How do we combine science and regulations for decision making following a terrorist incident involving radioactive materials?

Approaches to safety regulations-particularly radiation safety regulations-must be founded on the very best science possible. However, radiation safety regulations always lag behind the science for a number of reasons. First, the normal scientific process of peer-review, debate, and confirmation must ensure that the conclusions are indeed correct, the implications of the research are fully understood, and a consensus has been established. Second, in the U.S., there is a well-established, all-inclusive political process that leads to changes in radiation safety regulations. This process can take a very long time, as was demonstrated when the process was initiated to change the Code of Federal Regulations more than 20 y ago in response to International Commission on Radiation Protection Publication 26 and other recommendations. Currently, we find ourselves in a situation where the possibility of a terrorist radiological attack may occur and where the existing body of regulations provides very little guidance. Many international and national bodies, including several federal agencies, have provided recommendations on the appropriate levels of exposure for first-responders and first-receivers, as well as for the general public. However, some agencies provide guidelines based on very conservative dose limits which are not appropriate in situations where there is a substantial chance for the loss of lives and critical infrastructure. It is important that an emergency response is not hampered by overly cautious guidelines or regulations. In a number of exercises the impact of disparate guidelines and training in radiological situations has highlighted the need for clear reasonable limits that maximize the benefit from an emergency response and for any cleanup after the incident. This presentation will focus first on the federal infrastructure established to respond to radiological accidents and incidents. It will review briefly the major recommendations, both international and national, for responders and will attempt, where possible, to establish the scientific foundation for these guidelines. We will also stress the need to clearly and openly communicate the recommendations to the first-responders and the public so that no unnecessary anxiety or associated actions on their part impedes the ability to respond to a disaster. Finally, the use of these guidelines and recommendations by decision-makers at all levels will be discussed.