2-6 June 2014 Panama City, Panama Regional Workshop for the Safe Transport of Radioactive Material in the Caribbean Module 1.3 Review of Primer Material 2-6 June 2014 Panama City, Panama Chris Bajwa Transport Specialist Division of Radiation, Transport and Waste Safety IAEA Austria Paul Gray Vice President External Relationships and Global Logistics Nordion, Inc. Canada

Overview Primer Material included the following: - What are radioactive materials? - Uses of radioactive materials - Why transport radioactive material? - Consequences of delay - Regulations for transport of radioactive material - Package types - Package information - Involvement of public authorities - Facilitating movement of radioactive material

What is radiation? Emission of energy or particles Radiation is emission of electromagnetic energy (gamma) or particles (alpha, beta, neutron). 3

What are radioactive materials? Presenter to expand on the following: Materials which emit radiation are called radioactive materials There is natural radiation background from the outer space (e.g. sun) and earth’s crust (e.g rocks). Radioactive material could be naturally occurring substances (Granite, tobacco, some natural ores, milk, banana, beer) or artificially produced (radiopharmaceuticals, smoke detectors, processed radioactive material).

Radioactive Materials – Critical to Global Economy & Health Medical treatment, diagnostics, therapeutics and palliation (Nuclear Medicine) Sterilization of single-use medical devices Sterilization of consumer products Food safety and agricultural applications Process control Industrial, radiography and safety applications (NDT of welds, pipelines, castings and engines) Research and development Nuclear Energy Electronics components (tantalum/niobium) Law enforcement & counterterrorism The radioisotope sector is broad and diverse, long established, with a culture of safety and security 5

What is a medical isotope?

Like melting ice cubes… Radioactive decay melts away the product. But unlike ice, the decay can not be stopped.

Perishable products Radioactive decay: half-life Technetium-99m: 6.0 hours Molybdenum-99: 66 hours Iodine-123: 13.2 hours Yttrium-90: 64.1 hours Thallium-201: 3.0 days

Importance of Radioisotopes & Sealed Sources : Medical Applications U.N. declares that cancer is a “silent crisis” in the developing world and the need to treat cancer is rising Cancer takes more lives than HIV/AIDS, TB and malaria, combined Cobalt-60 is used for treating cancer (45,000 treatments/day in >50 countries) Caesium -137 is used in irradiation to prevent TA-GVHD following transfusions (Over 750 units installed in 50 countries) Brachytherapy techniques employ Iridium-192, Iodine-125, Palladium-103, Strontium-90 for novel treatment applications

Uses of Radioactive materials: Medical diagnosis IAEA Training Material on Radiation Protection in Nuclear Medicine Radiation protection in nuclear medicine Uses of Radioactive materials: Medical diagnosis Presenter to expand on the following: Nuclear medicine imaging detects functional properties of the human tissue. The imaging is done by tracing the distribution of “radiopharmaceuticals” within the body. The doctor can see the insides of a patient’s body without surgery.

Treatment of cancer Cancer Treatment A high activity radioactive source (cobalt-60) is used for treatment of tumours.

Sterilization and blood irradiation Sterilization of medical supplies Single use medical supplies (syringes, gloves, cotton and bandages) sterilized by radiation. Products “irradiated” in a packaged condition. No repacking after sterilization. Sterilized products directly sent to users - negligible chance of re-infection. Irradiated blood used in life-saving blood transfusion reduces risk of immunological reaction in the recipient.

Cobalt - 60 Cobalt-60 is depended upon to sterilize some 45% of all single-use medical supplies and devices in the world : sutures, catheters, syringes, heart valves, artificial joints and an estimated 80% of all surgeons’ gloves Cobalt-60 is also used extensively for sterilization of consumer products used in everyday life and purchased in many stores locally

Food preservation Preservation of food Enormous quantities of food grains, vegetables, spices, etc. are wasted every year due to infestation. Wastage can be stopped by irradiation of food. Cobalt-60 is used for food irradiation. Products are sterilized by radiation in a packaged condition. Sterilization of food is encouraged by WHO and used in many countries. Cobalt-60 is increasingly relied upon to enhance food safety and preservation ; destroying e-coli, food for the immuno-compromised; packaging treatment

Consumer products Daily needs Fluorescent lamps save power at low cost. Smoke detectors provide early warnings of fires thus saving lives and property. Many of the “Exit” signs we see in public halls operate even if there is power failure because of the radioactive material in them. (Tritium)

Industrial applications Quality control Film thickness Paper thickness Quality control of industrial products: Thickness measurement Filling level control Other examples: motorway surfaces, dredging of river beds, etc. Beverage filling level

Radioactive materials in industry – Non-destructive testing Film Developed film Object Defects in the welding and casting of metal objects can be detected without damaging the objects. The radiation source is kept on one side of the object being tested and X-ray film on the opposite side. “Industrial radiography” is reliable. It saves considerable cost and assures quality of product. Incident radiation 17 17

Industrial radiography Non-destructive testing of industrial products Expand on the examples: Testing during bridge construction Examination of Aircraft components Pipeline welds and valves.

Industrial radiography

20

Power production Uranium is the fuel for nuclear power. Uranium fuel is taken to the power plant. Amount of radioactivity in fresh nuclear fuel is small. Nuclear reactors are also used to produce radioisotopes for medical applications. Spent fuel has much radioactivity.; has to be taken to safe disposal site. About 15% of electricity is produced from nuclear power world-wide.

Delivering RAM to users Picture of a ship Radioactive materials are produced only in a few facilities in the world. From they have to be carried to the user: a hospital, a factory, a power station or a home. Some of the radioactive materials have a short useful life. They have to be rushed by air. It is easier to move a medical product than it is to move a sick patient – so the products need to be sent to wherever the patients are. 22 22

The World of Medical Isotopes – Global Supply Chain Small number of medical isotope producers in the world Most countries are importers of medical isotopes

Just-in-Time Shipments Patients and physicians depend on reliable daily delivery To meet these demanding logistical and humanitarian requirements, producers partner with couriers and reliable commercial air carriers Short half-lives means highly perishable and cannot be held up Same day / next day medical procedures Limited number of medical isotope suppliers Most countries are importers of such materials

Air Transport is Critical Air transport is essential to this daily, global supply chain Timely arrival at airport is half the battle Right product to right customer at right time Reliance on air carriers at all steps in logistics process - on time delivery to hub - on time clearance - on time / accuracy of sort - on time delivery - immediate notification of delays

Importance of Medical Isotopes Products - Summary Depended upon for diagnostic, treatment, therapeutic, palliation and research purposes in medical facilities around the world Preclude costly and painful invasive diagnostic procedures Out-patient vs. in-patient diagnosis and treatment Leading edge technology (e.g. MAb labeling for cancer treatment) Solid, liquid or gaseous form Tens of millions of procedures annually worldwide Short half lives, small volumes High volume of JIT shipments Hospitals, physicians and patients reliant Licensed facilities/users Any denial/delay has immediate and significant impact on healthcare and patients specifically; postponement or cancellation of diagnostic tests or therapeutic treatments for patients relying on this product Air transport primarily

Why transport RAM? The transport chain

Implementation of IAEA Regulations through Dangerous Goods Transport Regulations Class 7 UN Class 7 International Recommendations all 9 classes of dangerous goods CCNR/UNECE ICAO IMO OTIF UNECE International Modal Provisions National Regulations/Laws for Air, Sea and Road/Rail/Waterway Transport National Modal Provisions 28

Package types Package types The quantity hazard of radioactive material permitted in a package determine the type of the package! If a package has to carry large quantities of radioactive material, it needs to be approved by the concerned competent authority. Explain different types of packages ranging from excepted package to Type B(U)/(M) package.

Package types

Transport documentation The documentation which accompanies the package provides comprehensive details including Particulars of the shipment Approvals Consignor / consignee address Special handling instructions Emergency actions Consignor’s declaration Any other documents such as insurance papers as necessary

Public authorities Customs, Security, Port Authorities etc. In addition to the competent authority for transport of radioactive material, other public authorities, may have responsibilities in connection with shipments of radioactive material e.g., Port Authorities, Civil Aviation Authorities, Customs and security agencies. Close coordination among the various public authorities including the competent authority for transport of radioactive material would ensure safe and efficient shipment in the interest of the public.

Instances of delay / denial In some cases radioactive shipments which comply with the international transport regulations, are reported to have been delayed / denied. The reported reasons include: There were additional requirements for handling radioactive cargo. The ports were in nuclear free zones! (Common radioisotopes used for healthcare and industrial applications are not nuclear materials.). A port would refuse to receive the vessel if radioactive material on board the ship was intended for use in the some other country. A port would not allow a ship in its waters even if the radioactive material on the board the ship was intended for use in its country! Ships carrying radioactive material would be allowed berthing in a port only if they arrive during daylight hours! Ships carrying radioactive material were accorded a low priority in a port. The competent authority for transport of radioactive material of a State considered that a shipment was safe but a port authority official of the same State refused the shipment because he thought it was not safe! Lack of harmonization between national and international regulations Lack of appropriate training on safe transport of radioactive materials

What you can do to facilitate safe movement of radioactive material In case additional restrictions are proposed to be placed on transport of radioactive material, examine how the objective could be achieved without denying the society the benefits from radioactive materials. Coordinate with other authorities in your State. Inform the other authorities and carriers in advance about deviations of your regulations and procedures from international practice. Minimise such deviations from international regulations. Coordinate – Cooperate - Minimize deviation

Summary Isotopes have to be transported to the users. Isotopes are used for health care, industry quality control, power production, etc. Regulations assure safety of transport. Delay or denial of a shipment result in patients denied treatment; stop a factory or a nuclear power plant; or deny mankind of a safe product that would enhance the quality of life!

Questions? Thank you