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Environmental Medicine: Integrating a Missing Element into Medical Education
Radiation contamination caused by a transportation accident
You are a physician on duty in the emergency department of a hospital in a community of approximately 40,000 residents. At 7:45 A.M. you receive notification of a vehicular accident about 4 miles northeast of the city. A truck carrying radioactive material struck a guard rail and rolled 200 feet down an embankment. The truck, which came to rest at a point about 15 feet from the river bank, is on fire. The driver of the truck has minor burns on his hands and a deep laceration of the scalp; he is conscious but somewhat confused and incoherent. His assistant, a passenger in the truck, has second-degree burns on his hands and a simple fracture of his lower left leg.
A member of the highway patrol, who was first on scene and noticed the radioactivity placard on the truck, contacted a health physicist from the regional office of the Department of Energy. The health physicist found that the driver of the truck and his assistant are externally contaminated with the radioactive material, which is emitting beta and gamma radiation. The health physicist also detected radioactive contamination along the truck’s path as it rolled down the embankment. Three ruptured containers of radioactive material were found near the truck; it is believed that their contents may have entered the river. The community you serve relies on the river for drinking water, as well as for recreational activities.
State police have rerouted traffic and placed road blocks at all points within a 3-mile radius of the accident. However, a young boy whose family is vacationing on a houseboat about 20 yards from the site where the truck came to rest, is known to have approached the scene immediately after the accident occurred. The highway patrol is attempting to locate the boy.
(a) Where could you obtain consultation on treatment and management of persons contaminated with radioactivity?
(d) If the radioactive material entered the river and consisted of aqueous potassium iodide, what steps could be taken to protect the residents of your community who rely on the river for drinking water? Would these steps differ if the radioactive waste consisted of cesium-137 in solution?