Firefighters' and Emergency Medical Service Personnel's Knowledge and Training on Radiation Exposures and Safety: Results from a Survey.

Little is known about first responders' knowledge of radiation exposure and the training they receive regarding radiological events. Firefighters and emergency medical services (EMS) personnel were surveyed in July 2018 to February 2019 regarding their knowledge of radiation exposure and the radiological event training they had received. Knowledge was assessed using 15 true-false questions. Five types of radiological event training were assessed. A Mann-Whitney test assessed differences in training received by occupation. A linear regression identified predictors of knowledge scores. A total of 433 individuals completed the survey (response rate = 82.9%). Knowledge scores ranged from 5 to 13, with an average of 8.6. Predictors of knowledge included having received more training on radiological transportation incidents or improvised nuclear devices, and being a firefighter. About a quarter (23.6%,  = 102) had not received any of the 5 types of radiological event training. Firefighters received more training than EMS personnel except on nuclear reactor incidents. Only 14% had participated in a radiological event exercise. First responders' knowledge of radiation exposure and prevention measures is low, and many have received either no or very little training on radiological events. The lack of radiation exposure knowledge and radiological event training received, as identified in this study, could result in increased mortality rates. First responder agencies should provide additional radiological event training and exercise opportunities.