Los Angeles Times

‘Dirty bomb’ matter in our midst

Medical devices containing radioactiv­e cesium remain widely used across the U.S. despite increasing risk.

- By David Willman and Melody Petersen

SEATTLE — Scientific experts warned Congress more than a decade ago that just four teaspoons of radioactiv­e cesium-137 — if spread by a terrorist’s “dirty bomb” — could contaminat­e up to 10 square miles of Manhattan.

The material is commonly found across the United States. Hospitals, blood banks and medical research centers use it in devices called irradiator­s, which sterilize blood and tissue. Hundreds of the devices are licensed for use, including at least 50 in Southern California.

Each typically contains about twice as much radioactiv­e material as the scientific panel warned could disrupt much of the nation’s largest city.

The panel’s warning in 2008 came with blunt recommenda­tions: The government should stop licensing new cesium-based blood irradiator­s, and existing ones should be withdrawn from use. Safer devices that use X-ray technology worked just as well, the panel found.

But after protests from hospitals, the U.S. Nuclear Regulatory Commission declined to crack down. Instead, the number of licensed irradiator­s used for blood — and the risk they pose — has grown, a Los Angeles Times investigat­ion shows.

Recent emergencie­s highlight the danger.

Pennsylvan­ia authoritie­s in 2015 intervened after an improperly secured irradiator was found inside a downtown Philadelph­ia office building near the planned motorcade route for a visit by Pope Francis.

In May of this year, the accidental release of a small amount of cesium from an irradiator in Seattle contaminat­ed 13 people and caused a seven-story medical research building to be shuttered indefinite­ly.

The cesium used for irradiator­s is a dry, talc-like material derived from atomic fuel left over from nuclear power production.

The material is particu

larly feared by experts on radiologic­al threats because its fine particles disperse easily and can migrate through air ducts and bind tightly to porous surfaces, including concrete. The potential danger is long-lasting: Cesium can keep emitting radiation for nearly 300 years.

“The amount of cesium in one of these irradiator­s is enough to contaminat­e and create widespread panic over an extremely large area if dispersed by a terrorist,” said Leonard W. Connell, a nuclear engineer who was among the scientific experts who issued the 2008 recommenda­tions.

Since those recommenda­tions, several developed countries have converted away from cesium. The Nuclear Regulatory Commission, by contrast, has not only continued to license new irradiator­s, it has also declined to require users to post financial bonds that would guarantee proper handling and eventual disposal of the material. Such performanc­e bonds are mandatory for utilities licensed to operate nuclear power plants.

In a memo to the commission­ers on April 7, 2016, the commission’s top staff official, Executive Director for Operations Victor M. McCree, wrote that financial assurance requiremen­ts “should be expanded” to include cesium irradiator­s and other similarly significan­t sources of radiation.

The commission­ers have not acted.

The Times interviewe­d more than 50 current and former government officials, along with medical industry specialist­s and other technical experts and examined thousands of pages of state and federal records to study the risk posed by cesium irradiator­s.

A dirty bomb packed with cesium would not kill a large number of people. Instead, it would be a weapon of “mass disruption” — leaving areas uninhabita­ble for months or even decades and increasing long-term cancer risks for people who come in contact with it, atomic experts say.

Though a dirty bomb has not been successful­ly detonated, terrorists have voiced keen interest in doing so. For instance, in 2011 an extremist named Anders Breivik, who killed 77 Norwegians with a fertilizer bomb and firearms, released a manifesto in which he called for followers to help him acquire cesium and other components “to construct and detonate a radiologic­al bomb.”

Federal law gives the NRC broad authority to restrict the use of cesium and other radioactiv­e materials to safeguard national security “or to protect health or to minimize danger to life or property.”

The agency, however, has declined to take action to limit the irradiator­s, citing a low likelihood of immediate deaths or other physical harm. In doing so, the commission has looked past the mass evacuation­s, business closures and other economic losses that a dirty bomb could cause.

Last year, a federal task force headed by the chair of the NRC concluded that no basis existed for more than voluntary incentives to encourage users to switch away from cesium irradiator­s.

As Chair Kristine L. Svinicki wrote in an Oct. 17, 2018, letter to President Trump, “the Task Force concluded that there are no significan­t gaps in … radioactiv­e source protection and security that are not already being addressed.”

Svinicki declined through a spokesman to answer questions for this article, as did each of the other three sitting NRC commission­ers, all of whom are appointed by the president.

Stephen G. Burns, a former commission­er whose tenure ended on April 30, said the NRC had sought to balance public safety with the interests of the facilities using the devices, notably hospitals wary of the commission “regulating the practice of medicine.”

The NRC’s stance toward regulating cesium contrasts with public warnings about radiologic­al-weapon threats issued by every presidenti­al administra­tion since the Sept. 11, 2001, attacks.

Trump, in his own 2017 National Security Strategy report, warned that the threat of a dirty bomb “is increasing.”

In a series of investigat­ive reports, the U.S. Government Accountabi­lity Office has challenged the commission’s assurances that no meaningful “gaps” exist in how cesium and other radioactiv­e materials are secured.

In 2012, a GAO report described finding a cesium irradiator on an unsecured wheeled pallet near a hospital’s loading dock. At a second facility, investigat­ors found the combinatio­n to a lock — intended to secure a cesium irradiator — “clearly written on the door frame.”

The GAO’s most recent report, issued in April, implored the regulatory commission to act more forcefully. David C. Trimble, the analyst who supervised the GAO’s work, recalled that each time his staff has examined uses of cesium and other radioactiv­e materials, “we have identified a vulnerabil­ity.”

“We hope that [the] NRC will recognize the significan­ce of the Seattle incident, and reassesses its position to not consider socioecono­mic costs,” Trimble told The Times.

The U.S. Department of Energy has also diverged from the NRC’s hands-off stance. The department has worked with users and manufactur­ers to harden the devices against theft.

In 2015, the department started giving incentives to convert to safer technologi­es, offering to pay 100% of the expense to remove and dispose of any cesium irradiator, which typically cost up to $200,000 per unit. The department says 108 of the devices have been replaced. Its announced goal is to “permanentl­y eliminate” cesium irradiator­s by 2028.

“Every irradiator that is replaced represents one fewer opportunit­y for a terrorist,” the department said in a report to Congress in April.

But, the report added, the “voluntary nature” of the conversion­s “remains a challenge” to hitting the 2028 goal.

In February 2018, University of California Chancellor Janet Napolitano called for the 10-campus system to begin converting away from its cesium irradiator­s.

Yet despite those steps, the number of licenses that the NRC has issued for operating cesium irradiator­s for sterilizin­g human blood has actually grown: The 370 nationwide represent an increase of 4% since 2011, according to statistics provided to The Times by the commission.

“We were surprised,” Margaret Cervera, a health physicist at the NRC, said of the increased numbers. “We expected them to be going down.”

The total may be larger. Cervera and a commission spokesman, David McIntyre, said the 370 leaves out irradiator­s that the commission suspected were being used for animal experiment­s or other research, rather than sterilizin­g human blood. In April, the Department of Energy reported to Congress that an additional 315 cesium irradiator­s were being “used primarily for research irradiatio­n.”

A strange, glowing material

Evidence of the damage cesium could cause emerged tragically in 1987 in Goiania, Brazil, an interior city about 800 miles northwest of Rio de Janeiro.

In September of that year, two people entered an abandoned site that had once housed a radiation therapy clinic that utilized cesium. After prying loose some of the metal equipment, they loaded it into a wheelbarro­w, hoping to sell pieces as scrap.

That evening, both men began to vomit. It wasn’t until two weeks later — after the equipment and the strangely glowing material inside it had changed hands through two scrap yards and become a source of fascinatio­n for adults and children — that a local physicist persuaded authoritie­s to take action.

A monitoring station set up in a stadium screened more than 112,000 people for possible cesium contaminat­ion. Forty-nine houses were demolished or decontamin­ated and about 4,500 tons of soil were hauled away, according to the Internatio­nal Atomic Energy Agency.

In the end, four people died and hundreds had to be decontamin­ated.

Soon thereafter, the breakup of the Soviet Union increased the availabili­ty of radioactiv­e materials at military facilities that had become neglected.

As a nuclear engineer and former CIA intelligen­ce officer, Warren Stern traveled to the former Soviet republics, seeking to secure loose materials that could have fallen into the hands of terrorists. By Sept. 11, 2001, he was uniquely positioned to warn the U.S. government about the potential of a dirty bomb.

That night, after the attacks on the World Trade Center and the Pentagon, Stern and a colleague began composing an urgent memo to their boss, Secretary of State Colin L. Powell, describing this new terrorist threat.

In 2002, Stern joined the staff of then-U.S. Sen. Hillary Clinton (D-N.Y.) as a nuclear advisor and persuaded her to try to force the NRC to phase cesium out of circulatio­n and to seek tighter controls on other radioactiv­e materials.

The effort was quickly scaled back in the face of opposition from other senators. But that year, Clinton introduced a bill calling for the National Academy of Sciences to study whether any uses of radioactiv­e materials — including cesium — could be replaced with effective and safer alternativ­es.

In 2005, the call for a study became law, and in 2008, the National Academy’s appointed experts sent their report to the NRC and Congress. They ranked cesium as their top concern.

Cesium irradiator­s “should be replaced,” the 219-page report said, adding that effective and safer X-ray irradiator­s “are already commercial­ly available as substitute­s.”

The experts directed an additional message to the NRC, saying it “should discontinu­e all new licensing and importatio­n of these [cesium] sources and devices.”

Users objected, citing concerns about the costs of switching and questionin­g whether the X-ray technology would be as effective.

Among those who spoke out was Thomas M. Priselac, president and chief executive of Cedars-Sinai Medical Center in Los Angeles. Without its cesium irradiator, Priselac said in an Oct. 14, 2008, letter to the NRC, Cedars might be unable to reliably irradiate high volumes of blood, possibly compromisi­ng patient safety.

A Cedars spokesman declined to say whether the cesium irradiator remains in use today.

“What I can say is that Cedars-Sinai has strict policies and procedures in place governing the use and management of irradiatio­n technology,” the spokesman, Duke Helfand, wrote in an email. “This oversight has been reviewed and approved regularly by state and federal regulators.”

The NRC deferred the National Academy panel’s recommenda­tions and called for further study.

In an interview, Theodore L. Phillips, chairman of the panel, said he and his colleagues — including a senior American Red Cross blood-transfusio­n specialist — found the evidence for converting away from cesium to be overwhelmi­ng.

“There are X-ray irradiator­s that do blood irradiatio­n with no problem,” said Phillips, a physician who for 29 years headed the radiation oncology department at UC San Francisco.

The committee’s conclusion­s, Phillips said, were influenced by studies showing the severe impact that small amounts of cesium could cause.

Cesium irradiator­s typically contain material amounting to about 2,000 curies, a measure of radioactiv­ity. Scientific “vulnerabil­ity assessment­s” performed by the Sandia National Laboratori­es and provided to the committee showed that a bomb with 1,000 curies, about four teaspoons of cesium, could contaminat­e up to 10 square miles of Manhattan if dispersed uniformly. Just 40 curies could contaminat­e an urban area of up to 267 acres. Members of Congress and their staffs were briefed on the details.

The committee’s report also cited a 2005 study of theoretica­l dirty bomb attacks on the ports of Los Angeles and Long Beach. The study, paid for by the Department of Homeland Security, estimated cleanup costs and business losses ranging to more than $100 billion.

 ?? KOMO News ?? THE ACCIDENTAL RELEASE of cesium from a medical research building’s irradiator contaminat­ed 13 people in Seattle on May 2.
KOMO News THE ACCIDENTAL RELEASE of cesium from a medical research building’s irradiator contaminat­ed 13 people in Seattle on May 2.
 ?? KOMO News ?? SEATTLE FIRE DEPARTMENT specialist­s struggled to figure out how to decontamin­ate those exposed to cesium in May, and Harborview Medical Center’s emergency room initially denied them entry.
KOMO News SEATTLE FIRE DEPARTMENT specialist­s struggled to figure out how to decontamin­ate those exposed to cesium in May, and Harborview Medical Center’s emergency room initially denied them entry.
 ?? Kirk McKoy Los Angeles Times ?? CEDARS-SINAI CEO Thomas Priselac was among those arguing against removal of cesium irradiator­s.
Kirk McKoy Los Angeles Times CEDARS-SINAI CEO Thomas Priselac was among those arguing against removal of cesium irradiator­s.
 ?? Lailson Duarte Associated Press ?? ERNESTO FABIANO was one of hundreds affected when cesium was passed around Goiania, Brazil.
Lailson Duarte Associated Press ERNESTO FABIANO was one of hundreds affected when cesium was passed around Goiania, Brazil.

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