In this week's BMJ, Rubin and colleagues report a cross sectional survey and qualitative analysis of perceptions of risk and strategies to communicate risk in relation to the poisoning of Alexander Litvinenko with polonium-210 in London in 2006.1 The study breaks new ground, not only because it examines an important public health incident in a major metropolitan area, but because it is one of the first studies of behaviour and risk communication after an incident involving the intentional release of radioactive materials. As such, it offers valuable insights into emergency preparedness.

Major incidents involving radioactive materials can pose many challenges for emergency services, hospitals, and health departments. These include identifying the presence, type, and extent of contamination; issuing guidance on protective actions; implementing decontamination procedures; arranging health screening for potentially affected people; providing necessary treatment (for example, for internal contamination); and organising long term follow-up of affected populations.2

The extent of difficulty in meeting these challenges depends on several factors—one of the most …