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Prediction Modeling to Determine the Adequacy of Medical Response to Urban Nuclear Attack

Published online by Cambridge University Press:  08 April 2013

Cham E. Dallas  and
William C. Bell
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Abstract

Background: Government reports have persistently indicated the intent of terrorists and hostile nations to acquire and “weaponize” nuclear materials for deliberate attack on a major US metropolitan city.

Methods: A modeling analysis of the effects of 20- and 550-kiloton nuclear detonations on the 2 major metropolitan centers of Los Angeles and Houston is presented with a focus on thermal casualties. Brode’s work as modified by Binninger was used to calculate thermal fluence, using thermal fractions. The EM-1 and WE programs were used to calculate blast effects. Fallout radiation was calculated using the Defense Threat Reduction Agency’s Hazard Prediction and Assessment Capability V404SP4 with “urban effects” turned on. The ESRI ArcView program calculated affected populations from 2000 US Census block-level data for areas affected by thermal effects.

Results: The population affected by a 550-kiloton nuclear weapon detonated in Los Angeles and Houston is staggering: surviving thermal casualties are estimated at 185,000 and 59,000, respectively. Even the 20-kiloton detonations in Los Angeles and Houston are significant: the numbers of surviving thermal casualties requiring care exceed 28,000 and 10,000, respectively.

Conclusions: The surviving health care community postdetonation would be faced with an unprecedented burden of care for thermal casualties. A great expansion of personnel involved in emergency burn care response is critical. Bold, new approaches such as regionalization and predetermined medical air transport need to be considered. (Disaster Med Public Health Preparedness. 2007;1:80–89)

Keywords

burnmass casualtynuclearthermalurbanmedical air evacuation
Type
Original Research and Critical Analysis
Information
Disaster Medicine and Public Health Preparedness , Volume 1 , Issue 2 , November 2007 , pp. 80 - 89
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2007

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References

REFERENCES

1.Effect of Nuclear War on Health and Health Services, 2nd ed. Geneva:World Health Organization; 1987.Google Scholar
2. Bell WC, Dallas CE. Vulnerability of populations and the urban health care systems to nuclear weapon attack—examples from four American cities. Int J Health Geogr [serial online]. February 2007. http://www.ijhealthgeographics.com/content/pdf/1476-072X-6-5.pdf. Accessed August 27, 2007.Google Scholar
3.Clark, R, Ehrlich, A, Gunn, SWA.London Under Attack. Report of the Greater London Area War Risk Study (GLAWARS) Commission. Oxford, UK:Blackwell Scientific; 1986.Google Scholar
4.Brooks, JW, Evans, ET, Ham, WT, Reid, JD.The influence of external body radiation on mortality from thermal burns. Ann Surg. 1952;136:533–545.Google Scholar
5.Glasstone, S, Dolan, PJThermal radiation and its effects. The Effects of Nuclear Weapons. 3rd ed. Washington, DC: US Department of Defense and the Energy Research and Development Administration; 1977.CrossRefGoogle Scholar
6.Becker, WK, Buescher, TM, Cioffi, WG, McManus, WF, Pruitt, BA. Combined radiation and thermal injury after nuclear attack. In: Brown D, Weiss JF, MacVittie, TJ. Treatment of Radiation Injuries. New York: Plenum;1990: 145–151.Google Scholar
7.The Effects of Nuclear War. Washington, DC: Office of Technology Assessment; 1979.Google Scholar
8.Barnaby, S, Rotblat, J.Nuclear war: the aftermath. The effects of nuclear war. Ambio. 1982;11:2–3:84-94.Google Scholar
9.Eden, L.Whole World on Fire. Ithaca, NY: Cornell University Press; 2004.Google Scholar
10.Binninger, G, Hodge, JK, Wright, S, et alDevelopment of a Fire Prediction Model for Use Within HPAC. San Diego: L3 Titan Corp; 2003.Google Scholar
11.Brode, HL.Fire Targeting Methodology Improvements and Automation. Alexandria, VA: Defense Special Weapons Agency;1996: 94–100.Google Scholar
12.Postol, TAPossible fatalities from superfires following nuclear attacks in or near urban areas. Soloman F, Marston RQ. The Medical Implications of Nuclear War. Washington, DC: National Academy Press;1986:15–73.Google Scholar
13.Daugherty, W, Levi, B, Von Hippel, F. Casualties due to blast, heat and radioactive fallout from various hypothetical nuclear attacks on the United States. Soloman F, Marston RQ. The Medical Implications of Nuclear War. Washington, DC: National Academy Press; 1986: 207–233.Google Scholar
14. Diehl SR, Keith JR, Conley P. Probabilistic Thermal Transmission Curves. Vol 1: European and Mideast Results, Vol 2: KSC Curve-fitted Scattered Radiation Database. Washington, DC: Defense Nuclear Agency; 1987: DNA-TR 87–DNA-TR 62–V1 and –V2. Fig 8.6 Vol 1.Google Scholar
15.Brode, HL, Small, RDA. Review of the physics of large fires. Soloman F, Marston RQ. The Medical Implications of Nuclear War. Washington, DC: National Academy Press; 1986: 73–96.Google Scholar
16.Craver, RH, Martin, SB, Bacon, DP, et alNuclear Weapon Induced Urban Fires and Smoke Injection. Bellevue, NE: Defense Supply Service SAIC; 1987.Google Scholar
17. Northop JA. Handbook of Nuclear Weapons Effects: Calculational Tools Abstracted from EM-1. Washington, DC: Defense Special Weapons Agency; 1996, Table 6.1.Google Scholar
18. Effects Manual-1 (EM-1). DNA-EM1991.Washington, DC: Defense Nuclear Agency; 1991.Google Scholar
19.WE Program [computer program]. Pittsburgh: Defense Nuclear Agency; 1997.Google Scholar
20. Defense Threat Reduction Agency. HPAC Web site. http://www.dtra.mil/newsservices/fact_sheets/display.cfm?fs=hpac. Accessed August 27, 2007.Google Scholar
21. ESRI [computer program]. ArcView 9.2. GIS and Mapping Software, 2007.Google Scholar
22. US Census Bureau: PHC-T-40 [database online]. Estimated Daytime Population and Employment-Residence Ratios; 2000. http://www.census.gov/population/www/socdemo/daytime/daytimepop.html. Accessed June 26, 2007.Google Scholar
23. HoustonDowntown [database online] http://www.houstondowntown.com/Home/Business/DoingBusiness/EmployeesbyBlock/Employees%20by%20Block%20%28pdf%29.PDF. Accessed August 27, 2007.Google Scholar
24.Openshaw, S, Steadman, P, Greene, O, et alBritain After Nuclear Attack. Oxford, UK: Blackwell Scientific; 1983.Google Scholar
25. National Planning Scenarios: Executive Summaries. July 2004. http://www.globalsecurity.org/security/library/report/2004/hsc-planning-scenarios-jul04.htm. Accessed September 21, 2007.Google Scholar
26. ES&H Manual Document 22.6. Exposure to Radiation in an Emergency. Livermore, CA: Lawrence Livermore National Laboratory; 2003.Google Scholar
27.Alpen, EL, Sheline, GE.The combined effects of thermal burns and whole body X irradiation on survival time and mortality. Ann Surg. 1954;140:113–118.Google Scholar
28.Baxter, H, Drummond, JA, Stevens-Nesham, LG, et alReduction of mortality in swine from combined total body radiation and thermal burns by streptomycin. Ann Surg. 1953;137:450–455.Google Scholar
29.Abrams, HL, von Kaenel, WE.Medical survivors of nuclear war: infection and the spread of communicable disease. N Engl J Med. 1981;305:1226–1232.CrossRefGoogle ScholarPubMed
30.McIrvine, AJ, O’Mahony, JB, Saporoschetz, I.Depressed immune response in burn patients. Ann Surg. 1982;196:297–304.Google Scholar
31.Munster, AM.Immunologic response to trauma and burns: overview. Am J Med. 1984;176:142–145.Google Scholar
32. Volunteers in Police Service. Federal Emergency Management Agency Web site. http://www.citizencorps.gov/programs/vips.shtm. Accessed August 27, 2007.Google Scholar
33. Medical Reserve Corps. Medical Reserve Corps Web site. http://www.medicalreservecorps.gov. Accessed August 27, 2007.Google Scholar
34. ArcGIS 9 ESRI Data and Maps. Media kit [database]. Redlands, CA: ESRI; 2004.Google Scholar
35.Handbook for Emergencies. Geneva: UNHCR; 1982.Google Scholar
36.Kent Harding, D.Camp Planning. Geneva: UNHCR; 1987.Google Scholar
37. Norwegian Refugee Council Camp Management. NRC Web site. http://www.nrc.no/?did=9072071. Accessed August 27, 2007.Google Scholar
38.Leslie, CL, Cushman, M, McDonald, GS, Joshi, W, Maynard, AM.Management of multiple burn casualties in a high volume ED without a verified burn unit. Am J Emerg Med. 2001;19:469–473.Google Scholar
39.Waselenko, JK.Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med. 2004;140:1037–1051.Google Scholar
40.Kumar, P, Jagetia, GC.A review of triage and management of burns victims following a nuclear disaster. Burns. 1994;20:307–402.CrossRefGoogle ScholarPubMed
41.Rivara, FP, Nathens, AB, Jurkovich, GJ, et alDo trauma centers have the capacity to respond to disasters?. Injury, infection and critical care. J Trauma. 2006;61:949–953.Google Scholar
42.Gonzalez, AJ.Radiation protection in the aftermath of a terrorist attack involving exposure to ionizing radiation. Health Phys Soc. 2005;89:418–446.Google Scholar