Table 5 -16. Uranium Contamination Levels for Notification of Occupational Medicine Physician

DOE-STD-1136-2004

Guide of Good Practices for Occupational Radiological Protection in Uranium Facilities

Table 5 -16. Uranium Contamination Levels for Notification of Occupational Medicine

Physician

Medical Notification Level

Indicator

(dpm)

Nasal or mouth smears

1,000

Facial contamination

25,000

Skin breaks or wounds

100

The decision to administer treatment and the treatment protocol are solely the responsibilities of the

physician in charge. The basic principle is that the proposed intervention should do more good than harm

(Gerber and Thomas 1992).

Guidelines for the medical intervention of a radionuclide intake can be found in several publications.

NCRP Report No. 65 (NCRP 1980) and the joint publication of the Commission on European

Communities (CEC) and the DOE Guidebook for the Treatment of Accidental Internal Radionuclide

Contamination of Workers (Gerber and Thomas 1992) both contain detailed guidance in intervention and

medical procedures useful in mitigating radiation overexposures. The CEC/DOE Guidebook has been

based on the ALI for action levels, rather than on CEDE, to overcome the proble m of uncertainties in dose

per unit intake. The ICRP recommends in Publication 60 a limit of 2-rem/y (20-mSv/y) on effective dose.

Thus, the ALIs found in ICRP Publication 61 (1991b) and used in the CEC/DOE Guidebook noted above

are those which would provide a CEDE of 2-rem/y instead of current U.S. regulations of 5-rem/y.

Guidance in the CEC/DOE Guidebook can be summarized as follows:

When the estimated intake is below 1 ALI, treatment should not be considered.

When the estimated intake is between 1 and 10 times the ALI, treatment should be considered.

Under these situations, short-term administration will usually be appropriate, except for intake of

materials poorly transported from the lung (class Y).

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 control level suggested by the RCS 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.

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