WPM-C - Military Health Physics Part 2 Baltimore 3 14:30 - 17:00
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| Chair(s): Jama VanHorne-Sealy and Dan Sowers
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WPM-C.1
14:30 The establishment of a radiation safety program for the U.S. Military Healthcare System RA Reyes*, Defense Health Agency
; DA Smith, Defense Health Agency; S Shivji, Defense Health Agency; WS Bosley, Defense Health Agency; JL Allen, Defense Health Agency; CA Dufford, Defense Health Agency; GN Keeney, Defense Health Agency; KH Hammersborg, Defense Health Agency
Abstract: With the creation of the Defense Health Agency (DHA) in 2013, DoD medical activities under the Military Healthcare System (MHS) were to be under its Authority, Direction, and Control (ADC). In 2014, the transition to DHA included three permits under the Nuclear Regulatory Commission (NRC) Navy Master Materials License (MML). From January 2018 until October 2019, DHA added 27 additional Medical Treatment Facilities (MTFs) to its NRC license. The additions of Landstuhl Regional Medical Center and Naval Hospital Okinawa were in February of 2022. On October 1, 2022, multiple public health assets and research and development activities went under the ADC of DHA. The Army MTFs and activities had individual NRC licenses. Whereas the Navy and Air Force MTFs and activities had permits under their respective Navy and Air Force MMLs. The merging of the very three different radiation safety cultures, Army, Navy, and Air Force, presented the most significant challenge in the creation of the RSP. Other challenges, include: manning requirements, service-centric policies, three dosimetry centers providing services, and the lack of a medical physics program. The transition of radiation safety practices presents the compartmental handling of functions, sharing a fully DHA-controlled management of radioactive materials through its NRC license, and a partially service-led use of ionizing- and non-ionizing radiation producing devices. To standardize practices and establish a joint culture, the RSP developed common administrative instructions for establishing the program, the radiation safety committee, and the use of non-ionizing radiation. Other efforts included the tracking of unusual occurrences and the development of radiation safety guidelines. The presenter will introduce initiatives for the establishment of the joint program that accommodates the three distinct cultures, normalizes radiation safety practices, and sets common ground for the safe handling of radiation in the MHS.
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WPM-C.2
14:45 Lost and Not Found - A review of Lost Brachytherapy Sources and Corrective Actions Implemented DA Smith*, Defense Health Agency
; RA Reyes, Defense Health Agency; S Shivji, Defense Health Agency; WS Bosley, Defense Health Agency; JL Allen, Defense Health Agency; CA Dufford, Defense Health Agency; KH Hammersborg, Defense Health Agency; GN Keeney, Defense Health Agency
Abstract: On 14 May 2021 the Naval Hospital in San Diego reported the loss of four (4) I-125 brachytherapy (prostate) seeds to the Defense Health Agency (DHA) Radiation Safety Division. The hospital received the seeds in a shielded, White I shipping container. The container held four pre-sterilized, shielded, metal needle holders. Holders 1, 2 and 3 contained 27 needles pre-loaded with 88 implant seeds for the procedure, and three (3) needles pre-loaded with eight (8) spare seeds. Holder 4 contained three (3) spare needles pre-loaded with four (4) spare seeds. In addition to the implantable (and spare) seeds, the vendor also shipped one (1) calibration seed and 10 assay seeds separately, packaged for a grand total of 111 seeds. At the conclusion of the implant, the unused sources were ejected from Holder 3 into a steel pig provided by Radiation Safety. The extra seeds in Holder 4, which also should have been ejected into the steel pig, remained in the shielded shipping container. The needles containing the four (4) unaccounted seeds were facing the bottom of the shipping box. The holders were white in color, as was the shipping container and packing materials. As a result, Holder 4 was not seen when the container and materials were discarded. All survey readings were indistinguishable from background; however, the staff failed to conduct a physical inventory at that time, as required. While preparing the return package with the unused seeds, the Radiation Safety Officer discovered four (4) seeds were missing. The radiation safety staff conducted an exhaustive search but failed to locate the seeds. The hospital Associate Radiation Safety Officer reported the incident immediately to DHA and subsequently the DHA Radiation Safety Officer reported to the Nuclear Regulatory Commission. The facility implemented several corrective actions and conducted an assessment of the corrective actions six (6) months after the event. The NRC ultimately fined the DHA $3,500.00 for the loss of material.
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WPM-C.3
15:00 Most common findings while performing DHA Radiation Safety Site Assistance Visits at Military Treatment Facilities KH Hammersborg*, DHA
; RA Reyes, DHA; S Shivji, DHA; DA Smith, DHA; WS Bosley, DHA; JL Allen, DHA; C Dufford, DHA; GN Keeney, DHA
Abstract: The Defense Health Agency (DHA) Radiation Safety (RS) headquarters staff perform radiation safety site assistance visits (SAV) to ensure that military medical treatment facilities (MTFs) and medical activities: (1) meet the requirements of the DHA Nuclear Regulatory Commission (NRC) license; (2) radiation safety rules and regulations; (3) site-specific DHA radioactive materials authorization conditions; and (4) relevant DHA manuals and instructions. The intent of the SAVs is to ensure the safe use of radioactive materials, and ionizing- and non-ionizing- radiation producing devices. They help promote and protect the health and safety of radiation workers, the public, and the environment. DHA performs SAVs of each MTF or medical activity operating under the DHA NRC license every 30 months, with a goal of visitation every 24 months. During each SAV, DHA RS staff review results of previous audits, observe radiation safety-related activities and facilities, and review various areas of the program. These include, among others: (1) program management, (2) radioactive material control, (3) dosimetry, (4) nuclear medicine practices, and (5) training. DHA RS staff presents SAV results to the DHA Radiation Safety Committee and shares information and lessons learned with MTF Associate Radiation Safety Officers (ARSOs) at monthly ARSO roundtable meetings. This presentation will summarize the most common findings and deficiencies, areas of improvement, as well as good practices identified at 32 MTFs and activities during calendar years 2021-2022. The presenter will provide trends in radiation safety practices across the military healthcare system, corrective actions implemented, and recommendations for future improvements.
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WPM-C.5
15:30 Characteristics of Gamma Radiation Fields in Subterranean Structures for Radiation Protection and Decision Making SM Sublett*, US Army/Colorado State University
; AR Parker, US Army; AW Brandl, Colorado State University
Abstract: Due to the unique physical environment, the subterranean environment poses unique challenges for emergency planners and decision-makers when planning and training to respond to a CBRN attack or accident. Subterranean environments, like mass transit tunnels, warrant investigation due to the potential use of a radiological exposure device (RED) using a gamma-ray source to expose the unsuspecting. The radiation fields of significant gamma-ray sources, such as those emitted from Cs-137 or Co-60, behave differently in the well-shielded and confined space of the subterranean environment due to increased scattering than in free air or open space geometries. A better understanding of exactly how these fields act in this environment is crucial to the safety of first responders and render safe teams responding to a CBRN attack or accident. SpaceClaim, Attila4MC, and MCNP were used in this project to model the subterranean environment with a variety of tunnel materials, tunnel geometries, as well as gamma sources. The scenarios were modeled after the Zentrum am Berg training facility in Eisenerz, Austria, in collaboration with the IRON NIKE research group. The inverse square law is frequently used by radiation protection personnel or first responders to calculate a radioactive source's exposure or dose rate. In environments like subterranean environments with high scattering potential or shielding, the inverse square law may not be precise. The dose rate inside the well-shielded tunnel drops off very quickly as the high scatter angle photons greatly increase the dose rate near the source but are not directed down the length of the tunnel. The radiation field inside a lead tunnel did not respond according to the inverse square law. Understanding the unique behavior of radiation fields within a subterranean environment can optimize movement and protective actions necessary to allow optimal response time and reduce radiation dose.
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WPM-C.6
15:45 NRC Preceptorship Experience and Lessons Learned JC Witt*, US Army/Defense Health Agency
Abstract: The development of Army Medical Treatment Facility (MTF) Radiation Safety Officers (RSO) is a key development step for a junior Army officer and for establishing an overall radiation safety culture within MTF’s. This presentation will be based on personal experience from my NRC preceptorship at Madigan Army Medical Center from 2018 to 2021 as well as collective experiences that have been shared with me from peers at other programs. In this presentation I will go through the requirements of an NRC preceptorship to become a MTF RSO, what roles and responsibilities you will undertake during this time, recommendations on how to be successful, how this process can be sustained and improved, and the transition to becoming a RSO at your own facility.
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WPM-C.7
16:00 The role of an Army Nuclear Medical Science Officer in supporting the Defense Threat Reduction Agency mission DL Lawindy, U.S. Army
; WB Bosley*, U.S. Army
Abstract: Nuclear Medical Science Officers (NMSOs) are the Health Physics experts of the United States Army. As part of their broad set of responsibilities and range of assignments, they provide subject matter expertise in various settings outside of traditional health physics. One such assignment is located at the Defense Threat Reduction Agency (DTRA), the Department of Defense’s (DoD) premiere organization for Countering Weapons of Mass Destruction (CWMD). The NMSO provides support in various programs that primarily involve training U.S. allies and partners to effectively prevent and respond to radiological and nuclear incidents. The two largest programs are the congressionally mandated Building Partner Capacity (BPC) initiative and the International Counterproliferation Program (ICP). The primary responsibility of the NMSO under the Building Partner
Capacity initiative is to lead small teams of CWMD experts in training and equipping foreign military units to effectively manage and respond to WMD incidents. The primary responsibility under the International Counterproliferation Program involves coordinating a range of courses and seminars for law enforcement, customs and border officials, as well as senior government officials on topics that assist the partner nation to effectively detect and disrupt WMD proliferation and smuggling networks. The U.S. Army NMSO is an integral part of the DoD’s health physics enterprise and is at the forefront of U.S. countering weapons of mass destruction efforts.
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