Chernobyl Nuclear Power Disaster - Health Management - Case Study Example

Health Management Case Study Chernobyl Disaster Name Course Institution Instructor’s name Date The Chernobyl Disaster The Chernobyl Nuclear Power Disaster or the Chernobyl disaster as it is simply referred is one of the fatal nuclear power plant incidents in the world history. The disaster happened on the 26th of April, 1986 at the Chernobyl Nuclear Power Plant in Ukraine. The accident is one of the two nuclear accidents in the world classified as level 7 incidents on the International Nuclear Event Scale, the other incident being the Fukushima Daiichi nuclear catastrophe according to World Nuclear Association (2011). The accident entailed a massive explosion and a fire which scattered large quantities of radioactive materials into the atmosphere, which spread through the larger part of Europe and the western USSR. The accident happened when serious power increase was experienced at Reactor-4 which caused the inner core to explode at exactly 1.23 am (World Nuclear Association, 2011). The explosion led to the release of considerable amount of radioactive fuel and contents of the core into the atmosphere, which ignited the highly inflammable graphite moderator. The burning graphite elevated the emission of radioactive particles transported by the smoke as the reactor was not contained in a hard control vessel (World Nuclear Association, 2011). The resulting fire caused a cloud of extremely radioactive smoke into the air, over a vast geographical region including Pripyat. This incident occurred during an experimentation that was meant to investigate an impending safety emergency core-cooling feature that occurred during routine shutdown practice. Nuclear power vessels need cooling even after shutting down. The management of Chernobyl wanted to perform an essential experiment concerning the safety of reactor number 4. At the time of the experiment, the power gridlock from generators was poorly designed as they were required to pump cooling water into the reactor at a 15 seconds interval. Nevertheless, this objective was not met as they were taking longer (60-75 seconds) to supply enough power of 5.5 MW to run a single main cooling pump to full potential. The delay time was perceived unsafe as it would cause the reactor to heat up leading to a disaster. The reactor had been operating with this limitation for two years which was a breach of safety measures. Prior efforts to test this fault were futile. The station managers desperately needed to correct this fault, which is the possible reason why they did not seek procedural consent to perform the test from the Soviet Nuclear Regulator even though there was a representative at reactor 4 complex at the time of the experiment (World Nuclear Association, 2011). Besides, there is a possibility that, the night staff that executed the experiment after the day’s attempt backfiring due to power disruption were not prepared for the experiment. They were not informed of the procedure for carrying out the experiment as day time staff were the one that were familiar with the procedure. Thus, when a problem occurred, the staff at some point continuously inserted metal rods with the aim of restoring the system. This caused the situation to worsen, hence the explosion. Efforts to contain the catastrophe involved more than half a million people and cost approximately 18 million rubles which brought down the Soviet economy. Two workers died immediately from the accident while many others were affected later. Since the accident happened in 1986 until 2000, about 350,400 people from the most affected areas of Belarus, Russia and Ukraine were moved and resettled (Dyatlov, 2003). Over 60 percent of the fallout was in Belarus (Dyatlov, 2003). The countries affected (Russia, Belarus and Ukraine) have been laden by the decontamination and healthcare costs that have been in progress since the disaster. The number of deaths caused by Chernobyl disaster varies significantly as stated by the International Atomic Energy Agency (IAEA). The number of deaths from the accident is 31 comprising of workers in the plant and emergency response workers. The World Health Organization (WHO), estimates that 4000 civilians have died as a result of the disaster, while the Association of Concerned Scientist believe that, the disaster has caused 50,000 cancer cases in the region which has led to over 25,000 deaths (Dyatlov, 2003). Emergency Response Services during the Disaster Fire Fighters Chernobyl Nuclear Power Plant experienced a problem that led to two explosions; the first destroyed the core of reactor 4 while the second, which was massive, shot burning pieces of graphite and reactor fuel into the atmosphere. The graphite lumps landed in indiscriminate places causing several fires. In general, the explosion had formed a crater with burning graphite and over 30 fires in within the plant’s environs. The fires were the very first emergency. Emergency Response Services Fire Fighters The fire fighters in Chernobyl area responded straightaway after getting an alarm from the plant. Three fire engines were the first to arrive at the scene. The commander of the Chernobyl fire crew, Lieutenant Pravik sent an emergency signal to Pripyat, Chernobyl town and the whole region of Kiev for backup when he learnt that the fire was too big for his crew (ORACLE.ThinkQuest). Some firefighters mounted onto the machine hall to fight the fire. When fire fighters from Pripyat got to the scene a few minutes later, they decided to combat the fire by going into the reactor chamber. The commander of Pripyat second fire station, Major Leonid Telyatnikov responded to the emergency call and was at the scene 10 minutes after the first firefighters had commenced putting off the fire (ORACLE.ThinkQuest). He assumed overall command and climbed on top of reactor number 3’s roof, which had several fires on it. To make matters worse, reactor number 3 was still running. It was clear at this point that, the most rational thing was to prevent the fire from collapsing the roof of reactor 3, which would lead to even massive damage. Fruitless in their efforts to contain the fire, the fire fighters were substituted with the Kiev fire team. About four and half hours later (6:35AM) all the fires were successfully put off by 37 fire teams comprising of 186 firefighters and 81 fire engines, apart from for the graphite fire inside the reactor hole (ORACLE.ThinkQuest). The main graphite fire inside the reactor was put off nine days after by boron, sand, clay and leads to smoother the fire from drops by a helicopter. By then, the fire had already caused damage and polluted the environment with radioactivity. Several firefighters who combated the fire from the reactor chamber passed away. Firemen who fought the fire from the roof top of Reactor number 3 suffered ailment as a result of acute radiation although most of them lived (ORACLE.ThinkQuest). It was concluded that, the Chernobyl Nuclear Power Plant was not best designed for handling fires resulting from such explosions. The roofs of the reactor chambers were built from easily flammable bitumen material. In addition, the firemen were not sufficiently prepared. Firefighters in nuclear stations in other nations like the United States wear protective clothing and respire through special kits. The firefighters at Chernobyl did not have anything of this nature (ORACLE.ThinkQuest). Besides, there has never been a fire drill at the station since its establishment. Majority of the firemen never knew what kind of a fire they were fighting, they didn’t know of the dangers they were exposing themselves to. They were surrounded by radiation at the time of the fire and no account had been taken of the possibility of radiation. In august 1986, Soviet officials at the IAEA summit were advised to offer systems for firefighters with specific requirements for nuclear safety, provide firefighters with protective gear that can shield them from radioactive contamination and high temperatures, as well as consider the use of less flammable building materials (ORACLE.ThinkQuest). The firefighting exercise was poorly coordinated. Incident command was poor with the commanders of various fire stations failing to offer proper advice to the firefighters. In essence, there was no control, coordination nor communication. Even though the different fire crews worked together, they did not follow the required procedure of an effective incident command in firefighting. In addition, firefighting was done without adequate measures. They did not consider that the fire was from a nuclear reactor. There was no appropriate protective gear which exposed the firemen to radiation hence deaths. First, the firefighters would have waited for an account of radiation amount and advice from experts to know how to combat the fires. The fire inside the reactor number 3 took so long to put off which caused damage and release of radioactive materials. The firefighting management should have contained the fire within the first instance of the fire using clay, sand and lead to smoother the fire by airdrops from helicopters instead of going on the roof of the reactor which caused deaths. Pre-hospital emergency response During the Chernobyl disaster, little was done on pre-hospital emergency response. At the time of the disaster, the medical attention was very poor. Normally, a nurse was at the plant to ensure no staff left the plant with any contamination. Workers were required to pass through a dosimetric station that accessed their radiation levels before leaving the premises (ORACLE.ThinkQuest). At the time of the incident, the nurse was not there and some of the dosimetric stations were either closed or locked. The first doctor to arrive at the scene was Dr. Belokon who at the time of the accident worked at Pripyat medical service. When he arrived at the scene, he found casualties approaching almost immediately (ORACLE.ThinkQuest). He was helping the injured employees although he stayed for long without assistance from other medical practitioners. The accident involved vigorous fire and exposure to radiation. The doctor did very little to provide for first aid as he did not have the necessary equipment and protective clothing to deal with the risk of radiation that casualties and themselves were exposed to. There was no communication at the site between the various emergency response agencies which made it difficult for the pre-hospital response to execute their duty. In addition, the doctor was not able to identify radiation affected patients (Linnemann, 1987). They required assistance that was not available by the time. He also exposed himself to risk by dealing with casualties from the accident. In fact, the doctor suffered serious lung injuries from the radiation. In general, there was poor arrangement in command, control, coordination and communication. The healthcare personnel should have waited for command from radiation experts in order to know whether it was safe to get to the scene and assist the casualties (Emergency Management Australia, 1999). They should have coordinated and communicated effectively with other stakeholders including firefighters in order to establish the location of causalities and the accessibility of such the casualties. Having been cleared by the authorities, the pre-hospital emergency response at Chernobyl disaster should have employed Triage model in dealing with the casualties (Miller, 2009). In the Triage model in pre-hospital response, first aid is significant, followed by significant delay until expert medical help is available normally only after temporal infrastructure has been set up. Besides, there should have been a nurse to help identify casualties’ radiation level. Evacuation and Radiation Protection In the event of the disaster, it was established that, there were radiations released into the environment. This led to access being limited to the area in an 18 mile radius around the plant. Consequently, swift evacuation of the affected populations was done. Affected cleanup workers who cleaned the area were observed and the level of radiation contamination determined. In accordance with the Ministry of Health and Soviet National Commission on Radiation Protection, considering recent radiation situation; there was likelihood of powerful steam explosion due to overheating of the reactor core. An urgent evacuation in Belarus involving some 24,600 people was performed (Buglova and Kenigsberg, 1996). The total evacuation in Belarus, Ukraine and Russia was 115,000 in the year 1986 and 220,000 in the later years UNSCEAR 2008). Analysis of doses of radiation on the population was also carried out. Performance of thyroid blocking to prevent excess radiation from getting into thyroid glands was delayed. This has led to various cases of thyroid cancer in the affected countries. Fortunately, thyroid cancer is treatable. Nevertheless, stable iodine was administered to 43,000 children in Belarus in an effort to decontaminate them from radiation according to USSR Ministry of Health (Buglova and Kenigsberg, 1996). Administration of stable iodine to the greater population took place 3-6 days after the catastrophe. Experts argue that, only 20 percent of the millions of the distributed tablets have been utilized for thyroid protection (Buglova and Kenigsberg, 1996). Forming of doses to thyroid was thus ineffective to the population and especially children. Non-effective blocking of thyroid was caused by late beginning, lack of clear plan for distribution as well as insufficient stocks. In addition, prevention measures entailed banning of local food use by the population to avoid contamination. This included milk which is a major source of radionuclides (Buglova and Kenigsberg, 1996). The early clinical effects in the initial months after the incident were associated with radiation (ionizing radiation of all types) as well as non-radiation (changes in living conditions, high concentration of chemical substances, and insufficient psychological perception of the radiological hazards) factors. As a result, medical support was necessary across the region to help the population deal with the hazard. At the time of the Chernobyl incident, the health services were not prepared to deal with or contain the medical consequences of a large-scale nuclear accident. The stable iodine prophylaxis was not overseen immediately or on a sufficient degree and protective processes such as sheltering and the replacement of contaminated milk with “clean” milk were hardly used (Ivanov et al.,2004). In addition, countermeasures to minimize psychological trauma in the populace were ineffectual. In the first phase of the incident and for the first five years afterwards, there was a scarcity of medical personnel such as nurses, doctors, and laboratory workers) in the area hospitals. In general, only the major hospitals were able to offer high-quality, sensible and proper treatment (Lessons learned from Chernobyl). Radiation protection and evacuation process were supposed to be done immediately after the accident. The relevant authorities in the Soviet should have accessed the extent of radiation within the shortest time possible, probably 24hrs with the help of other agencies such as IAEA. Consequently, evacuation of populations should have been done swiftly to avoid contamination. Thyroid blocking plan should have been executed in a more organized manner. The entire population should have received this dose in the first few hours of the disaster, which could have prevented radiation induced thyroid cancer in the area that stands at 6000 in a lifetime by almost half (Buglova and Kenigsberg, 1996). On the other hand, medical support to the population could have been boosted through liaison with the international community such as the United Nations (UN), World Health Organization (WHO), the United States, and other well-wishers. The medical problem that was caused by Chernobyl disaster was so rampant and needed a global approach. Conclusion Much funds and effort is spent on enhancing nuclear safety, the likelihood of a nuclear accident will certainly not be nil and, since people will definitely be affected, it is good for various governments to be prepared to reduce damages through rapid emergency response. Analysis of the response experience in regard to the Chernobyl disaster gives an inimitable opportunity for enhancing the emergency response services, which should entail well laid procedures for action, appropriate paraphernalia, skilled personnel, incident command and a system for training emergency workforces. This experience should be assimilated into transnational commendations and approaches for assessing, monitoring and reacting to nuclear accidents. Lack of independent and appropriate information to the public and state experts concerning the accident at Chernobyl nuclear power plant resulted to an inadequate action to its latent consequences on the population’s living conditions and health, and also created the preconditions for socio-psychological stress. References Buglova, E. and Kenigsberg, J. (1996). Analysis of Emergency Response after the Chernobyl Accident in Belarus: Observed and Prevented Medical Consequences, Lessons Learned, accessed September 4, 2012 from, http://www.ipen.br/biblioteca/cd/go10anosdep/Cnen/doc/manu4.PDF Dyatlov, A. (2003). Chernobyl. How did it happen? Moscow: Nauchtechlitizdat. Emergency Management Australia (1999). Disaster Medicine, Accessed September 4, 2012, from http://www.ema.gov.au/www/emaweb/RWPAttach.nsf/VAP/%283273BD3F76A7A5DEDAE36942A54D7D90%29~Manual09-DisasterMedicine.pdf/$file/Manual09-DisasterMedicine.pdf Ivanov V, Ilyin L, Gorski A, et al. (2004). Radiation and epidemiological analysis for solid cancer incidence among nuclear workers who participated in recovery operations following the accident at the Chernobyl NPP. J Radiat Res (Tokyo). 45:41-44. Lessons learned from Chernobyl, accessed September 4, 2012 from http://www.tesec-int.org/chernobyl/Lessons.htm Linnemann, R. (1987). Soviet medical response to the Chernobyl nuclear accident, JAMA. 258, (5):637-43. Miller, (2009). Miller's Anesthesia: Prehospital Mass Casualty Incident Management and Disaster Medicine. Churchill Livingstone. ORACLE. ThinkQuest, Emergency: Fighting the Fire accessed September 5, 2012 from http://library.thinkquest.org/3426/data/emergency/fighting.fire.html UNSCEAR (2000.) Report, Sources and Effects of Ionizing Radiation Annex J, Exposures and effects of the Chernobyl accident. Accessed September 4, 2012 from http://www.unscear.org/docs/reports/annexj.pdf World Nuclear Association (2011). The Chernobyl Disaster 1986, Accessed September 4, 2012 from http://www.world-nuclear.org/info/chernobyl/inf07.html Read More