Radiologic Terrorism

1
(No Transcript)
2
Radiologic Terrorism
Thomas P. Foley, Jr. M.D. May 1, 2004
3
Radiologic Terrorism

• Radiation Exposure
• Dirty Bombs
• Atomic Bombs
• Five decades after the first atomic bomb
• Terrorist atomic bomb
• Nuclear Power Plants
• Three Mile Island accident 1978 in PA
• Chernobyl accident, April 26, 1986, in the
  Ukrainian SSR
• Management of pregnant women and children

4
Radiologic Terrorism

• Radiation Exposure
• Dirty Bombs
• Atomic Bombs
• Five decades after the first atomic bomb
• Terrorist atomic bomb
• Nuclear Power Plants
• Three Mile Island accident 1978 in PA
• Chernobyl accident, April 26, 1986, in the
  Ukrainian SSR
• Management of pregnant women and children

5
Exposure to Ionizing Radiation

• Definitions
• Unstable atoms emit energy in the form of
  ionizing radiation to achieve stability.
• High frequency particles and electromagnetic
  energy causes adverse biologic effects
• Damage to DNA
• Production of free radicles
• Disruption of chemical bonds
• Production of new macromolecules
• Radionuclides are elements that emit ionizing
  radiation. They occur naturally uranium or are
  created by man plutonium.

6
Types of Ionizing Radiation

• Alpha ( a ) particles Helium atom nucleus
• (2 protons 2 neutrons) source nuclear weapon
  detonation.
• Beta ( ß ) particles electrons (high speed
  particles)
• Source nuclear reactors and radioisotopes of
  iodine
• Gamma ( ? ) rays photons (visible light)
• High energy penetrance, external radiation
  hazard
• Sources nuclear reactors and weapon detonation.
• X-Rays energy emitted from electrons
• Unlikely source of ionizing radiation from
  disasters
• Neutrons powerful and very damaging to tissues
• Emitted only from a nuclear weapon detonation.
• Characteristics
• Extremely heavy with limited penetrability.
• Cellular injury when ingested or inhaled.

7
Sources of Ionizing Radiation

• Nuclear weapon detonations
• a particles
• ? rays
• Neutrons
• Nuclear reactors
• ß particles
• ? rays
• Medical therapy
• X rays
• ß particles
• ? rays

8
Radiation Exposure Units of Measure

• Energy Absorbed from ?-rays and X-rays
• Old SI Units Conversion
• Radiation absorbed dose Rad Gray (Gy) 1 Gy
  100 rad
• 1 cGy 1 rad
• Roentgen equivalent mass Rem Sievert (Sv) 1
  Sv 100 rem
• Average Annual Exposure 360 mRem or 0.0036 Sv
• Chest X-Ray 5-10 mrem CT Scan 5,000 mRem
  (0.05 Sv)
• Activity for Radiation Emission of Radionuclides
• Unit of Decay Old SI Unit Disintergrations/sec
• Curie Ci - 1 Ci 3.7 X 1010 dps
• 1 Ci 37 MBq
• Becquerel - Bq 1 Bq 1 dps
• 1 MBq 109 dps

9
Environmental (Natural) Radiation Exposure

• Average Annual Exposure
• 360 mRem or 0.0036 Sv
• Sources
• Cosmic radiation and radon
• Cigarette smoke
• Medical devices
• Home appliances
• Pharmaceutical agent
• Specific Exposures
• 5-10 mRem Flight from New York to Los
  Angeles
• 5-10 mRem Chest radiograph
• 5,000 mRem (0.05 Sv) CT Scan

10
Radiologic Terrorism

• Radiation Exposure
• Dirty Bombs
• Atomic Bombs
• Five decades after the first atomic bomb
• Terrorist atomic bomb
• Nuclear Power Plants
• Three Mile Island accident 1978 in PA
• Chernobyl accident, April 26, 1986, in the
  Ukrainian SSR
• Management of pregnant women and children

11
Dirty Bombs

• Radiological dispersion device
• Conventional explosives (dynamite) with
  radioactive chemicals in powder or pellet form
• Purposes
• Expose buildings and people to radioactivity.
• Instill fear in people and contaminate buildings.
• Sources of radioactivity
• Nuclear facilities high-level radioactive
  material (unlikely)
• Hospitals, construction sites, and food
  irradiation plants low-level radioactive
  materials.
• Dangers
• The effect of the explosive blast
• Low-level radiation exposure not enough
  radiation to cause severe illness from exposure

12
Dirty Bombs

• Previous use of dirty bombs in a UN report
• Iraq tested a device in 1987 abandoned its use
  because radiation levels were too low to cause
  significant damage.
• Clinical management
• Humans cannot see, smell, feel, or taste
  radiation
• They likely will not know if radioactive
  materials are present.
• If they are not severely injured, they should
• Leave the area to the nearest building remain
  inside.
• Remove clothes and place into sealed bags for
  testing.
• Shower or wash themselves as best they can.
• Maintain contact with emergency information.
• These procedures reduce injury from chemicals
  radiation.

13
Radiologic Terrorism

• Radiation Exposure
• Dirty Bombs
• Atomic Bombs
• Five decades after the first atomic bomb
• Terrorist atomic bomb
• Nuclear Power Plants
• Three Mile Island accident 1978 in PA
• Chernobyl accident, April 26, 1986, in the
  Ukrainian SSR
• Management of pregnant women and children

14
Atomic Bomb Detonation in NagasakiAugust 9, 1945
at 1102 AM

• Distance from Hypocenter
• 500 m 1000 m
• Radiation
• Gamma rays 70-80 Gy 9-10 Gy
• Neutrons 7-8 Gy 0.9-1 Gy
• Heat Energy 111.5 Cal/cm2 42.2 Cal/cm2
• Wind Pressure 19.0 ton/m2 8.7 ton/m2
• Wind Velocity 280 m/sec 160 m/sec
• Deaths before December 1945 73,884
• Atomic Bomb Survivors 110,716 in 1978
• 88,249 in 1995
• Total Population in Nagasaki City 210,000 in 1945

15
Late Effects from Atomic Bomb Exposure

• Diseases Increase Increase
• Suspected Confirmed
• Thyroid adenoma 3 years 5 years
• Leukemia 3 years 10 years
• Thyroid cancer 7 years 10 years
• Breast cancer 10 years 20 years
• Lung cancer 10 years 20 years
• Gastric cancer 15 years 30 years
• Colon cancer 15 years 30 years
• Multiple myeloma 23 years 30 years
• Parathyroid adenoma 30 years

16
Thyroid Disease and Atomic Bomb Radiation
17
(No Transcript)
18
Age at Radiation Exposure and Breast Cancer

• Land CE. JAMA 1995274402-407, Figure 4

19
Atomic Bomb Survivors Breast Cancer 1950-1990

• Land CE, et al. Radiat Res 2003160707-717.
  Figure 6

20
Radiologic Terrorism

• Radiation Exposure
• Dirty Bombs
• Atomic Bombs
• Five decades after the first atomic bomb
• Terrorist atomic bomb
• Nuclear Power Plants
• Three Mile Island accident 1978 in PA
• Chernobyl accident, April 26, 1986, in the
  Ukrainian SSR
• Management of pregnant women and children

21
Hypothetical Atomic Bomb Detonation in New York
City

• A 150 kiloton bomb constructed by terrorists
  is detonated in the heart of Manhattan, at the
  foot of the Empire State Building. The bomb goes
  off without warning at noon time. It's a clear
  spring day with a breeze to the east.

22
Hypothetical Atomic Bomb Detonation in New York
City

• 1 second after detonation Blast wave 0.4 mile,
  Fireball thermal effects 0.2 mi

23
Hypothetical Atomic Bomb Detonation in New York
City

• 4 seconds after detonation Blast wave for 1
  mile, buildings destroyed

24
Hypothetical Atomic Bomb Detonation in New York
City

• 6 seconds after detonation Blast wave for 1.5
  miles, thermal effects and fires

25
Hypothetical Atomic Bomb Detonation in New York
City

• 10 seconds after detonation Blast wave extends 4
  miles, damage to buildings

26
Hypothetical Atomic Bomb Detonation in New York
City

• Long-Term fallout pattern from a 150 kiloton
  surface burst, with a uniform 2 mph wind from the
  east.

27
Hypothetical Atomic Bomb Detonation in
New York City

• Fallout Effects
• Rem Effects
• 5-20 Possible late effect Possible
  chromosomal
• damage.
• 20-100 Temporary reduction in white blood
  cells.
• 100-200 Mild radiation sickness within a few
  hours
• vomiting, diarrhea,
  fatigue reduction in
• resistance to infection.
• 200-300 Serious radiation sickness effects (as
  above)
• and hemorrhage Lethal dose
  to 10-35 of
• population after 30 days
  (LD 1-35/30).
• 300-400 Serious radiation sickness also bone
  marrow
• and intestinal destruction
  LD 50-70/30).
• 400-1000 Acute illness, early death LD 60-95/30.
• 1000-5000 Acute illness, early death in days LD
  100/10.