Dirty bombs: More fear than substance

Sunday passed without incident at any of the seven stadiums supposedly targeted as sites for dirty bombs. No big surprise there. Last week, in warning state and local officials, the government said that the threat posted on the Internet was not credible. The arrest this weekend of a grocery clerk in Wisconsin (of all places) capped it.

What did surprise me was that the threat of damage from a radioactive bomb was so readily accepted by news media. The claim that hundreds of thousands would die from the simultaneous blasts and that countless other fatalities would later occur as result of radioactive fallout were reported as if these were reasonable assertions.

Anyone with even a cursory knowledge of dirty bombs knows these assertions are more about fear than substance. Jonathan M. Links, Ph.D., made exactly this point in an article in the October issue of the Journal of Nuclear Medicine, "Understanding radiological and nuclear terrorism as public health threats: preparedness and response perspectives."

On Oct. 9, three days before the grocery clerk posted the message that would gain international attention, DI SCAN quoted Links, director of the Center for Public Health Preparedness at Johns Hopkins' Bloomberg School of Public Health, who debunked the potential of dirty bombs to cause mass casualties. These bombs, he said, are designed to use conventional explosives to disperse radioactivity. Yet, while the physical risk involved in most dirty bomb scenarios is low, the psychosocial impact can be great, he noted.

You might think that with Links' article appearing in a medical journal the very month that a dirty bomb threat captures international headlines, he would be widely quoted by news media. Yet Googling Links' name under the "news" category brings two hits, one citing the Journal of Nuclear Medicine (Oct. 2) and the other DOTmed.com (Oct. 11). Do the same for "dirty bombs" and almost 300 links pop up, apparently none of which quoted the national expert on the subject. Some responsibly distinguished a fission or fusion weapon from dirty bombs, but the vast majority did not. What's going on here and what can be done about it?

The answer to the first is that, like the late Rodney Dangerfield, the imaging community gets no respect. Despite being experts in radioactivity, radiologists are not perceived as such.

The answer to the second is found in the Oct. 9 DI SCAN article. In this article, Links suggested that the makers of nuclear medicine equipment and radiopharmaceuticals work in concert with professional societies to wage a social marketing campaign to educate the public about the benefits of nuclear medicine.

"Social marketing means to use marketing techniques to promote societal benefits," Links said. "It uses classic advertising techniques to change behavior. Manufacturers are expert at all of them."

This kind of marketing is needed now to combat terrorists, who use the threat of a dirty bomb to create a climate of fear, Links said.

The industry can further boost the public image of nuclear medicine by financing and promoting training programs for nuclear medicine professionals in issues surrounding nuclear terrorism so they can assist local police, fire, public safety, and health departments in developing community response plans. Vendors should also reach out to the Department of Homeland Security, volunteering executives to serve as members of expert groups, such as the Nuclear Sector Coordinating Council, Links said. The council was formed two years ago to strengthen security and emergency preparedness at the nation's commercial nuclear facilities.

Breaking down perceptual barriers between medicine and the "war on terror" will grow more important as the government implements more antinuclear safeguards, Links said. Already, sensitive radiation detectors are being installed in major cities and public transportation facilities, detectors that may be triggered by patients who have recently undergone nuclear medicine procedures.

It's time the imaging community stepped up to the plate and got its message across to the American public. Nuclear terrorism is a clear example of where the community, vendors and practitioners alike, can contribute. But it doesn't stop there.

Medical imaging as a whole is underappreciated, which has led us to where we are today - two short months away from draconian cuts in Medicare due to a deficit reduction act passed by last year's Congress.

The fallout from these cuts in reduced healthcare could be far worse than a dirty bomb, imagined or real.

There's a lot to be told. If we don't tell it, who will?