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Polonium!!!. The London Po-210 Poisoning Case: What we know and what we don’t know May 15, 2008. CAPT Michael A. Noska, USPHS Senior Health Physicist U.S. Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health . Outline.

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the london po 210 poisoning case what we know and what we don t know may 15 2008

The London Po-210 Poisoning Case:What we know and what we don’t knowMay 15, 2008

CAPT Michael A. Noska, USPHS

Senior Health Physicist

U.S. Department of Health and Human Services

Food and Drug Administration

Center for Devices and Radiological Health

outline
Outline
  • Basic chronology of the events
  • Internal Radiation Dosimetry 101
  • Specifics of Polonium-210
  • Dosimetry for Mr. Litvinenko
  • Health physics, public health and criminal F/U
chronology
Chronology

11/1/2006 Litvinenko meets Russians at London hotel. Several hours later, becomes sick with vomiting.

11/4/2006 Litvinenko admitted to hospital

11/11/2006 Condition very bad. Placed under armed guard.

11/19/2006 Report of thallium poisoning.

11/21/2006 Litvinenko critical, suffers heart attack. Russians deny involvement.

11/23/2006 Litvinenko dies.

11/24/2006 Litvinenko’s statement read. Health authorities identify Po-210 as probable cause of death.

basic radiation physics and dosimetry
Basic Radiation Physics and Dosimetry
  • Types of radiation: α, β+/β-, γ/x, n
  • Radioactivity: (units: Ci, Bq)
  • Half-life
  • Absorbed dose: energy imparted per unit mass of tissue
  • Units: rad/rem, Gy/Sv

1 Gy=100 rad; 1 Sv=100 rem

dose parameters
Dose Parameters
  • Type of radiation
  • Amount of radioactivity
  • Half-life
  • Chemical form
  • Biodistribution
  • Biokinetics
  • Body/organ mass
  • Time of administration
  • Route of administration
polonium 210 po 210
Polonium-210 (Po-210)
  • Solid metal at room temperature
  • Dissolves readily in dilute acids
  • Decays by alpha particle emission

“Pure alpha”

  • Becomes easily airborne and “creeps” due to alpha recoil energy
po 210 continued
Po-210 continued
  • Uranium series

decay product

  • Physical half-life:

138.38 days

  • Biological half-life:

50 days

  • Effective half-life:

36.7 days

  • Specific activity:

4490 Ci/g

sources of po 210
Sources of Po-210
  • Naturally occurring in plants and foods (tobacco)
  • Grazing animals concentrate in body tissues
  • Nuclear weapons (not currently)
  • RTGs for space program (not currently)
  • Anti-static devices (sealed sources)
  • Nuclear reactors

Russia makes ~100 grams per year and exports ~1 gram per year to the US

radiation hazard
Radiation Hazard
  • No external hazard due to very low yield gamma emission
  • Internal hazard due to α-particle
  • High LET
  • Distributes in soft tissue → whole body dose
  • Concentrates in liver, kidney, RBM, spleen and skin
  • Excreted via urine, feces, skin
what do we know
What do we know?
  • Type of radiation
  • Amount of radioactivity
  • Half-life
  • Chemical form
  • Biodistribution
  • Biokinetics
  • Body/organ mass
  • Time of administration
  • Route of administration
what do we know15
What do we know?
  • Type of radiation YES
  • Amount of radioactivity
  • Half-life
  • Chemical form
  • Biodistribution
  • Biokinetics
  • Body/organ mass
  • Time of administration
  • Route of administration
what do we know16
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life
  • Chemical form
  • Biodistribution
  • Biokinetics
  • Body/organ mass
  • Time of administration
  • Route of administration
what do we know17
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life YES
  • Chemical form
  • Biodistribution
  • Biokinetics
  • Body/organ mass
  • Time of administration
  • Route of administration
what do we know18
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life YES
  • Chemical form NO
  • Biodistribution
  • Biokinetics
  • Body/organ mass
  • Time of administration
  • Route of administration
what do we know19
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life YES
  • Chemical form NO
  • Biodistribution MAYBE
  • Biokinetics
  • Body/organ mass
  • Time of administration
  • Route of administration
what do we know20
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life YES
  • Chemical form NO
  • Biodistribution MAYBE
  • Biokinetics MAYBE
  • Body/organ mass
  • Time of administration
  • Route of administration
what do we know21
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life YES
  • Chemical form NO
  • Biodistribution MAYBE
  • Biokinetics MAYBE
  • Body/organ mass YES
  • Time of administration
  • Route of administration
what do we know22
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life YES
  • Chemical form NO
  • Biodistribution MAYBE
  • Biokinetics MAYBE
  • Body/organ mass YES
  • Time of administration NO
  • Route of administration
what do we know23
What do we know?
  • Type of radiation YES
  • Amount of radioactivity NO
  • Half-life YES
  • Chemical form NO
  • Biodistribution MAYBE
  • Biokinetics MAYBE
  • Body/organ mass YES
  • Time of administration NO
  • Route of administration NO
retrospective dose assessment
Retrospective Dose Assessment
  • Incomplete information
  • Assumptions (time, route of administration)
  • Biological samples
  • Biokinetic models:

ICRP 30, ICRP 68, ICRP 72

  • Animal data
  • Lethal dose (LD50/60)
  • Acute versus chronic dose
icrp gi tract model
ICRP GI Tract Model

Stomach

1 hour

4 hours

SI

Blood

13 hours

ULI

f1 = 10% for polonium

LLI

24 hours

Feces

mr litvinenko s dose
Mr. Litvinenko’s Dose
  • He got a snootfull (Sf)!
  • 1-3 GBq (~25-80 mCi)
  • 50 mCi?
  • ~6 micrograms
  • Dose to RBM ≈ 9 Gy in three weeks
  • Other organs: liver (25 Gy/GBq), kidneys (40 Gy/GBq), spleen (15 Gy/GBq)*

*J. Harrison et al, Polonium-210 as a poison, J. Radiol. Prot. 27 (2007), pp. 17-40.

health physics response
Health Physics Response
  • HPA aka NRPB
  • Surveys
  • Laboratory analysis
  • Clean-up/remediation
  • Total government response (NRC, DOE, EPA equivalents)
other contaminated locations
Other Contaminated Locations
  • Offices
  • Restaurants
  • Coffee bars
  • Nightclubs
  • Football (soccer) stadium
  • Airplanes
  • Cars
  • Hotels (3 primarily)
public health response uk
Public Health Response (UK)
  • Health Protection Agency
  • Tracked plane passengers and anyone else who had contact with Litvinenko
  • Comm. plan (Website, media, call center)
  • Developed protocols for lab analysis and dose assessment based on urinalysis, ICRP models
  • Follow-up criteria: <1mSv,1 ≥EDE<6, ≥6
  • 738 samples (686/35/17)
public health response us
Public Health Response (US)
  • CDC worked closely with UK
  • State Department, CDC Quarantine program
  • Public Health message (HAN, Epi-X)
  • Identified labs and developed analytical plans (similar to UK)
  • ~100 self-reported, 24 samples analyzed

All results <1mSv

the cdc team
The CDC Team

Radiation Studies Branch

Charles W. Miller, PhD

Robert C. Whitcomb, PhD, CHP

Armin Ansari, PhD, CHP

CDR Jeffrey B. Nemhauser, MD, USPHS

Carol McCurley, MS

Communications

Bernadette Burden, Office of the Director

Dagney Olivares, National Center for Environmental Health/Agency for Toxic Substances & Disease Registry

Division of Laboratory Sciences

Robert Jones, PhD

Division of Global Migration and Quarantine

Gary W. Brunette, MD

Special Thanks: John Croft, PhD, Head of Emergency Response, United Kingdom Health Protection Agency

criminal investigation
Criminal Investigation
  • Poisoning suspected early, type unknown
  • Discovery of rad contamination (11/21)
  • Millenium hotel bar and sushi bar closed (crime scene and public health concern)
  • Easy to follow trail
  • Suspect identified May 2007
conclusion
Conclusion
  • Almost the perfect crime!
  • Major impact both in UK and internationally
  • Media frenzy
  • View to the future?
  • Could it happen here? It did!
june 29 1995
June 29, 1995
  • NIH P-32 Incident
  • 27 people (including pregnant worker) internally contaminated with ~1-500 μCi
  • Laboratories and researcher’s home contaminated
  • Massive survey, bioassay and decontamination effort
  • Local event
acknowledgement
Acknowledgement

Dr. Charles Miller

CDC, Radiation Studies Branch