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Society For Risk Analysis Annual Meeting 2008

Risk Analysis: the Science and the Art

Session Schedule & Abstracts

* Disclaimer: All presentations represent the views of the authors, and not the organizations that support their research. Please apply the standard disclaimer that any opinions, findings, and conclusions or recommendations in abstracts, posters, and presentations at the meeting are those of the authors and do not necessarily reflect the views of any other organization or agency. Meeting attendees and authors should be aware that this disclaimer is intended to apply to all abstracts contained in this document. Authors who wish to emphasize this disclaimer should do so in their presentation or poster. In an effort to make the abstracts as concise as possible and easy for meeting participants to read, the abstracts have been formatted such that they exclude references to papers, affiliations, and/or funding sources. Authors who wish to provide attendees with this information should do so in their presentation or poster.

Common abbreviations

Integrated CBRN Risk Assessment at DHS: Consequence and Medical Countermeasure Analysis for Radiological and Nuclear Terrorism

Room: Webster   4:00-5:30 PM

Chair(s): Brooke Buddemeier

W4-I.1  16:00  A public health response model for radiological terrorism events. Dingus CA*, Carnell RC, Buddemeier BR, Daxon E, Maheras SJ; Battelle Memorial Institute, Lawrence Livermore National Laboratory

Abstract: Homeland Security Presidential Directive (HSPD) 18 (Medical Countermeasures against Weapons of Mass Destruction) requires a risk assessment of Chemical, Biological, Radiological, and Nuclear terrorism for the purpose of risk based decision support in the area of medical countermeasure acquisition and development. The Department of Homeland Security’s Science and Technology Directorate has developed a public health response model for radiological terrorism events as a framework for evaluating proposed medical countermeasures. This presentation focuses on the development of the public health response model, its important parameters and inputs, and on various medical countermeasure strategies that it can assess. The model uses a time, countermeasure efficacy, and countermeasure quantity approach to determine the potential reduction in fatalities caused by a number of treatments. The methodology employs a discrete events model to simulate groups of people moving through the stages of illness and the public health system.

W4-I.2  16:20  A dose-response model for characterizing radiological exposure in terrorist events. Carnell RC*, Buddemeier BR, Maheras SJ; Battelle Memorial Institute, Lawrence Livermore National Laboratory

Abstract: A key component of any radiological terrorism consequence analysis is a careful consideration of the various modalities of exposure that can cause early fatalities (to include blood, lung and gastrointestinal syndromes). As part of the Department of Homeland Security’s efforts to conduct an integrated CBRN risk assessment to support medical countermeasure decision making, a novel dose-response model appropriate for radiological terrorism scenarios has been produced as a component of the consequence calculations for acute radiation sickness, early fatality, and latent cancer fatality. The radiological dose-response model described in this presentation builds on the relevant literature to provide a framework for calculating the consequences of radiological events in a variety of terrorist attack scenarios. Early fatalities due to hematopoietic syndrome, gastrointestinal syndrome, and pulmonary syndrome are considered. These consequence calculations are essential in accomplishing the goal of assessing the benefit of medical countermeasures at reducing mortality should a radiological terrorism event occur.

W4-I.3  16:40  Public health recognition and response to a radiologic event. Harlander S*, Sholl J, Jaine A; BTsafety, LLC

Abstract: Physician and public health department (PHD) recognition and response to a radiological terrorism attack will be critical in order to intervene, mitigate and minimize the impact of an event. The purpose of this study was to gain an understanding of how medical personnel and PHDs would recognize and respond to the covert introduction of radiologic agents into the food supply. The approach involved personal interviews with 24 medical personnel from a variety of disciplines (i.e., emergency, epidemiology, family medicine, gastroenterology, hematology, infectious disease, microbiology, pathology, pediatrics, pharmacy, toxicology, etc.) and a variety of institutions (i.e., emergency rooms/trauma centers, hospitals, clinics, urgent care facilities, tribal care center) in urban and rural areas. Ten PHDs with variable experience in foodborne illness outbreak investigations were also interviewed. All interviewees were presented with a symptom description for a patient who exhibited acute radiation syndrome as defined by HHS’ Radiation Event Medical Management consistent with a whole body exposure to 5.3 – 8.3 Grays. A questionnaire was used to explore initial and differential diagnoses, laboratory tests they would request, and initial treatment options. Additional information including metabolic panels and blood chemistry test results was provided to inform their decision-making process. The number of patients to trigger action, what actions would be taken and the factors that influence recognition and response were also explored. The results of the study indicate that all medical personnel recognized that they were dealing with symptoms consistent with advancing sepsis, but none of the medical personnel or PHDs recognized they were dealing with a radiologic exposure. Although the sample size was small, this study provides some basis for an estimate of recognition and response parameters for events for which we have no prior experience.

W4-I.4  17:00  Updated modeling for nuclear terrorism consequence assessments. Buddemeier BR*, Dombroski MJ, Wheeler RM, Maheras SJ, Carnell RC; Lawrence Livermore National Laboratory, Battelle Memorial Institute

Abstract: Homeland Security Presidential Directive (HSPD) 18 calls for an integrated Chemical, Biological, Radiological, and Nuclear terrorism risk assessment (iCBRNra) to inform public policy on medical countermeasure development. In support of this activity, the Department of Homeland Security's Science and Technology Directorate has undertaken detailed consequence modeling of a nuclear detonation in several modern U.S. cities that obtain insight into the nature and distribution of injuries and the potential effects of medical countermeasures. Atmospheric dispersion and prompt effects models are important tools for planning an initial response to a nuclear detonation; however some current operational predictions make overly simplified assumptions, which may impact the ability to make effective planning decisions. The analysis used for this study provided more realistic methods of estimating exposure by accounting for the presence of different building types, which can provide shielding and sheltering of the population, and also provide more realistic estimations of the number and type of casualties from nuclear-detonation prompt effects (prompt radiation, thermal and blast overpressure) that account for how these structures both protect people and cause injury due to building collapse and glass breakage. Results indicate that although high levels of casualties and extensive destruction may be unavoidable, both casualties and secondary effects can be significantly reduced with proper planning, equipment, training, and medical countermeasure development.

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