Better planning needed for 'dirty bomb' attack.

Experts who argue that the United States potentially is susceptible to radiological attacks--better known as "dirty bombs"--claim that this threat is often misconstrued.

"The reality is that the threat of a dirty bomb attack by terrorists is a credible one, although the psychological and economic consequences would likely far outweigh any casualties or physical destruction," said James Jay Carafano in a study published by the Heritage Foundation.

By better understanding the dirty bomb threat, policymakers can more effectively coordinate public- and private-sector responses, he noted.

"Policymakers and the public need to understand the costs and risks associated with dirty bombs to invest appropriate resources for preparation and prevention efforts as well as for consequence mitigation," he said. "Perhaps most important is ensuring that people do not overreact to the mere presence of radiation without full knowledge of the extent and type of contamination."

According to Carafano, the government should:

* Develop national standards for emergency response.

There are no national standards for an emergency response to a dirty bomb attack, or for that matter to any major terrorist incident.

* Create a national system-of-systems emergency response structure.

Networks should connect sensors, decision-makers and emergency responders. "This means linking knowledgeable entities in the response to emergencies from the local level to the national level," Carafano said.

* Focus federal resources on developing national surge medical capacity.

More than one-third of the current federal assistance provided to state and local government is for developing local hospital surge capacity. "A fixed hospital-based national emergency response system is not the answer," he said. "It is likely that local hospitals would be quickly overwhelmed by mass casualty attacks, particularly radiological strikes that might see thousands of contaminated victims, as well as additional thousands of the 'worried well,' or unaffected individuals who seek medical treatment out of fear."

* Centralize oversight of federal emergency medical response in the Department of Health and Human Services.

An effective national medical response could successfully mitigate casualties from a radiological attack. Oversight of national medical emergency programs, however, is split between HHS and the DHS.

* Enhance federal expertise in emergency medical care.

The federal government lacks an integrated approach to emergency medicine, a key component of responding to a radiological attack. HHS, for example, does not have a National Institute of Emergency Medicine.

Carafano said Congress should address the shortfall in federal expertise in emergency medical services by moving Emergency Medical Services Division functions to HHS and establishing an Institute for Emergency Medicine within the National Institutes of Health that is dedicated to spearheading emergency medical research efforts. This institute should work closely with the Centers for Disease Control and Prevention to devise more comprehensive emergency medical response strategies, particularly with regard to radiological contamination.

* Establish better coordination with the private sector.

A significant portion of the cleanup after a radiological disaster will be conducted by the private sector. Potentially, in addition to professional responders and volunteers, there are about 6.5 million skilled construction workers in the United States who could respond in the wake of a disaster, he said. The DHS should explore means to pre-train and certify construction workers; establish a registry of qualified contractors, firms, and unions, and link them to emergency management agencies.