Radiation threats and your safety A guide to Preparation and REsponse for Professionals and Community Radiation threats and your safety A guide to Preparation and REsponse for Professionals and Community Armin Ansari Chapman & Hall/CRC Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2010 by Taylor and Francis Group, LLC Chapman & Hall/CRC is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S Government works Printed in the United States of America on acid-free paper 10 International Standard Book Number: 978-1-4200-8361-3 (Hardback) This book contains information obtained from authentic and highly regarded sources Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use The authors and publishers have attempted to trace the copyright holders of all material reproduced in 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by the CCC, a separate system of payment has been arranged Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Library of Congress Cataloging‑in‑Publication Data Ansari, Armin Radiation threats and your safety : a guide to preparation and response for professionals and community / Armin Ansari p ; cm Includes bibliographical references and index ISBN 978-1-4200-8361-3 (hardcover : alk paper) Ionizing radiation Accidents Ionizing radiation Safety measures Emergency management I Title [DNLM: Radiation Injuries prevention & control Disaster Planning Disasters Radioactive Hazard Release prevention & control Radiologic Health WN 650 A617r 2010] RA569.A56 2010 362.196’9897 dc22 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com 2009030137 Dedication To community members and professionals who go the extra mile Contents Preface The Author ix xiii Part One • Understanding Radiation Introduction Radiation in Everyday Life Radiation 101 23 Part Two • The Impact of Radiation Accidental Radiation Emergencies 47 Intentional Radiation Emergencies 75 Health Effects of Radiation 103 Environmental Effects of Radiation 125 Psychosocial Effects of Radiation 143 Part Three • Responding to Radiation Protecting Yourself and Your Family 159 10 Preparing Your Family Emergency Plan 185 11 Medical Response to Radiation Emergencies 195 Radiation Drugs 217 Government Response to Radiation Emergencies 243 14 Responding as Professionals 261 Responding as a Community 275 vii viii  •    Contents Part Four • Conclusion 16 Living with the Threat 291 Glossary 293 Appendix A: Emergency Supply List 299 Appendix B: Radiation from Microwaves and Cellular Phones 303 Appendix C: Food Irradiation 309 Index 315 Preface S everal years ago, before the advent of Internet shopping, I bought an old issue of Life magazine from a shopping mall kiosk in Knoxville, Tennessee It was the September 15, 1961, issue and had a picture of a man in a “civilian fallout suit” on the cover with the title “How You Can Survive Fallout.” I browsed through the magazine thinking that it represented an era that we had moved beyond I had no idea that the events occurring exactly 40 years after publication of this particular issue would launch another era during which, once again, we would be concerned about this possibility Also, I had no idea at the time that I would be spending the second half of my career working on nuclear and radiological emergency preparedness and response issues, part of which entails lecturing and conducting training workshops across the country It was through these interactions with a broad spectrum of professionals and community members that I realized that an information gap had not been addressed, even though an enormous amount of information was available There has been an explosion of information on the subject of radiation emergencies and related issues in the scientific and technical literature Multitudes of radiation textbooks ably serve professionals in their respective medical and technical fields State, federal, and international agencies have created numerous guidance and planning documents, and some of that information keeps changing as new plans are drawn and new terminologies and acronyms are created Also, numerous fact sheets and information pages on radiation and radioactivity, radiation drugs, and other emergency response issues can be found on governmental and nongovernmental Web sites Finally, an aspect of commercialism offers information to private citizens as well as government consumers Although this vast body of information is valuable and, for the most part, serves the intended purpose, much of it is too detailed or too technical, tailored for specific audiences, or simply too dispersed Consumers of information who are new to the radiation arena have to sift through a lot of material to find what is important or applicable to them They are likely to be overwhelmed with information or not get enough of what they need My goal in writing this book is to bring together, in a concise way, essential, need-to-know, and practical information about radiation threats in an approachable form and content The book is written for discerning members ix Index A Activation, 72 Acute radiation syndrome (ARS), 89, 104, 124 defined, 293 prognosis, 116–117 recovery from, 118 symptoms, 113–114, 204 early, 113, 204 onset of, 113 severity of, 114 Acute vs chronic exposure, 110–112 Adaptive response, 122 Advisory Team for Environment, Food, and Health, 254 Aerial Monitoring System (AMS), 254 Air, radioactive contamination, 126–127 ALARA, 264–268 defined, 293 Alpha particles, 26–27 defined, 293 hazard, 28 health effects, 108 penetrating ability, 28 American College of Radiology, 21 Appropriateness Criteria, 20 American Veterinary Medical Association, 192 Americium, 30 Amifostine, 220 AMS See Aerial Monitoring System (AMS) Apollo lunar missions, 61 Appetite, 113, 144 Armed Forces Radiobiology Research Institute, 215, 220, 241 Atomic bomb See Improvised nuclear device (IND) B Background radiation, defined, 293 radiation dose from, 16 typical levels, 40 Baker test, 86 Bananas, radioactive potassium in, 12 Barium enema, 16 BAT See Biodosimetry assessment tool (BAT) Becquerel, 38, 40, 71 defined, 293 Beta burn, 108 defined, 293 Beta particles in body tissues, 108 defined, 293–294 hazard, 28 health effects, 108 penetrating ability, 28, 108 Bikini Atoll, 86 Bioassay, 209 defined, 294 Biodosimetry assessment tool (BAT), 215 Biological contamination radioactive contamination vs., 35 “Black rain,” 84 Bleeding, internal, 103, 113, 221, 293 Blocking agents, 219 Bomb(s) See also Improvised nuclear device (IND) dirty, 92 (See also Radiological dispersal device(s)) defined, 294 environmental impact, 136 people’s reaction to, 143 what to following explosion of, 165–169 fission (See Improvised nuclear device (IND)) fizzle, 82 home-made fertilizer, 92 nuclear, 72, 177 destruction by, 79, 81 detonation of Cs-137 following, 235 fallout following, 231 at or near ground surface, 83 heat and blast effects, 81 Bone marrow transplant, 202, 203 Brachytherapy, 57 Braking radiation, 108 315 316  •   Index Brazil nuts, radioactive potassium in, 12 Breast cancer, 120 Breast-feeding See Nursing mothers Breathing apparatus, self-contained, 268, 269 Building surfaces, radioactive contamination, 127–128 Burns, 117, 199 beta, 108, 293 from INDs, 77 lethal, 80 radiation, other burns vs., 106–107 retinal, 89, 172 Business Executive for National Security, 287 Bystander effect, 122 C Ca-DTPA, 236 Cameras, 58, 210 Cancer, 56, 109 breast, 120 cervical, 57 Chernobyl accident and, 70 Hiroshima bombing and, 87 incidence, 118–119 latent period for development of, 119 lung, 12, 130 mutation as precursor to, 106 neutropenic, 221 oxidative damages and, 106 prostate, 40, 57 risk, 124 in absence of radiation exposure, 109 for children, 90, 119–120, 231 of development in later life, 103, 104, 109 radiation dose and, 110, 122, 267 secondary, 220 skin, 303 therapy, 40, 165, 220 dose fractionation in radiation, 111 microwave energy for, 304 neupogen, 223 seed implantation, 57 thyroid, 30, 62, 133, 227, 231 time period between radiation exposure and appearance of, 119 U S incidence of, 118–119 Carrots, radioactive potassium in, 12 Cataracts, 110, 117–118 CBRNE, 75, 76 Cellular alteration, 106 Cellular death, 106 Cellular phones, 7, 304–307 Cellular repair, 105–106 Center for Disease Control and Prevention, 43 Center for the Study of Traumatic Stress, 155 CERT See Community Emergency Response Team (CERT) Cervical cancer, 57 Cesium, 30 Cesium-137, 58 half-life, 91 Cesium irradiators, 49 Chemical contamination, radioactive contamination vs., 36 Chernobyl accident, 68–71, 74, 132–136 cancer and, 70 Chernobyl reactor, 62 Chest X-ray, 16, 66, 111, 112 Children cancer risk, 90, 119–120 disaster preparedness for, 192 DTPA and, 238 KI dosage, 228 marketing cell phones to, 306 protection against radiation, 180 radiation exposure carcinogenic effects of, 119 food-related, 131 psychological effects of, 148, 152 searching for lost, 284 sheltering, 180, 192 thyroid cancer in, 231 Chronic lymphocytic leukemia, 119 Chronic vs acute exposure, 110–112 Citizen Corps, 282–283 guide for local officials, 287 Cobalt, 30 Cobalt-60, 58 Coconuts, radioactive potassium in, 12 Colonoscopy, virtual, 16 Colony-stimulating factors, 219, 221–222 Columbia space shuttle, 61 Combined injury, 114 Communication, 153–154 Community Emergency Response Team (CERT), 276, 284 Compassion fatigue, 149 Index   •   317 Complete blood count with differential, 205, 206–207 Conference of Radiation Control Program Directors (CRCPD), 259 Contamination chemical contamination vs radioactive, 36 defined, 294 external, 294 therapy for, 219, 224 fixed, 127 internal, 54 decorporation therapy for, 202 drug therapy, 224–240 drugs for, 224–240 of nursing mothers, 180 pharmaceutical countermeasures for, 239 of pregnant women, 121, 180 with radioactive americium, 225 with radioactive cesium, 225 with radioactive curium, 225 with radioactive iodine, 225 with radioactive plutonium, 225 with radioactive thallium, 225 RDD and, 96 reducing possibility of, 63 tests to estimate extent of, 205 treatment of, 54, 224–240 radioactive contamination vs chemical, 36 Coronary angiography, 16 Coronary angioplasty, 57 Countermeasures, 214 defined, 294 general recommendations for, 231 medical, 240 pharmaceutical, 239 CRCPD See Conference of Radiation Control Program Directors (CRCPD) CT abdomen, 16 CT scan, 34, 112, 200, 264 for children, 19 whole body, 41 Curie, 38 defined, 294 U S use of, 39 Cutaneous radiation syndrome, 124 Cytogenetic biodosimetry, 205, 207 Cytokine therapy, 202 Cytoprotective agents, 220 D Decay See Radioactive decay Decay chain, 31 Decay series, 31 Decelerating radiation, 108 Decontamination defined, 294 in Goiânian accident, 54, 138 instructions for home, 169–172 pet, 182 self, 169–172 time issue in, 171 touching others before, 171 way to remember how to, 170–171 Decorporating agents, 202, 219 Dehydration, 113, 132, 181 Density-moisture gauges, 59 Dental X-ray, panoramic, 16 Diagnostic imaging, 13, 14, 17 pediatric protocols, 19, 20 radionuclides for, 42 Diarrhea, 110, 113, 202, 204, 237, 293 Direct bioassay, 209, 294 Dirty bomb, 92 See also Radiological dispersal device(s) defined, 294 environmental impact, 136 people’s reaction to, 143 what to following explosion of, 165–169 Diuretics, 225 Dose, 38, 41–43 assessment tool, online, 215 from background radiation, 16 defined, 294 for food irradiation, 311–312 guidelines, 267 health effects and, 103–104, 108–110 high, 103 laboratory tests for estimating, 205 lethal, 31, 115 low, 104, 122 moderate, 103 rate, 111–112, 294 threshold, 110 U S annual, 11 Dosimeter, 204, 294 DTPA, 219 calcium, 236 for nursing mothers, 238 for pregnant women, 236 318  •   Index toxicity, 237 zinc, 236, 237 E Education, 153–154 Elderly people, 119–120, 148, 167, 168, 181, 186, 191, 257 Electromagnetic pulse, 87 Electromagnetic waves, 25, 303–304 Electron paramagnetic resonance, 205, 207 Electron spin resonance See Electron paramagnetic resonance Emergency(ies) See also Radiation emergency(ies) community response to, 275–287 examples from Hurricane Katrina, 277–281 of NGOs, 277 of private sector, 276–277 Emergency kit, 188–190 Emergency Management Assistance Compact, 255, 260 Emergency Management Institute, 260 Emergency planning zone (EPZ), 63 ingestion exposure pathway, 63 plume exposure pathway, 63 Emergency preparedness course, 192 Emergency supply list, 299–301 food, 299 medications and medical supplies, 300 for pets, 301 water, 299 Emetics, 225 Environment, 126–130 air, 126–127 building surfaces, 127–128 soil, 128–129 vegetation, 130 water, 129–130 EPZ See Emergency planning zone (EPZ) European Commission, 21 Exposure See Irradiation; Radiation exposure External contamination, 294 therapy for, 219, 224 External exposure, 107, 112, 219, 296 internal exposure vs., 112–113 F Face masks, 268 Fallout See Nuclear fallout Family emergency plan, 186–191 communication and getting reunited, 186–188 emergency kits, 188–190 for members with special needs, 191 FCC See Federal Communications Commission (FCC) FDA See Food and Drug Administration (FDA) Fecal bioassay, 205, 208–209 Federal Communications Commission (FCC), 305 Federal Emergency Management Agency (FEMA), 73, 247 Emergency Management Institute, 260 emergency preparedness course, 192 Federal Radiological Emergency Response Plan (FRERP), 247 Federal Radiological Monitoring and Assessment Center (FRMAC), 254 Federal Response Plan (FRP), 247 FEMA See Federal Emergency Management Agency (FEMA) Filgrastim, 219, 223 Fission, 77 defined, 295 product, 81 definition of, 295 half-life of, 90, 91 radioactive cesium as, 235 radioiodide as, 231 uncontrolled release of, 127 Fission bomb See Improvised nuclear device (IND) Fixed contamination, 127 Fluoroscopy, 57 Food emergency supply, 299 irradiation, 165, 309–312 criticism of, 310–311 international symbol for, 312 origins of, 311 purpose of, 309 radiation dose for, 311–312 sources of radiation for, 311 radionuclides in, 12, 142 Food and Drug Administration (FDA), 305 Food chain, 130–132 Frisker See Survey meter Index   •   319 FRMAC See Federal Radiological Monitoring and Assessment Center (FRMAC) FRP See Federal Response Plan (FRP) G Galileo spacecrafts, 60 Gamma cameras, 210 Gamma ray(s), 25, 26 defined, 295 hazards, 28 health effects, 107–108 penetrating ability, 28 X-rays vs., 26 Gamma-ray industrial irradiator, 311 Gastric lavage, 225 Geiger–Muller radiation detector, 36 Genomic instability, 122 Goiânia, Brazil, 50, 52–54, 73, 95, 138, 147 Gray (Gy), 38 defined, 295 “Ground shine,” 84 defined, 295 Groundwater, radioactive contamination, 129 Gy See Gray (Gy) H Hair loss, 57, 110, 113, 118, 293 Half-life, 30 biological, 31 defined, 31, 295 of fission product, 90, 91 Health impact See also Radiation, health effects of IND, 87–90 of RDD, 96–97 of RED, 99–100 Health physics, 43, 190 defined, 295 society for, 124, 184 Health Physics Society, 124 Hereditary effect, 120 Hiroshima, Japan, 77, 79, 88, 101 cancer incidence, 87 personal accounts of bombing, 146 Home decontamination, 169–172 Homeland Security Act (2002), 247 Homeland Security Council, 259 Homeland Security Presidential Directive, 247 Hospital(s) graceful degradation, 211 managing resources, 211–212 responses in radiation emergencies, 199–211 laboratory tests, 204–211 CBC with differential, 205, 206–207 cytogenetic biodosimetry, 205, 207 electron paramagnetic resonance, 205, 207 fecal bioassay, 205 field kits for triage, 205 nasal swabs, 205, 210–211 urine bioassay, 205, 208–209 whole-body counting, 205, 209–210 treatment options, 201–204 bone marrow transplant, 202, 203 cytokine therapy, 202 decorporation therapy, 202 palliative care, 202, 203–204 supportive care, 201, 202 transfusion, 202, 203 transportation to, 199 Hot area, 295 Hot source, 99, 295 radiation level, 38 Hot spot, 295 Hot zone, 269 Hurricane Katrina, 72–73, 150, 185, 275 evacuees, 187 legislation as result of, 182 lessons from, 277–281 military participation in rescue, 251 Hyperthermia, 304 Hypothyroidism, 227 I IAEA See International Atomic Energy Agency (IAEA) ICNIRP See International Commission on Non-Ionizing Radiation Protection (ICNIRP) ICS See Incident Command System (ICS) 320  •   Index IMAAC See Interagency Modeling and Atmospheric Assessment Center (IMAAC) Imaging procedures annual in, U S., 13, 14 pediatric protocols, 19, 20 radionuclides for, 42 Improvised nuclear device (IND), 77–91 air burst, 84–85 burns from, 77 defined, 296 electromagnetic pulse, 87 environmental impact, 90–91, 136–138 ground burst, 85, 89 health impacts, 87–90 immediate, 88–89 long-term, 90 short-term, 89 heat and blast effects, 79–80 immediate destruction, 79–80 mushroom cloud, 85 nuclear fallout, 83–84 radiation from, 80–83 prompt, 82–83 residual radioactivity, 90 underwater burst, 86–87 weapon yield, 79 Incident Command System (ICS), 253 IND See Improvised nuclear device (IND) Indirect bioassay, 294 Industrial accidents, 58–59 environmental impact, 139 Ingestion exposure pathway, 63 Interagency Domestic Terrorism Concept of Operations Plan, 247 Interagency Modeling and Atmospheric Assessment Center (IMAAC), 254 Internal contamination, 54 decorporation therapy for, 202 defined, 34, 294 drug therapy, 224–240 drugs for, 224–240 of nursing mothers, 180 pharmaceutical countermeasures for, 239 of pregnant women, 121, 180 with radioactive americium, 225 with radioactive cesium, 225 with radioactive curium, 225 with radioactive iodine, 225 with radioactive plutonium, 225 with radioactive thallium, 225 RDD and, 96 reducing possibility, 63 tests to estimate extent of, 205 treatment of, 54, 224–240 Internal exposure, 296 by alpha particles, 108 external exposure vs., 112–113 photons as source of, 107 International Atomic Energy Agency (IAEA), 50, 129, 195, 255, 259 publications on accident response, 73 International Commission on Non-Ionizing Radiation Protection (ICNIRP), 305 Iodine, 30 internal contamination with radioactive, 225 Ionizing radiation, 7, 24–25 carcinogenicity, 118, 123 defined, 296 exposure of U S population to, 11, 19 for food irradiation, 311 gene expression and, 211 health risks from exposure to low levels of, 109, 123 living cells and, 104 to lung tissue, 108 medical effects of, 123 medical sources of, 13–17 mortality after acute whole-body exposure to, 109 oxidative damage and, 106 reducing exposure to, 264 sources and effects of, 74 WHO website, 123 Iosat™, 227 Iridium, 30 Iridium-60, 58 Irradiation, 34, 42 defined, 296 food, 165, 309–312 criticism of, 310–311 international symbol for, 312 origins of, 311 purpose of, 309 radiation dose for, 311–312 sources of radiation for, 311 period, 112 radiation injury and, 55 whole-body vs partial body, 110 Index   •   321 J JCAHO See Joint Commission on Accreditation of Healthcare Organization (JCAHO) Joint Commission on Accreditation of Healthcare Organization (JCAHO), 211 L Lateral evacuation route, 174 Laxatives, 225 Leukemia, 119 Lima beans, radioactive potassium in, 12 Living cells, 104–107 ionizing radiation and, 104 Long-lived radionuclides, 296 Lung cancer, 12, 130 M Magnetic resonance imaging (MRI), 17 Mammography, 16 Media, role in mitigating psychosocial effects of radiation emergencies, 153–154 Medical accidents, 55–58 environmental impact, 140 Medical Reserve Corps, 276, 283–284, 286 Metal recycling facilities, 59 Microwave ovens, 7, 25, 296, 303 Milk, contaminated, 131, 231 Mortality, after acute whole body exposure to radiation, 109 Mushroom cloud, 85 Mutual aid agreements, 255 N N100 disposable particulate respirator, 271 Nagasaki, Japan, 85, 88, 101 personal accounts of bombing, 146 Nasal swabs, 205, 210–211 National Cancer Institute, 20, 304 National Center for Disaster Preparedness, 185 National Contingency Plan (NCP), 247 National Council on Radiation Protection and Measurements (NCRP), 16, 19, 215, 241 National Disaster Medical System (NDMS), 254 National Guard Weapons of Mass Destruction Civil Support Teams, 253 National Incident Management System (NIMS), 247, 253 National Response Framework Resource Center, 259 National Response Plan (NRP), 247 Natural background radiation See Background radiation Natural disasters, radiation exposure from, 72–73 Nausea as drug side effect, 220, 221, 237 onset of, 113, 204 NCP See National Contingency Plan (NCP) NCRP See National Council on Radiation Protection and Measurements (NCRP) NDMS See National Disaster Medical System (NDMS) Nerve agent, 36 Neulasta™, 223 Neupogen™, 222–223 long acting, 223 Neutrino, 28 Neutrons, 27–28 Neutropenic cancer, 221 NGOs See Non-governmental organizations (NGOs) NIMS See National Incident Management System (NIMS) Non-governmental organizations (NGOs), 277 Non-ionizing radiation defined, 296 international commission on, 305 tissue damage and, 303 NRP See National Response Plan (NRP) Nuclear bomb(s), 72, 177 destruction by, 79, 81 detonation of Cs-137 following, 235 fallout following, 231 at or near ground surface, 83 heat and blast effects, 81 Nuclear detonation radiation levels 48 hours after, 174 what to following, 172–177 322  •   Index Nuclear fallout after RDD explosion, 92 annual radiation dose and, 17 evacuation to evade, 174 following bomb detonation, 83–84 protection against, 173–174 structures’ protective effects against, 176 Nuclear incident, 143 defined, 296 distribution of KI following, 242 nuclear detonation and, 77 radiological incident vs., 76, 297 tiered response to, 245 Nuclear power plants criticality accidents, 71–72 emergency classification, 65–66 alert, 65 general, 65–66 site area, 65 unusual event, 65 emergency planning zone, 179 environmental impact of, 132–136 radiation exposure and, 61–72 Nuclear/Radiological Incident Annex, 247 Nuclear reactor accident, what to following, 177–179 Nuclear scenarios, 76–77 Nuclear terrorism, 3, 214 See also Terrorism incident Nursing mothers, 230 DTPA therapy, 238 instructions following radiation emergencies, 180–181 internal contamination of, 180 potassium iodide and, 230 sheltering, 180–181 Nutraceuticals, 240 O Oklahoma City bombing, 93 Operation Crossroads, 86 Orphan sources, 48–55 environmental impact, 138 P Palliative care, 202, 203–204 PAPR See Powered air-purifying respirator (PAPR) Partial-body vs whole-body irradiation, 110 Pegfilgrastin, 219 Personal protective equipment (PPE), 268, 269 Pet Evacuation and Transportation Standards Act (2006), 182 Petroleum exploration, 59 Pets, 180, 181–182, 186, 191, 301 Photons, 23, 25, 26, 107 as fission product, 80 as source of internal exposures, 107 Plume, 2, 126 defined, 296 Plume exposure pathway EPZ, 63 Plutonium, 30 Plutonium-238, 58 Polonium-210 poisoning, 95–96 Posse Comitatus, 252–253 Posttraumatic stress disorder (PTSD), 144, 149, 150 Potassium iodate, 219 dosage, 227 Potassium iodide, 219, 225, 226–232, 296 cost, 232 formulations, 227 indications, 226 limitations, 228–230 for nursing mothers, 230 precautions, 230 for pregnant women, 230 public distribution or predistribution of, 231–232 recommended dosage, 228 Powered air-purifying respirator (PAPR), 268, 270 PPE See Personal protective equipment (PPE) Pregnant women, 124 consideration in family emergency plan, 186, 190, 191 DTPA and, 236 instructions following radiation emergencies, 180–181 internal contamination of, 121, 180 potassium iodide and, 230 Prussian blue and, 234 radiation exposure medical, 121 occupational, 121 psychological effects of, 148 sheltering, 180–181 treatment for, 199 Index   •   323 Private sector organizations, 276–281 Prostate cancer, 40 therapy, 57 Protective action guide, 64 Psychological first aid, 151–152 Psychosomatic bind, 145 Pulmonary lavage, 225 R Radiation as additional stressor, 145–148 background, 8, 111 baseline, committed, 42 from consumer products, 17–18 cosmic, defined, 24, 296 detection, 36–37 dose, 38, 41–43 assessment tool, online, 215 from background radiation, 16 defined, 294 for food irradiation, 311–312 guidelines for, 267 health effects and, 103–104, 108–110 high, 103 laboratory tests for estimating, 205 lethal, 31, 115 low, 104, 122 moderate, 103 rate, 111–112, 294 threshold, 110 U S annual, 11 effects, reversibility of, 118 environmental effects, 125–142 decisions for long term, 140–141 range of, 132–140 food chain and, 130–132 fundamentals for protection against, 159–163 health effects, 103–124 age and, 119–120 factors affecting, 107–113 pregnancy and, 120–121 reversibility of, 118 hereditary effect, 120 internal, 11–12, 112–113 international symbol, 164 ionizing, 7, 24–25 carcinogenicity, 118, 123 defined, 296 exposure of U S population to, 11, 19 for food irradiation, 311 gene expression and, 211 health risks from exposure to low levels of, 109, 123 living cells and, 104 to lung tissue, 108 medical effects of, 123 medical sources of, 13–17 mortality after acute whole-body exposure to, 109 oxidative damage and, 106 reducing exposure to, 264 sources and effects of, 74 WHO website, 123 levels, 38, 39–41 48 hours after nuclear detonation, 174 from man-made sources, 13–18 from medical sources, 13–17, 55–58 average doses, 16 minimizing exposure to, 18–19 natural sources, 7–12 new supplementary warning symbol, 166 non-ionizing defined, 296 international commission on, 305 tissue damage and, 303 orphan sources, 48–55 particulate, 26–28 rate, 41–42 sources, 7–12, 48–55 split-dose effect, 111 terrestrial, 10–11 type of, 107–108 units, 37–43 wave, 25–26 worldwide annual doses, 10 Radiation burn, 114 Radiation detector, 36 See also Survey meter handheld, 50 for home use, 190 Radiation drugs, 217–242 cytoprotective agents, 220 Radiation emergency(ies) defined, 296 government response to, 243–260 challenges of, 256–259 communication and, 256–258 experience and, 258–259 human factors in, 258 324  •   Index mutual aid agreements, 255–256 private sector and, 256 unified command of, 256 medical responses to, 195–215 in alternate care centers, 212 golden hour of opportunity for, 199 in hospitals, 199–211 (See also Hospital(s)) on scene treatment, 197–199 for large affected populations, 197–199 for small affected populations, 197 transportation to hospitals, 199 national response to, 245–255 framework for, 246–255 nursing mothers following, instruction for, 180–181 pet care following, 181–182, 192 pregnant women following, instructions for, 180–181 from radioactive iodine, 231 responders to, 261–274 ALARA and, 264–268 expectations of, 262–263 hospital, 271–272 hot zone, 269–271 personal protection for, 268–272 professional concerns of, 261–264 public health, 272 radiation dose guidelines for, 268–272 training of, 264 volunteer, 286 role of media in mitigating psychosocial effects, 153–154 Radiation Emergency Assistance Center/ Training Site (REAC/TS), 195, 254 training courses, 214 Radiation Event Medical Management (REMM), 43, 122, 213 on line dose assessment tool, 215 Radiation exposure acute vs chronic, 110–112 case studies of Chernobyl accident, 68–71, 74 in Goiânia, Brazil, 50, 52–54, 73, 95, 138, 147 in Panama City, Panama, 56 in Samut Prakan, Thailand, 54–55, 56 in San José, Costa Rico, 56 Three Mile Island, 66–68, 74, 135, 147 cataracts and, 117–118 from industrial accidents, 58–59 internal vs external, 112–113 from medical accidents, 55–58 medical treatment options, 201–204 bone marrow transplant, 202, 203 cytokine therapy, 202 decorporation therapy, 202 palliative care, 202, 203–204 supportive care, 201, 202 transfusion, 202, 203 mortality and, 114–116 from natural disasters, 72–73 psychosocial effects, 143–154 behavioral, 144 cognitive, 144 emotional, 144 first aid, 150–154 manifestations of, 144 mitigating, 150–154 physical, 144 spiritual, 144 radioactive contamination vs., 33–35 risk, people at, 119–120, 148–149 space missions and, 60–61 therapy drug, 218–240 for external exposure, 219 future products, 240 home remedies and exotics, 240–241 from transportation accidents, 59–60 Radiation exposure device (RED), 98–100 defined, 296 environmental impact of, 100 health impact of, 99–100 as sealed source, 98 Radiation Injury Treatment Network (RITN), 215 Radiation monitoring program, 135 Radiation poisoning, 117 See Acute radiation syndrome (ARS) Radiation sickness See Acute radiation syndrome (ARS) Radiation therapy, 50 radiation overexposure and, 57 Radioactive contamination biological contamination vs., 35 chemical contamination vs., 36 Index   •   325 drug therapy for, 219 (See also DTPA; Potassium iodide; Prussian blue) internal, estimating extent of, 205 radiation exposure vs., 33–35 Radioactive decay, 23, 30–31 defined, 296 of plutonium, 60 Radioactive objects, what to when encountering, 163–165 Radioactive seeds, 57 Radioactive sources categories of, 51 cesium-137, 58 cobalt-60, 58 iridium-60, 58 Radioactivity, 24 amount of, 38 defined, 293 environmental, 19 international symbol, 164 natural, 8, 18, 19 sources of (See Radioactive sources) units, 38–39 Radiogardase™, 233 Radiography, industrial, 58 Radioisotope heater units (RHUs), 60 Radioisotope thermoeletric generators (RTGs), 60 Radioisotopes See Radionuclide(s) Radiological dispersal device (RDD), 91–98 construction, 92 defined, 296–297 economic impact, 97–98 environmental impact, 97 health impact, 96–97 key points regarding, 94 nonexplosive, 94–95 case studies of, 95–96 shrapnel from, 94 Radiological incident, 3, 262 defined, 297 nuclear incident vs., 76, 297 Radiological scenarios, 76–77 Radiological Survey, 297 Radionuclide(s), 29, 231 See also specific elements daughter, 30–31 defined, 297 examples, 30 in foodstuffs, 142 half-life, 30, 32 identification, 29 long-lived, 296 in milk, 133 parent, 30 primary radiation, 30 short-lived, 297 Radioprotectants, 219, 220 Radium, 30 Radium needles, 50 Radon, 12, 31 Radura, 312 REAC/TS See Radiation Emergency Assistance Center/Training Site (REAC/TS) Rem, 38, 111 sievert and, 297 REMM See Radiation Event Medical Management (REMM) RHUs See Radioisotope heater units (RHUs) RITN See Radiation Injury Treatment Network (RITN) RTGs See Radioisotope thermoeletric generators (RTGs) S Salvation Army, 279 Sarin gas, 36 SCBA See Self-contained breathing apparatus (SCBA) Secondary traumatic stress disorder (STSD), 149 Seizures, 113 Self-contained breathing apparatus (SCBA), 268, 269 Shelter(s) activities within, 175, 177 deciding whether to evacuate or seek, 173–175 evaluation, 184 function, 173 home, 188 leaving the, 177 location of, 175 supplies for, 190, 299–301 underground, 176 what to inside, 175, 177 when to leave, 177 Sheltering, 175 children, 180, 192 defined, 297 nursing mothers, 180–181 326  •   Index in place, 167 pregnant women, 180–181 for terrorism incident, 180 Short-lived radionuclides, 297 Shrapnel, 94 Sievert, 38, 41 defined, 297 rem and, 297 Skin cancer, 303 Skin damage, 114, 118 Society for Pediatric Radiology, 20 Soil, radioactive contamination, 128–129 Sources, 7–12, 48–55 defined, 297 hot, 99, 295 sealed, 98 Southern Mutual Radiation Assistance Plan, 255 Space missions, radiation exposure and, 60–61 Spinach, 40 radioactive potassium in, 12 Split-dose effect, 111 START system, 213 Stem cell transplantation, 202, 203 Sterility, 110, 118 Strontium, 30 Strontium-90, 61 half life, 91 STSD See Secondary traumatic stress disorder (STSD) Survey meter, 297 Sweet potatoes, radioactive potassium in, 12 T Technetium, 30 Terrorism incident, 3, 75, 220 emergency kit, 188–190 IND, 137 medical management of, 214 protection from, 184 psychosocial impact, 143, 155 sheltering procedures, 180 Thermotherapy, 304 Thorium, 31 Three Mile Island, 66–68, 74, 135, 147 Thyroid cancer, 30, 62, 133, 227 in children, 231 Thyroiditis, 227 ThyroSafe™, 227, 228 ThyroShield™, 227 Tiered response, 245 To-go kit, 189–190 Tokai-Mura accident, 72 Tracer elements, 37 Transfusion, 202, 203 Transportation accidents, 59–60 environmental impact, 139–140 Triage, 212–213, 274 field kits, 205 system categories, 213 delayed, 213 expectant, 213 immediate, 213 minor, 213 U U S Centers for Disease Control and Prevention, 213 U S Department of Health and Human Services, 155 U S Department of Homeland Security, 192 U S Environmental Protection Agency, 20, 43 protective action guide, 64 U S Food and Drug Administration Center for Drug Evaluation Research, 241 U S Northern Command (USNORTHCOM), 253 Ultrasound, 17 United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), 11, 19, 74 University of Michigan Health Physics, 43 UNSCEAR See United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Uranium, 29, 30, 31 Urine bioassay, 205, 208–209 USNORTHCOM See U S Northern Command (USNORTHCOM) V Vegetables, 10, 130, 175 leafy, 130–131 radioactive potassium in, 12 Vegetation, 130, 131 Volunteer(s), 276 from clergy, 151 legal considerations for, 284–286 Index   •   327 Whole-body vs partial-body irradiation, 110 World Health Organization (WHO), 19, 195 organizations, 282–284 for radiation emergencies, 286 Volunteer Protection Act (1997), 285, 287 Vomiting after acute whole-body exposure to radiation, 109 managing, 201 onset of, 109, 113, 204 stress and, 144 Voyager spacecrafts, 60 X W Y Water, radioactive contamination, 129–130 Weapons of mass destruction, 92 See also Radiological dispersal device(s) WHO See World Health Organization (WHO) YOYO-72, 244 X-rays, 25–26 gamma rays vs., 26 hazards, 28 penetrating ability, 28 Z Zn-DTPA, 236 .. .Radiation threats and your safety A guide to Preparation and REsponse for Professionals and Community Radiation threats and your safety A guide to Preparation and REsponse for Professionals and. .. intent to infringe Library of Congress Cataloging‑in‑Publication Data Ansari, Armin Radiation threats and your safety : a guide to preparation and response for professionals and community / Armin Ansari... potassium and carbon, abundantly found in nature and in the body, are radioactive and emit ionizing radiation to achieve a more stable form What Is Radiation? The word ? ?radiation? ?? is a broad term that,