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Recent Radiation Accidents

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  1. Recent Radiation Accidents Fun Fong, MD FACEP Emory-Adventist Hospital IAEA Photo - Radiation Triage at Goiania Secondary Assessment Center - 1987

  2. Radiation Accident Settings • Industry • Medicine • Occupational Settings • Research • Military • Transportation • Public Domain Shielded Radiography Unit DOE Photo – WIPP Shipment truck

  3. Contaminated 60Co Products Exported to the US ProductYear & Exporting Country Ferrous 1983 Mexico Ferrous 1985 Brazil Ferrous 1988 Italy Ferrous 1991 India Ferrophosphous 1993 Kazakhstan Ferrous 1994 Bulgaria Lubenau, J.O. and Yusko, J.G., “Radioactive Materials in Recycled Metals.” Health Physics 68:440-451 (April 1995).

  4. Gore, OK (1986) • UF6 Cylinder Reheated, Ruptured • 1 Death from HF Inhalation • 31 Others Exposed • Short-Term Kidney Damage

  5. Chernobyl, USSR (Apr 1986) • 1000 MW RMBK Supercritical Excursion and Steam Explosion • Release of • 45,000,000 Ci 133Xe • 5000,000 Ci 85Kr • 7,300,000 Ci 131I • 2,200,000 Ci 89Sr, 220,000 Ci90Sr • 116,500 Evacuated, 2 Deaths (Trauma) 28 Deaths (Radiation), 115 ARS, 56 Burns, 145 Exposures 0.7 – 1.6 Gy (Data Does not include ‘liquidator’ morbidity and mortality) Map – From IAEA, International Chernobyl Project – Technical Report, 1991

  6. Goiania Brazil (10 Sep 1987) • 1375 Ci 137Cs Breached Teletherapy Source • Delayed-Recognition • Population: Public Domain • 112,000 Surveyed • 249 Int or Ext Contamination • 129 Both Int + Ext Contamination • 28 Local Radiation Injury • 20 Intensive Care • 10 Critical • 4 Fatalities

  7. El Salvador, San Salvador (5 Feb 1989) • 18,000 Ci 60Co Irradiation Facility Source Jam • Delayed-Recognition • Cases: • 3 ARS + Local Radiation Injury • 1 Death • 4 Overexposures (9 – 22 cGy) IAEA, The Radiological Accident in San Salvador, Vienna: IAEA, 1989

  8. Soreq, Israel (21 Jun 90) • 340,000 Ci 60Co Irradiation Facility • 1 ¼ - 1 ½ minute Exposure • Expired 36 d Later IAEA, The Radiological Accident in Soreq, Vienna, IAEA, 1993, p34.

  9. Iran (1 Jul 90) • Radiography Source Found • Kept in L Trouser Pocket x 3 h • WB Dose 10 Gy (1000 rads) at midplane • 2 Others Involved • Cytogenetic Dose 1-2 Gy (100-200 rads)

  10. Zaragosa, Spain (1990) • Radiotherapy Linear Accelerator Misrepair Causes Electron-Beam Malfunction • 27 Oncology Pts • 20 Pts Expired since Jul 92

  11. Nesvidge Belarus (Oct 91) • 800,000 Ci 60Co Irradiation Facility • 1 – 3 minute Exposure • Expired 113 d later

  12. Shanxi, China (1992) • 10.7 Ci 60Co Lost Radiography Source • Delayed-Recognition • Cases: • >100 Surveyed for Overexposure • 12 Overexposures Confirmed • 3 ARS w / Fatality Phantom View – Shielded component of Radiography Unit

  13. Indiana, PA (1992) • 4.2 Ci 192Ir Lost Brachytherapy Source • Delayed-Recognition • Cases • 90 Overexposures (up to 20 cGy) • 1 ARS w / Fatality

  14. Hanoi, Vietnam (1992) • Electron Accelerator Facility • Exposed Hands to X-Ray Beam • 1 Hand amputated, 2 Fingers L Hand amputated

  15. Tammiku, Estonia (Oct 1994) • 3 Persons Entered Waste Repository Removed Metal Container Containing Radiation Source • 1 Death, Others Exposed

  16. Zheleznodorozhny, Russia (1995) • 137Cs Discovered in Truck Door Pocket • Exposure over 5 mo • WB Dose 8 Gy (800 rads)

  17. China (21 Nov 1995) • Industrial Irradiator • 2 Person Overexposure

  18. Jilin Province, China (5 Jan 96) • Radioactive Source Found, Placed in Trouser Pocket • R Leg, L Hand Exposures 2 – 9 Gy (200 – 900 rads) • Surgery Performed

  19. Houston TX (27 Feb 1996) • Stolen Radiography Cameras Containing 9, 40 Ci 60Co • 1 Significant Local Exposure • 22 Others Involved Source: REAC/TS Registry

  20. Baltimore, MD (1 Jun 1996) • Brachytherapy Seed Dislodged • 100 Gy (10000 rads) to Back • 1 Individual Photo – courtesy Dr. Fred Mettler

  21. Gilan Province, Iran (24 Jul 1996) • Radiography Source Missing x 2 Hours • 1 Overexposure • 55 Others Involved

  22. San Jose, Costa Rica (Aug – Sep 96) • Radiotherapy Unit Overexposures • 27 Significant Exposure • 115 Involved

  23. Lilo, Georgia (1 Apr 1997) • Sealed Sources Found • 11 with Significant Local Exposure Ricks RC, Berger ME, O’Hara FM, The Medical Basis for Radiation Accident Preparedness: The Clinical Care of Victims, Parthenon Publishing Group, New York: 2002, p 358.

  24. Arzamas-17 Russia (17 Jun 97) • HEU – Cu Reflector Assembly • 1 Individual • Neutron dose 45 Gy (4500 Rad) to Chest • Amputation both arms • Death 66 h after accident Flowmetry 11h and 33h after exposure Ricks RC, Berger ME, O’Hara FM, The Medical Basis for Radiation Accident Preparedness: The Clinical Care of Victims, Parthenon Publishing Group, New York: 2002, p 355.

  25. Kazahstan (1 Jan 1998) • Source of Exposure in Wall – Radioactive Scrap Metal • 50 – 80 mrem at 1 meter • 2 Significant Exposures • 34 Involved

  26. Ohio (Sep 98) • Medical Misadministration 131I • Fetal Dose WB 0.02 Gy (2.3 rads), Thyroid 88 Gy (8800 rads)

  27. Washington (16 Dec 1998) • Radiography Source • 1 Involved • WB Dose 0.5 Gy (50 rads) • Hand 6 – 17 Gy (600 – 1700 rads)

  28. Yanango, Peru (20 Feb 1999) • 36.75 Ci 192Ir Source • Placed Trouser Pocket for 6 Hours • R Hip Amputation, still healing • 1 Sat on Source for short time

  29. Boca Raton, FL (24 Feb 99) • X-ray device • Grabbed Focal Point of Device Inadvertently • Local Dose 20 Gy (2000 rads)

  30. Wichita, KS (7 May 1999) • Medical Misadministration • 20 wk Pregnant Pt received 11.8 mCi 131I • Fetal Dose WB 0.03 Gy (3 rads), Thyroid 253 Gy (25,330 rads)

  31. Tokaimura Japan (30 Sep 1999) • Criticality – Enriched Uranium • 69 Involved • 3 Significant Exposures • 2 Fatalities

  32. Albuquerque, NM (4 Dec 1999) • X-Ray Research Device • Hand – 10 Gy (1000 rads) • Fingertips – 30 Gy (3000 rads)

  33. Samuprakarn Province, Thailand (1 Feb 2000) • 4 60Co Radiotherapy Machines Left in Unsecured Area – 1 stolen • 10 Involved • 9 Hospitalized • 3 Fatalities Ricks RC, Berger ME, O’Hara FM, The Medical Basis for Radiation Accident Preparedness: The Clinical Care of Victims, Parthenon Publishing Group, New York: 2002, p 368.

  34. Los Alamos (16 Mar 2000) • Flow Meter Malfunction, causing transuranic radionuclide contamination • Nasal Smears 1250 – 170,000 dpm • Est CEDE < 20-50 rem • Ca-DTPA, Zn DTPA given

  35. St. Louis, MO (31 Mar 2000) • Glass Cylinder in Glovebox Handled Involving 99Mo and 99mTc • Portion of Hand 17 Gy (1700 rad)

  36. Meet Halfa (5 May 2000) • Lost Radiography Source • 31.5 Ci 192Ir • < 50 Exposed • 7 Family members exposed • 2 Fatalities (Father 7.5 – 8 Gy, (750 – 800 Rads), Younger Son 5 – 6 Gy (500 Rads)) Younger Daughter Hand 18 Dec 2000 Ricks RC, Berger ME, O’Hara FM, The Medical Basis for Radiation Accident Preparedness: The Clinical Care of Victims, Parthenon Publishing Group, New York: 2002, p 374.

  37. Panama (30 – 1 Jun 2001) • Medical Misadministration – Radiotherapy Pts

  38. Poland (2001) • Medical Misadministration – Linear Accelerator Used for Radiotherapy • 5 Pts – Progressively Larger Doses

  39. Kuala Lampur, Malaysia (2005) • Radiographers lost radiography source in ship piping • 2 Workers with ARS Symptoms Source: 21 Apr 05 – New Straits Times

  40. Summary • No Recent Broken Arrows / Bent Spears • Recent Drop in Irradiation Facility Accidents • Few Criticalities • Fewer Breached Sealed Sources • Fewer Delayed Recognition Accidents Needs Application of Epidemiological Treatment to Radiation Accidents and Injury Control Techniques

  41. Summary • All Triage Schemes Should Consider the Possibility of NBC Contamination • All Radiation Triage Schemes should Consider the Possibility of Combined Injury

  42. Any Questions? Fun.Fong@earthlink.net

  43. Any Questions? “Uncle” Erik Auf der Heide (Uncle of Disaster Medicine)

  44. Does/Did Usama bin Laden have Nukes? • 1993- 1994 Attempted U Purchase in Sudan • 1998 – Aide Charged w / Attempting to Obtain SNM • 1998 – Paid 2 Mil (PS) for “Suitcase” Bomb • 1998 – Al-Hayat declares UBL has Nuclear Weapons

  45. Did Saddam Have Nukes? • Saddam’s Bombmaker

  46. References • REAC/TS Accident Registry • IAEA, The Radiological Accident in San Salvador, Vienna: IAEA, 1989 • 3. IAEA, The Radiological Accident in Soreq, Vienna, IAEA, 1993, p34. • 4. Ricks RC, Berger ME, O’Hara FM, The Medical Basis for Radiation Accident • Preparedness: The Clinical Care of Victims, Parthenon Publishing Group, • New York: 2002. • 5. Dicus, GJ, “Materials Safety and Regulation” Speech Washington, DC, • 2 Apr 97 • 6. Dicus, GJ “Joint American-Russian Health Effects Research” Speech at • Washington, DC, 16 Jan 97 • 7. Hamza K, Saddam’s Bombmaker – The Terrifying inside story of the Iraqi • Nuclear and Biological Weapons Agenda, New York: Simon And Schuster, • 2000. Version 1.2, 1 May 2005