All evidence indicates that this number could be 4 handled by the Applicants' on-site plans. In fact it is 5 postulated that most of the traumatic injuries that were to 6 happen together with contamination would probably occur on-site.
7 8
9 IV 10 THE " LEGISLATIVE HISTORY" SUPPORTS THE READING OF INTERVENORS THAT " INJURED" REFERS TO THOSE 11 WITH RADIATION INJURY.
12 13 With respect to the " legislative history" of the 14 regulation, NUREG-0654 refers directly to both NUREG-0396 and 15 NUREG-75-111 as the guiding documents which for.t the basis for 16 the new regulations and NUREG-0654. Applican:s tend to rely on 17 NUREG-0396 which refers generally to the pre-TMI adoption of the 18 ten mile emergency planning zone concept for nuclear power 19 plants. It is submitted that the information contained in that 20 document is largely irrelevant to this proceeding as it is a 21 pre-TMI document which does not focus on the emergency medical 22 services or the adequacy thereof. The checklist, NUREG-75-111 is 23 a more appropriate source. The relevant portions of that 24 document are attached hereto as Exhibit "C". This document 25 directly refers to medical preparations for the general public 26 and the inplementation of off-site emergency planning for medical 27 services for the general public in the event of a radiological 28 ////
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I emergency. The document at Footnote 2 indicatts that the exact 2 nature of these services and planning should be based on site 3 specific data and determined by health care professionals in the 4 local jurisdictions and the State surrounding the nuclear plant.
5 This is precisely the position of the Atomic Safety and Licensing 6 Board, FEMA and the Intervenors in this proceeding.
7 8 This position is also supported by the Kemeny 9 commission Report at Pages 74 and 75 containing the recom-10 mendations for worker and public health and safety, which 11 indicate that it is recommended that the radioprotective drug, 12 potassium iodide be made available for the general population and 13 that there he sufficient health related equipment and that there 14 be State and local training for health professionals in the area 15 of the nuclear power plants regarding radiation and health 16 issues.
17 18 It is respectfully submitted that the appropriate 19 meaning of the quoted regulation encompasses not only the 20 traumatically injured but the radiologically injured as well.
21 22 OUESTION PPRESENTED NO. (2) 23 24 "(2) If Applicants are required to 25 provide arrangements for medical services 26 for the general public who are injured 27 and/or contaminated unde- 10 CFR 28 50.47(b)(12), to what extent does that
l 1 regulation recuir( advance, specific 2 arrangements and commitments for medical 3 services for the ceneral public as 4 opposed to the general knowledge that 5 facilities and resources exist and could j 6 be used on an ad hoc basis?
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10 ADVANCE, SPECIFIC ARRANGEMENTS AND COMMITMENTS FOR MEDICAL SERVICES FOR THE GENERAL PUBLIC MUST BE MADE 11 TO PERMIT THE PROMPT DELIVERY OF MEDICAL SERVICES TO MEMBERS OF THE PUBLIC WHO ARE INJURED AND/OR CON-12 TAMINATED IN A NUCLEAR POWER PLANT ACCIDENT.
13 14 The reason for advance planning, as opposed to mere 15 identification of resources (" preplanning"), is to facilitate the 16 prompt delivery of medical services which are needed to protect 17 the public health and safety. Prompt delivery of services will 18 be crucial in order to mitigate the effects of radiation exposure 19 in the event of a nuclear power plant accident. The services 20 referred to here might include distribution of radioprotective 21 drugs, decontamination of skin (whether broken or unbroken), and 22 treatment of traumatic injuries of contaminated individuals. In 23 order to deliver such services promptly, it will be necessary to 24 identify the persons requiring them. That is, a system of 25 " triage" will have to be established so that the available 26 resources are utilized to protect the public health and safety.
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1 Uithout such a system, it is probable that the available 2 resources would be overwhelmed, and the delivery of necessary 3 services to injured and contaminated members of the public would 4 be delayed beyond the bounds of efficacy. For example, if 5 potassium iodide were to be used to prevent uptake by the thyroid 6 of radioactive iodide, it would have to be distributed to the 7 population to be treated within "a few hours" in order to be 8 effective. NUREG-0654 at page 9 suggests "the possible 9 administration of the thyroid blocking agent, potassium iodide 10 should also be considered [for the plume Exposure pathacy EPZ)".
11 Unless plans were well established for identification of the 12 target population and distribution of the drug to members of the 13 population, there would be little, if any, likelihood that the 14 drug would be effective.
15 16 Similarly, if persons who are contaminated with 17 radiation must vie with those who are not contaminated, or who 18 are only minimally contaminated, for available decontamination 19 services, their decontamination will not be accomplished in time 20 to mitigate the effects of radiation on them, and their health 21 will be injured as a consecuence of delay. Thus, it is necessary 22 to do advance planning and make certain commitments for medical 23 services in order to reach the goal of protection of the public 24 health and safety. In cases where serious traumatic injury is 25 accompanied by contamination, the need for prompt delivery of 26 medical services is even more apparent.
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1 II 2 NUREG-0654 AND THE OUOTED REGULATION PROVIDE FOR ADVANCE PLANNING FOR MEDICAL SERVICES FOR A SPECTRUM 3 OF ACCIDENTS INCLUDING CORE MLLT SEQUENCES.
4 5 There is little guidance from actual experience of 6 nuclear power plant accidents to test the adequacy of medical 7 services arrangements during an accident. The TMI 2 accident is 8 the most recent and most severe accident in the history of 9 operating reactors, but it is still too soon to access whether 10 the medical services available succeeded in protecting the public 11 health to the extent required by the Atomic Energy Act of 1954 12 [42 U.S.C. 2021 (d)]. Generally, health planners recognize that 13 in planning for disasters of any kind, the more unusual the 14 disaster, the more there is a need to specify the procedures for 15 response to such a disaster. Disaster planning and disaster 16 drills are considered necessary for accidents which rarely occur 17 in the ordinary course of business. Since nuclear power plant 18 accidents are relatively infrequent, they require advance 19 planning which specifies the response which is appropriate to the 20 disaster, rather than ad hoc treatment.
21 22 Hence NUREG-0654 Appendix 1 provides for a spectrum of 23 accidents as a planning basis for the more detailed provisions.
24 As set forth explicitly in Exhibit "A" attached hereto and 25 incorporated herein by reference this includes much more than the 26 preplanning and identification ot resources.
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t 1 Without some required planning, it is difficult to 2 imagine what standard is being applied - beyond "what exists is 3 enough". How can experts conclude that there are sufficient 4 resources without a plan demonstrating that those resources can 5 be marshalled to meet the emergency.
6 7 III 8
9 ADVANCE PLANNING WHICH SPECIFIES THE APPROPRIATE ARRANGEMENTS FOR MEDICAL SERVICES FOR THE GENERAL 10 PUBLIC WILL ENHANCE THE EFFECTIVENESS OF AVAILABLE MEDICAL RESOURCES AND WILL BE COST EFFECTIVE.
11 12 Appropriate use of medical services in the event of a 13 nuclear power plant accident would make it more likely that 14 existing medical resources would prove adequate to the task of 15 providing care to injured or contaminated persons. Thus, if 16 procedures for access to emergency clinical facilities were in 17 place, only those persons who need clinical care would enter the 18 medical system, which would be less likely to be overburdened.
19 This would embody the " triage" concept, with screening, counseling, and referral components. It is important to note, 21 that while such a system would no doubt have a beneficial effect 22 on persons who are psychologically stressed, it is directed 23 toward appropriate utililzation of available resources, not toward providing psychological services, per se. A recent Commission decision, Metropolitan Edison Company, (Three Mile 26 Island Nuclear Station Unit No. 1), CLI-82-6, 15 NRC 407(1982),
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D 1; reveals the Cormission's reluctance to recognize psychological 2' stress as properly within the scope of the Commission's 3 authority. Even if this reading of the Atomic Energy Act is 4 correct, the use of screening, counseling and referral services 5; for the purpose of (nhancing the appropriate utilization of 6 existing medical services would be a cost effective method of 7 ensuring the delivery of medical care to those who need it. In 8 order to structure access to clinical facilities, such services 9 would have to be planned for in advance of an accident.
10 11 IV 12 13 THE EXACT NATURE OF THE MEDICAL ARRANGEMENTS WHICH SHOULD BE PLANNED FOR IMPLEMENTATION IN THE EVENT OF 14 A NUCLEAR POWER PLANT ACCIDENT IS A MATTER WHICH CAN BEST BE ADDRESSED BY MEDICAL PLANNING EXPERTS.
15 16 Although the general outlines of the medical arrange-17 ments which should be made to protect the health and safety of 18 the public in the event of a nuclear power plant accident can be 19 sketched in a brief, the planning for such arrangements is a 20 matter for experts in the fields of community health and health 21 planning. See Exhibit "C" hereto; Nureg 75-111 at page 31 and 32 22 Footnote 2. The hearing process will be useful in providing 23 evidence of the factors which must be considered in devising such 24 plans, but the content of the plans will reflect medical judgment 25 not available to the parties to this proceeding at the present 26 moment. This will involve site specific considerations of 27 28 ////
l 1 resources and population and need. Intervenors and FEMA, without 2 communicating with each other, arrived at essentially the same 3 conclusion regarding the kinds of medical services which'should 4 be planned for, including decontamination facilities, monitoring 5 equipment,. trained staff, clincical facilities, history taking 6 capability, etc. Compare Exhibit "B" to Intervenors' Response to 7 Licensing Board Order dated August 6, 1982.
8 9 CONCLUSION 10 11 It is respectfully submitted that 10 CRF 50.47(b)(12)
- 12 contemplates medical services for the general public who may 13 receive radiation injury in an emergency and said regulation 14 requires more than " preplanning" and identification of resources, 15 it requires planning-for the actual use of those resources in an 16 emergency.
17 18 Respectfully submitted, 19 PHYLLIS M. GALLAGHER and 20 FLEMI d,, ANDERSON,dipC UNG'I)P;INdH t r
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4 EXHIBIT "A" NUREG-0654 REFERENCES TO EMERGENCY MEDICAL SERVICES
- 1. A. Assignment of Responsibility (Organizational Control)
Section 2.a. "Each Organization shall specify the functions and responsibilities for major elements and key individuals by title-of emergency response, including the following: ...
emergency medical services ...."
This requirement is made applicable to the State and local governments, there is a completely separate Section B which refers to the Licensee. NUREG-0654 at 32.
Section 3. "Each Plan shall include written agreements referring to the concept of operations developed between Federal, State and local agencies and other support organizations having an emergency response role within the emergency planning zones
... (emphasis added)
FEMA concurs tnat this is applicable to medical support i organizations, see Exhibit "B", page 2, no. 4. NUREG-0654 page 32.
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- 2. B. On-Site-Emergency Organization-
'Section 9. "Each licensee.shall identify the services to be provided by local agencies for handling emergencies, e.g. police, ambulance, medical, hospital and fire. fighting organizations ...
shall be specified. NUREG-0654 at 39.
- 3. C. Emergency Response Support and Resources Section 4. "Each Organization shall identify nuclear and other facilities, organizations or. individuals, which can be relied upon in an emergency to provide assistance. Such as-sistance shall be identified and supported by appropriate letters of agreement."
This is made directly to the licensee, State and local government. NUREG-0654 at Page 41.
- 4. P. Emergency Communication Section 2. "Each Organization shall ensure that a co-ordinated communication link for fixed and mobile medical support facilities exists."
This criterion is made applicable to the licensee, State and local. NUREG-0654 at Page 48.
- 5. J. Protective Response Section 10.d. "Means for protecting those persons whose mobility may be impaired to such factors as institutional or other confinement."
"e. Provisions for the use of radioprotective drugs, particularly for emergency workers and institutionalized persons within the plume exposure EPZ, whose immediate evacuation may be infeasible or very difficult including quantities, storage and means of distribution."
"f. State and local organizations Plans should include the method by which decisions by the State Health Department for administering radioprotective drugs to the general population are made during an emergency and the predetermined conditions under which such drugs may be used by off-site emergency workers."
All these sections refer and are applicable to the State and local organizations and they are referenced by FEMA in Exhibit "B" hereto. NUREG-0654 at 63.
- 6. L. Medical and Public Health Support Section 1. "Each organization shall arrange for local and back-up hospital and medical services, having the capability for evaluation of radiation exposure and uptake, including assurance that persons providing these services are adequately prepared to handle contaminated individuals."
This provision is made directly applicable to all the response organizations. NUREG-0654 at 69.
Section 3. "Each State shall develop lists indicating the location of public, private and military hospitals and other emergency medical services facilities within the. State or contiguous States, considered capable of providing medical support for any contaminated injured individual. The listing shall include the name, location, type of facility and capacity and any special radiological capabilities. _These emergency medical services should be able to radiologically monitor contamination personnel and have facilities and trained personnel to care for contaminated injured persons."
This criterion is ..ade directly applicable to the State.
i NUREG-0654 at 69.
1 Section 4. "Each organization shall arrange for trans-porting victims of radiological accidents to medical support facilities."
i This criterion is made directly applicable to all response organizations. NUREG-0654 at 69.
- 7. N. Exercises in Drills Section 2.c. Medical Emergency Drills. "A medical emergency drill involving a simulated contaminated individual which contains provisions for participation by the local support services, (i.e. ambulance and off-site medical treatment facility) shall be conducted annually. The off-site portions of the medical drill may be performed as part of the required annual exercise." -
This criterion is made applicable to the licensee and local response organizations and is referred to in Exhibit "B" by FEMA.
NUREG-0654 at 72.
- 8. O. Radiological Emergency Response Training 1.a. "Each facility to which the Plan applies shall provide site specific emergency response training for those off-site emergency organizations who may be called upon to provide assistance in the event of an emergency."
i 1.b. "Each off-site response organization shall participate in and receive training. k'here mutual aid agreenents exist between local agencies, such as fire, police, ambulance and rescue, the training shall be offered to the other departments who are members of the mutual aid district."
- 4. "Each organization shall establish a training program
- for instructing and qualifying personnel who implement a radio-logical emergency response plans. The specialized initial' training and periodic retraining programs, including the scope nature and frequency shall be provided in the following cate-gories: ... h. Medical Support Personnel; ...
These sections refer generally to the response training required by all the emergency response personnel. Footnote 1.
NUREG-0654 at page 75 provides " training for hospital personnel, ambulance / rescue, police and fire departments, shall include the procedures for notification, basic radiation protection and their expected roles ..."
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b'bOE UNITED STATES OF AMERICA 00f. METED USNRC NUCLEAR REGULATORY COMMISSION ATO E W W E N M N *81 Odi 23 P1 OCT 2 6 1981 g.
BEFORE ADMINISTRATIVE JUDGES OFFICE OF SECRET!
James L. Kelley, Chairman 00CKETji g ERV Elizabeth B. Johnson Cadet H. Hand 0OCT23y
)
In the Matter of ) Docket Nos. 50-361-0L
) 50-362-0L SOUTHERN CALIFORNIA EDISON COMPANY, )
)
(San Onofre Nuclear Generating )
Station, Units 2 and 3) ) October 22, 1981 '
)
ORDER (Including Letters from Federal Emergency Minagement Agency in the Record)
Attached are copies of two letters dated October 15, 1981 from Marshall E. Sanders, Acting Chief, Technological Hazards Division, Office of Natural and Technological Hazards, Federal Emergency Management Agency, to the Board Chairman. Pursuant to the Board's Order of October 6, 1981, these letters are being included in the record. Any party who wishes to submit written coments on these letters shall do so by November 15, 1981.
FOR THE ATOMIC SAFETY AND LICENSING BOARD
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James L. Kelley, Chairmanf ADMINISTRATIVE JUDGE Dated at Bethesda, Maryland l this 22nd day of October,1981.
! EXHIBII B
, I j$, Federal Emergency Managernent Agency gc .ry@
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,2 Washington, D.C. 2002 f/A~
d 'f' OCT 15 ESI e 9
Judge James L. Kelley Administrative Judge 5
- OCT 2 319f Atomic Safety & Licensing Board Panel ofic cftS L=r t!ashington, D.C. 20555 (S W'4 a 3*
Dear Judge Kelley:
4 TMs letter sets forth answers of the Federal Emergency Management Agency (FEMt.)
to questions you posed to Mr. Spence Perry at the recent hearings on San OncTre concerning special arrangements for medical services for percons within the 10-
, mile EPZ around the San Onofre Nuclear Generating Stations 2 and 3.
Question: "In determining whether offsite emergency plans concerning the 10-mile EPZ provide adequate protective :. :asures in the event of a serious radiological emergency, does FEMA believe that any specific arrangements need to be, made for
.edical services for people in the zone who may be contaminated, suffering from ev'istion er both? If not, why not? If so, what kinds of arrangements?"
.~EMA believes that special arrangements for medical services need to be nade for persona within the 10-mile EPZ who may suffec from radiation exposure, radiologica contamination cf both. Moreover, this position is supported by specific planning st endards and criteria in NUREG-0654/ FEMA-REP.-1 Rev. 1 for usa, by State and Ir. cal gcvernments in accuring that adequate arrangements are made for the provision of medical services for accidents encompassing the full range of the fcur classes of emergency action levels as delineated in Appendix 1.
The question posed does not specify whether or not we should address exposure control meast.res and mer'ieal nervices for emergency workers who are raore likely to be exposed to dangerous levels of radiation. Because the int 2nt of the questic appears to be directed towards the general public and not emergency workers, our answer, thefefore, assumes the general public.
It is significant that your question draws a relationship between arrcngenents for medical services and the provision of protective measures. The primary intent cf protectice responsa measures as presented in planning stendard "3" of NUREG-0654/
FEMA-REP-1 is to prevent or significantly minimize the exposure of the general pcpulation within the 10-mile plume exposure pathway to dangerous radiation levels d
To the extent, therefore, that such protective measures ceconglish their purpose, there would be no or little need for medical services.
% u
The planning and preparedness guidance provided in NUREG-0654/ FEMA-REP-1 for medical services is based, in part, on the possibility that despite the application of protective response measures, persons within the 10-mile EPZ may be exposed to dangerous levels of radiation. Those persons so exposed would, therefore, require appropriate medical services.
Planning standard "L" and other related planning standards with NUREG-065'4/
FEMA-REP-1 describe the arrangements that should be made by State and local governmants for the provision of medical services to offsite contamincted and injured individuals. These arrangements include:
- 1. Provision of local and backup hospital and m:: dical services having the capability for evaluation of radiation exposure and uptake, including accurance that persons providing these
- services are adequately prepered to handle contaminated individuals. (L-1)
- 2. Identification of public, private and military hospitals and other medical services facilities within the State or contiguous States censidered capable of providing medical support for any contaminated injured individual. The listing should incJude'the and capacity and any special name, location,typeoffacility$>
radiological capabilities. L, '
Thesa emergency medical services provided should include the capability to radiologically monitor contaminated personnel.
Trained personnel within these facilitics should be able to care for centaminated injured persons. (L-3)
- 3. Provision of arrangenents for transporting victims of radiological incidents to medical support facilities. L 'l
- 4. Docunentation by written agreements of all designated Federal,
, t,/ State and local agencies and medical support organizations
! having en emergency role within the EPZs. (A-3) l l 5./ Provision of radiological monitoring and other appropriate f \s' rcedical services for those percons who have been cvccuated.
l (3-12)
- 6. Provision for protecting those persons whose mobility may be impaired due to such factors an institutional or other con-finement. (3-10d)
! 7. Provision for the use of radioprotective drugs, particularly for institutionalized persons within the plume exposure EPZ whose immediate evacuation mcy not be feasible or very difficult, l
including quantities, storage and means of distribution.
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State and local organizations' plans should include the method by which decisions by the State Health Department for administering radioprotective _ drugs to the general population are made during an emergency and the predetermined conditions under which such
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drugs may be used. (3-10e-f) -
- 8. Establishment of a training program for instructing and qualifying personnnel who will implement medical services.
These organiations include those within the EPZs who are party to written agreements with State and local governments.
Such organizations cnd their personnel should participate in exercises and drills on, at least, an annual basis. (N-2, 0-1-5)
FEMA is developing two courses related to the provision of medical services for radiologically contaminated individuals. Two contracts have been awarded to the Oak Ridge Associated Universities' Radiological Emergency Assistance Center / Training Site (REAC/TS) to develop two courses for training medical personnel on how to handle and previde emergency medical treatment to contaminated persons. The first course is for paramedics and the second course is for emargency room personnel in hospitals. It is expected these courses riill be ready for training these two groups of specialists in April or May of 19E2.
Questicn: "In FEMA's consideration of this questien [ previous question addressec what cor.cideration is given to very low probability high-consequence accidents, ccmmonly referred to as class 9 accidents?"-
Class 9 accidents are commonly understood to indicate nuclear power plant accider involving a core .T. cit down.
As indicated earlier, the planning and preparedness guidance provided in NUREG-0654 for the provision of ruedical services to cents.ais (injured) persons applies to all four classes of emergency action levels as desc.
in Appendix 1. The fourth class level, " General Emergency," involves " the actu:
imminent substantial core degradation or melting with the potintial for loss of containment." (Page 1-3)
In c?sponse to your specific question, general guidance is provided for the prov-of medical sers ices for "Gener al Emergencies." No specific considerations, owc-are provided for a class 9 accident. If such an accident occurrcd and if ti. .
accident resulted in a large number of. persons being contaminated by exqcssive levels of radiation, State and local. governments wculd have to rely upon i.dentif socd.ical support organizations in an area beyond the EPZs for the plant where the accident occurred and even other States with facilities that have- the required capabilities and resources. .
1
_4 Sech ruppport is already anticipated in the guidance provided in t;UREG-0654/
FEMA-F.EP-1. State and local governments are expected to document such support .
Also, all ;
by providing uritten agreements in their energency response plans. -
redicci organizations which are party to such agreements would assure that their Participation in emergency personnel were trained to cope with'such a scenario.
annual exercises and periodic drills would constitute a significant part of a training program.
I hope _ the foregoing is responsive to your questions.
Sincerely, b - M/
riarshdll E.DS 'nde..rs Acting Chief ,
Technological Hazards Division Office of Natural and Technological Hazards D
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g, 6 @u p 3hp@f Federal Ernergency. Managernent Agency #
p' h Washington, D.C. 20472
. OCT 15 IS81 e r Judge 3sses L. Kelley .
[- ' OCT 2 3198 Administrative Judge Atomic Safety & Licensing Boar.d Panel go Of y t.'ashington, D.C. 20555 gand
Dear Judge Kelley:
' 4 During the hearings on the licensing of the San Onofre Nuclear Generating Statiens 2 and 3, you asked Mr. Spence Perry, FEMA Staff Counsel, to have FEMA Headqusrters respond by letter to sono questions you raised. This letter is in compliance with this request.
.Que'stion #1: What further steps does FEMA plan to take in evaluating the of fsite emergency plans?
Answer: FEMA Region IX will continue to monitor the progress of Southern Californi Edison's efforts in working with the local jurisdictions to correct the deficiencie oc.ted in the June 3,1931, evaluation of offsite plcn3 and preparcdness. Monthly reports will be made by FEMA Region IX to FEMA Headquarters. FEMA Region IX will determine whnt limited exercises and drills are needed to demonstrate that the deficiencies have been corrected. When the corrective actions outlined in a June 26, 1981, letter from Mr. K. P. Baskins, Scuthern California Edison to Mc. Brian Grimes of the NRC are completed, FEMA will make an interim finding, under the tecms of the November 1980 NRC-FEMA Memorandum of Understanding, concerning the adequacy of of fsite emergency plans and preparedness.
O_uestion #2: Does FEMA consider that it is premature to consider qu6stions of of l site emergency preparedness for San Onofre at this time?
Answer: FEMA does not believe that it is r,remai.ure fct *the Board to consider ofTsite emergency preparedness. Much planning has been done, a full exercise hss been held, and interim FDIA findings have been nade end FEMA has continued to monit and update its views as is reflected in its testimony.
Question #3: What is the status of the Nauman testin:ony, should it be charac-terized as a national view or a regional view? .
Answer: Mr Nauman's testimony represents a FEMA Regional view, except where he leflected his knowledge of Headquarters views provided to him. He represents a Regional view because FEMA Headquarters has delegated to its Regions the responsibility for working with State and local governments in developing their plans and preparedness and in evaluating these efforts. Typically, Headquarters nakes findings and deter:ninations on adequacy based on the evaluations by the Region. Mr. Nauman's testimony will become a part of this evaluation process and as such have a bearing on the FEMA findings and determinations on offsite prcparedness.
1 Question #4: Is tSe July 14, 1981, memorandum to Mr. Brian Grimes (subject:
emergency preparedness and support of San Onofre Nuclear Generating Station (SONGS), signed by Mr. Jaske) still an accurate reflection of FEMA's proposed ections and timing?
Answer: Yes, this memorandum is an accurate reflection of the actions to be taken by FEMA. The timing, however, is contingent upon Southern California Edison being able to meet the schedule for correcting the deficiencies detailed in the enclosure to Mr. Baskin's letter of June 26, 1981, to Mr. Brian Grimes.
Ducstien #5: Does the Nauman testimony to the extent that it differs from the June 3,1981, FEMA findings, supercede those findings?
Answer: No, the Nauman testimony does not represent new or different findings from those of June 3. The present delegation of authorities to the FEMA Regions do not include the making of findings which is reserved for _the FEMA National Headquarters. The Nauman testimony, to the extent that it differs frca the June 3 FEMA finoings, reflects actions that have been taken by Southern California Edison and local jurisdictions to correct the deficiencies r.cted in the June 3 findings.
Question #6: Was the target date of November 1,1981, for the issuance of new FEMA findings, set in the Jaske memorandum of July 14, 1981, the recult of external activities by the Southern California Edison Ccmpany or internal FEMA considrations? ,
Ar$swer : FEMA was given October 15, 1981, by the company as a target for completing the improvement activities to correct the deficiencies. On the assumption that this schedule was met, FEMA added 15 days for processing and forwarding to FEMA Headquarters an evaluation by the Region and for the preparation o r findings by FEMA Headquarters. Thus, the target date was the result for a combination of factors, those outside its control and those within its control.
I hope that the foregoing is responsive to your questions.
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Sincerely, Wf -v1 -C Marshall E. Sanders GW Acting Chief Technological Hazards Division Office of Natural and Technological Hazards
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September 9,1982 James L. Kelley, Esq. , Chairman Mrs. Elizabeth B. Johnson Administrative Judge Administrative Judge Atomic Safety and Licensing Board Oak Ridge National Laboratory U.S. Nuclear Regulatpry Comission P.O. Box X, Building 3500 Washington, D.C. Oak Ridge, Tennessee 37830 Dr. Cadet H. Hand, Jr.
Administrative Judge c/o Bodega Marine Laboratory University of California P.O. Box 247 Bodega Bay, California 94923 f In the Matter of SOUTHERN CALIFORNIA EDISON COMPANY, ET AL.,
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(San Onofre Nuclear Generating Station, UnTts7 and 3)
Docket Nos. 50-361 OL & 50-362 OL
Dear Members of the Board:
On September 3, l'982, the Staff served its response to the Licensing Board's Memorandum and Order of August 6,1982, appending to it the then best available copy of FEMA's response. Subsequently, the Staff has received the original of FEMA's response and is able to provide the Licensing Board and parties with a more legible copy, which is attached.
Sincerely, Gpi lerncz . O
, Lawrence J. Chandler i Deputy Assistant Chief Hearing Counsel
Enclosure:
As stated above CC:
J. Calvin Simpson, Esq. Lawrence Q. Garcia, Esq.
Mrs. Lyn Harris Hicks Alan R. Watts, Esq.
Daniel K. Spradlin Gary D. Cotton Louis Bernath A. S. Carstens David R. Pigott, Esq. Samuel B. Casey, Esq.
John A. Mendez, Esq. Edward B. Rogin, Esq.
Richard J. Wharton, Esq. Charles R. Kocher, Esq.
. James A. Beoletto, Esq. Atomic Safety and Licensing Board Charles E. McClung, Jr., Esq. Atomic Safety and Licensing Appeal Panel
! Phyllis M. Gallagher, Esq. Docketing and Service Branch Janice E. Kerr, Esq.
h.oml Fdderal Emergency Management AgenEy 1 (, # E Washington, D.C. 20472
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SEP 3 1982 lEMORA'NDUM FOR: Brian Grimes, Director Division of Emergency Preparedness U.S. ifuele Re atory Commission s._ - , s FROM: Richar i. in j/
Assistant ssociate Director Office of Natural and Technological Hazards
SUBJECT:
ASLB Memorandum and Order (8/6/82) San Orofre Nuclear Generatincj Station, Of fsite Planning Medical Services I am responding to the letter to Spence W. Perry, Esquire, the Federal Emergency Management Agency Associate General Counsel (8/11/82), from Mr. Joselp Scinto, Deputy Director, Hearing Division, Nuclear Reguatory Commission (NRC), which requested information concerning whether further proceedings on the adequacy of of fsite planning for medical services should be conducted. This subject appears in a Memorandum and Order issued by the NRC/ASLB dated August 6,1982, for the San Onofre Generating Station, Units 2 and 3 (Docket Nos. 50-361-OL and 50-362-OL). The ASLB is proposing to consider in the light of further submissions whether further proceedings may produce a better evidentiary record on the need, if any, for medical services arrangements for the of fsite public.
Following are questions the Board asked FEMA as well as our responses (it should be noted that both the questions and the answers address the radiological conditions of contamination or exposure and not a concurrent condition such as broken bones, bleeding or unconsciousness. While I am aware of a variation in viewpoint on the breadth of the discussion, this does not constitute an inconsistency.):
- 1. If further proceedings were directed, what additional evidence, if any, would .
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you produce on the need for medical services arrangements of fsite, beyond that recognized by the Appeal Board in ALAB-680? Describe briefly the thrust of that evidence and the qualifications of proposed expert witnesses. -
There is no additional evidence that FEMA would produce on the need for medical services arrangements offsite, but we will restate our position that appeared on page 36 of the initial decision dated May 14, 1982, which is as follows:
" FEMA believes that special arrangements for medical services need to be made for persons within the 10-mile EPZ who may suffer from radiation exposure, radiological contamination, or both. Moreover, this position is supported by specific planning standards and criteria in NUREG-0654/ FEMA-REP-1, Rev. 1 for use by State and local governments in assuring that adequate arrangements are made for the provision of medical services for accidents encompassing the full range of the four classes of emergency action levels as delineated in.
Appendix 1."
The planning and preparedness guidance pro'vided in NUREG-0654/ FEMA-REP-1 for medical services is based, in part, on the possibility that despite the.
application of. protective response measures, persons within the 10-mile EPZ may be exposed to dangerous levels of radiation. Those persons so exposed would, therefore, require appropriate medical services. (Letter to the Board Chairman from Marshall Sanders, Acting Chief, Technological Hazards Division, dated October 15, 1981.)"
The use of expert witnesses for the presentation of new evidence is not expected.
Expert witnesses for clarification or reaffirmation may be used by FEMA if needed.
- 2. Two witnesses, Drs. Linnemann and Ehling, testified that hospitalization was indicated for a person who has received a 150 to 200 rem whole body radiation dose, Tr. 7728, 9992. If that is so, and if it is prudent to assume that perhaps several hundred people offsite could receive such doses in a serious accident, then is it necessary, or at least prudent, to make advance arrangements for medical services for such people? _
Yes, it is prudent to make advance arrangements for medical services for offsite persons who might be classified as contaminated or radiologically exposed (150 to 200 rem whole body radiation dose).
The justification for this ' answer is, in part, the difficulty of predicting additional and concurrent medical needs. Advanced arrangements are justified because of the need to initiate a medical history for those exposed individuals whose future health could be affected and to reduce organizational demands on hospital emergency staff.
'The medical services being called for here are those predominantly of medical staff knowledge and capability to handle the additional factor of radiological contamination or exposure.
3.
If such~ arrangements were to be made, what would they consist of--beds, decontam-ination and testing facilities, specially trained personnel, special medicines, what else? Would it be possible to make the necessary arrangements on an ad hoc basis?
If so, how long would that take?
e, Decontamination facilities and monitoring equipment would be necessary along with trained and knowledgable staff. Planning, training and pre-established procedures are clearly a need. The arrangements for beds, special medicines, if any, and perhaps the need for isolation could be handled on an ad hoc basis. The time involved is indeterminate because of the variation in facilities, variation in the magnitude of the demand, :nd the location of the medical supply source with respect j to the hospital (s).
4.
In assessing the need for medical services, should one assume that the emergency plans for evacuation and sheltering will be effective (as suggested at p. 20 of ALAB-680) or ineffective (as suggested in the FEMA letter quoted at p. 36 of the initial decision)?
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No assumption should be made about the effectiveness of evacuation and sheltering.
These are protective actions available for use just as medical services are to be available when needed. To protect the health of the public, one or all may be required and the decisionmakers need the availability of all three. NUREG-0654/ FEMA REP 1, Rev 1, planning standards D, 3, and L call for these protective actions to assure that State and local officials will be aware of these alternatives for protecting the public health.
- 5. Did the Board in its Initial Decision (at 35-37) correctly state the FEMA position?
Yes, the position is correctly stated. Arrangements for medical services should be
.made. for the general public in the 10-mile emergency planning zone.
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. PLANNING OBJECTIVE
- :1 Akh e -. To determine the availability within the State and local communities of public mns and private medical facilities that could accommodate and care for persons 3l p p. " mvolved in a radiological emergency who may require medical care, and to establish the role of each medical facility in the medical and public health 7 ", support plan. (See footnote 1.)
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GUIDANCE PLAN
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.[ 1. Public, private, and military medical and first aid support facilities within the State and local communities (including those of the nuclear facilities)
-- capable of providing both emergency and definitive care of offsite victims of a radiological accident should be identified.
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4l 2. A medical response plan for dealing with nuclear facility incidents with
- ., j l offsite conseouences should be developed.
- ',J l p'a f, [ 3. Maps showing the physical location of all public, priva:e and military 2 hospitals and other emergency medical services facilities within the State n.;
1:3 considered capable of providing medical support for any offsite victims of h a radiological incident should be included in the plan. These emergency medical services facilities should be able to radiologically monitor WI o Footnote 1.
the availability of an integrated emergency medical services system and a public e health emergency plan serving the area in which the facility is located and, as a b^ ~ minimum, equivalent to the Public Health Service Guide for Developing Health b.. '.! Disaster Plans,1974 and to the requirements of an emergency medical services GR$ system as outlined in the Emergency Medical Services System Act of 1973 (P.L.
- /)93-154), thould be a part of and c,onsistent with overall State or local disaster
,- control plans and should be compatible with the specific overall emergency response 4 plan for the facility, s 30
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contaminated personnel, and have facilities and trained personnel able to h M
. care for victims of radiological accidents. Persons may also need to be evacuated to a hospital due to an existing physical condition not related . !..y
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- 4. Arrangements should be developed for transporting offsite victims of radiological accidents to medical support facilities.
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- 5. A system for State public health medical recording and followup of ; j'
,, e radiologically exposed individuals should be established in collaboration . .. r:
with the local or State medical association. The record should include p}.y such items as location at time of emergency, radiation d se, contamina- @j,i.
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tion status treatmerit status, and release status. (See footnote 2.) Jd.
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- 6. Training programs should be developed for aedical support personnel who may be ca!!ed upon to care for offsite victims of a radiological accident. 5.x
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'iT*i facility emergency, should be developed. g; 05 t'
- 8. Medical facilities and ambulances should be equipped with emergency u..d bn communications capability for intrasystem communications as well as for l3S g{n communications with the State and local government emergency operat- .
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Footnote 2. ;e 2
The circumstances under which medical attention would be required or useful for ?
any offsite victims of a radiological accident should be determined b'/ guidance f?f provided by the State or local government public health of ficer, in consultation with ips Federal health authorities, private physicians and hospitals. @
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[lb UNITED _ STATES OP R'4 ERICA NUCLEAR REGULATORY COMMISSION
. BEFORE Tile ATOMIC SAFETY AND LICENSING APPEAI.
BOARD l
In the Matter of )
) Docket Nos. 50-361 OL SOUTl!ERN CALIFORNI A EDISON COMPANY, ) 50-362 OL i ET AL. )
)
(San Onofre Nuclear Generating Station,)
Units 2 and 3) )
CERTIFICATE OF SERVICE I certify pursuant to 10 C.F.R. 52.712(e)(2) that:
I am employed as an attorney in the County of Orange, California and one of counsel for Intervenors Guard, et al.
I am over the age of eighteen years and not a party to the within action; my business address is 24012 Calle de la Plata, Suite 330, Laguna Hills, California 92653.
On October 13, 1982 I served the attached "INTERVENORS' BRIEF REGARDING REQUIRED MEDICAL SERVICES FOR THE GENERAL PUBLIC IN RESPONSE TO COMMISSION ORDER CLI 82-27" in said cause by placing a true copy thereof enclosed in the United States mail, first class (or by Fed. Exnress, where asterisked), at Laguna Hills, California addressed as f6110ws:
Spence. Perry, Esq.
i Federal Emergency Management i Stepnen F. Eilperin, Esq. Agency Chairman, Atomic Safety and Office of General Counsel Room 840 Licensing Appeal Board U.S. Nuclear Regulatory Commission 500 C Street, S . W.
- Washington, D.C. 20555 Washington, D. C. 20472 James L. Kelley, Esq., Chairman David R. Pig o t t , Esq.
i Administrative Judge Samuel B. Casey, Esq.
Atomic Safety and Licensing Board John A. Mendez, Esq.
.U.S. Nuclear Regulatory Commission Edward B. Rogin, Esq.
Wa shing ton , D.C. 20555 of Orrick,11errington & Sutclifft A Professional Corporation Dr. Cadet II. Ila nd , Jr., 600 Montgomery Street Admin.strative Judge San Francisco, California 94111 c/o Bodega Marine Laboratory University of California Alan R. Watts, Esq.
P.O. Box 247 Daniel K. Spradlin Bodega Bay, California 94923 Rourke & Woodruff 1055 North Main Street, #1020 Dr. Reginald L. Gotchy Santa Ana, California 92701 Atomic Safety and Licensing Appeal Board Dr. W. Reed Johnson
{ U.S. Nuclear Regulatory Commission Atomic Safety and Licensing Washington, D.C. 20555 Appeal Board U.S. Nuclear Regulatory Commissi<
Washington, D.C. 20555
r e Mrs. Elizabeth P. Johnson, Richard J. Pharton, Esc. [
Administrative Judge University of San Diego Oak Ridge National Laboratory School of Law Alcala Park
, P. O. Box X, Building 3500 San Diego, California 92110 j Oak Ridge, Tennessee 37830 Mrs. Lyn 11arris Ficks I Janice E. Kerr, Tso. GUARD
- J. Calvin Simpson, Fsq. 3908 Calle Ariana Lawrence O. Garcia, esc. San Clemente, California 92672-California Utilities Commission 5066 State Puilding A. S. Carstens San Francisco, California 94102 2071 Caminito Circulo Norte
- Mt. La Jolla , California 92037 4
Charles R. Kocher, Esc.
James A. Beoletto Esc.
Southern California Fdison Company Lawrence J. Chandler, Esg. :
4244 Walnut Grove Avenue Donald Hassel, Esc.
Rosemead, California 91770 U. S. Nuclear Regulatory Commission ,
Gary D. Cotton Office of the Txecutive Louis Bernath Leoal Director
? San Diego Gas & T3ectric Company Washington, D. C. 20555 P. O. Box 1831, 101 Asn Street San Diego, California 92112 Atomic Safety and Licensing _
Appeal Board Panel Fhyllis M. Gallacher, Esc. U. S. Nuclear,Reculatory 1695 West Crescent Avenue Commission Suite 222 Washincton D. C. 20555 ,
Anaheim, California 92701 7
- Secr etary j Robert Dictch, Vice Dresident U. S. Wucicar Reculatory Comm.
Southern Edison Celifornia Company Attn: Chief, Docketing &
P. O. Box 800 Service P, ranch 2244 Walnut Grove Avenue Washington, D. C. 20555 Rosemead, California 91770 (3 copies) i
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Charles E. McClung, Jr.
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