Historical Prologue

1. In the Beginning

2. The Discovery of Invisible, Unbelievably Energetic Radiations

3. The Development of a Radiation Technology

4. The Need for Radiation Protection

PART ONE: ENERGY--THE UNIFYING CONCEPT IN RADIATION PROTECTION

1. Radiation's Dual Identity

2. Energy Relationships in the Hydrogen Atom

3. Energy Levels in Atoms with Higher Z

4. Energy Levels in Molecules

5. Energies of Motion Associated with Temperature

6. Bonding Energies

7. Energy from Mass--The Ultimate Energy Source

8. Some Interesting Energy Values

PART TWO: PRINCIPLES OF PROTECTION AGAINST IONIZING PARTICLES

1. The Approach

2. Energy and Injury

3. Charged and Uncharged Ionizing Particles

4. Energy Transfer by Charged Particles

5. The Stopping Power Equation

6. Beta Particles--A Major Class of Charged Ionizing Particles

6.1 Properties of Some Common Beta-Emitting Radionuclides

6.2 Protection from External Beta Particle Sources--Time, Distance, and Shielding

7. Characteristics of Uncharged Ionizing Particles

8. Gamma Rays--A Major Class of Uncharged Ionizing Particles

8.1 Energies and Penetration of Gamma Rays from Some Gamma-Emitting Radionuclides

8.2 Positron-Emitting Radionuclides and Annihilation Radiation

8.3 The Three Major Mechanisms Affecting the Penetration of Gamma Radiation

8.4 Attenuation Coefficients of Gamma Photons in Different Materials

8.5 Calculation of Attenuation of Gamma Photons by the Half-Value Layer Method

8.6 Protection from Gamma Sources--Time, Distance, Shielding

9. Heavy Charged Ionizing Particles

9.1 The Alpha Particle--A Heavy Particle with High Linear Energy Transfer and High Capacity for Producing Damage

9.2 The Proton--Another Heavy Charged Particle with High Linear Energy Transfer

10. The Neutron--A Second Important Uncharged Ionizing Particle

10.1 Sources of Neutrons

10.2 Neutron Collisions

10.3 Attenuation of Neutrons

11. The Absorbed Dose--A Measure of Energy Imparted to a Medium

11.1 The Pattern of the Imparted Energy in a Medium

11.2 Definition of Absorbed Dose

11.3 The Gray--The SI Unit for Absorbed Dose

12. The Equivalent Dose--A Common Scale for Doses to Organs and Tissues from Different Radiation Types and Energies

12.1 The Radiation Weighting Factor and the Quality Factor--Measures of the Relative Hazard of Energy Transfer by Different Particles

12.2 The Sievert--The Special Unit of Equivalent Dose

13. Tissue Weighting Factors and the Effective Dose--A Measure of Risk and Severity of Consequences

14. The Roentgen--The Traditional Unit for Expressing Radiation Exposure

15. The Significance of External Radiation Levels

16. Exposure from Internal Radiation Sources

16.1 The Activity--A Quantity for Describing the Amount of Radioactivity

16.2 The Unit of Activity--The Becquerel

16.3 The Accumulating Dose from Radioactivity in the Body and the Committed Dose

17. The Annual Limit on Intake--The Basic Quantity for the Control of Internal Exposures

18. Limit for the Concentration of a Radionuclide in Air--A Derived Limit

19. Levels of Radioactivity Inside the Body--A Useful Benchmark for Internal Exposure

20. Protection from Radioactive Contamination

21. Some Simple Calculations in Radiation Protection

21.1 Dose from Beta Particles

21.2 Exposure Rate and Dose Rate from Gamma Photons

21.3 Reduction of Dose Rate by Both Distance and Shielding

21.4 Correction for Radioactive Decay

21.5 Shielding of Large or Complex Sources

22. X Rays--Radiation Made by Machine

22.1 Production of X Rays

22.2 Diagnostic Radiology

22.3 X-Ray Attenuation in the Body

22.4 Effects of Photon Energy Distribution on Image Formation and Absorbed Dose

22.5 A Description of an X-Ray Machine

22.6 Production of a Photograph of the X-Ray Image

22.7 Fluoroscopy

22.8 Mammography

22.9 Computed Tomography: Taking Cross Sections with X Rays

22.10 Technical Approaches for Minimizing the Doses Required to Record an X Ray

22.11 Impact of the Digital Computer in Radiation Medicine

23. Dose Measurements in Diagnostic Radiology

24. Exposure Guides and Reference Levels in Diagnostic Radiology

25. Protection of the Patient in X-Ray Diagnosis

25.1 Principles

25.2 Policy of the International Commission on Radiological Protection

25.3 Studies in the United Kingdom

25.4 Radiography of the Spine in Scoliosis

25.5 Screening for Specific Diseases

26. Radiation Levels in the Working Areas around X-Ray Machines

26.1 Shielding the X-Ray Beam

27. Dose Reduction in Nuclear Medicine

28. Exposure of the Embryo, Fetus, or Nursing Child

29. Protection of the Patient in Radiation Therapy

29.1 Treatment with External Radiation Beams

29.2 Brachytherapy

29.3 Therapeutic Use of Radiopharmaceuticals

30. Misadministrations in the Medical Use of Radiation and Radioactive Material

31. Occupational Exposures Incurred in the Medical Use of Radiation

31.1 Studies of Occupational Exposures in the Conduct of Specific Procedures

32. Comments for Users of X-Ray Diffraction Machines

33. Particle Accelerators--The Universal Radiation Source

33.1 History of Particle Accelerators

33.2 Interactions of High-Energy Particles

33.3 Shielding High-Energy Particles

33.4 Particle Accelerators in Radiation Therapy

34. Regulation of Radiation Sources and Uses

34.1 Regulatory Measures for Medical Radiation Programs

PART THREE: RADIATION DOSE CALCULATIONS

1. Dose from Beta-Emitting Radionuclides inside the Body

1.1 Calculating the Initial Dose Rate

1.2 Dose Calculations for a Decaying Radionuclide

1.3 Some Relationships Governing Radioactive Decay

1.4 Relationships Involving Both Radioactive Decay and Biological Elimination

1.5 Absorbed Beta Dose over a Period of Time

2. A Closer Look at the Dose from Beta Particles

2.1 Beta Particle Point Source Dose-Rate Functions

2.2 Evaluation of Beta Particle Dose from the Fluence and Stopping Power

3. Calculation of the Absorbed Dose from Gamma Emitters in the Body

3.1 Dose Rate from a Point Source of Photons--The Specific Dose-Rate Constant for Tissue

3.2 Evaluation of the Specific Dose-Rate Constant

3.3 Dose Rate from Distributed Gamma Sources

3.4 The Absorbed-Fraction Method--Dose within the Source Volume

3.5 Dose to Targets Outside the Source Volume by the Absorbed-Fraction Method

3.6 The Specific Absorbed Fraction--Sparing the Need to Divide by the Target Mass

3.7 Use of the Equilibrium Dose Constant--Computer-Generated Source Output Data

3.8 The S Factor--Doses from Cumulated Activity

4. Summary of Formulas

4.1 Radioactive Decay

4.2 Physical Decay and Biological Elimination

4.3 Dose from Nonpenetrating Radiation from Internal Emitters

4.4 Dose from Penetrating Radiation from Internal Emitters

4.5 Inverse Square Law

4.6 Dose Rates at a Distance from Gamma Sources

4.7 Attenuation of Radiation

4.8 Equivalent Dose

5. Dose Calculations for Specific Radionuclides

5.1 Hydrogen-3

5.2 Iodine-131 and Iodine-125

5.3 Strontium-90 / Yttrium-90 / Zirconium-90

5.4 Xenon-133 and Krypton-85

5.5 Uranium-238 and Its Decay Products

5.6 Radon-222 and Its Decay Products

5.7 Plutonium-239 and Plutonium-240

6. Dose Rates from Small, Highly Radioactive Particles

6.1 Evaluation of the Dose from Beta Particles

6.2 Biological Effects of Hot Particles

6.3 Risk of Cancer from Hot Particles

6.4 Highly Radioactive Particles in Fallout

6.5 Recommendations of the NCRP on Limits of Exposure to Hot Particles

6.6 NRC Enforcement Policy for Exposures to Hot Particles

7. The Radioactive Patient as a Source of Exposure

8. Radiation Doses in Nuclear Medicine

8.1 Dose to the Fetus from Uptake of Radionuclides from the Mother

9. Evaluation of Doses within the Body from X Rays

9.1 Patient Doses in Mammography

9.2 Evaluation of Doses in CT Examinations

10. Survey Results, Handbooks, and the Internet

10.1 Surveys of Doses in X-Ray Examinations

11. Producing an Optimum Radiation Field for Treating a Tumor

PART FOUR: RADIATION MEASUREMENTS

1. Radiation Counting with a Geiger-Mueller Counter

1.1 A G-M Counter Described

1.2 Adjusting the High Voltage on a G-M Counter and Obtaining a Plateau

1.3 How a G-M Counter Can Lose Counts and Even Become Paralyzed

1.4 How to Distinguish between Beta and Gamma Radiation with a G-M Counter

1.5 How to Determine Source Strength of a Beta Emitter with a G-M Counter

1.6 Factors Affecting Efficiency of Detection of Beta Particles

1.7 Correcting for Attenuation of Beta Particles by Determining Absorption Curves

1.8 Counting Gamma Photons with a G-M Counter

1.9 Standardization of Radionuclides with G-M Counters

1.10 Interpreting Counts on a G-M Counter

2. Energy Measurements with a Scintillation Detector

2.1 Description of Scintillation Detectors and Photomultipliers

2.2 Pulse Counting with a Scintillation Counter and Scaler

2.3 Pulse-Height Distributions from Scintillation Detectors

2.4 Electronic Processing of Pulses Produced by Scintillation Detectors

3. Detectors for Special Counting Problems

3.1 Gas-Filled Proportional Counters

3.2 Semiconductor Detectors

4. Measuring Radiation Dose Rates

4.1 Measuring X and Gamma Dose Rates with Ionization-Type Survey Meters

4.2 Use of Scintillation Detectors to Measure Dose Rates

4.3 Use of G-M Counters to Monitor Dose Rates

4.4 Routine Performance Checks of Survey Meters

4.5 Calibration of Survey Meters

4.6 Beta Dose-Rate Measurements

4.7 Neutron Monitoring

5. Measuring Accumulated Doses over Extended Periods--Personnel and Environmental Monitoring

5.1 Use of Biodosimetry in Reconstructing Radiation Exposures

6. Specifying Statistical Variations in Counting Results

6.1 Nature of Counting Distributions

6.2 Sample Average and Confidence Limits

6.3 Standard Deviation

6.4 The Normal Error Curve--A Good Fit for Count Distributions

6.5 Precision of a Single Radiation Measurement

6.6 The Effect of Background on the Precision of Radiation Measurements

6.7 The Precision of the Ratio of Two Measurements

6.8 Testing the Distribution of a Series of Counts--The Chi-Square Test

6.9 Measurements at the Limits of Sensitivity of Detectors

7. Comments on Making Accurate Measurements

PART FIVE: PRACTICAL ASPECTS OF THE USE OF RADIONUCLIDES

1. Obtaining Authorization to Use Radionuclides

1.1 Administration of Radioactive Material to Humans

1.2 Requirements for Obtaining Approval to Use New Radioactive Drugs

1.3 Protection of the Patient in Nuclear Medicine

2. Training Required for Working with Radionuclides

2.1 Implementation of a Training Program

2.2 Radiation Safety within a Comprehensive Institutional Program in Laboratory Safety

3. Responsibilities of Radionuclide Users

4. Standards for Protection against Radiation

5. Personnel Monitoring for External Radiation Exposure

5.1 Ambiguities in Using the Personnel Dosimeter Dose as a Surrogate for Personnel Dose

6. Monitoring Personnel Subject to Intakes of Radioactive Material

7. NRC and ICRP Values for Annual Limits on Intake and Airborne Radioactivity Concentration Limits

7.1 Air Monitoring for Environmental Radioactivity

8. Posting of Areas

9. Laboratory Facilities

10. Protective Clothing

11. Trays and Handling Tools

12. Special Handling Precautions for Radioiodine

12.1 Use of Potassium Iodide as a Thyroid-Blocking Agent

13. Hygiene

14. Trial Runs

15. Delivery of Radionuclides

16. Storage and Control of Radionuclides

17. Storage of Wastes

18. Waste Disposal

18.1 Disposal of Gases to the Atmosphere

18.2 Disposal of Liquids to Unrestricted Areas

18.3 Disposal of Liquid Wastes to Sanitary Sewerage Systems

18.4 Solid Wastes

18.5 Disposal on Site by Incineration and Other Methods

18.6 Government Regulation of the Disposal of Hazardous Wastes

18.7 Volume Reduction in Waste Disposal

18.8 The Designation of De Minimus Concentrations of Radioactivity

18.9 Natural Radioactivity as a Reference in the Control of Environmental Releases

19. Use of Radioactive Materials in Animals

20. Transportation of Radionuclides

20.1 Transportation within the Institution

20.2 Mailing through the U.S. Postal Service

20.3 Shipment of "Limited Quantities"

20.4 Shipment of "Low-Specific-Activity" Materials

20.5 Shipment of Type-A Packages

20.6 Shipping Papers and Shipper's Certification

21. Contamination Control

21.1 Monitoring for Contamination

21.2 Decontamination of Equipment and Buildings--Limits for Uncontrolled Release

22. Personnel Contamination and Decontamination

23. Leak Tests of Sealed Sources

24. Notification of Authorities in the Event of Radiation Incidents

25. Termination of Work with Radionuclides

Appendix A: Emergency Instructions in the Event of Release of Radioactivity and Contamination of Personnel

A.1 Objectives of Remedial Action

A.2 Procedures for Dealing with Minor Spills and Contamination

A.3 Personnel Decontamination

A.4 Major Releases of Airborne Radioactivity as a Result of Explosions, Leakage of High-Level Sealed Gaseous and Powdered Sources

Appendix B: The Regulatory Process

B.1 Radiation Control at the Federal Level

B.2 Radiation Control at the State Level

B.3 Inspection and Enforcement

Appendix C: Control of Airborne Releases to the Environment

C.1 Dilution in the Atmosphere

C.2 Filtration of Particles

C.3 Adsorption of Gases and Vapors on Charcoal

C.4 Adsorbers for Radioiodine

PART SIX: IONIZING RADIATION AND PUBLIC HEALTH

1. Formulation of Standards for Radiation Protection

1.1 Standards for Protection of the Public against Radioactive Contamination

1.2 Standards for the Cleanup of Sites Contaminated with Radioactivity

1.3 Protective Actions for Exposures of the Public from Long-Term and Unattributable Sources

2. Medical Findings on Humans Exposed to Radiation

2.1 Sources of Human Exposure Data

2.2 Epidemiological Studies of Leukemia and Other Cancers

2.3 Risk of Cancer from Exposure to Radiation

2.4 Effects on the Developing Embryo

2.5 Genetic Risks

2.6 Basic Mechanisms in the Genesis of Cancer by Ionizing Radiation

3. Risks to Health from Exposure to Alpha Radiation

3.1 Evolution of Protection Standards for Radon Gas and Its Decay Products

3.2 Risk of Lung Cancer from Extended Exposure to Radon and Its Short-Lived Decay Products

3.3 Exposure of Bone to Alpha Radiation

4. Implications for Humans from Results of Animal Experiments

5. Sources Producing Population Exposure

5.1 Natural Sources of External Radiation

5.2 Natural Sources of Radioactivity within the Body

5.3 Population Exposure from Medical and Dental X Rays

5.4 Population Exposure (Internal) from Radiopharmaceuticals

5.5 Environmental Radiation Levels from Fallout from Past Weapons Tests

5.6 Potential External Exposure to the Population from Large-Scale Use of Nuclear Power

5.7 Population Exposure (Internal) from Environmental Pollutants

6. Population Exposure from Radiation Accidents

6.1 Windscale, England--The First Major Nuclear Reactor Accident Causes Significant Environmental Contamination

6.2 Palomares, Spain--Atomic Bombs Drop from the Sky, Igniting and Contaminating a Countryside

6.3 Thule, Greenland--A Bomber Crashes and Its Nuclear Weapons Ignite

6.4 Rocky Flats, Colorado--A Case History in Environmental Plutonium Contamination from an Industrial Plant

6.5 Gabon, Africa--Site of Nature's Own Nuclear Reactor

6.6 Three Mile Island, Pennsylvania--A Nation Confronts the Awesome Presence of the Atom

6.7 Chernobyl

6.8 Nuclear Power from the Perspective of the Three Mile Island and the Chernobyl Accidents

7. Nuclear Weapons--Ready for Armageddon

PART SEVEN: EXPOSURE TO NONIONIZING ELECTROMAGNETIC RADIATION

1. Electromagnetic Fields--Quantities, Units, and Maxwell's Equations

1.1 The Electric Field

1.2 The Magnetic Field

1.3 Maxwell's Equation for Faraday's Law of Induction

1.4 Maxwell's Equation for Ampere's Law as Modified for the Displacement Current

1.5 The Interactions of Electric and Magnetic Fields in a Medium

2. Interaction of Fields from Electric Power Lines with the Body

3. The Physics of Radiating Electromagnetic Fields

3.1 The Derivation of Equations for Electromagnetic Waves from Maxwell's Equations

3.2 Electromagnetic Waves Generated by a Sinusoidal Oscillator

3.3 Relationships of Photons and Waves

4. Absorption of Electromagnetic Radiation in the Body

4.1 Penetration of EMF into the Body

4.2 Induced and Contact Currents

5. Specifying Dose to Tissue from Electromagnetic Fields

5.1 The Production of Heat as the Main Biological Effect

5.2 Resonance--A Special Concern in Exposure to Radiofrequency Radiation

5.3 The Specific Absorption Rate--The Basic Quantity for Assessment of Exposure to Radiofrequency Radiation

6. Devices That Produce Electromagnetic Fields

6.1 Antennas

6.2 Cellular Phone Networks

6.3 Magnetic Resonance Imaging (MRI)

6.4 Video Display Terminals

7. Making Measurements of ELF and Radiofrequency Electromagnetic Fields

8. Standards for Protection against Electromagnetic Fields

8.1 Power Lines

8.2 Radiofrequency Standards

8.3 Telecommunications Standards

8.4 Microwave Ovens

8.5 Video Display Units

8.6 Static Magnetic and Electric Fields

8.7 Comparison of Basic Limits for Ionizing and Nonionizing Radiation

9. Medical Findings on Humans

9.1 Static Magnetic Fields

9.2 Extremely Low Frequencies, Including Power Lines

9.3 Radiofrequencies

10. Effects on Animals--Basic Research

11. Exposures from Environmental Fields

11.1 Broadcasting: The Dominant Source of RF Radiation in the Environment

11.2 Radar Installations for Civilian and Military Purposes

11.3 Transmitters for Cellular Phone Systems

11.4 Power lines

11.5 Home and Office

12. Effects of Electromagnetic Interference on Pacemakers

13. Exposures to Patients and Staff from Medical Devices

13.1 Magnetic Resonance Imaging (MRI)

14. Occupational Exposure to Electromagnetic Radiation

15. Beyond Microwaves

PART EIGHT: CURRENT ISSUES IN RADIATION PROTECTION: WHERE THE EXPERTS STAND

1. On Electromagnetic Fields

2. On Defining and Regulating the Hazards of Exposure to Ionizing Radiation

2.1 On the Validity of the Linear No-Threshold (LN-T) Theory

2.2 The Exemption from Regulatory Control of Radiation Levels Below Which Causation of Cancer Is Considered Insignificant

3. On Reducing Population Radiation Exposure from Medical and Dental X Rays

4. On the Safety of Nuclear Power

5. On the Hazards of Nuclear Weapons Tests and Underground Explosions

5.1 Hazards to the Public from Fallout from Atmospheric Testing of Nuclear Bombs

5.2 Safety of the Use of Nuclear Explosives Underground for Large-Scale Excavation or Development of Natural Resources

6. On the Consequences to Civilization of an All-Out Thermonuclear War

7. A Personal Statement

Appendix I: Problems

Appendix II: Data on Selected Radionuclides

Appendix III: Some Constants and Conversion Factors

Selected Bibliography

References

Index

Author photo: Lincoln Russell

Jacob Shapiro is former Director of the university Radiation protection Program and Senior Scientist in the Environmental Health and Safety Office, Harvard University. He is also Lecturer on Biophysics in Environmental Health at the Harvard School of Public Health.