Note MANAGEMENT OF ACUTE TRAUMATIC STRESS IN NUCLEAR AND RADIOLOGICAL EMERGENCIES Marina Vazquez,* Osvaldo Jordan,* Enrique Kuper, † Daniel Hernandez,* Martin Galmarini, ‡ and Augusto Ferraro ‡ Abstract—In order to effectively respond to and minimize the psychological impact following disasters, such as radio-nuclear ones, it is essential to understand the mechanisms involved in such conditions and how to prevent and treat the psychological impacts, including those related to acute traumatic stress and its consequences across life span. Radio-nuclear emergencies may cause psychological traumatic stress, with its potentially significant consequences in mental health, with both short and long-term effects, which extend beyond the individuals directly affected. Ionizing radiation cannot be perceived by human senses and most people are unaware of the magnitude of its effects, which could result in feelings of helplessness and vulnerability. Those situations with a high degree of uncer- tainty, regarding potential future health effects, are more psychologically traumatic than others. The present century has witnessed a steady increase in the number of publications concerning the mental health impact of traumatic events, showing the need of increasing the study of traumatic stress and its impact on mental health. A prompt, planned and effective response to manage disaster-induced acute traumatic stress may prevent the evolutionary reactions of traumatic stress into disorders or even chronic stress diseases that can appear after a nuclear or radiological emergency. Health Phys. 98(6):795–798; 2010 Key words: World Health Organization; emergencies, radio- logical; emergency planning; health effects INTRODUCTION THERE WERE two relevant turning points in the qualitative perception of the risk associated with the use of ionizing radiation: the bombs of Hiroshima and Nagasaki, and the Chernobyl nuclear power plant accident. Technological disasters bring about psychological effects of varied durability and intensity in exposed populations. Nuclear and radiological disasters have been more likely to induce chronic psychopathologies than other types of disasters, such as storms, floods, and hurricanes. Studies of radiological accidents at Chernobyl, Goia ˆnia, and Three Mile Island have shown that the traumatic stress and long-term psychological damage caused by the release of radioactive material into the environment are disproportionate to the actual damage inflicted (Baum et al. 1983; Curado et al. 1991; Zafra et al. 2002; Bennett et al. 2006; Bromet and Havenaar 2007). Several investi- gations have shown increased levels of somatization disorders, increased drug and alcohol abuse, increased levels of suicidal/homicidal ideas, and that traumatic stress is the most frequent disorder and one of the most severe that may follow an event of this nature. Pirard et al. (1998) reviews the epidemiological studies which assess psychological and psychiatric consequences of the Three Mile Island, Goia ˆnia, and Chernobyl accidents. It shows, in different accidental and cultural contexts, a statistically significant and durable increase of psycho- logical symptoms in various exposed population groups. Radiological and nuclear emergencies share com- mon aspects and the perception of their risk tends to be overestimated because ● People relate them to past accidental or catastrophic situations such as Hiroshima and Chernobyl; ● They lead to very long-term consequences; ● They are related to little understood activities; ● The causative agent is not perceived by the senses; ● They can also affect unborn children, pregnant women, children and future generations; and ● The control of the situation is beyond the individual, who depends on other people’s decisions (lack of self control). Classification of the victims Primary victims are those who suffer from the “bio- logical effects” of radiation while the secondary victims may be relatives and friends of the primary victims. * Nuclear Regulatory Authority, Av. Del Libertador 8250 (BNP1428) Buenos Aires, Argentina; † Neurobiological and Trau- matic Bio-psycho-medical Center, Argentina; ‡ Ministry of Security and Justice, Buenos Aires Government, Argentina. For correspondence contact: Vazquez Marina, Emergency Control Center, Nuclear Regulatory Authority, Av. Del Liberta- dor 8250 (BNP1428) Buenos Aires, Argentina, or email at mvazquez@cae.arn.gov.ar. (Manuscript accepted 11 August 2009) 0017-9078/10/0 Copyright © 2010 Health Physics Society DOI: 10.1097/HP.0b013e3181bbc742 795