Psychosocial consequences of a radiological emergency

Every disaster is accompanied by psychosocial stress for the (affected) population and emergency service personnel. This applies in particular to radiological emergencies, as radiation and the uncertainty regarding how to handle it represent particular causes of anxiety.

Psychosocial consequences of a radiological emergency

Studies of the nuclear power plant accidents at Three Mile Island (USA, 1979), Chornobyl (Ukraine, 1986) and Fukushima (Japan, 2011) have shown that the greatest impact of the reactor accidents on the health of affected persons related not to the physical harm caused by the released radioactive material, but rather to the psychosocial consequences of the incidents.

In the case of the studied reactor accidents, the observed consequences on mental health included:

• serious depression
• anxiety disorders
• post-traumatic stress disorder
• stress-related symptoms and various physical complaints, such as nausea, stomach trouble, headaches, sleep disorders and loss of appetite.

Excessive alcohol consumption and increased rates of suicide were also observed.

Although the prevalence of such effects depended on how directly the individuals were affected, for example due to proximity to the site of the radiological accident or due to the protective measures adopted, they can in principle occur in all people.

The fact that the studies were carried out based on nuclear power plant accidents does not mean that psychosocial consequences can only occur in the event of nuclear power plant accidents with a supra-regional impact. Indeed, the fear of radioactive material and the lack of knowledge regarding not only the dispersion and effects of radioactivity but also the means of protection can also lead to feelings of uncertainty and contribute to psychological stress in the case of radiological accidents whose impact is limited to the local or regional level. Even incidents without relevant release of radioactive material lead to feelings of uncertainty and contribute to mental health load.

Causes of psychosocial stress

Following the nuclear power plant accident at Fukushima in 2011, the Fukushima Health Management Survey took a more in-depth look at the existing insights into psychosocial stress factors of radiological emergencies. This led to valuable findings concerning the management of radiological emergencies and identified the following principal stress factors for those affected:

• radiation as a particular cause of anxiety
• mental association of a radiological accident with previous reactor accidents
• a lack of knowledge regarding the dispersion and effects of radiation
• overestimation of radiological risk
• concern for one’s own health and/or for relatives
• lack of reliable information on the current radiological emergency
• protective measures such as evacuation and resettlement, along with the resulting consequences due to altered living conditions and structures
• criticism of the authorities involved and the bodies responsible, with a corresponding loss of trust
• discrimination and stigmatisation – for example, if people are stigmatised as “victims” or “evacuees” in connection with the emergency or discriminated against as “people who have been exposed to radiation”, causing anxiety in others, after potentially being exposed to increased levels of radiation.

Germany: emergency plans take account of psychosocial aspects

The more information is provided about the fears and concerns associated with radiological emergencies and the more this information is taken into account in decisions regarding protective measures, the better the adverse psychosocial consequences can be mitigated.

When it comes to emergency preparedness, Germany developed a general emergency response plan of the Federation that, in conjunction with the emergency response plans of the federal states, is intended to enable all organisations involved in the emergency response to immediately make coordinated decisions and take appropriate measures to protect the population in the event of potential radiological emergencies. In addition to the radiological criteria, this plan takes into account of psychosocial aspects as non-radiological criteria in decisions regarding protective measures.

A "Special emergency response plan for contaminated areas" is to put these criteria in concrete terms, thereby also helping to put protection against the psychosocial consequences of an emergency into practice.

It is important for all emergency-preparedness and civil-protection actors at the federal and state level to provide information on psychosocial consequences and to help mitigate them. In the federal states, these actors also include the general civil-protection institutions responsible for disaster management at the federal-state level.

Avoiding psychosocial consequences or coping with them better

Those working in emergency preparedness can help the (affected) population and emergency service personnel to avoid psychosocial effects and/or to cope with them better by:

• providing information on radiological emergencies and their potential consequences on an ongoing basis
• providing information on psychosocial aspects and coping strategies in the event of an emergency, especially in areas where a major impact is possible
• raising awareness in general medical practice
• working in collaboration with psychosocial institutions
• identifying and responding to potential stigmatisation.

Members of the general public can also take action themselves and avoid psychosocial stress due to radiological emergencies and/or cope with it better by:

• consulting reputable sources in order to inform themselves about radiological matters: In addition to the Federal Office for Radiation Protection, the relevant public bodies include the Federal Environment Ministry and the relevant state authorities.
• examining current radiological measurement data: The Federal Office for Radiation Protection uses a national measurement network to continuously monitor external radiation exposure. The measured values can be found online at https://odlinfo.bfs.de.

Scientific projects on the subject

In 2020, with the report entitled "A framework for mental health and psychosocial support in radiological and nuclear emergencies", the World Health Organization (WHO) made proposals as to how psychosocial stress can best be addressed in advance of a potential radiological emergency, during an acute emergency and in the post-emergency phase.

An Expert Group of the OECD Nuclear Energy Agency (NEA) is currently putting these proposals in concrete terms and providing guidance on their implementation: "Mental health and psychosocial impacts of radiological and nuclear emergencies: NEA’s Work to build a practical extension based on a new World Health Organization framework".

Specifically, for example:

• effective communication, crisis communication,
• allocation of tasks and roles of the actors in an emergency,
• cooperation between mental health and emergency response agencies,
• education and training in Mental Health and Psychosocial Support (MHPSS),
• communication with the affected population and
• consideration of core ethical values.