Accident Any unintended event, including operating errors, equipment failures or other mishaps, the consequences or potential consequences of which are not negligible from the point of view of protection or safety. Incident The word incident is often used, in International Nuclear and Radiological Event Scale (INES) and elsewhere, to describe events that are, in effect, minor accidents, i.e. that are distinguished from accidents only in terms of being less severe. This is an arbitrary distinction with little basis in normal usage. An incident can be minor or major, just as an accident can, but unlike an accident, an incident can be caused intentionally.

1. INCIDENCE & ACCIDENT IN
RADIATION
Mohd Aiman bin Azmardi
Radiographer
Hospital Sultanah Bahiyah, Alor Setar

2. Definition
• Accident
• Any unintended event, including operating
errors, equipment failures or other mishaps,
the consequences or potential consequences
of which are not negligible from the point of
view of protection or safety.

3. Definition
• Incident
• The word incident is often used, in
International Nuclear and Radiological Event Scale
(INES) and elsewhere, to describe events that are, in
effect, minor accidents, i.e. that are distinguished from
accidents only in terms of being less severe. This is an
arbitrary distinction with little basis in normal usage.
An incident can be minor or major, just as an accident
can, but unlike an accident, an incident can be caused
intentionally.

4. INES (International Nuclear and
Radiological Event Scale)

5. Atomic Bombing of
Hiroshima And Nagasaki &
Its After effect…

6. • An atomic bomb, called Little Boy,
was dropped on Hiroshima on
August 6th, 1945.
More than half of the buildings in
the city were destroyed.
It was estimated that about
70,000 people were killed
instantly.
And by 1946, about 140,000 had
died due to injuries and radiation.
•
•
•
HIROSHIMA - Summary of
events..

7. Reasons for Bombing in Hiroshima & Nagasaki…
• Many historians believe that a main
reason for the use of the bomb was
retaliation for the surprise and
brutal attack on Pearl Harbor.
• United states came with a new
tactic to force Japan to surrender –
By Potsdam Declaration.
• Potsdam Declaration
• Truman’s First attempt at
negotiating with Japan
• Called for Japan’s unconditional
surrender and an end to
Militarism in Japan.
• Issued on July 26.

8. Reasons forBombing in
Hiroshima &Nagasaki
Harry Trauman
The U.S. President
• Japan refused the Declaration.
• The USA did not want to invade
Japan.
• They reasoned that using an
Atomic- bomb would deliver a
huge blow to Japan.
• This would save the lives of
hundreds of thousands of
American troops.

9. TheManhattan
Project….• The research on atom bomb
was called Manhattan project
Los Alamos National
Laboratory and Lawrence
Livermore National Laboratory
were the two laboratories in
the United States where work
towards the design of nuclear
weapons have been
undertaken.
The first nuclear test was
located near Alamogordo, New
Mexico, under code name
“Trinity” on July 16, 1945
•
•
TrinityNuclearTest

10. Fat Man and
Little
Boy..

11. TheBomb
Day…• In the morning of the 6th August
1945 plans of first atomic
mission were set.
A B-29 Superfortress bomber
named the Enola Gay, under
•
colonel Paul Tibbits was chosen to
drop the first bomb on Hiroshima
They left Tinian north field airbase
in the West Pacific.
The six hour flight went exactly as
expected.
The bomb was armed midway and
clear weather permitted for
accuracy.
•
•
•
Enola Gay with Its Crew

12. ‘Little Boy’ before loading to B-29
bomber ‘Enola Gay’
MoreAboutLittle
Boy
• Little boy’ was one of the first
kind of nuclear weapons that
the world had seen.
• ‘Little boy was a Gun-type
fission bomb or a non nuclear
explosive blasts a uranium
wedge down a gun barrel into a
uranium target causing the
fission reaction.
• Fission occurs when the
nucleus of an atom is split.
When it happens, gamma rays
are emitted. If fission occurs,
high amounts of energy in the
form of radiation are released.

13. The Bomb
Day…• • At 8.15 am, the Bomb The
Bomb was fused and set to
explode about 2000 ft. above
the center of the town.
• It took 43 sec to reach its
designated altitude.
• It had a blast that was
equivalent to 13 kilotons of
TNT.
• The radius of total
destruction was about one
mile (1.6 km), with resulting
•
•
•
fires across 4.4 square miles
(11 km2).
Mushroom cloud that appeared
after the atomic bomb was dropped

14. Hiroshima – Beforethe blast
Detail from a U.S. Air Force map with pre-bombing circles radiating out
from ground zero, the site directly under the explosion

15. Hiroshima – After the
Blast..
Detail from a U.S. Air Force map with pre-bombing circles radiating out
from ground zero, the site directly under the explosion

16. Immediate
Aftermath
..
• According to most estimates the
bombing of Hiroshima killed
approximately 70,000 people due
to immediate effects of blast.
Estimate of total deaths by the end
of 1945 “140,000” due to burns,
radiation and related diseases.
Most deaths and injuries occurred
when people were trapped in their
burning houses or struck by
debris.
Of the city’s 90,000 buildings,
60,000 were destroyed
This left many survivors homeless
•
•
•
•

17. Pictures – Hiroshima After
Blast..
A bridge across the Ota river. Note where
roadway is burned and the ghostly shadow
imprints left where the surface was shielded
by cement pillars.
A View of ground zero in Hiroshima on
August 6, 1945

18. Pictures –
Hiroshima After
Blast.. Smoke rising from the atomic explosion
above the city of Hiroshima on August 6, 1945
View from ground Zero..

19. Pictures – Hiroshima After
Blast..
A Human Body turned into
carbon..
The energy that was released from the
bomb caused severe burns and
scarring.

20. Photos –
Hiroshima After
Blast..
Chart on %. of Death due to Atom
Bomb in Hiroshima..
A man with sickness due to Radiation

21. A victim who was about 6,500 feet from ground zero when the rays struck him
from the left. His cap was sufficient to protect the top of his head against flash burns.

22. Photos –
Hiroshima After
Blast..
A atomic bomb Victim…
A atomic bomb Victim…

23. Bomb damage to Okita Iron Works

24. View of Hiroshima after blast

25. • Three days later on August 9, 1945, the
second atomic bomb named “Fat Man”
was dropped on Nagasaki.
The Fat Man weapon, containing a core
of about 6.4 kilograms (14 lb.)
of plutonium, was dropped over the
city's industrial valley.
• It exploded 43 seconds later at 469
m(1,539 ft.) above the ground. This was
nearly 3 km (1.9 mi) northwest of the
planned hypocenter.
• The resulting explosion had a blast yield
equivalent to 21 kilotons of TNT (88 TJ).
•
Next
Target.
.

26. • Bockscar a B-29 bomber
Superfortress, flown by
Major Charles W. Sweeney
dropped the “Fat Man” on
August 9, 1945.
Sometimes called Bock’s
car.
•
• The Bockscar did didn't
have enough fuel to return
to Tinian or Iwo Jima, so
Major Sweeney flew the
aircraft to Okinawa for an
emergency landing with
practically dry fuel tanks.
Next
Target.
.
Bockscar With its crew

27. Immediate
Aftermath
..
• The death toll (of all related
deaths) was about 135,000.
• More than 40% of the city was
destroyed.
• 75,000 instantaneous deaths,
50,000 explosion injured.
• Total deaths by the end of 1945
may have reached 80,000.
• The radius of total destruction was
about 1 mile (1.6 km), followed by
fires across the northern portion of
the city to 2 miles (3.2 km) south
of the bomb.
Mushroom cloud from the
atomic explosion over
Nagasaki rising 60,000 feet
into the air

28. Nagasaki – Before
And After..
Nagasaki before the bombing.
Nagasaki after the bombing

29. Before After
Nagasaki – Before
And After..

30. Photos –
Nagasaki
After
Blast…
Devastated City After Blast

31. Finally…
• Japanese Foreign Minister Shigenori
Togo, proposed acceptance of the
Potsdam Declaration.
• The Emperor Hirohito convened an
Imperial Conference and at noon on
August 15, 1945, announced Japan's
surrender.
• On Sept. 2, 1945, Japanese Foreign
Minister Shigenori formally signed the
surrender documents on board the USS
Missouri.
Signing of Document
Japan Emperor

32. Involvement Of Einstein
• In 1905 Albert Einstein discover that a
large amount of energy
• could be released from a
small amount of matter.
• However Bombs were not in his
mind because even he
considered himself a pacifist.
• The first letter Einstein stated
the Germany is pursuing the
interest of an A bomb and we
should do the same.
• Einstein felt very guilty for what he
caused after he saw the destruction of
Hiroshima and Nagasaki.
•
•
•
• Albert Einstein

36. CHERNOBYL UKRAINE
26TH APRIL 1986

37. • The Chernobyl disaster was a nuclear reactor accident in the
Chernobyl Nuclear Power Plant in the Ukraine, which used to
be a part of the Soviet Union.
• It is considered to be the worst nuclear power plant disaster in
history and the only level 7 instance on the International
Nuclear Event Scale.

38. What happened?
• Reactor 4 was undergoing a
test to test the backup
power supply in case of a
power loss.
• The power fell too low,
allowing the concentration of
xenon-135 to rise.
• The workers continued the
test, and in order to control
the rising levels of xenon-
135, the control rods were
pulled out.

39. What happened?
• The experiment involved shutting down the coolant pumps,
which caused the coolant to rapidly heat up and boil.
• Pockets of steam formed in the coolant lines. When the
coolant expanded in this particular design, the power level
went up.
• All control rods were ordered to be inserted. As the rods were
inserted, they became deformed and stuck. The reaction could
not be stopped.
• The rods melted and the steam pressure caused an explosion,
which blew a hole in the roof. A graphite fire also resulted
from the explosion.

40. • The Chernobyl Reactor after the explosion.

41. IMMEDIATE IMPACT
• 203 people were
hospitalized immediately.
31 of them eventually
died. Most of these
people were workers in
the plant or local
firefighters.
• NW winds from the Black
Sea carried the radiation
for miles in the following
days. Scandinavian
detectors picked up on
the abundance of
radiation, but the Soviet
government denied
everything.

42. • People were evacuated the
day after the explosion.
• A month later 116,000 people
in an 18 mile radius of the
plant were evacuated.
• Over 300,000 people were
moved from the accident.
• Many still live in contaminated
areas and the long term effect
is not yet known.
• The Soviet Union has not
been able to study effects
due to lack of funds and
secrecy.

43. EFFECTS ON THE ENVIRONMENT AROUND
THE CHERNOBYL EXPLOSION.
• Fallout levels were very high right around explosion and affected
all wildlife.
• Red Forest- was a forest right by the plant was named this because
plants had a red hue after the explosion. These trees also died from
the amount of radiation they received.

44. BELARUS AFTER CHERNOBYL
Abandoned city in
southern Belarus

45. Effects of Radiation

46. THYROID CANCER
• The thyroid gland is the most vulnerable organ to
radiation in the human body.
• Normally, this is a rare disease, with only 1 case per
year being reported in Belarus before the Chernobyl
accident.
• Thyroid cancer can take 10-30 years to show it’s
effects.
• There has been a 2,400% increase in the rates of
thyroid cancer in Belarus since 1986.
• In the Homyel region of Belarus, the region closest to
Chernobyl, there has been a 100-fold increase in
thyroid cancer.

47. THYROID CASES GRAPH
BLUE :-
RED :-
Yellow :-
20–46 Years old
Children
Adults over the age of 46

48. The Clean Up
• “Liquidators”
• These were firemen who helped put
out the fires and helped clean up the
radiation
• Most did not realize the dangers of
radiation.
• Many later died from radiation,
because they didn’t wear protection.
• An estimated 8,000-20,000 to date
have died (20% from suicide)
• Robots
• United States supplied
• Specifically designed to enter
reactor core and help build the
sarcophagus

49. CLEAN UP
Approximately 300,000 to 600,000
liquidators were involved in the cleanup
of the 30 km evacuation zone around the
plant in the years following the
meltdown.

50. EFFECTS ON ECONOMY AROUND THE CHERNOBYL
EXPLOSION.
• Between 300,000 and 600,000 people were
brought in to clean-up.
• Crops were destroyed, livestock was killed,
everywhere there was radiation.
• Over 235 billion dollars has been spent to
clean up the disaster.
• Belarus lost 1/5 of its farming lands(700
million dollars a year loss.)
• 350 industries were lost due to the disaster.

51. TODAY
• The plant has been shut down
by Ukraine (Dec. 2000)
• The cement sarcophagus is
falling apart, due to the quick
emergency construction of it.
• The UN estimates that up to 9
million people have been
affected directly or indirectly by
the fallout.
• The full consequences will not
be seen for at least another 50
years.

52. SOME PICTURES OF THE DISASTER.

53. Chernobyl Memorials
A memorial to the firefighters
who died after trying to stop
the fires that engulfed the
plant. They weren’t even told
there was radioactivity.
A memorial to all of those who
died at Chernobyl

54. Aerial view Chernobyl nuclear power plant with sarcophagus.
(Chernobyl, Ukraine) Photo Credit: Vadim Mouchkin / IAEA.
Taken: 7th May 2007

57. MEDICALRADIOGRAPHY
INCIDENT&ACCIDENT

59. Collective effective dose as a percentage for all exposure categories in 2006,
according to NCRP report no. 160 (1).

60. Fig 1. Reported radiation overexposure accidents worldwide and sector involved, 1980–
2013. (a) number of reported radiation accidents

61. Fig 2. Reported radiation overexposure accidents worldwide and sector involved, 1980–
2013. (b) number of reported overexposed people

64. Fluoroscopy Incident Cronology
• A 57-year-old, 6-foot-2-inch-(188 cm) tall man
weighing 99 kg
• angina pectoris and exertional dyspnea
• underwent cardiac catheterization for stenosis in the
left circumflex artery
• perform balloon dilation and adjunctive rotational
atherectomy.
• 173 min of fluoroscopy time
• Procedure successful

65. 5 month later
• Five months later, the patient experienced a recurrence of
chest discomfort.
• But now a marked degree of stenosis was noted in the left
anterior descending artery.
• Procedure 74 min of fluoroscopy time and more than 2700
cine images (performed balloon dilation and adjunctive
rotational atherectomy to reestablish arterial flow)
• Successful from a cardiology POV
• within 24 hr; developed a painful and erythematous area
involving the skin below his right scapula.
• In 5 months the affected skin went on to ulcerate and then
necrose.
• Eventually, the patient underwent extensive skin grafting.

66. One Year Later
• Patient filed a medical malpractice lawsuit
against the cardiologist
• Alleging been negligent in using fluoroscopy
during the angio procedures; caused severe
skin burns, increased the patient's likelihood
of later developing lung cancer.
• Efforts to achieve an out-of-court settlement
of the lawsuit were unsuccessful, and the case
proceeded to a jury trial.

67. Fig. 1. —Headline and photograph
accompanying article published in USA
Today. Patient filed medical malpractice
law-suit alleging use of excessive
fluoroscopy. (Reprinted with permission
from Cohn J, Pttsburgh, PA)
Jury award of $1 million to 57-year-old man who
sustained serious skin injury after two coronary
artery angioplasties that occurred 5 months apart

68. Earlier
• Almost immediately after the announcement in 1895 of Wilhelm
Roentgen's discovery of the X-ray beam
• Manufacturers began producing X-ray apparatuses
• Potential dangers of X-radiation were not well understood, many patients
sustained skin injuries as a result of undergoing diagnostic radiography.
• There was medically induced injury, there was malpractice litigation.
• In 1896, in what was apparently the first malpractice lawsuit in the United
States
• Chicago laborer sued a physician who specialized in using this new
diagnostic modality
• Claiming ulcerating burn of the skin on his ankle
• The patient had fractured his ankle
• Radiographs exposure times of 35-40 min each.
• The skin injury eventually led to amputation
• The jury awarded the patient $10,000 in damages

69. CT BRAIN PERFUSION

70. CT Brain Perfusion
• What is CT Perfusion scan
• It’s a kind of diagnostic x-ray scans
produce cross-sectional images or 'slices'
of specific areas of the head.

71. Why do the Procedure?
• For stroke test which is the evaluation of
blood flow in the brain
• Causes – when blood flow to part of the
brain stops, which lead to brain cells die
or causing permanent damage due to lack
of blood and oxygen

72. Accident description
• In Oct. 2009, the first notification was
reported (FDA)
• Patients undergoing computed tomography
(CT) brain perfusion scans were accidently
exposed to excess radiation doses.

73. Dose received
• Hair loss at the scan part
• patients experienced
headaches
• memory loss
• confusion
• 3 – 4 Gy

74. Other big Event…
• 1987 Accidental poisoning in Brazil
– On this day in 1987, cesium-137 is removed from an
abandoned cancer-therapy machine in Brazil
• 11 March 2011 - Fukushima Accident
– Following a major earthquake, a 15-metre tsunami
disabled the power supply and cooling of three
Fukushima Daiichi reactors, causing a nuclear accident
on 11 March 2011. All three cores largely melted in
the first three days.
– The accident was rated 7 on the INES scale
• Others

75. Learning Point
• RESPECT RADIATION, BUT DO NOT FEAR IT
• UNDERSTAND WHAT RADIATION CAN AND
CANNOT DO

76. REFERENCES
• http://health.phys.iit.edu/extended_archive/0411/msg00007.html
• Cerezo, L. (2011). Radiation accidents and incidents. What do we
know about the medical management of acute radiation
syndrome?. Reports of Practical Oncology and Radiotherapy,16(4),
119.
• Johnston, W. R. Radiation accidents and other events causing
radiation casualties—tabulated data, 2008.
(http://www.johnstonsarchive.net/nuclear/radevents/index.html)
• Coeytaux, K., Bey, E., Christensen, D., Glassman, E. S., Murdock, B.,
& Doucet, C. (2015). Reported radiation overexposure accidents
worldwide, 1980-2013: a systematic review. PloS one, 10(3),
e0118709.