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Radiation as a Weapon of Terror

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  • Why does radiation prove to be an effective weapon of terrorists. Radiation cannot be detected by the senses. Radiation is poorly understood by the public. It will not be clear to individuals whether they have been exposed or not. This is likely to produce panic. A radiological terrorist incident could well produce mass casualties. Thermal and radiation burns are difficult, time consuming, and resource intensive injuries to treat. There will likely be many psychosomatic “injuries”. Medical facilities will be quickly overloaded. The actual spread of radioactive “dirt” may be widespread. In addition, the public will be unable to detect whether they are contaminated or not. The number of people who think that they are contaminated, irradiated, and suffering from radiation sickness may be large. Efforts at self-evacuation will probably result in urban grid-lock, complicating emergency response. Until the extent of contamination is evaluated, many public services will be disrupted. This will contribute to psychological distress.
  • In 1994, while 17-yer-old David Hahn was still in high school, he managed to build a working nuclear breeder reactor, using mostly commercial products, in the shed behind his mother’s house in suburban Detroit. He worked secretly, and hoped that his achievement would help him to become an Eagle Scout. What is a breeder reactor? The Department of Energy described it with this way: “Imagine you have a car and begin a long drive. When you start, you have half a tank of gas. When you return home, instead of being nearly empty, your gas tank is full. A breeder reactor not only generates electricity, but it also produces new fuel for itself. It becomes more radioactive over time.
  • Hahn collect the necessary precursors from readily available sources. He located many of them by driving around his town with a Geiger counter. He learned the necessary techniques from readily available government and scientific publication.
  • The reactor became significantly more radioactive within a matter of weeks as it produced Uranium-233. When he could detect the radiation from 5 doors down, he terminated the experiment. His activities were discovered by authorities when his car was stopped by police, who became suspicious and found the reactor in the trunk of his car. They mistakenly believe that it was an improvised explosive device. When radiation was detected, numerous federal agencies were called in and the true significance of his achievement was discovered. His backyard was declared a Superfund Site and it was decontaminated by the EPA. The EPA stated that the 40,000 nearby residents could have been put at risk had radioactive dust been accidentally liberated. After graduation from high school, he joined the Navy and was stationed on the nuclear powered USS Enterprise aircraft carrier as a lowly seaman, where his duties included swabbing decks and peeling potatoes. It is not yet known what the long range effects of his exposure to high doses of radiation will be.
  • Radiation is energy that comes from a source and travels through space. It is critical to differentiate between radiation and its source because the source itself can be a contaminate, while radiation itself cannot. Radioactive contamination continues to emit radiation. A person who has been irradiated poses no threat to health professionals. A person who is contaminated carries radioactive sources on his person and is a definite threat to others. Decontamination involves removing the sources from a person or object, after which the person or object no longer poses a threat. This distinction is critical for you to understand. Some victims of a radiological incident pose no threat to you. Others may be dangerous. Some can be cared for with impunity. Others must be decontaminated to remove radiation sources before they are safe. Light, heat, and sounds are also forms of radiation. The are forms of energy that are emitted from a source and travel through space.
  • The types of radiation that are emitted from a source may be either photons, electrons and/or neutrons. An alpha particle is made up of photons and neutrons . A beta particle is a very high speed electron . Gamma rays and x-rays are pure energy consisting of photons. Neutron radiation is very high speed neutrons . Notice that alpha radiation, beta radiation, and neutron radiation consists of particles, while gamma rays and x-rays are pure energy.
  • Helium nucleus An alpha particle contain two protons and two neutrons. As a result it has a strong positive charge. An alpha particle is a large particle that will travel only a few inches in air. It will not penetrate paper or dead skin, therefore it is only dangerous when incorporated into the body by ingestion, inhalation or through a wound.
  • A beta particle is a very small particle consisting of a very high speed electron. It carries a negative charge. A high-energy beta particle can travel about ten feet in air and can penetrate paper and human skin. It can be shielded by plastic, glass, and metal foil.
  • Gamma rays and x-rays are pure energy and not particles. They consist of photons and have no mass or electrical charge. Photons travel at the speed of light. These forms of pure energy travel as waves of a very short wavelength. Gamma rays and x-rays can penetrate and damage all organs and must be shielded by lead, steel, or concrete.
  • Neutron radiation is a high speed neutron particle having no electrical charge. Neutrons ionize matter by direct collision with electrons. Neutron radiation can be shielded by carbon, lithium, cadmium, boron, plastic, and water.
  • (OPTIONAL SLIDE) Normal background radiation includes cosmic radiation from outer space and radiation from sources in the earth’s crust. Some normal background radiation is deposited in the body from ingestion of food and water which have absorbed radiation sources from the environment. There is also naturally occurring radon in the soil.
  • (OPTIONAL SLIDE) Manmade sources of background radiation include tobacco products (which contain radon absorbed by the plant leaf), medical radiation (from x-rays, nuclear medicine diagnostics, and radiation therapy), building materials (which contain terrestrial radiation sources) and the water supply (which contains dissolved radioactive minerals).
  • Radioactive isotopes are found in natural sources, such as radon in the air, radium in the soil or uranium ore. Some devices produce nuclear interactions which produce isotopes, such as cyclotrons and linear accelerators. Nuclear reactor produce large quantities of radioactive isotopes.
  • The moral of the story is: Intelligent people with enough determination can build sophisticated nuclear devices using readily available materials and information that can be collected from sources accessible to the public. This is a deeply disturbing but indisputable conclusion.
  • Thousands of former Soviet weapons scientists have not successfully found suitable new jobs in the civilian economy and are currently impoverished. They are poor people with something to sell. Nuclear expertise can be bought.
  • Russia currently has no consolidated system of nuclear materials registration and it is very difficult to track the quantity, deployment, and transportation of nuclear material. Radioactive materials can be bought.
  • Reactor wastes are the ideal material for terrorists to use in radiation dispersal devices or “dirty bombs”. Reactor wastes can be stolen and sold.
  • Anti-nuclear activists in the former Soviet Union have taken photos from close range of storage facilities in dilapidated states of repair. Electric fences are in disrepair and guard posts are unmanned. In 1994 alone their was documentation of 65 incidents of bribing guards for entry, 35 individuals caught passing through fences, 45 caught with false documents, and 6 who sold uranium to undercover police at a single plant! In 2002, police seized a 2 kilogram segment of a uranium fuel rod found in the luggage rack of a car. The motorist was found to have almost $10,000 on his person in a very impoverished country.
  • The nuclear black market is most active around and inside nuclear plants in the former Soviet Union. Fifteen kilograms of commercial grade uranium from a reactor site were found under the bathtub of one plant employee. In Moscow in 1995, enriched uranium was found inside a cabinet secured with a bicycle lock!
  • In 1998, Russian Army Lieutenant General Lebed said one of his assignments was to account for 132 suitcase-sized nuclear weapons that the Soviet Union had manufactured during the 1970’s and 1980’s. He could account for only 48. “We do not know what the status of the other devices is. We just could not locate them.” The device, built by the KGB for sabotage purposes had an explosive potential equivalent to one thousand tons of TNT. We know that this could have been done. In the 1960’s, the United States built a mini nuclear device, the Special Small Atomic Demolition Munition. The device weighed 80-100 pounds and could fit into a duffel bag. It was designed for sabotage missions to destroy airfields, bridges, and dams.
  • High and low level wastes are the byproducts of electricity production at nuclear power plants. These include spent fuel and various “garbage” created by the reactor. Terrorists could use these in a “dirty bomb” dispersed by high explosives to contaminate an area so that it could not be accessed or used safely. Many engineering safeguards at a nuclear power plant are disabled during a “Shut Down”. The reactor is most vulnerable to attack by terrorists during this time.
  • A Radiological Dispersal Device spreads radiation or nuclear material contamination over an area and constitutes the most realistic means of a terrorist nuclear attack. It would involve the use of a dispersal device, (such as explosives, fire or water) designed to disperse radioactive material. For example, radiography check sources found in most local hospitals could spread considerable contamination if dispersed in a conventional explosion. Weapons grade material is not required for a Radiological Dispersal Device.
  • Contamination is the deposition of radioactive material in any place where it is not desired, particularly where its presence can be harmful. Contamination is radioactive “dirt” and radioactive materials are “dirty”.
  • Avoid contamination in the first place. Use a respirator early Use time, distance, and shielding effectively Removal of outer garments removes most radiological contamination. Soap and water remove most of the rest. If entering a contaminated area, use light, disposable, one-piece attire if available. Do not eat, drink, smoke, scratch, apply make-up or rub your eyes in a contaminated environment. Avoid cuts and abrasions.
  • A patient who has been exposed to ionizing radiation has been injured by the exposure but does not emit radiation himself. There is no ongoing source of radiation injury. A patient who has be contaminated with radiation-emitting materials continues to be injured by them and posses a threat to others
  • This is a critical point for health care providers. Using proper technique, it is impossible for a living patient to be so contaminated as to pose a threat to care providers. This is because the radioactive contaminations is not so radioactive as to be immediately lethal, and providers can use time, distance, shielding, and decontamination to minimize their own exposure.
  • To prevent biological injury it is important to minimize exposure to radiation and contamination. The principle of A-L-A-R-A is “As low as is reasonably achievable.” Time, distance and shielding are ways to minimize exposure. The shorter the time of exposure, the lower the dose. The greater the distance from an emitter, the lower the dose. The greater the mass of effective shielding between the body and the emitter, the lower the dose. Time, distance, and shielding are ways to minimize exposure to radiation and contamination and to keep exposure “as low as reasonable achievable”.
  • A rescue can be performed even in a high radiation area with relative low exposure if the rescue procedure is broken down into tasks requiring only a brief period of time. Then each tiny segment of the rescue is performed by a different rescuer. Each rescuer’s exposure time (and thus his total dose) will be dramatically minimized.
  • The area of a sphere increases as the square of its radius. Since energy radiates from a source in all directions, radiation dose varies as the inverse square of the distance from the source. Therefore, doubling the distance from a source halves the radiation dose and halving the distance from a source increases the dose four times! If you don’t follow the math, just understand that distancing oneself from a source by even a small amount will significantly decrease ones radiation exposure.
  • Four to twelve inches of soil used to cover a discrete radiation source will stop 50% to 90% of the radiation! A shovel may be an important defense tool. An engine block, a concrete wall, or an earthen berm can be adequate shielding if kept between a rescuer or a care provider and the source.
  • Ionizing radiation interacts with the atoms in tissue and causes cellular damage.
  • External exposure occurs when the source of radiation is remote from the person, such as is the case with an x-ray, where the emitter is some distance form the patient’s body. After receiving an x-ray, the patient is NOT radioactive and the patient is NOT a threat to others.
  • Internal exposure poses the most serious chronic radiation risk. Radioactive materials are internalized by inhaling radioactive particles in the air, or by ingesting contaminated food or water, or by absorbing material through the skin or mucous membranes, or by incorporating contaminants in a wound. An individual who has internalized radioactive material has become a radioactive source. He continues to expose himself to radiation and also poses a threat to others.
  • Ionizing radiation causes biological damage when it interacts with the atoms forming cells. If the damage is sufficient, the cell dies. The nucleus is a sensitive cell structure. Changes begin to occur within DNA and RNA with even low doses of ionizing radiation. If chromosomes replicate too slowly, the cell may die. If the chromosomes replicate, but are damaged such that they contain errors, mutations will occur. This may result in the formation of a tumor. In some cases it leads to fetal abnormalities.
  • The water in the cells may be broken down by ionizing radiation to produce H+ ions and OH- ions. They may recombine to form hydrogen peroxide is very toxic. The damage to the cells inflicted by hydrogen peroxide is more damaging to the cell structure than ionizing radiation itself.
  • Cells have different sensitivities to ionizing radiation. An actively dividing cell is most vulnerable. Lymphocyte, blood producing cells, hair follicles, and male reproductive cells are constantly replicating and are therefore the most sensitive. Gastrointestinal cell do not regenerate as quickly and are less sensitive. Nerve and muscle cell are the slowest to regenerate and are the least sensitive to radiation. Therefore, a victim who demonstrates neurological signs and symptoms has had a very large radiation exposure and has a poor prognosis.
  • High doses of radiation to the whole body over a short period of time produce acute health complications. Low doses of radiation to the whole body over an extended period of time produce chronic health complications
  • Acute Radiation Syndrome occurs over a period of hours to weeks, sometimes up to sixty days. It has four stages: (1) the Prodromal Stage, characterized by onset of symptoms, (2) the Latent Stage, in which the patient seems to be getting better, and (3) the Manifest Illness Stage, in which the patient’s symptoms recur in their most advanced form. In the fourth stage, the patient either recovers or dies. As doses increase, the onset of symptoms is earlier and more severe, the latent period is briefer with less improvement, the period of manifest illness is longer and more profound, recovery becomes more protract (up to several months), and the probability of death increases. If the patient survives, the probability of chronic issues, such as malignancy, increase with dose.
  • The dose of radiation is important in predicting the time of onset and the severity of the symptoms. High doses produce severe symptoms of rapid onset. This is indicative of a poor prognosis. Low doses produce no obvious sickness. Transient decreases in blood cell counts and sperm counts in males may be noted in the laboratory. After moderate exposures moderate symptoms may occur within hours of exposure. There may be moderate degrees of nausea and vomiting beginning three to six hours after exposure and lasting from several hours to several days. Blood cell counts decrease because of marrow suppression and the risk of infection is high. As doses increased, nausea and vomiting occur earlier and last longer. Decreases in blood counts become increasingly profound. Hair loss will become increasingly severe. The risk of infection and death increases. The risk of cancer in later life increases incrementally to about 70%. Above one million millirem of exposure, gastrointestinal symptoms are immediate and profound. Severe hemorrhagic diarrhea is present. The patient experiences cardiovascular collapse. Although there may be a transient period of apparent improvement for several hours to one or two days, the patient relapses with prostration, fever, bloody diarrhea, delirium, coma, and death. At doses over three and a half million millirem, clinical symptoms begin within seconds and are primarily neurological in nature. Disorientation is followed by coma and seizures. Death occurs within one or two days. The LD-fifty for victims without medical care is about 300,000 millirem. The LD-fifty for victims give proper hospital care is about 500,000 millirem.
  • There is a tendency for iodine to concentrate in the thyroid. Radioiodine enters the body by inhalation and by consuming milk from cows that have ingested radioiodine contaminated food and water. Radioiodine concentrated in the thyroid gland dramatically increases the incidence of thyroid adenocarcinoma, a cancer. If normal iodine is made available in the blood prior to the absorption of radioiodine, the normal iodine will saturate the gland so that no radioiodine can be absorbed. Potassium iodide is 95% effective in blocking the absorption of radioiodine if taken two hours before exposure. In radiation emergencies, the FDA recommends a daily adult dose of two 65 milligram tablets. Smaller doses are given for children and infants. Potassium iodide is NOT effective against any other isotope except for radioiodine! It is not a panacea against radiation.
  • The somatic effect of chronic radiation exposure is usually some form of cancer. The main types of cancers are lung, bone, thyroid, breast, skin, and leukemia. Genetic effects result from mutations of the egg or sperm. This results in malformation of organs in the offspring. There has so far been no evidence that mutations can be passed to future generations. When the embryo or fetus experiences chronic radiation exposure, the result may be intrauterine death, birth defects, growth retardation, developmental abnormalities, and childhood cancers.
  • An individual exposed to ionizing radiation incurs a lifetime increased risk of cancer. These organs are commonly involved. (Pause)
  • Radiation can be an effective terrorist weapon. It causes fear and social disruption as well as actually injuring and killing citizens. It is possible to sabotage sources of radiation in the community to cause widespread contamination. Sources of radiological expertise and radioactive materials are available, so it is even feasible to construct radiological weapons of various types. Health professionals can take steps to protect themselves while providing care to victims of a radiological attack.
  • South Carolina AHEC wishes to give credit where credit is due. This presentation borrows heavily from “The Weapons of Mass Destruction Radiation/Nuclear Course for Hazardous Materials Technicians” produced by the U.S. Department of Justice - Office for Domestic Preparedness, the U.S. Department of Energy, and Bechtel Nevada AND Emergency Medicine , Fourth Edition, produced by the American College of Emergency Physicians and edited by Judith Tintinalli, M.D.

Radiation as a Weapon of Terror Radiation as a Weapon of Terror Presentation Transcript

  • Radiation as a Weapon of Terror
  • Acknowledgements
    • South Carolina Area Health Education Consortium (AHEC)
      • Funded by the Health Resources and Services Administration.
        • Grant number: 1T01HP01418-01-00
      • P.I. : David Garr, MD, Executive Director AHEC
      • BT Project Director: Beth Kennedy, Associate Program Director AHEC
      • Core Team:
        • BT Co-director: Ralph Shealy, MD
        • BT Project Manager: Deborah Stier Carson, PharmD
        • BT CME Director: William Simpson, MD
        • IT Coordinator: Liz Riccardone , MHS
        • Web Master: Mary Mauldin, PhD
        • P.R Coordinator: Nicole Brundage, MHA
        • Evaluation Specialist: Yvonne Michel, PhD
        • Financial Director: Donald Tyner, MBA
  • Acknowledgment This material has been prepared for SC AHEC Bioterrorism Training Network by Ralph M. Shealy, M.D., FACEP Co-Director of SC AHEC Bioterrorism Training Network Medical Director for Operations, Charleston County EMS Medical Director, Charleston County Rescue Squad
  • Objectives 1
    • At the conclusion of this presentation, the participant will:
      • List five radiological/nuclear threats
      • Identify three effects of a radiological incident on the community
      • Describe the availability of, and the threat posed by, radiological materials on the international black market
      • Define ionizing radiation and radioactive contamination.
  • Objectives 2
      • State the four basic types of ionizing radiation.
      • State the potential biological effect from acute radiation exposure
      • Identify the protective measures of time distance, and shielding.
      • List the five possible health effects from ionizing radiation exposure
  • Objectives 3
      • List materials that are most effective in shielding alpha, beta, gamma, and neutron radiation.
      • List five sources that can be used as a radiological dispersion device
      • List five dispersal techniques
  • Effects of a Radiological Incident
    • Panic.
    • Mass casualties with difficult injuries.
    • Medical facilities overloaded.
    • Contamination issues.
    • Gridlock.
    • Public services disrupted.
  • A True Story
    • “Boy Scout builds working nuclear breeder reactor from readily available materials!”
  • Ingredients
    • Radium-226 from antique clocks with luminous radium dials.
    • Americium-241 from smoke detectors.
    • Beryllium-9 stolen from a local college.
    • Thorium-232 collected from Coleman gas lantern mantles.
    • The reactor became significantly more radioactive within a matter of weeks as it produced Uranium-233.
    • When he could detect the radiation from 5 doors down, he terminated the experiment.
    • The EPA stated that the 40,000 nearby residents could have been put at risk had radioactive dust been accidentally liberated.
  • Radiation
    • Energy that comes from a source and travels through some material or through space.
    • Light, heat, and sound are types of radiation
    • Types of radiation associated with radioactivity are alpha and beta particles and gamma and x- rays .
  • Radiation Released When a Radioactive Atom Decays
    • Alpha particles
    • Beta particles
    • Gamma rays and x-rays
    • Neutron radiation
  • Alpha Particles
    • Helium nucleus
    • Contain two protons and two neutrons.
    • Have strong positive charge
    • Is a large particle
    • Will travel only a few inches in air
    • Will not penetrate paper or dead skin
    • Only dangerous when incorporated in the body by ingestion, inhalation or through a wound.
  • Beta Particles
    • Very small particle
    • Carry a negative charge
    • Actually an electron traveling at very high speed
    • A high-energy beta particle can travel about ten feet in air and can penetrate paper and human skin
    • Can be shielded by plastic, glass, and metal foil
  • Gamma Rays and X-rays
    • Pure energy photons and not particles
    • No mass or electrical charge
    • Travel at the speed of light
    • Very short wavelength
    • Can penetrate and damage all organs
    • Shielded by lead, steel, and concrete
  • Neutron Radiation
    • Neutron radiation is a high speed neutron particle
    • Have no electrical charge
    • Neutrons ionize matter by direct collision with electrons.
    • Shielded by carbon, lithium, cadmium, boron, plastic, and water
  • Background Radiation
    • Sources of normal background radiation are:
      • Cosmic radiation
      • Sources in the earth’s crust
      • Sources deposited in the body from food and water
      • Naturally occurring radon in the soil
  • Manmade Sources of Background Radiation
    • Tobacco products contain radon absorbed by the plant leaf.
    • Medical radiation from x-rays, nuclear medicine diagnostics, and radiation therapy.
    • Building materials contain terrestrial radiation sources.
    • Water supply contains dissolved radioactive minerals
  • Sources of Radioactive Isotopes
    • Natural sources
      • Radon in air
      • Radium in soil
      • Uranium ore
    • Machine produced nuclear interactions
      • Cyclotrons
      • Linear accelerators
    • Nuclear reactors
  • Moral of the Boy Scout Story
    • Intelligent people with enough determination can build sophisticated nuclear devices using readily available materials and information that can be collected from sources accessible to the public.
  • Nuclear Expertise Can be Bought
    • Thousands of former Soviet weapons scientists have not successfully found suitable new jobs in the civilian economy and are currently impoverished.
  • Radioactive Materials Can Be Bought
    • Russia currently has no consolidated system of nuclear materials registration and it is very difficult to track the quantity, deployment, and transportation of nuclear material.
  • Nuclear Black Market
    • Weapons grade nuclear materials are located in nearly 100 facilities in the former Soviet Union.
    • The black market for radioactive materials is very active in Russia since 1993.
    • The United Nations Atomic Energy Agency has documented 370 confirmed incidents of nuclear trafficking between 1993 and 2001.
  • Nuclear Black Market
    • Reactor wastes are the ideal material for terrorists to use in radiation dispersal devices (“dirty bombs”).
  • Nuclear Black Market
    • Security at nuclear plants and storage facilities in the former Soviet Union is lax.
    • Facilities are in dilapidated condition.
    • There is much evidence of an active and lucrative trade in radioactive materials in a country in deep economic decline.
  • Nuclear Black Market
    • Most intense around and inside nuclear plants in the former Soviet Union.
    • Fifteen kilograms of commercial grade uranium were found under the bathtub of one plant employee.
    • In Moscow in 1995, enriched uranium was found inside a cabinet secured with a bicycle lock.
  • Suitcase Bombs
    • A Russian Lieutenant General testified in 1998 that ninety suit-case sized one kiloton atomic bombs were unaccounted for.
    • We know that this weapon is feasible, since we built them in the 1960’s.
  • Nuclear Power Plants
    • High and low level wastes are the byproducts of electricity production at nuclear power plants.
    • Terrorists could use these to contaminate an area so that it could not be accessed or used safely.
    • Many engineering safeguards at a nuclear power plant are disabled during a “Shut Down”. The reactor is most vulnerable to attack at that time.
  • Radiological Dispersal Device (“Dirty Bomb”)
    • A radioactive Dispersal Device spreads radioactive contamination over an area.
    • Radioactive material can be acquired from numerous unsecured locations.
      • Radiographic, industrial, medical, agricultural, defense wastes, reactor waste.
    • The radioactive material can be easily dispersed with a conventional explosive.
  • Contamination
    • Deposition of radioactive material in any place where it is not desired, particularly where its presence can be harmful.
  • Avoiding Contamination
    • Use respirator early
    • Use time, distance, and shielding effectively
    • Removal of outer garments removes most radiological contamination.
    • Soap and water remove most of the rest.
    • Do not eat, drink, smoke, scratch, apply make-up or rub your eyes in a contaminated environment.
    • Avoid cuts and abrasions.
  • Irradiated versus Contaminated
    • A patient who has been exposed to ionizing radiation has been injured by the exposure but does not emit radiation himself. There is no ongoing source of radiation injury.
    • A patient who has be contaminated with radiation-emitting materials continues to be injured by them and posses a threat to others.
  • Critical Point for Health Providers
    • “It is impossible for a living patient to be so contaminated as to pose a threat to care providers.”
    • ( Medical Management of Radiological Casualties , December, 1999, P. 67.)
  • ALARA
    • Minimize exposure to radiation and contamination.
    • Keep exposure “As Low as Reasonably Achievable”
    • Time – Distance – Shielding
  • Time Practical Pearls
    • Break task into many small segment.
    • A different individual performs each small segment.
    • Time of exposure is minimized.
    • Total radiation dose is minimized
  • Practical Distance Pearls
    • The Inverse Square Law:
      • Doubling the distance from a source halves the radiation dose
      • Halving the distance from a source increases the dose four times!
      • Distancing oneself from a source by even a small amount will significantly decrease ones radiation exposure.
  • Practical Shielding Pearls
    • Four to twelve inches of soil used to cover a discrete radiation source will stop 50% to 90% of the radiation!
    • An engine block, a concrete wall, or an earthen berm can be adequate shielding if kept between a rescuer and the source.
  • Ionizing Radiation
    • Ionizing radiation interacts with the atoms in tissue and causes cellular damage.
  • External Exposure
    • Like an x-ray: the source of radiation is remote from the person.
    • The person is NOT radioactive.
    • The person is NOT a threat to others.
  • Internal Exposure
    • The most serious chronic risk.
    • Inhaled radioactive particles in the air.
    • Ingested contaminated food or water.
    • Absorbed material through the skin or mucous membranes.
    • Incorporated contaminants in a wound.
  • Health Effects
    • Ionizing radiation damages cells by interacting with its atoms.
    • The nucleus is especially sensitive.
    • Even low dose radiation effects chromosomes.
    • Chromosome damage may result in mutations, possibly resulting in malignancies or fetal abnormalities.
  • Health Effects
    • Ionization of cellular water produces hydrogen peroxide.
    • Intercellular hydrogen is very toxic and more destructive than the radiation itself.
    • Hydrogen peroxide is more destructive than the radiation itself.
  • Health Effects Radiation Sensitivity of Different Cells
    • Developing sperm cells
    • White blood cells
    • Red blood cells
    • Small intestine
    • Stomach
    • Neural tissue (nerves, spinal cord, brain)
    • Colon
    • Skin
    • Muscle
    • Bone
    • Collagen
    MOST Sensitive LEAST Sensitive
  • Whole Body Effects
    • High dose radiation over a short period of time produces acute health complications.
    • Low doses of radiation over an extended period of time may produce chronic health complications
  • Acute Radiation Syndrome
    • Prodromal Stage
    • Latent Stage
    • Manifest Illness
    • Recovery or Death
  • Acute Radiation Syndrome
    • Low dose ( up to 100,000 millirem)
    • Moderate dose (100,000 to 1,000,000 millirem)
    • High dose (greater than 1,000,000 millirem)
    • LD 50 is about 300,000 to 500,000, depending on the extent of medical care.
  • Drug Intervention for Acute Thyroid Exposure
    • Iodine concentrates in thyroid.
    • Radioiodine enters by inhalation and ingestion.
    • Normal iodine will saturate the gland so that radioiodine cannot be absorbed.
    • Potassium iodide (KI) is effective if taken before exposure.
    • KI does not protect against any other isotope.
  • Chronic Radiation Exposure
    • Somatic Effects
    • Genetic Effects
    • In-Utero Effects
  • Lifetime Increased Cancer Risk
    • Stomach
    • Lung
    • Liver
    • Colon
    • Bladder
    • Breast
    • Ovaries
    • Thyroid
    • Skin
    • Bone marrow
  • Summary
    • Radiation can be an effective terrorist weapon.
    • It is possible to sabotage sources of radiation in the community or even to construct radiological weapons of various types.
    • Sources of expertise and materials are available.
    • Health professionals can take steps to protect themselves while providing care to victims of a radiological attack.
  • Acknowledgement
    • This presentation borrows heavily from
      • “ The Weapons of Mass Destruction Radiation/Nuclear Course for Hazardous Materials Technicians” produced by the U.S. Department of Justice Office for Domestic Preparedness, the U.S. Department of Energy, and Bechtel Nevada.
      • “ Emergency Medicine , Fourth Edition, produced by the American College of Emergency Physicians and edited by Judith Tintinalli, M.D.
  •