Biological Effectsgonuke.org/wp-content/toolkits/Radiation Protection/chscc... · Web viewData in the area of biological effects of ionizing radiation was collected by combining information

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Biological Effects of Exposure to Ionizing

Radiation

HPT001.008Revision 2Page 1 of 66

NUCLEAR TRAININGTRAINING MATERIALS COVERSHEET

RADIOLOGICAL PROTECTION TECHNICIAN INITIAL TRAININGPROGRAM FUNDAMENTALS TRAINING HPT001COURSE

COURSE NO.

BIOLOGICAL EFFECTS OF EXPOSURE TO IONIZING RADIATION

HPT001.008

LESSON TITLE LESSON PLAN NO.

INPO ACCREDITED YES X NO

MULTIPLE SITES AFFECTED YES X NO

PREPARED BY C. Daphne Stephens

______________________________________ Signature / Date

PROCESS REVIEWGale Blount

______________________________________ Signature / Date

LEAD INSTRUCTOR/PROGRAM MGR. REVIEWRoy Goodman

______________________________________ Signature / Date

PLANT CONCURRENCE - BFN ______________________________________ Signature / Date

PLANT CONCURRENCE - SQN ______________________________________ Signature / Date

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Standardized Training MaterialCopies to:

TVA 40385 [NP 6-2001] Page 1 of 2


SEQUOYAH NUCLEAR PLANT

NUCLEAR TRAINING

REVISION/USAGE LOG

REVISIONNUMBER

DESCRIPTIONOF CHANGES

DATE PAGESAFFECTED

REVIEWED BY

0 Initial Issue All

1 General revision to enable lesson plan to be used as initial training and continuing training

5/7/93 All

2 General revision to update material for reactivation of initial training program

All C. Daphne Stephens

TVA 40385 [NP 6-2001] Page 2 of 2


I. PROGRAM: Radiological Protection Technician Initial Training

II. COURSE: Fundamentals Training

III. LESSON TITLE: Biological Effects of Exposure to Ionizing Radiation

IV. LENGTH OF LESSON/COURSE: 24 Hours

V. TRAINING OBJECTIVES:

A. Terminal Objective:

Upon completion of this course, the participants will demonstrate their knowledge and understanding of the information presented training by obtaining a score or greater than or equal to 80% on a written examination. The information presented in this lesson plan may be part of an overall examination or be the only information for which the student is tested.

B. Enabling Objectives:

1. Explain how events from the early history of radiation biology have influenced modern health physics.

2. Identify typical cell structures and explain the function of each.

3. Describe the mechanisms of radiation interactions with cells.

4. Describe the formation of free radicals, including completion of equations involving free radicals.

5. Explain why free radicals are of biological concern.

6. List the four possible results after chromosomes are damaged by ionizing radiation.

7. State the Law of Bergonie and Tribondeau and explain what it means in terms of cell radio-sensitivity.

8. Differentiate between radiosensitive and radio-resistant cells.

9. Define and distinguish between stochastic and non-stochastic effects.

10. Explain the difference between acute and chronic radiation exposure.

11. For chronic exposures, list some possible long-term health effects.

12. Compare chronic radiation exposure risks to other health risks.


13. Define somatic effects and give examples.

14. Define genetic effects and give examples.

15. Define teratogenic effects and give examples.

16. Define acute radiation syndrome.

17. Describe the dose response relationship for acute exposure.

18. List the four stages of the acute radiation syndrome.

19. List the three classes of the acute radiation syndrome and give the dose range, the critical organs, the symptoms, and the prognosis of recovery for:

a. Hematopoietic syndromeb. Gastrointestinal syndromec. Central nervous system syndrome

20. Define the term LD-50/60 and state the accepted value for humans.

21. For internally deposited radionuclides, list:

a. The principle modes of entry into the body.b. The ways radionuclides enter the bloodstream for transfer within the

body. c. The exit routes from the body.

22. Recognize the basis for and the implications of the linear zero-threshold dose response curve.

23. State why radiation exposures to both individuals and groups of workers should be kept as low as reasonably achievable.

24. Discuss risks to the general public from operation of a nuclear power plant and compare it to other risks accepted in everyday life.

25. Explain what is meant by the term radiation hormesis and how is viewed in nuclear industry.

Note: Conditions and Standards for enabling objectives, unless otherwise specified, are implied. Conditions are “as presented in the lesson plans, with the use of reference material as directed by the instructor” and Standards are “as evaluated by written examination.”


VI. TRAINING AIDS:

A. Whiteboard and markers

B. Overhead projector and screen

C. Computer

VII. TRAINING MATERIALS:

A. Handouts

1. List for additional information

2. Student copy of transparencies listed below

B. Slides (p:/Training/Technical Programs and Services/RadCon/Initial Program/Lesson Plan Library/Power Point Files/HPT001.008r2)

1. Cell Structures

2. Free Radicals

3. Damage to DNA or Chromosomes

4. Cell Division – No radiation involved

5. Cell Division – Damage repaired

6. Cell Division – Abnormal Daughters

7. Cell Division – Daughters Die

8. Cell Division – Parent Dies

9. Radio-sensitivity of Cells

10. Threshold Doses

11. Lethality Dose

12. Internal Deposition

13. Loss of Life Expectancy


C. Attachments

1. Case report from 1984 exposure to members of the public from scrap 60Co teletherapy source in Ciudad Juarez, Mexico.

2. Case report from gamma irradiation plant used for sterilizing medical equipment

in Kjellar, Norway, in 1982. 3. Case report on radiation accidents of 1974 and 1977 at product sterilization plants

in New Jersey. 4. Case report from radiation accident at a Van de Graff linear accelerator in

Pittsburgh in 1967. 5. Case report from event in Goiania, Brazil in 1987 that resulted in four deaths and

widespread contamination.

6. Case report on core damaging accident at Chernobyl nuclear power plant in 1986. 7. Case report from criticality accident at a uranium processing plant in Tokaimura,

Japan on September 30, 1999. Case report from criticality accident at the Russian Federal Nuclear Center on June 17, 1997 at Sarov, Russia.

D. Appendices

1. Instructions for Student Discussion and Presentation of Case Study

2. Worksheet for Student Discussion and Presentation of Case Study

VIII. REFERENCES:

A. BEIR V, Committee on the Biological Effects of Ionizing Radiation, Health Effects of Exposure to Low Levels of Ionizing Radiation. National Academy Press, 1990

B. Gollnick, Daniel A. Basic Radiation Protection Technology. 2nd ed. Altadena: Pacific Radiation Corporation, 1988.

C. Regulatory Guide 8.13, “Instruction Concerning Prenatal Radiation Exposure.” Revision 2, December 1987.

D. Regulatory Guide 8.29, “Instruction Concerning Risks From Occupational Radiation Exposure.” July 1981.

E. INPO ACAD 93-008, Guidelines for Training and Qualifications of Radiological Protection Technicians, August 1993.

F. Arena, Victor. Ionizing Radiation and Life. C. V. Mosby Company, 1971.


G. Bacq, Z. M. and P. Alexander. Fundamentals of Radiobiology, 2nd ed. Permagon Press, 1967.

H. Casarett, A. Radiation Biology, 1st ed. U. S. Atomic Energy Commission, 1968.

I. Pizzarello, D. and R. Wicofski. Basic Radiation Biology, 2nd ed. Lea and Febiger, 1975.

J. Grosch, D. and L. Hopwood. Biological Effects of Radiation. Academic Press, Inc., 1979

K. Johns, H. E. and J. R. Cunningham. The Physics of Radiology. 4th ed. Charles C. Thomas, 1983

L. Animal Cells. 2003. <http://users.ren.com/jkimball.ma.ultranet/BiologyPages/A/AnimalCells.htm

M. The Virtual Cell Web Page. 17 October 1999. <http://personal.tmlp.com/Jims57/textbook/chaptr3/chapter3.htm

N. The Cell. Carpi, Anthony and Dr. G. Weaver. 1998 <http://web.jjay.cuny.edu/~acarpi/NSC/13-cells.htm

O. Standards For Radiation Protection, Title 10, Code of Federal Regulations, Part 20, 1999.

P. Radiation Hormesis and Zero-Risk Threshold Dose: Two Scientifically Refuted, but Stubborn Myths. Rudi H. Nussbaum, PhD. <http://www.gfstrahlenschuts.de/docs/horment2.pdf

Q. Fry, Shirley, Hübner, Karl: The Medical Basis for Radiation Accident Preparedness, New York: Elsevier North-Holland, Inc., 1980.

R. Ricks, Robert, Fry, Shirley: The Medical Basis for Radiation Accident Preparedness II, New York: Elsevier Science Publishing Co., Inc., 1990.

S. NEA Committee on Radiation Protection and Public Health, OECD Nuclear Energy Agency, Chernobyl Ten Years on Radiological and Health Impact, Nov. 1995.

T. INPO, Significant Event Report, SER 3-00, Criticality Accident At A Uranium Processing Plant, 2000.

U. International Atomic Energy Agency, IAEA, The Criticality Accident in Sarov, Vienna, Austria, 2001.


IX. INTRODUCTION:

Although radioactive material is an extremely important and valuable energy source, it is

not without hazards to man. With improper control procedures, there is a possibility of

harmful biological effects. An understanding of these harmful biological effects of

radiation to humans is necessary in all work involving radioactive materials.

Data in the area of biological effects of ionizing radiation was collected by combining

information gained from animal experiments, mistakes made by early radiation scientists,

observations of bomb victims in Japan, clinical reports of radiation exposures for

treatment of cancer patients, as well as information from other areas. In years to come,

valuable information will be gained from the observations of those affected by the

Chernobyl accident.

Because almost all useful information on the effects of ionizing radiation is based upon

observations of effects at high dose and dose rates, the data was extrapolated down to

estimate risks at lower doses and for lower doses rates. This was done because of the

difficulty of exactly determining the effects of low levels of ionizing radiation. Because

we know there is damage at the higher doses, we assume that any radiation no matter how

small the dose carries some degree of risk.

If science was to offer protection from radiation, there had to be people with knowledge in

the fields of health and biology and with an in depth knowledge in the physical sciences.

This need for scientists with knowledge of both health and of radiation physics led to the

formation of a whole new scientific field known as health physics.

The job of the health physics technician is to allow for the maximum beneficial use of

radioactive material while protecting humans and the environment from the harmful

effects of ionizing radiation. Therefore, it is imperative that health physics personnel have

a thorough understanding of the hazards associated with ionizing radiation. Additionally,

the effects of ionizing radiation occur at the cellular level, so health physics personnel

need to know the basic structure of the cell and the mechanisms of cellular activity.


X. LESSON BODY: INSTRUCTOR NOTES

A. Early History of Radiation Biology

1. It was discovered soon after the discovery of x-rays, by Wilhelm Conrad Roentgen in 1895, that these new rays had both harmful and beneficial effects.

a. Cancer was first treated with x-rays in 1896.

b. Dr. Webster, in England, exposed an elbow of a patient with rheumatic pains and was successful in relieving the pain.

Ask: Who can name one scientist that received observable physiological effects from radiation?

Ask: Did any scientist die from injuries caused by radiation?

c. By 1897 there were 69 recorded cases of skin damage due to x-ray exposure.

d. By 1902, the list had grown to 107 cases. Madame Curie's husband Pierre was one of these recorded cases.

e. Madame Curie died from aplastic anemia secondary to chronic overexposure to radiation, as did her daughter Irene and many others of her scientific contemporaries.

f. Leukemia was induced in rats by long-term exposure in 1903.

g. The first recorded death attributed to a radiation induced tumor took place in 1904. This was Daly, Edison's assistant.

2. Early radiation workers became concerned about these and other immediate consequences of exposures to large amounts of radiation. What was not appreciated by these workers was the effect that continuous exposure to radiation had on the production of cancer cells 10 to 30 years after the exposure began.

3. By 1922, it was estimated that more than 100 early radiologists had died from occupationally induced cancer.



4. The event that finally caused a focusing of concern on the adverse health effects from exposure to radiation was the radium dial painters.

a. During World War I, it was found that radium paint, a mixture of radium and phosphor, could be used on airplane instruments to make them glow in the dark. This resulted in a dial painting industry.

b. After the war, the industry switched from painting airplane gauges to painting clock and watch faces.

c. Young girls were employed in this type of work. They would form a fine point on their brushes by shaping them between their lips before putting the paint on the dials.

d. From this procedure, small amounts of radium was ingested into their bodies on a daily basis.

e. Today, over 50 known cases of death as well as many cases of illness have been attributed to radium ingestion by these workers.

f. These illnesses include bone destruction, bone cancer, and blood disorders.

Radium is a “bone seeker”.

5. Information gathered from the mistakes of the early radiologists and the radium dial painters was the first useful data in studying the effects of ionizing radiation on humans.

6. In the 1920's, scientists and radiation workers began to contemplate setting up standards for protection against radiation as a result of human experience with radiation injury.

Objective B.1



B. Structures of a Typical Cell

1. The whole cell is enveloped within the plasma membrane.

a. The membrane is a double layer of lipids, fatty tissues, and numerous proteins.

b. It separates the outside, extra-cellular material, from the inside of the cell.

c. The plasma membrane is approximately one millionth of a centimeter thick.

Objective B.2

HO-2 Slide 1

The plasma membrane is analogous to the skin of a person.

d. The main function of plasma membrane is to bring outside nutrients into the cell and also move waste products outside the cell.

(1) This is a complicated mechanism called active transport.

(2) It is selectively permeable to allow only certain chemicals to pass into and out of the cell.

e. The plasma membrane acts a boundary layer to contain the fluid in the cells.

f. The membrane has interlocking surfaces that bind cells together.

2. Cytoplasm is the semi-liquid material, jelly-like substance, which constitutes the interior environment of the cell.

a. Cytoplasm is the fluid material within which all the other cell organelles reside.

b. It is 70 to 80% water, but it is full of proteins.

c. The primary function of the cytoplasm is to control cell metabolism.



3. The nucleus is an oval shaped body near the center of the cell that controls cell division and contains the genetic material.

a. The function of the nucleus is to direct all cell activity.

b. The nucleus controls normal cell growth.

c. It controls the repair of injured cells.

Objective B. 2The nucleus is the "brain" of the cell.

d. The nucleus contains:

(1) Chromatin, which contains instructions that control cell metabolism and heredity.

(2) The nucleolus, which copies instructions for the DNA .

(3) Deoxyribonucleic acid, DNA, which provides the master blueprint for cell division.

(a) The DNA is responsible for providing specific types of cells with its own unique characteristics.

(b) DNA is similar in every cell of the body, but some genes may be turned on or off, depending on the specific cell type.

That is why a liver cell is different from a muscle cell or a fat cell.

e. The nucleus produces RNA, ribonucleic acid.

(a) The RNA is distributed throughout the cell.

(b) The RNA is a messenger that translates information contained in the DNA into instructions that determine what types of protein are produced.

RNA converts amino acids into the proteins essential for life.



f. The nucleus initiates and controls the complex process of cell division, called mitosis.

(1) Genes are stored on the chromosomes.

(2) Genes are organized into chromosomes to allow cell division. When cells divide, chromatic coils form chromosomes.

(3) DNA is uncoiled to replicate key genes. Chromosomes contain several hundred genes responsible for traits.

(4) Prior to cell division, the number of chromosomes is temporarily doubled.

(5) When a cell divides, the daughter cell receives a duplicate set of chromosomes from the parent, as well as, identical genes.

(6) If the process is normal, no alterations or changes occur.

(7) However, any changes which do occur in the chromosomes or genes are called cell mutations.

Objective B.2

Humans have 23 pairs of chromosomes.

Changes or mutations then affect either future cells or daughter cells.

4. Ribosomes are spherical structures composed of RNA and protein enzymes.

a. They are attached to the rough endoplasmic reticulum.

b. The function of the ribosomes is to synthesize proteins.



5. The mitochondria are small structures, composed of lipids and protein, which float around in the cytoplasm.

a. Their function is to release chemical energy for the cellular functions from food.

b. This is accomplished via the compound adenosine triphosphate (ATP).

c. Food is combined with oxygen to produce ATP, which is the primary energy source for the cell.

d. The mitochondria assembles ATP and stores it until the cell needs energy, at which time, the ATP is released.

Objective B.2

Glucose + Oxygen → Carbon Dioxide + Water + Energy (ATP)

This is similar to a battery.

6. The lysosome consists of a membrane that surrounds a digestive enzyme.

a. Lysomes within a cell acts as a recycling center.

b. Worn out structures within a cell are passed through the membrane, dissolved into more basic components and then released into the cell cytoplasm.

c. The function of lysosomes is to break down large molecules by inserting a molecule of water into the chemical bond.

7. The endoplasmic reticulum is a folded system of membranes in the cytoplasm.

a. Endoplasmic reticulum which is covered with ribosomes is referred to as rough, while smooth endoplasmic reticulum has no or very few ribosomes.

b. The primary function of the endoplasmic reticulum is to transport chemicals between cells and within cells.



8. The golgi complex, or apparatus, is a stack of membranes.

a. The golgi complex is devoted to processing proteins.

b. The major processing activity is the addition of sugar molecules.

c. It produces lysosomes and endoplasmic reticulum.

d. The primary function of the golgi complex is to modify, store, and secrete chemicals.

Objective B.2

C. Mechanisms of Radiation Interactions with Cells

1. Radiation damage at the cellular level is the result of one or the other of two mechanisms, or a combination of the two. The damage is either a direct effect by the ionizing radiation or an indirect effect as a result of the formation of free radicals.

2. Direct effects damage the cell structures by the transfer of energy from the radiation to the components of the organism.

Objective B.3

a. Plasma membrane

(1) Ruptures at doses of 3,000 – 5,000 rads.

(2) Beneficial fluids will leak out of the cell.

(3) Harmful fluids will leak into the cell.

(4) At lower doses, the permeability will increase and some leakage will occur.



b. Cytoplasm

(1) Radiation has a negligible effect on the cytoplasm.

(2) High doses can effect cell metabolism.

Objective B.3

c. Nucleus

(1) Most radiologically sensitive part of a cell.

(2) Major radiation alters DNA replication and cell can not prepare for division.

(3) With damaged DNA, duplicate chromosomes can not be manufactured.

(4) If the process of cell division is delayed long enough, the cell will die.

d. Mitrochondia

(1) A few thousand Rad can disrupt the function of the mitrochondia and interrupt the storage of energy.

(2) If the cell has a large reserve of food stored, via ATP, and the radiation dose is low, the damage can be repaired.

(3) Higher doses cause more damage and require longer repair time.

(4) If the dose is too high, the food reserve fails, and the cell dies.



e. Lysosomes

(1) Lysosomes rupture at 500 – 1,000 rads.

(2) The enzymes released when the lysosomes rupture will begin to digest the cell.

(3) At larger doses, the enzymes are rendered inactive.

Objective B.3

3. Adverse Effects on Cells from Radiolysis of Water

a. The other mechanism by which ionizing radiation adversely affects cells is through the radiolysis of water. Cellular damage as the result of radiolysis of water is referred to as an indirect effect.

b. The exposure of water to ionizing radiation results in the production of free radicals which adversely affect cells.

The greatest part of the cell is water.

c. A free radical is highly reactive chemically due to the presence of an unpaired electron.

d. Electrons tend to "pair up" in such a way that a suborbital shell is filled.

e. One electron has its spin vector pointed up and the other has its spin vector pointed down. Thus a free radical tries to "pair up" with another unpaired electron which is why the free radical is so highly reactive.

A free radical is not an ion. Free radicals are electrically neutral.



f. Free radicals are produced as follows:

(1) Water exposed to radiation results in an ion pair.

H2O + radiation → H2O+ + e-

The water ion combines with water to produce hydronium and a free radical.

H2O+ + H2O → H3O+ + OH∙

Objective B.4

HO-2 Slide 2

(2) Hydronium can combine with a free electron to produce water and a free radical.

H3O+ + e- → H2O + H∙

(3) Free radicals can combine with like free radicals to produce hydrogen gas or hydrogen peroxide.

H∙ + H∙ → H2

OH∙ + OH∙ → H2O2

(a) Hydrogen peroxide is highly toxic to living tissues.

(b) Hydrogen peroxide poisons the cell and can lead to cell death

(4) If oxygen is present, a free radical can combine with it, resulting in a hydroperoxyl radical.

H∙ + O2 → H2O∙

(5) Hydroperoxyl radicals can combine with other free radicals to produce hydrogen peroxide.

HO2∙ + H∙ → H2O2

HO2∙ + HO2∙ → H2O2



g. Free radicals are responsible for 70% to 80% of the radiation damage to cells.

Objective B.5

4. Radiation Damage to DNA and Chromosomes

a. Damage to DNA is a result of direct ionization or of indirect action, free radicals.

b. DNA is the critical molecule after exposure to radiation.

c. DNA damage and cell wall destruction are likely the basis for lethality due to radiation.

HO-2 Slide 3

d. Cells depend on their DNA coding information to make various classes of protein, enzymes, hormones, and to transport proteins. When the genetic information is disrupted, a wide range of effects follow.

e. DNA base damage is the predominant type of damage, followed by single-strand breaks, cross-linkages, and double-strand breaks.

f. Single-strand breaks stand the best chance of repair.

(1) One strand is still intact, so single-strand breaks are usually stable and within a reasonable distance from each other.

(2) Also, there is a template on the adjacent strand to determine where various bases go on the missing strand.

g. Following radiation exposure, some molecules can be altered and prevented from transferring genetic code properly.



5. After exposure there are four possible results to the cell following radiation induced chromosome damage.

a. Damage is repaired before division.

b. Cell dies.

c. Cell divides, daughter dies.

d. Cell divides, daughter mutated.

(1) Mutated daughters will continue passing on the mutated code.

(2) Continued irradiation will produce further mutations, cumulative effects, which will be passed on.

Objective B.6

HO-2 Slide 4

HO-2 Slide 5

HO-2 Slide 6

HO-2 Slide 7

HO-2 Slide 8

6. Chromosome Aberrations

a. There are three common chromosomal aberrations resulting from exposure to ionizing radiation.

(1) Terminal deletion – the end segment of the chromosome is broken off.

(2) Ring chromosome – the chromosome is broken at each end and the terminal segments are curled around and rejoined to form a ring-like structure.

(3) Dicentric chromosome – has two centromeres.

Draw aberrations on board.

b. Because of this consistency, chromosome aberration research can be used to get a fairly accurate estimate of dose.

c. The number of cells which show chromosome aberrations decreases with time. Some of the bomb survivors were observed to have elevated chromosome aberrations even 25 years after their exposure.

The useful range is 25 to 500 Rad.



D. Cell Radio-sensitivity

1. There is no law that can predict, with 100% accuracy, the exact kind and amount of damage to a cell following exposure to ionizing radiation at low doses.

2. However, a theory developed by two French researchers can predict which types of cells are the most sensitive to radiation.

3. Their names were Bergonie and Tribondeau and their theory is referred to as the Law of Bergonie and Tribondeau.

4. The Law of Bergonie and Tribondeau states that “the radio-sensitivity of a cell is directly proportional to the rate of multiplication and inversely proportional to the degree of specialization.”

a. Cells which have a high division rate are more radio-sensitive than those cells which have a lower division rate.

b. Cells that are more specialized are less radiosensitive than unspecialized cells.

Objective B.7

HO-2 Slide 9

Also, cells with a high oxygen content (healthy cells) and cells with a long dividing future have increased radio-sensitivity.

5. Dividing cells are more prone to radiation damage because the DNA is most vulnerable during replication. If DNA gets damaged during this time, the cell can not repair the damage and will produce more damaged DNA.

6. The cells that undergo more frequent divisions have less repair time and a resulting increase in sensitivity to radiation.

a. Blood cells.

b. Sperm cells.

c. Fetal cells.

Objective B.8



7. Cells with less frequent mitotic activity are less radiosensitive.

a. Nerve cells.

b. Muscle cells.

c. Bone cells.

Objective B.8

E. Stochastic and Non-stochastic Effects

1. Stochastic effects do not have a threshold.

a. Any exposure, no matter how low the dose,could result in the effect.

b. The probability of the occurrence of the effect does increase as dose increases.

c. The severity of the effect does not vary with the dose.

Objective B.9

d. An example of a stochastic effect is cancer.

(1) There is no threshold dose for cancer; any dose, no matter how low, could result in cancer.

(2) The risk of getting cancer increases with increases in dose.

(3) The amount of radiation received does not affect the severity of the cancer.

e. Other examples of stochastic effects include:

(1) Genetic mutations.

(2) Life span shortening.



2. Non-stochastic effects are those effects for which there is a threshold.

a. These effects do not appear at low doses but suddenly appear at a higher (threshold) dose.

b. The severity of the effect is dependent upon the dose.

Objective B.9

HO-2 Slide 10

c. A good example of a non-stochastic effect is cataract in the lens of the eye.

(1) Cataracts do not occur at low doses but suddenly appear after the higher, threshold dose.

(2) The severity of the cataract increases with an increase in dose.

d. Other examples of non-stochastic effects are:

(1) erythema (reddening of skin).

(2) leucopenia (or leukopenia, low white blood count).

(3) sterility.

The threshold dose for cataracts is ~ 600 Rads beta..

F. Acute and Chronic Exposure

1. An acute exposure is a large dose received over a short period of time.

2. A chronic exposure is a small dose received over a long period of time.

3. While there is much information on the effects of acute exposure, there is not enough data for radiation biologists to fully understand the effects of chronic exposure.

Objective B.10



4. It is known that radiation doses received chronically are less of a hazard than those received acutely. Chronic doses allow the biological repair mechanisms to have an opportunity to work.

5. Radiation workers in the nuclear industry receive chronic doses.

Objective B.10

G. Chronic Exposure

1. All occupations and activities carry some degree of risk.

2. There are several scientific committees that study the health risks associated with chronic radiation exposure.

3. Biological effects associated with chronic exposure include:

a. Life span shortening.

b. Leukemia.

c. Cancer.

d. Cataracts.

ICRP and NCRP are two such committees.

Objective B.11

Also an acute effect.

4. One of the most useful ways to explain the health risks from chronic radiation exposure is to compare the estimated days of life expectancy lost from other activities to days lost from radiation exposure.

5. While the exact magnitude of risk is not agreed upon, it is agreed that the risk from exposure to low level ionizing radiation is quite low.

6. It is also agreed upon by most that the health risks from occupation exposure is smaller than the risks associated with many of our activities we accept on a daily basis.

Objective B.12

HO-2 Slide 11



H. Somatic, Genetic and Teratogenic Effects

1. Somatic effects refer to the effects on the individual which is exposed to ionizing radiation.

a. These effects cannot be passed on to future generations.

b. Somatic effects can be caused by acute or chronic exposures.

Objective B.13

c. Some examples of somatic effects include:

(1) Erythema.

(2) Sterility.

(3) Cancer.

(4) Life span shortening.

(5) Cataracts.

2. Genetic effects are those effects which show up in future generations of those who received the exposure.

a. These effects are passed on to offspring.

b. Genetic effects can result from acute or chronic exposures.

c. Mutations may not appear for several generations.

Objective B.14

d. Examples of genetic effects are:

(1) Mental retardation.

(2) Small head/brain size.

(3) Growth impairment.

(4) Childhood cancer.



3. The most common concept used to try to quantify the risk of genetic effects of radiation is the Doubling Dose.

a. Doubling dose is the amount of radiation for genetic effects that would be expected to double the natural incidence.

b. In humans, the doubling dose is estimated to be about 100 rem, but more current research leads some radiation biologists to estimate the doubling dose to be as low as 50 rem.

4. Teratogenic effects are effects observed in children who were exposed during the fetal and embryonic stage of development.

a. The human embryo is subject to severe radiation effects.

b. In accordance with the Law of Bergonie and Tribondeau, this is because of the rapid division of cells.

Objective B.15

c. Cells which are dividing and growing most rapidly, spend a considerable portion of their time in the division process.

(1) For adult cells, research has found these cells to be about 10 times more susceptible to radiation damage than slowly dividing cells.

(2) For the fetal and embryonic stages, scientists speculate the factor will be even higher.



d. The effects of high level doses of prenatal irradiation on the growth and development of the human embryo and fetus are:

(1) Gross structural malformations.

(2) Growth retardation.

(3) Embryo lethality.

(4) Sterility.

(5) Central nervous system abnormalities.

(6) Blindness.

(7) Coordination defects.

(8) Cleft palate.

Objective B.15

e. The gestational age at the time of the exposure is the critical factor for teratogenic

effects.

f. The maximum sensitivity of the human brain occurs between 8 and 15 weeks gestation.

(1) One hundred Rad acute exposure to the embryo can lower IQ by 30 points.

(2) During this period, a 43% frequency of mental retardation occurs for a 100 Rad exposure.

(3) There appears to be a threshold for mental retardation at the 30 to 40 Rad range.

g. A 10% increase in frequency of mental retardation is expected following a 100 Rad exposure to the fetus between 16 to 25 weeks gestation.

BEIR V Report



I. Acute Radiation Syndrome

1. There are specific medical symptoms and biological effects commonly associated with acute radiation exposure. Symptoms observed within a few months following the radiation exposure are collectively called “acute radiation syndrome.”

NOTE: These acute effects apply only when the whole body is relatively uniformly irradiated. The effects can be significantly different when only portions of the body or an individual organ system are irradiated.

Objective B.16

Blood changes have been detected at 10 Rad, reduced sperm count at 15 Rad, and vomiting at 50 Rad.

a. Among syndrome symptoms are vomiting, diarrhea, reduction in the number of blood cells, bleeding, epilation, temporary sterility, and lens opacity, as well as others.

b. Vomiting is observed within a few hours to a few days after the exposure.

The cause for vomiting is still unknown.

c. Diarrhea occurs due to damage in the cells that maintain intestinal integrity.

d. Hair is lost due to damage to hair-root cells.

(1) Hair is made of protein which is formed by clusters of cells residing in the follicle or hair bulb.

(2) These cells die when exposed to radiation.

The hair does not fall out; rather, the hair becomes thinner and eventually breaks off.

e. Clouding in the lens of the eye is the result of damage to cells covering the anterior crystalline lens.

f. Sterility occurs in men from damage to sperm generating cells.

g. Sterility occurs in woman due to a loss of fertile eggs.

Temporary sterility in men occurs at 200 Rad and permanent sterility occurs in both sexes at 500 Rad.



h. Reduction in the number of blood cells results from death of the hematopoietic stem cells in the bone marrow.

i. Vascular changes occur in all tissues that have been exposed to radiation.

(1) The endothelial cells (cells that line blood vessels) may be affected by radiation.

(2) Immediately after irradiation, vessels in the skin may only show dilation, producing some erythema.

(3) Later, or with higher doses, there is endothelial swelling or destruction of endothelial cells, resulting in secondary blood clots and bleeding.

(4) It can take up to 1 year for the vascular effects to appear.

j. If the radiation dose is low, not all of the symptoms of the acute radiation syndrome discussed above necessarily occur.

(1) Conversely, a person may die due to bone marrow disorder in one to two months after exposure due to intestinal disorder and could be expected to experience most of the acute radiation syndrome symptoms.

(2) If the radiation dose is high a person may die in ten to twenty days after the exposure and have some of the acute radiation syndrome symptoms.

(3) In the case of extremely high dose, the person may die before experiencing many of the acute radiation syndrome symptoms.

Objective B.16



2. The dose response relationship for acute radiation exposure is the relationship between the amount of radiation dose and the resulting changes in body functions or health response.

a. The dose response relationship for acute exposures clearly indicates that as radiation dose increases there will be an increase in adverse health effects.

b. For stochastic effects, the dose response relationship is linear. There is no threshold dose below which the effects do not occur.

c. For non-stochastic effects, the dose response relationship is S-shaped. There is a minimum threshold dose below which the effect does not occur and an upper level at which the effect occurs 100% of the time.

Objective B.17

The data on radiation dose response relationship are very reliable for high doses.

3. There are four distinct phases or stages of the acute radiation syndrome.

a. Prodomal Period – during the prodomal period, patients might experience loss of appetite, nausea, vomiting, and diarrhea. After extremely high doses, additional symptoms such as fever, prostration, respiratory distress, and hyper-excitability can occur.

b. Latent Period – during the latent period, the patient is symptom free.

c. Illness Period – the period of illness is characterized by infection, electrolyte imbalance, diarrhea, bleeding, cardiovascular collapse, and short periods of unconsciousness.

d. Death or Recovery Period – the death or recovery period is the phase in which the person dies or recovers.

Objective B.18

Symptoms usually go away within a few days.

Symptoms may last for several months. This is the critical period.



4. The higher the dose, the greater the severity of early effects and the chance of later effects.

5. There are three classes of the acute radiation syndrome.

a. Hematopoietic syndrome.

b. Gastrointestinal syndrome.

c. Central nervous system syndrome.

Objective B.19

6. Hematopoietic Syndrome

a. Characterized by deficiencies of white blood cells, lymphocytes, and platelets.

b. The hematopoietic syndrome includes doses of 200 Rad up to 600 Rad.

c. The critical organs for the hematopoietic syndrome are the blood forming organs;

(1) Bone marrow.

(2) Spleen.

(3) Thymus.

(4) Lymph nodes.

Objective B.19.aNCRP Report 98

d. Symptoms of the hematopoietic syndrome are:

(1) Fatigue, listlessness, and lethargy that progresses to headache, anorexia, nausea and vomiting

(2) Decrease in white blood count, epilation, chills, fever, malaise, swollen throat, gingivitis, bleeding gums, blood blisters, ecchymosis, anemia, and acute infectious diseases.

e. The prognosis is fair at lower doses, but poor at doses above 600 Rad.

Occurs within a few hours and lasts 2-3 days

Occurs 2-3 weeks after exposure and lasts for 3-6 monthsEcchymosis is bruising



7. Gastrointestinal Syndrome

a. The cells that absorb nutrients are completely destroyed, and blood, often in large amounts, leaks from the diseased area into the intestines. The blood stream becomes flooded with bacteria.

b. The critical organ is the small intestines, but can include the linings of other gastrointestinal organs. Characterized by loss of cells lining intestinal crypts and loss of mucosal barrier.

c. The dose range for the gastrointestinal syndrome is from 600 Rad to 1,000 Rad.

Objective B.19.b

NCRP Report 98

d. Symptoms the Gastrointestinal Syndrome are:

(1) Explosive diarrhea (often bloody).

(2) Fever.

(3) Massive electrolyte imbalance.

(4) Decreased intestinal motility.

(5) Loss of normal intestinal bacteria.

(6) Extreme dehydration.

(7) Vascular effects.

(8) Sepsis (toxins in bloodstream or tissue).

(9) Damage to intestinal microcirculation.

In addition to the symptoms associated with the gastrointestinal syndrome, the patient will also exhibit the symptoms of the hematopoietic syndrome.

e. The prognosis for recovery from the gastrointestinal syndrome is poor, even with extensive and aggressive medical care.



8. Central Nervous System Syndrome

a. The central nervous system gets damaged to the point that the body completely runs out of control and various organ systems stop functioning properly.

b. The critical organs for the central nervous system syndrome are the brain and spinal column.

c. The dose for the central nervous syndrome starts at 1,000 Rad.

Objective B.19.c

NCRP Report 98

d. Symptoms of the central nervous system syndrome include:

(1) Feeling of sickness.

(2) Headache.

(3) Dizziness.

(4) Coma.

e. There is no chance of recovery from the central nervous system syndrome. At very high doses, the victim will fall dead within a matter of a few minutes.

I. LD 50/60

1. LD 50/60 is the lethality dose.

2. It is the dose at which 50% of the exposed population will die within 60 days.

3. For humans, the LD 50/60 is in the range of 300 to 500 Rad.

4. The accepted value for LD 50/60 for humans, with medical treatment, is 450 Rad.

Objective B.20

HO-2 Slide 11

NCRP Report 98NUREG CR-4214



J. Internally Deposited Radionuclides

1. It is possible for radionuclides to get internally deposited within the body.

2. Once inside the body, these radionuclides give off radiation.

3. The biological effects from internally deposited radionuclides are essentially the same as the biological effects from external exposure.

HO-2 Slide 12

4. Nevertheless, there are some characteristics unique to internal radiation.

a. Once a radionuclide gets deposited inside the body, it will remain there and it will continue to give off radiation until it becomes stable or until it is eliminated from the body.

You can not walk away from internal radiation the way you can simply walk away from an external source.

b. Radiation workers tend to be much more, and sometimes overly, concerned about a very small amount of internally deposited radionuclides than they are about a significantly higher external exposure.

Radiation workers seem to forget that an external radiation source penetrates to internal organs.

c. Some radionuclides “seek” or concentrate in particular organs or body locations and can give a significant dose to the particular organ.

(1) Iodine concentrates in the thyroid.

(2) Radium, Strontium, and Plutonium are bone seekers.

(3) Cesium tends to concentrate in muscle tissue.

(4) Cobalt goes to the gastrointestinal tract.

Critical organ is the body organ that receives the greatest overall damage from exposure.



5. Modes of entry into the body

a. Inhalation is the primary means by which radionuclides enter the body.

(1) Much of what is inhaled will deposit in the lungs; however, it will often be expelled from the lungs and exhaled or swallowed.

(a) For soluble, readily absorbed compounds, only about 25% is retained in the respiratory tract and absorbed into the blood stream.

(b) For insoluble compounds, it is assumed that 12% is retained in the lower respiratory tract.

(2) Some of what is inhaled will be caught in the upper air passages and subsequently swallowed.

(a) About 50% of soluble compounds are held up in the upper respiratory tract and swallowed. Part of this will be absorbed through the GI system and enter the bloodstream.

(b) Roughly 88% of insoluble compounds deposited in the lungs will be eliminated by exhalation or swallowing. In particular, coughing forces insoluble compounds out of the lungs back into the respiratory tract where they can be inhaled again, swallowed, or exhaled.

Objective B.21.a



b. Ingestion is the second most predominant means for entry into the body.

(1) Soluble materials will be retained in organs or tissues or excreted.

(2) Insoluble materials will be excreted.

c. Entry through the skin, or through breaks in the skin, is the least common entry pathway; however, this entry pathway can lead directly to the bloodstream for soluble or insoluble materials.

Objective B.21.a

6. Transfer within the body is via the bloodstream. Radioactive material can enter the bloodstream through the walls of the small intestine, through the lungs, or through subcutaneous tissue.

7. Radionuclides exit the body via perspiration, urine, feces, or exhalation.

8. Just as every isotope has a physical half-life, every isotope has a biological half-life. The biological half-life is the time the body to remove one-half of the material from the body.

Objective B.21.b

Objective B.21.c

This will be covered in detail in another lesson.

K. Linear Zero Threshold Dose Response Curve

1. Researchers have disagreed over whether or not radiation effects require a minimum dose, threshold, or whether small doses produce some degree of risk.

2. It is very difficult to estimate the risk at small doses of radiation because the effects of radiation can be seen clearly only at high doses.

3. All estimates of risk from the chronic level of exposure are derived from data accumulated for exposure at high dose levels and dose rates.

Draw curve on board.



4. This data is then extrapolated down to the chronic level.

5. Radiation protection programs in the nuclear industry are based upon the assumption that all dose, no matter how small, involves some risk. This assumption is based upon the linear zero threshold dose response curve.

6. We have data on effects seen at high doses and dose rates and this data has been linearly extrapolated down to the low doses and dose rates.

7. This linear extrapolation results in belief that there is a zero threshold for effects from chronic exposure and therefore some small risk of injury even at small doses.

8. The linear model is the model endorsed by the NRC.

Objective B.22

L. ALARA

1. ALARA is an acronym for As Low As Reasonably Achievable.

2. The use of the linear zero threshold dose response model in radiation protection leads to the assumption that all dose, no matter how small, involves some risks.

a. This assumption results in radiation protection programs applying the ALARA principle.

b. ALARA is a concept that supports exposure to workers only when the result of the exposure justifies the risk.

c. A job should only be scheduled when the benefit clearly outweighs the increased assumed risk caused by the exposure from the job.

Objective B.23



3. Reasonably is a key word in the ALARA concept. Obviously, it is not reasonable to spend a million dollars on a dose saving of 10 mrem. The small risk saved could not be justified by such a high cost.

Give current cost per person-rem that is being used. Check with site ALARA for current value.

4. An ALARA program is required by the Code of Federal Regulations. Here are some excerpts from 10CFR20:

a. “ALARA means making every reasonable effort to maintain exposures to radiation as far below the dose limits in this part as is practical consistent with the purpose for which the licensed activity is undertaken, taking into account the state of technology, the economics of improvements in relation to the benefits to the public health and safety, and other societal and socioeconomic considerations, and in relation to utilization of nuclear energy and licensed materials in the public interest.”

b. “Each licensee shall develop, document, and implement a radiation protection program commensurate with the scope and extent of licensed activities and sufficient to ensure compliance with the provisions in this part.”

c. “The licensee shall use, to the extent practical, procedures and engineering controls based upon sound radiation protection principles to achieve occupational doses and doses to members of the public that are as low as is reasonably achievable.”

Objective B.23

10CFR20.1003 Definitions

10CFR20.1101(a)Radiation Protection Programs

10CFR20.1101(b) Radiation Protection Programs

5. The ALARA concept is not limited to maintaining individual doses ALARA.

a. From the viewpoint of minimizing health risks to a population, the ALARA concept must be applied to the collective dose.

b. For collective dose, it is assumed that the health risk is the same even when a larger population shares the dose.



c. Spreading the dose out to a larger population will minimize individual risks but not risks to the entire population.

Objective B.23

M. Risks to the General Public

1. Naturally occurring radioactive materials are found in our environment and in the human body. Cosmic radiation contributes additional exposure.

2. Man made sources such as medical and dental x-rays along with nuclear medicine contribute significantly to the radiation exposure of an average person.

3. The average person receives approximately 200 mrem (excluding radon) with only about 0.28 mrem originating from nuclear power. This risk is well within the risks accepted in everyday life from voluntary activities such as smoking, drinking, being overweight, and riding in a car, medical x-rays as well as other activities.

Objective B.24

HO-2 Slide 13

N. Radiation Hormesis

1. Radiation hormesis is the presumption that exposing people to increased doses, very low doses, of ionizing radiation will make them healthier by strengthening their immune systems. In particular, it is the hope that low doses of chronic exposure will result in a radio-adaptive response that causes the body to develop immunity to cancer.

2. The promoters of radiation hormesis cite studies on plants and animals. In regard to humans, they make the scientifically false analogy with beneficial effects of vaccinations, by ignoring the fundamentally different interaction of ionizing radiation with living tissues, as compared to that of bacteria, viruses, or chemicals.

Objective B.25

The presumptive theory behind radiation hormesis is that small chronic doses of radiation are beneficial.



3. Health studies on human populations have never shown any evidence that small amounts of radiation are beneficial.

4. It is important to remember that radiation programs in the nuclear industry are not based upon the belief in radiation hormesis.

Objective B.25

O. Medical Treatment and Preventive Drugs

1. The treatment for radiation exposure can include:

a. replacement of blood constituents.b. replacement of fluids.c. replacement of electrolytes.d. high doses of antibiotics.e. surgical excision of damaged tissuef. antifungal agents (used because radiation

victims have lowered defense mechanisms and fungi, which normally live in the mucous membranes, if left unchecked can spread to the pharynx and esophagus resulting in death).

g. barrier nursing (maintaining victim in isolation in a sterile atmosphere to prevent infection).

h. bone marrow transplants.

2. There are radio-protective drugs that can be taken to minimize the exposure or to minimize the effect.

a. There are two drugs that can be taken to saturate the thyroid with non-radioactive iodine, thereby minimizing the amount of radioactive iodine the thyroid would take up during an accident.

(1) Potassium Iodide, KI(2) Potassium Iodate, KIO3

b. Cystene is used for pre-irradiation protection and floods tissues with excess hydrogen free radicals to increase the chance for hydroxyl free radicals to combine with them and produce water.

Blocking agents are used to minimize uptake.

One tablet taken within 2 hours of the exposure can reduce thyroid dose by up to 90%. TVA has KI available.

Developed by the military to be used prior to the exposure.



c. Prussian Blue

(1) A blue dye, Fe4[Fe(CN)6]3 is the chemical formula.

(2) It is effective when there has been internal contamination with cesium or thallium.

(3) It traps cesium or thallium in the small intestines to prevent absorption into the blood stream.

(4) It reduces the biological half-life of cesium-137 from 115 days to 40 days and of thallium-201 from 8 days to 3 days.

Administered by medical personnel following large uptakes.

d. Fluids

(1) Force feeding of liquids, under a physician’s care, can speed up excretion of soluble contaminants.

(2) Physician’s may prescribe diuretics to speed up excretion of soluble radioactive materials.

Effective following tritium uptakes.

e. Chelating Agents

(1) Chelating agents are useful against heavy transuranic elements such as plutonium and americium.

(2) The chelate forms a soluble metal ion complex with the heavy atom and is removed via the kidneys.

P. Overexposure Events

1. Much of the knowledge regarding the biological effects of ionizing radiation was gained from animal studies; however, the study of actual over exposure events has proven invaluable in helpingscientists understand radiation effects on the humanbody.

Appendix 1, 2

Attachment 1, 2, 3, 4

Attachment 5, 6, 7


XI. SUMMARY:

Radiation, both natural and man-made, affects humans and

their environment. Understanding the means by which

radiation affects humans allows those involved in the field

of health physics to better control and minimize these

effects.

It is the responsibility of each worker in the nuclear

industry to maintain his/her exposure as low as reasonably

achievable, ALARA. Radiation workers in the nuclear

industry look to the RADCON staff for answers to their

concerns and guidance in minimizing their exposure.

Therefore, it is vital that the health physics staff be

knowledgeable of the biological effects of ionizing

radiation and that they be kept informed of new research

relating to the effects of ionizing radiation on the human

body.

A health physics staff that is knowledgeable in the area of

biological effects of radiation can play a major role in

litigation minimization for that utility. Furthermore, a

knowledgeable technician can give better guidance to both

employees and the general public regarding the effects of

ionizing radiation.

This course has been an attempt to increase that

knowledge.


Handout-1

Web Address List for Additional Information

1. www.consumerlab.com/results/potassio.asp Gives information on radioprotective drugs Potassium Iodide, KI, and Potassium Iodate, KIO3.

2. www.gfstrahlenschutz.de/docs/hormeng2.pdf Gives information on radiation hormesis and cites scientific evidence to refute the theory.

3. www.rbc.kyoty-u.ac.jp/dbMSSFiles/CRT-Recuplex.htm Provides results of chromosomal dosimetry of 3 workers involved in a criticality accidents where exposures were 47 Rad, 22.5 Rad, and 12 Rad.

4. www.nea.fr/html/wp/chernobyl/chernobyl.html Chapter 4 gives dose estimates for various groups of workers and the public following the accident at Chernobyl. Chapter 5 discusses the health impact of the accident.

5. www.cellsalive.com Contains detail of animal cells, including parts of the cell and functions of the various parts.

TP-1



TVAN Technical TrainingHealth Physics (RADCON) Initial Training Program

Cell StructuresCell Structures

TP-2




Free RadicalsFree RadicalsWater exposed to radiation results in an ion pair

H2O + radiation → H2O+ + e-

The water ion combines with water to produce hydronium and a free radical

H2O+ + H2O → H3O+ + OH∙Hydronium can combine with a free electron to produce water and a free radical

H3O+ + e- → H2O + H∙

Free radicals can combine with like free radicals to produce hydrogen gas or hydrogen peroxide

H∙ + H∙ → H2OH∙ + OH∙ → H2O2If oxygen is present, a free radical

can combine with it, resulting in a hydroperoxyl radical

H∙ + O2 → H2O∙

Hydroperoxyl radicals can combine with other free radicals to produce hydrogen peroxide

HO2∙ + H∙ → H2O2HO2∙ + HO2∙ → H2O2

TP-3




Damage to DNA or Chromosomes

TP-4




Cell DivisionCell DivisionParent Cell

Cell Division

Normal Daughter Cells

Normal Cell Division – No Radiation Involved

TP-5





Cell Division

Normal Daughter Cells

Radiation

Damage Repaired

Radiation Damage Repaired – Followed By Normal Cell Division

TP-6





Cell DivisionAbnormal Daughter Cells

Radiation

Radiation Damage Resulting in Abnormal Daughter Cells

TP-7





Cell DivisionDaughter Cells Die

Radiation

Radiation Damage --Daughter Cells Incapable of Life

TP-8





Parent Cell Dies

Severe Radiation

Severe Radiation Damage -- Parent Cell Dies

TP-9




RadiosensitivityRadiosensitivity of Cellsof CellsMost Sensitive

Sperm cells

Leukocytes –white blood cells

Erythrocytes –red blood cells

Blood Forming Tissue – bone marrow, spleen, lymph nodes

Fetal Cells

Moderately Sensitive

Digestive System

Vascular System –affected in many ways

Outer and inner layers of skin

Hair follicles

Least Sensitive

Muscle

Collagen –connective tissue

Central Nervous System

Bone

TP-10




Threshold DosesThreshold DosesDose Health Effect5 Rad Blood Changes

10 Rad15 Rad50 Rad

100 Rad150 Rad200 Rad

300 Rad600 Rad

1000 Rad Central nervous system syndrome, survival virtually impossible

Chromosome AberrationsTemporary sterility in men, up to 4 yrDecreased white blood cells, nausea, vomiting, immune system depressionMild radiation sickness, survival almost certainMortality rare, ovulatory suppression

Hair loss, erythema, blisters, scarring, survival possibleGastrointestinal syndrome, permanent sterility in women aged 15 to 40, death likely

Hematopoietic syndrome, permanent sterility in men and temporary in women, survival possible

TP-11




Lethality DoseLethality DoseSpecies LD50 Rads Species LD50 Rads

Sheep 155Burro 155Swine 195Marmoset 200Goat 230Guinea pig 255Dog 265Monkey 398Human * 320-360

Human ** 480-540Human *** > 540Rabbit 840Mouse 900Gerbil 1059Desert Mice 1520* With medical care** With supportive medical care*** With intensive medical care

TP-12




Internal Deposition Internal Deposition

Kidneys

Lungs

Lymph Nodes

Subcutaneous Tissue

Organs

Liver

ExtracellularFluid (Including Blood) SkinGI

Tract

Inhalation

Ingestion WoundExhalation

Perspiration

Urine

Bile

Feces

TP-13




Loss of Life ExpectancyLoss of Life ExpectancyHealth Risk Days Lost Health Risk Days Lost

Smoking * 2370 (6.5 years)Overweight ** 985 (2.7 years)All accidents 435 (1.2 years)Auto accident 200Alcohol use 130Home accident 95Drowning 41Safest jobs 30Natural Bkgd 8

Medical X-rays 6All catastrophes 3.51 Rem *** 11 Rem/yr 30 yr 305 Rem/yr 30 yr 150

** by 20%*** Industry average occupational

exposure is 0.34 Rem/year

* 20 cigarettes (1 pack) per day


Appendix 1

Instructions for Student Discussion and Presentation

Part I

1. Each student will receive a case report, Attachment 1, 2, 3, or 4, of an actual

overexposure event.

2. Each student will read the event and note the following on Appendix 2:

a. The cause of the event and details about the event.

b. The amount of radiation dose received and the biological effects

observed.

3. Students with the same events will be grouped to compare information and

prepare to present information to the class.

4. Students from each group will report to the class.

5. Instructor will facilitate class discussion of the each event.

Part II

1. The instructor will divide the class into 3 groups.

2. Each group will receive a case report, Attachment 5, 6, or 7, of an actual

overexposure event.

3. Each group will review their event and note the following on Appendix 2:

a. The cause of the event and details about the event.

b. The amount of radiation dose received and the biological effects

observed.

4. Students from each group will report to the class.

5. Instructor will facilitate class discussion of the each event.


Appendix 2

Worksheet For Student Discussion and Presentation

Event Details

What happened:

Date of event:

Location of event:

Cause of event:

Person Overexposed

How many exposed:

How much radiation:

Biological Effects:

Symptoms of victim:

Medical treatments given:

Long term effects:

Note: For cases involving large numbers of exposed people, group victims according to dose received and report for each group.


Attachment 1

Case report from 1984 exposure to members of the public from scrap 60Co teletherapy

source in Ciudad Juarez, Mexico.

Reference: Ricks, Robert, Fry, Shirley: The Medical Basis for Radiation Accident

Preparedness II, New York: Elsevier Science Publishing Co., Inc., 1990, p. 13-23.


Attachment 2

Case report from gamma irradiation plant used for sterilizing medical equipment in

Norway, in 1992.


Preparedness II, New York: Elsevier Science Publishing Co., Inc., 1990, p. 3-11.


Attachment 3

Case report on radiation accidents of 1974 and 1977 at product sterilization plants in

New Jersey.

Reference: Fry, Shirley, Hübner, Karl: The Medical Basis for Radiation Accident

Preparedness, New York: Elsevier North-Holland, Inc., 1980, p. 151-160.


Attachment 4

Case report from radiation accident at a Van de Graff linear accelerator in Pittsburgh in

1967.

Reference: Fry, Shirley, Hübner, Karl: The Medical Basis for Radiation Accident

Preparedness, New York: Elsevier North-Holland, Inc., 1980, p. 131-140.


Attachment 5

Case report from event in Goiania, Brazil in 1987 which resulted in four deaths and

widespread contamination.


Preparedness II, New York: Elsevier Science Publishing Co., Inc., 1990, p. 89-107,

p. 173-181, p. 243-251, p. 271-279.


Attachment 6

Case report on core damaging accident at Chernobyl nuclear power plant in 1986.

Reference:

Ricks, Robert, Fry, Shirley: The Medical Basis for Radiation Accident

Preparedness II, New York: Elsevier Science Publishing Co., Inc., 1990, p. 79-87,

p. 183-189, p. 195-209, p. 231-240, p. 259-271.

NEA Committee on Radiation Protection and Public Health, OECD Nuclear

Energy Agency, Chernobyl Ten Years on Radiological and Health Impact, Nov. 1995,

http://www.nea.fr/html/rp/chernobyl/allchernobyl.html


Attachment 7

Case report from criticality accident at a uranium processing plant in Tokaimura, Japan

on September 30, 1999 and case report from criticality accident at the Russian Federal

Nuclear Centre on June 17, 1997 at Sarov, Russia.

Reference: INPO, Significant Event Report, SER 3-00, Criticality Accident At a Uranium

Processing Plant, http://www.inpo.org/seein/wano/ser3-00/ser3-00.asp

Reference: IAEA, The Criticality Accident in Sarov, Vienna, Austria, February, 2001.

www.//nea.fr/html/science/wpnsc/excursions/resources/accident/iaea_karvo.pdf

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