ML22129A128
| ML22129A128 | |
| Person / Time | |
|---|---|
| Issue date: | 03/08/2022 |
| From: | Office of Nuclear Security and Incident Response |
| To: | |
| Cecere B | |
| References | |
| Download: ML22129A128 (56) | |
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UNITED STATES OF AMERICA
NUCLEAR REGULATORY COMMISSION
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34TH REGULATORY INFORMATION CONFERENCE (RIC)
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TECHNICAL SESSION - T6
EXACTING THE SCIENCE OF EMERGENCY PREPAREDNESS
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TUESDAY,
MARCH 8, 2022
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The Technical Session met via Video-
Teleconference, at 3:00 p.m. EST, Todd Smith, NSIR,
presiding.
PRESENT:
TODD SMITH, Senior Level Advisor for Emergency
Preparedness, Division of Preparedness and
Response, NSIR/NRC
TOMOHIKO MAKINO, Director for International
Cooperation, Japan Cabinet Office
GREG LAMARRE, Head, Radiological Protection and Human
Aspects of Nuclear Safety, OECD Nuclear Energy
Agency
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TRISTAN BARR, Section Head of Planning, Outreach,
Exercises and Training, Nuclear Emergency
Response and Preparation, Health Canada
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P R O C E E D I N G S
(3:00 p.m.)
DR. SMITH: Good afternoon, good morning
and good evening. I'm Todd Smith, Senior Level
Advisor for Emergency Preparedness and Incident
Response in the office of Nuclear Security and
Incident Response at the NRC.
And welcome to this session on exacting
the science of emergency preparedness. In
radiological emergency preparedness, preparing for
tomorrow is our constant work. It's what we do. And
whether we're learning it from the past or looking to
the future, emergency preparedness is constantly
evolving. And as you'll learn in this session, it's
an international effort.
With me today is a distinguished panel of
colleagues from around the globe. I'm joined by Dr.
Tomohiko Makino, Director for International
Cooperation at the Cabinet Office for the government
of Japan.
Dr. Makino's contributions include
extensive experience in the fields of emergency
preparedness, resilient health systems, disaster
response, global health diplomacy and biosecurity.
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Mr. Greg Lamarre, head of the Division of
Radiological Protection and Human Aspects of Nuclear
Safety at the Nuclear Energy Agency.
Mr. Lamarre has over 30 years of
experience as a systems engineer and providing world-
class technical expertise as a leader in military
government and international organizations.
Mr. Tristan Barr, head of the Planning,
Outreach, Exercises and Training Section within the
Radiation Protection Bureau of Health Canada.
Mr. Barr has expertise in radiation
detection, characterization, dosimetry, radioactive
waste management and emergency response.
Rounding out this panel will be myself.
Starting my ninth year here at the NRC. All of which
time I've had the pleasure working on emergency
preparedness regulation, oversight and research.
And I'll add that this group of panelists
holds a combined total of 12 graduate and
undergraduate degrees spanning the fields of
medicine, chemical and nuclear engineering, biology,
health, physics and business. This is a very
knowledgeable panel and we will have time for your
questions at the end.
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So as you listen to today's
presentations, please submit your questions.
In this session, we're going to take a
closer look at how the science of emergency
preparedness has evolved to prepare us for tomorrow.
To set the stage for this discussion, we need to start
with a look at the challenges that have faced us
yesterday and still face us today.
So it's appropriate that we lead off with
a discussion on the impact that the Fukushima Daiichi
accident has had on emergency preparedness in Japan.
I'll now turn it over to Dr. Makino. Tomo.
DR. MAKINO: Thank you, thank you very
much for that introduction. And it's my great, great
pleasure to be here NRC and have a chance to introduce
what Japan has experienced through the Fukushima
Daiichi accident.
So they have done a lot to diverse our
policies but there are also some things they haven't
done well. So this session, we'll introduce some of
the issues and the concerns they caused in front of
you. So next slide, please.
At the first slide and the last location
is a picture. So they, here on the right side, this
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shows how long this process and how many time the
people travel, migrating.
So the village, entire village moves one
place to the other and then they, they are actually
contaminated. Then they are have to travel out of
that place.
So over about 100 kilometers travel that
may also make the committee (inaudible). Next slide,
please.
This shows the, some of the areas are
still restricted and the people cannot come back. And
the figure on the left, right, below, shows the people
who returned back to their original places.
The blue column are the people who
traveled out, inside the prefecture and who came back
who are stay away our area for years. But the orange
column, those who traveled beyond the prefecture
border are less likely to come back. That means
their repatriation is another issue. Next one,
please.
That describes the stable element
distribution. At that time, the government
stockpiled but not distribute the stable iodines.
Then the decision of the local governments to
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urgently distribute are. And then they, after some
of those areas where the people received the stable
iodine urgently and were advised to take.
But the people didn't take because of
their concern about the side effect or the concern
about the next big emergency may happen. So just
take it with them.
But education or good communication
(inaudible) of the urgent distribution of the
iodines. These are the, some of the problems but the
big challenge was a long application of process of
the hospitalized people. So next slide please. Next
slide, please.
So the picture on that right is a queue
of the people, senior citizens, who get on a bus.
Then these senior citizens who travel so long way
that is shown in the right lower picture.
And I show you because of the missing
information or missing communication from the
government, the bus travels to north to west and then
eventually far south. That is several hundred
kilometers travel journey which caused about 40
patients' death within a month. That was a very big
tragedy of that long, evacuation, urgent evacuation
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procedure.
But the quick lesson is that evacuation
is risky but please proceed to the next slide, Slide
6.
This picture here also shows that staying
is also risky. Sheltering, the shelter in place
order was also issued leaving a 30-kilometer radius
from Fukushima Daiichi. So there are many hospitals
who are advised for shelter in place orders.
But the staff members could not stay
because of the disrupted social function. Like
school closure or no groceries in the community. So
the right figure shows that the number of the
healthcare staff members decreased after early fate
of the emergency.
Some hospitals retained the staff members
but some couldn't get a sufficient number of the staff
members. Then as is shown in left figure of Slide
6, the survival of the patient inside the hospital
where shelter in place order was issued also
decreased. So the staying inside the area of a
natural disaster is also risky. That's all on this
slide. So please proceed to the next slide. Slide
7, please.
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Fukushima after a decade. This is my
personal addition from listening to the local people
and my observation. So they ask about learnings.
One, that the urgent evacuation is very risky and led
to the 40 deaths of its evacuees.
But shelter in place is also challenging.
That this can disrupt the social function and then
the people cannot stay there for long time. Maybe
one will be maximum.
The third bullet, the certified disaster-
related deaths, that means this is not due to the
immediate earthquake or tsunami, but those residents
who requested that the area to the accident are pretty
much bigger in Fukushima compared to other
prefectures where the incidents are much bigger.
That means the long-term effects is
severe for such a large-scale evacuation otherwise.
The fourth bullet. Community was disrupted because
of the prolonged evacuation and then the people went
back to the community and who traveled inside that
area for work or just migrated. There are very
different types of the people were there.
So getting a good consensus to reveal the
community has become a big issue over there. And
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then people are from different positions so even the
radiological decay, but mental barrier may stay there
to split the community. These are the station in
Fukushima. Next slide, please. Slide 8, please.
In terms of the emergency response and
management, there are really many lessons. Such as
unexpected situation or unplanned stations or staff
are not skilled.
In order to overcome these three big
challenges, government took actions. Next slide,
please. Slide 9, please.
Before Fukushima, user and safety
authorities somewhat mixed in the left figure. So
after Fukushima, governments, they restructured the
authorities between two. And it's safety and
community.
And the other on the right is the user or
promoter of the nuclear energy. So as to divide
these two or three pieces. Next slide, please.
National legal framework for the nuclear
emergency was actually built in 1999, pre-event. But
it didn't assume such a combined existence but the
nuclear existence was triggered by the mass
existence.
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So that special arrangement for nuclear
emergency was revised and then that establishment of
the Nuclear Regulatory Authority and also the Nuclear
Regulatory Authority requested to build the EPR
Guide. Next slide, please. Slide 11, please.
So the nuclear, based upon the new EPR
Guide, each local governments are requested to build
their device or renewed emergency response plan. So
each site has a combined local government responding
time which is called as Regional Emergency Responses.
These needs to get approval by the
committee led by the prime minister. So far, these
little regions have EPR plans are approved. And
there are four sites operating right now. Next slide,
please.
Let me introduce three examples of the
newly introduced protective actions on the sheltering
facilities. One is the site number 12 sheltering
facilities with radiological protections.
So after the emergency event, some
buildings, including the responding office buildings
to the emergency didn't work well. Stuff like
windows are broken by the earthquake and then the
radiological plumes came inside. Then that building
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couldn't be used for response.
People were up and moved to their special
prefecture government 60 kilometers away. So after
Fukushima, key buildings such as responding buildings
and the safety for patients to be sheltered inside
are equipped with these possibilities.
Like airtight and the pressurization and
the filtration to make the air clean to be placed
inside the buildings. This is a pressurization
facility. These facilities are subsidized by the
national government. Next slide, please. That's
13.
So the stable iodine blocking
methodology. So the confusion is that the people
will not be clear about whether to take the iodine or
not. And those are in need of pre-distribution.
So after Fukushima, local governments
started to pre-distribute the stable iodine to the
government out to the local residents. But that
process did not just mail or send. But the
government needs to hold town hall meetings to
provide information to the residents.
What is the right timing to take and what
is the effectiveness of the stable iodine? And
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communication of these outlets. These are the
changes after Fukushima.
Now, let me introduce some drill and
training programs. Responding staff members of the
government are more, just public office are rotating
from different ministries and governments.
So the different drills and the training
programs are mainly targeted for these responding
officers of the operation centers. The various
training programs, like lectures, seminars and this
special sessions and the drills that test the actual
procedures to go on.
The key drill is at the head of the drill
box. And that's NEDPD. So let me go over that
drill. Next slide, please. Slide 15, please.
Thank you.
For the NEDPD, a Nuclear Energy Disaster
Prevention Drill is an annual, large-scale drill lead
by the national government. The feature of this
drill is to invite the prime minister and the
political leaders as well as the local residents.
About 1,000 people joining.
The scenario is open so it is not that
much for testing the decision making but good for
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checking the procedure to implement the protective
actions.
(inaudible) the commitment.
So the next slide, Slide 21, is the
medical drill that the healthcare staff members with
the PPE and are ready to see the contaminated
patients. These are the pictures of our national
drill.
So the last section of my presentation is
about our lessons and the responses to the COVID-19
pandemic. And now we are on Slide 22.
Thank you, thank you. I'm very sorry for
the sessions. After seeing the COVID-19, some of the
challenging station. How to balance the two risks.
From November of 2020, we issued a kind of guide to
the local governments to think about how to balance
the two risks. Especially in the station of
counting, evacuation counts or in doing
transportation.
The question was whether to ventilate or
not. So to stay on the principle to ventilate but
try to ventilate during the time that the
radioactivity is not there. Next slide, please.
Slide 23, please.
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And as a side, the COVID-19 response was
that they told us what we should do during this
situation. Especially the good lesson from the
COVID-19 was what are the essential number of the
people to respond.
(inaudible) but also the questions are
that nobody was (inaudible) and it's not easy to say
whether that is good between stay or move. Stay and
shelter in place or evacuate. So after all, we are
all still on a long wait to keep improving our
emergency responses. Thank you very much.
DR. SMITH: Thank you, Tomo. You made
clear in your presentation that the challenges that
you faced are multi-dimensional. And the reality of
the situation goes beyond just radiological impacts.
Specifically, the social disruption and
stigmatization reminds us there are human and
societal dimensions to consider. It also indicates
the need to integrate the social sciences into
planning and response. And recognizing this, we'll
now turn to Greg Lamarre to discuss how might we
integrate non-radiological health impacts into the
field of radiological protection. Greg?
MR. LAMARRE: Thanks very much, Todd.
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And good evening, everyone, from Paris. I'm very
happy to be here and thank you very much to the NRC
for this opportunity for us to present some of the
work of the Nuclear Energy Agency and some of our
groups.
As it says, the title of the presentation
is NEA progress to-date on those non-Radiological
health impacts of protective actions from recognition
to mitigation.
Hopefully I can build on some of what
you've heard in Tomo's presentation as well. And
also complement what I know Tristan is going to talk
about.
I've got the pleasure of giving the
presentation but I'd like to also call out my
colleagues, Jatienne Garnier-Laplace, Jan-Hendrik
Kruse. And also a couple very important people
within our community. Matthias Zhringer who is
the chair of our working party on nuclear emergency
matters. And Thierry Schneider, the chair of CRPPH.
The work that I'm going to talk about
over the next 15 to 20 minutes is largely based upon
the work of two expert groups. The expert group on
non-radiological public health aspects, EGNR, and
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the expert group on recovery management.
So maybe just to make a little bit of a
plug here, EGRM has got a launch event later in May,
23rd of May, in order to launch its report.
And then there's also going to be an in-
person workshop in October in Paris when we can
start to hopefully meet face to face again. So
please keep your eyes open for both of those events.
Next slide, please.
So just very quickly on the Nuclear
Energy Agency for those of you that aren't familiar.
We founded in 1958, 34 member countries plus a number
of strategic partners, 8 high-level standing
technical committees. You can see them along the
right-hand side.
The work that I'm talking about is under,
sort of the middle pilar there, CRPPH. And some of
the expert groups that report up to that.
A real myriad of working parties, expert
groups and the like. 24 international projects. In
the organization approximately 110, 120 strong with
supports across all of those different committees
and working parties. Next slide, please.
So to get into the heart of the
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presentation, I think we can all confirm that
internationally, much has been learned from the
tragic events at Fukushima Daiichi over the last ten
plus years.
I think we can also probably all agree
that a lot of the work in the early stages of that
led to some very significant improvements in the
engineering and design of the plants when we look at
robustness, the defense against external events and
the like.
What we've done now with the support and
direction of our member states is really pivoted and
turned our attention to some of the other aspects
related to emergency preparedness and response.
And I'll talk to you now a little bit
about where we're going on some of the psychosocial
pieces. I think Tomo mentioned quite well in his
presentation that when you look at the impacts of an
accident like Fukushima, it goes much beyond the
radiological consequences.
And I think we're also all very aware
that although radiation induced illnesses, deaths are
very, very minimal if not nil, that some of those
psychosocial impacts due to evacuation and some of
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the other decisions that were made had a much more
profound impact.
And it's with that in mind that we move
forward to our expert groups in work in this area.
We've also realized through our collective
investigation that not only does work need to be done
there but the decision makers are not yet
sufficiently equipped to move from what has
traditionally been a radiation protection-centric
approach, i.e. trying to avert certain dose, perfect
protective action levels that are dose centric to one
that has a more comprehensive approach to the
protection of health and wellbeing in the broader
sense.
And it's with that in mind that the NEA
has moved forward. Next slide. Slide 4.
So a little bit of background. As I
mentioned, non-radiological consequences of nuclear
or radiological accidents are complex. And they're
multidimensional in nature with human and societal
dimensions at its core.
That makes it all the more challenging.
They are a combination of direct health consequences
and indirect public health consequences of those
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protective strategies.
We've learned through the work of the
expert group on non-radiological consequences and
recovery management that management needs to reassess
the risks of the protective actions to reflect a more
holistic and inclusive approach throughout the entire
cycle of an emergency.
Among many lessons, some have been well
documented. For instance, there's a need to consider
specific actions for vulnerable groups. Elderly,
children and parents, pregnant women.
Clearly, one size cannot fit all. And a
lot of those demographic specificities need to be
considered in the strategy.
We need to proactively consider balancing
the risk of immediate evacuation against the possible
benefits of sheltering in place with continuous care.
And what's required for continuous care also needs to
be considered within your strategy.
And I'll talk further about this later on
in the presentation. The need to further promote
stakeholder engagement in a collaborative, inclusive
manner from preparedness to recovery, all the way
through in order to achieve the best possible
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outcomes. Next slide, please.
So how to proceed. Many of you may be
aware, perhaps others are not. Last year we
published a Fukushima Daiichi Ten Years On report.
If you haven't had the opportunity to look at it, I
strongly suggest that you do. It's available by a
link on our NEA website.
It looked over the last ten years and the
compendium of work that's gone on from the nuclear
regulatory communities, the committee on safety of
nuclear installations, CRPPH came up with nine
recommendations on future areas for improvement and
how the international community can help.
Some of those have to do with more
advanced research. Some of them have to do,
obviously, with fuels and physics and some of the
science of engineering design.
The ones that I want to talk to you about
a little bit here are Recommendation 6 and 7.
Recommendation 6 involves stakeholder involvement and
risk communication and the need to promote
stakeholder involvement approaches to enhance
community engagement and society resilience. And I
think that has a lot to do with what we're talking
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about in this session.
Just as an aside, the NEA also, in
recognition of the risk communication part of that
recommendation, is later on this year launching a
first risk communication training course to be hosted
on Slovakia in December.
Recommendation 7 looks at the recognition
of mental health impacts. Important to note that
both these recommendations promote an all-hazards
approach aligned with UN Sendai Framework for
disaster risk reduction. Next slide, please.
So a little bit more about the problem
statement on mental health and psychosocial impacts.
Mental health and psychosocial impacts need to be
better considered in protection strategies for
preparedness, response to and recovery from the
events.
The work within the expert groups also
drew largely on the World Health Organization
framework for mental health and psychosocial support.
Radiological and nuclear emergencies have provided
some high-level guidance across these areas.
It is realized that more work is required
to prepare decision makers to move from, once again,
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a radiation centric approach to a more holistic
approach that looks at the overall health and well-
being.
It's also very important to realize that
one size does not fit all. As a stakeholder, needs
and expectations are very circumstance, population,
demographic dependent.
Optimization and decision-making for
overall public well-being must integrate the social,
cultural and other relevant factors. And I'll talk
in the next few slides about how we're going to try
to address that. Slide 7, please.
So Action 1, action-oriented solution.
Stakeholder dialogue through the emergency cycle.
Some of what we're looking to do is exploring possible
options to improve decision-maker's responses to
stakeholders' needs and concerns by involving
stakeholders in the protection strategy.
By starting at the preparatory phase to
develop mutual trust that is central to the success,
drawing on existing frameworks such as the ICRP co-
expertise approach that is highlighted at a high
level on the right-hand side. That brings together
people, experts, NGO's decision makers to facilitate
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radiological protection culture dissemination.
And the dialogue will provide people with
the knowledge on health risks and radiation exposure.
The am I safe, how safe is safe enough and methods to
put into perspective potential deleterious effects of
protective actions allowing informed protection
decisions. The ability of the stakeholders to be
involved in that risk benefit consequence decision
making process. Next slide, please.
In order to support this, obviously
member countries are also looking for us to assist in
the development of tools and data to support these
dialogues.
Such tools and data are necessary to
balance the health risks of radiation exposures
against the health risks from protective actions and
their subsequent disruption of normal life as Tomo
mentioned in his presentation.
Data on mental health and psychosocial
consequences of actions such as evacuation,
sheltering, relocation, societal disruption can be
documented from other disasters and brought into the
conversation.
And it's also, we're also promised, we're
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very heartened to see good progress being made in a
number of NEA countries. I know Tristan's going to
talk about that being done at Health Canada. We're
also aware that our partners at the US NRC have moved
very boldly forward in this area as well. Next
slide, please.
So ongoing work and next steps. So NEA
member counties are committed to bring forth
practical, actionable guidance to advance
preparedness, response and recovery using this
multidimensional approach with human and societal
dimensions at the core.
NEA expert groups that I've mentioned
previously, continue to work on operationalizing the
World Health Organization framework. First, by
developing national-level guidance on how to better
prepare for recovery with health and wellbeing being
supported, being one objective of recovery.
And by preparing the translation of the
framework into a series of operational action sheets
on mental health and psychosocial support during
preparedness, response and recovery.
Those action sheets are under development
right now, action sheets on training of first-line
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respondents, how to distribute educational material
to the communities on mental health and psychosocial
support. And other supporting material like that.
That work continues.
The ultimate goal is to evolve beyond the
optimization of radiological protection to the
optimization of well-being. Ultimately, testing and
validating of these new approaches and tools using
national and or international exercises will be key.
And I would also like to highlight that
we're well advanced on planning of the INEX-6
exercise. That will happen in 2023, 2024. That
we'll hopefully be able to put to action some of this
new learning. Next slide, please.
Just a little bit more on ongoing and
complimentary work. We're in the midst of planning
our third stakeholder involvement workshop entitled,
Optimization in Decision-making.
That we'll get to the key of this
decision-maker paradigm and how to most effectively
involve the stakeholders in the decision-making
process.
It's been determined that a series of
webinars will be held in 2022 starting in June and
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going through the fall. And then that the actual
workshop itself will be held likely here in Paris the
first part of 2023.
The program committee has been convened
and is looking at the specific objectives listed at
the bottom. Improving the common, practical
understanding of what optimization decision making
means. Increasing the consideration of inclusive
stakeholder involvement to optimize the decision
making. And ultimately, developing a foundation for
generic multidimensional framework to support
optimization for policy and regulatory decision
makers.
I think with a successful outcome to this
workshop, this could really be important pillar as
well for us to build upon as we advance science of
emergency preparedness and response.
And next slide, I think, is the last one.
Yes, thank you very much for your attention and happy
to answer any questions at the end. Over to you,
Todd. Thank you.
DR. SMITH: Thank you for sharing that,
Greg. I'm really glad to be part of the work the
NEA's doing in the area of non-radiological health
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impacts along with Tristan.
For those of you who have joined us
today, I do apologize if you missed anything in the
slides. I will remind you that all the presentations
will be available on the RIC website for your review
after the session.
Greg, getting back to what you discussed,
I appreciate that in your presentation you provided
not only a concise problem statement but you also
proposed action-oriented solutions. You spoke of the
need to develop mutual trust and to be ready to dialog
with people who want to know what are the risks and
want to know am I safe.
You also spoke of the work that is
required to prepare decision makers. And you
proposed that we develop tools and data to help
optimize protective action decision.
Fortunately, we have Tristan Barr with
us. And he's been giving that a lot of thought. So
he's going to share now with us some ideas, how we
can use science to sharpen our tools. Tristan, the
floor is yours.
MR. BARR: Thanks Todd for that
introduction. In fact, you took the words out of my
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mouth. I was taking notes and was going to refer
back to what Greg said and Tomo. And that will save
me some time in this presentation.
So I wanted to start, just with pointing
out that, well, it says I'm the section head in
planning, outreach, exercises and training. That is
within the Nuclear Emergency Response and
Preparedness Division at Health Canada's Radiation
Protection Bureau.
So we're currently active so in the event
that I get a call, I may have to drop but I hope that
won't be the case for the next 20 minutes.
If you could, I'm sorry, before we go to
the next slide. So I will be presenting on measuring
the psychosocial impacts and the title of the
presentation is A Case for a Non-radiological
Sievert. Which I think speaks to what we've heard
so far.
Namely, Tomo explained some of the risks
associated with the protective actions that we would
normally apply in the radiation or the nuclear event.
And we heard from Greg regarding the things to
consider. In particular the psychosocial and mental
health impacts to be considered.
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So if you go to the next slide, I
reiterate that as the premise for the work that we
are doing. And while this presentation will talk to
the case that we made to develop a non-radiological
sievert, it will also let you know that we failed to
do so.
However, we did manage to develop a
decision-making tool or rather a proof of concept for
a decision-making tool for decision makers that would
allow them, in concept of a protection strategy, to
balance the potential impacts of the mental health
and psychosocial impacts versus the radiological
detriment in the event of an emergency while applying
protective actions.
So the premises that Canada is improving
and formalizing protection strategies for nuclear
emergency response, it's a shared responsibility
amongst the provinces that have nuclear power plants
as well as the federal government.
We recognize that current nuclear energy
response plans are well established and provide clear
guidance on radiation dose thresholds for
implementing protective actions to minimize those
radiation doses.
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And we heard much of the same from Tomo
earlier on. However, we recognize that protective
actions that minimize radiation doses may actually
increase the psychosocial impacts to the affected
population. In particular, the use of evacuation and
or relocation.
In light of COVID-19 lessons, we also, we
note that this highlights how protective actions for
nuclear emergencies, although -- well, protective
actions for nuclear emergencies could cause
additional harm in the event of combined emergencies
such as COVID.
So Tomo discussed this as well, but in
Canada we recommended adjusting the reference levels
in the event of a nuclear emergency for the public to
a 150 millisieverts or 15 rem rather than a hundred
millisieverts over seven days. In order to account
for the potential increase from the spread of COVID
where we communicate or evacuate people into
reception sites.
So as a consequence, we asked the
question, can we develop a unit of psychosocial
detriment to compare to the unit of radiation
detriment.
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So effectively, is it possible to develop
a non-radiological sievert and develop that balancing
mechanism between the risks. Next slide, please.
To do this, we received funding and put
together a team for a research project and for the
development of a decision tool. And the objective
of the research was to attempt to quantify
psychosocial detriment and to develop a decision tool
for emergency decision makers effectively, to balance
radiological and psychosocial detriment.
To do this, we searched, we did a
significant lit review and we searched available
studies and data sets related to aftereffects of
nuclear disasters. And then we looked to develop a
common unit and decision-making tool to compare
radiological effects to psychosocial health. Next
slide, please.
And so we recognize that a current gap,
the one that we're trying to fill, one of the ones
that's been identified, is that challenge that
decisionmakers have in the emergency response to
include psychosocial factors in optimizing and
justifying protective actions that form the
protection strategy. Next slide, please.
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So a summary of our research. And you'll
see underlined that we identified no significant
different. The objective here was we took data from
Statistics Canada and used a model to evaluate the
changes in outcomes measured by psychosocial impacts
between a population that was affected by a disaster
and one that was not.
Now, recognizing that there were
significant cultural differences between the, well,
the Japanese population, medium population. We
looked to do that with Canadian data following
evacuation events in Canada.
So we used the Canadian Community Health
Survey information to evaluate psychosocial impacts
that arise from an evacuation and we used the 2013
Alberta flood data that was available to us.
Specifically, we looked at variables such
as life satisfaction, the time period, specifically
the pre and post flood. We captured population data
by postal code which is similar to a zip code in the
United States, which captures the individual's
proximity to the floods for those affected.
And then we applied control variables.
So we used, these we used to control additional
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factors that we had identified as affecting life
satisfaction such as socioeconomic controls,
demographic controls and physical and mental
disorders. Existing physical and mental disorders.
In the analysis, unfortunately, we
actually found no difference in the data before and
after the flood. Next slide.
So we had to get rid of that model. And
we moved to again look at the literature review and
identify the main factors or the main drivers for
psychosocial impacts.
And from there, we identified that
residence related factors were the key driver. But
there were also significant contributions related to
risk reception and socioeconomic changes.
And the idea that we had was that we could
potentially propose a weighting factor for each of
these key impacts on psychosocial health that would
contribute to an overall psychosocial detriment. If
you'll go to the next slide, please.
For those of you, and I think many of you
are, who are knowledgeable in radiation protection
and health physics, you'll notice that that concept
would be somewhat similar to applying radiation
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weighting factors and tissue weighting factors that
are used to generate the sievert which is that unit
of overall detriment for radiation.
And the idea was to propose the unity of
psychosocial detriment for decision makers that would
allow them to compare radiation dose averted by
protective actions against potential psychosocial
impacts that could be exacerbated by those same
actions. Next slide, please.
And the outcome was that we found that
the data was not currently available to generate that
non-radiological sievert. Notably, we noted mental
health and psychosocial impacts from nuclear
emergencies have been measured with general and
summary indicators as opposed to indicators that
speak to the particular impacts on psychosocial
health.
We reviewed a paper whose lead author, I
believe, is Todd from the NRC from 2021, that
quantified various non-radiological health effects
from evacuations and relocations. But we noted that
the paper specified that the impacts were not
additive.
So we couldn't effectively make some
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waiting factor out of those numbers to use to compare
to the Sievert. So the overall the conclusion is
that we cannot wait the psychosocial impacts and some
of them to get a Sievert-like unit at this point.
And that in order to do so, we would need
specific studies on the non-radiological health
impacts that measure each health effect and their
combined impact as well.
If you go to the next slide, we can get
to the good news. We still have the objective of
building a decision tool for emergency planners and
emergency managers to balance the psychosocial
impacts and the radiological impacts in an emergency
and while applying protective actions.
So we noted that in the NRC paper, of the
14 psychosocial impacts that were assessed,
depression had the greatest magnitude of impact on
the populations. The prevalence and the impact of
depression following a nuclear emergency with and
without evacuation, relocation was used to model in
the decision tool.
And we note that the prevalence of
depression in a Canadian population following
evacuation was estimated to be 19 percent. And here
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I indicated 28.9 percent in the U.S. And this is
actually an error. And I do apologize.
I think that was the upper bound of the
impact of depression where 19 percent was from the
United States and was the average prevalence. So we
used this number and note that the impact from
depression represents a lower bound of what would be
combined psychosocial impacts.
So again, our model, and I'll present to
you now, is based solely on the impact of depression
following a nuclear emergency leading to a potential
evacuation of location.
And again, this is why I note that this
a proof of concept so as we develop further, we may
look to model impacts into the model but at this
point, we're basing it solely on the potential for
depression.
We also had to use quality adjusted life
years or QALYs to provide a metric for that impact.
And we noted that various QALYs are proposed by
application and may vary from $50,000 to $200,000
U.S. dollars.
And then we pulled radiological
detriments estimated from the U.S. NRC 2014-dollar
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value per rem. So again, given that we were using
QALYs as a metric for the impact of psychosocial
impacts, we needed a dollar value to assign to
radiological impacts and those were pulled form that
2012 NRC paper. Next slide, please.
So in building the decision tool, we had
to establish a life satisfaction quotient which was
pulled from a paper by Redhanz et al, 2015, which
predicts lower life satisfaction with increasing
proximity to a nuclear accident based on the
Fukushima Daiichi evidence and studies.
We estimated costs to unit increases of
life satisfaction that are relative to the starting
socioeconomic conditions before the accident. So
this is based on the liquid view but identifying that
it's the relative change in the socioeconomic
conditions that are one of the key drivers for life
satisfaction.
We then broke down the population
information as well as the socioeconomic levels of
the population by postal code out of Statistics
Canada data.
And we developed what we call a relative
cost ratio. The formula for which you have here.
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And we'll worry with the details. We can extrapolate
it later if we have more time. But what I will show
you is the results of this proof-of-concept model
when applied to one particular scenario.
So if you run the model, you'll note that
it produces actually postal code by postal code
recommendations on whether to evacuate or not based
on the cost ratio that was developed through our
model.
And we have here a graphical
representation of that same information. So you'll
see relative sizes of the populations in each postal
code that was modeled. And this was a total of 97
postal codes that are within the 57-kilometer radius
of one of the nuclear power plants.
And you'll see that there is a line at
one which is that relative cost ratio that we
developed. And in this model, we have a kind of
threshold at distance which turns out to be about 47
kilometers out. You can't really see on the graph.
But would suggest that there's a tipping
point for that cost-ratio balance at 47 kilometers
given the default parameters that we used. Now those
default parameters for any particular evacuation,
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population, location can be changed.
But to specify in this particular case,
the default parameters include that there is zero
dose to evacuees whereas there is a hundred
millisievert or 10-gram potential dose for non-
evacuees.
We use a quality adjusted life year of
$50,000 which is probably on the low end. And as you
increase that, the curve, the slope would get
steeper.
We used a life satisfaction quotient of
minus 0.08 per 3 kilometers distance from the
accident which can be adjusted as well. And we used
the population statistics around the Darlington
Nuclear Power Plant near Toronto, Canada and a
depression prevalence of 19 percent.
So those are just the key parameters that
can be adjusted. Recognizing again, this is a proof
of concept and this is not to say that the distance
at which the cost ratio changes is 47 kilometers.
But we're just starting to play with the
outputs from the model in order to basically beta
test it and come up with a useable decision. Next
slide, please.
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So at this point, we'll talk about the
proposed usage of the tool. So I want to highlight,
again, that this really is a proof of concept for a
decision tool to balance radiological and
psychosocial detriment. It's our first step.
What we hope is that this will have a
significant contribution to evidence-based guidance
on a justified and optimized protection strategy that
would allow us to consider psychosocial impacts in
both planning and decision making.
Additionally, recognizing that most
people assume that nuclear and emergency response
plans are based on radiological detriment. And they
effectively are at the moment.
Proposing a tool that allows us to
compare the psychosocial impacts or mental health
impacts versus the radiological impacts, would be a
key tool to explain to the population why you might
evacuate or why you might not evacuate. And start a
discussion to maybe better understand what
radiological dose represents in terms of risk.
Because currently, I believe that
radiological detriment is overvalued in terms of its
potential risk in the event of a nuclear emergency
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and needs to be discussed with stakeholders before
anything happens so that we can have more educated
discussions going forward. Next slide, please.
So just quickly to point out the next
steps, I would love to share the decision tool with
you but it's not actually finalized and I cannot
distribute it. But we do expect the research report
to be ready for review in March.
I actually received it yesterday and
because of our activation and response to the
situation in the Ukraine, I have not had a chance to
open that email. And then similarly, we expect the
-- we have the tool which is currently in review as
of yesterday.
Going forward, we expect to hold a
Canadian workshop on recovery planning in the fall of
2022 in Ottawa, Ontario, where we would present a
recently published paper which is another tool that
actually addresses something Greg was mentioning.
Which was a guidance on planning for
recovery following a nuclear radiological emergency.
This is geared towards Canadian provinces that have
a responsibility to generate recovery plans but may
be of interest to this audience as well. It's
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available online.
And then to present our research on
psychosocial detriments in the nuclear emergency in
order to accompany that discussion on recovery. And
then introduce the decision tool to balance
radiological and psychosocial impacts for nuclear
emergency response when applying protective actions.
On the last slide I just wanted to
highlight the references that were mentioned
throughout this presentation and thank you for your
time.
DR. SMITH: Well, thank you for that
presentation, Tristan. And again, I do apologize for
those of you following along. There appears to be a
delay in the slides updating. But we'll just keep
moving forward with this discussion.
And please, visit the RIC website to
download these presentations later.
Tristan, that's a very novel idea that
you had and certainly I think an interesting tool
that would seem to have much practical use.
Specifically as you mentioned, in the development of
evidence-based guidance.
I think that evidence-based policy is a
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key component to building trust. If you listened to
our Chairman's opening remarks this morning, you
heard, him talk about a term called truth decay which
is the diminishing role of facts and analysis in
public life.
And how that can lead to a lost trust in
government. And this is something we must pay
attention to in emergency planning because we know
that the foundations of trust have to be established
long before any accident occurs.
Ultimately, that trust translates into
confidence of decision makers and the public to make
informed decisions based on the best available
information.
How do we produce that information? And
how do we get the evidence we need to inform
protective actions. Let me now share how the NRC is
using science to support emergency preparedness and
public protection. Next slide, please.
Emergency preparedness ensures that
protective actions can and will be taken in the event
of a significant radiological release. Within
emergency planning zones, predetermined prompt
protective actions are in place to avoid a reduced
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dose from exposure to radioactive material.
The choice of protective action includes
primarily evacuation and sheltering. NRC
regulations require nuclear power plant operators to
promptly notify offsite authorities and to provide a
protective action recommendation if conditions
warrant.
Offsite authorities consider the
recommendations and will issue protective action
decisions to the public. In the U.S., both the
protective action recommendation and the protective
action decision are informed by the U.S.
Environmental Protection Agency, Protective Action
Guide, or PAG.
PAGs are reference levels for action.
But while PAGs can help decide when to act, it's not
always clear which action to take. There are
practical guidelines that describe how the protection
principles of justification and optimization could be
applied to aid in this decision.
Even so, it's said that selection of
evacuation or sheltering is far from an exact
science. But if that's the case, then we should be
able to exact our science to help decision makers and
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the public make informed decisions. Next slide.
And the NRC is working to support
protective action decisions with science. Just in
the past few years, the NRC has published and
continues to perform analysis to enhance our guidance
and regulations and improve our state of practice.
These analyses are providing the
scientific evidence needed to better inform
protection from radiation in an emergency.
I'll now share a few of the insights from
the studies listed here. Next slide.
Emergency response is broken up into
phases. There is an emergency phase when immediate
decisions are needed. An intermediate phase lasting
weeks to months when releases have been brought under
control and measurement data can be used as a basis
for action.
And a late phase marking the beginning of
recovery which can last for years. As we heard
today, decisions to protect the public continue long
after the emergency phase. To better understand
this, the NRC performed a study of capabilities and
practices in the intermediate phase of a radiological
emergency response.
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We gathered information from state
response organizations and exercise reports and
identified best practices for communicating to the
public, developing partnerships and sharing resources
for monitoring. How to base protection decisions on
science. How to leverage technology to aid and
response and carrying for vulnerable populations,
including animals, throughout the event.
These insights have been gathered to
promote a shared understanding among off-site
response organizations and the public. These insights
were also gathered to improve modeling assumptions
and NRC consequence analysis which can be used to
provide a technical basis for protective action
guidance. Next slide.
In fact, the current basis for protective
action strategies was informed by a detailed
computational study into the benefits of protective
actions known as the PAR study.
A conclusion of the PAR study is that
evacuation should remain a major element of
protective action strategies. Another conclusion is
that the effectiveness of a protective action is
sensitive to the timing of the release in relation to
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the timing of the action.
As such, the NRC requires the use of
evacuation time estimates in the formulation of
protective action strategies. To inform development
of evacuation time estimates, the NRC developed
state-of-the-art microscopic traffic simulation
models of representative rural, coastal and urban
communities, as you see here. And we used these
models to examine a multitude of topics to enhance
our understanding of evacuation dynamics.
The ETE study was then used to update NRC
guidance for development of evacuation time
estimates. The updated guidance reflects the state
of the art in transportation modeling and provides
measures of effectiveness useful for verifying the
adequacy of ETEs.
Updates of the ETEs are periodically
required. A task which all nuclear power plant
licensees are currently performing as part of
required 2020 decennial census updates. The updated
ETEs will then be used to inform protective action
strategies ensuring these strategies ensuring these
strategies are based on the best available
information.
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As part of the ETE study, we also found
ways to better protect our first responders. Some
evacuation plans rely on traffic control officers to
help direct traffic in an emergency. Our study
demonstrated that effective evacuation does not
always require police officers to control traffic at
intersections and that normal means of traffic
control can be just as effective.
And this could provide two benefits.
First, police officers can avoid exposure to a
radioactive plume and second, it frees up those law
enforcement resources for other use in an emergency
and where they're most needed. Next slide.
And while evacuations are a common
protective action response to many hazards and are
typically safe and effective, as we've heard, there
are other issues brought on by long displacement.
That is, after the evacuation event, there are
additional stressors unrelated to the hazard that can
lead to negative health outcomes.
While many individual health effects from
a specific evacuation event have been widely studied
and reported in the literature, holistic view of the
risk of prolonged displacement was lacking.
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To bridge this gap, the NRC published a
meta-analysis of the health consequences from
evacuation and relocation across all types of
emergencies. The meta-analysis identified 14
different health effects common to a response to a
variety of events including natural, technological
and manmade hazards.
What we found is that across emergency
events, displaced populations were more likely to
experience a negative health outcome than those who
stayed or returned home.
And we gathered qualitative insights to
look at which populations like children and the
elderly might be more at risk from certain health
effects. An important insight was that radiological
emergencies did not result in outsized health
effects.
Rather, the effect affect size seen in
radiation events was generally similar to other
hazards. This suggests these insights could be
applied to all hazards planning. This also suggests
that it was the disruption of the social ties and
prolonged displacement from home communities that led
to the effects.
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More importantly, it begs the question,
what can we do then to minimize the impacts of
prolonged displacement? Is evacuation always the
right response and what about the alternative of
sheltering in place? Next slide.
Sheltering in place is another protective
action common to many hazards including radiation.
The U.S. EPA's Federal Protection Action Guide Manual
was updated in 2017 with the latest information on
shelter effectiveness for radiological emergencies.
But there's still many questions we can
ask that are open to scientific inquiry. For
example, how is the source term and the
characteristics of the release change the
effectiveness of shelters in providing protection.
Early shelter studies assume that
radiological releases contain large amounts of
radioactive iodine. Mostly in its elemental or
gaseous form. Which was assumed to easily penetrate
a shelter.
But as our knowledge of source terms has
evolved, we know now that iodine is released in many
chemical forms. Many of which are particulates. So
how does the chemical form of a release impact shelter
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effectiveness?
And tomorrow's technology will continue
to look different with accident powered fuels, small
modular reactors, nonlight-water reactor technology.
These advances in technology change our understanding
of what could be released in what form, how much and
when. Which can then change what actions we take.
And we can develop models to examine
shelter effectiveness for tomorrow's technology and
find better ways to implement sheltering in place.
For example, could we use filtered
ventilation to our benefit? Many heating and cooling
systems do not actually need to draw air in from the
outside in order to function. And this suggests that
rather than securing air conditioning systems, we
could use them to help filter out airborne
particulates and maintain livable conditions inside
a shelter.
This could increase radiological
protection and would also avoid shifting the health
risk to environmental concerns like heat exhaustion
or heat stroke on a hot day.
And what can we learn from other fields
of study by looking at how shelters are already being
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used to protect from other hazards like chemical
release, dust storms and other airborne contaminants.
There's lots of data already out there
and the NRC's performing studies to gather this data,
build better models and inform implementation
strategies for sheltering. Next slide, please.
And masks, we've all developed the habit
of wearing our mask for protection and masks are now
a household item readily available for use. The
current guidance suggests that wet towels and
handkerchiefs can be useful to reduce dose. So does
it make sense to wear a mask in a radiological
emergency? If you wear a mask, what is the trade-
off between internal and external dose buildup on the
mask?
At the NRC we have the tools and the
talent in place to answer these questions. We're
using the tools from NRC's Radiation Protection
Computer Code Analysis and Maintenance Program, or
RAMP, to quantify the benefit of wearing a mask and
to understand the tradeoffs.
And this will give the public confidence
that protection habits they've already developed can
be a simple means of protection against radiation.
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Next slide.
And this is what the public wants to
know. Our U.S. Centers for Disease Controls
performed studies in which they've asked the public
what is the information you want to hear. And the
reply was just tell us what we need to know to be
safe. And as you see illustrated here, we can
provide clear, concise messages to decision makers
and the public on simple measures they can take to be
safe in a radiological emergency.
And, by maintaining consistency with the
actions the public would use for other emergencies,
we can build resilient communities ready to respond
to and recover from all hazards including radiation.
So whether it's a tornado, a chemical release, a
pandemic or a radiological event, the simple message
of go inside, stay inside, tune in and the decisions
made for following action can be trusted because
we'll inform these decision with solid evidence from
science. Next slide.
So than you for listening. This
concludes our panel presentations which I trust you
found informative. I also hope you found it
encouraging and you've come away with a better
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understanding of the tremendous efforts underway
across the globe to prepare us for a safe tomorrow.
With that, I think we'll transition to
question-and-answer period.
Okay. First question is a general
question. How do NRC emergency preparedness programs
compare with U.S. Department of Energy's?
That's a great question. I think there's
a lot of similarity between the U.S. NRC and the DOE
in terms of preparedness programs. That information
is publicly available. A lot of it comes down into
the use of hazard assessments to inform the planning
and then it comes down to how we use those hazard
assessments to inform the tools that inform the
planning. Like the size of emergency planning zones
around the hazards.
And it informs the development of the
emergency planning functions that ensure that
protective actions can and will be taken. And I
think in both the DOE and NRC requirements, these
functions are scaled commensurate to the risk of the
facility. So risk-informed approach is used in both.
Question for Tomohiko. A major
criticism about the Fukushima evacuation was the
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number of --
(Whereupon, the above-entitled matter
went off the record at 4:11 p.m.)
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