Response to Suspected Intakes - STD-1128-98master0159

DOE-STD-1128-98

Guide of Good Practices for Occupational Radiological Protection in Plutonium Facilities

-- For poorly transported material in an 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 an 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 an in the manner presented in

an 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 an in the lung.

Decorporation therapy should be administered immediately following any suspected intake or

accidental internal contamination in an 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

239

Pu 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

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