Polonium!!!. The London Po-210 Poisoning Case: What we know and what we don’t know May 15, 2008...

Polonium!!Polonium!!!!

The London Po-210 Poisoning Case:What we know and what we don’t know

May 15, 2008

The London Po-210 Poisoning Case:What we know and what we don’t know

May 15, 2008

CAPT Michael A. Noska, USPHSCAPT Michael A. Noska, USPHSSenior Health PhysicistSenior Health Physicist

U.S. Department of Health and Human ServicesU.S. Department of Health and Human ServicesFood and Drug AdministrationFood and Drug Administration

Center for Devices and Radiological Health Center for Devices and Radiological Health

CAPT Michael A. Noska, USPHSCAPT Michael A. Noska, USPHSSenior Health PhysicistSenior Health Physicist

U.S. Department of Health and Human ServicesU.S. Department of Health and Human ServicesFood and Drug AdministrationFood and Drug Administration

Center for Devices and Radiological Health Center for Devices and Radiological Health

OutlineOutline

Basic chronology of the eventsBasic chronology of the events

Internal Radiation Dosimetry 101Internal Radiation Dosimetry 101

Specifics of Polonium-210Specifics of Polonium-210

Dosimetry for Mr. LitvinenkoDosimetry for Mr. Litvinenko

Health physics, public health and criminal F/UHealth physics, public health and criminal F/U

ChronologyChronology

11/1/2006 11/1/2006 Litvinenko meets Russians at London hotel. Litvinenko meets Russians at London hotel. Several hours later, becomes sick with vomiting.Several hours later, becomes sick with vomiting.

11/4/2006 11/4/2006 Litvinenko admitted to hospitalLitvinenko admitted to hospital11/11/2006 11/11/2006 Condition very bad. Placed under armed Condition very bad. Placed under armed

guard.guard.11/19/2006 11/19/2006 Report of thallium poisoning.Report of thallium poisoning.11/21/2006 11/21/2006 Litvinenko critical, suffers heart attack. Litvinenko critical, suffers heart attack.

Russians deny involvement.Russians deny involvement.11/23/2006 11/23/2006 Litvinenko dies.Litvinenko dies.11/24/2006 11/24/2006 Litvinenko’s statement read. Health Litvinenko’s statement read. Health

authorities identify Po-210 as probable cause of death.authorities identify Po-210 as probable cause of death.

Basic Radiation Physics and DosimetryBasic Radiation Physics and Dosimetry

Types of radiation: Types of radiation: αα, , ββ+/+/ββ-, -, γγ/x, n/x, n

Radioactivity: (units: Ci, Bq)Radioactivity: (units: Ci, Bq)

Half-lifeHalf-life

Absorbed dose: energy imparted per unit Absorbed dose: energy imparted per unit mass of tissuemass of tissue

Units: rad/rem, Gy/SvUnits: rad/rem, Gy/Sv

1 Gy=100 rad; 1 Sv=100 rem1 Gy=100 rad; 1 Sv=100 rem

Dose ParametersDose Parameters

Type of radiationType of radiationAmount of radioactivityAmount of radioactivityHalf-lifeHalf-lifeChemical formChemical formBiodistributionBiodistributionBiokineticsBiokineticsBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

Absorbed DoseAbsorbed Dose

Polonium-210 (Po-210)Polonium-210 (Po-210)

Solid metal at room temperatureSolid metal at room temperature

Dissolves readily in dilute acidsDissolves readily in dilute acids

Decays by alpha particle emissionDecays by alpha particle emission

““Pure alpha”Pure alpha”

Becomes easily airborne and “creeps” due Becomes easily airborne and “creeps” due to alpha recoil energyto alpha recoil energy

Po-210 continuedPo-210 continuedUranium seriesUranium series

decay productdecay product

Physical half-life:Physical half-life:

138.38 days138.38 days

Biological half-life:Biological half-life:

50 days50 days

Effective half-life:Effective half-life:

36.7 days36.7 days

Specific activity:Specific activity:

4490 Ci/g4490 Ci/g

210210Po Decay SchemePo Decay Scheme

Pb Po 20682

21084

99.999% MeV) (5.3045 42

0.001% MeV) (0.8031 MeV) (4.524 42

Sources of Po-210Sources of Po-210

Naturally occurring in plants and foods (tobacco)Naturally occurring in plants and foods (tobacco)

Grazing animals concentrate in body tissuesGrazing animals concentrate in body tissues

Nuclear weapons (not currently)Nuclear weapons (not currently)

RTGs for space program (not currently)RTGs for space program (not currently)

Anti-static devices (sealed sources)Anti-static devices (sealed sources)

Nuclear reactorsNuclear reactors

Russia makes ~100 grams per year and exports Russia makes ~100 grams per year and exports ~1 gram per year to the US~1 gram per year to the US

Radiation HazardRadiation Hazard

No external hazard due to very low yield No external hazard due to very low yield gamma emissiongamma emissionInternal hazard due to Internal hazard due to αα-particle-particleHigh LETHigh LETDistributes in soft tissue → whole body Distributes in soft tissue → whole body dosedoseConcentrates in liver, kidney, RBM, spleen Concentrates in liver, kidney, RBM, spleen and skinand skinExcreted via urine, feces, skinExcreted via urine, feces, skin

Mr. LitvinenkoMr. Litvinenko

What do we know?What do we know?

Type of radiationType of radiationAmount of radioactivityAmount of radioactivityHalf-lifeHalf-lifeChemical formChemical formBiodistributionBiodistributionBiokineticsBiokineticsBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivityHalf-lifeHalf-lifeChemical formChemical formBiodistributionBiodistributionBiokineticsBiokineticsBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-lifeChemical formChemical formBiodistributionBiodistributionBiokineticsBiokineticsBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-life YESYESChemical formChemical formBiodistributionBiodistributionBiokineticsBiokineticsBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-life YESYESChemical formChemical form NONOBiodistributionBiodistributionBiokineticsBiokineticsBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-life YESYESChemical formChemical form NONOBiodistributionBiodistribution MAYBEMAYBEBiokineticsBiokineticsBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-life YESYESChemical formChemical form NONOBiodistributionBiodistribution MAYBEMAYBEBiokineticsBiokinetics MAYBEMAYBEBody/organ massBody/organ massTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-life YESYESChemical formChemical form NONOBiodistributionBiodistribution MAYBEMAYBEBiokineticsBiokinetics MAYBEMAYBEBody/organ massBody/organ mass YESYESTime of administrationTime of administrationRoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-life YESYESChemical formChemical form NONOBiodistributionBiodistribution MAYBEMAYBEBiokineticsBiokinetics MAYBEMAYBEBody/organ massBody/organ mass YESYESTime of administrationTime of administration NONORoute of administrationRoute of administration

What do we know?What do we know?

Type of radiationType of radiation YESYESAmount of radioactivityAmount of radioactivity NONOHalf-lifeHalf-life YESYESChemical formChemical form NONOBiodistributionBiodistribution MAYBEMAYBEBiokineticsBiokinetics MAYBEMAYBEBody/organ massBody/organ mass YESYESTime of administrationTime of administration NONORoute of administrationRoute of administration NONO

Retrospective Dose AssessmentRetrospective Dose Assessment

Incomplete informationIncomplete informationAssumptions (time, route of administration)Assumptions (time, route of administration)Biological samplesBiological samplesBiokinetic models:Biokinetic models:ICRP 30, ICRP 68, ICRP 72ICRP 30, ICRP 68, ICRP 72Animal dataAnimal data

Lethal dose (LDLethal dose (LD50/6050/60))

Acute versus chronic doseAcute versus chronic dose

ICRP GI Tract ModelICRP GI Tract Model

Stomach

SI

ULI

LLI

Feces

Blood

1 hour

4 hours

13 hours

24 hours

f1 = 10% for polonium

Mr. Litvinenko’s DoseMr. Litvinenko’s Dose

He got a snootfull (Sf)!He got a snootfull (Sf)!1-3 GBq (~25-80 mCi)1-3 GBq (~25-80 mCi)50 mCi?50 mCi?~6 micrograms~6 microgramsDose to RBM Dose to RBM ≈ 9 Gy in three weeks≈ 9 Gy in three weeksOther organs: liver (25 Gy/GBq), kidneys (40 Other organs: liver (25 Gy/GBq), kidneys (40 Gy/GBq), spleen (15 Gy/GBq)*Gy/GBq), spleen (15 Gy/GBq)*

**J. Harrison et al, Polonium-210 as a poison, J. Radiol. Prot. 27 (2007), J. Harrison et al, Polonium-210 as a poison, J. Radiol. Prot. 27 (2007), pp. 17-40.pp. 17-40.

Health Physics ResponseHealth Physics Response

HPA aka NRPBHPA aka NRPB

SurveysSurveys

Laboratory analysisLaboratory analysis

Clean-up/remediationClean-up/remediation

Total government response (NRC, DOE, Total government response (NRC, DOE, EPA equivalents)EPA equivalents)

Other Contaminated LocationsOther Contaminated Locations

OfficesOfficesRestaurants Restaurants Coffee barsCoffee barsNightclubs Nightclubs Football (soccer) Football (soccer) stadiumstadiumAirplanesAirplanesCarsCarsHotels (3 primarily)Hotels (3 primarily)

Public Health Response (UK)Public Health Response (UK)

Health Protection AgencyHealth Protection AgencyTracked plane passengers and anyone Tracked plane passengers and anyone else who had contact with Litvinenkoelse who had contact with LitvinenkoComm. plan (Website, media, call center)Comm. plan (Website, media, call center)Developed protocols for lab analysis and Developed protocols for lab analysis and dose assessment based on urinalysis, dose assessment based on urinalysis, ICRP modelsICRP modelsFollow-up criteria: <1mSv,1 Follow-up criteria: <1mSv,1 ≥EDE<6, ≥6≥EDE<6, ≥6738 samples (686/35/17)738 samples (686/35/17)

Public Health Response (US)Public Health Response (US)

CDC worked closely with UKCDC worked closely with UK

State Department, CDC Quarantine State Department, CDC Quarantine programprogram

Public Health message (HAN, Epi-X)Public Health message (HAN, Epi-X)

Identified labs and developed analytical Identified labs and developed analytical plans (similar to UK)plans (similar to UK)

~100 self-reported, 24 samples analyzed~100 self-reported, 24 samples analyzed

All results <1mSvAll results <1mSv

The CDC TeamThe CDC TeamRadiation Studies BranchRadiation Studies Branch

Charles W. Miller, PhDCharles W. Miller, PhDRobert C. Whitcomb, PhD, CHPRobert C. Whitcomb, PhD, CHPArmin Ansari, PhD, CHPArmin Ansari, PhD, CHPCDR Jeffrey B. Nemhauser, MD, USPHSCDR Jeffrey B. Nemhauser, MD, USPHSCarol McCurley, MSCarol McCurley, MS

CommunicationsCommunicationsBernadette Burden, Office of the DirectorBernadette Burden, Office of the DirectorDagney Olivares, National Center for Environmental Health/Agency for Dagney Olivares, National Center for Environmental Health/Agency for Toxic Toxic Substances & Disease RegistrySubstances & Disease Registry

Division of Laboratory SciencesDivision of Laboratory SciencesRobert Jones, PhDRobert Jones, PhD

Division of Global Migration and QuarantineDivision of Global Migration and QuarantineGary W. Brunette, MDGary W. Brunette, MD

Special Thanks: Special Thanks: John Croft, PhD, Head of Emergency Response, United Kingdom John Croft, PhD, Head of Emergency Response, United Kingdom Health Protection AgencyHealth Protection Agency

Criminal InvestigationCriminal Investigation

Poisoning suspected early, type unknownPoisoning suspected early, type unknown

Discovery of rad contamination (11/21)Discovery of rad contamination (11/21)

Millenium hotel bar and sushi bar closed Millenium hotel bar and sushi bar closed (crime scene and public health concern)(crime scene and public health concern)

Easy to follow trailEasy to follow trail

Suspect identified May 2007Suspect identified May 2007

ConclusionConclusion

Almost the perfect crime!Almost the perfect crime!

Major impact both in UK and Major impact both in UK and internationallyinternationally

Media frenzyMedia frenzy

View to the future?View to the future?

Could it happen here? It did!Could it happen here? It did!

June 29, 1995June 29, 1995

NIH P-32 IncidentNIH P-32 Incident

27 people (including pregnant worker) 27 people (including pregnant worker) internally contaminated with ~1-500 internally contaminated with ~1-500 μμCiCi

Laboratories and researcher’s home Laboratories and researcher’s home contaminatedcontaminated

Massive survey, bioassay and Massive survey, bioassay and decontamination effortdecontamination effort

Local eventLocal event

AcknowledgementAcknowledgement

Dr. Charles MillerDr. Charles Miller

CDC, Radiation Studies BranchCDC, Radiation Studies Branch