It's these national and local strands of activity that provide the theme for "Understanding radiologic and nuclear terrorism as public health threats: preparedness and response perspectives", a continuing education paper published in this month's issue of the Journal of Nuclear Medicine (47 1653). Written by, among others, Jonathan Links, professor and director of the Center for Public Health Preparedness at Johns Hopkins Bloomberg School of Public Health (Baltimore, MD), the paper takes a wide-ranging look at radiological and nuclear terrorism scenarios.

The authors define radiological terrorism as the non-nuclear release of radioactive materials, such as radiation sources intentionally hidden in public places or the dispersal of radioactive materials using conventional explosives (a "dirty bomb"). Nuclear terrorism, on the other hand, covers the detonation of a nuclear weapon or an attack on a nuclear reactor or fuel-storage depot. Against such backdrops, radiation exposure, health effects and public health response are all considered in the US context, as are other key issues like crisis communication and national response infrastructure.

What emerges from the analysis is a headline conclusion that should engage medical physicists not just in the US but everywhere. Specifically, the authors argue that nuclear-medicine professionals - medical physicists, clinical scientists/technologists and radiologists - have a fundamental role to play in preparedness and response to radiological and nuclear terrorism. They identify all manner of potential contributions, including oversight of radiation plans and detection equipment; monitoring of radiation exposures; assistance with patient screening and radiation decontamination procedures; laboratory guidance for radiological assays; medical treatment of patients with internal contamination or significant exposures; oversight of radioactive waste disposal; and communication of risk guidance on radiation to first responders and the general public.

Think local

What's more, Links and his co-authors go further by encouraging nuclear-medicine professionals to get actively involved with the first-responder community in their local area. "Most municipalities do not have formally identified radiation experts, and nuclear-medicine professionals can fill this need," argues the paper. "A strong working relationship between such professionals and the public-safety sector (especially fire and police) needs to be built before a terrorist event, not during it."

Links, a former president of the Society of Nuclear Medicine who now works closely with officials from the Department of Homeland Security, offered an individual perspective in a separate press statement: "All preparedness starts locally. Their [the terrorists'] target isn't those who may get injured or killed in an explosion - it's all the rest of us."

As a call to action, this is strong stuff. As always, though, it's one thing putting recommendations down on paper, quite another translating those recommendations into action, especially when multiple agencies and resources need to be coordinated in a logical and agile fashion.

• Are you a nuclear-medicine professional involved in either a local or national capacity in terrorism preparedness and response? How do you rate the experience - encouraging, discouraging, downright depressing? If you're thinking about getting involved, would you carry out such work on a voluntary basis - an add-on to the day job - or only with the right financial package in place? Have your say now by using the Commenting tool below.