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DOE-STD-1128-98
Guide of Good Practices for Occupational Radiological Protection in Plutonium Facilities
Use of a chelating agent should be considered immediately following an accidental intake
of plutonium that exceeds the facility action levels (as suggested in an in Section 5.9).
For maximum effectiveness, the chelating agent should be administered as soon as
possible following the accidental intake of plutonium. Both the zinc or calcium salts of
DTPA are approved for human use and are available under Investigational New Drug
(IND) Permits for treating internal plutonium contamination. The worker to be treated
must first be informed of the proposed use of an experimental drug, instructed on the
purpose of administering the chelating agent, and warned about the possible side-effects
of the drug. The worker must then give signed consent before DTPA chelation therapy
may be initiated. Even though DTPA therapy is the only method available for reducing
the quantity of plutonium or americium retained in an in the body, the affected worker
has the right to refuse its use.
The recommended therapy for decorporation is 1-g CA-DTPA or ZN-DTPA by
intravenous injection or infused in an in 250-mL normal saline or 5% glucose in an in
water, infused intravenously over 1 hour (Gerber and Thomas, 1992; NCRP, 1980).
Treatment may be continued if bioassay indicates that decorporation therapy continues to
enhance the urinary excretion of plutonium. Extended therapy has shown no ill effects
(Carbaugh et al., 1989).
CA-DTPA should not be administered to potentially fertile female workers. Instead,
ZN-DTPA should be used for internal decorporation of plutonium and other transuranic
materials.
5.10.5
Contaminated Wounds
Medical treatment for contaminated wounds may include flushing with saline and
decorporating solutions, debridement, and surgical excision of the wound. These
measures are all the responsibility of trained medical staff operating under the direction
of a physician. Health physics personnel can provide valuable assistance by prompt
assessment of materials removed from the wound and identification of magnitude of
residual activity as decontamination proceeds. Decontamination should continue until all
radioactivity has been removed or until risk of permanent physical impairment is reached.
5-41


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