[ RadSafe ] Hospital emergency response and RDD waste management

[Andrew Lukban]

I am the RSO in a hospital in New York City. Our hospital Emergency
Management Committee has been charged with planning a procedure of
response to emergency situations associated with radiation dispersal
devices (RDD's or "dirty bombs".) It is rumored that the next round of
city-wide table-top exercises for emergency preparedness are to involve
RDD scenarios. There are many things invloved with such a scenario which
range from detection (portal monitors), isotope identification (handheld
MCA), determination of internal decontamination (swab nostrils and mouth
and count), actual decontamination (undress, shower), calculation of
scheduled quantities in sewage from mass showering (close my eyes),
treatment (should be teh doc's job), dose calculations (call REAC/TS)
and... waste management (?).

I can almost deal with all the first steps but find myself bothered by
"waste management". I suppose it is not "waste" but, rather, "evidence"
if it were involved with an act of terrorism. What could be used for an
RDD? By nature of it being "dispersed" to cause maximum panic, it is
also more spread out and less concentrated when concerns about
contamination are brought up. This is different then from a single
source planted in one place and resulting in plain ol' external exposure
because the hospital would not be dealing with radiaiton contaminated
patients and produce radiation "waste" that I would ten have to deal
with.

Liquid RAM would likely be stolen from a medical purpose (likely imaging
and not oncology) and is likely the the easiest to disperse but is also
the shortest lived. Longer lived, higher specific activity material have
half-lives > 65 days and usually is from a solid form and would have to
be crushed for dispersal if the mode of dispersal is not via explosion.
It is interesting to note that regulations prevent us from doing
decay-in-storage for materials with half-lives >65 days. I would be
requird to return it to the "vendor" - "Hello Mr Terrorist, here's your
stuff back." No matter. Either way, both short lived and long lived RAM
"waste" now present at the hospital resulting from decon, emesis, feces,
etc. would not have been "purchased according to our license" and the
institution should not be responsible for storing or disposing it. We
can follow due diligence in preparing for proper radiation safety
procedure to contain and isolate the stuff, but what is the limit of
preparation? Should we prepare for storing clothing contaminated with
therapeutic amounts of powdered Co-60? How many Pb lined steel drums is
considered OK? What government entity will say that the "foreign RAM of
extramural origin" is "their problem" and will pick it up? Should I be
pursuing a memo of understanding with some magically appropriate
government entity? Real estate is big problem in NYC and there is no
"spare parking lot" that can be used to contain RAM in an emergency
scenario.

The more I think about it, the more I think that the conclusion is that
"radioactive waste" from an RDD emergency is NOT the hospital's problem
in the long term. However, what is considered the short term (when will
it no longer be my problem because someone will remove it) and who is
going to be responsible for it (who will remove it)?

Sorry for the venting...