ON THE NEW IMPERATIVES AFTER SEPTEMBER 11, 2001

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Email: iredlener@montefiore.org

Irwin Redlener, M.D.

President, The Children’s Hospital at Montefiore

President, The Children’s Health Fund

Testimony before the Committee on Environment and Public Works

United States Senate

Re: The Nuclear Security Act

June 5, 2002

Thank you, Chairman Jeffords, Ranking Member Smith and members of the Committee, for the opportunity to testify this morning. I am Dr. Irwin Redlener, a pediatrician and president of the Children’s Health Fund headquartered in New York and the new Children’s Hospital at Montefiore Medical Center in the Bronx. I have had a career in public health and health services delivery spanning more than three decades. However, allow me to share some background information with respect to my role in the matters before the Committee today.

First, on September 11, 2001 I dispatched two mobile medical units from our New York programs to lower Manhattan to participate in the enormous emergency medical response to the terrorist attacks at the World Trade Center. We also assisted in a number of additional ways in the immediate aftermath in terms of medical services and continue to provide mental health support to families and children throughout the City who have been affected by the attacks.

In addition, with a colleague who heads the Center for Pediatric Emergency Medicine at the New York University Medical Center, Dr. George Foltin, I established the New York City Task Force on Pediatric Disaster Preparedness in December. I am also a founding member of the Task Force on Terrorism of the American Academy of Pediatrics. Over the last eight months I have been working to ensure that federal efforts designed to improve preparedness for terrorist attacks include specific provisions to ensure the safety of children.

In New York City I have had regular contact, formal and informal, with City and private sector officials responsible for disaster response. Since October of last year I have had continuous contact with federal officials regarding various issues with respect to homeland security. These issues have included my ongoing concerns regarding the security of nuclear power plants in general and the Indian Point nuclear power plants in particular. Finally, during the 1980s, I was significantly involved in the analysis of Crisis Relocation Planning, the response proposed by the Federal Emergency Management Agency, to the threat of large-scale nuclear attack on the United States.

The September 11 attacks on the United States have had remarkable consequences for Americans and for American society. In a real sense, on a beautiful day this past September, we were both invaded and profoundly shaken as a nation. For generations we have had a sense of detachment from the grim realities which plague so many parts of the world, where uncertainty and terror play out in daily life and the public consciousness is always aware, on some level, of the potential for deadly large-scale violence. Less than two dozen violent and suicidal fanatics, connected to a diffusive and elusive global network of terror, has essentially ended the American reverie of protected isolation.

The cliché is that this is a “new world”, and, indeed, it is. How we respond, what plans we make, how we adjust ourselves psychologically, what resources we ultimately bring to bear and how we reorganize our government systems and agencies to prevent, mitigate or reduce the impact of on-going terrorism in the United States remain open questions.

We will see conflicts between civil rights and necessary intelligence gathering capability; we’ll struggle with interagency communications and rivalries over areas of responsibility and control. And there will be major debates over how to prioritize and balance the response to terrorism against the ongoing societal concerns which pre-date September 11, 2001.

However, no matter how these debates unfold, it is clear that the perceptions of risk, vulnerability and homeland security must rapidly evolve and adapt to the new realities of a nation targeted by smart, committed agents of terror. There are, needless to say, a myriad of complex issues to be covered under the rubrics of the war against terrorism and the effort to enhance the security of the United States. One of these areas, the subject of this morning’s hearings, concerns the potential risks and vulnerabilities of the 103 nuclear power plants currently operating throughout the country. Unfortunately, I also need to add that children, the elderly and the infirm bear a disproportionately high burden of vulnerability to consequences of and reactions to a successful terrorist attack on a nuclear power plant.

Although the possibility of a catastrophic event occurring at a nuclear power plant as a result of accident, natural disaster or deliberate act of terrorism has always been on the table, the events of September 11 demand a re-examination of all aspects of the vulnerability and security of the nation’s nuclear facilities. Simply put, what was improbable to the point of impossible, has become possible. Assessment of risk and specific planning scenarios need to evolve to new levels taking into account a much more aggressive, educated, trained and organized terrorist for whom capture or death is not a deterrent to action.

A medical analogy here would be the mutation of a bacteriologic agent which becomes orders of magnitude more virulent and simultaneously unresponsive to first-line antibiotics. Traditional approaches to prevention, early identification and treatment would need to change dramatically. In effect, this is precisely what we are dealing with in terms of necessary measures to secure and reduce the risk posed by nuclear power facilities today in the United States. Acceptable risk and security measures appropriate on September 10, became unacceptable and insecure on September 11.

The potential consequences of failing to do everything possible to reduce or eliminate the population risks from acts of terrorism carried out against nuclear facilities are extraordinary and horrific. Attack scenarios well within the realm of possibility for many nuclear facilities can have horrendous consequences for populations in the vicinity of a nuclear plant. Immediate civilian fatalities can range from a hundred or so to five thousand or more, depending on the extent of damage to the reactor, its support systems and the spent fuel containment systems. Excess cancers from radiation exposures can range into the tens of thousands. Moreover, nuclear terrorism is in a special category of horror, evocative of the nightmare scenarios which first arose during the height of the cold war.

Beyond the direct mortality and morbidity estimates, verified by numerous studies of experts in and out of government, are layer upon layer of unimaginable potential health and economic consequences from a successful attack on a power plant. Studies by independent physicists and organizations, including the Brookhaven National Laboratories, have concluded that thousands of square miles could be contaminated and uninhabitable for years or decades under a variety of highly plausible attack scenarios. In sum, the economic, psychological and societal consequences of such an event in a major population center would be almost incalculable.

For all of these reasons, it is imperative that we take necessary and prudent steps to reduce the likelihood of a successful act of terrorism against a nuclear power facility. There are two points which are, perhaps obvious, but worth stating:

First, to the very limits of our human limits, intelligence capacity should be upgraded to the point where terrorist planning can be disrupted prior to implementation. And, second, a cogent case can be made for closing nuclear power plants altogether, particularly those with inherent safety problems, those in highly populated areas with inadequate evacuation plans or those with relatively insufficient means of safeguarding spent fuel rods. The fact is that the Indian Point facility meets all three criteria for closing, even though discontinuing energy production does not fully eliminate the risk and even though there would be modest temporary increases in energy costs in the region. In my opinion, this is clearly a case in which the true risks to people of continuing operations are far greater than the benefits, by any measure.

Putting aside the question of plant decommissioning, here are some actions that can be undertaken immediately:

1. Security at nuclear plants needs to be upgraded dramatically and immediately, commensurate with our new and totally different understanding of the capacity and ferocity of terrorism on American soil. The “design basis threats” which used to be the standard scenarios for anti-terrorism planning need to be upgraded, informed by the events of September 11, to include a whole new range of potential actions for which security measures must anticipate, plan for and test. Can we explain to our children and grandchildren in Westchester County, New York why special U.S. military forces, for instance are not guarding Indian Point? Incredibly, just six weeks ago the New York Post reported that a journalist spent 20 minutes flying over the Indian Point facility. Can we explain why aircraft are not forbidden to fly over the plant?

2. All spent fuel rods should be stored in hardened, on-site, dry storage facilities, pending a more definitive solution to the challenge of permanent storage. Spent nuclear fuel rods in places like the Indian Point plant are kept in deep water pools. Unlike the reactor core itself, which is in a hardened containment structure, the spent fuel pool is in an adjacent, comparatively lightweight structure. Many of these spent rod structures are covered with nothing more than a corrugated steel roof. Moreover, the pools are now packed at high density, so much so that spent fuel will ignite and burn if water, essential to keeping the spent rods cool, is lost from the pool. This would release a massive amount of radioactive material to the atmosphere. Dry storage can make the spent fuel dramatically less vulnerable. Money is the only barrier to moving rapidly to hardened, dry storage of the used fuel.

3. There needs to be a top-to-bottom revision and upgrading of the emergency planning process, with active federal oversight. Planning for evacuation in densely populated areas is extremely difficult. The grossly inadequate emergency evacuation planning process around.

4. The Indian Point facility is a case in point. Spontaneous, uncontrolled evacuation in time of crisis, as happened at Three Mile Island, could quickly result in chaos and paralysis of egress. Permanent relocation for evacuees in the event of substantial ground contamination would be an extraordinary challenge.

Reuniting school children and children in day care with their parents in the current plans are dependent upon wildly unrealistic expectations with respect to the likely behavior of school bus drivers, emergency officials and parents. Plans are extremely insufficient regarding the size and scope of the area which would need evacuation in a nuclear emergency. The same could be said regarding what to do with senior citizens, hospitalized or disabled individuals and those who refuse to leave. The entire notion of evacuation planning is so massive, complex and resource intense that it is unfair and unreasonable to expect this to happen, if it can happen at all, without extensive and revised preparations and a strong role for the federal government. A recent Marist Institute survey on the subject of evacuation planning revealed that more than 75% of residents living within 10 miles of Indian Point do not believe that the current evacuation plan is workable. Only a very small percentage of people even within a 10 mile radius of the plant know where the reception centers are located. Chaos would ensue under any attempt to evacuate the area in the event of a terrorist nuclear incident at Indian Point since 60% of people within 50 miles of the plant, well beyond the planning zone, would attempt to evacuate. We have every reason to be concerned that people within the 10 mile evacuation zone would, in fact, not be able to leave because of road and transportation congestion caused by people in large numbers outside the 10 mile range attempting to leave as quickly as possible.

5. Potassium iodide should be acquired and distributed on a “point of use” basis for a minimum of 50 miles radius from all nuclear power plants. Radioactive iodine, I-131, is released from reactor explosions and, if inhaled or ingested in sufficient quantities, can cause high rates of thyroid cancer in children. If the proper dose of potassium iodide (KI) is given prior to or within two hours of exposure to I-131, this particular outcome, that is excess thyroid cancers, can be almost entirely prevented.

Because the window of opportunity to have this beneficial effect of KI is very narrow, it is not sufficient to have the drug only at central distribution points. It must be available at home, in schools and in day care centers. In addition, there must be a major public education campaign to inform people about the benefits of having KI ready for administration, especially to children and pregnant women. It also must be pointed out that KI is not a “radiation pill.” It will do nothing for any other consequence of exposure to cesium-137 or other isotopes. It is also essential that proper measures be taken by government to ensure that food and water available for ingestion by children not have evidence of I-131 or other harmful radiation by-products such as Strontium-90.

These four steps would, in my estimation, be appropriate initial measures to prevent and/or ameliorate a terrorist attack on any one of the nation’s nuclear power facility. As a physician and public health professional, as a resident of a community with the least safe nuclear power plant in the nation – one which has 21 million people living with 50 miles of the facility, I urge you to strongly consider these recommendations and move forward as quickly as possible.

I also recognize that this is just the beginning and nothing more than a component – albeit a very important component – of a much larger agenda. Even in the nuclear arena, there are many other concerns beyond nuclear plant security. The Federation of American Scientists and the Health Physics Society have begun to raise important concerns about the status of so-called “sealed” and “orphan” sources of radioactive materials used in health care and many other industries. Management control, security and oversight of these materials is variable to the extreme. Stolen radioactive materials can be used to make simple and potentially deadly “dirty bombs” which, if nothing else, have the capability of rendering large land areas uninhabitable.

Again, I thank you for the opportunity to offer testimony at his hearing. I deeply respect the responsibility you and your colleagues have in this time of enormous uncertainty and danger. On behalf of my colleagues in health care and public health I wish you strength and courage to do what needs to get done to safeguard all Americans from every form of terror.

Thank you.