Radiation Exposure Devices Guidance for Responders

1. Radiation Exposure Devices Guidance for Responders Prepared by the Homeland Security Committee RED Rev 08 AUG 2011

2. Learning Objectives (1) • Describe a radiation exposure device (RED) and its potential hazards. • Identify visual indicators to recognize the presence of an RED. • Identify initial actions applied by emergency responders due to the presence of an RED. RED Final 2012

3. Learning Objectives (2) • Identify and list the types of radiation survey meters utilized to initially detect the presence of and measure the dose rates from an RED. • List actions taken by health care providers to recognize that an individual has been exposed to a large dose of radiation. • Discuss medical actions to be taken when it has been determined that an individual has been exposed to a large dose of radiation. RED Final 2012

4. Lesson Plan • Presentation on radiation exposure device— background and response actions • Presentation on meters used to detect the presence of radioactive materials • Review of job aid for responders RED Final 2012

5. Radiation Exposure Device • Radiation Exposure Device (RED) • A device intended to expose people to significant doses of ionizing radiation without their knowledge • Constructed from partially or fully unshielded radioactive material(s) • Placed in public settings (subways, malls, etc.) and usually hidden from sight RED Final 2012

6. Radiation Exposure Device (cont.) • International effort to improve security of sources of radioactive material • Regulations on use and storage • Programs to identify and collect orphan sources • Customs and Border Controls • Some radioactive materials of concern • 241Am, 252Cf, 60Co, 137Cs, 192Ir, 226Ra, and 90Sr RED Final 2012

7. Radiation Exposure Device (cont.) Reference documents for radioactive materials of concern: IAEA Nuclear Security Series No. 5 IAEA Dangerous Quantities of Radioactive Material (D-Values) IAEA Nuclear Security Series No. 6, Combating Illicit Trafficking in Nuclear and Other Radioactive Material RED Final 2012 7

8. Radiation Exposure Device (cont.) • Radioactive materials of interest are used in: • Medical diagnosis (usually short half-life). • Cancer treatment (long half-life). • Industrial radiography (medium half-life). • Construction (medium half-life). • Sterilization of medical products (long half-life). • Gauges (long half-life). RED Final 2012

9. Brief History of RED Use • 1993—Russia. A radioactive substance, probably cesium-137 (and/or cobalt-60), was planted near the director of a packing company. 1 death. • 1995—Russia. A cesium-137 source had intentionally been placed in a door pocket of a truck. The driver was exposed for 5 months. 1 death. RED Final 2012

10. Brief History of RED Use 2002—China. Iridium-192 used in an attack on a business rival. The iridium-192 was placed above the ceiling panels in the hospital office of the rival. 1 death and another 74 staff members of the hospital had injuries. RED Final 2012 10

11. Some Radiation Basics • Radioactive materials emit energy in the form of radiation. • Types of radiation released when a radioactive material decays may include alpha, beta and/or gamma, and neutrons. • Radioactive materials may emit more than one type of radiation. • From an external exposure hazard, the most penetrating types are gamma and neutron, followed by beta and then alpha radiation. RED Final 2012

12. Some Radiation Basics (cont.) • From an internal exposure hazard, the most hazardous type is alpha, followed by beta and then gamma radiation. • If a radioactive source is encapsulated, it most likely cannot be easily dispersed. • Past history indicates that most REDs used were encapsulated sources. • Victims were exposed to ionizing radiation; however, they were not contaminated with the radioactive material. • In cases where the encapsulation has been breached, there has been contamination. RED Final 2012

13. Radiation Effects on Humans • At lower levels of penetrating gamma radiation exposure, the human body has a tendency to repair the damage. • Exposure to background radiation would be an example of chronic low levels. NCRP Report No. 160 (2009) RED Final 2012

14. Radiation Effects on Humans • From external penetrating gamma • At higher exposure levels, the human body may not be able to repair the damage. • Acute Exposures (whole body) Effects • Blood cell changes occur around 50 rem (0.5 Sv) • Nausea and vomiting begin around 70 rem (0.7 Sv) • LD 50/60: 450 rem (4.5 Sv) without medical intervention • Highest dose in Chernobyl survivor was 870 rem (8.7 Sv) • There are a number of variables that make people more or less affected. RED Final 2012

15. Potential Sources of Radioactive Material • Black market • Stolen • Abandoned • Unsecured • Illegally obtained RED Final 2012

16. Minimizing the Threat • Improve international control of materials. • Train/equip border and port security. • Locate and secure orphaned sources. • Seek non-radiological alternatives. • Continue research and development of technologies to detect and monitor. • Educate public and media. • Educate physicians in recognizing acute radiation syndrome and skin burns without thermal or chemical cause. RED Final 2012

17. Response to an RED Emergency RED Final 2012

18. Response to an RED Emergency • Most exposure discoveries have been in response to medical surveillance or by accidentally detecting the radiological signature. • Medical professionals (local doctors) are often the first to discover a radiological emergency when they recognize symptoms indicating the possibility of radiation exposure in their patients. • RED response would not be a lights-and-siren incident. • Seek advice from radiation safety experts. • Develop resources during preplanning phase. RED Final 2012

19. Initial Response—Medical RED Final 2012

20. Initial Response—Medical • Once a victim’s medical symptoms are determined to be due to exposure to radiation, notify: • Local public health authorities. • Local, state, and/or national (CDC) epidemiology staff. • Radiation authority having jurisdiction. • Law enforcement. RED Final 2012

21. Initial Response—Medical • Once a victim’s medical symptoms are determined to be due to exposure to radiation: • Survey patient for potential external and internal contamination. • Survey health care facility for contamination. • Contact REAC/TS for consultation. • Develop medical care plan. RED Final 2012

22. Incident Response Activities • Medical staff will reconstruct exposure. • Determine dose • Determine patient impact from dose • Law Enforcement • Determine responsible party • Conduct forensics • Radiation Authorities • Notified by local response agencies • Subject matter experts • Radiation surveys to locate RED Final 2012

23. Visual Clues for Responders Visual Indicators of radioactive sources Labels may be removed/defaced to hinder identification. RED Final 2012 23

24. Visual Clues for Responders RED Final 2012

25. Emergency Responder Actions • Response Actions • Work with other disciplines to establish command and control of response efforts. • Emergency Operations Center notifies other disciplines, including hospitals, public information, etc. • If a source is found, using the Emergency Response Guide 2008, initial isolation zone is 75 feet. DO NOT TOUCH! • Remember, this is a law-enforcement crime scene. RED Final 2012

26. Emergency Responder Actions • Response Actions • Consider potential for other hazards, such as explosives . . . modify zone as appropriate. • Modify zones under the direction of radiological expertise and radiation authority. • Request additional resources (hazardous materials response teams, specialists). • Support operations at the scene. RED Final 2012

27. Emergency Responder Actions Response Actions Acute radiation syndrome signs and symptoms: May not appear shortly after exposure. May take hours to days to develop. Victims may need evaluation if clinical course is unusual or does not respond to medical treatment. RED Final 2012 27

28. End Section: Presentation on Radiation Exposure Device—Background and Response Actions Questions RED Final 2012

29.  Health Physics Society* Disclaimer: The information contained herein was current as of 9-April-2012 and is intended for educational purposes only. The authors and the Health Physics Society (HPS) do not assume any responsibility for the accuracy of the information presented herein. The authors and the HPS are not liable for any legal claims or damages that arise from acts or omissions that occur based on its use. *The Health Physics Society is a nonprofit scientific professional organization whose mission is to promote the practice of radiation safety. Since its formation in 1956, the Society has grown to nearly 5,000 scientists, physicians, engineers, lawyers, and other professionals representing academia, industry, government, national laboratories, the Department of Defense, and other organizations. Society activities include encouraging research in radiation science, developing standards, and disseminating radiation safety information. Society members are involved in understanding, evaluating, and controlling the potential risks from radiation relative to the benefits. Official position statements are prepared and adopted in accordance with standard policies and procedures of the Society. The Society may be contacted at 1313 Dolley Madison Blvd., Suite 402, McLean, VA 22101; phone: 703-790-1745; fax: 703-790-2672; email: HPS@BurkInc.com.