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17 Medical Response
17.7 Radioactive Decedents
In any other than the most minor attacks people are going to die, whether killed by
the blast or dying later from their injuries. It is inevitable that some decedents will
be contaminated or might even contain embedded radioactive fragments and it is
important that they be handled both respectfully and safely. To that end, guidance on
this matter has been developed [6, 24], to help physicians, medical examiners, and
mortuary workers to do their work while remaining safe.
The NCRP report #161 [24] begins with a reminder that any bodies found at
the scene of an attack should not be moved or decontaminated, and their clothing
or personal effects should not be examined until they have been photographed and
examined by the Medical Examiner or members of the Medical Examiner’s staff.
They also recommend labeling the bodies and body bags with the radiation symbol
and, if possible, storing them in a field morgue to minimize contamination of facilities,
although those that have low levels of contamination can be sent to fixed facilities
for examination.
The primary radiation safety concerns are radiation and contamination from the
bodies being examined. Contamination can place constraints on the manner in which
work is done; specifically, high levels of contamination can call for workers to wear
appropriate personal protective equipment and to need to survey themselves, as well
as requiring surveys of the body and the examination room during and after each
autopsy. But contamination in and of itself does not normally pose a health risk. The
CDC also notes that placing the body bag inside a plastic container after removing
it from the scene can help to contain any contamination that might be on the exterior
of the body bag.
Radiation is not normally expected to be dangerously high from contamination
alone, but embedded fragments of radioactive materials might be. For example,
consider a Co-60 source set on top of high explosives. Cobalt-60 sources are usually
comprised of a solid piece of metal alloy; when the metal is hit with a shock wave,
pressure, and high temperatures it can spall or break into multiple pieces and any of
these pieces can fly off and become embedded in a bystander to the explosion. If the
source fragment contains a relatively large amount of radioactivity the ensuing radiation levels can pose a risk to the medical examiner while lower-activity fragments
can cause high local radiation dose to the fingers and hands of personnel working
in close proximity or handling the sources. For this reason, the medical examiner
(or a radiation safety professional) should perform a quick survey of any remains
with elevated dose rates to locate any embedded fragments so they can be removed,
shielded, and stored for future disposal.
If possible, all remains should be surveyed in the field before moving them or
at the field morgue to detect the presence of any high-activity radioactive materials
(e.g. sources or source fragments) that might pose a risk to medical examiners and/or
mortuary personnel. Any such sources or source fragments that are found should
be removed and placed into a shielded container if possible; if removing them is
not possible then the remains should be labeled with the radiation symbol and, if
17 Medical Response
17.7 Radioactive Decedents
In any other than the most minor attacks people are going to die, whether killed by
the blast or dying later from their injuries. It is inevitable that some decedents will
be contaminated or might even contain embedded radioactive fragments and it is
important that they be handled both respectfully and safely. To that end, guidance on
this matter has been developed [6, 24], to help physicians, medical examiners, and
mortuary workers to do their work while remaining safe.
The NCRP report #161 [24] begins with a reminder that any bodies found at
the scene of an attack should not be moved or decontaminated, and their clothing
or personal effects should not be examined until they have been photographed and
examined by the Medical Examiner or members of the Medical Examiner’s staff.
They also recommend labeling the bodies and body bags with the radiation symbol
and, if possible, storing them in a field morgue to minimize contamination of facilities,
although those that have low levels of contamination can be sent to fixed facilities
for examination.
The primary radiation safety concerns are radiation and contamination from the
bodies being examined. Contamination can place constraints on the manner in which
work is done; specifically, high levels of contamination can call for workers to wear
appropriate personal protective equipment and to need to survey themselves, as well
as requiring surveys of the body and the examination room during and after each
autopsy. But contamination in and of itself does not normally pose a health risk. The
CDC also notes that placing the body bag inside a plastic container after removing
it from the scene can help to contain any contamination that might be on the exterior
of the body bag.
Radiation is not normally expected to be dangerously high from contamination
alone, but embedded fragments of radioactive materials might be. For example,
consider a Co-60 source set on top of high explosives. Cobalt-60 sources are usually
comprised of a solid piece of metal alloy; when the metal is hit with a shock wave,
pressure, and high temperatures it can spall or break into multiple pieces and any of
these pieces can fly off and become embedded in a bystander to the explosion. If the
source fragment contains a relatively large amount of radioactivity the ensuing radiation levels can pose a risk to the medical examiner while lower-activity fragments
can cause high local radiation dose to the fingers and hands of personnel working
in close proximity or handling the sources. For this reason, the medical examiner
(or a radiation safety professional) should perform a quick survey of any remains
with elevated dose rates to locate any embedded fragments so they can be removed,
shielded, and stored for future disposal.
If possible, all remains should be surveyed in the field before moving them or
at the field morgue to detect the presence of any high-activity radioactive materials
(e.g. sources or source fragments) that might pose a risk to medical examiners and/or
mortuary personnel. Any such sources or source fragments that are found should
be removed and placed into a shielded container if possible; if removing them is
not possible then the remains should be labeled with the radiation symbol and, if