RE: U.S.: 'Dirty Bomb' Danger Real

[Carol Marcus <csmarcus@ucla.edu>]

Nov. 12, 2003



At 11:16 AM 11/12/2003, Chilton, Milton W. wrote:

>

>The good news is that barring a few scenarios it is unlikely that the RDD 

>would actually kill anyone aside from those actually killed by the blast. 

>The most likely impacts are denial of access and use of the impacted area 

>(You lose the ability to conduct business in the impacted area), 

>potentially huge economic impacts from clean up operations and lost 

>business, potentially huge psychological issues with the potentially 

>exposed population due to exaggerated fears, and finally some real concern 

>that the exposed population could actually exhibit an increase in the long 

>term cancer rate due to exposure.





Dear Radsafers:



I think that Milton's answer is basically good, but there is more to the 

issue that he didn't really cover.  While I would disagree with NRC that 

all the lost sources combined wouldn't make an effective RDD (I think they 

would), it is largely irrelevant.  There are other ways to disperse high 

activities of radionuclides in populated areas other than running around 

gathering up stolen sources or importing radionuclides from other 

countries.  You simply go to where the sources are, kill any security 

people or those who question what you're doing there, blow up the locks on 

the doors, and detonate the radioactive material.  If the terrorists don't 

care if they die, this should be relatively easy to do.  The RSO's and 

regulators among you should know full well where these sources of 

radioactive material are located at present.  This is what I worry about, 

and I am actively planning the medical response to an RDD event that could 

take place in Los Angeles County.



While it is true that few, if any, people would die of acute radiation 

effects from an RDD event, people could suffer significant morbidity and 

increased risk of radiation-induced disease (not just cancer)  if response 

is not appropriate and complete.   In most (if not all) places in the USA 

at present, response will not be appropriate and complete.  First 

responders need to be carrying (and know how to use) radiation detectors, 

and need to quickly alert those who can identify and roughly quantify the 

radioactive material in a speedy manner.  While these health physics people 

are determining what areas need to be evacuated, persons in the vicinity 

need to be externally decontaminated (basically hosed down) and the injured 

need to be brought to hospitals and decontaminated there or perhaps, on the 

way.  This means training of hospital and ambulance personnel.  First and 

second responders need personal radiation dosimeters so that they do not 

become overly exposed.



We also need methods for estimating internal radiocontamination, from 

inhalation and ingestion pathways, as well as from traumatic entry.  How 

many of you have working, calibrated whole body counters available to 

you?  How many have other methods?  I have spent 1 1/2 years trying to get 

some "humanized" gamma ray constants calculated or measured, so that with a 

calibrated ion chamber and a known radionuclide, a body burden may be 

estimated.  That has been quite an undertaking.  A couple of highly 

competent physicists I know will do the job for about $30,000, mostly to 

cover the computer time for the Monte Carlo calculations.  No one will put 

up the money.  NRC says it isn't their responsibility.  The CDC says it 

might be their responsibility but they have spent all their money on 

bioterrorism, and aren't going to spend any on this.  The National Disaster 

Medical System (NDMS) says it isn't their problem.  The DOE won't fund 

this.  Heck, I have been trying for a year to get equipment through DOE's 

HDER Program, and have seen nothing but paperwork and bureaucracy.  Not a 

single instrument.  If you read the Federal Guidance for Radiological 

Emergencies (or some name like that), all it is is a document to assign 

turf and divide up money.  The FEMA document has no value.  The American 

College of Radiology (ACR) document doesn't address this, and neither does 

NCRP or ICRP.



It is very important to get estimates of internal contamination, because 

there are a number of effective decorporation drugs that are 

useful.  Potassium iodide will probably be worthless, but this is all you 

hear about from government.  Los Angeles County has stockpiled several 

hundred doses of the useful drugs.  As some are not FDA-approved, or the 

uses are not FDA-approved, FDA says you can't use them.  We think 

otherwise, and we will use them.  But we have to know who has more than an 

ALI (or a multiple of ALI's) contaminating them in the first place, and we 

have to monitor therapy.  How many of you live in areas that have 

stockpiled these drugs, and how many have a way to assess body burden and 

monitor treatment?  It would surprise me if any of you did.  I am still 

trying to get the money to bring the UCLA whole body counter into useful 

operation.  No bucks yet, but I'm still trying.  Does anyone have $12,680 

they don't need?



While it is suggested that a nuclear medicine gamma camera can be a rough 

sort of "whole body" counter if you lift it high above the patient, remove 

the collimator, and use it as a counter, this turns out not to be so 

easy.  Some cameras only detect up to 511 kev.  Some cannot be lifted that 

high.  Some will not operate at all without a collimator.  And, those that 

are serviceable need to be calibrated for a dozen or so radionuclides that 

are good candidates for RDD's.  We need other methods for pure beta and 

alpha emitters.  Anyone have any they'd like to share?



People will panic only if we let them.  Most people, upon hearing calm, 

competent directions will do as told, and if we tell the public that we can 

assess any contamination, use drugs to remove significant amounts, assess 

the drug therapy, care for those who remain contaminated, and competently 

assess the consequences of the radiation absorbed doses involved, most 

members of the public will cooperate.  Of course, we can't do these things, 

because we haven't got the tools, equipment, calibrations, and skilled 

personnel in place.  None of this is new technology, of course, but none of 

the government entities charged with protecting us have put it 

together.  The Department of Homeland Security (DHS) doesn't even appear to 

understand the issues.  Physicists concentrate on physics issues, and 

ignore the medical ones.  Physicians concentrate on the medical issues, and 

ignore most of the physics ones.  First responders tend not to understand 

either the physics or the medical issues.  The whole RDD response program 

needs high level coordination that isn't happening.



Then we have the very real problem that our regulators are a very real 

problem.   If cleanup standards are down to 15 mrem (EPA) or 25 mrem + 

ALARA (NRC), then the socioeconomic consequences will be enormous, and this 

is completely unnecessary.  We need standards that make sense.  Our 

government is paralyzed, because too many bureaucrats' jobs depend upon 

protecting us from something that isn't hurting us in the first 

place.  And, these falsely low standards are what will make people 

panic.  Our government is in large part causing the panic, because it will 

not take on the antinukes and lay them low, set sensible safety standards, 

and refuse to budge to political pressure from extremists.  And what is DHS 

doing about this?  Nothing that I've heard.  And NRC?  Well, it wants to 

develop a master list of all sealed sources in the USA.  And how will that 

help us?  It won't.  But, when a hacker hacks into that list, he will now 

know where everything is.  And what is the probability that NRC will have a 

hackerproof list?  About zero, I'd guess.



In conclusion, I believe that at present the technology exists to minimize 

the radiologic consequences of an RDD event.  However, I also believe that 

the bureaucrats in our government will ensure that we will not have the 

opportunity to use our technology as needed.  I would just love to be 

proved wrong.



Carol S. Marcus, Ph.D., M.D.

<csmarcus@ucla.edu> 



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