Should we evacuate elderly people in a nuclear or radiological accident?

There is an interesting talk on the ICRP’s ICRP Digital Workshop: The Future of RP by Jessica Callen-Kovtunova entitled Making ICRP Recommendations ‘Fit for Purpose’ for the Response to a Nuclear or Radiological Emergency.

In this she reports a meta-analysis of 600+ papers which reviewed the impact of protective actions and claims that for every 1000 people evacuated we may expect 7 deaths among the general public due to dislocations caused by the protective action and between 15 and 117 among residents of facilities for long stays and the elderly as well as between 120 – 220 mental health problems.

They compare this to 5 deaths prevented by evacuating 1000 people with an averted dose of 100 mSv each (this appears to be based on the ICRP-103 approximation of the overall fatal risk coefficient of 5% per sievert).

They conclude that: “Taking protective actions consistent with dose criteria used in many countries could result in far more excess deaths than hypothetical excess radiation-induced deaths prevented.  We must include these effects to protect people effectively.”

If we agree with these findings, and before doing that I’d like a closer look at the applicability of the evidence, we must ensure that the current ERL for evacuation is reconsidered and its application to homes for the elderly, in particular, given very careful thought.

If we start to think about different protective action thresholds for different age groups maybe we could also consider stopping planning to give those over 40 -50 years old stable iodine.