Response to Suspected Intakes cont'd - doe-std-1128-98

DOE-STD-1128-98

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

of plutonium.

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

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