Re : Safety Culture

["B. DIXON" <RADBD@south-01.novell.leeds.ac.uk>]

  Jim Presley commented :
>      
>      I am not totally versed in how the source at Goianna was abandoned
>      but I would speculate that it was not ultimately due to an oversight
>      by a radiotherapist, physicist or some such similar person.
>      I would expect that the professional staff either left or were
>      let go before the facility was actually closed/abandoned.
>       Who knows, perhaps they stated to management as they were leaving 
>      "don't forget about the source". At this point it became a management
>      responsibility with the ultimate responsibility for public safety 
>      falling on the regulatory body.
>      As a regulator, it is my view that an appropriate regulatory framework 
>      was not in place to ensure that such sources were not abandoned.
>      
>      If I missed the mark on this one please let me know.
>      


  
      Goiania was a private radiotherapy facility(IGR), and the  
      circumstances are well described in an IAEA Report(Vienna 
      1988). According to this, the situation was  as described 
      below:-


      Under the terms of its operating licence, issued by the 
      national regulatory authority(CNEN),a physicist and one of
      the medical partners were jointly responsible for licence 
      compliance.

      At the end of 1985 the medical partnership owning IGR ceased 
      operating and a new partnership took over other premises to 
      which their Co-60 unit was transfered. Ownership of the IGR 
      clinic contents was then disputed and the Cs-137 unit was 
      left in situ.      
      
      CNEN did not recieve appropriate notifications of these changes 
      in status, even though this was apparently a particular 
      requirement of the licence.                        

      The IAEA report clearly states
      
       "....the professional and moral responsibiliy for the 
      security of a radiaoactive source must lie with the person 
      or persons licenced as responsible for it." 


      Bryan Dixon
      radbd@leeds.ac. uk