September 2011 Edition

LAW ENFORCEMENT AND PUBLIC HEALTH 

INVESTIGATION HANDBOOK

U.S. Department of Justice

Federal Bureau of Investigation

U.S. Department of Health & Human Services

Centers for Disease Control and Prevention
2

To identify community and regional response agencies’ point of contact 

(use the list below as a starting point on which to build)

Resource Contact Phone Number

FBI WMD 

Coordinator

Local FBI

FBI Hotline

Local JTTF

City LE Agency

County LE Agency

State LE Agency

City PH Agency

County PH Agency

State PH Agency

CDC Emer Ops Center 770-488-7100 

FEMA Ops Center 800-634-7084

EPA Emer Ops Center 202-564-3850

EPA National 

Response Center

800-424-8802

NRC Ops Center 301-816-5100

DOE Ops Center 202-586-8100

FBI HQ SIOC, 24/7 202-323-3300

DHS National Ops 

Center

202-282-8000

DHS National Ops 

Center Senior Watch 

Officer

202-282-8101

FDA Emer Ops Center 866-300-4374
3

INTRODUCTION 5

Purpose..................................................................................................................................... 7

NATIONAL POLICY 9

Homeland Security Presidential Directive-5 ..................................................................... 10

Nuclear Forensics................................................................................................................... 11

National Incident Management System ............................................................................. 12

National Response Framework ........................................................................................... 13

Nuclear/Radiological Incident Annex ............................................................................... 14

Terrorism Incident Law Enforcement and Investigation Annex ................................... 18

PUBLIC HEALTH 21

Centers for Disease Control and Prevention Role ........................................................... 22

Public Health Goals .............................................................................................................. 25

Public Health Investigations................................................................................................ 25

LAW ENFORCEMENT 29

Federal Bureau of Investigation Role ................................................................................. 30

Law Enforcement Investigation Goals ............................................................................... 32

Law Enforcement Criminal Investigations........................................................................ 33

JOINT OPERATIONS 41

Joint Investigative Information ........................................................................................... 42

Effective Information Exchange .......................................................................................... 42

Potential Barriers................................................................................................................... 44

Sharing Sensitive Information............................................................................................. 49

Public Information Release.................................................................................................. 55

SUMMARY 59

APPENDICES 61

Appendix A. Applicable Federal WMD Statutes ............................................................. 62

Appendix B. Understanding Radiation and its Health Effects....................................... 63

Appendix C. Effects of a Nuclear Detonation .................................................................. 73

Appendix D. Transportation of Radiological/Nuclear Materials .................................. 79

Appendix E. Indicators of Radiological Incidents............................................................. 81

Appendix F. Radiological/Nuclear Forensics and Attribution ....................................... 85

Appendix G. Acronyms....................................................................................................... 87

Appendix H. Glossary ......................................................................................................... 89

Appendix I. References ..................................................................................................... 100
4
INTRODUCTION

5

INTRODUCTION
INTRODUCTION

6

Current information indicates that, regardless of location, American assets 

and citizens will continue to be targets of terrorist activities. Terrorists have 

demonstrated their willingness to employ nontraditional weapons to achieve 

their ends. One such class of nontraditional weapons is radiological/nuclear 

(RN) devices. RN devices pose new challenges to both law enforcement 

(LE) and public health (PH) officials in their efforts to minimize the effects 

of a RN attack, prevent or stop additional attacks, attribute the attack to the 

perpetrators, and apprehend those responsible for it.

In the past, it was not uncommon for LE and PH officials to conduct 

separate and independent investigations. However, a RN attack requires 

a high level of cooperation between these two disciplines to achieve their 

respective objectives of minimizing public panic and radiation exposure, 

preventing the spread of radioactive contamination, identifying the perpetrators, and apprehending/prosecuting those responsible for the attack. 

The lack of mutual awareness and understanding, as well as the absence of 

established communication procedures, could hinder the effectiveness of 

separate, but often overlapping, LE and PH investigations. The effective use 

of all resources will be critical to an efficient and appropriate response to 

any terrorist RN attack.

“The greatest threat before humanity today is the possibility of a secret 

and sudden attack with chemical or biological or radiological or nuclear 

weapons.” Former President George W. Bush

February 11, 2004

“...the greatest threat to United States and global security is no longer 

a nuclear exchange between nations, but nuclear terrorism by violent 

extremists...”

President Barack H. Obama

April 6, 2010
INTRODUCTION

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PURPOSE

This handbook serves several purposes:

• Provide an introduction to RN LE and PH investigations so personnel 

have a better understanding of each other’s information requirements 

and investigative procedures.

• Identify potential barriers LE and PH personnel will encounter during 

their respective RN incident investigations and provide potential 

solutions that can be adapted to meet the needs of the various 

jurisdictions and agencies throughout the United States (US).

• Enhance the appreciation and understanding by all parties of each 

discipline’s expertise.

► Common LE and PH Goals

• Protect public health and safety.

• Prevent or stop the spread of contamination and avoid unnecessary 

radiation exposure.

• Identify those responsible for a threat or an attack.

• Protect their respective employees during their responses and 

investigations.

• Prevent or stop another attack.

This handbook has been developed to maximize resources and facilitate 

communication and interaction among LE and PH officials. Additionally, 

it seeks to foster a greater understanding among LE and PH personnel to 

minimize potential barriers to communication and information sharing 

during an actual RN incident. LE and PH officials are encouraged to read 

the entire handbook and not limit their review to just their respective sections. This shared understanding is critical because LE and PH communities 

have two common concerns: early identification of the criminal act or PH 

emergency and time sensitivity associated with obtaining information.
INTRODUCTION

8

Even with common concerns, each group may be hesitant to provide specific 

types of information to the other because of actual or perceived information 

sharing limitations. Identifying and resolving the potential barriers to a free 

flow of information in advance will facilitate the timely exchange of critical 

information when dealing with an actual RN incident.
NATIONAL POLICY

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NATIONAL POLICY
NATIONAL POLICY

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HOMELAND SECURITY PRESIDENTIAL DIRECTIVE-5

On February 28, 2003, President George W. Bush issued Homeland 

Security Presidential Directive-5 (HSPD-5), Management of Domestic 

Incidents, which directs the Secretary of Homeland Security (Secretary) to 

develop and administer the National Incident Management System (NIMS). 

In consultation with other departments/agencies, the National Response 

Framework (NRF), which integrates the Federal government domestic 

prevention, preparedness, response, and recovery plans into a single, alldiscipline, all-hazard plan was developed. The objective is to ensure that all 

levels of government across the nation have the capability to work effectively 

together by using a national approach to domestic incident management. 

In these efforts, with regard to domestic incidents, crisis and consequence 

management are treated as a single, integrated function, rather than two 

separate functions.

According to HSPD-5, the Secretary is the Principal Federal Official for 

domestic incident management. Pursuant to the Homeland Security Act 

of 2002, the Secretary is responsible for coordinating Federal operations 

within the US to prepare for, respond to, and recover from terrorist attacks, 

major disasters, and other emergencies. The Secretary shall coordinate the 

Federal government’s resources used in response to or recovery from terrorist attacks, major disasters, or other emergencies if and when any one of 

the following four conditions applies: (1) a Federal department or agency 

acting under its own authority has requested the assistance of the Secretary, 

(2) the resources of state and local authorities are overwhelmed and Federal 

assistance has been requested by the appropriate state and local authorities, 

(3) more than one Federal department or agency has become substantially 

involved in responding to the incident, or (4) the Secretary has been directed 

to assume responsibility for managing the domestic incident by the President.

Per HSPD-5, the Attorney General (AG) has lead responsibility for criminal 

investigations of terrorist acts or terrorist threats by individuals or groups 

inside the US or directed at US citizens or institutions abroad, where such 

acts are within the Federal criminal jurisdiction of the US, as well as for re-
NATIONAL POLICY

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lated intelligence collection activities within the US, subject to the National 

Security Act of 1947 and other applicable law, Executive Order 12333, and 

AG approved procedures pursuant to that Executive Order. Generally acting 

through the Federal Bureau of Investigation (FBI), the AG, in cooperation 

with other Federal departments and agencies engaged in activities to protect 

our national security, shall also coordinate the activities of other members of 

the LE community to detect, prevent, preempt, and disrupt terrorist attacks 

against the US. 

Following a terrorist threat or incident that falls within the criminal jurisdiction of the US, the full capabilities of the US shall be dedicated to assisting 

the AG to identify the perpetrators and bring them to justice. The AG and 

the Secretary shall establish appropriate relationships and mechanisms for 

cooperation and coordination between their two departments.

NUCLEAR FORENSICS

On July 3, 2007, the President approved Annex IV to National Security 

Presidential Directive (NSPD)-17/HSPD-4. This annex further defined roles 

and responsibilities relative to RN forensics, which are referred to as “technical nuclear forensics” (TNF). The complete text of the annex is classified, 

but the basic roles and responsibilities assigned to the AG, normally through 

the FBI, can be summarized as follows: (1) conducting and directing TNF 

operations, (2) maintaining TNF capabilities across the government, (3) 

coordinating TNF developments, and (4) reporting results from any TNF 

investigations.

To provide further coordination for the US Government’s (USG) efforts to 

identify the nature, source and perpetrator(s) of an attempted or actual RN 

attack, the US Congress passed the Nuclear Forensics and Attribution Act 

(Public Law 111-140) on February 16, 2010. This public law established the 

National Technical Nuclear Forensics Center (NTNFC) with the Department of Homeland Security’s (DHS) Domestic Nuclear Detection Office 

(DNDO) as a mechanism to provide centralized stewardship, planning, 

assessment, gap analysis, exercises, improvement, and integration for all 

federal nuclear forensics and attribution activities.
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NATIONAL INCIDENT MANAGEMENT SYSTEM

The NIMS provides a consistent nationwide template to enable Federal, state, 

local, and tribal governments and private sector and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, 

respond to, and recover from domestic incidents, regardless of cause, size, 

or complexity, including acts of catastrophic terrorism. The NIMS provides 

mechanisms for further development of supporting national standards, 

guidelines, protocols, systems, and technologies.

Building on the foundation provided by existing incident management and 

emergency response systems used by jurisdictions and functional disciplines 

at all levels, this system integrates best practices that have proven effective 

over the years into a comprehensive framework for use by incident management organizations in all-hazard context (terrorist attacks, natural disasters, 

and other emergencies) nationwide. It also sets in motion the mechanisms 

necessary to leverage new technologies and adopt new approaches that will 

enable continuous refinement of the NIMS over time. The NIMS was developed through a collaborative, intergovernmental partnership with significant 

input from the incident management functional disciplines, the private 

sector, and nongovernmental organizations. HSPD-5 requires all Federal 

departments and agencies to adopt the NIMS and use it in their individual 

domestic incident management and emergency prevention, preparedness, 

response, recovery, and mitigation programs and activities, as well as support of all actions taken to assist state, local, and tribal entities. The directive 

also requires Federal departments and agencies to make adoption of the 

NIMS by state and local organizations a condition for Federal preparedness 

assistance (through grants, contracts, and other activities) beginning in 

fiscal year 2005.

The NIMS represents a core set of doctrine, concepts, principles, terminology, and organizational processes to enable effective, efficient, and 

collaborative incident management at all levels. It is not an operational 

incident management or resource allocation plan. To this end, HSPD-5 

requires the development of the NRF, which integrates Federal government 

domestic prevention, preparedness, response, and recovery plans into a 
NATIONAL POLICY

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single, all-discipline, all-hazard plan. Using the comprehensive framework 

provided by the NIMS, the NRF provides the structure and mechanisms 

for national-level policy and operational direction for Federal support to 

state, local, and tribal incident managers and for exercising direct Federal 

authorities and responsibilities as appropriate under the law.

NATIONAL RESPONSE FRAMEWORK

The NRF (or Framework) is a guide to how the US conducts all-hazards 

response. It is built on scalable, flexible, and adaptable coordinating structures to align key roles and responsibilities across the nation. It describes 

specific authorities and best practices for managing incidents that range 

from the serious, but purely local, to large-scale terrorist attacks or catastrophic natural disasters.

This document explains the common disciplines and structures that have 

been exercised and matured at the local, tribal, state, and national levels 

over time. It describes key lessons learned from Hurricanes Katrina and 

Rita, focusing particularly on how the Federal government is organized to 

support communities and states in catastrophic incidents. Most importantly, 

it builds on the NIMS, which provides a consistent template for managing 

incidents. The term “response” as used in the Framework includes immediate actions to save lives, protect property and the environment, and meet 

basic human needs. Response also includes the execution of emergency 

plans and actions to support short-term recovery. The Framework is always 

in effect, and elements can be implemented as needed on a flexible, scalable 

basis to improve response.

The Framework is written especially for government executives, privatesector and nongovernmental organization leaders, and emergency management practitioners. It is addressed to senior elected and appointed leaders, such as Federal department or agency heads, state governors, mayors, 

tribal leaders, and city or county officials—those who have responsibility to 

provide for effective response. For the nation to be prepared for any and all 

hazards, its leaders must have a baseline familiarity with the concepts and 

mechanics of the Framework.
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The Framework also informs emergency management practitioners by 

explaining the operating structures and tools used routinely by first responders and emergency managers at all levels of government. For these readers, 

the Framework is augmented with online access to supporting documents, 

further training, and an evolving resource for exchanging lessons learned.

The NRF Resource Center (http://www.fema.gov/nrf) is an important online 

reference center that provides stakeholders at all levels of government, the 

private sector, and nongovernmental organizations access to the NRF and 

supporting documents. In particular, the NRF incident annexes address 

contingency or hazard situations requiring specialized application of the 

NRF. The incident annexes describe the missions, policies, responsibilities, 

and coordination processes that govern the interaction of public and private 

entities engaged in incident management and emergency response operations across a spectrum of potential hazards. The annexes are typically augmented by a variety of supporting plans and operational supplements. Two 

annexes are applicable to address our current national policy as it relates to 

this handbook. The Nuclear/Radiological Incident Annex and the Terrorism 

Incident Law Enforcement and Investigation Annex are available at http://

www.fema.gov/emergency/nrf/index.htm.

NUCLEAR/RADIOLOGICAL INCIDENT ANNEX

► Purpose

The Nuclear/Radiological Incident Annex (NRIA) of the NRF describes 

the policies, situations, concepts of operations, and responsibilities of the 

Federal departments and agencies governing the immediate response and 

short-term recovery activities to address the consequences of incidents 

involving release of radioactive materials. These incidents may occur on 

Federally owned or licensed facilities, privately owned property, in urban 

centers, or other areas and may vary in severity from small to catastrophic. 

The incidents may result from inadvertent or deliberate acts. The NRIA 

applies to incidents where the nature and scope of the incident requires a 

Federal response to supplement the state, tribal, or local incident response.
NATIONAL POLICY

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The NRIA has several purposes:

• Define the roles and responsibilities of Federal agencies in responding 

to the unique characteristics of different categories of RN incidents

• Discuss the specific authorities, capabilities, and assets the Federal 

government has for responding to RN incidents that are not otherwise 

described in the NRF

• Discuss the integration of the concept of operations with other 

elements of the NRF, including the unique organization, notification, 

and activation processes and specialized incident-related actions

• Provide guidelines for notification, coordination, and leadership 

of Federal activities

Because there are several categories of potential incidents and impacted 

entities, this annex identifies different Federal agencies as “coordinating 

agencies” and “cooperating agencies” and associated strategic concepts of 

operations based on the authorities, responsibilities, and capabilities of those 

departments or agencies. In addition, this annex describes how other Federal departments and agencies support the DHS when leading a large-scale, 

multiagency Federal response.

► Scope

This annex applies to two categories of RN incidents: inadvertent or 

otherwise accidental releases and releases related to deliberate acts. These 

incidents may also include potential release of radioactive material that 

poses an actual or perceived hazard to public health, safety, national security, and/or the environment. The category covering inadvertent releases 

includes two categories of nuclear facilities (commercial or weapons production facilities), lost radioactive material sources, transportation accidents 

involving RN material, domestic nuclear weapons accidents, and foreign 

accidents involving nuclear or radioactive material that impact the US or its 

territories, possessions, or territorial waters. The second category includes, 

but is not limited to, response to the effects of deliberate attacks perpetrated 

with radiological dispersal devices (RDDs), radiological exposure devices 

(REDs), nuclear weapons, or improvised nuclear devices (INDs).
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This annex applies whenever a Federal response is undertaken unilaterally 

pursuant to Federal authorities or when an incident exceeds or is anticipated 

to exceed state, local, or tribal resources. The level of Federal response to 

a specific incident is based on numerous factors, including, the ability of 

state, local, and tribal officials to respond; the type, amount, and custody 

of (or authority over) radioactive material involved; the extent of the impact 

or potential impact on the public and environment; and the size of the 

affected area.

If any agency or government entity becomes aware of an overt threat or act 

involving RN material/device or indications the incident is not inadvertent 

or otherwise accidental, the Department of Justice (DOJ) should be notified 

through the FBI. The AG has lead responsibility for criminal investigations 

of terrorist acts or terrorist threats by individuals or groups inside the US 

or directed at US citizens or institutions abroad, where such acts are within 

the Federal criminal jurisdiction of the US. The AG, in cooperation with 

other Federal departments and agencies engaged in activities to protect our 

national security, shall also coordinate the activities of the other members of 

the LE community to detect, prevent, preempt, and disrupt terrorist attacks 

against the US. For investigations pertaining to RN incidents, the coordinating and cooperating agencies perform the functions delineated in this annex 

and provide technical support and assistance to the FBI in the performance 

of its LE and criminal investigative mission. Further details regarding the 

FBI response are outlined in the Terrorism Incident Law Enforcement and 

Investigation Annex. In situations resulting from a deliberate act, NRIA response actions will be coordinated with the NRF and the Terrorism Incident 

Law Enforcement and Investigation Annex and the Catastrophic Incident 

Annex, as appropriate.

Under the NRF and the NRIA, the Department of Health and Human 

Services (HHS) has the major role in protecting people’s health through 

the following:

• assessing, monitoring, and following up on people’s health;

• ensuring the safety of workers involved in and responding to the 

incident;
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• ensuring that the food supply is safe;

• providing medical and public health advice; and

• providing medicines (medical countermeasures) to treat radiation 

exposure or contamination with radioactive materials.

When exercising domestic incident management responsibilities, the 

Secretary is supported by other coordinating agencies (Table 1, page 17) and 

cooperating agencies. For incidents wherein the Secretary is not fulfilling 

domestic incident management responsibilities, the coordinating agency will 

be the responsible agency for domestic incident management as defined by 

its authorities.

Table 1. Coordinating Agencies for RN Incidents

RN Facilities or Materials Involved in Incident Coordinating Agency

Nuclear facilities 

Owned or operated by the Department of Defense (DoD) or 

the Department of Energy (DOE)

DoD or DOE

Licensed by the Nuclear Regulatory Agency (NRC) or an

Agreement State

NRC

Not licensed, owned, or operated by a Federal agency or an 

Agreement State or currently or formerly licensed facilities for 

which the owner/operator is not financially viable or is otherwise unable to respond

Environmental 

Protection Agency (EPA)

Radioactive materials being transported

Materials shipped by or for DoD or DOEa DoD or DOE

Shipment of NRC or Agreement State–licensed materials NRC

Shipment of materials in certain areas of the coastal zone that 

are not licensed or owned by a Federal agency or Agreement 

State (see DHS/U.S. Coast Guard (USCG) list of responsibilities 

for further explanation of “certain areas”)

DHS/USCG

All others EPA
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RN Facilities or Materials Involved in Incident Coordinating Agency

Radioactive materials in space vehicles impacting within the United States

Managed by the National Aeronautics and Space 

Administration (NASA) or DoD

NASA or DoD

Not managed by DoD or NASA and impacting certain areas 

of the coastal zone

DHS/USCG

All others EPA

Foreign, unknown, or unlicensed materialb

Incidents involving inadvertent import of radioactive materials DHS Customs and 

Border Protection

Incidents involving foreign or unknown sources of radioactive 

material in certain areas of the coastal zone

DHS/USCG

All others EPA

Nuclear weaponsa DoD or DOE (based 

on custody at time of 

incident) 

All deliberate attacks involving RN facilities or materials, 

including RDDs or INDsc,d

DHS 

a. The coordinating agency is either DoD or DOE, depending on which of these agencies has 

custody of the material at the time of the incident.

b. The DHS DNDO coordinates the adjudication of unresolved radiation detection alarms.

c. For deliberate attacks, DHS assumes its domestic incident management responsibilities 

under HSPD-5, paragraph 4, and is also the coordinating agency for implementing the 

activities in this annex with respect to deliberate attacks.

d. For deliberate attacks, DOJ assumes those LE coordination activities under HSPD-5, 

paragraph 8.

TERRORISM INCIDENT LAW ENFORCEMENT AND 

INVESTIGATION ANNEX

► Purpose

The purpose of this annex is to facilitate an effective Federal LE and 

investigative response to all threats or acts of terrorism within the US, 

regardless of whether they are deemed credible and/or whether they escalate 
NATIONAL POLICY

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to a major RN incident. To accomplish this aim, the annex establishes a 

structure for a systematic, coordinated, unified, timely, and effective national 

LE and investigative response to threats or acts of terrorism within the US. 

The FBI is the coordinating agency for the Terrorism Incident and Law Enforcement and Investigation Annex.

► Scope

This annex is a strategic document that:

• provides planning guidance and outlines operational concepts for the 

Federal LE and investigative response to a threatened or actual terrorist 

incident within the US; and

• acknowledges and outlines the unique nature of each threat or incident, 

the capabilities and responsibilities of the local jurisdictions, and the LE 

and investigative activities necessary to prevent or mitigate a specific 

threat or incident.

Under the NRF and NRIA, the LE and investigative response to terrorist 

threats or incidents is based on the following priorities:

• preserving life or minimizing risk to health, which constitutes the first 

priority of operations;

• preventing a threatened act from being carried out or an existing 

terrorist act from being expanded or aggravated;

• locating, accessing, rendering safe, controlling, containing, recovering, 

or disposing of a weapon of mass destruction (WMD) that has not yet 

functioned and disposing of chemical, biological, radiological, nuclear, 

and explosive material in coordination with appropriate departments 

and agencies (e.g., DoD, DOE, and EPA); and

• apprehending and successfully prosecuting perpetrators of terrorist 

threats or incidents.
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PUBLIC HEALTH

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PUBLIC HEALTH
PUBLIC HEALTH

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CENTERS FOR DISEASE CONTROL AND PREVENTION ROLE

Based on the terrorist events of 2001, people have expressed concern 

about the possibility of a terrorist attack involving radioactive materials. 

During and after such incidents, the Centers for Disease Control and 

Prevention (CDC), in cooperation with Federal agencies, would assist state, 

local, and tribal authorities in protecting people’s health and offer guidance 

on actions that people can take to reduce their exposures to radiation.

CDC is a part of HHS, which includes the National Institutes for Health 

(NIH), the Food and Drug Administration (FDA), and several other health 

and family service agencies. CDC’s goal is to improve the health of the 

people of the US through disease control and prevention, the promotion and 

protection of environmental health, and health promotion and education 

activities. CDC would be a significant public health (PH) entity to respond 

to a RN incident, whether accidental or intentional, with the following 

specific roles and responsibilities:

• assessing the health of people affected by the incident;

• assessing the medical effects of radiological exposure on people in 

the community, emergency responders and other workers, and highrisk populations (such as children, pregnant women, and those with 

immune deficiencies);

• advising state, local, and tribal health departments (working in conjunction with other Federal agencies such as the US Department of 

Agriculture, FDA, and EPA) on how to protect people, animals, and 

food and water supplies from contamination by radioactive materials;

• providing technical assistance and consultation to state, local, and tribal 

health departments on exposure assessment, health risk evaluation, 

medical treatment, follow-up, and decontamination of victims exposed 

to radioactive materials;

• providing laboratory services for analysis of urine samples to assess 

internal contamination from radionuclides; decontamination of people 

contaminated with or exposed to radioactive materials; and

• supporting state, local, and tribal authorities in establishing and main-
PUBLIC HEALTH

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taining a registry of people contaminated with or exposed to radioactive materials.

In the hours and days following a RN incident, CDC would assist and 

advise state and local health departments on recommendations for 

communities to:

• protect people from radioactive fallout,

• protect people from radioactive contamination in the area,

• safely use food and water supplies from the area,

• assess and explain the dangers in the area of the incident, and

• monitor people (http://www.bt.cdc.gov/radiation/population

monitoring.asp) for contamination (http://www.bt.cdc.gov/radiation/

contamination.asp) with RN materials and exposure to radiation.

CDC also will have representatives on the Advisory Team for Environment, 

Food, and Health (sometimes referred to as the A-Team), a collection of 

experts from a variety of Federal agencies that advise state, local, and 

tribal governments on ways to protect people and the environment following 

a RN incident. To learn more about the A-team visit: http://www.crcpd.org/

ATeam/Ateam.htm.

If necessary, CDC would also deploy the Strategic National Stockpile, a 

Federal store of medical supplies and radiological or medical countermeasures set aside for emergency situations. Table 2 (page 24) lists some countermeasures available.

In addition, CDC’s National Institute for Occupational Safety and Health, 

in coordination with the Occupational Safety and Health Administration, 

would give workers in the area information on:

• the amount of time they can safely work in an area contaminated with 

RN materials;

• procedures needed to protect themselves from radiation and RN 

materials;
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• types of personal protective equipment needed to work in the 

contaminated area; and

• use of radiation monitoring devices.

Following an incident involving RN materials, CDC would support state, 

local, and tribal authorities in establishing an exposure registry to monitor 

people’s exposure to radiation and perform dose reconstructions to determine the amount of radiation to which people were exposed. This registry 

would assist with long-term medical follow-up for those who were affected 

by the incident.

Table 2. Countermeasures in Strategic National Stockpile

Name Symbol or 

Brand Name 

Targeted 

Radionuclide(s)

Benefit to Patients

Potassium iodide KI Iodine-131 Blocks radioactive iodine 

absorption in the thyroid

Prussian blue Fe7(CN)18 Cesium-137

Thallium-201

Traps radioactive 

cesium and thallium in the 

intestines, keeping them 

from being reabsorbed by 

the body so that they are 

excreted

Calcium and 

zinc diethylenetriaminepentaacetic acid 

(DTPA)

Ca DTPA and Zn 

DTPA

Plutonium-239

Americium-241

Curium-244

Removes radioactive 

plutonium, americium, and 

curium by binding onto the 

materials so that they will 

be eliminated by the body

Cytokines Neupogen, 

Neulasta, and 

Leukine

N/A Stimulates growth of white 

blood cells to help recovery 

of the bone marrow
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PUBLIC HEALTH GOALS

The radiation PH community investigations have the following basic goals:

• Protect public safety. PH professionals use radiological and medical 

information, surveys, surveillance, and evaluation of trends to guide 

investigations for protecting PH. Disease surveillance will play a definitive role in protecting PH in a RN incident. Additionally, education, 

both before and after the incident, will affect the public response to a 

RN emergency and thus a substantial impact on human health.

 An essential aspect of PH is prevention of radiation contamination 

and/or exposure of the population. PH professionals will use survey 

instruments and data analysis to determine the source and the extent 

of environmental contamination. Additionally, members of the population will be given instructions on how to remove physical contamination to prevent further exposure and spread of contamination.

 The PH community will also be responsible for determining the extent 

of the exposure to the population through epidemiology, surveillance, 

laboratory analysis, risk and/or exposure assessment, and a long-term 

exposure registry. Medical intervention may be necessary in some 

cases, depending on the radionuclide(s) involved and the extent of 

exposure and/or contamination.

• Protect PH personnel. One major consideration during these investigations is the protection of PH personnel. Since interviewers could 

potentially come in contact with radioactively contaminated individuals, it is important that the proper protective protocol is provided for 

these individuals during their investigation.

PUBLIC HEALTH INVESTIGATIONS

Successful investigations require the thorough accumulation of information 

in the field. The field investigation will resemble LE investigations because 

of the types of information collected and the means that it is collected. The 

basic elements of a PH investigation occur simultaneously or in a different order, depending on the availability of personnel. The following list is a 

synopsis of the basic elements of a PH investigation. 
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► Detecting a Radiological Incident

Radiological incidents include a RDD, a transportation accident, and a 

nuclear reactor accident. Only one incident—the nuclear reactor accident—

would provide pre-event situational awareness for the PH and LE agencies 

to address radiation exposure immediately before or after the incident. Deployment of RDDs (“dirty bomb”) might also provide pre-event situational 

awareness for the LE and PH agencies because first responders have radiation absorbed dose (RAD) detectors that would be used during investigations dealing with bombs. Therefore, the first sign that a radiological PH 

emergency may have occurred is an increase in people that display some 

of the following adverse health effects: general weakness and discomfort, 

nausea, and vomiting. In fact, due to the infrequency of physicians actually encountering a case of radiation exposure or acute radiation syndrome, 

it is easy to see how such signs and symptoms could initially be attributed 

to food poisoning, metal poisoning, or an infectious disease. For most 

radiological incidents, disease surveillance will most likely produce information of interest to LE personnel. Hospitals, ambulatory clinics, urgent care 

facilities and possibly community-based primary care practitioners in the 

area affected should be contacted to determine whether anyone is currently 

or was recently receiving treatment for a similar illness.

In a nuclear detonation or IND incident, PH and LE personnel will both be 

aware of the source of the incident. Therefore, syndromic surveillance will 

not be an issue for PH investigations. The investigation will move to collecting specimens for analysis, reporting, and possible medical intervention 

depending on the quantity and type of RN material(s) used.

► Identify and Characterize Additional Cases

This element of the PH investigation has many similarities to a LE 

investigation. At this stage sources for cases are analyzed, and additional 

cases are identified. Individuals may be contacted multiple times as investigators collect additional information. Information collected by PH investigators can include the following:

• pertinent demographic data (name and contact information);
PUBLIC HEALTH

27

• clinical data (signs and symptoms, duration, onset, etc.);

• exposure history (travel, meals, and significant incidents, all based 

on the type of illness suspected); and

• case contacts and knowledge of other cases.

In addition to interviewing personal contacts of the cases, PH officials 

will attempt to identify all the cases of exposure to treat the victims with medical 

countermeasures and to initiate long-term tracking. This step will be accomplished through soliciting media assistance to notify everyone with the symptoms 

of the time, date, and location of the incident and to decontaminate themselves 

through CDC-provided instructions. Affected individuals should go to a population monitoring welcome center for further assistance. Population monitoring 

welcome centers will be essential in triaging cases and post-incident tracking of 

individuals.

► Confirm Diagnosis Through Collection of Specimens

Due to its noninvasive nature, collecting urine specimens will be one of 

the primary methods for diagnosis of exposure to radionuclides. Other 

materials that may be collected to support the investigation include food, water, 

environmental samples (air filters, soil, vegetation, etc.), and other biological 

samples (nasal swabs). The Division of Laboratory Sciences within the National 

Center for Environmental Health at CDC will be responsible for testing the clinical 

samples, while EPA, DOE, and others will test environmental samples.

► Reporting

The time necessary for a confirmatory diagnosis can range from hours to days, depending on the radionuclide(s) involved in the incident. PH officials may develop 

a potential scenario about the source of the radiological incident as they accumulate additional clinical laboratory results and receive intelligence information from 

their LE partners. Senior officials may wait for the results of the confirmatory tests 

prior to confirming the diagnosis if RN terrorism is suspected; however, implementation of the intervention plan may require action prior to this confirmation 

based on the available information.
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► Implement Intervention Plans

The ultimate objective of the above procedures is to identify the 

radionuclide(s) used in the incident and protect the public’s health through 

medical intervention, depending on the dosage and the type of radionuclide 

used. Implementation of the intervention plan should be executed as soon 

as it is known that radiation is involved. Thus, the spread of contamination 

can be reduced significantly and PH can be addressed. An intervention 

plan developed by CDC is outlined in the document entitled “Population 

Monitoring in Radiation Emergencies: A Guide for State and Local Health 

Planners”, which can be downloaded at http://emergency.cdc.gov/radiation/

pdf/population-monitoring-guide.pdf. The guide focuses on planning a PH 

response to RN terrorism incidents. 

Population monitoring is an essential element that is often overlooked in 

emergency response planning for RN terrorism incidents. Many critical 

components of population monitoring should be put in place in the first 

few hours after the incident, before the arrival of Federal assets that might 

be used to assist in the monitoring efforts. The planners’ guide described 

above, focuses on the significant effort required to identify, screen, measure, 

and monitor populations (people and possibly even their pets) for exposure 

to or contamination from RN materials. The guide also presents the concept 

of a community “reception” center (monitoring and decontamination facility) for a large-scale RN incident. The community reception centers would 

be established to assess people for exposure, contamination, and the need for 

decontamination and to register people for follow-up monitoring or medical 

assessment.
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LAW ENFORCEMENT
LAW ENFORCEMENT

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FEDERAL BUREAU OF INVESTIGATION ROLE

As affirmed by HSPD-5 and the NRF, the FBI is the lead agency for criminal 

investigations of terrorist acts or terrorist threats and intelligence collection 

activities within the US. All Federal, state, local, and tribal departments and 

agencies must notify their local FBI WMD Coordinator (WMDC) and/or 

the Joint Terrorism Task Force (JTTF), through the FBI field office, regarding information associated with the threat of terrorism or an actual terrorist incident. In many cases, the WMDC is a member of the JTTF, which is 

operational in every FBI field office. The JTTF consists of representatives 

from Federal, state, local, and tribal LE/response agencies. The institution of 

the JTTFs improves real-time information sharing, analysis, and investigations/prevention activities. 

WMDCs are located in each of the 56 field offices of the FBI. Their purpose 

is to act as a conduit to FBI Headquarters (FBIHQ) for investigative expertise, technical information, advice, and assistance. The WMDC is contacted 

by state, local, and tribal emergency responders in the event of a threat or 

incident potentially involving WMD. In addition, the WMDCs liaise with 

Federal regional counterparts such as the EPA, the FDA, the Drug Enforcement Administration, and PH and representatives of state, local, and tribal 

organizations. 

In the event of a threat or an incident potentially involving WMD, the 

local WMDC will contact FBI Headquarters (FBIHQ) WMD Operations 

Unit (WMDOU) for operational response direction. WMDOU initiates a 

Threat Credibility Evaluation (TCE) conference call - the forum for addressing WMD threat and incident response protocols. The TCE process consists 

of evaluating the plausibility of the threat based on three major factors: behavioral resolve, operational practicality, and technical feasibility. Through 

the course of the threat analysis, WMDOU will involve, as needed, other 

Federal, state and local partners having relevant subject matter expertise. 

During the conference call, the evaluation of the situation is developed and 

conveyed to the WMDCs in support of their response and investigation. 

TCEs can be conducted throughout the investigative process as determined 

necessary and additional information is acquired to determine the credibility of the threat. 
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The two primary sections at FBIHQ assisting the WMDC are the Investigations and Operations Section (IOS) and the Countermeasures and 

Preparedness Section (CPS). IOS’ mission is to identify, prevent, mitigate, 

investigate, and resolve the use or threatened use of WMD as a means of terrorism directed against the US, its citizens, or its interests. CPS’ mission is 

to understand the scientific aspects of current and anticipated WMD threats 

encountered by the FBI, as it pursues its goals in the prevention of WMD 

terrorism, and develop countermeasures against them.

The FBI has multiple response resources or assets to provide assistance in 

the event of a terrorist incident involving WMD including the Hazardous 

Materials Response Team Unit (HMRTU), Hazardous Materials Response 

Teams (HMRT), Hazardous Materials Operations Unit (HMOU), Hazardous Materials Science Response Unit (HMSRU), Evidence Response Teams 

(ERT), and the Chemical Biological Radiological and Nuclear Sciences Unit 

(CBRNSU). 

The HMRTU’s mission is to provide investigative, forensic, and incident 

command system expertise to FBI field offices and Legal Attache offices 

(LEGAT) involving CBRN/WMD suspicions, threats, and/or crime scenes. 

HMRTs are comprised of FBI Special Agents, FBI support personnel and 

JTTF Officers specially trained in the collection and preservation of forensic 

evidence in a CBRN environment including WMD. The HMRTs are located 

at select FBI field offices within the US to regionally respond to hazardous 

material crime scenes and investigations. 

HMOU’s mission is to provide advanced hazardous materials and technological response services/capabilities to the FBI and Interagency partners to 

support crime scene operations. HMSRU’s mission is to provide scientific, 

technical and forensic support to FBI criminal and intelligence investigations. Every FBI field office has an ERT whose mission is to conduct crime 

scene investigations and to collect physical evidence using the techniques 

of forensic science. CBRNSU’s mission is to develop and maintain the FBI’s 

ability to conduct and/or direct high-quality forensic examinations of hazardous chemical, biological, and RN materials and all related evidence. 
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LAW ENFORCEMENT INVESTIGATION GOALS

The LE community has the following set of goals during a RN attack:

• Prevent a criminal act. The role of LE begins with steps to prevent 

a terrorist from successfully executing an attack. Through investigations and intelligence, LE personnel seek to obtain information to 

identify terrorists, their targets, and methods of attack before a criminal act can be executed. It is necessary to safeguard against disclosure 

of intelligence information and the means by which it was gathered, 

especially during ongoing productive operations. Inadvertent release 

of sensitive information may compromise not only the specific threat 

being investigated, but also other/future investigations.

•	 Protect public safety. The overriding goal of LE is to protect the public 

from terrorist threats or attacks. Ideally, this goal includes preventing 

the terrorist attacks or alternatively apprehending the terrorist after the 

incidents to prevent additional attacks.

• Protect LE personnel. LE personnel are likely to encounter radioactive contamination (on the ground, suspended in air, and/or in all 

surrounding objects, structures, etc.) and/or be exposed to radiation. 

LE personnel must take precautions and wear appropriate personal 

protective equipment to avoid radioactive contamination or inhaling 

any suspended radioactive material. Additionally, LE personnel must 

be knowledgeable on radiation exposure limits/guidance and wear 

appropriate dosimeters (to measure cumulative exposure) to avoid 

exceeding safety limits. There may not be sufficient information about 

all the radiological hazards at the incident site. Thus, LE personnel are 

encouraged to contact the local FBI WMDC or HMRT Team Leader 

who will coordinate consultation with experts at the HMTRU, HMSRU 

and HMOU prior to entering the site. 

• Support the US attribution process. The US attribution goal is to 

identify the nature, source, and perpetrator(s) of an attempted or actual 

RN attack. This includes rapid and comprehensive coordination of 

intelligence reporting, LE information, technical forensic information, 

and other relevant data streams to evaluate adversaries’ capabilities, 

resources, supporters, and modi operandi in the context of a recent, 

completed or attempted RN attack(s).
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• Identify, apprehend, and prosecute the perpetrators. LE personnel seek to obtain sufficient evidence and information to identify and 

to apprehend the individual(s) responsible for the attack. A criminal 

investigation into a RN attack is not complete until there is a successful 

prosecution and conviction of those responsible for the attack. Collection of evidence includes interviewing victims and witnesses, as well 

as obtaining and preserving physical evidence. In a RN attack, individuals and evidence may be contaminated with RN materials, requiring special decontamination and handling procedures. LE personnel 

must follow strict evidence collection procedures to obtain sufficient 

admissible evidence needed to achieve conviction. Any abnormalities, 

such as a break in chain of custody in the collection or maintenance of 

evidence, may prevent the use of potentially incriminating evidence at 

the trial. LE personnel will coordinate closely with the agencies and 

their personnel responsible for the collection of contaminated evidence 

to ensure proper procedures are followed.

LAW ENFORCEMENT CRIMINAL INVESTIGATIONS

► Preventing a RN Attack

Preventing a RN attack is the first line of defense and is the ultimate goal of 

LE. The first step in preventing and preparing for a RN attack is to attempt 

to identify potential terrorists or terrorist organizations likely and capable of 

executing a RN attack. This information allows LE officials to identify potential targets and possible modes of attack. Detecting a potential terrorist 

during planning, procurement, or development of a RN device is a second 

investigative avenue that LE must explore to prevent a RN attack. In reality, 

not every RN attack can be prevented; therefore, appropriate Federal, state, 

local, and tribal agencies must be prepared to respond to a RN incident.

► Criminal Investigation Process

Individuals conducting criminal investigations must operate within the 

applicable laws governing the investigations and the ensuing prosecution. 

As information is compiled, a thorough understanding of the elements 
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necessary to prove each pursued offense will help guide the investigators to 

identify any missing or weak evidence. A brief summary of the criminal 

investigation process is provided below. While the steps are presented 

sequentially, some aspects of the investigation may occur simultaneously.

► Threat Evaluation—Real or Hoax

LE personnel may be confronted with a noncredible threat (hoax), 

threatened RN attack, announcement that a RN attack has occurred (overt), 

or an unannounced RN attack (covert). When a claim that a RN device has 

been or will be used is received, the FBI, in consultation with recognized 

experts, will conduct a threat evaluation to determine whether the threat 

is credible. If the threat is credible, LE in conjunction with PH, must take 

action to prevent or minimize the effect of a RN attack. Whether or not 

the threat is deemed credible, LE personnel will initiate an investigation to 

identify and prosecute those responsible for the threat. Under Federal law, 

a threat involving RN material or device is a criminal act whether or not the 

perpetrator actually possesses the RN material or device.

In an unannounced or covert RN attack, the PH community will most likely 

see the effects of radiation and/or contamination on patients seeking medical attention from their private practitioners and hospital emergency rooms. 

In a covert RN attack, the PH surveillance system will be the key to identifying unexplained illnesses across the population or similar symptoms being 

reported by community-based primary care practitioners and hospitals. As 

soon as the PH community suspects radiation exposure or contamination to 

be the result of an intentional act, LE personnel should be contacted to initiate a preliminary criminal investigation. If PH officials and LE have forged 

a working relationship prior to a RN attack, it is more likely that the PH 

officials will feel more comfortable contacting LE early in their radiological 

investigation, allowing for prompt initiation of the criminal investigation.

► Gather Evidence

The process of gathering evidence during the investigation of a RN 

incident involves collection of physical evidence, such as contaminated 

evidence or samples of RN materials, parts of the device, human body 
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35

specimens, clothing of both victims and suspects, documents, as well as 

photographs and witness statements. LE personnel must consider a variety 

of issues to ensure that the evidence they gather can ultimately be used in a 

criminal prosecution. The list below provides a summary of some of the key 

issues LE personnel must consider.

• Chain of custody. Chain of custody is the method used to track and 

maintain control and accountability of all evidentiary items. This encompasses initial collection of the evidence through final disposition of 

the contaminated evidence or RN materials. Both LE and PH personnel must provide accountability at each stage of collecting, handling, 

testing, storing, and transporting the evidentiary items and reporting 

any test results. Failure to properly maintain the chain of custody may 

prevent the evidence in question from being introduced at trial. In 

some instances, there may be an overriding need by authorities to identify the RN materials as soon as possible to ensure the proper response 

is implemented and steps can be taken to protect the responders and 

the public. In this instance, the need for rapid collection and testing of 

evidence to save lives outweighs the normal evidence collection procedures. PH officials should be aware that specimens collected for PH 

investigations could become evidence for criminal prosecutions.

• Delivery of contaminated evidence to appropriate laboratories.

Forensic laboratories that process traditional criminal evidence are 

not equipped to test for the presence of RN materials or handle 

contaminated evidence. The FBI has partnered with DOE and DoD 

to create a network of laboratories across the country with appropriate 

facilities and expertise to conduct appropriate analyses with approved 

equipment, qualified personnel, and accepted practices. 

• Documents. Original documents should be obtained by LE when 

possible. Issues of authenticity and admissibility arise if copies are 

relied upon when original documents are available. Potentially contaminated documents should be stored and examined using appropriate procedures and personal protective equipment to protect both the 

individuals handling the evidence and the evidence itself.
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36

• Witness statements. Witness descriptions of dissemination devices, 

vehicles, suspects, sounds, flashes, and other specific information must 

be obtained as soon as possible after a RN incident. The information a 

witness has to provide is “time sensitive,” and the sooner the information can be obtained, evaluated, and disseminated, the more value it has 

to investigators. The potential for errors in witness statements increases 

proportionally with time since the incident occurred. This can occur 

as witnesses hear others describe their experiences. The accuracy of a 

witness’ recollection can be greatly eroded by the influence of others’ 

comments and by fading memories.

► Evaluate Evidence

The FBI is responsible for the collection of contaminated evidence for traditional and technical nuclear forensics. As evidence is gathered and collected, 

an ongoing evaluation of the evidence must be part of the investigative process. An understanding of the types of evidence and the rules governing the 

admissibility of the evidence will lead to better evaluations of the evidence 

as the investigation progresses. While not intended to be all inclusive, Table 

3 (page 37) identifies and briefly explains some of the types of evidence collected during the investigative process.
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Table 3. Types of Evidence Collected During an Investigative Process

Type of 

Evidence

Explanation Examples

Circumstantial Facts, if proven, allow the factfinder to draw conclusions. In 

most jurisdictions, circumstantial 

evidence has probative value.

Suspect has radiation burns or 

exhibits symptoms of radiation 

sickness. Suspect is contaminated with radioactive materials.

Direct Documents, records, physical 

evidence, notes, computer data, 

videotapes, or other types of 

information that directly relate to 

the case.

Vehicle rental agreements, 

purchase receipts, phone 

records, eyewitness statements.

Trace Minute particles of matter 

which can be examined through

microscopic, physical, chemical, 

or radiological analysis.

Traditional RN material residue, 

fibers, hair.

Hearsay A statement, other than one 

made by the declarant while 

testifying at the trial or hearing, 

offered in evidence to prove the 

truth of the matter asserted.

A person who did not personally witness a suspect engaging 

in a particular manner but is 

reporting the observation based 

upon what someone else told 

him or her, and the person who 

actually made the observation is 

not testifying or available for the 

opposing party to cross examine.

Eyewitness Observation or sensation 

personally seen, smelled, heard, 

felt, or tasted.

Witness reporting seeing a 

blinding flash or hearing a 

specific explosion sound or 

seeing someone.
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► Protection of Evidence

It should be noted that evidence collected in a potentially contaminated environment must be assumed to be contaminated, significantly complicating 

the evidence review and evaluation process. The evidence can be tested to 

rule out contamination, reviewed in a facility designated to handle contaminated evidence, photographed to allow review of the contents in a safe 

environment, or when possible decontaminated prior to review. To properly 

focus their investigation in a terrorist incident, LE personnel need the results 

of any analyses or tests on evidence as quickly as possible. During major 

criminal investigations, LE officers expect a quick turnaround on laboratory 

results. In a RN terrorism attack, the time required to positively identify RN 

material(s) or device(s) may be considerably longer.

Like other investigations, during a RN incident, the investigators never 

know what nuance or piece of information will be the crucial break needed 

to identify, arrest, convict, and attribute those responsible for the terrorist 

attack. From the beginning of a criminal investigation into a RN attack until 

the case is submitted to a jury for a verdict, all facts collected during the 

investigation must be verified, and inconsistencies resolved and submitted to 

the prosecutor. Documents must be carefully analyzed to ensure they have 

been thoroughly reviewed and the information contained in the documents 

is interpreted correctly. Sometimes information contained in statements or 

reports is subject to differing interpretations. Investigators must examine 

the evidence for conflicting interpretations and resolve these issues as soon 

as possible or be prepared to explain the contradictions.

It is equally important to develop a mechanism to submit all information, 

statements, laboratory reports, documents, photos, and other evidentiary 

items to the prosecutor in an organized manner to ensure all of the facts are 

identified prior to trial. Additionally, sufficient time should be allowed to 

permit the prosecutor to meet with the investigators and witnesses to review 

all reports, evidence, and anticipated testimony.
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► Apprehend Suspects

Once a RN threat has been prevented or a RN attack occurs and the threat 

to the public is either reduced or eliminated, identifying and supporting 

the US attribution process and building a prosecutable case against those 

responsible for the attack are the top priorities for LE personnel. Suspecting 

or even knowing who is responsible for a RN attack is different from having 

sufficient evidence to attribute or charge and prosecute the perpetrators. 

Especially when human lives are lost in a RN attack, there is tremendous 

pressure on LE personnel to identify, locate, and arrest the perpetrator(s).

During the apprehension of a suspect or group of suspects, LE personnel 

involved in the arrest need to take precautions against possible injury from 

the perpetrator(s). By the time LE personnel are prepared to make an arrest, 

the perpetrator(s) have already demonstrated or professed the willingness 

to kill or injure large numbers of innocent citizens. It is also possible that 

the arresting officers will be confronted with a radioactively contaminated 

environment, contaminated evidence, or even one or more contaminated 

suspects. While apprehending the suspects is a major phase of the investigative process, safety of the arresting team and innocent bystanders is paramount. Appropriate personal protective equipment and strict protocols for 

working in contaminated areas or high-radiation fields must be followed to 

avoid radioactive contamination or radiation exposure.

► Render Testimony

Prior to testifying at trial, each potential government witness should be 

available to meet with the prosecutor. It is important for the prosecutor to 

have the opportunity to evaluate how each witness may appear to the jury. 

Additionally, any issues, problems, discrepancies, or gaps in the evidence or 

testimony can be discussed and resolved. To avoid lost evidence or rulings 

of inadmissibility, LE officers must know and have access to all sources 

of information and evidence so inconsistencies or discrepancies can be 

investigated and addressed.
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JOINT OPERATIONS

41

JOINT OPERATIONS
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42

JOINT INVESTIGATIVE INFORMATION

The successful execution of LE and PH investigations during a RN incident 

will depend on the efficient use of all available resources. When possible, 

LE and PH personnel should work in teams and jointly conduct interviews 

with victims and witnesses. Prior to the actual interview with a witness or 

victim, the joint investigation team should decide which person will lead 

the interview and how they will work together during the interview. It is 

recommended that the epidemiological interview proceed first during a 

joint interview; however, the order of the interviews must be decided on 

a case-by-case basis.

When joint interviews are not possible, the separate investigative 

communities should be aware of the types of information their counterpart is seeking. PH personnel should obtain and provide information from 

their epidemiological investigation to LE personnel that would benefit a 

criminal investigation. Conversely, the LE community should provide data 

to PH personnel that would benefit an epidemiological investigation. The 

objective of the joint investigation and joint interviews of victims and 

witnesses is to maximize the efficiency of both LE and PH investigators 

through the exchange of real-time information.

EFFECTIVE INFORMATION EXCHANGE

One of the goals of this handbook is to encourage LE and PH officials 

to notify and involve each other early in an investigation, even if it turns 

out to be a noncriminal act (Table 4, page 43). It is essential to establish 

key communication mechanisms between the LE and the PH communities. 

These mechanisms are especially important for the expeditious exchange 

of information in an actual RN incident. This exchange of information 

requires LE and PH personnel to be familiar with one another and to know 

which people in each agency need to receive the information.
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Table 4. How to Recognize RN Incidents

Radiological Nuclear

•Does not involve a nuclear explosion

•Victim can have contamination and/or 

exposure

•Examples:

◦ RDD

 ◦ RED

◦ Nuclear reactor accident

◦ Transportation accident

•Involves a nuclear explosion (fusion/

fission)

•Victims can have contamination and/or 

exposure

•Examples:

◦ Nuclear weapon

◦ IND

Not Obvious in Real Time Obvious in Real Time

•Hazardous materials professionals 

detect radiation on scene of explosion

•Monitoring of water, soil, food, and/or 

air for unexpected radiation

•Requires clinical recognition of cluster 

of unusual clinical signs and symptoms 

of victims

•Environmental detectors locate hidden 

sources outside of expected places 

(e.g., subway, sports facilities)

•Examples:

◦ Explosive dispersal

◦ Nonexplosive dispersion into 

environment, water, food, and/or air

◦ Hidden radiological source

◦ Malicious industrial, nuclear reactor, 

and/or medical facility sabotage

◦ Transportation accident

•Information from Federal, state, local, 

and/or tribal authorities

•News report

•Routine radiation monitoring of

◦ Industrial radiation sources

◦ Planned transport of radiation sources

◦ Medical facility radiation sources

•Personal observation

•Examples:

◦ Nuclear explosion

◦ Transport accident

◦ Medical facility accident or lost source

◦ Nuclear reactor accident or sabotage

◦ Industrial radiation source accident
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POTENTIAL BARRIERS

► PH Barriers

The first potential barrier is that the PH community is concerned it will be 

held legally liable for the release of patient information without consent. 

Some legal issues associated with confidentiality are listed below: 

• PH officials normally obtain patient information from medical practitioners. The issue of whether or not this information is confidential 

and legally “privileged” must conform with Federal and state laws, 

including the Health Insurance Portability and Accountability Act 

(HIPAA). PH officials should consult their agency legal counsel 

regarding the applicability of the HIPAA exception.

• PH officials may take clinical samples from patients to aid in their RN 

investigation, suggest the most effective treatment, and assist in assessing the potential impact on public safety. LE officials may require 

access to these clinical samples and/or sample results (as potential 

evidence) of a criminal investigation. PH officials and LE personnel 

must properly maintain chain of custody for evidentiary purposes. A 

review of applicable Federal and state statutes should be conducted to 

determine protocols to address limitations and challenges while meeting both organizations’ needs to obtain these samples.

• LE officials may want to obtain specific information from health 

records at hospitals, health maintenance organizations, or the Centers 

for Medicare and Medicaid Services. HIPAA protects the confidentiality of health information and governs the release of this information 

by medical providers to LE officials. Generally, LE officials will require 

patient consent or legal process, such as a subpoena or court order, to 

obtain patient medical information. HIPAA does contain some exceptions to this general rule for LE request for protected health information under 45 Code of Federal Regulations 164.512. One exception is 

“to avert a serious threat to health or safety” if the health care provider, 

in good faith, believes that disclosure is necessary to prevent or lessen 

a serious or imminent threat to the health and safety of a person or the 

public. The disclosure must be made only to a person or persons who 

are reasonably able to prevent or lessen the threat. There are other LE 
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45

exceptions that may be used in the absence of consent or legal process 

to obtain these records. LE officials should consult their agency’s legal 

counsel regarding these exceptions. LE officials should also be aware 

that psychotherapy notes and patient substance abuse medical records 

are afforded additional special protections under the law.

A second potential barrier to the exchange of patient information is based 

on issues of ethics and trust. Patients provide detailed information to the 

medical community with the tacit understanding that physicians and PH 

professionals will retain that information in confidence. The PH community 

has expressed concern that providing confidential patient information to the 

LE community, regardless of reason or intent, may jeopardize their future 

ability to obtain data that are critical to identify and treat patients. Additionally, protecting the confidentiality of information is one of the elements of 

the code of conduct for medical and PH professionals.

The doctor-patient privilege is a statutory privilege that varies from state 

to state, but generally can be waived by the patient. In some jurisdictions 

and cases, the physician may assert the privilege on behalf of the patient. 

In general, the three elements listed below must be present for the privilege 

to exist:

• The information must be given with the expectation that it will not 

be disclosed and must be given in the usual context of a professional 

relationship;

• The purpose of the professional relationship is to maintain 

confidentiality; and 

• The possible injury to the professional relationship from the disclosure 

must be greater than the expected benefit to justice or the public in 

obtaining the information.

It should be noted that neither Federal common law nor the Federal rule of 

evidence recognize the physician-patient privilege. However, Federal law 

does recognize the psychotherapist-patient privilege. Patient consent, a 

subpoena, or a court order are typical methods for obtaining patient medical 

information and records. As noted earlier, however, information that is 
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46

provided by physicians to PH authorities can be provided to LE authorities 

for the purposes of protecting public health and safety. There are no specific 

barriers to the sharing of this information between PH and LE officials, but 

it is widely recognized that recipients should be limited to those working 

an investigation or public safety response. Efforts should be made by LE to 

ensure the protection of sensitive identifying information associated with 

medical data and limit its use for the purpose of investigating instances of 

disease and preventing illness.

► LE Barriers

The LE community also has two primary concerns regarding the exchange 

of investigative information. First, they may be reluctant to provide information that could jeopardize the safety of confidential informants or the 

security of classified sources. Information that LE personnel obtain from 

informants is frequently so sensitive that, if the information were exposed, 

the suspects would be able to determine exactly who had provided the information to LE officials. As a result, the more people who have access to the 

sensitive information, the greater the possibility that the information source 

will be exposed. While not discounting the need for closely held, informantprovided information, PH officials would like to receive an alert from LE of 

the need for heightened awareness and/or preparedness. This alert may or 

may not require the disclosure of sensitive information, but it would notify 

PH officials of unusual or unexplained symptoms and to monitor what may 

otherwise initially be overlooked as a signal that a radiation exposure and/or 

contamination has occurred.

Second, the LE community is concerned that the suspects may avoid 

detection as a result of the exchange of sensitive information. For example, 

should LE personnel inform the PH community to look for a specific 

individual or group, the number of individuals who know the specifics of 

the case will obviously increase. As in any investigation, the more people 

who have access to sensitive information, the more opportunities exist for 

inadvertent disclosure of the information. As a result, there is a greater opportunity for sensitive information to inadvertently leak back to the 
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suspected perpetrators, thus giving them the advanced warning needed to 

facilitate the destruction of evidence, possibly avoiding detection, and potentially affecting a successful prosecution of the perpetrator(s).

► Joint Interviews

Collaboration between LE and PH officials has not always been recognized 

as beneficial. There are concerns that the presence of LE officers would 

compromise the collection by PH of sensitive medical information (e.g., 

a person uses illegal drugs). Indeed, some degree of separation from LE 

may be advantageous for obtaining complete and accurate data during PH 

investigations. However, LE investigation of potential RN incidents requires 

interviewing all potential witnesses and victims. Separate questioning by LE 

and PH investigators may lead to conflicting statements by the interviewee, 

jeopardizing the admissibility of those statements in subsequent judicial proceedings. Despite these challenges, joint interviews are recommended 

in certain situations.

When there are benefits from doing joint LE and PH interviews, a process 

should be established that allows for confidential LE communications with 

PH officials regarding specific health-related issues that interviewees may 

be unwilling to share when LE personnel are present. Both LE and PH 

must recognize that the sharing of information can be crucial for identifying persons who have been contaminated or exposed and may be in need 

of medical services. Conducting joint interviews affords the opportunity to 

examine relevant facts based on the unique perspectives of both investigators. It also highlights that the primary goal of both LE and PH is protecting 

life and safety.

Special consideration should be made to protect the identifying information 

of interviewees, both to preserve victim privacy as well as the integrity of 

a criminal investigation. Because of different training backgrounds and 

professional experiences, LE and PH interviewers may recognize and note 

different information or clues that could aid in identifying the source of 

illness and its perpetrator(s). Additionally, concurrent interviews reduce the 

number of times persons must be questioned.
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► Information Exchange Triggers

During a RN incident, certain information or a specific event should trigger 

the exchange of information between the LE and the PH communities. For 

example, the LE community conducts criminal investigations every day, and 

in recent years, there have been numerous RN hoaxes. What should prompt 

the LE community to contact the PH community and involve them in the 

criminal investigation of such an incident? At what point in an epidemiological investigation should the PH community be prompted to contact 

LE? Both communities are legitimately concerned about overreacting and 

further stretching their already overburdened infrastructure and resources.

Below are lists of factors that could trigger LE or PH communities to 

exchange information. These lists are not all inclusive but are intended to 

provide a starting point to tailor or improve individual jurisdictional needs. 

Each jurisdiction may want to add or remove triggers to suit its individual 

needs. The most important aspect of this information exchange is to overcome the hesitation or reluctance to share information before all of the facts 

are known.

► LE Triggers

• Any intelligence or indication that an individual or group is 

unlawfully in possession of RN material and/or devices

• Seizure of any RN material, devices, and/or its specialized handling 

tools from an individual, group, or organization where there appears to 

be no legitimate use

• Seizure of any potential dissemination devices from an individual, 

group, or organization where there to be seems no legitimate use

• Report of a theft or loss of industrial or medical radiological source(s)

• Identification or seizure of literature pertaining to the development 

of RN devices and/or dissemination of RN materials where there is no 

discernible lawful purpose and is a perceived risk to public health

• Any assessments that indicate a credible RN threat exists

• A hazardous material response which involves the presence of RN 

materials
JOINT OPERATIONS

49

► PH Triggers

• Large numbers of patients with similar and unusual symptoms

• Large numbers of unexplained deaths

• Higher than expected morbidity and mortality associated with 

common symptoms and/or failure of patients to respond to traditional 

therapy

• Simultaneous clusters of similar illness in noncontiguous areas

• RN agents transmitted through aerosol, food, or water, suggestive of 

sabotage

• Ill persons presenting near the same time, suggestive of a point source

SHARING SENSITIVE INFORMATION

► Information Matrices

The timely exchange of information is critical to achieve an effective 

response to a RN incident. However, there are concerns within LE and PH 

communities about the types of information that each group will openly 

exchange. Both communities may determine there are circumstances that 

may necessitate withholding certain types of information from each other 

because of legal restrictions.

To help lower barriers to the free exchange of information, Table 5 (page 51)

can assist members of the LE and PH communities to understand the types 

of information each seeks and potential means to obtain that information. 

The categories in the table are defined below.

• Known information. Information that each group has during the 

specific phase of the incident.

• Needed information. Information that each group needs to effectively 

conduct its investigation during the specific phase of the incident— 

information that the PH community needs from the LE community or 

vice versa.

• Actions. Steps that should be taken by each community to obtain the 

information or to identify what information can be readily obtained.
JOINT OPERATIONS

50

• Presuspicion. Both communities may be receiving unusual information, but there is nothing to raise suspicion of a criminal act or a RN 

incident.

• Suspicion. The LE community has information that leads it to believe 

a criminal act may be committed or has been committed, or the PH 

community suspects radiation illness. LE personnel would initiate 

measures to identify, acquire, and plan the use of resources needed to 

anticipate, prevent, and/or resolve an attack.

• Incident management. Measures to protect PH and safety, restore 

essential government services, and provide emergency relief to 

governments, businesses, and individuals affected by the consequences 

of terrorism.

• Recovery. Gradual return to normal operations. 
JOINT OPERATIONS

51

Table 5. Information Matrix

Phase Known 

Information

Needed 

Information

Actions

PH and Medical Information

Pre-suspicion 

of a RN 

incident

• Unusual 

symptoms

• Potential 

recognition 

of radiation 

sickness/

contamination

• Potential 

radioactive 

material 

available in 

the area

• Threat: RDD, 

RED or IND?

• Can freely provide 

assessments and analyses 

without personal data

• Medical examiner provides 

data on fatalities to 

prosecutor; no subpoena 

needed

• Prosecutor can request 

post-mortem data; no 

subpoena needed

• No specific case data 

released

• Hospital/emergency 

medical service does 

not report to LE directly; 

immediately report up the 

chain to PH officials

• Follow state laws for 

reporting
JOINT OPERATIONS

52

Phase Known 

Information

Needed 

Information

Actions

PH and Medical Information

Suspicion 

of a RN 

incident

• Same as above

• Analysis of 

incident

• Medical 

examiner 

findings

• FBI laboratory 

network 

findings

• Contact 

information on 

other potential 

cases via 

interviews

• Medical 

community 

information

• Specific data: 

potential 

targets?

• Any specific 

information on 

type (alpha, 

beta, gamma) 

or isotope of 

radiation?

• Laboratory analyses 

provided to all response 

groups

• PH will take steps to ensure 

appropriate release of 

information

• A subpoena ensures the 

release of information and 

legally protects PH from 

liability

• Prosecutors can 

obtain medical examiner 

information

• Information is reported 

to CDC

• Report to local health 

departments

• Require patient permission 

for additional laboratory 

testing

Incident 

management

• Same as above • Same as above

• Survey extent of 

the devastation 

and/or 

contamination

• Approximate 

number of 

casualties

• Epidemiological 

investigation

• Local PH personnel 

advised by CDC on epidemiological questions

• Share epidemiological 

investigation results with 

LE officials
JOINT OPERATIONS

53

Phase Known 

Information

Needed 

Information

Actions

PH and Medical Information

Recovery • Patient 

treatment

• Post-incident 

dose 

calculations

• Long-term 

registry

• Same as above

• Damage to 

infrastructure

• Same as above

LE Information

Pre-suspicion 

of a RN 

incident

• Data concerning potential 

terrorist 

threat(s)

• Data 

concerning 

potential radiological device/

material

• Information 

about unusual 

symptoms

• Patient 

information

• LE will openly reveal 

general information

• No specific case 

information will be 

released

• Special consideration 

should be given regarding 

whether sources and methods will be compromised 

by information release

Suspicion of a 

RN incident

• Specific case 

data

• Suspect group 

and/or 

individuals

• Threat information: type of 

radiological 

device, target, 

and method of 

delivery

• Patients are 

potential victims 

of radiation 

exposure or 

contamination

• Personal 

information

• Suspect 

radionuclide 

• Can exchange information 

with appropriate cleared 

and vetted individuals to 

help with investigation
JOINT OPERATIONS

54

Phase Known 

Information

Needed 

Information

Actions

LE Information

Incident 

management

• Specific data 

on the attack

• Sources and 

methods data

• Potential 

suspect(s) in 

custody

• Same as above

• Location of 

victims

• Medical 

assessments

• Laboratory 

information for 

prosecution

• LE will alert PH officials

• Share known information 

to minimize PH risk

Recovery • Same as above • All potential 

suspects

• Ongoing victim 

report, list of 

victims and/or 

casualties, 

patient 

information

• Any information 

on any criminal 

activity, regardless of time frame

•Investigation and 

prosecution
JOINT OPERATIONS

55

► Recommendations to Improve the Information Exchange

As noted above, the LE and PH communities are more willing to exchange 

information once they have confirmed a criminal act. An exchange of available information in the early stages of a RN incident is critical to contain the 

situation (RN material, contamination, evidence, etc.) and effectively apprehend/prosecute the perpetrators. Table 5 (page 51) and Table 6 (page 57) 

provide some guidance on how to obtain and disseminate sensitive information. However, the steps required to obtain the information may cause both 

communities to lose valuable time in their investigations. Some guidance 

is listed below on how individual jurisdictions can improve information 

sharing between LE and PH officials. The recommendations are intended to 

be general so that any jurisdiction can tailor the recommendations based on 

local needs and any legal restrictions on information sharing.

• Establish information exchange group;

• Develop close working relationships between LE and PH officials;

• Include a PH official in the Joint Operations Center;

• Include a LE official in the PH Operations Center;

• Prepare the local emergency response community on the characteristics 

of a RN terrorist attack;

• Preestablish agreements on sensitive and laboratory results information 

sharing; and

• Conduct training/exercises on topics such as chain of custody, joint 

interviews, etc.

PUBLIC INFORMATION RELEASE

The media will have a significant impact on the response and the public 

reaction to a RN incident. As a result, each community should use a single 

representative, identified by each jurisdiction, to coordinate and disseminate 

the response to queries, ensuring that the appropriate information, especially 

sensitive information, is released to the media at the proper time. Table 6 

(page 57) provides general guidance concerning a jurisdiction’s interaction 

with the media.
JOINT OPERATIONS

56

MEDIA ISSUES

LE and PH officials need to develop a working relationship with the media 

to ensure timely and useful information is shared with the media to keep the 

public accurately informed, but not overly alarmed. While not intentional, 

the media may negatively impact the investigation by releasing information that could cause public panic or compromise LE sources. The goal 

of keeping the public accurately informed can be accomplished by issuing 

public announcements. It is paramount that LE and PH officials coordinate 

their media information in accordance with the NIMS. The designated 

spokesperson will help to ensure the accuracy of the information being 

disseminated to the public and should have adequate expertise to respond 

to technical questions specific to either LE or PH issues. The spokesperson 

may also help avoid the release of sensitive information. With the public fear 

and the psychological impact of a RN attack, the media will aggressively seek 

information from the investigators. Establishing a Joint Information Center 

(JIC) will aid both the LE and PH officials in dealing with the media and 

providing timely and accurate information.
JOINT OPERATIONS

57

Table 6. Release of Information to the Media/Public

Phase Information for the Media Who Releases the 

Information

Pre-suspicion of a RN 

incident

NA NA

Upon suspicion of a RN 

incident

• Confirm something 

unusual

• Need to provide rumor 

control

• Prepare to respond to 

inquires

• Do not release any threat 

assessments

• Designate a single point 

of contact for LE and PH 

agencies to coordinate 

information release

• Points of contact work 

together to develop a single 

response to queries

• Develop agreed-upon rules 

of public release

Incident management • Alert media to decontamination procedures 

and other pertinent 

information

• Confirm and announce 

any protective actions

• Provide rumor control

• Use risk/crisis 

communications to 

address the psychological impact of RN 

terrorism

• Same as above

• LE and PH agencies 

coordinate response; 

establishment of a joint 

information center to 

coordinate communications 

with the public; develop 

a joint LE and PH press 

release, if appropriate

 

Recovery • Focus on closure issues

• Media reassurance 

“everything is back to 

normal” if possible

• Emphasis on LE and PH 

actions in support of the 

community

• Focus on the investigation 

and prosecution
JOINT OPERATIONS

58
SUMMARY

59

SUMMARY
SUMMARY

60

This handbook provides recommendations for, and is intended to increase 

the reader’s awareness of issues surrounding the effective coordination of 

LE and PH investigations. Individual jurisdictions should modify this guidance to accommodate their individual needs and the special characteristics 

of their emergency response procedures. The recommendations made in 

this handbook should not be viewed as policy directives from the Federal 

government for immediate implementation.

The primary goal of this handbook is to promote the sharing of information 

and to encourage LE and PH personnel to establish effective information 

exchange procedures to improve their LE and PH investigations. Both 

communities will be better prepared to save lives, avoid panic, and work 

together. This cooperation should lead to improved capabilities to prevent 

a RN attack, minimize the impact of an attack, prevent subsequent attacks, 

and ensure the successful prosecutions and convictions of the perpetrator(s).
APPENDICES

61

APPENDICES
APPENDIX A

62

Appendix A. Applicable Federal WMD Statutes

18 U.S.C. §13 Laws of states adopted for areas within Federal 

jurisdiction

18 U.S.C. § 35 Imparting or conveying false information 

18 U.S.C. § 831 Prohibited transactions involving nuclear materials

18 U.S.C. § 832 Participation in nuclear and weapons of mass 

destruction threats to the United States

18 U.S.C. § 842 Unlawful acts

18 U.S.C. § 844 Penalties

18 U.S.C. § § 872–880 Extortion and threats

18 U.S.C. § 876 Mailing threatening communications

18 U.S.C. § 1038 False information and hoaxes

18 U.S.C. § 1365 Tampering with consumer products

18 U.S.C. § 1366 Destruction of an energy facility

18 U.S.C. § 1992 Terrorist attacks and other violence against railroad 

carriers and against mass transportation systems on 

land, on water, or through the air

18 U.S.C. § 2283 Transportation of explosive, biological, chemical, or 

radioactive or nuclear materials

18 U.S.C. § 2332a Threatened use of a weapon of mass destruction

18 U.S.C. § 2332b Acts of terrorism transcending national boundaries

18 U.S.C. § 2332f Bombings of places of public use, government facilities, 

public transportation systems and infrastructure 

facilities

18 U.S.C. § 2332h Radiological Dispersal Devices

42 U.S.C. § § 2011–2284 Atomic Energy Act

49 U.S.C. § 60123 Criminal penalties
APPENDIX B

63

Appendix B. Understanding Radiation and its Health 

Effects

Ionizing radiation is radiation capable of producing ions when passing 

through matter. Alpha, beta, gamma, and neutron radiation are released 

from a nuclear reaction, such as fission, fusion, and radioactive decay. Alpha 

particles are helium nuclei with a mass of 4 atomic mass units and a +2 

charge. They are emitted in radioactive decay and formed in fusion. Betas 

are charged particles of very small mass which are emitted during decay 

and are identical to electrons moving at high speeds. Electrons carry a –1 

charge, and positrons carry a +1 charge. Gammas, also called “photons,” 

are small packets of energy that have no mass or charge. They are released 

in fission, fusion, radioactive decay, inelastic scatter, and neutron capture. 

Neutrons are atomic particles with no charge and a mass of 1 atomic mass 

unit. They are released from fission and fusion. Alphas and betas are the 

primary health concern internally while gamma and neutrons are for external exposure. Some of the most radiotoxic radionuclides are alpha emitters.
APPENDIX B

64

► How Radiation Interacts with Matter

Alpha particles interact strongly with atomic electrons because of their 

strong positive charge. Because alpha particles interact so strongly with 

atomic electrons, they travel a short range. They move in a straight line, 

deposit all of their energy quickly, and are what is known as a densely 

ionizing radiation.

Unlike the interaction of alpha particles with matter, the path of beta 

particles through matter is not in a straight line. While beta particles may 

penetrate only a short distance into a medium, their mean path length (the 

average distance that a beta particle would travel in a medium if its path 

were straightened out) can be quite long.

Ionizing electromagnetic radiation (gamma and X-rays) interacts with 

orbital atomic electrons through various processes, causing atomic electrons 

to be ejected from their orbits. Like beta particles, if the gamma ray or X-ray 

ejects an atomic electron with enough energy, the atomic electron can cause 

additional ionizations. Neutrons are electrically neutral and interact with 

matter by either collisions with or absorption by an atomic nucleus. 

Collisions with atomic nuclei slow down, or thermalize, a neutron so 

it may undergo nuclear capture.

In nuclear capture, the incident neutron is actually absorbed into the 

nucleus. This event can make the nucleus unstable and, therefore, radioactive. An unstable nucleus will shed its excess energy through radioactive 

decay and will emit particulate radiation and/or gamma rays. Nuclear 

capture is how objects, people, soil, etc., become radioactive after a nuclear 

detonation.

► How Radiation Is Measured

Gamma radiation is measured in roentgens (R), which measure the amount 

of ionization caused in air. One R will cause 2.08 x 109 ion pairs when it 

passes through 1 cm3 of dry air at standard temperature and pressure. Since 

gamma rays have no mass, R is purely a measure of energy. Exposure rates 

are normally expressed in R/hr or mR/hr.
APPENDIX B

65

The rad is used to measure gamma energy absorption. Converting R to 

rad is dependent on the material absorbing the radiation. In tissue near the 

surface of the body, 1 R equals 1 rad. Dose rates are usually expressed in 

rad/hr or mrad/hr.

The rem, an abbreviation of “roentgen equivalent in man,” measures the expected effects of radiation on body and organs. It is convertible to different 

types of radiation, not just gamma. To find the total rem, multiply the rad 

(which measures gamma absorption) by the quality factor for the type 

of radiation involved. The quality factor for beta radiation is 1, the quality 

factor for alpha radiation is 10–20, the quality factor for gamma radiation 

is 1, and the quality factor for neutrons is 4–10. Dose rates are usually 

expressed in rem/hr or mrem/hr. The metric unit is the sievert (Sv). 

Every person on Earth is exposed to ionizing radiation every day. The 

average US resident receives a dose of about 360 mrem per year. The most 

significant contributor to this dose is radon, a gas created by the radioactive 

decay of uranium. Since uranium occurs naturally in the ground and rocks, 

including building materials, radon seeps into buildings, where it concentrates in enclosed spaces and is inhaled.

The exposure rates in the “Radiation Dose” chart (page 66) are for the average person. A person who does not receive a medical X-ray during 

the year does not get that dose. Note that the average person receives less 

than 1 mrem per year from nuclear power production and fallout from 

atmospheric weapons testing.
APPENDIX B

66

The annual radiation dose that each person receives also varies by geographic 

location. For example, the background radiation levels in Denver are higher 

than those at sea level. Being a mile high, Denver has less air between it and 

the sun than does a city at sea level. Although not dense, air still acts as a shield 

from cosmic rays.

► Protecting Yourself from Radiation

The three cardinal rules of radiation protection for external radiation 

exposure (not contamination) from a radiation source are time, distance, 

and shielding.

	 •	 Time — The less time spent near the radiation source, the lower the exposure will be.

	 •	 Distance — The greater the distance from the source, the less the exposure will be. Radiation exposure decreases with distance according to the 

inverse-square law. That is, if you triple your distance from the radiation 

source, your exposure will decrease by a factor of nine.

	 •	 Shielding — External exposure to radiation can be partially blocked by the 

use of shielding. Traditionally, shielding is made of lead or concrete. However, staying behind vehicles, buildings, or other objects will also decrease 

exposure.
APPENDIX B

67

► Effects of Ionizing Radiation on the Body

Ionizing radiation affects the body by damaging or killing parts of the cells. 

Damaged cells are not able to perform their normal functions to keep the 

body alive and healthy. Cells can become so damaged that they are not able 

to reproduce themselves as they normally would, resulting in the death of 

the cell and thus reduced functioning of that tissue or in cancer.

► Biological Effects of Radiation

Radiation has two effects on health, deterministic and stochastic. A deterministic effect is a clinically observable symptom, such as hair loss, nausea, 

or changes in lymphocytes in the blood. The severity of a deterministic effect is directly proportional to the dose received. Time duration from exposure to manifestation of symptoms is inversely proportional to the dose. A 

stochastic effect is a long-term effect that may or may not happen, like 

cancer. The risk of a stochastic effect is proportional to the dose, but the 

severity of the effect is independent of dose received.

Ionizing radiation can cause changes in our cells by breaking the bonds 

that hold molecules together. Ionizing radiation’s principal target is 

deoxy-ribonucleic acid, or DNA. The damage done to DNA can cause 

changes that would either destroy or alter the cell’s growth or function. 

Our cells, however, do have mechanisms to repair the damage inflicted by 

the ionizing radiation. The efficiency of the mechanisms depends on several 

factors, including the type and dose of radiation. The possibility of small 

radiation doses inducing a clinically significant illness or other problem is 

remote.

The cells most sensitive to radiation are found in the lymph tissue, bone 

marrow, spleen, reproductive system, and gastrointestinal tract. Moderately 

sensitive cells are found in the skin, lungs, and liver. The least sensitive 

cells are in the muscles, nerves, and adult bone. Doses of radiation which 

are received in a 24-hour period are referred to as “acute” doses. The same 

amount of radiation received over a long period of time (“chronic” dose) 

would be less damaging to the body due to the body’s ability to repair itself.
APPENDIX B

68

The severity of effects from internal ionizing radiation also depends on the 

radioactive and biological half-lives of the elements and the type and energy 

of radiation emitted when they decay. Elements with a long radioactive halflife continue to emit decay gammas for longer periods of time, extending 

the time during which the body is exposed to radiation. Elements which the 

body cannot easily remove have longer biological half-lives and expose the 

body to ionizing radiation for longer periods. Lastly, those elements which 

emit alphas or high-energy gammas or betas also expose the body to more 

damaging types of radiation.

After entering the body, radionuclides normally found in the body concentrate in areas where their counterparts are normally found. For instance, 

radioiodine concentrates with nonradioactive iodine in the thyroid, contributing to incidents of thyroid cancer. Elements not normally found in the 

body concentrate in areas with similar elements. For instance, radioactive 

barium and strontium are similar to calcium and, like calcium, accumulate 

in the bones, contributing to incidents of leukemia.

	 •	 Deterministic effects. Following acute whole-body dose of ionizing radiation, the body reacts in three stages: initial, latent, and final. 

Clinical expression of the acute radiation syndrome is strongly modified by dose, dose rate, uniformity of exposure, the extent of treatment 

provided, and variations in individual susceptibility. No immediate 

illness is observed in acute doses up to 100 rem. Between 100 and 200 

rem, nausea and vomiting occur within the first day or two. During the 

latent period, which can last up to two weeks, few symptoms are seen, 

but changes in the blood appear. During the final phase, the original 

symptoms may reappear mildly.

 Over 200 rem, the symptoms become increasingly more severe and 

life-threatening. The immune system can be degraded, creating the 

possibility of lethal infections, especially in burn victims. Between 

200 and 1000 rem, the initial phase is marked by nausea, vomiting, 

diarrhea, loss of appetite, and fatigue for one to two days. The latent 

period lasts up to two weeks, during which blood changes occur. 

During the final phase, the initial symptoms recur, accompanied by a 

step increase in temperature and hemorrhaging under the skin and in 
APPENDIX B

69

the mouth, intestines, and kidneys. At doses over 300 rem, the final 

stage also includes hair loss.

 At doses over 1000 rem, the victim suffers almost immediate incapacitation and organ failure. Death occurs in a few hours to a week.

 After recovery, a victim of ionizing radiation may continue to 

experience effects, depending on the type of radiation received, the 

dose received, and the person’s age and gender. One of the first effects 

seen is cataracts. Cataracts appear within a few months to several years 

and are especially prevalent in patients who received more than 200 

rem of radiation. The fast neutrons produced by nuclear explosions 

are particularly effective at causing cataracts.

	 •	 Stochastic effects. Long-term effects of radiation exposure are various 

types of cancer. One common type is leukemia, a cancer of the blood. 

Leukemia can appear in victims 1–20 years after exposure and affects 

children under 10 more often. Other common cancers seen after 

exposure to ionizing radiation are cancers of the thyroid, lung, gastrointestinal tract, and female breast.

	 •	 Prenatal exposure. When pregnant women are exposed to ionizing 

radiation, the children may also suffer effects. The possibility of severe 

health effects depends on the gestational age of the unborn baby at the 

time of exposure and the amount of radiation it is exposed to. Unborn 

babies are less sensitive during some stages of pregnancy than others. 

However, unborn babies are particularly sensitive to radiation 

during their early development, between weeks 2 and 15 of pregnancy. 

The health consequences can be severe, even at radiation doses too 

low to make the mother sick. Such consequences can include stunted 

growth, deformities, abnormal brain function, or cancer that may 

develop sometime later in life. However, since the baby is shielded by 

the mother’s abdomen, it is protected in the womb from radioactive 

sources outside the mother’s body. Consequently, the radiation dose 

to the unborn baby is lower than the dose to the mother for most 

radiation exposure events.

	 •	 Biological effects specific to nuclear explosions. Fallout is activity which is spread over areas by wind. It extends the time people are 

exposed to radiation as well as the area of the country in which people 
APPENDIX B

70

are exposed. Since fallout is airborne, it can cause both internal and 

external effects. Externally, contact with fallout can cause burns to the 

skin due to beta radiation. Symptoms of beta burns include lesions, 

discoloration, and hair loss. Beta burns typically appear on areas of 

the body that are exposed. Normally, alphas and betas do not present 

an external danger to people because they cannot penetrate the outer 

layer of clothing or the external layer of skin. They do, however, pose a 

significant threat when inhaled, ingested, or introduced through open 

wounds. Early fallout drops in the first 24 hours after the detonation 

and poses a biological hazard. Delayed fallout drops after the first 24 

hours. While the biological hazard is reduced as time passes due to the 

continued decay of fission products, uranium, plutonium, and activated 

elements in the environment, a long-term health risk still exists. The 

risk to health and the possibility of shifting winds can make evacuation 

of an area very difficult. 

► Materials Used to Shield from Ionizing Radiation

People can be shielded from ionizing radiation by various materials. The 

most effective shield depends on the type and energy of the radiation. Due 

to their strong interactions with atomic electrons, alpha particles can be 

stopped by a piece of paper. On the other hand, a thicker or denser material 

such as aluminum is needed to stop beta particles.

Gamma rays and X-rays 

are even more difficult 

to shield against. A 

material with a large 

number of protons per 

atom (and thus a large 

number of electrons) 

is needed to limit the 

number of gamma and 

X-rays that penetrate 

the shield. Such materials are called “high 
APPENDIX B

71

Z” materials, and a good example is lead. No matter how thick or dense a 

gamma- or X-ray shield is, some of the photons will get through.

Neutron shielding is a more complicated task due to the process of nuclear 

capture. To be effective, the shielding material must be able to slow down 

the neutrons. The best elements for this are “low Z” elements such as hydrogen.

In a practical situation, a 12-inch concrete wall placed between a person and 

the detonation will attenuate approximately 90% of fission product gammas 

and fast neutrons coming straight from the detonation toward the person. 

However, the actual dose received will be higher due to the refraction of 

radiation through the air that allows radiation to reach the person around 

the edges and top of the wall.

► Contamination

Contamination is radioactive material that has deposited on surfaces. 

Contamination can be internalized through inhalation, ingestion, or open 

wounds. Because the particles can be atom-sized, contamination is not 

visible in all cases and must be detected using radiation detectors.

► Decontamination Is Important

Decontamination is important because it prevents the spread of contamination. When contamination is removed from people, the total dose received 

is minimized, the possibility of inhalation and ingestion is reduced, and the 

possibility that others will be exposed is reduced. Decontaminating equipment limits activation of the equipment and reduces the possibility that 

others will be exposed.

► Priorities for Decontamination

Lifesaving efforts always take priority over preventing the spread of 

contamination. Do not delay urgent medical care or emergency responders 

for decontamination or donning protective equipment. Also, do not delay 

evacuation from high or potentially high exposure rate areas.
APPENDIX B

72

► Personnel Decontamination

Following emergency response to a nuclear event, a warm area—adjacent to 

and upwind of the hot area—should be established. The warm area should 

be far enough from high exposure rate areas that people waiting on the edge 

of the hot area are not exposed to high exposure rates. Decontamination 

lines should be established for emergencies, responders, and mass casualty 

decontamination. The number and use of these lines can vary with each 

incident and the stage of emergency response. The basic process in each 

line will be to remove the outer layer of clothing, walk through a shower, be 

checked for contamination, redress in uncontaminated clothing, and exit to 

the cool area. For responders dressed in protective equipment, the process 

may include only removal of protective clothing and disposing of or decontaminating equipment such as boots, gloves, and breathing equipment by 

wiping, rinsing, or scrubbing.

The shower area can be set up using fire hydrants or fire hoses set on lowpressure fan spray. If possible, the shower area should be curtained to 

provide separate lines for men and women. The water should drain back 

into the hot area, not forward into the cool area. People do not need to be 

completely free of contamination to exit to the cool area. They need only to 

meet the prescribed limits. Decontaminating the injured requires special 

precautions depending on the type of injury to avoid worsening the injury or 

flushing contamination into the wound. Those with life-threatening injuries 

do not need to be decontaminated!

Once cleared to exit the warm area, people will enter the cool area to be 

triaged and staged for evacuation. A monitoring and decontamination area 

may also be established at evacuation sites and hospitals to recheck for 

contamination.

CDC’s intervention plan is outlined in the document entitled Population 

Monitoring in Radiation Emergencies: A Guide for State and Local Health 

Planners, which can be downloaded at http://emergency.cdc.gov/radiation/

pdf/population-monitoring-guide.pdf.
APPENDIX C

73

Appendix C. Effects of a Nuclear Detonation

► Overview

There are three principal categories of primary effects resulting from a 

nuclear detonation: thermal radiation (35% of the energy from a nuclear 

detonation), blast energy (50%), and nuclear radiation (15%). Nuclear 

weapons effects vary significantly with the yield of the weapon detonated 

and the detonation’s height of burst.

► Thermal Radiation

Thermal radiation occurs when the fireball emits intense electromagnetic 

radiation as a result of its very high temperature and burns objects in the 

surrounding area. Temperatures associated with a nuclear explosion are 

similar to the interior temperature of the sun, approximately tens of millions 

of degrees Fahrenheit. The fireball can cause damage to eyes for many miles, 

and combustible materials can burst into flame, creating firestorms.

Nuclear weapons detonated in the atmosphere emit thermal radiation in two 

distinct pulses. The first pulse emits mostly X-ray and ultraviolet radiation 

and very little energy of the visible thermal type. The second pulse emits 

mostly visible light and infrared radiation and has much more energy than 

the first pulse. This energy, which extends great distances, is responsible for 

most of the thermal damage of military significance. The total amount of 

thermal energy is directly proportional to the yield.

The thermal pulses 

can ignite wood-frame 

buildings and other 

combustible materials. 

Anything that casts a 

shadow, such as buildings, trees, and dust 

from the blast wave, 

will protect objects 

within its shadow from 
APPENDIX C

74

burns or ignition. Any solid or opaque material between a given object 

and the fireball will act as a shield and provide some protection. Transparent materials, such as glass or plastic, attenuate thermal radiation only 

slightly.

► Flash Burns

Flash burns result from absorbing high intensities of 

thermal radiation and are most severe close to the 

explosion. Flame burns are caused indirectly by the 

thermal energy emitted from fires. Exposed people at 

great distances from the burst can be burned. Thirddegree burns over 25% of the body or second-degree 

burns over 30% of the body cause serious shock and are 

usually fatal unless immediate medical care is received.

► Flash Blindness

Looking in the direction of a nuclear detonation can result in flash blindness, which is caused by the effect on the retina of the initial brilliant flash of 

light produced by the explosion; temporary retinal burns may result. Flash 

blindness may occur even if the fireball is not in direct view. A one megaton nuclear detonation could cause flash blindness up to 11 miles away on a 

clear day and up to 45 miles away on a clear evening. Because pupils dilate 

at night, the effect of flash blindness is prolonged by as much as three times. 

Depending on the yield of the detonation, sufficient direct thermal radiation can result in permanent burns to the retina. Damage to the eyes can 

occur farther from the burst site than damage to the skin. Reflex actions 
APPENDIX C

75

to protect the eyes, such as blinking, provide only limited protection. After 

viewing a nuclear detonation, a person will continue to see the afterimage of 

the fireball. This will not affect the central vision unless the individual was 

situated at or near the fireball. The afterimage may last from several seconds 

to several minutes. A transient dazzling effect will occur for two – three 

seconds as the individual’s field of vision resets.

► Blast Energy

Blast energy is produced by X-rays heating the air surrounding the fireball; 

an enormous amount of energy is released in a small volume of air, producing intensely hot gases at extremely high pressures. The result is a shock 

wave (blast wave) that 

continues outward 

from the explosion, 

crushing and moving 

objects in the surrounding area. 

Blast effects depend on 

overpressure, measured in pounds per 

square inch (psi). The 

magnitude of the blast 

depends on the yield 

of the weapon, height of the burst, and distance from ground zero. Blast 

injuries and fatalities generally result from the indirect effects resulting from 

overpressure (i.e., injuries/ fatalities result when objects become missiles 

during motion caused by winds generated by the overpressure).

► Overpressure

Shock waves produce overpressure large enough to destroy virtually any 

structure. Overpressure is the difference between the pressure in the shock 

wave front and the atmospheric pressure, measured in psi. An overpressure 

of five psi is sufficient to destroy normal residential buildings and cause a 

50% casualty rate. If the overpressure is five psi or greater; the wind velocity 
APPENDIX C

76

will be more than 150 miles per hour. The duration of the blast wave’s overpressure and dynamic pressure may last from tenths of a second to seconds, 

depending on the yield and the distance from the burst.

► Initial Radiation

Initial radiation is radiation that arrives within the first 60 seconds after 

a nuclear detonation, generally consisting of gamma rays and neutrons, 

but can include alpha and beta particles and X-rays. In general, the larger 

the weapon’s yield, 

the larger the dose 

of initial radiation. 

Alpha particles have an 

extremely limited range 

in the air, have little 

ability to penetrate the 

skin, and are of little 

significance unless they 

are inhaled or ingested. 

Beta particles are much 

less penetrating than 

gamma rays but can 

be extremely harmful if a beta-emitting substance is ingested or deposited 

on the skin. X-rays are rapidly attenuated in the air, but their effects do 

not dominate in the lower regions of the atmosphere. On the other hand, 

neutrons and gamma rays have a long range in the air, are highly penetrating, and are the main cause of casualties. Three percent of the total energy 

generated from a nuclear explosion is initial radiation. Gamma radiation is 

the most difficult to shield and is the major radiation dosage received from 

radioactive fallout.

Although the US no longer has neutron bombs in its arsenal, neutron bomb 

effects are unique. To reduce the safety distance for populated areas, designers produced the enhanced radiation weapon (the neutron bomb). This 

weapon produces less of its energy as blast and heat and more as nuclear 
APPENDIX C

77

radiation. On target, that radiation consists of a higher proportion of neutrons and gamma rays of higher energy than would be received from fission 

devices of comparable yields.

► Residual Radiation

Residual nuclear radiation is defined as radiation that is emitted later than 

one minute after the explosion. It consists chiefly of beta particles and 

gamma rays. The radiation is emitted mainly by fission products and other 

bomb residue in the fallout, and it persists for some time following a nuclear 

explosion. Early fallout occurs within the first 24 hours; delayed fallout 

occurs days to years following a nuclear explosion. Fallout patterns vary 

with terrain, wind speed, and direction. Residual gamma radiation, neutron, 

and beta effects are similar to those defined in the previous section.

► Electromagnetic Pulse

Electromagnetic pulse (EMP) is a sharp pulse of long-wavelength electromagnetic radiation produced when an explosion occurs in a nonsymmetrical environment, especially at or near the earth’s surface or at high altitudes. 

EMP occurs when gamma radiation collides with atoms or objects in the air. 

The intense electric and magnetic fields can damage unprotected electrical 

and electronic equipment (i.e., communication systems, radar) over a large 

area.

► Transient Radiation Effects on Electronics

Transient radiation effects on electronics (TREE) can be temporary or permanent, depending on the type of component, its construction, the materials used, the operating state, the type of radiation, and total dose (rad) or 

the dose rate (rad/sec). TREE can vary widely, even among similar devices. 

Examples include degradation in the current amplification of transistors, 

temporary or permanent altering of vacuum or gas-filled tubes, and changes 

in capacitance and resistance. Radiation can cause a current in cables that 

were not exposed to a voltage. The insulation around cables and wires can 
APPENDIX C

78

also be damaged but usually recovers well. As a result, electrical service may 

be restored even after some physical damage to the area. Batteries, including 

nickel-cadmium and mercury, can withstand high levels of radiation with 

very few adverse affects.

► Ground Shock and Cratering

Ground shock is produced by two primary mechanisms: directly coupling 

energy to the ground in the area of the crater and pressure from the air blast 

as it travels over the surface. Ground shock is transmitted through the earth 

downward and outward. The air blast pressure at the surface, an airslap, 

damages surface structures and also causes a shock wave that is transmitted 

beneath the surface, creating most of the stress experienced by underground 

structures outside the crater area.

Explosions on or near the ground surface create displacement craters when 

soil is vaporized, displaced, or compressed. The effect varies with yield and 

the depth of the burst. Soil is vaporized and carried up into the fireball and 

eventually appears as fallout. Considerable material is displaced, or thrown 

out, by the air blast. Some of this material falls back into the crater, and 

most of the remainder forms the lip of the crater. The huge pressures from 

the detonation also compresses the soil.

► Blackout

Electromagnetic interference and complete disruption of short-wave and 

high-frequency radio frequency signals (radio, cell phones, and radar transmissions) are caused by an ionized region of the atmosphere (produced by a 

high-altitude nuclear detonation). Blackout can significantly affect military 

wartime operations or first responder operations after a nuclear detonation 

in a populated area during peacetime. Blackout can last for several hours, 

depending on the nuclear yield and height of burst of a nuclear weapon 

detonation.
APPENDIX D

79

Appendix D. Transportation of Radiological/Nuclear 

Materials

The transportation of nuclear materials is highly regulated. More than three 

million packages of radioactive material are shipped in the US each year, 

posing an environmental threat. Radioactive material is transported by 

highway, rail, air, and sea. During the past 40 years, more than 3000 shipments of used nuclear fuel have navigated more than 1.7 million miles of US 

roads and railways without any accidental release.

NRC and the Department of Transportation (DOT) are the primary 

Federal agencies that regulate the transportation of nuclear materials. NRC 

regulates users of radioactive material and the design, construction, use, and 

maintenance of shipping packages by establishing regulatory requirements, 

transportation package certification, inspections, and a system of monitoring to ensure that safety requirements are met. Additionally, NRC regulates 

the use of special nuclear material (SNM), which can be used in the production of nuclear weapons, through licensing and oversight of licensee operations. DOT regulates shippers and carriers of radioactive material and the 

conditions of transport. Regulated materials include SNM, source material, 

and by-product materials. Regulated activities include medical, industrial, 

and academic uses of nuclear materials, fuel cycle facilities, source material 

facilities, materials decommissioning, and materials transportation.

Nuclear waste is transported by land, rail, air, and sea. During the transportation process, global satellites monitor all materials, minimizing the 

likelihood of theft or disaster. The public transportation routes must meet 

strict safety requirements before the transporation of nuclear material is 

permitted. Nuclear material is transported in casks approximately 15 times 

thicker than a gasoline truck shell, with a three-inch-thick, stainless steel 

radiation shield. Typically, for every ton of fuel, more than three tons of 

protective packaging and shielding is provided. The casks must pass a series 

of four tests before they are certified to carry nuclear waste: the ability to 
APPENDIX D

80

withstand high-speed crashes, fire, water immersion and puncture. Current 

trends in the transportation process include reduction in the pool of available commercial carriers, routing restrictions, package validation issues, and 

political sensitivities. All of these trends will help to increase security and 

decrease the potential for disaster.
APPENDIX E

81

Appendix E. Indicators of Radiological Incidents

The table below illustrates indicators of potential and imminent radiological 

incidents.

Potential Incidents

Indicator Discussion

Reported loss/theft of 

commercial or medical 

sources in the area

In the US and most developed countries, the 

loss or theft of a significant source is a major 

event and is included in most threat reports. 

This is not the case in less developed countries.

Reports of impending transportation of 

significant quantities of 

radioactive materials

Radioactive materials are routinely and safely 

transported in most industrialized countries 

for medical and industrial uses. In general, 

the amounts shipped are limited and do not 

post a significant threat. This is not the case 

for the movement of spent fuel rods, special 

nuclear materials, and large sources used 

for radiation therapy, instrument calibration, 

and blood irradiation or sterilization (food and 

other products). These products are particularly 

vulnerable to theft during transportation.

Suspected illegal 

purchase or transfer of 

radiological materials or 

sources

The illegal purchase and transfer of radioactive 

materials is a clear warning of malicious intent. 

In developed countries, these acts are difficult 

and readily identified because of the controls 

in place. This is not the case in less developed 

countries.

Intelligence indicating a 

heightened potential for 

attack

Close coordination with intelligence gathering and information sharing organizations is 

required.
APPENDIX E

82

Imminent Incidents

Indicator Discussion

Reported spent, broken, or 

used cartridges or containers of commercial sources 

outside of normal commercial 

use areas

Radioactive materials are transported or stored 

in a manner that readily identifies the presence of 

radioactive materials. Containers for significant sources 

are particularly well marked, and there are clear 

guidelines for the disposal of containers. Finding these 

containers has more significance if coupled with reports 

of stolen sources. 

Unexplained personnel or 

vehicle portal radiation 

detector readings (e.g. border 

crossings, airports, ports, 

ships boarded by Coast Guard 

units)

The DHS has installed monitors to detect illicit use of 

radioactive materials. These are the best methods to detect the presence of illicit radioactive materials because 

they are specifically designed for this purpose. 

Unusual readings for other 

radiation monitoring devices 

(For some radioisotopes of 

interest, the external dose 

rate can be very low because 

they are alpha or pure beta 

emitters. Perpetrators may 

shield sources to reduce the 

potential for identification.)

Multiple businesses and locations use radiation 

monitors as a routine part of operations. Examples 

include nuclear reactors, facilities using radioactive 

materials or radiation-producing devices, radioactive 

waste disposal facilities, and normal waste disposal 

facilities, which are designed to prevent the illegal 

disposal of radioactive materials.

Positive results from 

environmental monitoring of 

water, soil, food, or air

Many organizations, including military installations, 

routinely monitor air, water, and soil for radioactive materials. Unusual or unexplained readings could indicate 

that a RDD incident is about to occur.

Unusual radiation readings 

for radiation detectors

Many organizations require personnel to wear radiation 

dosimeters or use radiation detection instrumentation. Unusual readings include those above normal 

background levels, apparently coming from a specific 

location not known to have radioactive materials (some 

materials like granite, some brick, and ceramic glazes 

have higher levels of radioactive material), or on a person who has not had a nuclear medicine procedure.
APPENDIX E

83

Imminent Incidents (continued)

Indicator Discussion

Responder radiation meters 

detect increasing dose rates 

as the area/package is 

approached

This is a clear indication of the presence of radioactive 

material.

Unexplained thermal burns 

reported by medical facilities

This is one of the most common ways that the presence 

of lost or stolen high-activity radioactive material is 

identified. The usual scenario is that the person picks 

up a lost or illegally discarded source and places it 

in a pocket. Radiation burns have a specific clinical 

presentation that distinguishes them from thermal or 

chemical burns. The burns are usually accompanied by 

acute radiation sickness (ARS) symptoms. 

Clinical recognition and 

diagnosis of acute radiation 

sickness (ARS)

While ARS symptoms are well defined, multiple other 

illnesses have similar symptoms. ARS is likely if 

multiple victims present with the same illnesses, or 

with other signs and symptoms like radiation burns. 

Some radioisotopes - including plutonium-239, 

uranium-235, depleted uranium, and natural uranium 

- cannot include ARS because the external dose rate 

is so low.

Bomb found near nuclear or 

radiological facility

This is a clear indication that a radiological event 

is about to occur. If the bomb is placed outside the 

radiation area, no special precautions are required 

to defuse and dispose of the bomb. If it is inside the 

radiation area, personnel at the site can advise on any 

precautions required.

Fixed nuclear or radiological 

facility perimeter radiation 

alarm

This is a definite indication that an event has occurred 

that may or may not have originated at the facility. The 

outside world learned of the Chernobyl reactor accident 

because of alarming detectors at a Swedish nuclear 

power plant.

Suspicious package with 

radiological placards and 

labels

Any package with a radiation warning symbol needs to 

be radiologically assessed for the presence of gamma, 

beta, or alpha emitters or contamination.
APPENDIX E

84

The table below illustrates radioactive sources that could be potentially used 

in a WMD attack. 

Radioisotopes of Concern Uses

Americium-241 Calibration sources

Americium-241/Berylium Well logging, research test reactor start up, 

static eliminators, portable gauges

Californium-252 Fixed industrial gauges, well logging, medical, 

portable gauges

Curium-244 Teletherapy

Cobalt-60 Irradiators, medical, calibration, radiography, 

gauges, well logging

Cesium-137 Irradiators, teletherapy, calibration, radiography, 

gauges, well logging, medical

Iridium-192 Radiography, medical

Plutonium-238 Gauges, medical

Plutonium-238/Beryllium Calibration, medical

Radium-226 Well logging, medical, gauges

Selenium-75 Radiography

Strontium-90 Calibration, medical

Thulium-170 Radiography

Ytterbium-169 Radiography
APPENDIX F

85

Appendix F. Radiological/Nuclear Forensics and Attribution 

Following a Domestic RN Incident

In the context of RN materials, forensic processes might be divided into two 

broad categories. One category deals with the thorough analysis and characterization of the RN materials, the devices employing these materials, the 

debris resulting from detonation of a RN device, and the prompt effects from 

a nuclear detonation. The US government refers to this category as TNF. 

A second category of forensic processes deals with the conventional forensic 

examinations performed on evidence known to be or suspected of being 

contaminated with radioactivity. This category includes the traditional 

forensic disciplines, such as DNA, explosives, fibers, hairs, latent fingerprints, and questioned documents.

Both categories of forensic processes require specialized infrastructure, 

facilities, and expertise, some of which reside outside LE current capabilities. 

Furthermore, both processes are relatively new. For instance, TNF draws 

on US Government experience gained during the nuclear weapon program, 

where the analysis and characterization requirements often dealt with issues 

related to weapon design but where the provenance of a weapon was well 

known. Often times this experience supported requirements of the intelligence community. Therefore, LE requirements regarding chain of custody, 

admissibility of methods, and defensibility of results may be novel or may 

be incompatible with intelligence community needs to protect sources and 

methods. Consequently, TNF success may require the development of new 

procedures that meet the needs of LE without jeopardizing the interests of 

the intelligence community.

TNF is expected to prove vital to answering such questions as the following: 

Did the RN incident involve a RDD or a nuclear device (that is, one in which 

a nuclear yield occurs)? If a nuclear device was involved, was the nuclear 

fuel uranium or plutonium? If a nuclear detonation occurred, did it result 

from a device that had been boosted? The answers to these questions aid in 

estimating the level of sophistication and state support required in assem-
APPENDIX F

86

bling the device and in carrying out the RN incident. TNF may also reveal 

characteristics that identify the likely origin of the RN material or that allow 

certain nations or places to be excluded as potential suppliers. For example, 

TNF conducted on a recovered radioactive material may have the presence 

of certain trace-level impurities that are known to be uniquely associated 

with a geographical location, with a production or processing method, or 

with a nation state.

Similarly, conducting conventional forensic examinations on RN-contaminated evidence requires that protocols be revised to ensure they are compatible with the appropriate infrastructure and facilities. Once protocols are 

revised, they must be validated, and the laboratory examiners must document their competencies in using these revised protocols. Efforts have been 

underway since 2003 to ensure that LE can perform these conventional 

forensic exams and have a cadre of competent and qualified examiners 

and technicians to carry out these exams. The FBI’s Hazardous Evidence 

Analysis Teams (HEAT) are a notable example of this effort. HEAT personnel are certified forensic examiners from the FBI Laboratory who have 

received additional training to perform their respective forensic specialties 

in infrastructure required when working with CBRN materials. The results 

of such conventional forensic examinations are expected to aid in identifying individuals and tradecraft involved in RN incidents and in establishing 

investigative leads regarding suspect individuals and groups. These results 

are also likely to aid in eliminating prospective suspects.

In the aftermath of any domestic RN incident, the LE and intelligence 

communities will engage to aid in determining whether additional 

incidents are imminent, likely, or planned. They will also participate in 

efforts at attribution, in which responsibility is assigned to the nation states, 

nonstate groups, or individuals responsible for the RN incident. Both TNF 

and conventional forensics on RN-contaminated evidence will support the 

process of attribution; however, forensics alone will be insufficient to permit 

attribution. Results from forensics will need to be combined with both other 

investigative information and intelligence reporting to enable responsibility 

to be assigned to the RN incident.
APPENDIX E

87

APPENDIX G

Appendix G. Acronyms

AG Attorney General

CBRNSU Chemical Biological Radiological and Nuclear Sciences Unit

CDC Centers for Disease Control and Prevention

CPS Countermeasures and Preparedness Section

DHS Department of Homeland Security

DoD Department of Defense

DOE Department of Energy

DOJ Department of Justice

DOT Department of Transportation

DNA deoxy-ribonucleic acid

EMP electromagnetic pulse

E.O. Executive Order

EPA Environmental Protection Agency

ERT Evidence Response Team

FBI Federal Bureau of Investigation

FDA Food and Drug Administration

HEAT Hazardous Evidence Analysis Team

HIPAA Health Insurance Portability and Accountability Act

HHS Department of Health and Human Services

HMOU Hazardous Materials Operations Unit

HMRTU Hazardous Materials Response Team Unit

HMSRU Hazardous Materials Science Response Unit

HQ Headquarters

HSPD Homeland Security Presidential Directive
APPENDIX G

88

IND improvised nuclear device

IOS Investigations and Operations Section

JTTF Joint Terrorism Task Force

LD lethal dose

LE law enforcement

NASA National Aeronautics and Space Administration

NIMS National Incident Management System

NRC Nuclear Regulatory Commission

NRF National Response Framework

NRIA Nuclear/Radiological Incident Annex

PH public health

RDD radiological dispersal device

RED radiological exposure device

RN radiological/nuclear

SNM special nuclear material

TCE Threat Credibility Evaluation

TNF technical nuclear forensics

TREE transient radiation effects on electronics

U.S.C. U.S. Code

USCG U.S. Coast Guard

WMD Weapons of Mass Destruction
APPENDIX H

89

Appendix H. Glossary

Provided is an abbreviated version of the glossary that can be found in its 

entirety at http://emergency.cdc.gov/radiation/glossary.asp.

activity (radioactivity): the rate of decay of radioactive material expressed 

as the number of atoms breaking down per second measured in units called 

becquerels or curies.

acute radiation syndrome (ARS): a serious illness caused by receiving a 

dose greater than 75 rads of penetrating radiation to the body in a short time 

(usually minutes). The earliest symptoms are nausea, fatigue, vomiting, and 

diarrhea. Hair loss, bleeding, swelling of the mouth and throat, and general 

loss of energy may follow. If the exposure has been approximately 1,000 rads 

or more, death may occur within two – four weeks. For more information, 

see CDC’s fact sheet “Acute Radiation Syndrome” at http://emergency.cdc.

gov/radiation/ars.asp.

air burst: a nuclear weapon explosion that is high enough in the air to keep 

the fireball from touching the ground. Because the fireball does not reach 

the ground and does not pick up any surface material, the radioactivity in 

the fallout from an air burst is relatively insignificant compared with a surface burst. For more information, see Chapter Two of CDC’s Fallout Report 

at http://www.cdc.gov/nceh/radiation/fallout/.

alpha particle: the nucleus of a helium atom, made up of two neutrons 

and two protons with a charge of +2. Certain radioactive nuclei emit alpha 

particles. Alpha particles generally carry more energy than gamma or beta 

particles and deposit that energy very quickly while passing through tissue. 

Alpha particles can be stopped by a thin layer of light material, such as a 

sheet of paper, and cannot penetrate the outer, dead layer of skin. Therefore, 

they do not damage living tissue when outside the body. When alphaemitting atoms are inhaled or swallowed, however, they are especially 

damaging because they transfer relatively large amounts of ionizing energy 

to living cells. See also beta particle, gamma ray, neutron, X-ray.
APPENDIX H

90

americium (Am): a silvery metal, man-made element whose isotopes Am237 through Am-246 are radioactive. Am-241 is formed spontaneously by 

the beta decay of plutonium-241. Trace quantities of americium are widely 

used in smoke detectors and as neutron sources in neutron moisture gauges.

atom: the smallest particle of an element that can enter into a chemical 

reaction.

background radiation: ionizing radiation from natural sources, such as 

terrestrial radiation due to radionuclides in the soil or cosmic radiation 

originating in outer space.

beta particles: electrons ejected from the nucleus of a decaying atom. 

Although they can be stopped by a thin sheet of aluminum, beta particles 

can penetrate the dead skin layer, potentially causing burns. They can pose 

a serious direct or external radiation threat and can be lethal depending on 

the amount received. They also pose a serious internal radiation threat if 

beta-emitting atoms are ingested or inhaled. See also alpha particle, gamma 

ray, neutron, X-ray.

cesium (Cs): one of the radioactive fission products created within a nuclear 

reactor during its operation. Cesium is a silvery-white, ductile material that 

has industrial uses in photoelectric cells as a radioisotope for encapsulated 

energy sources. Cs-137 is radioactive for a long period of time and can 

contaminate property, entailing extensive cleanup. It can also be absorbed 

into the food chain and is a potential cancer-causing agent. Cs-137 is used 

in industry for measuring the thickness or density of materials and for 

gamma-radiography.

chronic exposure: exposure to a substance over a long period of time, 

possibly resulting in adverse health effects. See also acute exposure.
APPENDIX H

91

cobalt (Co): a gray, hard, magnetic, and somewhat malleable metal. Cobalt 

is relatively rare and generally obtained as a by-product of other metals, such 

as copper. Its most common radioisotope, cobalt-60, is used in radiography 

and medical applications. Cobalt-60 emits beta particles and gamma rays 

during radioactive decay.

contamination (radioactive): the deposition of unwanted radioactive 

material on the surfaces of structures, areas, objects, or people, where it may 

be external or internal. See also decontamination.

decay, radioactive: disintegration of the nucleus of an unstable atom by the 

release of radiation.

decontamination: the reduction or removal of radioactive contamination 

from a structure, object, or person.

dose (radiation): radiation absorbed by a person’s body. Several different 

terms describe radiation dose.

dose equivalent: a quantity used in radiation protection to place all 

radiation on a common scale for calculating tissue damage. Dose equivalent 

is the absorbed dose in grays times the quality factor. The quality factor 

accounts for differences in radiation effects caused by different types of ionizing radiation. Some radiation, including alpha particles, causes a greater 

amount of damage per unit of absorbed dose than other radiation. The 

sievert (Sv) is the unit used to measure dose equivalent.

dose rate: the radiation dose delivered per unit of time.

dose reconstruction: a scientific study that estimates doses to people from 

releases of radioactivity or other pollutants. The dose is reconstructed by 

determining the amount of material released, the way people came in 

contact with it, and the amount they absorbed.
APPENDIX H

92

dosimeter: a small portable instrument (such as a film badge, thermoluminescent dosimeter, or pocket dosimeter) for measuring and recording the 

total accumulated dose of ionizing radiation a person receives.

dosimetry: assessment (by measurement or calculation) of radiation dose.

electron: an elementary particle with a negative electrical charge and a 

mass 1/1837 that of the proton. Electrons surround the nucleus of an atom 

because of the attraction between their negative charge and the positive 

charge of the nucleus. A stable atom will have as many electrons as it has 

protons. The number of electrons that orbit an atom determine its chemical 

properties. See also neutron.

element: all isotopes of an atom that contain the same number of protons. 

For example, the element uranium has 92 protons, and the different isotopes 

of this element may contain 134–148 neutrons.

exposure (radiation): a measure of ionization in air caused by X-rays or 

gamma rays only. The unit of exposure most often used is the roentgen. 

See also contamination.

exposure pathway: a route by which a radionuclide or other toxic material can enter the body. The main exposure routes are inhalation, ingestion, 

absorption through the skin, and entry through a cut or wound in the skin.

exposure rate: a measure of the ionization produced in air by X-rays or 

gamma rays per unit of time (frequently expressed in roentgens per hour).

external exposure: exposure to radiation outside of the body.

fallout, nuclear: minute particles of radioactive debris that descend slowly 

from the atmosphere after a nuclear explosion. For more information, see 

Chapter 2 of CDC’s Fallout Report at http://www.cdc.gov/nceh/radiation/

fallout/.
APPENDIX H

93

fissile material: any material in which neutrons can cause a fission 

reaction. The three primary fissile materials are uranium-233, uranium-235, 

and plutonium-239.

fission (fissioning): the splitting of a nucleus into at least two other nuclei 

that releases a large amount of energy. Two or three neutrons are usually 

released during this transformation. See also fusion.

fusion: a reaction in which at least one heavier, more stable nucleus is 

produced from two lighter, less stable nuclei. Reactions of this type are 

responsible for the release of energy in stars or in thermonuclear weapons.

gamma rays: high-energy electromagnetic radiation emitted by certain 

radionuclides when their nuclei transition from a higher to a lower energy 

state. These rays have high energy and a short wavelength. All gamma rays 

emitted from a given isotope have the same energy, a characteristic that 

enables scientists to identify which gamma emitters are present in a sample. 

Gamma rays penetrate tissue farther than do beta or alpha particles, but 

leave a lower concentration of ions in their path to potentially cause cell 

damage. Gamma rays are very similar to X-rays. See also neutron.

gray (Gy): a unit of measurement for absorbed dose. It measures the 

amount of energy absorbed in a material. The unit Gy can be used for any 

type of radiation, but it does not describe the biological effects of the different radiations.

half-life: the time any substance takes to decay by half of its original 

amount. See also radioactive half-life.

ingestion: in the case of radionuclides or chemicals, swallowing by eating 

or drinking.

inhalation: in the case of radionuclides or chemicals, breathing in 

radionuclides or chemicals.
APPENDIX H

94

internal exposure: exposure to radioactive material taken into the body.

iodine: a nonmetallic solid element. There are both radioactive and nonradioactive isotopes of iodine. Radioactive isotopes of iodine are widely 

used in medical applications. Radioactive iodine is a fission product and 

is the largest contributor to people’s radiation dose after an accident at a 

nuclear reactor.

ionizing radiation: any radiation capable of displacing electrons from 

atoms, thereby producing ions. High doses of ionizing radiation may 

produce severe skin or tissue damage.

isotope: a nuclide of an element having the same number of protons but a 

different number of neutrons.

latent period: the time between exposure to a toxic material and the 

appearance of a resultant health effect.

lethal dose (50/30): the dose of radiation expected to cause death within 30 

days to 50% of those exposed without medical treatment. Typically, the LD 

50/30 is in the range from 400 to 450 rem (4 to 5 sieverts) received over a 

very short period.

neutron: a small atomic particle possessing no electrical charge typically 

found within an atom’s nucleus. Neutrons are, as the name implies, neutral 

in their charge. That is, they have neither a positive nor a negative charge. 

A neutron has about the same mass as a proton. See also alpha particle, beta 

particle, gamma ray, and X-ray.

nucleus: the central part of an atom that contains protons and neutrons. 

The nucleus is the heaviest part of the atom.

nuclide: a general term applicable to all atomic forms of an element. 

Nuclides are characterized by the number of protons and neutrons in the 
APPENDIX H

95

nucleus, as well as by the amount of energy contained within the atom.

photon: a discrete “packet” of pure electromagnetic energy. Photons have 

no mass and travel at the speed of light. The term “photon” was developed 

to describe energy when it acts like a particle (causing interactions at the 

molecular or atomic level), rather than a wave. Gamma rays and X-rays are 

photons.

plutonium (Pu): a heavy, man-made, radioactive metallic element. The 

most important isotope is Pu-239, which has a half-life of 24,000 years. Pu239 can be used in reactor fuel and is the primary isotope in weapons. One 

kilogram is equivalent to about 22 million kilowatt-hours of heat energy. 

The complete detonation of a kilogram of plutonium produces an explosion 

equal to about 20,000 tons of chemical explosive. All isotopes of plutonium 

are readily absorbed by the bones and can be lethal depending on the dose 

and exposure time.

proton: a small atomic particle, typically found within an atom’s nucleus, 

that possesses a positive electrical charge. Even though protons and neutrons are about 2000 times heavier than electrons, they are tiny. The number 

of protons is unique for each chemical element.

quality factor (Q): the factor by which the absorbed dose (rad or gray) is 

multiplied to obtain a quantity that expresses, on a common scale for all 

ionizing radiation, the biological damage (rem) to an exposed person. It 

is used because some types of radiation, such as alpha particles, are more 

biologically damaging internally than other types

rad (radiation absorbed dose): a basic unit of absorbed radiation dose. It 

is a measure of the amount of energy absorbed by the body. The rad is the 

traditional unit of absorbed dose. It is being replaced by the unit gray (Gy), 

which is equivalent to 100 rad. One rad equals the dose delivered to an 

object of 100 ergs of energy per gram of material.
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radiation: energy moving in the form of particles or waves. Familiar 

radiations are heat, light, radio waves, and microwaves. Ionizing radiation 

is a very high-energy form of electromagnetic radiation.

radiation sickness: See also acute radiation syndrome (ARS) or the CDC 

fact sheet “Acute Radiation Syndrome,” at http://emergency.cdc.gov/

radiation/ars.asp.

radiation units: In the international system of units, the activity of a radioactive source is measured in becquerels (symbol Bq), where one becquerel 

is equal to one nuclear disintegration per second (an older unit is the curie). 

The exposure is measured in coulombs per kilogram (C kg-1); the amount 

of ionizing radiation (X-rays or gamma rays) that produces one coulomb of 

charge in one kilogram of dry air (replacing the roentgen). The absorbed 

dose of ionizing radiation is measured in grays (symbol Gy), where one gray 

is equal to one joule of energy being imparted to one kilogram of matter (the 

rad is the previously used unit). The dose equivalent, which is a measure of 

the effects of radiation on living organisms, is the absorbed dose multiplied 

by a suitable factor that depends upon the type of radiation. It is measured 

in sieverts (symbol Sv), where one sievert is a dose equivalent of one joule 

per kilogram (an older unit is the rem). Conversion factors are: 1 curie (Ci) 

= 37 billion Bq, 1 rad = 0.01 Gy, and 1 Sv = 100 rem.

radioactive contamination: the deposition of unwanted radioactive 

material on the surfaces of structures, areas, objects, or people. It can be 

airborne, external, or internal. See also contamination, decontamination.

radioactive decay: the spontaneous disintegration of the nucleus of an 

atom.

radioactive half-life: the time required for a quantity of a radioisotope to 

decay by half. For example, because the half-life of iodine-131 (I-131) is 

8 days, a sample of I-131 that has 10 mCi of activity on January 1, will have 

5 mCi of activity 8 days later, on January 9.
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radioactive material: material that contains unstable (radioactive) atoms 

that give off radiation as they decay.

radioisotope (radioactive isotope): isotopes of an element that have an 

unstable nucleus. Radioactive isotopes are commonly used in science, 

industry, and medicine. The nucleus eventually reaches a stable number of 

protons and neutrons through one or more radioactive decays. Approximately 3700 natural and artificial radioisotopes have been identified.

radiological or radiologic: related to radioactive materials or radiation. 

The radiological sciences focus on the measurement and effects of radiation.

radiological dispersal device (RDD): a device that disperses radioactive 

material by conventional explosive or other mechanical means, such as a 

spray.

radiological exposure device (RED): also called a “hidden sealed source,” a 

RED is a terrorist device intended to expose people to significant doses of 

ionizing radiation without their knowledge. Constructed from partially or 

fully unshielded radioactive material, a RED could be hidden from sight 

in a public place, exposing those close by. If the seal around the source is 

broken and the radioactive contents release, the device could become a RDD 

capable of causing radiological contamination. 

radionuclide: an unstable and therefore radioactive form of a nuclide.

radium (Ra): a naturally occurring radioactive metal. Radium is a radionuclide formed by the decay of uranium and thorium in the environment. 

It occurs at low levels in virtually all rock, soil, water, plants, and animals. 

Radon (Rn) is a decay product of radium.
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radon (Rn): a naturally occurring radioactive gas found in soils, rock, and 

water throughout the United States. Radon causes lung cancer and is a 

threat to health because it tends to collect in homes, sometimes to very high 

concentrations. As a result, radon is the largest source of exposure to people 

from naturally occurring radiation.

rem (roentgen equivalent, man): a unit of equivalent dose. Not all radiation has the same biological effect, even for the same amount of absorbed 

dose. Rem relates the absorbed dose in human tissue to the effective biological damage of the radiation. It is determined by multiplying the number of 

rads by the quality factor, a number reflecting the potential damage caused 

by the particular type of radiation. The rem is the traditional unit of equivalent dose, but it is being replaced by the sievert (Sv), which is equal to 100 

rem.

roentgen (R): a unit of exposure to X-rays or gamma rays. One roentgen 

is the amount of gamma or X-rays needed to produce ions carrying one 

electrostatic unit of electrical charge in one cubic centimeter of dry air under 

standard conditions.

shielding: the material between a radiation source and a potentially exposed person that reduces exposure.

sievert (Sv): a unit used to derive a quantity called dose equivalent. This 

relates the absorbed dose in human tissue to the effective biological damage 

of the radiation. Not all radiation has the rem.

stable nucleus: the nucleus of an atom in which the forces among its 

particles are balanced. See also unstable nucleus.

strontium (Sr): a silvery, soft metal that rapidly turns yellow in air. Sr-90 

is one of the materials created within a nuclear reactor during its operation. 

Strontium-90 emits beta particles during radioactive decay.
APPENDIX H

99

surface burst: a nuclear weapon explosion that is close enough to the 

ground for the radius of the fireball to vaporize surface material. Fallout 

from a surface burst contains very high levels of radioactivity. See also air 

burst. For more information, see Chapter 2 of CDC’s Fallout Report at 

http://www.cdc.gov/nceh/radiation/fallout/.

thermonuclear device: a “hydrogen bomb.” A device with explosive energy 

that comes from fusion of small nuclei, as well as fission.

thorium (Th): a naturally occurring radioactive metal found in small 

amounts in soil, rocks, water, plants, and animals. The most common 

isotopes of thorium are Th-232, Th-230, and Th-238.

unstable nucleus: a nucleus that contains an uneven number of protons and 

neutrons and seeks to reach equilibrium between them through radioactive 

decay (i.e., the nucleus of a radioactive atom). See also stable nucleus.

uranium (U): a naturally occurring radioactive element whose principal 

isotopes are U-238 and U-235. Natural uranium is a hard, silvery-white, 

shiny metallic ore that contains a minute amount of U-234.

whole body exposure: an exposure of the body to radiation, in which the 

entire body, rather than an isolated part, is irradiated by an external source.

X-ray: electromagnetic radiation caused by deflection of electrons from 

their original paths, or inner orbital electrons that change their orbital 

levels around the atomic nucleus. Like gamma rays, X-rays can travel long 

distances through air and most other materials and require more shielding 

to reduce their intensity than do beta or alpha particles. X-rays and gamma 

rays differ primarily in their origin: X-rays originate in the electronic shell; 

gamma rays originate in the nucleus. See also neutron.
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100

Appendix I. References

1. Federal Emergency Management Agency

National Response Framework Resource Center 

http://www.fema.gov/emergency/nrf

2. U.S. Department of Health and Human Services

Radiation Emergency Medical Management

Guidance on Diagnosis and Treatment for Health Care Providers

http://www.remm.nlm.gov

3. Centers for Disease Control and Prevention

Emergency Preparedness and Response

Radiation Emergencies

http://emergency.cdc.gov/radiation

4. Uniformed Services University of the Health Sciences

Armed Forces Radiobiology Research Institute

Medical Effects of Ionizing Radiation 

http://www.afrri.usuhs.mil/outreach/meir/meir.htm

5. U.S. Environmental Protection Agency

Radiation and Radioactivity

http://www.epa.gov/ebtpages/radiationandradioactivity.html

6. U.S. Nuclear Regulatory Commission

Radiation Protection

http://www.nrc.gov/about-nrc/radiation.html
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September 2011 Edition