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Inadvertent Cs-137 Release @ UW Seattle

scarbrtj

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Of potential interest here...

On May 2, 2019 International Isotopes, Inc. (INIS), a subcontractor to Triad National Security, LLC (Management and Operations [M&O] contractor for Los Alamos National Laboratory), inadvertently breached a sealed cesium-137 source at the University of Washington (UW), Harborview Medical Center, Research and Training Building (HRT) in downtown Seattle while attempting to recover the source for the NNSA Off Site Source Recovery Program (OSRP). The source breach resulted in contamination of personnel, the building, and a release of material to the environment. A Joint Investigation Team (JIT) co-led by National Nuclear Security Administration (NNSA) and Triad completed a thorough review of the event to identify the root and contributing causes...

In preparation for the source recovery activity, HMC [Harborview Medical Center] Security established a security boundary using yellow caution tape around the portion of the HRT parking lot. Radiation tape was not used throughout the source removal activities, in order to avoid advertising that radiation work was being conducted...

At 21:29 hrs., the RCO took a large area swipe on the MHC along the manipulator opening. The MHC was open to the environment and had no contamination control or containment capability. When the RCO turned on the contamination survey meter (which had been staged near the MHC) it pegged on the highest scale, >500,000 counts per minute (cpm)* [ed note: I think that's in the neighborhood of at least >0.01Sv/minute] Believing the meter to either be showing a high ambient background reading or broken, the RCO moved to the back of the loading dock; however, the meter indication did not drop...

SFD’s decontamination process did not remove all contamination from personnel. HMC medical staff were concerned about contaminating their emergency room. Consequently, affected personnel waited in ambulances for an extended period. REAC/TS and DOH advised HMC medical staff, which resulted in affected personnel evaluation at the HMC at about 04:00 hrs. on May 3. Urine samples were collected at the hospital, but never analyzed. DOH personnel conducted post-decontamination surveys, including qualitative nasal swabs from all INIS personnel. Four of the swabs were identified as positive, which indicated that radioactive material was inhaled into the body. Workers were released from the hospital by 09:00 hrs. Bioassay sample collection for INIS personnel was completed approximately 48 hours after the event. They were analyzed by GEL Laboratories and validated by Triad. The results confirmed internal uptake of Cs-137. In August, DOE, through Triad, reached out to involved organizations to offer confirmatory in vivo whole body counts conducted on affected individuals. The offer was declined by all parties.
 
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scarbrtj

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scarbrtj

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This report is wild!!
One reason to read these reports is to ask: where the rad oncs at? (Was there one in "Chernobyl?" Don't think so.) Waiting to see that "radiation oncologists succeed in help fixing radiation accident" or "radiation oncologists save day in radiation disaster" headline. Now maybe that's silly. But ASTRO tells us "Radiation oncologists are the most qualified individuals to be involved in emergency preparedness measures in the event of a nuclear/radiologic incident or disaster." Yet we never hear tell of one on-site in any substantial fashion when a disaster happens. I can't determine there's a single rad onc at ORISE at the REAC/TS (which Hall talks about in the textbook, actually). Opinion: all residents should go to one of these REAC/TS multi-day radiation disaster courses. Let's really produce some disaster experts rather than saying "because we're board certified in rad onc, we're more qualified radiation disaster experts than radiologists or nuc med or heme MDs."
 
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Palex80

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One reason to read these reports is to ask: where the rad oncs at? (Was there one in "Chernobyl?" Don't think so.) Waiting to see that "radiation oncologists succeed in help fixing radiation accident" or "radiation oncologists save day in radiation disaster" headline. Now maybe that's silly. But ASTRO tells us "Radiation oncologists are the most qualified individuals to be involved in emergency preparedness measures in the event of a nuclear/radiologic incident or disaster." Yet we never hear tell of one on-site in any substantial fashion when a disaster happens. I can't determine there's a single rad onc at ORISE at the REAC/TS (which Hall talks about in the textbook, actually). Opinion: all residents should go to one of these REAC/TS multi-day radiation disaster courses. Let's really produce some disaster experts rather than saying "because we're board certified in rad onc, we're more qualified radiation disaster experts than radiologists or nuc med or heme MDs."
Well, indeed, we do understand a lot more that other physicians. However we are trained to work with sealed sources. When things like ingestion and contamination come into play, I would suggest nuclear medicine doctors may actually know a thing or two more than us.
I do however understand that this may be country-specific. In Europe radiation oncologists do not perform SIRT (or help the interventional radiologists to perform SIRT would be the more correct wording) or treat with Alpharadine (Xofigo). These are domains of nuclear medicine specialists.

I recall that our department was queried at some timepoint on these matters, I think it was during the rise of terrorism when people started questionning which physicians could tackle situations as these. I recall that nuclear medicine specialists knew a thing or two better about half-life (most radiation oncologists know half-lifes of iridum, cesium and iodine), contamination and stuff like that. However when the question popped up concerning signs of acute radiation sickness a big question mark appeared over the nuclear medicine specialists' heads...
:)
 
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medgator

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Well, indeed, we do understand a lot more that other physicians. However we are trained to work with sealed sources. When things like ingestion and contamination come into play, I would suggest nuclear medicine doctors may actually know a thing or two more than us.
I do however understand that this may be country-specific. In Europe radiation oncologists do not perform SIRT (or help the interventional radiologists to perform SIRT would be the more correct wording) or treat with Alpharadine (Xofigo). These are domains of nuclear medicine specialists.

I recall that our department was queried at some timepoint on these matters, I think it was during the rise of terrorism when people started questionning which physicians could tackle situations as these. I recall that nuclear medicine specialists knew a thing or two better about half-life (most radiation oncologists know half-lifes of iridum, cesium and iodine), contamination and stuff like that. However when the question popped up concerning signs of acute radiation sickness a big question mark appeared over the nuclear medicine specialists' heads...
:)
In the US, it's generally split between nuc med or rad onc, and in some cases, IR itself. Where I trained, Nuc med did the iodines/Xofigos etc, where we do it in practice here. IRs here can get their own "AU" license to not need either RO or NM to do SIRS-spheres/Yt cases here. Nuc Med is really a dying specialty here anyways because of the above since rads can read their studies and read other diagnostics as well.
 
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thecarbonionangle

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Based on my understanding this had nothing to do with the residency and in no way reflects on them. A contractor screwed up when removing a radioactive source to replace with x-ray source.

sorry buddy i repeat bad place, filled with scut, double coverage, residents struggle to get all their research time. pay attention folks!!!
 
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scarbrtj

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Based on my understanding this had nothing to do with the residency and in no way reflects on them. A contractor screwed up when removing a radioactive source to replace with x-ray source.
Indeed I think it can be said, positively, that the radiation oncology attendings and residents 10 feet away from this radiation accident had nothing to do with the accident and the people that got exposed to radiation.

But it can also be said, negatively, that the radiation oncologists 10 feet away from this radiation accident had nothing to do with the accident and the people that got exposed to radiation. Were all the government and private sector people involved in the accident simply unaware that just next door were the humans—radiation oncologist humans—"most qualified... to be involved... in the event of a [radiation] disaster"?

What I'm suggesting is that it's time to drop the Radiation Oncologists Are Good At Radiation Accidents charade. Or else, as a specialty, we should actually, you know, do something about it. Versus constantly releasing "we are the best! " statements which wind up in retrospect looking like delusions of grandeur.
 
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