Introduction: Nuclear power generation is increasing globally and is expected to triple by 2050. This, combined with the proliferation of nuclear materials, has highlighted the need for enhanced public health preparedness. Although an emergency event has a low probability, it could have a devastating impact on human life. Despite similar risks, emergency response communities around the globe have developed different public health approaches to nuclear and radiation preparedness. To address this challenge, a scorecard approach was piloted to identify and prioritize strategies to strengthen public health preparedness for a nuclear and radiation incident. Methods: A pilot nuclear and radiation resilience scorecard was applied in a workshop in Montgomery, Alabama, United States, with 14 participants. There were representatives from emergency preparedness and planning (n=7), nursing, operations, program management, radiation safety, safety and security, technical hazards, and academia. Workshop participants discussed each scorecard question and then individually scored the level of resilience using a Likert scale. The questions were organized around the United Nations Office for Disaster Risk Reduction (UNDRR) Ten Essentials for Making Cities Resilient. When consensus was reached, participants developed and prioritized actions. Results: There were four priority actions identified. This included increasing the outreach of representatives in the nuclear and radiation industry to health facilities. Expanding planning to non-traditional areas such as primary care facilities, education systems, and transport networks. Increasing the scope of emergency warning systems to counter misinformation and creating a standardized process for educating and onboarding public health officials involved directly and indirectly in emergency management. This should include training and exercises focused on nuclear or radiation incidents. Conclusion: The scorecard approach and the recommended actions provide a path forward for public health systems to function at the highest possible level when preparing for and responding to a nuclear or radiation incident.
Noel et al. (Sun,) studied this question.