In the aftermath of September 11, the threat of nuclear terrorism is among the most real - and most dire - of our country's current public health concerns, according to a report in the Feb. 8 issue of the British Medical Journal (BMJ), which estimates that a Hiroshima-scale nuclear explosion on a ship in port in New York City would result in more than 250,000 deaths.
"The most important messages are actually very simple," says co-author Lachlan Forrow, M.D., Director of Ethics Support Services at Beth Israel Deaconess Medical Center (BIDMC) and Associate Professor of Medicine at Harvard Medical School. "First, there is, in 2002, only one thing in the world that could truly destroy the U.S. as an entity, and that is an attack using the Russian nuclear arsenal, which remains on hair-trigger alert despite decaying computer and radar systems. The only way to forever prevent the use of nuclear weapons by nations or terrorists is to abolish them."
As past Chairman and CEO of the 1985 Nobel Peace laureate organization International Physicians for the Prevention of Nuclear War (IPPNW), Forrow and his colleagues have spent more than two decades warning of the potential catastrophic consequences posed by the stockpiles of nuclear weapons and materials, such as those that still exist in the U.S., Russia, and other countries.
In the new study, Forrow and his co-authors used software developed by the U.S. Defense Threat Reduction Agency (DTRA) to calculate the impact of a 12.5 kiloton nuclear explosion - the same size as the bomb dropped on Hiroshima - in the port area of New York City. They found that such an attack would result in the immediate deaths of 52,000 people, while another 44,000 individuals could be expected to develop cases of radiation sickness, of which 10,000 would likely be fatal. According to their calculations, radiation from fallout would cause another 200,000 deaths and several hundred thousand cases of radiation sickness. Furthermore, they say, in the wake of such an attack, little could be done to help survivors: More than 1,000 hospital beds would likely be destroyed, while nearly 9,000 more would be rendered unusable as they are located in areas of projected radiation fallout.
"As awful as the World Trade towers attacks were, the casualties were less than 2 percent of those that would result from even a small-scale nuclear explosion in a populated area," says Forrow.
According to the BMJ report, "There is clear evidence that some terrorist groups have been trying to obtain nuclear materials, primarily from the enormous stockpiles of the former Soviet Union. … "The efforts of the al-Qaeda network to obtain nuclear weapons or weapons grade materials are particularly worrying."
The answer, say the authors, is to secure and abolish all existing stockpiles of nuclear weapons and materials, including those in Russia, Pakistan and India, a goal that should be high on the global public health agenda. IPPNW has collaborated with international legal scholars in developing a model Nuclear Weapons Convention, a United Nations document that has been distributed worldwide in the official UN languages.
"There's an enormous surge of patriotism in our country right now," says Forrow. "I would just say that if you truly care about life, liberty and the pursuit of happiness, consider that they are simply incompatible with the existence of nuclear weapons. To ensure the survival of our extraordinary country, our democracy should be leading the world in achieving the verifiable and enforceable elimination of all nuclear weapons. I can't think of a more truly patriotic cause."
Co-authors include Ira Helfand, M.D., of Cooley Dickinson Hospital, Northampton, Mass., and Jaya Tiwari, of the Center for Global Security and Health, Physicians for Social Responsibility, Washington, DC.