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A huge earthquake struck the northeast coast of the main island of Japan on March 11, 2011, triggering a tsunami with 14–15 meter-high waves hitting the area. The earthquake was followed by numerous sustained aftershocks. The earthquake affected the nuclear power plant (NPP) in Fukushima prefecture, resulting in large amounts of radioactive materials being released into the environment. The major nuclides released on land were 131I, 134Cs, and 137Cs. Therefore, almost 170 000 people had to be evacuated or stay indoors. Besides the NPP and the telecommunications system, the earthquake also affected infrastructures such as the supplies of water and electricity as well as the radiation monitoring system. The local hospital system was dysfunctional; hospitals designated as radiation-emergency facilities were not able to function because of damage from the earthquake and tsunami, and some of them were located within a 20 km radius of the NPP, the designated evacuation zone. Local fire department personnel were also asked to evacuate. Furthermore, the affected hospitals had not established their evacuation plans at that time. We have learned from this “combined disaster” that the potential for damage to lifelines as well as the monitoring systems for radiation in case of an earthquake requires our intense focus and vigilance, and that hospitals need comprehensive plans for evacuation, including patients requiring life support equipment during and after a nuclear disaster. There is an urgent need for a “combined disaster” strategy, and this should be emphasized in current disaster planning and response.

Maintaining a high quality atmosphere is one of the essential factors in effective operation and performance of a nuclear submarine. Deviations from the Bureau of Medicine & Surgery (BUMED) atmospheric contaminant limits can result in a submarine altering operations, surfacing to ventilate or even aborting missions. Continuous shipboard monitoring of the major constitutents and contaminants of the air provides the atmosphere quality data needed to insure safe operations and assist the Medical Community in evaluating potential problems. This task is currently accomplished with the Naval Reaearch Laboratory's (NRL's) Central Atmosphere Monitoring System (CAMS) MK I. CAMS MK I is a combination mass spectrometer-infrared atmosphere monitor that for the first time provides the Fleet with a reliable, service approved analyzer with the ability to monitor the atmosphere in various submarine locations. Concentrations of oxygen, nitrogen, carbon monoxide (CO), carbon dioxide (CO2), hydrogen, water vapor, and three refrigerants (R-11, R-12, R-114) are monitored continuously and displayed in a digital format for the crew. The atmosphere throughout the submarine can be analyzed rapidly (within a few minutes) by obtaining air samples from various submarine locations through a compartment selector valve. A second generation of the CAMS, CAMS MK II, is currently under development. CAMS MK II will significantly expand the flexibility of CAMS MK I while maintaining its high level of reliability. The expanded capability of CAMS MK II is designed to meet the future requirements of the Submarine Fleet. Using Navy approved microprocessors, CAMS MK II will automatically acquire, store, and interpret atmosphere data. Software changes to the CAMS MK ***IT'S powerful and flexible data processor will allow ready expansion of monitoring capability to meet the changing requirements of the Fleet as well as allowing CAMS MK II to control other life support equipment. A description of CAMS MK I is presented as well as examples of operational accomplishments. A technical description of the CAMS MK II development program also is presented along with the system approach for integrating the life support equipment.