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clinmed/2002010001v1 (January 11, 2002)
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Projected Casualties from a Terrorist Nuclear Explosion in a Large Urban Area

Ira Helfand, MD
Chief, Emergency Medicine Section
Cooley Dickinson Hospital
Northampton, Massachusetts USA
International Physicians for the Prevention of Nuclear War/Physicians for Social Responsibility

Lachlan Forrow, MD
Associate Professor of Medicine
Beth Israel Deaconess Medical Center, Harvard Medical School
Boston, Massachusetts USA
International Physicians for the Prevention of Nuclear War/Physicians for Social Responsibility

Jaya Tiwari
Research Director
Center for Global Health and Security
Physicians for Social Responsibility (IPPNW-USA)
Washington, DC USA

Correspondence to Ira Helfand, Cooley Dickinson Hospital, 30 Locust Street, Northampton, MA 01061-5001 USA (ihelfand@igc.org).



Background

The events of September 11, 2001 have focused new attention on the danger of nuclear terrorism. The attack on the World Trade Center in New York demonstrated clearly that there are terrorists in the world who are willing to inflict civilian casualties on the massive scale that would be anticipated with the use of a weapon of mass destruction. In this paper we examine the expected casualties from a terrorist attack involving a Hiroshima-sized nuclear weapon detonated in a large urban area.

There is now abundant evidence that terrorist groups have been trying aggressively to obtain nuclear materials, primarily from the enormous stockpiles of the Former Soviet Union. In December 1994, Czech police seized 4 kg HEU. During that same year, German police seized more than 400 grams of plutonium. (1) In October 2001, Turkish police arrested two men with 2.56 pounds of weapons grade uranium. (2) Also in October 2001, the Russian Defense Ministry reported two recent incidents in which terrorist groups attempted to break into Russian nuclear storage sties, but were repulsed. (3) Since 1993, the IAEA has reported 175 cases of nuclear trafficking, 18 involving HEU or plutonium. (4) Even more worrisome are reports that small fully built nuclear weapons are missing from the Russian arsenal. In 1996 Russian General Alexander Lebed claimed that 40 of these weapons were unaccounted for. He subsequently retracted the claim but in a manner that failed to reassure many experts. (3)

Even before the attack on the World Trade Center, a special high level task force at the US Department of Energy warned, "The most urgent unmet national security threat to the United States today is the danger that weapons of mass destruction or weapons useable material in Russia could be stolen and sold to terrorists or hostile nation states and used against American troops abroad or citizens at home." (5)

The efforts of the al-Qaeda terrorist network to obtain nuclear weapons or weapons grade nuclear materials are particularly worrisome. Al-Qaeda agents have tried to buy uranium from South Africa, and have made repeated trips to three Central Asian states to try to buy weapons grade material or completed nuclear weapons. (4) Sultan Bashiruddin Mahmood, a leading Pakistani nuclear engineer, made repeated visits to the Taliban stronghold of Kandahar between 1998 and 2001, leading the Pakistani government to place him and two other nuclear scientists under house arrest. (6) Reputable news agencies have even published stories, though they are highly speculative, that al-Qaeda has purchased 20 of the Russian suitcase weapons from Chechen sources for a reported $30 million plus two tons of opium. (6)

In the aftermath of September 11, Russian nuclear experts have even raised concerns about the possibility that terrorists could gain control of a Russian nuclear missile facility and initiate an attack against the United States using Russian strategic nuclear weapons. (7)


Methods

Using the CATS (Consequences Assessment Tool Set) software created by the US Federal Emergency Management Agency (FEMA) and the Defense Threat Reduction Agency (DTRA), the authors have calculated the numbers of dead and wounded to be expected from a 12.5 kiloton nuclear explosion at ground level in New York City. The casualty model used assumed a cloudless day and a 100% fatality rate for people in the firestorm area, which extends out to 2.4 km (1.5 mi) for a blast of this size. To calculate the effects of direct radiation exposure from the explosion, it assumed a 100% fatality rate for people beyond the firestorm who are exposed to > 600 cGY, and a 50% fatality rate for people exposed to 450 to 599 cGy. It also assumed that people with exposures in the range of 50 to 449 cGy would develop radiation sickness. To calculate the effects of local fallout beyond the zone of firestorm and direct radiation exposure, we assumed an attack in September, and the model examined a fallout footprint extending 113 km (70 mi) to the East from the explosion. The size and shape of the fallout footprint were calculated from the most probable prevailing wind direction and speed at that time of the year. The model used residential demographic data and thus predicted casualties for an attack at night. An attack during the day when large numbers of people come into Manhattan from outlying areas would produce substantially higher casualty figures. For purposes of this study, the explosion was placed in New York Harbor between lower Manhattan and Brooklyn to reflect concerns that a nuclear device could most easily enter a US city smuggled in a cargo container on board a commercial ship.

Results

A 12.5 kiloton nuclear explosion in New York Harbor produce casualties more than one order of magnitude greater than those inflicted at the World Trade Center. Blast and thermal effects would kill 52,000 people immediately. Another 238,000 would be exposed to direct radiation from the blast, and of these 44,000 would suffer radiation sickness and more than 10,000 of these would receive lethal doses. In addition to this direct radiation from the explosion, fallout would expose another million and a half people. For this group, the 24 hour cumulative dose would be high enough to kill another 200,000 and cause several hundred thousand cases of radiation sickness. In addition there would be many thousands of people with mechanical and thermal injuries.

Casualties on this scale would immediately overwhelm medical facilities leading to a high mortality rate among those injured but not killed by the initial blast and thermal effects. Over 1000 hospital beds would be destroyed by blast, and 8700 beds would be in areas with radiation exposures high enough to cause radiation sickness.



Discussion

In light of the events of September 11, the possibility of a terrorist attack using a nuclear explosive can no longer be dismissed, and public health planning must take account of this possibility.

Having said this, we must recognize the very limited ability of the medical community to aid survivors of such an attack, especially in the first days after an attack. Local medical facilities will be quickly overwhelmed, and even with advance preparation we must anticipate significant delays in the arrival of outside help. After the 1995 earthquake in Kobe, Japan, which resulted in many fewer casualties, (6,500 died and 34,900 were injured) and which had few of the complicating factors that would accompany a nuclear attack with extensive radioactive contamination, there were long delays before outside medical assistance arrived. (8)

While security measures to prevent terrorist attack must be continued, we cannot rely primarily on efforts to block terrorists from detonating nuclear devices. We have to focus on steps to prevent their acquiring these weapons in the first place.

These efforts will need to focus primarily on the massive stockpiles in Russia. There remain tens of thousands of tactical nuclear warheads in the Russian arsenal along with 603 metric tons of weapons useable nuclear material stored at 53 different sites. (9) This is enough to make 41,000 additional nuclear bombs. (9) The United States is currently spending between $900 million and $ 1 billion annually on a number of related Cooperative Threat Reduction programs to try to secure these stockpiles. (10) This represents approximately 0.3% of the current US defense budget and less than 1/7 the amount spent annually to try to develop a national missile defense (NMD) system.

The United States and other Western states urgently need to expand their efforts to help the Russian government secure these nuclear weapons and materials.

In addition increased attention must be directed at the dangers posed by Pakistan's newly acquired nuclear arsenal and the possible danger of further nuclear proliferation.

References

1. Allison GT, Cote OR Jr, Falkenwrath RA, Miller SE. Avoiding nuclear anarchy. Cambridge, Massachusetts: Center for Science and International Affairs, Harvard University. 1996.
2. Reuters. Turkish Police Detain Suspects Selling Uranium. November 6, 2001.
3. Allison GT. Could worse be yet to come? The Economist. Novemeber 1, 2001.
4. International Atomic Energy Agency. Press Release November 1, 2001 http://www.iaea.org/worldatom/Press/P_release/2001/nt_pressrelease.shtml
5. US Department of Energy. Task force report: a report card on the Department of Energy's non proliferation programs with Russia.Washington, DC: DOE. January 10, 2001.
6. Kluger J. Osama's nuclear quest. Time. November 12, 2001:38-40.
7. Blair B. Remarks delivered National Press Club, November 14, 2001.
8. Tanaka K. The Kobe earthquake: the system response: a disaster report from Japan. European Journal of Emergency Medicine 1996;3:263-269.
10. US Department of Energy. Material protection, control and accounting program, strategic plan. Washington, DC: DOE. July 2001.
11.Tiwari J. The Cooperative Threat Reduction Program: Essential for U.S. and Global Security. Washington, DC: PSR Center for Global Security and Health. November, 2001.



This Article
Right arrow Abstract Freely available
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Right arrow Similar articles in this netprints
Right arrow Download to citation manager
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Right arrow Articles by Helfand, I.
Right arrow Articles by Tiwari, J.
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Right arrow Articles by Helfand, I.
Right arrow Articles by Tiwari, J.
Related Collections
Right arrow Health Policy:
International health

Right arrow Public Health:
Medical Consequences of Conflict

Right arrow Other Public Health
Right arrow Environmental Issues


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