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What if it happened again? What we need to do to prepare for a nuclear event

As we observe the 70th anniversary of the bombings of Hiroshima and Nagasaki, it may seem like the threat from nuclear weapons has receded. But it hasn’t; the threat is actually increasing steadily. This is difficult to face for many people, and this denial also means that we are not very well-prepared for nuclear and radiological events. The Conversation

I’ve been studying the effects of nuclear events – from detonations to accidents – for over 30 years. I’ve been involved in research, teaching and humanitarian efforts in multiple expeditions to Chernobyl- and Fukushima-contaminated areas. Now I am involved in the proposal for the formation of the Nuclear Global Health Workforce.

Such a group could bring together nuclear and non-nuclear technical and health professionals for education and training, and help to meet the preparedness, coordination, collaboration and staffing requirements necessary to respond to a large-scale nuclear crisis.

Any nuclear weapon exchange or major nuclear plant meltdown will immediately lead to a global public health emergency. The Ebola outbreak taught the world that we should have resources in place to handle a major health emergency before it happens.

What would a Nuclear Global Health Workforce need to be prepared to manage? For that we can look back at the legacy of the atomic bombings of Hiroshima and Nagasaki, as well as the nuclear accidents like Chernobyl and Fukushima.

The Hiroshima Prefecture Industrial Promotion Hall after the blast. Maarten Heerlien/Flickr, CC BY-SA

What happens when a nuclear device is detonated over a city?

Approximately 135,000 and 64,000 people died, respectively, in Hiroshima and Nagasaki. The great majority of deaths happened in the first days after the bombings, mainly from thermal burns, severe physical injuries and radiation.

Over 90% of the doctors in nurses in Hiroshima were killed and injured, and therefore unable to assist in the response. This was largely due to the concentration of medical personnel and facilities in inner urban areas. This exact concentration exists today in the majority of American cities, and is a chilling reminder of the difficulty in medically responding to nuclear events.

What if a nuclear device were detonated in an urban area today? I explored this issue in a 2007 study modeling a nuclear weapon attack on four American cities. As in Hiroshima and Nagasaki, the majority of deaths would happen soon after the detonation, and the local health care response capability would be largely eradicated.

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