Development of WHO Guidelines on Public Health Response to Radiological and Nuclear Emergencies (2012-2016)
International safety standards and safety guides for emergency preparedness, planning, and response to radiological and nuclear emergencies have been published by IAEA and co-sponsored by a number of international organizations, including WHO. These safety standards/guides are based on radiation protection principles and use measurable quantities of radiation levels for justifying certain interventions. However, as demonstrated by the Fukushima Daiichi nuclear power plant accident experience (2011), there is an array of issues pertinent to public health and other factors not necessarily directly linked to the radiological parameters and criteria of the evolving nuclear emergency (e.g. psychological, social, cultural, ethical impacts, etc.). It was therefore considered necessary to provide additional guidelines targeting specifically public health authorities in order to support the decision making at the time of planning and/or managing emergency response to a radiological or nuclear accident.
In 2012, WHO conducted a survey of the member states needs for additional guidelines for public health authorities on interventions that may be used in case of radiological or nuclear emergencies. Based on this survey, it launched the project on the development of WHO guidelines on public health response to radiological and nuclear emergencies (PHR Guide project).
- The PHR Guide project follows the procedure described at the WHO Handbook on guidelines development (2nd ed.)
The Guidelines Development Group (GDG) worked by electronic means and through three face-to-face meetings as follows:
- 1st GDG-1 meeting on scoping and developing PICOs – 12 to 13 June, 2012, Geneva, Switzerland
- 2nd GDG-1 meeting on developing recommendations – 06 to 08 June, 2013, Amman, Jordan
- 3rd GDG-1 meeting (by Webex) on risk communication – 14 November 2014
In addition, the revision of the 1999 WHO Guidelines for Iodine Prophylaxis following Nuclear Accidents was started in 2014 as a part of the PHR Guide project. Additional experts were invited to join the GDG to work on the WHO recommendations on use of iodine thyroid blocking (ITB) in case of a nuclear or radiological emergency. As a part of this undertaking, the following meetings were held:
- 4th GDG-2 meeting on scoping and PICO questions on ITB – 10 May 2016, Wuerzburg, Germany
- 5th GDG-2 meeting (by Webex) on the results of systematic review for ITB – 23 September, 2015
- 6th GDG-2 meeting on developing recommendations on ITB – 11-13 January 2016, Pisa, Italy
The draft guidelines were circulated for external review in December-2016 – January 2017. As a result of the review and based on the discussions with the GDG and Secretariat, it was decided to limit the scope of the guideline at this time to only one intervention – iodine thyroid blocking, as the rest of the urgent protective actions are have been addressed by the IAEA’s international safety standards co-sponsored by WHO. However, the work conducted by the GDG will be reflected in a future policy briefing that will complement the existing high-level international standards and elaborate on public health aspects of recommended interventions.
The membership of the GDG on Public Health Response to Radiological and Nuclear Emergencies and the GDG on Iodine Thyroid Blocking is provided below. In line with WHO policy on conflict of interest, members of the public and interested organizations can access the biographies of these GDG members and inform WHO of their views about them
Full report on the results of the systematic review on iodine thyroid blocking
- Protocol of systematic review on iodine thyroid blocking
If you have any comments relating to conflict of interest of the members of the Guideline Development Group for this guideline, you may send an email to PHR-Guide@who.int.