State-level emergency preparedness and response capabilities.

Background: Prior assessments of public health readiness had identified gaps in radiation preparedness. In recent years, preparedness planning has involved an “all-hazards” approach. Current assessment of the nationalstatusrelatedtoradiationpublichealthemergencypreparednesscapabilitiesatthestateandlocalhealth department levels was needed. Methods: A survey of state health departments related to radiation readiness was undertaken in 2010 by the Council of State and Territorial Epidemiologists (CSTE). States with nuclear power plants were instructed to consider their responses exclusive of capabilities and resources related to the plants given that the emergency response plans for nuclear power plants are specific and unique. Results:Thirty-eight (76%) state health departments responded to the survey, including 26 of the 31 states with nuclear power plants. Specific strengths noted at the state level included that the majority of states had a written radiation response plan and most plans include a detailed section for communications issues during a radiation emergency. In addition, more than half of the states indicated that their relationship with federal partners is sufficient to provide resources for radiation emergencies, indicating the importance states placed onfederalresourcesandexpertise.Specificweaknessesarediscussedandincludethatmoststateshadcompleted little to no planning for public health surveillance to assess potential human health impacts of a radiation event; less than half had written plans to address exposure assessment, environmental sampling, human specimen collection and analysis, and human health assessment. Few reported having sufficient resources to do public health surveillance, radiation exposure assessment, laboratory functions and other capabilities. Discussion:Levelsofplanning,resourcesandpartnershipsvariedamongstates,thosewithnuclearpowerplants werebetterprepared.Gapswereevidentinallstates;howeverandadditionaltrainingandresourcesareneeded to ensure adequate levels of preparedness. Conclusion: Overall results of this assessment indicate that in most measures of public health capacity and capability, states are poorly prepared to adequately respond to a major radiation emergency event. Specific recommendations are noted in the discussion. (Disaster Med Public Health Preparedness. 2011;5:S134-S142)