18. Radiation emergencies

States Parties should have surveillance and response capacity for radiological emergencies and nuclear incidents. This requires effective coordination among all sectors involved in radiation emergency preparedness and response.


Timely detection and effective response to potential radiological emergencies and nuclear incidents with cross-sectoral coordination.

Monitoring and evaluation

(1) Mechanisms established and functioning for detecting and responding to radiological emergencies.

Benchmark 18.1

Mechanism is in place for detecting and responding to radiological and nuclear emergencies emergencies

Objective: Establish a mechanism to detect and respond to radiological and nuclear emergencies

No capacity
No mechanism (such as policies, plans and coordination process) is in place for the detection, assessment and response to radiation emergencies.
Limited capacity
Actions to achieve this level:
  • Identify key stakeholders and designate focal points responsible for radiation-related hazards and emergencies, especially from radiation authorities and public health units.
  • Develop SOPs or protocols for coordination and communication with national authorities, clearly indicating roles and responsibilities, including for the health ministry and IHR focal points.
  • Convene a meeting with key stakeholders to review, assess, map and develop policies, strategies and plans for detection, assessment and response to radiation emergencies.
  • Disseminate these policies, plans and legislation for radiological event surveillance, alert and response to relevant stakeholders.
  • Conduct a risk assessment for radiation hazards.
  • Develop a radiation monitoring mechanism with required SOPs and guidelines, and establish a mechanism to share information among the relevant stakeholders.
  • Train relevant staff on these SOPs, guidelines and information sharing.
  • Procure logistics for robust radiation monitoring systems.
  • Designate or secure access to laboratory capacity to monitor, identify and assess exposure.
Developed capacity
Actions to achieve this level:
  • Identify key technical experts from relevant sectors to develop technical guidelines or SOPs for the management of radiation emergencies (including risk assessment, reporting, event confirmation, notification and investigation).
  • Develop training package(s) on these guidelines/SOPs for the management of radiation emergencies and train relevant staff at least at the national level.
  • Develop policies, protocols and strategies for national and international transport of radioactive materials, samples and waste management, and ensure logistic requirements for transportation.
  • Procure or ensure access to stockpile to support radiation emergency preparedness and response, and develop a distribution plan for the event of an emergency.
  • Develop guidelines for management of radiological waste including that from the hospitals and medical services.
  • Establish a waste management site with the required capacity for monitoring it.
  • Develop case management guidelines to manage cases of radiation emergencies (either as a stand-alone guideline or as part of the case management guidelines for all hazards (refer to Benchmark 14.3)).
  • Identify health facilities that can manage patients in the event of a radiation emergency.
  • Train relevant healthcare workers on these protocols and guidelines.
  • Develop a mechanism for systematic information exchange between competent radiological authorities and human health surveillance units about radiological events and potential risks.
Demonstrated capacity
Actions to achieve this level:
  • Conduct after-action reviews or simulation exercises in the absence of real events to:
  • evaluate/test the guidelines/SOPs (conduct jointly with the competent radiation authorities and the public health unit);
  • test coordination and communication mechanisms between relevant national competent authority for nuclear regulatory control/safety and relevant sectors;
  • test case management capacity; and
  • update guidelines/SOPs and coordination and communication mechanisms based on the findings.
  • Respond to any radiological threats with joint risk assessment, investigation and implementation of the response plan.
  • Ensure that if SOPs call for prepositioning of logistics to address a radiation emergency, distribute these logistics in all designated places at all times.
  • Share information with relevant stakeholders regularly on the risk and threats that are potential for emergencies.
Sustainable capacity
Actions to achieve this level:
  • Document and disseminate best practices of test results and reviews.
  • Conduct regular training of staff of health facilities to manage patients in the event of a radiation emergency.
  • Develop and conduct emergency response drills and other exercises on radiation emergency and update the response plan, mechanisms and guidelines accordingly.
  • Sustain a mechanism to ensure response capacity at national, subnational and local levels.