From the lost radium files: misadventures in the absence of training, regulation, and accountability.

PURPOSE: Radium was the foundation of brachytherapy in the early decades of the 20th century. Despite being a most precious and perilous substance, it was mislaid with surprising frequency. This essay explores how it was lost, the efforts taken to recover it, and measures instituted to prevent mishandling. METHODS AND MATERIALS: Review of contemporary literature, government publications, archives, and lay press. RESULTS: Radium is a particularly dangerous substance because of its long half-life, its gaseous daughter (radon), and the high-energy emissions of its decay products. Despite the hazard, it was unregulated for most of the century. Any physician could obtain and administer it, and protocols for safe handling were generally lacking. Change came with appreciation of the danger, regulation, mandated training, and the institution of a culture of accountability. Unfortunately, careless management of medical radionuclides remains a global hazard. CONCLUSION: Responsible stewardship of radioactive material was not a high priority, for practitioners or the federal government, for much of the 20th century. As a result, large quantities of radium had gone astray, possibly subjecting the general public to continued radiation exposure. Lessons from the radium era remain relevant, as medical radionuclides are still mishandled.

Safety and security of radiation sources in the aftermath of 11 September 2001.

The attack on the United States on 11 September 2001 resulted in an increased awareness of the need for safety and security measures to protect against terrorism. The potential use of radiation sources in terrorism, in particular radioactive sources, was recognized prior to 11 September 2001, but has taken on new significance since. The planning of security measures for radioactive sources must take greater account of the potential for deliberate acts to attack or use radioactive sources to expose people and cause contamination. The potential consequences of an act of terrorism using radioactive sources can be gauged from the consequences of serious accidents that have occurred involving radioactive sources. These include fatal and injurious radiation exposures, contamination of the environment, and serious economic and psychosocial costs the total effect of which is mass disruption. Steps are being taken to improve security for radioactive sources but strategic approaches that can minimize the threat of radiological terrorism should be considered. When justifying a practice that uses radioactive sources, the potential for diversion or use in terrorism should be considered to be a detriment. In this regard, the consideration and development of alternatives to radioactive sources, such as radiation producing machines, have been recommended by terrorism experts as measures to reduce the threat of radiological terrorism. If a practice using radioactive sources is determined to be justified, the need for special security measures to protect against terrorism should then become part of the safety assessment.

Too many notes?

Orphan sources are now recognized as a radiation protection problem needing attention. Government and private sector initiatives have been mounted in response. Should more be done? There are promising possibilities. Under the ICRP 60 system of radiation protection, any use of radiation should be justified. Key NRC licensing regulations predate ICRP 60 and, consequently, if a use is authorized by license, then the use is presumed to be justified even if alternatives are available. As an example, x-ray gauges can be successfully substituted for nuclear container fill level gauges in the food and beverage industry. But this development is not widely known to potential users and regulators, and current regulatory policies do not address this. Limiting the number of radioactive devices would limit the number of potential orphan sources. From an operational radiation safety point of view, persons wanting to dispose of unneeded or unwanted radioactive sources are faced with a system loaded with disincentives, in part because disposition options are not well known and in part because options have become limited, complex, and expensive. New approaches are needed if the orphan source problem is to be effectively addressed. Paramount are the needs to (1) update U.S. regulatory policies to incorporate the ICRP principle of justification, (2) create a system that encourages prompt, safe dispositioning of unneeded and unwanted radioactive sources, and (3) make information on these points universally known to users of radioactive sources.