The country's 40 largest metropolitan areas are not well prepared to handle a non-power-plant related radiological or nuclear incident, such as a terrorist attack, according to a report from HHS' inspector general's office (PDF).

The report's authors found that among the 40 largest metropolitan statistical areas, 36 localities had conducted risk assessments regarding such incidents, 30 had determined their threat level and just 21 had conducted public health planning in at least one of five related areas of responsibility.

In addition, only 13 localities had coordinated with hospitals in planning for non-power-plant related radiological or nuclear incidents, and 12 had coordinated with emergency medical services.

The inspector general's office recommends a number of changes be implemented by the Centers for Disease Control and Prevention, including working with CDC grantees on better aligning preparation with needs, and providing more guidance on localities' responsibilities and coordination with other entities.

The CDC concurred with the recommendations, according to the report.