Fool Irradiation: A Potential Unwanted Byproduct of Food Irradiation

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Fool Irradiation A Potential Unwanted Byproduct
of Food Irradiation?

• January 27, 1999 Health Physics Society
• Albuquerque, New Mexico

Daniel J. Strom and Charles R. Watson Pacific
Northwest National Laboratory Richland,
Washington Work supported by the U.S. Department
of Energy under Contract No. DE-AC06-76RLO
1830 http//QECC.pnl.gov
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Overview

• fool a person lacking in judgment or prudence
• some are fools, most are innocent victims
• history of irradiator accidents
• Quantitative Evaluation of Contamination
  Consequences (QECC) database
• http//qecc.pnl.gov/
• qualitative and quantitative lessons from
  irradiator accidents

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Italy 1975

• an untrained worker was able to bypass all the
  safety and procedural controls by entering the
  irradiation cell through an opening that was not
  foreseen
• died 13 days later

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Norway 1982

• flawed design
• one switch failure caused false reading
• 2 procedures violated
• didnt note fixed radiation monitor
• didnt use portable instruments
• died 13 days later

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El Salvador 1989

• operators had only received informal on-the-job
  training
• facility poorly maintained
• safety systems failed and were not replaced
• irregular maintenance
• operator manipulated source down microswitch to
  induce a green light
• manipulated the control panel to simulate monitor
  detection of a safe radiation level
• 1 worker died, 1 with multiple amputations

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Israel 1990

• operating procedures not in local language
• didnt follow procedures
• malfunctioning source down indicator
• disconnected radiation alarm
• used established trick to simulate radiation
  monitor test
• did not check portable radiation monitor
  (inoperative)
• died 36 days later

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Belarus 1991

• details not known
• operating procedures not followed
• safety features circumvented
• died 113 days later

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Illinois 1965

• crawled under door, bypassing interlocks
• 10 MeV electron accelerator
• 0.002 to 2400 Gy
• amputation of arm and leg

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Maryland 1991

• no personnel dosimeters or survey meters
• flashing warning signals ignored
• padlock missing from gate
• 2 of 3 photocells inoperative (1 switched off)
• pressure mat removed
• deliberately passed beneath only working
  photocell
• safety procedures interlocks routinely bypassed
• fingers of both hands amputated

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Viet Nam 1992

• complete lack of safety systems and procedures
• exposed physicist was officer responsible for
  radiological protection
• hand, fingers of other hand amputated

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Quantitative Lessons from Accidents

• QECC database produces outcome measures
• time-and-proximity factor (unshielded) (hr/m2,
  i.e., hours at a meter)

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QECC Data on Sealed Source Accidents
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Acceptance of Food Irradiation

• acute radiation deaths or injuries of food
  irradiation workers must not be substituted for
  the rare consumer death attributable to E coli
• irradiator accidents
• ghastly horrible burns, amputation, sterility,
  death
• high signal potential to public
• failure to prevent such accidents is very bad
  press
• third world is a particular problem

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Sources of Information

• NRC NUREG-1345, 1989 Review of Events at Large
  Pool-Type Irradiators
• IAEA 1996 Lessons Learned from Accidents in
  Industrial Irradiation Facilities
• ICRP Pub. 76, 1997 Protection from Potential
  Exposures Application to Selected Radiation
  Sources
• IAEA SRS No. 7, 1998 Lessons Learned from
  Accidents in Industrial Radiography

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Conclusions

• radiation accidents have occurred too frequently
• gt300 resulting in injury
• 55 in QECC
• design, maintenance, training, inspection, and
  safety culture needed for safe use
• fool irradiation can be a threat to food
  irradiation
• please share your data to help us learn
  quantitative lessons
• daniel.j.strom_at_pnl.gov