Optimization of health protection of the public following a major nuclear accident: interaction between radiation protection and social and psychological factors.

National and international guidance on the optimization of countermeasures to reduce doses in the post-release phase of an accident rightly emphasizes the importance and relevance of psychological, social, and economic factors to this process (e.g., NRPB 1990; ICRP 1991: CEC 1993; IAEA 1994). However, whilst economic factors are, at least partially, taken into account in developing the advice, explicit guidance is not provided on how psychological and social factors should be included in the optimization. Instead it is suggested that this is a matter for those with the appropriate competence and those with responsibility for making the final decisions. This approach implicitly assumes that the optimization of psychological and social factors, and that the results of the two procedures can then be combined to arrive at an optimum course of action. We recognize that formal optimization only forms one input to the process of making decisions on countermeasures and that it is important that psychological and social factors, as well as any other factors, are not {open_quotes}double-counted.{close_quotes} i.e., accounted for within international advice and then again at the time of the decision. It is our view that the optimization of radiation protection and economic factors, and certain psychological and socialmore » factors, should not be carried out independently. Research conducted by our respective organization indicates a number of areas in which the optimization of radiation protection and economic factors requires an understanding of key psychological and social processes. These areas fall into three groups; the need to ensure that countermeasures are successfully implemented, the need to achieve a net benefit for overall health, and the need to ensure a smooth transition back to normal living. 10 refs.« less