harmful effects. The health physicist and medical staff should work closely to ensure that
the proper course of action is followed.
All employees suspected of having received an intake of plutonium should be referred for
special bioassay measurements. Because a fraction of an intake by inhalation may be
retained in the nasal passages for a few hours after exposure to airborne radioactive
materials, any level of contamination on a nasal swab indicates an intake that should be
followed up by a special bioassay measurement program. However, lack of detection on
nasal smears cannot be taken as evidence that an intake did not occur either because the
nasal passages can be expected to clear very rapidly or, alternatively, because the worker
could be a mouth-breather. Special bioassay should also be initiated if plutonium
contamination is found on the worker in the vicinity of nose or mouth.
For acute intakes, direct bioassay measurements should be taken before, during, and after
the period of rapid clearance of activity. Urine and fecal samples collected after known or
suspected inhalation incidents should also be used to estimate the magnitude of the intake.
Initial assessment of intakes from contaminated wounds are based primarily on wound
count and urinalysis data.
If a significant intake is indicated, the worker should not return to further potential
exposure to plutonium until the intake has been thoroughly assessed and a predictable
bioassay pattern established. This is particularly important because a new intake of a very
low level may confound the interpretation of bioassay measurements for previous intakes
The health physicist must make important decisions for prompt action at the site of an
accidental or suspected intake of plutonium or other radioactive materials. Often, these
decisions must be based on limited data. Information that may be available for initially
estimating the amount and type of intake may include the following:
-- levels of measured contamination in the work area
-- skin contamination levels, affected areas, and whether the skin is damaged or punctured
-- wound contamination levels
-- chemical form of the material involved
-- results of air monitoring