Workshop Objectives:

The purpose of the workshop is to assess the current level of medical preparedness for a nuclear detonation of up to 10 kilotons in tier 1 Urban Area Security Initiative cities (New York/New Jersey; National Capitol Region; Houston; Chicago; Los Angeles; and San Francisco/Bay Area). The specific objectives of the workshop are to:

• Review and summarize the overall emergency response activities, and available healthcare capacity (including shelter, evacuation, decontamination, and medical infrastructure interdependencies) to treat the affected population;
• Examine the capacity and identify gaps in the capability of the federal, state, and local authorities to deliver available medical countermeasures in a timely enough way to be effective;
• Review and summarize available treatments for pertinent radiation illnesses including the efficacy of medical countermeasures; and,
• Appraise the expected benefit of medical countermeasures, including those currently under development.
   

PRELIMINARY PUBLIC AGENDA

Day 1

Thursday, June 26, 2008

Lecture Room

National Academy of Sciences

2101 Constitution Ave., NW

(C Street Entrance)

Washington, DC

 8:30 a.m.         Welcome, Introductions, and Overview of Workshop Purpose and Objectives

Georges C. Benjamin, Committee Chair

Executive Director

American Public Health Association

Til Jolly, Office of Health Affairs

Department of Homeland Security

Session Objectives: Provide basic information on the scope of the emergency medical needs that would be created by the detonation of a 10-kiloton (kT) nuclear device in a major city, including primary and secondary blast and thermal effects and the effects of prompt nuclear radiation and radiation from fallout on inhabitants and emergency responders. The main focus will be on the acute injuries caused by the blast, thermal, and prompt radiation effects of the initial explosion and by acute radiation exposure from fallout during the first three days after the explosion (excluding other important but longer-term impacts, such as long-term radiation effects, environmental contamination, and displacement of residents from contaminated areas). The potential impacts of the explosion on local emergency response and health system capacities will also be described. At the end of the session, workshop participants will have a basic understanding of the medical situation faced by emergency responders during the first 3 days post-explosion, which in turn will be the basis for assessing current medical preparedness at the local, state, and federal levels.

 9:00 a.m.         Session Overview and Objectives

Daniel F. Flynn, Session Moderator

Department of Radiation Oncology

Caritas Holy Family Hospital and Medical Center

Methuen, MA

 9:05 a.m.         Health Effects of a 10-kT-Equivalent Nuclear Explosion on an Urban Population and Emergency Responders

Brooke Buddemeier

Radiation Safety Specialist

Radiological and Nuclear Countermeasures Division

Global Security Principal Directorate

Lawrence Livermore National Laboratory

 9:35 a.m.         Health System Impacts of a 10-kT-Equivalent Nuclear Explosion on an Urban Area

Cham Dallas

Director,

Institute for Health Management and Mass Destruction Defense

Professor,

Department of Health Policy & Management, College of Public Health, University of Georgia

Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, University of Georgia

Department of Emergency Medicine, Medical College of Georgia

10:05 a.m.        Discussion led by

Daniel F. Flynn, Session Moderator

10:35 a.m.       BREAK

Session Objective: Provide an overview of current approaches to medical response in the event of an IND explosion. The first presentation will cover the triage, decontamination, evacuation, and medical care of casualties from the immediate effects of a nuclear detonation, i.e., treatment of blast, thermal, and prompt radiation effects, including combined injuries. The second presentation will cover medical decision making and care of casualties from the delayed effects of a nuclear detonation, i.e., secondary triage and injuries from radioactive fallout.

10:45 a.m.        Session Overview and Objectives

Donna F. Barbisch, Session Moderator

President

Global Deterrence Alternatives, LLC

Washington, DC

10:50 a.m.        Urban Nuclear Detonation: Operational Conditions, Human Response and Casualty Management

John Mercier

Director of Military Medical Operations

Armed Forces Radiobiology Research Institute

11:20 a.m.        Medical Decision Making and Care of Casualties from Delayed Effects of a Nuclear Detonation

Fred A. Mettler, Jr.

Professor Emeritus

Department of Radiology

New Mexico Federal Regional Medical Center

University of New Mexico

11:50 a.m.        Discussion led by

Donna F. Barbisch, Session Moderator

12:20 p.m.       WORKING LUNCH IN THE LECTURE ROOM

Committee, speakers, participants, and staff will briefly recap the discussions from the morning sessions of the first day of the workshop.

Session Objective: Provide an overview of current medical countermeasures for the acute effects of radiation exposure and of their efficacy and an assessment of the expected benefit of medical countermeasures currently under development.

 1:30 a.m.         Session Overview and Objectives

Richard J. Hatchett, Session Moderator

Associate Director for Radiation Countermeasures Research and Emergency Preparedness

National Institute of Allergy and Infectious Diseases

 1:35 p.m.         Efficacy and Expected Benefit of Currently Available Radiation Countermeasures

Albert L. Wiley, Jr.

Radiation Emergency Assistance Center/Training Site and World Health Organization Collaborating Center for Radiation Emergency Assistance

Oak Ridge Associated Universities

 2:05 p.m.         Expected Benefit of Radiation Countermeasures Currently under Development

Nelson J. Chao

Professor of Medicine and Immunology

Chief, Division of Cellular Therapy

Duke University Medical Center

 2:35 p.m.         Distribution and Dispensing of Medical Countermeasures (i.e., how and when will countermeasures get to those who need them?)

Steven A. Adams

Deputy Director, Division of Strategic National Stockpile

Centers for Disease Control and Prevention

Carmen T. Maher

Policy Analyst

Office of Counterterrorism & Emerging Threats

Food and Drug Administration

 3:00 p.m.         Discussion led by

Richard J. Hatchett, Session Moderator

 3:30 p.m.        BREAK

Session Objective: Provide an overview of current policies and programs to protect first responders and medical personnel from radiation exposure.

 3:45 p.m.         Session Overview and Objectives

Paul E. Pepe, Session Moderator

Professor of Medicine, Surgery, Pediatrics, Public Health and Riggs Family Chair in Emergency Medicine

University of Texas Southwestern Medical Center at Dallas

 3:50 p.m.         Radiation Protection Standards

Sara D. DeCair

Health Physicist

Center for Radiological Emergency Preparedness, Prevention, and Response

U.S. Environmental Protection Agency

John MacKinney

Deputy Director, Nuclear/Radiological/Chemical Threats and Science and Technology Policy, Office of Policy Development

Department of Homeland Security

Jill A. Lipoti

Director, Division of Environmental Safety and Health

New Jersey Department of Environmental Protection

Eric G. Daxon

Health Physicist

Battelle - San Antonio Operations

 4:40 p.m.         Discussion led by

Paul E. Pepe, Session Moderator

 5:10 p.m.        ADJOURNMENT OF OPEN SESSION

PRELIMINARY PUBLIC AGENDA

Day 2

Friday, June 27, 2008

Auditorium

National Academy of Sciences

2101 Constitution Avenue, NW

(C Street Entrance)

Washington, DC

8:30 a.m.          Welcome, Introductions, and Overview of Workshop Purpose and Objectives

Georges C. Benjamin, Committee Chair

Executive Director

American Public Health Association

Session Objective: Provide overview of best population protection practices during an IND incident. Issues include risk communication, psychosocial factors, and readiness to implement interventions to reduce mental and physical impacts.

 8:45 a.m.         Session Overview and Objectives

Robert J. Ursano, Session Moderator

Chairman and Professor of Psychiatry and Neuroscience

Chairman, Department of Psychiatry

Uniformed Services University of the Health Sciences

 8:50 a.m.         Behavioral and Risk Communication Issues, and Interventions Strategies, in Nuclear Detonation Incidents

Steven M. Becker

Associate Professor of Public Health

Vice Chair, Dept. of Environmental Health Sciences

Director, Disaster & Emergency Communication Research Unit

Director, Community Resilience & Disaster Management Program

The University of Alabama at Birmingham

H. Keith Florig

Senior Research Engineer

Department of Engineering & Public Policy

Carnegie Mellon University

Ann E. Norwood

Senior Associate

UPMC Center for Biosecurity

Dori B. Reissman

Senior Medical Advisor

Office of the Director

NIOSH

10:20 a.m.       BREAK

10:30 a.m.        Behavioral and Risk Communication Issues, and Interventions Strategies, in Nuclear Detonation Incidents (continued)

11:00 a.m.        Discussion led by

Robert J. Ursano, Session Moderator

11:30 a.m.        Summary of workshop discussions

Jerome M. Hauer

The Hauer Group

12:00 p.m.        Wrap-up and final thoughts

Georges C. Benjamin, Committee Chair

12:30 p.m.       ADJOURNMENT OF OPEN SESSION