Session Three: Advances in Assessment and Management of Internal Contamination

Chair: Volker List (MD) Head of Medical Services, Karlsruhe Inst. of Technology, Germany

Abstract

Medical consequences from internal contamination are rare. Radionuclides like pure alpha emitters are difficult to detect and information about physical and chemical qualities is often insufficient. The low limits of annual uptake together with a conservative approach to dose estimation can lead to formal consequences to the affected person and the employer. Treatment might be insufficient from lack of effective methods, approved substances or time-consuming monitoring methods leading to a late start of decorporation treatment. Despite large international databases for documented cases of internal contamination there is still no therapeutic action model available to be adjusted for individual treatment.

France has much experience with monitoring and treatment of internal contamination from plutonium, and there is a traditionally very good cooperation between civil and military groups in radiation accident management. We are happy to be demonstrated two different cases of pu- wound contamination, one treated medically, the other surgically from the French Armed Forces Health Organisation and Percy Military Hospital, Paris.

The NCRP Wound Model, report No 156, 2007 was the last to be developed for the different existing pathways of internal contamination. The data coming mostly from animal experiments will hopefully optimize the treatment for mainly insoluble materials and optimize the interpretation of bioassay data, R. Toohey will give us an overview of its application for 38 relevant radionuclides in industrial and military use.

A.Wiley, being a member of the scientific committee of the new "bible" on decorporation treatment, NCRP report No 161, 2009, talks about internal contamination management with regard of deterministic effects.

Apart from the power plant accidents like Fukushima, the Goiania medical source accident 1987 remains a very important model case for all kinds of radiation accidents and scenarios. In this seminar, Luiz Bertelli from CNEN, Brazil and coauthors will focus on diagnostic problems with internal contamination, cytogenetic dosimetry and treatment with Prussian Blue.