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Update (11/15): Status of patients from the JCO Criticality
RADSAFERs,
Health Physics Society's own Richard Toohey visited Tokaimura on September 30.
[Thanks to Pete Wildenborg of Northern State Power for the article.]
"Oak Ridger returns from Japan with details of radiation tragedy," November 15,
1999, By Frank Munger News-Sentinel staff writer, <
mailto:73302.1254@CompuServe.Com>
"Richard Toohey, a health physicist on the staff at the Radiation Emergency
Assistance Center/Training Site in Oak Ridge, was among a group of international
experts invited to Japan recently for briefings and discussions on the Sept. 30
radiation accident at Tokaimura.
Three workers at the uranium-processing facility received severe radiation doses
in the criticality accident, one of the worst in decades, and they remain
hospitalized.
"They could not be getting better medical care anywhere in the world," Toohey
said, although he indicated the odds are still against one of the men
recovering.
Toohey said there is great uncertainty about the dose estimates, and the medical
response is focused on treating the biological effects and trying to counter the
ever-present threat of infection as bodily systems fail.
The nuclear accident occurred when the men poured a nitrate solution with
enriched uranium (19 percent U-235) from a safely configured container into one
that was not shaped properly to hold the fissile material. Some of the "why's"
regarding the accident are still the subject of investigation.
A flash of blue light signaled the start of the fissioning process, and the
initial burst of radiation -- gamma rays and neutrons -- reached the three men
at different angles and in different amounts.
According to Toohey, the worker (identified as Mr. O) standing on the floor and
holding a funnel over the entry port received the highest radiation dose --
somewhere in the range of 1,200 rads. No one has ever survived that kind of
exposure.
His co-worker (Mr. S) was on a platform, leaning over the vessel and pouring the
solution through the funnel. He received an estimated dose of 800 to 900 rads,
often a fatal dose as well.
The third employee (Mr. Y) was in an office about 5 meters away, and his dose
was about 300 rads, maybe less.
All three of the men saw the blue flash, although Mr. Y saw it indirectly as a
reflection in a glass wall.
Mr. O and Mr. S left the room after seeing the flash and hearing the alarm
activated by gamma rays. Mr. Y reported the accident by telephone, and then he,
too, ran for safety.
Toohey said there was no explosion, although there was some release of gaseous
fission products (including krypton and xenon) in the room. And he said the room
remains hot because of the fission products left in the container, including
radioactive cesium that's emitting gamma radiation.
Mr. O lost consciousness almost immediately, which apparently delayed the
departure of the ambulance from the scene as attendants tried to revive him.
The radiation victim now faces a whole host of medical problems, ranging from
kidney failure to huge blisters from the radiation burns.
His bone marrow was virtually destroyed, and he received a transfusion of stem
cells from his sister's blood. He subsequently showed some recovery in that
aspect, but Toohey said Mr. O's long-term survival is very unlikely.
"If he does, he'll set a new record" for surviving the highest radiation dose,
Toohey said.
Mr. S "has a shot" at survival, according to Toohey.
He received a fetal cord blood transport, which involves cells from a placenta
that have not yet been imprinted for immunological response.
These cells reportedly are effective in helping rebuild the bone marrow because
they do not attack the tissues as some foreign cells would.
Mr. S's blood cell count has shown substantial improvements since the
transplant, Toohey said.
Mr. O and Mr. S are in "reverse isolation" at the Japanese hospitals to prevent
them from coming into contact with potential carriers of infections.
The third employee, Mr. Y, initially showed a drop in his blood count but has
since recovered well.
"He's fine," Toohey said.
About 70 other workers at the Tokaimura nuclear facility received radiation
doses from the accident. The highest dose in that group was about 10 rems, and
Toohey said doctors would not expect any near-term health effects from those
exposures, although it could increase their lifetime risk of developing cancer.
There was some exposure to residents in the area, but the levels probably were
inconsequential from a health standpoint, Toohey said.
Blood tests of 1,800 nearby residents in the first week after the accident did
not show any substantial change in blood counts, but Toohey said accident
specialists recommended a second test after a month. The effects from low doses
would most often be seen about 30 days after exposure, he said.
"The lower the dose, the longer it takes to see the response," Toohey said.
There was a bit of unusual proof that neutrons -- which will penetrate virtually
anything -- reached the residential neighborhoods around the nuclear facility.
A gold necklace in a house 200 meters away became radioactive because of a
reaction in which a neutron was captured by the stable material, creating a
small amount of the radioisotope, Au-198.
"It was very slightly radioactive but not a concern," Toohey said."
Tosh Ushino
ICN Dosimetry
==========================================================================
RBC = Red Blood Cell WBC = White Blood Cell BP = Blood Pressure
Temp = Temperature Pulse = Pulse Rate Resp = Respiration rate
CRP = C-reactive protein
Mr. A: 18 Sv
------------------------------------------------------------------------------
11/09/99 17:00
BP: 150/75 mm Hg, Pulse: 125/min., Resp: 21/min., Temp: 37.7 C
Continuing with sedative and ventilation. No major change to respiratory
function. More renal function recovery. WBC count in small blood vessels is
15,000/mm^3. No major change to injuries due to radiation burn. Continuing
problem with radiation damage to intestine. Volume of stool in diarrhea
decreased (1,850 gram from midnight to 4:00 PM ).
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/10/99 17:00
BP: 145/80 mm Hg, Pulse: 126/min., Resp: 25/min., Temp: 38.7 C
Continuing with sedative and ventilation. No major change to respiratory
function. Renal function recovering little at a time. WBC count in small blood
vessels is 16,700/mm^3. Areas of injuries due to radiation burn has expanded
more. Continuing problem with radiation damage to intestine. Volume of stool in
diarrhea increased again (2,255 gram from midnight to 4:00 PM ). No clear
indication of infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/11/99 17:00
BP: 150/90 mm Hg, Pulse: 132/min., Resp: 25/min., Temp: 38.8 C
Continuing with sedative and ventilation. No major change to respiratory
function. Renal function recovering little at a time. WBC count in small blood
vessels is 17,100/mm^3. No major change to areas of injuries due to radiation
burn. Continuing problem with radiation damage to intestine (Volume of stool in
diarrhea was 2,255 gram from midnight to 4:00 PM ). No clear indication of
infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/12/99 17:00
BP: 125/65 mm Hg, Pulse: 125/min., Resp: 20/min., Temp: 39.0 C
Continuing with sedative and ventilation. No major change to respiratory and
renal functions. WBC count in small blood vessels is 14,200/mm^3. Fluid seeping
from the areas of injuries due to radiation burn (2,390 gm during the previous
day). Continuing problem with radiation damage to intestine (Volume of stool in
diarrhea was 3,262 gram from midnight to 4:00 PM ). No clear indication of
infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/13/99 17:00
BP: 142/78 mm Hg, Pulse: 130/min., Resp: 20/min., Temp: 39.2 C
Continuing with sedative and ventilation. No major change to respiratory, renal
and liver functions. WBC count in small blood vessels is 12,000/mm^3. Increase
in volume of fluid seeping from the areas of injuries due to radiation burn.
Radiation damage to intestine and skin is extremely critical problem at this
time (Volume of stool in diarrhea was 1,400 gram from midnight to 4:00 PM ). No
clear indication of infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/14/99 17:00
BP: 120/64 mm Hg, Pulse: 128/min., Resp: 26/min., Temp: 38.6 C
Continuing with sedative and ventilation. No major change to respiratory, renal
and liver functions. WBC count in small blood vessels is 13,400/mm^3. Fluid
continuing to seep out from the areas of injuries due to radiation burn.
Radiation damage to intestine and skin is extremely critical problem at this
time (Volume of stool in diarrhea has decreased to 800 gram from midnight to
4:00 PM ).
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/15/99 17:00
BP: 155/95 mm Hg, Pulse: 130/min., Resp: 21/min., Temp: 38.6 C
Continuing with sedative and ventilation. Fluid in lungs and stomach has
increased and oxygen intake has decreased. Renal function has decreased again.
WBC count in small blood vessels is 12,000/mm^3. Increase in volume of fluid
seeping out from the areas of injuries due to radiation burn (3,238 gm over a
day). Problem with radiation damage to intestine continues (Volume of stool in
diarrhea was 1,350 gram from midnight to 4:00 PM ). No clear indication of
infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Overall condition is critical, requiring continued vigilance.
Mr. B 10 Sv
-------------------------------------------------------------------------
11/09/99
No major change.
BP: 130/78 Pulse: 98/min Temp (peak): 37.4 C WBC count:
15,150/mm^3
11/10/99
Vomited small amount yesterday and today. No other change to overall condition,
skin condition, or examination result. Conscious, lucid, but nauseated.
BP: 136/70 Temp (peak): 37.8 C WBC count: 19,240/mm^3
11/11/99
No major change to overall condition, skin condition, or examination result.
Unconscious, lucid but drowsy.
BP: 148/92 Temp (peak): 38.1 C WBC count: 19,460/mm^3
11/12/99
Vomited once today.
BP: 150/80 Temp (peak): 38.4 C WBC count: 21,370/mm^3
11/13/99
No major change to overall condition, skin change, and examination result.
(There is some sort of viral infection and they are providing anti-viral drug.)
BP: 135/88 Temp: 38.0 C WBC count: 20,700/mm^3
11/14/99
No major change to overall condition, skin change, and examination result.
Conscious, lucid.
BP: 140/90 Temp: 38.1 C WBC count: 23,000/mm^3
11/15/99
No major change to overall condition and examination result, but skin change
(damage) spreading. Conscious, lucid. Area of skin peeling is large, and is
covered with topical dressing. Patient experiences extreme pain while dressing
is changed. Since this is a slow process that takes long time, the patient's
agony is great.
BP: 140/82 Temp: 38.3 C WBC count: 21,200/mm^3
Since the patient's condition has become relatively unchanging, unless there is
major change, we will henceforth update the patient condition three times a week
on Monday, Wednesday and Friday.
Mr. C: 2.5 Sv
------------------------------------------------------------------------
11/09/99: Stable. Temp: 36.2 C, BP: 122/75 mm Hg
11/10/99: Stable. Temp: 36.0 C, BP: 95/73 mm Hg
11/11/99: Stable. Temp: 36.0 C, BP: 102/70 mm Hg
11/12/99: Stable. Temp: 36.0 C, BP: 104/68 mm Hg
11/13/99: Stable. Temp: 36.0 C, BP: 125/85 mm Hg
11/14/99: Stable. Temp: 36.0 C, BP: 130/65 mm Hg
11/15/99: Stable. Temp: 36.0 C, BP: 118/80 mm Hg
-------------------------------------------------------------------------
Toshihide "Tosh" Ushino, CHP Tel: (800) 548-5100 x2413
Product Development Manager Fax: (714) 668-3149
Dosimetry Div., ICN Biomedicals, Inc. Email: tushino@icnpharm.com
3300 Hyland Ave., Costa Mesa, CA USA 92626 tushino@hotmail.com
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