The EU-OPERA SHAMISEN project started in December 2015. One driver 
for this project was the realisation that existing recommendations on nuclear accident dose control had an almost exclusively technical focus which was directed towards the decision making process of experts while failing to consider the impact on the general populations. Both Chernobyl and Fukushima taught us that averting dose is only part of the process of protecting the public; social, ethical, psychological issues are as important, if not more so. What was needed was a set of recommendations that would contribute to health surveillance and related communication with affected populations after nuclear accidents.
The project has now reported (here). It presents a number of recommendations and, for each one, it briefly explains why they make the recommendation, how it can be satisfied and who should take the lead. This is a very good format for this type of document.
Of particular interest to me are:
R7 Build a radiation protection culture between radiation protection experts, healthcare workers, professionals and the general public. This is a very big ask. Radiation Protection is eye wateringly complex and it takes several hours to explain the basics to people with a good science education. The big questions are how are the healthcare workers going to find the time to listen and how are you going to convince the public that they need to devote the time and effort to learning. After an accident in their area I think we’d have their attention but not before. This is a laudable ambition, teaching materials can be written (indeed many good examples already exist) but after that there are no quick wins.
R8 Establish early response and communication protocols with responsibilities and roles clearly laid out. Engage relevant stakeholders in the establishment of these protocols, and prepare the necessary material and channels to communicate with the public (including social media). This is part of the preparedness phase. Much of this is already part of basic emergency plans. Off-site plans invariably list who should be alerted and define the roles and responsibilities of responders. Maybe more could be done to prepare information and discuss how it could be presented to the public on the day of an event and in the days and weeks following an event.
R10 Prepare and facilitate training and education material and resources adapted to healthcare and other professionals, as well as other stakeholders. This is another laudable ambition to pre-position healthcare, community leaders and teachers with suitable knowledge and teaching materials ready to step and inform and reassure the public if the worst happens. Again the problem is one of time and focus. Healthcare professionals have a lot of competing issues to consider as they strive to support the community health.
R13 Foster participation of stakeholders and communities by engaging them in emergency preparedness, including planning for socio-economic health surveillance and, where appropriate, epidemiology. Again the industry and the government already does a lot in this area with regular meetings with community groups and community group representation on multi-agency emergency planning meetings. This tends to be more about the arrangements to promulgate and alert and support early countermeasures rather than socio-economics and epidemiology. (Having said that health physics is a challenge to teach it must be recognised that it is relatively straightforward compared to epidemiology).
R14 Ensure prompt sharing of accurate and reliable information (e.g., plant conditions, radiation dose, radiation protection actions) between nuclear plant representatives, authorities, experts and the population. The paper has a great quote here; “it is easier to scare than to reassure”. Talking about the tendency of misinformation to quickly fill any gaps in communication it reports that “a recent study found that, during the Zika virus outbreak, the most popular social media health stories were the least accurate”. This isn’t a surprise but it does focus us on the reality of public communication – it is difficult. The authors conclude this section by saying that “the benefits of online information offer the public a unique opportunity to learn about nuclear power, which may outweigh the costs associated with “internet cacophony”.
I find the recommendation R18 Provide support to populations who wish to make their own measurements, recommending reliable equipment and resources (e.g., apps, social media, information centres) that can contribute to the characterisation of population exposure and its evolution a little hard to agree with. Radiation detection is relatively easy. Radiation measurement is quite difficult. Interpretation of radiation measurements in terms of harm is difficult. There could be benefits from providing groups of people immediately affected by the incident with a group EPD to give a quick assessment of their dose during the acute phase, and providing everyone who returns from evacuation with a personal TLD (collected and read by the authorities) to assess their doses systematically. But I would hesitate to encourage unskilled people to wield unfamiliar radiation monitors and use the results to affect their behaviour.
The recovery phase recommendations all have merit and consideration of this document should be included in any recovery phase planning effort.
What do we need to do better as a result of this advice?
I think that the idea of building up radiological protection knowledge capital prior to an event is sensible but difficult. Encouraging healthcare professions, community leaders and people the community might trust such as teachers is always going to struggle against competing calls on their time and attention. Given that other threats such as flu pandemic, other health scares and themes such as mental health, diet and obesity are more likely to impact they are more likely to take the training time of these people. The industry’s outreach and information programmes should continue.
Early response tools, such as briefing material, are often spoken about and nuclear operators tend to have trained Media Technical Briefers to explain the complexities of nuclear accidents and health implications on the day. A review to see if more can be done, particularly with emerging technology and communications channels, should be undertaken periodically.
Summary
This report is well thought out, well presented and valuable. It deserves to be read by nuclear emergency planners and those responders with responsibility for advising and supporting members of the public before, during and after an accident.