Radiation risksCesium chloride blood irradiators increase dirty bomb risk

Federal officials want to halt the use of blood irradiators used by hospitals and blood centers to ensure that blood is properly treated before transfusions occur. The irradiation devices contain cesium chloride, a highly radioactive powder which terrorists could use to make a dirty bomb.

“If we could make headway on this — if you could get all the cesium chloride off the market — it would be permanent risk reduction,” said Charles Ferguson, president of the Federation of American Scientists.

Cesium chloride is derived from cesium-137, a by-product of nuclear fission. In blood irradiators, it is compressed into stainless steel capsules but when released into the atmosphere, cesium chloride can cause radiation sickness, burns, and death. An accidental exposure in Brazil in 1985 killed four people and left 249 others contaminated. The contamination required 112,000 people to be monitored for adverse health effects.

A 2008 report by the National Academy of Sciences recommended stopping the licensing of new cesium chloride radiation sources, thereby encouraging the adoption of alternative sources with a less dispersible form of radioactive cesium, including cobalt-60 or X-ray irradiators.

The Boston Globe reports that some members of the medical industry are reluctant to discontinue the use of relatively low cost blood irradiators that can last up to thirty years and require little maintenance, and replace them with more expensive devices which are safer but considered less reliable. X-ray irradiators, the method preferred by Energy Department (DOE) officials, can cost up to $2 million each, not including maintenance costs.

“X-ray irradiators break with regular abandon, so of course you have to buy two,” said Dr. Jed Gorlin, vice president of medical and quality affairs at Innovative Blood Resources, and an adviser to AABB, formerly known as the American Association of Blood Banks. Blood banks are worried that even a temporary loss of service with X-ray irradiators would “have a dramatic impact on the standard of care that is provided to the most seriously ill patients,” according to a recent paper from AABB.

A DOE internal panel recently concluded that the United States is behind Japan, France, Canada, Germany, Italy, Norway, Sweden, and the United Kingdom in eliminating cesium chloride-based blood irradiators and adopting X-ray irradiators. Now officials are working to phase out blood irradiators used by hospitals and blood banks, and federal grants are being offered to speed up the process.

Massachusetts, along with Pennsylvania, Texas, and California are states with the largest number of radiological medical materials which are considered lethal and vulnerable to theft. More than $11 million have been spent at twenty-five facilities in Massachusetts on upgrading security for radiological devices, according to the Government Accountability Office (GAO). GAO investigators recently detailed a series of security mishaps around the country where blood irradiators were vulnerable to theft. One hospital stored research irradiators in a basement open to the public, and one of the irradiators was kept on a wheeled pallet.

“Yet even if hospitals replace blood irradiators with alternative devices, there is no practical way of disposing of the cesium irradiator,” said Gorlin. “And Congress shows no ability to have radiological medical disposal sites. I think government incentives would be fantastic.”

The American Red Cross has voiced its support of the transition to X-ray irradiators. “It is FDA-cleared and it has been for a long time and they have been in use in blood banks,” said Stephen Wagner, a biophysicist and director of the blood component department at the Red Cross’ Jerome H. Holland Laboratory in Rockville, Maryland. “I think that they are equivalent. But there are still some concerns about significant downtime (with X-ray irradiators) that companies will have to address.”