Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Whitcomb RC [original query] |
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Developing a radiation-savvy public health workforce
Salame-Alfie A , Whitcomb RC , Evans CL , Howard G , Gilstrap J , Gill A , Hardrick H . Environ Adv 2022 9 In 2016 the United States Centers for Disease Control and Prevention (CDC) established a Nuclear/Radiological Training and Exercise Preparedness (TEP) Program to better prepare its workforce to respond to a nuclear/radiological incident. The TEP program is comprised of staff across CDC programs with a variety of specialties such as epidemiologists, clinicians, data managers, communicators, environmental health specialists, at risk population specialists and health physicists. Key TEP activities include the preparation of the CDC Nuclear/Radiological Incident Response and Recovery Annex that describes CDC's roles and responsibilities in the event of a nuclear/radiological incident; establishment of an Incident Management System (IMS) structure to reflect an agency-wide response consistent with CDC's All Hazards Plan; and completion of nuclear/radiological public health preparedness and response training and exercises. In addition to training sessions on the various radiation topics, the TEP program includes seminars on the various roles and responsibilities of the task forces defined in IMS during a response. The TEP program includes a range of discussion-based (seminars, workshops, tabletop exercises) and operations-based (drills and functional exercises) activities aimed at enhancing IMS staff capabilities and capacity to be prepared to respond to a nuclear/radiological incident. In summary, the CDC's Nuclear/Radiological TEP Program prepares knowledgeable, well-trained staff, or a radiation-savvy workforce, ready for a robust response to a nuclear/radiological emergency. |
US Centers For Disease Control and Prevention experience in the joint external evaluation process - radiation emergencies technical area
Whitcomb RC Jr , Ansari AJ , Salame-Alfie A , McCurley MC , Buzzell J , Chang A , Jones RL . Radiat Prot Dosimetry 2018 182 (1) 9-13 In 2015-16, the US Department of Health and Human Services led 23 US Government (USG) agencies including the Centers for Disease Control and Prevention (CDC), and more than 120 subject matter experts in conducting an in-depth review of the US core public health capacities and evaluation of the country's compliance with the International Health Regulations using the Joint External Evaluation (JEE) methodology. This two-part process began with a detailed 'self-assessment' followed by a comprehensive independent, external evaluation conducted by 15 foreign assessors. In the Radiation Emergencies Technical Area, on a scale from 1-lowest to 5-highest, the assessors concurred with the USG self-assessed score of 3 in both of the relevant indicators. The report identified five priority actions recommended to improve the USG capacity to handle large-scale radiation emergencies. CDC is working to implement a post-JEE roadmap to address these priority actions in partnership with national and international partners. |
A public health perspective on the U.S. response to the Fukushima radiological emergency
Whitcomb RC Jr , Ansari AJ , Buzzell JJ , McCurley MC , Miller CW , Smith JM , Evans DL . Health Phys 2015 108 (3) 357-63 On 11 March 2011, northern Japan was struck by first a magnitude 9.0 earthquake off the eastern coast and then by an ensuing tsunami. At the Fukushima Dai-ichi Nuclear Power Plant (NPP), these twin disasters initiated a cascade of events that led to radionuclide releases. Radioactive material from Japan was subsequently transported to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to cause health effects, but the presence of this material in the environment was enough to require a response from the public health community. Events during the response illustrated some U.S. preparedness challenges that previously had been anticipated and others that were newly identified. Some of these challenges include the following: (1) Capacity, including radiation health experts, for monitoring potentially exposed people for radioactive contamination are limited and may not be adequate at the time of a large-scale radiological incident; (2) there is no public health authority to detain people contaminated with radioactive materials; (3) public health and medical capacities for response to radiation emergencies are limited; (4) public health communications regarding radiation emergencies can be improved to enhance public health response; (5) national and international exposure standards for radiation measurements (and units) and protective action guides lack uniformity; (6) access to radiation emergency monitoring data can be limited; and (7) the Strategic National Stockpile may not be currently prepared to meet the public health need for KI in the case of a surge in demand from a large-scale radiation emergency. Members of the public health community can draw on this experience to improve public health preparedness. |
Public health and medical preparedness for a nuclear detonation: the nuclear incident medical enterprise
Coleman CN , Sullivan JM , Bader JL , Murrain-Hill P , Koerner JF , Garrett AL , Weinstock DM , Case C Jr , Hrdina C , Adams SA , Whitcomb RC , Graeden E , Shankman R , Lant T , Maidment BW , Hatchett RC . Health Phys 2015 108 (2) 149-60 Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience, and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal, and territorial governments; private sector organizations; academia; industry; international partners; and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a "bottom-up" systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication, and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided. |
Murder by radiation poisoning: implications for public health
Miller CW , Whitcomb RC , Ansari A , McCurley C , Nemhauser JB , Jones R . J Environ Health 2012 74 (10) 8-13 On November 23, 2006, former Russian military intelligence officer Alexander Litvinenko died in a London hospital. Authorities determined he was deliberately poisoned with the radionuclide Polonium-210 (210Po). Police subsequently discovered that those involved in this crime had--apparently inadvertently--spread 210Po over many locations in London. The United Kingdom Health Protection Agency (HPA) contacted many persons who might have been exposed to 210Po and provided voluntary urine testing. Some of those identified as potentially exposed were U.S. citizens, whom the HPA requested that the Centers for Disease Control and Prevention (CDC) assist in contacting. CDC also provided health care professionals and state and local public health officials with guidance as to how they might respond should a Litvinenko-like incident occur in the U.S. This guidance has resulted in the identification of a number of lessons that can be useful to public health and medical authorities in planning for radiological incidents. Eight such lessons are discussed in this article. |
Commentary on the combined disaster in Japan
Coleman CN , Whitcomb RC , Miller CW , Noska MA . Radiat Res 2012 177 (1) 15-7 The report by Dr. Takeo Ohnishi in this issue of Radiation Research (1) is a comprehensive detailing of the Fukushima-Daiichi nuclear power plant (NPP) disaster. We have chosen for the title of this commentary “combined disaster,” which is emphasized by both Dr. Ohnishi and Dr. Makoto Akashi from the National Institute of Radiological Sciences (2), who was involved in the management of the incident. Dr. Akashi and others emphasize the catastrophic loss of life and damage primarily from the earthquake and tsunami and that the NPP disaster was the consequence of the loss of infrastructure, including power supply and access to the facility. There are lessons observed regarding NPP issues, and there is now broad worldwide discussion on the future of energy sources. The consequences of the NPP disaster will take years to better understand as the Fukushima-Daiichi incident plays out. In addition, nuclear power issues will take decades to be addressed, given the complexity of worldwide energy needs, potential sources and suppliers of alternative forms of energy, and the environmental impact of the rising worldwide energy demand. Furthermore, energy policy complicates matters as decisions by one country can have an enormous impact on its neighbors and the entire world. | This commentary is from the personal and professional perspective of the four coauthors, who were directly involved in the response at the U.S. Embassy in Japan (CNC and MAN) and in the U.S. at the National Security Staff (CBM) at the White House and Centers for Disease Control and Prevention (RCW). In that the number of radiation experts within the U.S. government (USG) is small and there are many ongoing interagency collaborations [e.g., Planning Guidance (3)], the overall U.S. response involved people who worked tirelessly over the first month to provide their expertise and support for the international and domestic aspects of the response, including supporting the Japanese. This NPP disaster is unique in the enormity of the overall infrastructure damage, the sophisticated response and monitoring ability, the breadth of the media attention, the presence of multiple potential sources for radiation release, and the stepwise evolution with real-time monitoring of an environmental radionuclide release. While comparisons are made with Chernobyl, this incident was certainly different in terms of the type of reactor, character of radionuclide release, and timeliness of reporting in regard to the onset of the incident (2). |
Use of epidemiological data and direct bioassay for prioritization of affected populations in a large-scale radiation emergency
Miller CW , Ansari A , Martin C , Chang A , Buzzell J , Whitcomb RC Jr . Health Phys 2011 101 (2) 209-15 Following a radiation emergency, evacuated, sheltered or other members of the public would require monitoring for external and/or internal contamination and, if indicated, decontamination. In addition, the potentially-impacted population would be identified for biodosimetry/bioassay or needed medical treatment (chelation therapy, cytokine treatment, etc.) and prioritized for follow-up. Expeditious implementation of these activities presents many challenges, especially when a large population is affected. Furthermore, experience from previous radiation incidents has demonstrated that the number of people seeking monitoring for radioactive contamination (both external and internal) could be much higher than the actual number of contaminated individuals. In the United States, the Department of Health and Human Services is the lead agency to coordinate federal support for population monitoring activities. Population monitoring includes (1) monitoring people for external contamination; (2) monitoring people for internal contamination; (3) population decontamination; (4) collecting epidemiologic data regarding potentially exposed and/or contaminated individuals to prioritize the affected population for limited medical resources; (5) administering available pharmaceuticals for internal decontamination as deemed necessary by appropriate health officials; (6) performing dose reconstruction; and (7) establishing a registry to conduct long-term monitoring of this population for potential long-term health effects. This paper will focus on screening for internal contamination and will describe the use of early epidemiologic data as well as direct bioassay techniques to rapidly identify and prioritize the affected population for further analysis and medical attention. |
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