Radiological Response: Myth vs. Reality

1. Radiological Response:Myth vs. Reality James Barnes Certified Health Physicist Chairperson, Homeland Security Committee, Health Physics Society Bobbie Walton Governor’s Office of Emergency Services State of California

2. Health Physics SocietyHomeland Security Committee http://hps.org/hsc/

3. Radiation and the First Responder

4. Visualizing Radiation For best viewing, turn brightness and contrast on the monitor to maximum values http://faraday.physics.uiowa.edu/modern/7D30.60b.htm

5. Average Exposures From Background Radiation Average Exposure: 0.360 rem/year

6. Radiation Risk – High Dose

7. 2,000 Cancer Fatalities 10,000 people 2,004 Cancer Fatalities 10,000 people 1 REM (4 additional fatalities / 10,000 people) / 1 REM 0.0004 / rem Radiation Risk – Low Dose In our society, about 20% of the population will die of cancer. In 10,000 people, this means that 2,000 will die from cancer. If 10,000 people were to be given 1 REM of radiation, statistics suggest that 2,004 will die of cancer. This suggests that the risk of excess cancer deaths is increased by a factor of about 0.0004 per rem.

8. Myth 1 Radiation is so deadly that an attack using radioactive materials will kill thousands of people.

9. The Goiania Experience (Sept, 1987) Rozental, J. J. Radiological Accident in Goiana - An Overview.

10. The Goiania Experience • A mothballed tele-therapy irradiator was present in an abandoned hospital building. • Two men decided to “mine” the metal in the irradiator. • The unit (containing 1400 curies of Cs-137) was dismantled. The source capsule was ruptured and the cesium was released. • The “glowing crystals” (due the the extremely high radioactivity of the material) was taken home and shared with family and friends. • There was widespread contamination of the neighborhood.

11. Initial Response • 112,000 people (10 % of Goiania’s population) were surveyed at an Olympic Stadium. • 250 were identified as contaminated • 50 contaminated people were isolated in a camping area inside the Olympic Stadium for more detailed screening • 20 people were hospitalized or transferred to special housing with medicaland nursing assistance • 8 patients transferredto the Navy Hospital inRio de Janeiro • Residential contamination surveywas initiated

12. Early Consequences • Widespread contamination of downtown Goiania • 85 residences found to have significant contamination (41 of these were evacuated and a few were completely or partially demolished) • People cross-contaminated houses 100 miles away • Hot Spots at 3 scrap metal yards and one house

13. Radiation Injuries and Uptakes • 4 fatalities (2 men, 1 woman and 1 child) • 28 patients had radiation induced skin injuries(they held/played with the source for extended periods) • 50 people had internaldeposition (ingestion)

14. The Goiania Experience (cont.) • Significant psychological consequences amongst the population such as fear and depression. • Discrimination against the victims and key products of local economy • Psychomatic illnesses related to the accident stress. • In first 60,000 monitored individuals; • 5,000 presented symptoms consistent with Acute Radiation Syndrome (i.e, rash, nausea, vomiting, diarrhea, weakness, etc.). • Of these 5,000 persons, NONE were contaminated. Salter (citing Peterson in Nuclear News; 1988). Helping to Prevent Terror Following A Radiological Incident. HPS Annual Meeting; 2001.

15. Conclusions • Long and expensive clean-up effort. • Profound psychological effects such as fear and depression on large populations • Isolation and boycott of goods by neighbors

16. The Reality: The primary effect of this dispersed radioactivity was psychological and sociological, not radiological. The true radiation effects were limited to those in the immediate vicinity of the source remnants: • They were exposed the longest • They were closest to the source material • They had little protection from the source

17. The “Radiation” Terrorist

18. involves a violent act or an act dangerous to human life, property, or infrastructure; and • (ii) appears to be intended -- •       (A) to intimidate or coerce a civilian population; •       (B) to influence the policy of a government by intimidation or coercion; or •       (C) to affect the conduct of a government by mass destruction, assassination, kidnapping, or hostage-taking. Executive Order on Terrorist Financing, 24-September-2001 The term "terrorism" means an activity that --

19. The Nuclear Weapon

21. What was your reaction to that last slide?

22. Myth 2 Nobody can survive the aftermath of a nuclear weapon. There is so much radiation that it will scorch the earth.

23. Blast and Fire create high levels of destruction

25. The process (nuclear fission), creates radioactive materials and distributes them over a wide area (“fallout”).

28. The Reality Terrorists do not have thermonuclear weapons. They may have small yield nuclear (fission) weapons. The levels of an atomic weapon’s dispersion are NOT as severe as a hydrogen bomb’s, and CAN be survived. While such an attack would be devastating, it does not create an inescapable environment in the surrounding areas (i.e., survive the blast, and you have a good chance of escaping). With proper planning and preparation, people can escape from fallout affected areas without incurring serious exposures.

29. Radiological Dispersal Device

30. Myth 3 Thousands will die if a “dirty bomb” is exploded in a major city.

31. The Radiological Dispersal Device (RDD) Radioactive Material High Explosive

32. Detectable Ground Contamination Can be Found Miles Downwind ≥ 0.2 uCi/m2 Can be detected with thin window G-M meter ≥ 2 uCi/m2 Can be detected with dose rate meter

33. Despite Widespread Contamination, There Are Relatively Small Exposures ≥1 REM EPA Shelter Area Less than 0.1 miles downwind 0.01 – 0.1 REM out to 2 miles [Dose similar to a chest x ray or ~30% of natural background]

34. Los Angeles Example: EPA PAG Would Recommend Shelter/Evacuation of a Few Residential Blocks Release: 1.3 KCi CS-137 RDDwith 5 lbs HE 4-Day Dose (Internal + External)Evacuation/Relocation PAG HYPOTHETICAL Release location: Burbank Police Department 34 10' 60"N, 118 18' 31"W 100% Aerosolized release fraction Normal summertime west-northwest winds, 10-12 mph. Map size: 6 x 6 km

35. The Reality The Dirty Bomb is a weapon of mass disruption, not mass destruction. It is effective to the degree that it would: • Deny area access • Induce psychological stress in a population • Create economic disruption

36. What Will You Need to Know?

37. Know the Basics About Radiation • Lack of trained personnel is the primary reason for loss of control of radiation / radioactive environments • Responders FEAR radiation about as much as the public • Training should be tailored to the mission / scope of the responder (Firefighter vs. EMT vs. Haz Mat’l Team)

38. Where do you get this information? http://training.fema.gov/EMIWeb/IS/is301.asp

39. Where do you get this information? Many local HPS Chapters will provide training (general or specific) as a public service (especially to small (poor) organizations). http://hps.org/aboutthesociety/organization/chapters.html

40. Where do you get this information? http://hps.org/hsc/documents/

41. Know Your Response Mission Precisely • Examples: • Fire fighters: Set Perimeter; Recover Victims • Police: Secure Perimeter / Scene Investigation • FBI: Scene Management • Red Cross (and others): Mass Shelter and Feeding • EMTs / Medical: Victim Triage and Medical Services Management Each Mission Requires a Different Radiation Protection Approach

42. Where do you get this information? http://www.usfa.fema.gov/applications/nfacsd

43. Where do you get this information? http://terrorism.spjc.edu/ceu/blurb.asp?examid=11

44. Where do you get this information? http://hps.org/publicinformation/asktheexperts.cfm

45. Obtain and Maintain Instruments • “Simple” works • Match the Instrument to the Mission • Dose Rate instrument for scene entry • Contamination instruments for perimeters • No one instrument does it all • Cover a range of levels / doses • Dose Rates: 0.010 – 50,000 millirem • Contamination: 100 – 100,000 dpm • Keep them working and calibrated

46. Can I get instruments with no budget? http://www.ojp.usdoj.gov/odp/equipment_hder.htm

47. Know Your Radiation Exposure Limits for a Terrorist Scene • What is a “safe” dose level for a member of the public? • What dose level should a responder not exceed? • What dose level would make a rescue too dangerous to attempt? • When would the dose levels apply? These levels should be formally described. If you’re trying to figure this out AT THE SCENE, it’s TOO LATE!

48. “Emergency” Limits • No dose: Anecdotally reported to be the limit in several U.S. cities • 100 mrem: Limit listed for first responders in several emergency response guidance documents (some in draft stage) • 5,000 mrem: OSHA limit, (first responders to be engaged in occupational exposure in an emergency scenario) • 10,000 mrem: EPA guidance for property protection • 25,000 mrem: EPA guidance for lifesaving activities • 50,000 mrem: NCRP Report 138 • 75,000 mrem: “Old” military limit for lifesaving activities • No upper limit: Draft ICRP Guidance for lifesaving activities

49. Know Where to Get Expert Help • Local Radiation Regulatory Organizations (City, County, State) • Federal Organizations with Radiation Expertise (NRC, DOE, EPA) • Local Professional Societies (Health Physics Society Chapters, Medical Physicists, Radiation Oncologists, etc.) Do it NOW! Don’t wait until the event happens!