Goiania radiation accident

1. Biological Effects of Ionizing Radiation
Deterministic effects
Case history – Goiânia accident
Lecture
IAEA Post Graduate Educational Course Radiation Protection and Safe Use of Radiation Sources
IAEA Post Graduate Educational Course Radiation Protection and Safe Use of Radiation Sources

2. 2
Introduction - Where did the
accident occur?
 Goiânia - the Capital
of Goiâs State, Brazil
 Population - about
one million
 Accident area - poor
section of the city
 Facility - abandoned
premises of a
radiotherapy institute

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Content
 Where did the accident occur
 What happened
 Information about the source
 How the accident was discovered
 Main actions taken
 Main consequences
 Medical management
 Therapeutic procedures for the victims at the
acute stage
 Follow-up of the victims
 Lessons learned

4. 4
Overview - What happened?
 End of 1985 a private radiotherapy institute
moved to new premises, leaving in place a Cs-
137 teletherapy unit without notifying the
licensing authority
 The former premises were subsequently partly
demolished
 September 13, 1987 two persons entered the
premises, removed the source assembly from
the radiation head of the machine
 They took the source assembly home and tried
to dismantle it
 In the attempt, the source capsule was ruptured

5. 5
Information about the source
 Nuclide Cs-137
 Activity (Sept.87) 50.9 TBq (1375 Ci)
 Chemical form CsCl
 Physical form powder
 CsCl mass 93 g
 Cs-137 mass 19.3 g
 Physical half-life 30 years

6. 6
How the Accident Was Discovered
 After the source capsule was ruptured, the
remnants of the assembly were sold as scrap
to a junkyard
 Fragments of the source the size of rice
grains were distributed to several families
 In five days a number of people were
showing gastrointestinal symptoms from
exposure to radiation
 One of the irradiated persons connected the
illnesses with the source capsule, and took
the remnants to the public health department
 This action began a chain of events which
led to the discovery of the accident

7. 7
Main actions taken
 Medical triage
 Monitoring of the people and survey the
environment
 Medical treatment of the irradiated/contaminated
persons
 Actions to bring sources of exposure under
control
 Decontamination of the main sites of
contamination (houses, public places, vehicles,
etc.)
 Demolition and removal of houses
 Removal of contaminated soil
 Clear information to the public

8. Basic facts about triage performed
Population Triage Period:
September 30 - December 21, 1987
Number of persons 112,800
Internal/external contamination 129
Contamination of clothes and shoes 120
Persons hospitalized 20
Local radiation injuries 28
Bone marrow depression 17
Acute radiation syndrome 8
Deaths 4

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Radiological triage

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More Statistics
 Decontamination of the city: 730
workers required
 Number of houses affected: 98
 41 evacuated
 6 demolished
 53 repaired
 Number of public places
decontaminated: 58
 pavements, squares, shops and bars
 Number of vehicles decontaminated: 64

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The Consequences
 Four early fatalities
 A large number of persons contaminated
 The environment severely contaminated
 Large quantities of radioactive wastes
generated
 Significant economic loss and burden
 Substantial psychological impact

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Waste generated
 Waste storage site:
 20 km from the city
 Designed to accommodate 4,000-5,000m3 of
waste
 Types of waste packaging used:
 4,500 metal drums (200L)
 1,400 metal boxes (5 tones)
 10 shipping containers (32m3)
 6 sets of concrete packaging
 Volume of waste stored: 3,500 m3, or
more than 275 construction lorry loads

13. Medical Management during the
Goiania Accident
 Reverse isolation
 Dietary management (no uncooked food)
 Nail trimming and scrubbing
 Local neomycin in nasal cavities
 Gut sterilization
 Systemic antibiotics
 Platelet and RBC infusions
 Antiviral

14. Therapeutic procedures during the
acute phase of the accident
 Managing critical period of the ARS,
manifested by bone marrow
suppression
 Therapy for local radiation injury
 Decorporation of cesium-137
 General support and psychotherapy

15. Prussian blue administration
 46 persons received Prussian Blue
 Dosage related to internal burden
 Initially 3 g/day
 Then 4-6 g/day in adults exceeding 5 x ALI
 For children initial dose 1-1.5 g/day then
3 g/day for those exceeding 5 x ALI
 Some adults with very high burdens received
10 g/day

16. Medical Follow-up of the Goiânia
accident victims
• Status of skin injuries after initial healing
 8/28 patients required surgery in 1989
 6/28 patients required surgery in 1990
 1/28 patients required surgery in ‘91, ‘92, ‘93
• 1 cancer death (1993), 1 suicide (1992)
• 5 year follow-up of children
 no significant findings (occasional eosinophilia, chronic
anemia)
 7 exposed in-utero have no abnormalities
 10 conceived post-accident born with no abnormalities
• 2 exposed teenage males have fathered children
• Skin lesions tended to be affected by stress

17. Psychological follow-up of the
Goiânia accident victims
• Psychological alterations
• Continuation of some early problems
• Discrimination from the other people
• Establishment of illness behavior
• Concern about the consequences of the
exposure
• Stigmatization
• Victims blamed for accident by many citizens

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Lessons Learned
 Regulatory controls could have prevented
this accident
 An adequate system of information is
essential to avert panic
 Emergency workers should be instructed
on how to convey information to the
population
 Response to the psychological impact is a
major element of the response strategy

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Lessons Learned (Cont’d)
 International assistance can be timely and
extremely useful
 This should be considered at the planning
stage
 Customs regulations should be amended to
facilitate the import and return of goods
 This will accelerate international assistance

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Summary
 This lecture presented materials about
Goiânia accident
 The following conclusion could be made:
 Radioactive sources taken out of the regulatory system
can present a serious hazard
 Recognition by the general public of the potential
danger of radiation sources is an important factor in
lessening the likelihood of radiological accident
 Good plans can accelerate response and significantly
reduce health impacts
 Comments are welcomed

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Where to Get More Information
 International Atomic Energy Agency, The
Radiological Accident in Goiânia, IAEA
Report, IAEA, Vienna (1988)
 IAEA Regional Train-the-Trainers Workshop
Practical Response to a Radiological
Emergency, November, 2000. Slovenia,
Training materials
 IAEA Training Course at Emergency Medical
Preparedness and Response. Medical
Education and Inter-Regional Harmonization
Program for Nuclear Accident Preparedness.
September, 1999, Budapest, Hungary,
Training materials