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Table 5.7. Plutonium or 241Am Indicator Levels for Internal Dosimetry Evaluation - doe-std-1128-98_ch10146
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DOE Standard Guide of Good Practices for Occupational Radiological Protection In Plutonium Facilities
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Response to Suspected Intakes cont'd - doe-std-1128-98_ch10148


DOE-STD-1128-98
-- When the estimated intake exceeds 10 times the ALI, then extended or protracted
treatment should be implemented, except for materials poorly transported from the
lung.
-- For poorly transported material in the lung, lung lavage is the only recommended
treatment, and it is only a consideration for intakes exceeding 100 times the ALI.
Because the dose associated with the ALI in the CEC/DOE Guidebook is 2-rem CEDE and
because the upper administrative level recommended by the standard, Radiological Control,
is 2 rem, intervention levels of 2 rem and 20 rem might be used for guidance in the manner
presented in the CEC/DOE Guidebook:
-- When the CEDE estimated intake is below 2 rem, treatment is not generally
recommended.
-- When the CEDE for an estimated intake is between 2 rem and 20 rem, treatment should
be considered. Under these situations, short-term administration will usually be
appropriate.
-- When the CEDE equivalent for an estimated intake exceeds 20 rem, then extended or
protracted treatment is strongly recommended, except for poorly transported material in
the lung.
Decorporation therapy should be administered immediately following any suspected intake
or accidental internal contamination in excess of established action levels. The extent and
magnitude of an internal plutonium contamination usually cannot be determined quickly;
however, the usefulness of therapy will diminish if plutonium is allowed to translocate to
bone where DTPA is ineffective. La Bone (1994b) has provided a recent approach to
evaluating urine data enhanced by chelation (DTPA) therapy.
An initial prophylactic chelation therapy may be appropriate because bioassay
measurements (particularly urinalysis) cannot usually be completed within the response
time required for effective chelation therapy. Urinalysis becomes very helpful following
administration of chelation therapy because there is a direct correlation between DTPA,
urinary excretion, and dose averted because of plutonium excreted. Bihl (1994) has shown
that about 2 mrem of CEDE is averted for every dpm of 239Pu excreted. This provides a
method of measuring the effectiveness of DTPA therapy and determining if it is worthwhile
to continue therapy. For example, if DTPA is administered when untreated excretion is 2
dpm/d, excretion should increase to 20 to 100 dpm for a dose savings of 40- to 200-mrem/d
CEDE. It is probable that the efficacy of treatment will decrease with continued
administration as plutonium is removed from the liver and the rate of transfer into the
systemic compartment decreases.
5.10 RESPONSE TO SUSPECTED INTAKES
Experience has shown that most intakes of plutonium are accidental. Plutonium facilities
and operating procedures are designed to prevent intakes. Nonetheless, it is important for
management to prepare for the possibility that workers might receive an intake of
plutonium--even though the probability of an incident may be very small. Prompt and
appropriate action following an accidental intake of plutonium will allow for therapeutic
measures to be taken to minimize the internal contamination and lessen the potential for
5-37


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