Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home

psychological impacts of the attack. The severity of the psychological effects depends in
part on the type of RDD material and the method of deployment. Mass psychosomatic
symptoms resulting from an unrealistic fear of the effects of radioactive material could
place unnecessary strain on the medical system, through medical screening of large
numbers of anxious individuals. This would add to the chaos of identifying truly exposed
cases, also mixed in among the existing cases of gastrointestinal, dermatologic, and
respiratory illness that are prevalent in any population at baseline.
In the event an RDD is deployed, everything possible should be done to contain panic. It
is very important to reassure the public that all necessary steps are being taken to
safeguard their health and well being. This allows appropriate authorities to methodically
contain and manage the incident in an atmosphere free of public interference. Public
perception that appropriate treatment is not being provided, particularly for children and
other vulnerable individuals, could markedly increase the psychological impact of the
event. Medical authorities also need to manage the flow of casualties through proper
layout and use of casualty reception stations, decontamination areas, and patient
assessment and triage procedures.
Medical and Industrial Sources of Radiation
Radioactive materials used in medical or industrial settings can produce irradiation or
contamination from accidental or intentional misuse. Irradiation and contamination are
significantly different problems—a person can be irradiated from a distance without
being contaminated by radioactive material. Radiological contamination is an issue
because of the close proximity of the radionuclide to tissue, whether the contamination
lies against the skin (external) or is inside the body (internal).
Powerful industrial radiography sealed sources used in the nondestructive testing of oil
and water pipelines have caused severe exposures. Their bright stainless steel casings are
eye-catching when the sources are accidentally left behind, and they have been stolen
when positive control of the source was lost. They are a potential terrorist weapon and
could present a serious localized radiation threat.
Another important medical/industrial source is Cs-137, which is an important decay
product resulting from the fission of uranium and plutonium fuels. This isotope is used in
both industrial sealed-gamma sources as well as medical therapeutic sealed sources.
Cesium (Cs) is an alkaline metal that is metabolized much like potassium and excreted
through the kidneys. It has a radioactive half-life of 30 years but a biological half-time in
adults ranging from 68 to 165 days (average 109 days). The biological half-time is
shorter in children, ranging from 12 days in infants to 57 days in older children. It is also
shorter in women (84 ± 27days) than in men.
An example of the potential danger from an uncontrolled Cs-137 source occurred in
1987. An abandoned radiotherapy sealed source containing 1400 Curies (Ci) of Cs-137
powder was opened by looters in Goiania, Brazil. About 250 people were subsequently
exposed. The victims included children who rubbed the glowing powder on their bodies
and, in at least one case, ingested it. Resulting radiation doses were as high as 10 Sv
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