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Suggested Citation:"Front Matter." National Research Council. 2008. Radiation Source Use and Replacement: Abbreviated Version. Washington, DC: The National Academies Press. doi: 10.17226/11976.
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Suggested Citation:"Front Matter." National Research Council. 2008. Radiation Source Use and Replacement: Abbreviated Version. Washington, DC: The National Academies Press. doi: 10.17226/11976.
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Suggested Citation:"Front Matter." National Research Council. 2008. Radiation Source Use and Replacement: Abbreviated Version. Washington, DC: The National Academies Press. doi: 10.17226/11976.
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Suggested Citation:"Front Matter." National Research Council. 2008. Radiation Source Use and Replacement: Abbreviated Version. Washington, DC: The National Academies Press. doi: 10.17226/11976.
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Committee on Radiation Source Use and Replacement Nuclear and Radiation Studies Board Division on Earth and Life Studies

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by U.S. Nuclear Regulatory Commission under grant # NRC-04-06- 069. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number-13: 978-0-309-11014-3 International Standard Book Number-10: 0-309-11014-9 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. Copyright 2008 by the National Academy of Sciences. All rights reserved. Printed in the United States of America.

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

COMMITTEE ON RADIATION SOURCE USE AND REPLACEMENT THEODORE L. PHILLIPS (Chair), University of California, San Francisco EVERETT BLOOM, University of Tennessee, Knoxville DAVID R. CLARKE, University of California, Santa Barbara LEONARD W. CONNELL, Sandia National Laboratories, Albuquerque, New Mexico ROBIN GARDNER, North Carolina State University, Raleigh C. RICHARD LIU, University of Houston, Texas RUTH MCBURNEY, Conference of Radiation Control Program Directors, Austin, Texas ERVIN B. PODGORSAK, McGill University, Montréal, Québec, Canada TOR RAUBENHEIMER, Stanford Linear Accelerator Center, Palo Alto, California STEPHEN WAGNER, American Red Cross, Rockville, Maryland DAVID L. WEIMER, University of Wisconsin at Madison NUCLEAR AND RADIATION STUDIES BOARD LIAISON SUSAN LANGHORST, Washington University in St. Louis, Missouri (September 2006 to December 2006) ANDREW M. SESSLER, E.O. Lawrence Berkeley National Laboratory, Berkeley, California (January 2007 to August 2007) Staff MICAH D. LOWENTHAL, Study Director FEDERICO SAN MARTINI, Program Officer TRACEY BONNER, Program Assistant (October 2006 to March 2007) MANDI M. BOYKIN, Senior Program Assistant (April 2007 to April 2008) MARILI ULLOA, Senior Program Assistant (May 2006 to September 2007) iv

NUCLEAR AND RADIATION STUDIES BOARD RICHARD A. MESERVE (Chair), Carnegie Institution, Washington, DC S. JAMES ADELSTEIN (Vice Chair), Harvard Medical School, Boston, Massachusetts JOEL S. BEDFORD, Colorado State University, Fort Collins SUE B. CLARK, Washington State University, Pullman ALLEN G. CROFF, Oak Ridge National Laboratory (retired), Oak Ridge, Tennessee SARAH C. DARBY, Clinical Trial Service Unit (CTSU), Oxford, United Kingdom JAY C. DAVIS, Lawrence Livermore National Laboratory (retired), Livermore, California ROGER L. HAGENGRUBER, University of New Mexico, Albuquerque PAUL A. LOCKE, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland BORIS F. MYASOEDOV, Russian Academy of Sciences, Moscow, Russia JOHN C. VILLFORTH, Food and Drug Law Institute (retired), Gaithersburg, Maryland PAUL L. ZIEMER, Purdue University (retired), West Lafayette, Indiana Staff KEVIN D. CROWLEY, Director NAOKO ISHIBE, Program Officer MICAH D. LOWENTHAL, Senior Program Officer JOHN R. WILEY, Senior Program Officer TONI GREENLEAF, Administrative and Financial Associate LAURA D. LLANOS, Administrative and Financial Associate MANDI M. BOYKIN, Senior Program Assistant COURTNEY GIBBS, Senior Program Assistant SHAUNTEÉ WHETSTONE, Senior Program Assistant JAMES YATES, JR., Office Assistant v

REVIEWERS This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures approved by the National Research Council’s Report Review Committee. The purposes of this review are to provide candid and critical comments that will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following for their participation in the review of this report: Ahmed Badruzzaman, Chevron Corp. and University of California, Berkeley Anthony Berejka, Ionicorp+ Joel Bedford, Colorado State University Barbara Bierer, Brigham and Women’s Hospital Paul Fischbeck, Carnegie Mellon University Gregory Van Tuyle, Los Alamos National Laboratory Karl Hemmerich, Steris Isomedix, Inc. William Hendee, Wisconsin College of Medicine Joel Lubenau, private consultant Richard Meserve, Carnegie Institution of Washington and Nuclear and Radiation Studies Board of the National Research Council John Poston, Texas A&M University Bruce Thompson, Iowa State University Raymond Wymer, Oak Ridge National Laboratory (retired) Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse, nor did they see the final draft of, the report before its release. The review of this report was overseen by Louis Lanzerotti, New Jersey Institute of Technology, and Thomas Budinger, University of California at Berkeley. Appointed by the National Research Council, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the National Research Council. vii

PREFACE On September 11, 2001, terrorists turned passenger airliners in New York, Washington, and Pennsylvania into weapons, killing not only those onboard, but also thousands of people working in office buildings and many of those who tried to rescue them. The perverse success of those attacks has forced the nation to contemplate the possibility that other technologies that were designed, and are used, solely for the benefit of society—to treat and cure illness, to prevent infection, illness, and disease, to improve safety in industrial equipment, and to help obtain resources that we rely on every day—could be used maliciously against us. The U.S. Congress requested this study as part of a set of actions to improve the nation’s security against attacks that might use radiation sources. The committee had this in mind throughout the study. The committee’s charge from the Congress was to evaluate technologies and make recommendations on options for implementing those technologies. Risk considerations were at the center of this task: What are the high-risk sources? What makes them hazardous? Would implementing replacements reduce risks? So, as the committee set out to hear from experts on the radiation source applications, the committee also examined the hazards associated with the radiation sources, including both accidents and malevolent acts. Policy makers will seek to balance among alternative technologies, physical security measures, tracking and accounting, and intelligence and law enforcement operations to prevent or mitigate the consequences of a radiological attack. In this report, the committee offers its recommendations on replacements for high-risk radiation sources, including priorities among the sources, and options for implementing those replacements. In carrying out the study, the committee was cognizant of the broad array of people and institutions that use and benefit from the use of radionuclide radiation sources, and that would be affected by the committee’s recommendations. The committee met with practitioners and researchers in the relevant fields, talked with radionuclide source manufacturers and providers of alternatives or replacements for the sources, and visited facilities that use the radiation sources. The committee also talked, to some extent, to the customers for the services provided. The recommendations in this report, and indeed any moves for replacement of radionuclide radiation sources, will affect those people and institutions to varying degrees and in different ways. It is the committee’s hope that any actions for implementation of replacements will consider the input from the people and institutions affected, because those people and institutions are providing important services to society, have a stake in the outcomes, and are likely to benefit or suffer the most from the government’s actions. Readers who examine this report thoroughly will notice that the task statement explicitly requests an evaluation of worker hazards from technologies meant to replace the current high- risk radiation sources, and the report discusses these hazards only briefly (see, e.g., Chapter 4 and Chapter 6). This is not an oversight. The committee devoted little of the report to this topic because the most common replacement technologies, electron accelerators, and the high-risk radiation sources pose similar radiation hazards while the accelerator is operating, and the accelerators operating at energies below 10 MeV pose fairly insignificant radiation hazards when they are not operating. Further, these matters are already covered well in other reports (see especially NCRP, 2005). Readers might desire to see more on the costs and time lines for readiness of replacement technologies. These are discussed for many, but not all, replacements. In this case, more extensive discussion and detail were not included because the data available to the committee do not support saying more. ix

Throughout the study the committee benefited from the input of people who manufacture, use, and regulate the radiation source devices and their potential replacements. The committee thanks Bob Adolph, Mike Ault, Lester Boeh, Les Braby, Kevin Brooks, Ian Brown, Greg Budner, Tom Chadwick, Marshall Cleland, David Coppell, Mike Creech, Kirsten Cutler, Jim Dempsey, Donny Dicharry, Brian Dodd, Patricia Eifel, James Elrod, Hugh Evans, Tara Federici, Michal Freedhoff, Peter Fundarek, Colette Germain, Allen Gilchrist and Baker Hughes Incorporated, Michael Gillin, Paul Gray, Dave Hall, Sally Hamlin, Barbara Hamrick, Patricia K. Holahan, Merri Horn, Bob Irwin, Ramzi Jammal and the Canadian Nuclear Safety Commission, Carol Jantzen, Slobodan V. Jovanovic, Randol Kirk, Ken Koziol, Steve Laflin, Ann Lawyer, Benjamin Lichtiger, Glenn Light, Mick Lord, Grant Malkoske and MDS Nordion, John Masefield, Joseph E. Maxim, Ray Meyn, Radhe Mohan, Aaron Morrison, Paul Moses, Boris Myasoedov, Wayne Norwood, Pearce O’Kelley, Mike Pearson, Vladimir Pet’kov, Brendan Plapp, Jay Poston, Karl Prado and the M. D. Anderson Medical Center, André Régimbald, Robert Rushton, Ward Schultz, J. L. and Mary Shepherd, Mark Shilton, Almon Shiu, Mark Smith and Sterigenics, Inc., Mickey Speakmon, Makuteswara Srinivasan, Chris Stoller, Orhan Suleiman, Peggy Tinkey, David Tiktinsky, Chuck Vecoli, Mark Vist, Bill Ward, Tom Wasiak, Ruth Watkins, Richard Wiens, Shiao Woo, and Otto Zeck and Memorial Hermann Hospital. These people were generous with their time, information, and advice. The committee would specifically like to acknowledge the support provided by the U.S. Nuclear Regulatory Commission (U.S. NRC) staff, especially the committee liaison, Tony Huffert, and his office director, Brian Sheron, who made efforts throughout the study to ensure that the U.S. NRC provided what it could to assist the committee in fulfilling its task. Finally, the committee thanks its staff: Mandi Boykin, Tracey Bonner, and Marili Ulloa were responsible for the care and feeding of the committee; Kevin Crowley and Federico San Martini made important contributions at key points in the study; and Micah Lowenthal provided the guidance, coordination, and various kinds of support the committee needed to get the job done well. They were all important to the successful completion of the study, and we are grateful to them for their help and support. Prior to public release, and as required under the terms of the grant for this study, the report was sent to the U.S. NRC in August 2007 for security classification review. The agency determined that the report contained information that is exempt from public release under 5 U.S.C. § 552(b). In late January 2008, the National Research Council and the U.S. NRC reached agreement that this abbreviated version could be released to the public without restriction. The findings and recommendations remain substantively unchanged from the full version, which has been provided to the government. During the security classification review the U.S. NRC also provided additional non-security-related comments on the report. The National Research Council made some factual corrections and revised wording to improve clarity in the report in response to those comments (but made no other substantive changes) and consulted with its Report Review Committee about the nature of these changes. While this abbreviated report was being readied for release, the committee was informed that the U.S. NRC has begun exploring options to address some of the concerns raised in the report. Although the committee has not received detailed information about the U.S. NRC’s actions, the committee commends the U.S. NRC for these explorations and encourages the government to take steps that will facilitate replacement of high-risk radiation sources and improve radiation source safety and security. Theodore L. Phillips, Chair Committee on Radiation Source Use and Replacement x

CONTENTS EXECUTIVE SUMMARY 1 SUMMARY 3 1. INTRODUCTION 13 2. RADIATION SOURCES IN THE UNITED STATES AND THEIR USES AND ORIGINS 23 3. RADIATION SOURCE RISKS 43 4. ACCELERATOR AND DETECTOR TECHNOLOGIES 67 5. SELF-CONTAINED IRRADIATORS 85 6. PANORAMIC IRRADIATORS 101 7. RADIOTHERAPY 117 8. INDUSTRIAL RADIOGRAPHY 135 9. WELL LOGGING 147 10. IMPLEMENTATION OPTIONS FOR ENCOURAGING REPLACEMENT OF RADIONUCLIDE RADIATION SOURCES WITH ALTERNATIVES 159 REFERENCES 175 APPENDIXES A. BIOGRAPHICAL SKETCHES OF COMMITTEE MEMBERS 189 B. BACKGROUND ON THE ATOM, RADIOACTIVE DECAY, RADIATION, AND RADIATION DOSE DEPOSITION 193 C. GLOSSARY 209 D. INFORMATION-GATHERING MEETINGS 217 xi

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In the United States there are several thousand devices containing high-activity radiation sources licensed for use in areas ranging from medical uses such as cancer therapy to safety uses such as testing of structures and industrial equipment. Those radiation sources are licensed by the U.S. Nuclear Regulatory Commission and state agencies. Concerns have been raised about the safety and security of the radiation sources, particularly amid fears that they could be used to create dirty bombs, or radiological dispersal device (RDD). In response to a request from Congress, the U.S. Nuclear Regulatory Commission asked the National Research Council to conduct a study to review the uses of high-risk radiation sources and the feasibility of replacing them with lower risk alternatives. The study concludes that the U.S. government should consider factors such as potential economic consequences of misuse of the radiation sources into its assessments of risk. Although the committee found that replacements of most sources are possible, it is not economically feasible in some cases. The committee recommends that the U.S. government take steps to in the near term to replace radioactive cesium chloride radiation sources, a potential "dirty bomb" ingredient used in some medical and research equipment, with lower-risk alternatives. The committee further recommends that longer term efforts be undertaken to replace other sources. The book presents a number of options for making those replacements.

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