IMBA Expert: internal dosimetry made simple

A Holistic Approach to Assessment of Population Exposure to Radiation: Challenges and Initiatives of a Regulatory Authority

A regulatory authority for radiation safety should continuously evaluate and improve the national safety framework, in line with current requirements and standards. In this context, the Greek Atomic Energy Commission initiated a series of concerted actions. The radiation dose to the population due to public and medical exposures was assessed. The assessment of dose due to public exposure was based on measurements of radon concentrations in dwellings, radionuclide concentrations in environmental samples, and air dose rates; the assessment of dose due to medical exposure was based on dose measurements for typical examinations or procedures and data on their frequency. The mean effective dose to a member of the population was found to be 4.5 mSv (1.8 mSv and 2.7 mSv from medical and public exposures, respectively). Regarding occupational exposure, aircrew dose assessment, eye lens monitoring, and the national dose registry were significantly improved. With respect to artificial tanning (sun beds), the ultraviolet radiation produced was assessed and the practices followed were observed. Results demonstrated exceedance of the 0.3 W m erythema effective irradiance limit set in European Union standards by 63.5% of the sun beds measured, along with general noncompliance with standards. An overarching activity was the upgrade of the Greek Atomic Energy Commission information system in order to collect and disseminate radiation data electronically, launch a networking strategy for interaction with stakeholders, and facilitate the process of regulatory control. In response to the above findings, regulatory actions have been initiated.

TESTING THE IDEAS GUIDELINES AS APPLIED TO PLUTONIUM INTAKES

The IDEAS Guidelines [Doerfel, H., et al General Guidelines for the Estimation of Committed Effective Dose from Incorporation Monitoring Data. Report FZKA 7243, Forschungszentrum Karlsruhe, GmbH (2006); Castellani, C. M., Marsh, J. W., Hurtgen, C., Blanchardon, E., Berard, P., Giusani, A. and Lopez, M. A. IDEAS Guidelines (Version 2) for the Estimation of Committed Doses from Incorporation Monitoring Data. EURADOS Report 2013-01, Braunschweig (2013)] provide a structured approach to the assessment of intakes of radionuclides. In order to check that the guidelines, when applied to typical monitoring programmes, lead to reliable assessments, a number of numerically-generated datasets have been constructed and assessed using the guidelines. The dose and intake obtained by the assessment can be compared with the 'true' dose and intake. In this way, the accuracy of the IDEAS assessment process can be examined when applied to monitoring programmes that are typically used in the nuclear industry. The simulations focus on assessments carried out as a result of elevated (239)Pu activities in routine urine samples, which lead to follow-up urine and faecal samples being provided. Cases where the assessor makes the correct initial assumption about lung solubility can be compared with cases where this initial choice is wrong. The results of these simulations and the implication for the use of monitoring programmes are discussed.

Design and functionalities of the MADOR® software suite for dose-reduction management after DTPA therapy

A software suite on biokinetics of radionuclides and internal dosimetry intended for the occupational health practitioners of nuclear industry and for expert opinions has been developed under Borland C++ Builder™. These computing tools allow physicians to improve the dosimetric follow-up of workers in agreement with the French regulations and to manage new internal contaminations by radionuclides such as Pu and/or Am after diethylene triamine penta-acetic acid treatments. In this paper, the concept and functionalities of the first two computing tools of this MADOR(®) suite are described. The release 0.0 is the forensic application, which allows calculating the derived recording levels for intake by inhalation or ingestion of the main radioisotopes encountered in occupational environment. Indeed, these reference values of activity are convenient to interpret rapidly the bioassay measurements and make decisions as part of medical monitoring. The release 1.0 addresses the effect of DTPA treatments on Pu/Am biokinetics and the dose benefit. The forensic results of the MADOR(®) suite were validated by comparison with reference data.

Development of a computer code to calculate the distribution of radionuclides within the human body by the biokinetic models of the ICRP

This paper describes the Basic Radionuclide vAlue for Internal Dosimetry (BRAID) code, which was developed to calculate the time-dependent activity distribution in each organ and tissue characterised by the biokinetic compartmental models provided by the International Commission on Radiological Protection (ICRP). Translocation from one compartment to the next is taken to be governed by first-order kinetics, which is formulated by the first-order differential equations. In the source program of this code, the conservation equations are solved for the mass balance that describes the transfer of a radionuclide between compartments. This code is applicable to the evaluation of the radioactivity of nuclides in an organ or tissue without modification of the source program. It is also possible to handle easily the cases of the revision of the biokinetic model or the application of a uniquely defined model by a user, because this code is designed so that all information on the biokinetic model structure is imported from an input file. The sample calculations are performed with the ICRP model, and the results are compared with the analytic solutions using simple models. It is suggested that this code provides sufficient result for the dose estimation and interpretation of monitoring data.

Occupational exposure to 131I-a case study

In a laboratory in a company manufacturing radiopharmaceuticals, a laboratory technician was contaminated with I. The employee was preparing I capsules for thyroid carcinoma treatment. The employee was wearing two pairs of protective gloves and, when changing gloves, noticed a rupture in the right inner glove but no visible rupture in the outer glove. Only 3-4 h later, routine monitoring revealed heavy contamination of the back of the right hand. Immediate actions to decontaminate the hand were taken on-site. Stable iodine was not administered. On the next day, besides persisting heavy contamination of the hand, I was also detected in the thyroid gland. Based on original measurements on-site and later follow-up at STUK, including surface contamination measurements and whole body counting, the original I activity on the hand was estimated at 12 MBq and the superficial skin dose at 33 Gy, affecting a skin area of about 10 cm. The thyroid dose was estimated at 430 mGy. Eleven days after the incident, the skin was dry and slightly desquamated. After 15 d, the skin was intact with no desquamation left. No further signs of skin damage have occurred. Cytogenetic analysis of circulating lymphocytes indicated a slight elevation of chromosomal aberrations.

Biokinetic analysis code development and applications to visualise the distribution of intake activity

Measurements for internal dose assessment are required to be conducted based on the distribution of radionuclides in the body, which may change depending on the lapsed time. In this study, a biokinetic analysis code, which can be used in practical radiation control is developed, and the results of (60)Co and (137)Cs biokinetics are visualised as examples by drawing the depositions for each organ and tissue in a figure of the body as a function of lapsed time. In addition, based on visualised biokinetics, precautions for in vivo measurements are also discussed. These discussions led to the conclusion that the information of visualised biokinetics is useful for actual measurements in practical radiation control.

Various consequences regarding hypothetical dispersion of airborne radioactivity in a city center

In case of dispersion of airborne radioactive material in a city center a number of questions will prompt for an answer. While many questions can get their answers in due course of time based on results of tests and sampling, a good understanding of the quantitative effect of dispersion will be very helpful to rescue staff, in particular in the early stage. In the following dose and dose rate estimates are presented for three scenarios including dispersion of radioactivity in a city center. In one case the activity is released in an open place, in another from a roof and in the third case from a source on a street where the wind is blowing along the street. In each case, at specific positions, estimates are made of dose from inhalation, and dose rates for contamination on skin as well as from radioactive particles deposited onto ground, walls and roofs (external exposure) in the city center. It should be noted that the deposition pattern in urban areas varies greatly which means that the consequences are difficult to predict. The dispersion is influenced by recirculation behind tall buildings and diverted flow close to street-ends, which have significant effects on the deposit pattern. Regarding the relative importance of contributions to total dose it is found that inhalation could play a major role for long term effects while dose to skin might dominate acute effects.

A real-time internal dose assessment exercise

A real-time internal dose assessment exercise has been conducted in which participants were required to make decisions about sampling requirements, seek relevant information about the 'incident' and make various interim dose assessments. At the end of the exercise, each participant was requested to make a formal assessment, providing statements of the methods, models and assumptions used in that assessment. In this paper we describe how the hypothetical assessment case was set up and the exercise was conducted, the responses of the participants and the assessments of dose that they made. Finally we discuss the lessons learnt from the exercise and suggest how the exercise may be adapted to a wider range of participants.

Natural variation in 210Po and 210Pb activity concentrations in the urine of Finnish population groups

A study to determine activity concentrations of (210)Pb and (210)Po in the urine of certain Finnish population groups was conducted, to investigate the variation in natural background level of urinary excretion. The study participants were divided into three groups mainly based on their diet. The first group comprised recreational fishermen and the second group represented people consuming more reindeer meat than an average Finn, while people using drinking water with very high activity concentrations of (210)Po were selected for the third group. The fourth group was a control group. The mean urinary excretion of (210)Po in groups 1 and 2 was 73 and 100 mBq d(-1), respectively. These values were higher than the value of the control group (20 mBq d(-1)) and the mean values reported in the literature. The mean daily urinary excretion of (210)Pb in groups 1 and 2, 70 and 52 mBq d(-1), was also slightly higher than that in the control group (32 mBq d(-1)). In contrast, the excretion rates of both (210)Po and (210)Pb for the members of group 3 were one to two orders of magnitude higher than those reported in the literature. This was clearly due to the elevated levels of natural radionuclides in their drinking water. The present study demonstrates the importance of possessing good knowledge of the background levels, in order to allow the determination of the additional exposure due, for example, to the malevolent use of radiation.

The mean concentration of uranium in drinking water, urine, and hair of the occupationally unexposed Finnish working population

Uranium concentrations in the household water, urine, and hair of the occupationally unexposed Finnish working population were determined using inductively coupled plasma mass spectrometry (ICP-MS). The age of the randomly selected participants ranged from 18 to 66 y. The mean concentrations of uranium in water, urine, and hair were 1.25 microg L(-1), 0.016 microg L(-1), and 0.216 microg g(-1), respectively. The mean uranium concentration in hair of the Finnish working population was from 3- to 15-fold higher than the values reported in the literature, while the mean uranium concentration in urine was similar to those measured elsewhere in Europe. The observed large variation in the uranium concentrations in hair and urine can be explained by the variation in the uranium concentration in drinking water. Exceptionally high concentrations have been measured in private drilled wells in the granite areas of Southern Finland.

Development of rapid methods for assessing doses from internally deposited radionuclides

During the initial phases of the National Institute for Occupational Safety and Health Radiation Dose Reconstruction Program, all calculations of organ doses due to internally deposited radionuclides were performed using the Integrated Modules for Bioassay Analysis program. However, limitations associated with this program, including the need to calculate separate internal dose assessments for each radionuclide, created inefficiencies in the processing of claims. As a result, the National Institute for Occupational Safety and Health developed and introduced a suite of tools to expedite the process. The first of these was the Chronic Annual Dose Workbook program. This innovative tool permits a dose reconstructor to calculate, in a single step, an organ dose that involves up to 255 separate intakes in any combination of radionuclides, intake modes, and absorption types. In addition, the program enables dose reconstructors to determine the specific radionuclide characteristics that will deliver the highest organ dose for a specific intake. Furthermore, the results are displayed in a format that is compatible with the Interactive RadioEpidemiological Program, which is used by the U.S. Department of Labor in establishing the probability of causation. The value of the probability of causation, in combination with other information, subsequently enables the U.S. Department of Labor to render a decision on compensability. These developments have played a major role in enabling the dose reconstruction teams to meet the claim processing goals with increased efficiency and accuracy.

Scientific issues in radiation dose reconstruction

Stakeholders have raised numerous issues regarding the scientific basis of radiation dose reconstruction for compensation. These issues can be grouped into three broad categories: data issues, dosimetry issues, and compensation issues. Data issues include demographic data of the worker, changes in site operations over time (both production and exposure control), characterization of episodic vs. chronic exposures, and the use of coworker data. Dosimetry issues include methods for assessment of ambient exposures, missed dose, unmonitored dose, and medical x-ray dose incurred as a condition of employment. Specific issues related to external dose include the sensitivity, angular and energy dependence of personal monitors, exposure geometries, and the accompanying uncertainties. Those related to internal dose include sensitivity of bioassay methods, uncertainties in biokinetic models, appropriate dose coefficients, and modeling uncertainties. Compensation issues include uncertainties in the risk models and use of the 99th percentile of the distribution of probability of causation for awarding compensation. A review of the scientific literature and analysis of each of these issues distinguishes factors that play a major role in the compensation decision from those that do not.

Fitting bioassay data and performing uncertainty analysis with BIOKMOD

We have developed a computer code called BIOKMOD that we have applied to analyze several sources of uncertainties in the evaluation of internal exposures using bioassay data: (1) Multiple constant and random intakes in occupational exposures taking into account periods without intake (weekends, holidays, etc.) are evaluated, and they are compared with chronic intakes showing that the chronic approximation is not always good; (2) An analytical method to evaluate the statistical uncertainties associated with the biokinetic model is described; and (3) Non linear techniques are applied to estimate intakes using bioassay data, where not only the quantities taken in are assumed unknown but also other non linear parameters (AMAD, f1, etc). The methods described are accompanied with examples. Some of the most usual features of BIOKMOD can be run directly, using BIOKMODWEB, at the Web site: http://www3.enusa.es/webMathematica/Public/biokmod.html .

Radioactive aerosols released from the Chernobyl Shelter into the immediate environment

The release of radioactive particles through large gaps in the containment of the destroyed Chernobyl reactor was assessed during two measurement periods. In 1996-1999, a total radionuclide flow rate of 274 Bq s(-1) or 8.64 x 10(9) Bq year(-1) was determined. These releases were predominantly due to (137)Cs (78.5%), (90)Sr (21.1%), and (239+240)Pu (0.4%). The mean activity concentration in the aerosol measured directly at the gaps was about 240 mBq m(-3) with an activity median aerodynamic diameter (AMAD) of 2.4 microm for (137)Cs, 120 mBq m(-3) with an AMAD in the range 3.1-13 microm for (90)Sr, 1.8 mBq m(-3) with an AMAD in the range 3.5-11 microm for (239+240)Pu, and 2.0 mBq m(-3) with an AMAD of 1.5 microm for (241)Am. The resulting total inhalation dose rate calculated close to the gaps was about 100 nSv h(-1). In the near environment, the mean (137)Cs activity in the aerosol was 2.2 mBq m(-3) with an AMAD of 2.2 microm, which gave rise to an inhalation dose rate of about two orders of magnitude lower than the corresponding dose rate at the gaps. Occasionally, however, dose levels were measured in the near environment that were similar to those at the gaps. In 2000-2003, lower activity concentrations were observed. The decrease was more pronounced at the gaps than in the near environment. The results indicate that effective dose due to inhalation must be considered for the dose assessment of construction workers who will be deployed at the Chernobyl site to reconstruct the old or to build the new Shelter, in the future.

Obtaining an unbiased estimate of intake in routine monitoring when the time of intake is unknown

A common problem in internal dosimetry occurs in routine monitoring, when it is required to estimate an intake from a measurement made at the end of a monitoring interval, and the time of intake is unknown. ICRP suggests that, in these cases, it should be assumed that the intake occurred in the middle of the monitoring period. However, it has been shown that this will, in the long term, lead to biased estimates of a worker's intake and dose. In order to overcome this biasing, the United States Department of Energy (USDOE) recommends a different method based on calculating the intakes for all possible intake-times in the interval, and then taking an arithmetic average. In this paper, it is shown that both the ICRP and USDOE methods are biased. An alternative method is suggested, which assumes a constant chronic intake throughout the monitoring interval. Monte Carlo simulations are used to estimate the magnitude of bias for two realistic monitoring programmes using all three methods. It is shown that the proposed method is unbiased and also yields estimates of intake that are generally closer to the actual intake, than the other two. The Monte Carlo conclusions are backed up by a theoretical analysis of bias. Finally, the source of bias in the apparently intuitive approach of the USDOE method is revealed by viewing the problem from a Bayesian perspective.

Unexpectedly high activity of 228Th in excretion samples following consumption of Brazil nuts

A worker provided a routine faecal sample for plutonium and americium analysis. In the course of this analysis 500 mBq of (228)Th was discovered. There seemed no credible occupational route for intake of thorium. Further investigation revealed that the worker consumed approximately 25 g d(-1) of nuts, including Brazil nuts. A sample of these nuts was analysed and found to contain activities of (228)Th in sufficient quantity to account for the faecal activity. However, follow-up urine samples taken from the worker showed 0.6-0.7 mBq of (228)Th. The intake of (228)Th via nuts is insufficient to account for this activity in urine. However, it is likely that the intake of (228)Th was accompanied by similar activity of the parent (228)Ra, and biokinetic calculations show that decay of (228)Ra in vivo would produce sufficient (228)Th to account for the observed urine activity.

Biokinetic modeling of uranium in man after injection and ingestion

Uranium is a naturally occurring primordial radioactive element. Small amounts found in air, water, and food are regularly consumed and inhaled by humans. Even the military, medical, and industrial use of depleted uranium can affect humans. There is an appreciable retention of incorporated uranium in skeleton, kidneys, and liver, and a review of respective effective dose coefficients has been given by the International Commission on Radiological Protection (ICRP) in its "Publication 69"; however, data regarding retention in organs or tissues and rates of urinary and fecal excretion for different age groups are incomplete. Therefore, the present study provides retention data that have been calculated for uranium in all compartments and for urinary and fecal excretion, following acute and chronic injection and ingestion for six age groups. The calculations are based on the current ICRP biokinetic model for uranium, and the data can be plotted by using any mathematical software to obtain the retention data at any time after incorporation or to calculate the internal average organ dose induced by uranium provided that specific absorbed fractions are available. The dynamic relationship of the retention in plasma and blood after intravenously and orally administered uranium can easily be derived from the database for injection and ingestion. The calculated contents of uranium in organs or tissues (using the uranium concentration in foodstuffs published by UNSCEAR for Europeans) are compared with autopsy data available in the literature. According to this model, the whole body of a 75-year-old man contains 7 microg uranium, of which 76% is in the skeleton, 1% in the kidneys, and 2.1% in the liver.

A step-by-step procedure to aid the assessment of intake and doses from measurement data

The interpretation of bioassay data to assess intakes and doses depends not only on the biokinetic model used but also on the choice of parameter values made by the assessor. Therefore, it is understandable that different assessors will draw different conclusions from the same datasets even if the same models are used. A systematic step-by-step procedure is proposed for the assessment of cases with comprehensive data in which the time of intake is known. The aims are to promote harmonisation of dose assessments and to assist in obtaining the best available assessment of intake and dose from the monitoring data. The procedure is illustrated by means of an example reported recently in the literature. The case which involves a 6 y follow-up of a subject who inhaled (241)Am, is somewhat unusual in that there are comprehensive in vivo measurements, but few excretion data. The rate at which activity is absorbed from lungs to blood can be one of the largest sources of uncertainty in any inhalation assessment, and significantly improved fits to the measurement data were obtained by choosing appropriate values for the relevant parameters. 'The best estimate' of the resulting effective dose in this case was higher by a factor of approximately 2 or 3, respectively, than those obtained assuming ICRP default values for Type M or Type S.