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5.44. Operating personnel for activities in category IV, first responders in an
emergency at an unforeseen location and those personnel at locations where there
is a significant likelihood of encountering a dangerous source that is not under
control (see para. 4.21) shall be provided with guidance and training on taking
urgent protective actions and other response actions. This shall include guidance
and training on the approximate radius of the inner cordoned off area in which
urgent protective actions and other response actions would initially be taken and
on the adjustment of this area on the basis of observed or assessed conditions
on the site.
Requirement 10: Providing instructions, warnings and relevant information
to the public for emergency preparedness and response
The government shall ensure that arrangements are in place to provide the
public who are affected or are potentially affected by a nuclear or radiological
emergency with information that is necessary for their protection, to warn
them promptly and to instruct them on actions to be taken.
5.45. For facilities in category I or II and areas in category V, arrangements shall
be made to provide the permanent population, transient population groups and
special population groups or those responsible for them and special facilities
within the emergency planning zones and emergency planning distances
(see para. 5.38), before operation and throughout the lifetime of the facility,
with information on the response to a nuclear or radiological emergency.
This information shall include information on the potential for a nuclear
or radiological emergency, on the nature of the hazards, on how people would
be warned or notified, and on the actions to be taken in such an emergency. The
information shall be provided in the languages mainly spoken by the population
residing within the emergency planning zones and emergency planning
distances. The effectiveness of these arrangements for public information shall
be periodically assessed.
5.46. For facilities in category I or II and in areas in category V, arrangements
shall be made to register those members of the public in special population
groups and, as appropriate, those responsible for them, and to promptly issue
them and the permanent population and transient population groups, as well
as special facilities in the emergency planning zones and emergency planning
distances, with a warning and with instructions to be followed upon declaration
of a general emergency (see para. 5.14). This shall include providing instructions
on the actions to be taken in the languages mainly spoken by the population
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residing within these emergency planning zones and emergency planning
distances (see para. 5.38).
5.47. For facilities in category III and category IV, arrangements shall be made
to provide the public with information and instructions in order to identify
and locate people who may have been affected by a nuclear or radiological
emergency and who may need response actions such as decontamination, medical
examination or health screening. These arrangements shall include arrangements
for issuing a warning to the public and providing information in the event that
a dangerous source could be in the public domain as a consequence of its loss
or unauthorized removal.
5.48. Arrangements shall be made by response organizations in a State
to promptly provide information and advice to its nationals and to those people
with interests in other States
29
in the event of a nuclear or radiological emergency
declared beyond national borders, with due account taken of the response actions
recommended in the State in which the emergency occurs as well as in the
State(s) affected by that emergency (see paras 5.73 and 6.14).
Requirement 11: Protecting emergency workers and helpers in an emergency
The government shall ensure that arrangements are in place to protect
emergency workers and to protect helpers in a nuclear or radiological
emergency.
5.49. Arrangements shall be made to ensure that emergency workers are, to the
extent practicable, designated in advance and are fit for the intended duty. These
arrangements shall include health surveillance for emergency workers for the
purpose of assessing their initial fitness and continuing fitness for their intended
duties (see also GSR Part 3 [8]).
5.50. Arrangements shall be made to register and to integrate into operations in an
emergency response those emergency workers who were not designated as such
in advance of a nuclear or radiological emergency and helpers in an emergency.
This shall include designation of the response organization(s) responsible
for ensuring protection of emergency workers and protection of helpers
in an emergency.
29 Examples of people with interests in other States include people travelling, people
working and/or living abroad, importers and exporters, and people working in companies
operating abroad.
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5.51. The operating organization and response organizations shall determine
the anticipated hazardous conditions, both on the site and off the site, in which
emergency workers might have to perform response functions in a nuclear
or radiological emergency in accordance with the hazard assessment and the
protection strategy.
5.52. The operating organization and response organizations shall ensure that
arrangements are in place for the protection of emergency workers and protection
of helpers in an emergency for the range of anticipated hazardous conditions
in which they might have to perform response functions. These arrangements,
as a minimum, shall include:
(a) Training those emergency workers designated as such in advance;
(b) Providing emergency workers not designated in advance and helpers in an
emergency immediately before the conduct of their specified duties with
instructions on how to perform the duties under emergency conditions
(‘just in time’ training);
(c) Managing, controlling and recording the doses received;
(d) Provision of appropriate specialized protective equipment and
monitoring equipment;
(e) Provision of iodine thyroid blocking, as appropriate, if exposure due
to radioactive iodine is possible;
(f) Obtaining informed consent to perform specified duties, when appropriate;
(g) Medical examination, longer term medical actions and psychological
counselling, as appropriate.
5.53. The operating organization and response organizations shall ensure that all
practicable means are used to minimize exposures of emergency workers and
helpers in an emergency in the response to a nuclear or radiological emergency
(see para. I.2 of Appendix I), and to optimize their protection.
5.54. In a nuclear or radiological emergency, the relevant requirements for
occupational exposure in planned exposure situations established in GSR Part 3 [8]
shall be applied, on the basis of a graded approach, for emergency workers,
except as required in para. 5.55.
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5.55. The operating organization and response organizations shall ensure that
no emergency worker is subject to an exposure in an emergency that could give
rise to an effective dose in excess of 50 mSv other than:
(1) For the purposes of saving human life or preventing serious injury;
(2) When taking actions to prevent severe deterministic effects
or actions to prevent the development of catastrophic conditions that could
significantly affect people and the environment;
(3) When taking actions to avert a large collective dose.
5.56. For the exceptional circumstances of para. 5.55, national guidance
values shall be established for restricting the exposures of emergency workers,
in accordance with Appendix I.
5.57. The operating organization and response organizations shall ensure that
emergency workers who undertake emergency response actions in which doses
received might exceed an effective dose of 50 mSv do so voluntarily
30
; that they
have been clearly and comprehensively informed in advance of associated health
risks as well as of available protective measures; and that they are, to the extent
possible, trained in the actions that they might be required to take. Emergency
workers not designated as such in advance shall not be the first emergency
workers chosen for taking actions that could result in their doses exceeding the
guidance values of dose for lifesaving actions, as given in Appendix I. Helpers
in an emergency shall not be allowed to take actions that could result in their
receiving doses in excess of an effective dose of 50 mSv.
5.58. Arrangements shall be made to assess as soon as practicable the individual
doses received in a response to a nuclear or radiological emergency by emergency
workers and helpers in an emergency and, as appropriate, to restrict further
exposures in the response to the emergency (see Appendix I).
5.59. Emergency workers and helpers in an emergency shall be given appropriate
medical attention for doses received in a response to a nuclear or radiological
emergency (see Appendix II) or at their request.
30 The voluntary basis for response actions by emergency workers is usually covered in
the emergency arrangements.
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5.60. Emergency workers who receive doses in a response to a nuclear
or radiological emergency shall normally not be precluded from incurring
further occupational exposure. However, qualified medical advice
31
shall
be obtained before any further occupational exposure occurs if an emergency
worker has received an effective dose exceeding 200 mSv, or at the request of the
emergency worker.
5.61. Information on the doses received in the response to a nuclear
or radiological emergency and information on any consequent health risks shall
be communicated, as soon as practicable, to emergency workers and to helpers
in an emergency.
Requirement 12: Managing the medical response in a nuclear or radiological
emergency
The government shall ensure that arrangements are in place for the
provision of appropriate medical screening and triage, medical treatment
and longer term medical actions for those people who could be affected in a
nuclear or radiological emergency.
5.62. On the presentation by an individual of clinical symptoms of radiation
exposure or other indications associated with a possible nuclear or radiological
emergency, the medical personnel or other responsible parties who identify
the clinical symptoms or other indications shall notify the appropriate local
or national officials and shall take response actions as appropriate.
5.63. Arrangements shall be made for medical personnel, both general
practitioners and emergency medical staff, to be made aware of the clinical
symptoms of radiation exposure, and of the appropriate notification procedures
and other emergency response actions to be taken if a nuclear or radiological
emergency arises or is suspected.
31 Such qualified medical advice is intended for assessing the continuing fitness of
workers for their intended tasks involving occupational exposure in line with GSR Part 3 [8].
In line with para. 5.59 of this Safety Requirements publication, any emergency worker is
to be given appropriate medical attention for doses received. To illustrate this, the generic
criterion for dose that is received (100 mSv effective dose in a month), as provided in Table II.2
of Appendix II, will indicate that an emergency worker receiving such a dose needs to be
registered and subjected to health screening and that the emergency worker will then need
appropriate longer term medical follow-up in order to detect radiation induced health effects
early and to treat them effectively.
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5.64. Arrangements shall be made so that, in a nuclear or radiological emergency,
individuals with possible contamination can promptly be given appropriate
medical attention. These arrangements shall include ensuring that transport
services are provided where needed and providing instructions32 to medical
personnel on the precautions to take.
5.65. For facilities in categories I, II and III, arrangements shall be made
to manage an adequate number of any individuals with contamination or of any
individuals who have been overexposed to radiation, including arrangements for
first aid, the estimation of doses, medical transport and initial medical treatment
in predesignated medical facilities.
5.66. For areas within emergency planning zones (see para. 5.38), arrangements
shall be made for performing medical screening and triage and for assigning to a
predesignated medical facility any individual exposed at levels exceeding the
criteria in Table II.1 of Appendix II. These arrangements shall include the use
of pre-established operational criteria in accordance with the protection strategy
(see para. 4.28(4)).
5.67. Arrangements shall be made to identify individuals with possible
contamination and individuals who have possibly been sufficiently exposed for
radiation induced health effects to result, and to provide them with appropriate
medical attention, including longer term medical follow-up. These arrangements
shall include:
(a) Guidelines for effective diagnosis and treatment;
(b) Designation of medical personnel trained in clinical management
of radiation injuries;
(c) Designation of institutions for evaluating radiation exposure (external and
internal), for providing specialized medical treatment and for longer term
medical actions.
These arrangements shall also include the use of pre-established operational
criteria in accordance with the protection strategy (see para. 4.28(4)) and
arrangements for medical consultation on treatment following any exposure
32 These instructions include advice that universal precautions in health care against
infection (e.g. surgical masks and gloves) generally provide medical personnel with adequate
protection when treating individuals with possible contamination.
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that could result in severe deterministic effects (see Appendix II) with medical
personnel experienced in dealing with such injuries.
33
5.68. Arrangements shall be made for the identification of individuals who
are in those population groups that are at risk of sustaining increases in the
incidence of cancers as a result of radiation exposure in a nuclear or radiological
emergency. Arrangements shall be made to take longer term medical actions
to detect radiation induced health effects among such population groups in time
to allow for their effective treatment. These arrangements shall include the use
of pre-established operational criteria in accordance with the protection strategy
(see para. 4.28(4)).
Requirement 13: Communicating with the public throughout a nuclear or
radiological emergency
The government shall ensure that arrangements are in place for
communication with the public throughout a nuclear or radiological
emergency.
5.69. Arrangements shall be made for providing useful, timely, true, clear and
appropriate information to the public in a nuclear or radiological emergency, with
account taken of the possibility that the usual means of communication might
be damaged in the emergency or by its initiating event (e.g. by an earthquake
or by flooding) or overburdened by demand for its use. These arrangements shall
also include arrangements for keeping the international community informed,
as appropriate. These arrangements shall take into account the need to protect
sensitive information in circumstances where a nuclear or radiological emergency
is initiated by a nuclear security event. Communication with the public in a
nuclear or radiological emergency shall be carried out on the basis of a strategy
to be developed at the preparedness stage as part of the protection strategy.
Arrangements shall be made to adjust this strategy in the emergency response
on the basis of prevailing conditions.
5.70. Arrangements shall be made to ensure that information provided to the
public by response organizations, operating organizations, the regulatory body,
international organizations and others in a nuclear or radiological emergency
33 Such arrangements for medical consultation on treatment could include international
assistance to be provided through or to be coordinated by the IAEA and by WHO; for example,
under the Assistance Convention [13].
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is coordinated and consistent, with due recognition of the evolutionary nature
of an emergency.
5.71. Arrangements shall be made so that in a nuclear or radiological emergency
information is provided to the public in plain and understandable language.
5.72. The government shall ensure that a system for putting radiological health
hazards in perspective in a nuclear or radiological emergency is developed and
implemented with the following aim:
— To support informed decision making concerning protective actions and
other response actions to be taken;
— To help in ensuring that actions taken do more good than harm;
— To address public concerns regarding potential health effects.
In the development of such a system, due consideration shall be given to pregnant
women and children as the individuals who are most vulnerable with regard
to radiation exposure.
5.73. Arrangements shall be made to explain to the public any changes in the
protective actions and other response actions recommended in the State and any
differences from those recommended in other States (see paras 6.13–6.15).
5.74. Arrangements shall be made to identify and address, to the extent practicable,
misconceptions, rumours and incorrect and misleading information that might
be circulating widely in a nuclear or radiological emergency, in particular those
that might result in actions being taken beyond those emergency response actions
that are warranted34 (see Requirement 16).
5.75. Arrangements shall be made to respond to enquiries from the public and
from news media, both national and international, including enquiries received
from or through the IAEA. These arrangements shall recognize the evolutionary
34 Actions beyond those emergency response actions that are warranted include, but are
not limited to: actions that interfere with prompt implementation of protective actions, such
as self-evacuation both from within and from outside areas from which evacuation is ordered;
actions that unnecessarily burden the health care system; actions that shun or otherwise
discriminate against people or products from an area affected by a nuclear or radiological
emergency; elective terminations of pregnancy that are not radiologically informed; and
cancellations of commercial flights that are not radiologically informed.
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