Recent Radiation Accidents

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
Product Year 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
68440-451 (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
• gt100 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, OHara 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, OHara 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, OHara 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 lt 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
• lt 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, OHara 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_at_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?

• Saddams 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, OHara 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, Saddams 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