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

(1000 rem), resulting in four fatalities from acute radiation sickness (ARS). In this case,
the Cs-137 had the exposures characteristic of both a sealed source (producing ARS) and
an RDD causing both external and internal contamination. An estimated 120,000
concerned people had to be screened for possible contamination, with incident
management costs in the millions of dollars.
Nuclear Power Plants
The United States has 104 nuclear reactors licensed to provide electric power, as well as
36 reactors licensed for other uses. The U.S. Nuclear Regulatory Commission (NRC) has
stringent physical protection requirements against sabotage, which cover both plant
design and security protection features. Unlike the design of some foreign reactors,
designs for power reactors operating in the United States incorporate a layered system of
physical shields and walls, including a potentially pressurized containment vessel.
Consequently, there have been relatively few mishaps involving American-designed
power reactors.
The primary down-wind hazard from destruction or sabotage of a nuclear reactor is the
venting of radioactive iodine gas. Power reactors cannot detonate like a nuclear bomb,
because reactor fuel does not contain the highly enriched uranium needed for detonation.
The only significant U.S. catastrophic reactor failure occurred in March 1979, at the
Three Mile Island (TMI) nuclear power facility in Pennsylvania. At that time, one of the
TMI reactors experienced overheating and a meltdown of a portion of its fuel rods. This
event resulted in a small release of radioactive gas to the environment, primarily Iodine-
131. The radiation produced negligible doses to people residing near the plant (estimated
maximum dose of 0.001 Sievert [Sv] [100 mrem]), which is equivalent to a routine chest
radiograph). There has been no evidence to date of public injury resulting from the small
amount of nuclear material that was vented as a result of this incident.
Pediatricians may be asked about the safety of consuming milk after a reactor accident.
Iodine-131 fallout on vegetation has an effective half-life of about 5 days (combination of
radioactive decay half-life [8 days] and vegetation half-life). An infant consuming 1 L of
milk per day contaminated with 1 microCurie (µCi)/L would receive a total cumulative
dose to the thyroid of about 16 rem. Therefore, locally produced milk, fruit, and
vegetables should be declared fit for consumption only after clearance by appropriatelytrained
health inspectors. Emergency reference doses of 0.25 µCi/L peak level in milk
and 1.5 µCi/m 2 on pasture can be used to guide consumption (exposure)
countermeasures. (See Medical Treatment section later in this chapter for information on
radioactive iodine and thyroid issues.)
Historical Overview of Radiation Injury
Radiation in the form of “x-rays” was discovered in 1895 by the German physicist
Wilhelm Roentgen. Radioactivity in ore was discovered by Antoine Henri Becquerel in
1898. Within a few years of discovery, ionizing radiation was used for a wide variety of
medical diagnostic and treatment purposes. Radiation was found to be an extremely
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