1. Public Health Response to the Fukushima Dai’ichi Nuclear Crisis Baltimore-Washington Chapter, HPS Annual Meeting May 11, 2012 CAPT Michael A. Noska, M.S. US Public Health Service Senior Advisor for Health Physics US Food and Drug Administration CAPT Michael A. Noska, M.S. US Public Health Service Senior Advisor for Health Physics US Food and Drug Administration

2. Scope of Presentation Domestic interagency response Joint Forces (Force protection) International (including gov’t → gov’t and support of US citizens in Japan) Food Safety Assessments

3. CONUS Response All key rad agencies activated EOCs (2-3 shifts per day) Federal Radiological Preparedness Coordinating Committee (FRPCC) National Security Staff Interagency Task Groups DOE: NARAC/IMAAC Advisory Team

4. The Advisory Team for the Environment, Food and Health The mission of the A-Team is to provide coordinated advice and recommendations to the State, Coordinating Agency, and DHS concerning environmental, food, and health matters. Membership is comprised principally of : and other Federal agencies as needed

5. Advisory Team Duties Overview Advisory Team provides recommendations in matters related to Advisory Team provides recommendations in matters related to Environmental assessments (field monitoring) required for developing recommendations; Protective Action Guides and their application to the emergency; Protective Action Recommendations using data and assessments from FRMAC;

6. Advisory Team Duties Overview (cont.) Recommendations to prevent or minimize exposure through the ingestion pathway from contaminated milk, food, and water; Recommendations regarding the disposition of contaminated livestock, poultry, and foods; Recommendations for minimizing losses of agricultural resources;

7. Advisory Team Duties Overview (cont.) Guidance on availability of clean food, animal feed, and water supply inspection programs to assure wholesomeness; Recommendations on relocation, reentry, and other radiation protection measures prior to recovery; Recommendations for recovery, return, and cleanup issues;

8. Advisory Team Duties Overview (cont.) Estimated effects of radioactive releases on human health and the environment; Recommendations on the use of medical countermeasures (e.g., thyroid blocking agents, chelators, etc.); Health and safety advice or information for the public and for emergency workers; and Other matters as requested by Incident Command, the coordinating agency, or State and local agencies.

9. Domestic Issues Addressed Modeling of potential plumes and water currents Contamination of imported products –Import Bulletins and Alerts –Monitoring guidance Potential contamination of domestic products –Food, milk, water –Seafood Medical Countermeasures

10. Operation Tomodachi USA Public Health Command USA Vet Command PACOMUSFJ DTRA, AFRRI, AFRAT DOE/FRMAC

11. The “Health Team” HHS response based on request from US Ambassador to Japan Mission: Provide health advice and support to Embassy staff and families, American citizens living in Japan, US military and families and the Government of Japan. “Health Team” deployed 3/15/11 as part of DART: –Rad SME/Medical planner from HHS/ASPR –SNS expert from CDC –Risk communicator from CDC –DoD Liaison (PACOM) Second deployment 3/29/11: –Health Physicist (food and water) from FDA –Health Physicist (risk assessor) from NCI Third deployment 5/9/11

12. Major Activities Collaboration with interagency representatives at Embassy (NRC, DOE, USDA, DoD) Consultation with Embassy staff, including health, security and safety Daily briefings at Embassy Data interpretation (food, water, air) PARs/Travel Advisories Meetings with GoJ representatives Outreach

13. We’re Not Alone

14. Major Activities Collaboration with interagency representatives at Embassy (NRC, DOE, USDA) Consultation with Embassy staff, including health, security and safety Daily briefings at Embassy Data interpretation (food, water, air) PARs/Travel Advisories Meetings with GoJ representatives Outreach

15. Outreach Four Sessions: –US Embassy –American Chamber of Commerce in Tokyo –American Citizens (at ACCJ twice) Topics: –Radiation basics –Food and water protection –Radiation risk http://japan2.usembassy.gov/e/acs/tacs- health.html http://japan2.usembassy.gov/e/acs/tacs- health.html

16. Food Safety Assessment FDA PAGs/DILs Codex Japanese approach Other assessments

17. FDA Guidelines (1998) DIL (Bq/kg) = PAG (mSv) f*Intake (kg)*DC (mSv/Bq) PAG: 5 mSv CEDE or 50 mSv CDE f: fraction of food supply contaminated, 30 or 100% Intake: Annual consumption based on total diet DC: Dose conversion factors from ICRP 56, NRPB

18. Derived Intervention Levels (Bq/kg) Radionuclide Group DIL Sr-90 160 (15 years) I-131 170 (1 year) Cs group 1200 (adult) Ru-103 6800 (3 months) Ru-106 450 (3 months) Pu+Am group 2 (3 months)

19. Codex Alimentarius (2010) E = GL(A) * M(A) * e ing (A) * IPF E: mean internal dose of public (mSv) GL(A): guideline level (Bq/kg) M(A): age-dependent food consumption (kg) e ing (A): age-dependent ingestion coefficient (mSv/Bq) IPF: import/production factor (unitless) (Comparable to f in DIL equation) Based on 1 mSv PAG (annual) (Codex Standard 193-1995)

20. Guideline Levels (Bq/kg) ProductNuclidesGL Infant food Pu-238, Pu-239, Pu-240, Am-2411 Infant food Sr-90, Ru-106, I-129, I-131, U-235100 Infant food S-35, Co-60, Sr-89, Ru-103, Cs-134, Cs-137, Ce-144, Ir-192 Cs-134, Cs-137, Ce-144, Ir-1921000 Infant food H-3, C-14, Tc-99 1000 Other than infant Pu-238, Pu-239, Pu-240, Am-24110 Other than infant Sr-90, Ru-106, I-129, I-131, U-235100 Other than infant S-35, Co-60, Sr-89, Ru-103, Cs-134, Cs-137, Ce-144, Ir-192 1000 Other than infant H-3, C-14, Tc-99 10000

21. Japanese Index Levels Based on 5/50 mSv PAG Assume food contaminated at 50 or 100% Different food classes Dose distributed over all food classes for Cesium 30% of PAG for I-131 distributed to thyroid

22. Index Levels (Bq/kg) Nuclide Food Group Index level Iodine Water, Milk, Dairy Vegetables, fish 300/1002000 Cesium Water, Milk, Dairy Vegetable, grain, meat, eggs, fish 200500 Uranium Infant food, Water, Milk, Dairy Vegetable, grain, meat, eggs, fish 20100 Alpha Infant food, Water, Milk, Dairy Vegetable, grain, meat, eggs, fish 110

23. Summary NuclideUS/FDACodexJapan I-131170100100/300/2000 Cesium12001000200/500 Sr-90160100- Alpha21/101/10

24. Revised Japanese Standards CategoryCommodity Maximum Limit (Bq/kg) Drinks Mineral waters (soft drinks produced from water only) 10 (200) Tea and tea Leaves for drinking Milk Milk and milk products 50 (200) Infant Foods Food and drinks sold as intended for infants 50 (200/500) General Foods Food other than items given above 100 (500)

25. Assessment for Rice Planting Operational Guidelines Taskgroup RESRAD-RDD Japanese data on root transfer factors National data on Japanese consumption ICRP 72 DCFs Cs-137: 5.4 E5 Bq/m 2 Sr-90: 2.5 E5 Bq/m 2 Japanese levels = 1000-5000 Bq/kg soil

27. Acknowledgements Health Team –Norm Coleman, MD, PhD (NCI/HHS-ASPR) –Steve Simon, PhD (NCI) –CAPT Tom Bowman, MS, USPHS (CDC) –Ms. Jana Telfer, MS (CDC) –CAPT Michele Hancock, MD, USN (PACOM) –CAPT Joe Hughart, USPHS (USAID/DART) NRC, DOE, DoD, USDA, Embassy Staff Government of Japan