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The cause for the severity of the Fukushima nuclear accident is explained, and the radiological consequences are assessed. Moreover, the non-radiological effects are critically evaluated and failures in onsite and offsite emergency response highlighted. In conclusion, disregarding the principle of justification, the evacuation of residents and hospital patients was implemented too rigorously, resulting in unnecessary fatalities due to the protective action.

For emergency preparedness and response with respect to nuclear power plant accidents, the concept of Emergency Care Centers has been developed in Germany. This setup aims at monitoring contamination, to decontaminate if needed, assess the dose, and perform an initial medical evaluation of people who might have been affected by the accident. The concept has been tested in many exercises. In response to a terrorist attack involving a dirty bomb, this concept may prove useful for attending contaminated people who are not severely injured.