Final PPT for ERERT 2025 (cite CoPilot) with ADPH

Conglomeration of AI with training slides for ADPH ERERT members

1. Title

2. Agenda

3. Basic Radiation Training – 45 minutes Simple overview of radiation Types of radiation you may encounter Safety protocols

4. PPE demonstration – 20 minutes

5. PPE steps

6. TTX – 20 minutes Scenario

7. TTX Steps or decision points to think through Guide for decision making

8. Debrief / Q&A – 10 minutes Learned Lingering questions Chance to share final thoughts of putting it all together

9. Expanded Radiological Emergency Response Team (ERERT) Training Presentation - Alabama Department of Public Health

10. Team Purpose The ERERT provides rapid response to radiological emergencies across Alabama. Members include environmentalists and nurses from each Public Health District.

11. Roles and Responsibilities Environmentalists: Survey scenes, communicate with ORC, assess radiation. Nurses: Assist with decontamination, support medical staff, monitor exposure.

12. Equipment Overview Key equipment includes Ludlum 14C, dosimeters, PRD, PPE, and contamination monitoring tools.

13. Response Procedures Follow ORC instructions, assess radiation, establish boundaries, monitor contamination, and assist with decontamination.

14. Training Requirements Environmentalists: RERO course and Basic Radiation Training. Nurses: REM course and Basic Radiation Training. Annual refresher training required.

15. Tabletop Exercise: Transportation Accident Scenario: A truck transporting radiological material crashes on I-65. Objectives: - Assess radiation levels - Establish safety perimeter - Coordinate with first responders - Perform contamination monitoring - Communicate with ORC

16. Training Schedule 08:30 AM - Welcome & Overview 09:00 AM - Team Roles & Equipment 10:30 AM - Response Procedures 12:00 PM - Lunch Break 01:00 PM - Training Requirements 02:00 PM - Tabletop Exercise 04:00 PM - Debrief & Q&A 04:30 PM - Adjourn

17. CTOS WEB-BASED TRAINING https:// www.ctosnnsa.org / training.aspx#aWEB-BASED_TRAINING AWR -140-W, Introduction to Radiological/Nuclear WMD Operations AWR -350-W, Hospital Radiological Emergency Operations: Hospital Operations Plan AWR -410-W, Hospital Radiological Emergency Operations: Hazards and Countermeasures AWR -411-W, Hospital Radiological Emergency Operations: Personal Protective Equipment AWR -412-W, Hospital Radiological Emergency Operations: Preparation AWR -400-W, Radiological Dispersal Device (RDD) Response Guidance: Planning for the First 100 Minutes PER-307-W, Introduction to Nuclear Detonation Effects and Response Strategies

18. Fig. 1. Competencies for bioterrorism and emergency readiness: public health nursing. Rowney, R., & Barton, G. (2005). The role of Public Health Nursing in emergency preparedness and response. Nursing Clinics of North America , 40 (3), 499–509. https://doi.org/10.1016/j.cnur.2005.04.005 Accessed 30 Sept. 2025.

19. Courses outside of ERERT/ADPH Create a course repository that is just a placeholder (e.g., IS-100) Allow the user to simply upload the certificate to show completion in Litmos

20. Radiological Emergency Response Team Training Activities Hands-on and Tabletop Exercises

21. Zone Establishment Drills Practice identifying and setting up hot, warm, and cold zones using the Emergency Response Guide.

22. Patient Decontamination and Transport Simulate decontaminating and escorting patients, with nurses applying the REAC/TS algorithm.

23. Radiation Survey Practice Environmentalists use Geiger-Mueller survey meters to measure levels and record exposure rates.

24. Communication and Coordination Drills Practice inter-agency communication between EMS, hospitals, and responders.

25. Decision-Making Scenarios Tabletop exercises on evolving conditions such as shifting radiation levels or unexpected complications.

26. ERERT Training Overview An introduction to essential skills and knowledge

27. Team Purpose

28. Mission and Objectives of ERERT Rapid Radiological Response ERERT provides swift and effective response to radiological emergencies throughout Alabama to minimize hazards. Coordinated Statewide Effort The Office of Radiation Control coordinates ERERT actions, ensuring expert guidance during radiological incidents. Trained Multi-Disciplinary Team ERERT includes trained environmentalists and nurses from each Public Health District ready for radiological incidents. Strategic Member Deployment Statewide placement of ERERT members enables timely and organized radiological threat assessment and management.

29. Roles and Responsibilities

30. Environmentalists and Nurses Duties Environmentalists' Responsibilities Environmentalists respond to radioactive accident scenes, conduct surveys, and measure exposure rates to ensure safety. Primary Communication Role They act as the main contact for the ORC, relaying instructions and coordinating site activities. Nurses' Medical Support Nurses assist medical staff with decontamination and safe handling of potentially contaminated patients. Coordinated Emergency Response Environmentalists and nurses collaborate closely, following protocols to safeguard public health during radiological emergencies.

31. Equipment Overview

32. Essential Tools for ERERT Members ITEM(s) QUANTITY Disposable Coveralls 1 pair Non-latex Gloves 2 pairs Waterproof Shoe Covers 1 pair Thermoluminescent Dosimeter (TLD Card) 1 Pocket/Direct Reading Dosimeter 1 low range RadEye – Electronic Dosimeter 1 Masking Tape 1 roll

33. Response Procedures

34. Operational Protocols During Emergencies Preparation and Equipment Check ERERT members collect and prepare all necessary equipment before deployment including dosimeters and radiation detectors. On-site Safety Procedures Members don protective clothing, attach radiation monitors, and establish contact with the Incident Commander upon arrival. Medical Triage and Contamination Control Life-threatening injuries receive immediate medical care, while others are triaged and surveyed for contamination before relocation. Continuous Communication and Coordination All actions are coordinated with the ORC and require constant communication for guidance and reporting findings.

35. Training Requirements

36. Courses and Certification for ERERT Members Environmentalists Training Environmentalists must complete the RERO course and Basic Radiation Training before receiving their equipment. Nurses Certification Nurses attend the REM course and Basic Radiation Training to prepare for radiological emergencies. Annual Refresher Training Annual refresher sessions include equipment calibration and protocol updates to maintain proficiency. Continuous Education Importance Ongoing hands-on practice and education sustain readiness and improve ERERT program effectiveness.

37. ADPH AEMA Waste Isolation Pilot Program in Alabama Jerome Coleman Emergency Planning & Environmental Monitoring Office of Radiation Control Alabama Department of Public Health Quinton Dailey Emergency Management Coordinator Field Operations Division Alabama Emergency Management Agency Abria Grimmett Emergency Planning & Environmental Monitoring Office of Radiation Control Alabama Department of Public Health

38. Introductions Quinton Dailey, Alabama Emergency Management Agency Abria Grimmett, Alabama Department of Public Health, Office of Radiation Control

39. THE UNITED STATES DEPARTMENT OF ENERGY (DOE) Waste Isolation Pilot Program (WIPP)

40. History/Timeline 1957-1979 1957: the National Academy of Science concludes that the most promising method of disposal of radioactive waste is in salt deposits. 1974: The U.S. Atomic Energy Commission (AEC) chooses an ancient salt bed 26 miles east of Carlsbad for exploratory work in the search for an underground radioactive waste repository site 1979: Congress authorizes the Waste Isolation Pilot Plant (WIPP) as a research and development facility to demonstrate the safe disposal of radioactive waste from defense activities not regulated by the U.S. Nuclear Regulatory Commission (NRC). 1992 1992: Congress passed the WIPP Land withdrawal Act which reserved 16 sections of land for the nations first deep-geologic repository for disposal of defense-generated transuranic (TRU) waste

41. Waste Isolation Pilot Plant The U.S. Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP) is a deep geological repository for permanent disposal. Waste is collected from disposal sites around the country and deposited in Carlsbad, New Mexico. WIPP is the nation’s only repository for the disposal of nuclear waste known as transuranic waste. Many of your contaminated items found in waste may include small amounts of plutonium. Transuranic waste is disposed of in deep geological salt beds. Salt beds are easily mined, free of flowing water, impermeable, and geologically stable. The possible items found in transuranic waste are; clothing, tools, rags, residues, debris, and soil.

42. WIPP Facility To view from PC, follow this link: https://youtu.be/E9MzWJLhDu8?si=GNTanPKlZwtkVwoB

43. Emergency Response to a Transportation Accident Involving Radioactive Material

44. WIPP ROUTE

45. SUMTER GREENE TUSCALOOSA JEFFERSON TALLADEGA ST. CLAIR CALHOUN DEKALB ETOWAH CLEBURNE ALABAMA WIPP ROUTE

46. The Waste Isolation Pilot Plant is the only deep geological radioactive waste depository. 2150 feet underground Waste Isolation Pilot Plant

47. Alabama Shipping Update The shipping total changes annually. These shipments are on a 12-month cycle and include the following sites: Argonne National Laboratory Idaho National Laboratory Los Almos National Laboratory Oak Ridge National Laboratory Savannah River Site

48. Emergency Worker Training Standardized training for the state of Alabama on how to respond to a radiological incident. This training is consistent throughout the state of Alabama.

49. WHAT IS RADIATION? Radiation is energy that travels in the form of waves or high-speed particles . There are 2 ways radiation can occur: Naturally or Man-made. This Photo by Unknown Author is licensed under CC BY-SA-NC

50. (Roentgen Equivalent in Man) REM A unit of radiation dose equivalent used to measure the amount of damage to human tissue caused by all types of ionizing radiation. 1 R ≈ 1 Rad = 1 Rem

51. This Photo by Unknown Author is licensed under CC BY Non-Ionizing: Radio and TV waves, Infra-Red, Microwaves, UV-A & UV-B rays Ionizing: Alpha & Beta Particles, Gamma Rays, X-Rays, UV-C rays _____________________________________________________________________ TWO TYPES OF RADIATION

52. IONIZING RADIATION Ionizing radiation- radiation that has enough energy to break an electron away from an atom. This gives ionizing radiation the ability to change the chemical composition of the material it interacts with.

53. ALARA As Low As Reasonably Achievable

54. What’s the Difference? Exposure vs. Contamination Exposure is the process where a person absorbs energy from ionizing radiation. Contamination is when radioactive material is deposited on to or inside a person or object.

55. Inhalation Ingestion Absorption Injection Radiation pathways There are four pathways to become contaminated with radiation:

56. Eat Drink Smoke Chew/Dip Apply Lip Balm Apply Makeup Do not : AVOID RADIOACTIVE CONTAMINATION Use PPE while on the scene of an incident involving radioactive material.

57. https://bit.ly/ADPHgreencard Radiation Dosage Limits Pocket dosimeters and the Radiation Dosage Limits card is crucial to your stay time with radiological material. Multiply your dosimeter readings by 2 in order to get you Total Effective Dose Equivalent (TEDE). Check dosimeters and record readings every 30 minutes!

58. POCKET DOSIMETERS Look through the dosimeter toward a light source

59. Reload dosimeter onto charger if: Filament won’t move/appear Filament “floats” (keeps on moving while on the charger Get a new dosimeter (or charger) if above cannot be resolved Get a new dosimeter if 1. The filament still moves when off of the charger

60. Clamp Clamp Trigger Discharge Button Generator Lever CDV-750 DOSIMETER CHARGER

61. Measures contamination ( cpm ) and exposure mR /h Ludlum 26-1

62. Before Arriving On Scene Notify proper agencies and personnel Dispatch Law Enforcement Fire Department Alabama Office of Radiation Control Special Response Groups (ERERT) First on-scene begins the process Follow local notification procedures Restrict access to area If possible, detain individuals at a safe distance Document all pertinent information

63. Radiation transportation placards The transportation of radioactive materials requires specific placarding requirements to ensure safety and compliance with regulations. Placards are more durable standard hazmat identifiers than labels and are placed on outer containers, trucks, cylinders, or other vehicles used for transport. They are not made of paper and provide additional identifiers beyond hazard labels and placards. The placarding requirements are determined by the type of radioactive material being transported and the level of radioactivity present.

64. Exclusive Use Closed Transport Vehicles Packages

65. Equipment Drop Area

66. Decontamination corridor Decontamination corridor Decontamination corridor

67. Questions?

68. Radiation Safety Environmental, Health & Safety Department Wichita State University 76

69. Radiation Safety Training Required for all users of radioactive material at WSU Covers material license conditions, regulations and all safety practices associated with use of radioactive materials. 77

70. Course Outline Radiation Safety Principles Biological Effects and Risk Postings and Labels Contamination Control and Spills Proper Survey Techniques Survey meter and wipe test Radiation Safety Checklist Security of stock vials Radioactive Waste Disposal Contact Information 78

71. Radiation Safety Committee (RSC) Radiation Safety Officer The (RSC) oversees all uses of radioactive material permitted by the materials license and  has overall responsibility for development and recommendation of comprehensive polices and guidelines for the safe use of all sources of radiation The RSO ensures that radiation safety activities are being performed in accordance with approved procedures and regulatory requirements. 79

72. Basic Terms Radiation : energy in transit in the form of high speed particles or electromagnetic waves. Radioactivity : Characteristic of an unstable atom that releases energy in the form of a particle or electromagnetic wave. 80

73. Types of Ionizing Radiation Alpha particles : contains 2 neutrons and 2 protons, which is ejected from the nucleus of a radioactive atom. Beta particles : A high-speed electron or positron, usually emitted by an atomic nucleus undergoing radioactive decay. Electrons carry a negative charge. X-rays : Electromagnetic radiation originating in the electron field of an atom. Gamma rays : A gamma ray is an electromagnetic radiation originating in the nucleus of an atom. 81

74. Radiation is Energy 82

75. Types of Radiation Ionizing Radiation : Radiation capable of liberating electrons from an atom. ex. beta particles, x-rays Non-ionizing radiation : Radiation not capable of liberating electrons, but can excite the atom. ex. microwaves, radio waves, lasers 83

76. Radiation Units There are two systems of units used in the measurement of radioactivity and radiation dose. The older units (Curie, rad and rem) are commonly used in U.S. regulatory language. The SI units (Becquerel, Gray and Sievert) are commonly used internationally. 84

77. Radiation Unit Roentgen : unit for measuring the amount of ionization in air (exposure) due to gamma or x-rays. (SI unit is Coulomb per kilogram) RAD : Radiation Absorbed Dose a unit used to describe the amount of energy deposited per unit mass from radiation in any type of medium. SI Unit: 100 rads = 1 Gray REM : Roentgen Equivalent Man a unit used for measuring human dose equivalent. SI Unit: 100 rem = 1 Sievert 85

78. Radiation Quantities Curie : 3.7x10 10 disintegrations per second or 2.2x10 12 disintegrations per minute. 1 milliCurie (mCi) = 2.2 x 10 9 dpm 1 microCurie ( m Ci ) = 2.2 x 10 6 dpm 100 m Ci = 0.1 mCi Becquerel : one disintegration per second. (SI system) 1 mCi = 3.7x10 7 dps = 37 MegaBecquerel (MBq) 1 m Ci = 3.7x10 4 dps = 37 kiloBecquerel ( kBq ) 86

79. Radiation Quality Factors Two different types of radiation may deliver the same absorbed dose, but produce a different biological effect, and hence, dose equivalent. 1 rad of alpha = 20 rem 1 rad of beta = 1 rem 87

80. Half-Life The time required for any given radioisotope to decrease to one-half of its original activity by radioactive decay. This period of time is called the half-life 32 P - 14.3 days 14 C - 5730 years 3 H - 12.3 years 35 S - 89.7 days 125 I - 60 days 88

81. External Exposure Common isotopes with external exposure potential P-32, I-125, Cr-51 Not all radioisotopes are external exposure hazards H-3, C-14, S-35 External exposure occurs when all or part of the body is exposed to penetrating radiation from an external source. 89

82. Pathways of Internal Exposure Ingestion Absorption Inhalation Puncture 90

83. Contamination and Exposure Radioactive Contamination is Radioactive material where it shouldn’t be. e.g. floors, bench tops, hands Fixed vs. Removable Contamination All radioisotopes have contamination potential even if they do not have external exposure potential. The goal is to prevent contamination from getting on to your skin and/or inside your body . How Contamination Differs From Exposure: A person exposed to radiation is not necessarily contaminated with radioactive material. 91

84. You are NOT radioactive if you receive an external exposure from radioactive material. 92

85. 93 ALARA The goal of radiation protection is to keep radiation doses As Low As Reasonably Achievable WSU is committed to keeping radiation exposures to all personnel ALARA NCRP Definition of ALARA As Low As Reasonably Achievable (ALARA): A principle of radiation protection philosophy that requires that exposures to ionizing radiation be kept as low as reasonably achievable, economic and social factors being taken into account. The protection from radiation exposure is ALARA when the expenditure of further resources would be unwarranted by the reduction in exposure that would be achieved.

86. Contributions from Man Made and Natural Background Source of Radiation 94 From NCRP Report No. 160, “Ionizing Radiation Exposure of the Population of the United States” (2009) Annual Exposure 620 millrem/yr.

87. NCRP SUMMARY Average dose to individual is 620 mrem/yr Approximately 37% of dose was attributed to radon An additional 13% attributed to other natural sources (cosmic, terrestrial, internal) Total ~50% attributed to natural sources Medical comprised ~48% Dose from nuclear power was grouped into a category comprising <0.1% 95

88. Biological Effects Studies If 100,000 persons were exposed to 10 Rem of radiation each, 800 excess cancer deaths would be expected during their remaining lifetimes in addition to the nearly 20,000 cancer deaths that would occur in the absence of radiation. - BEIR V Report, page 162 - 1989 96

89. Genetic Effects Damage to cells DNA Effects have not been observed in human populations Extrapolated from larger doses and animal studies 97

90. Declared Pregnant Worker Any radiation worker who is pregnant may voluntarily declare her pregnancy and the estimated date of conception in writing to EHS and thereafter her occupational radiation exposure shall be limited to 500 millirem (50 millirem/month) for the entire period of gestation. If you are pregnant and want to declare pregnancy, please contact EHS for consultation. Ref: US NRC Regulatory Guide 8.13 rev. 3 1999 98

91. MINIMIZE EXTERNAL EXPOSURE Time (Reduce exposure time) Distance (Increase Distance) Shielding (Place dense object between you and source of radiation) 99

92. 100

93. How To Minimize External Exposure TIME : 60 mR/hr = 6 mR in 6 minutes 101

94. 102

95. How To Minimize External Exposure   103

96. 104

97. Shielding Alpha particles can be stopped by a sheet of paper. Most Beta particles can be stopped by 1-2 cm of plexiglass. Most gamma and x-ray photons can be absorbed by several cm of lead. Neutrons may require several feet of concrete . 105

98. Do you work directly with a source of radiation? No Badge Required Is the radiation source an isotope or a machine? No Yes Do you work with one of the following isotopes? * badge type in ( ) Brachytherapy Sources (1 and 4) >1 mCi. of gamma or positron emitter (1 and 4) >1 mCi. high (>500 keV) max energy Beta emitter (1 and 4) Nuclear Medicine (1 and 4) Do you work with any one of the following machines? * badge type in ( ) Fluoroscope (2 and 3) LINAC (1) Diagnostic x-ray (1) CT (1) Isotope Machine A badge is mandatory A badge is voluntary Yes No No Badge Type (1) – Whole body (2) – Collar (3) – Waist (4) – Ring Dosimetry Requirement Decision Tree 106

99. Labeling 107 Refers to quantities of radioactive material used or stored. Refers to areas accessible to personnel, in which a major portion of the body could receive a dose of 5 mrem in any one hour at 30 centimeters from the radiation source or from any surface that the radiation penetrates

100. Postings Kansas Department of Health and Environment “Notice to Employee” 108

101. Contamination Definition: Radioactive material where it shouldn’t be. e.g. floors, bench tops, hands All radioisotopes have contamination potential even if they do not have external exposure potential. The goal is to prevent contamination from getting on to your skin and/or inside your body. 109

102. Skin Contamination Cool water, mild soap 2-3 minutes working up a good lather, dry No harsh chemicals or detergents Survey for contamination Notify the RSO or EHS 110

103. Notify the people in area that a spill has occurred Report incident to the RSO and EHS Prevent the spread of contamination. Cover the spill with absorbent material and prevent access to the area by unauthorized personnel Clean up using disposable gloves Survey area with a low range thin window GM survey instrument Emergency Office Phone RSO Dr. Bousfield – [phone] EHS Andrew Clem – [phone] Spill Response 111

104. Direct Survey Survey Meters “Pancake probe” Model 44-9 Used to monitor: 14 C, 35 S, 32 P, 33 P Move slowly at 2 inches/second from a distance no greater than 1 cm above the surface * Annual Survey Meter calibration is required Model 3 known as a “Scintillation” or “NaI” Probe Used to monitor low energy gammas such as I-125 112

105. Radiation Detection Instruments Liquid Scintillation counter is required for Tritium Contamination surveys End Window (S-35, P-32, P-33, C-14) *Lower Detection Efficiency than End Window Pancake (S-35, P-32, P-33, C-14) *Better Detection Efficiency than End Window GM Portable Survey Meter Gamma Scintillator (NaI) probe (I-125 and Cr-51) 113

106. Proper Survey Technique Use appropriate survey meter Check Calibration Status (Sticker) Check battery Audible on Check background level Start at the lowest scale Audio On/Off Switch Rotary Switch Off Battery Check Scalar Multiplier Battery Compartment 114

107. Survey Meter Face Plate 115 Scale: 0 - 5 K cpm on X 1 multiplier *Some meter faces will have the Middle and Bottom scale (As shown on left). In research setting the CPM scale is the only scale we use Use This Top Scale

108. Direct Monitoring Set meter on lowest scale and observe background. Bring probe 1/4 to 1/2 inch from surface without touching. Move probe slowly. (2 inches/sec) Listen for audible chirp and observe count rate. Results expressed in units of counts per minute (CPM). 116

109. Wipe Tests A wipe test only assesses removable contamination. Use absorbent paper to wipe an (100 cm 2 )area For H-3, a wipe test is the only means to assess potential removable contamination. For other isotopes (i.e. P-32, S-35, C-14) a Geiger Counter may be used to assess removable contamination. (Note: efficiency is much lower than wipe test counted with LSC) 117 Liquid Scintillation Counter

110. Radioisotope Ordering Process Order placed through department Department places order with vendor Package arrives at EHS for inspection EHS delivers package to your lab Lab personnel receives and secures package. 118

111. Security of Radioactive Material You must do the following: Keep radioactive material in constant view Lock up radioactive stock solutions Lock the laboratory Always keep the access door to your floor of the building locked. (Use Key Card Access or the Combination Lock) 119

112. Iodination Precautions Verified negative pressure hood Double glove Lab coat Double bag radioactive waste Lead bricks in front of hood causes turbulence Use charcoal to absorb iodine vapors Air sampling and thyroid monitoring required 120 Fume Hood REQUIRES ADDITIONAL TRAINING: Iodination procedures

113. Sulfur 35 - Amino Acid Precautions Because of volatility : Open Stock vial in hood Place charcoal in incubators, water baths, etc. 121

114. Phosphorous-32 Precautions 3/8 inch lucite lab coat, double gloves, safety goggles absorbent paper or trays Dosimetry (> 1 mCi) whole body badge and ring dosimeter Geiger counter 122

115. 123 Use flat top tube opener to reduce radiation levels to fingers

116. Use of Radioactive Materials in Animals Radioactive material in animal use must be approved by Radioisotope Committee IACUC (Animal Care Committee) 124

117. 125

118. Radioactive Waste Categories a. Solid waste b. Aqueous liquid waste c. Organic liquid d. Deregulated liquid scintillation vials e. Regulated liquid scintillation vials f. Animal carcass/tissue g. Volatile material h. Stock vials All radiation waste pick up requests are scheduled online at: 126

119. Radioactive Waste Guidelines Environmental Waste Management approved containers by half-life : < 30 DAYS, 30-90 DAYS, > 90 DAYS 4 ml thick plastic bag Inventory sheet No radioactive waste is allowed in cold trash or biohazard bags All rad labels must be defaced before placing in waste containers waste pickups are scheduled on-line 127

120. Radwaste Guidelines Put radioactive needles etc., in “radioactive” sharp container No liquids No lead pig (Deface and store lead pigs in separate containers next to waste. Environmental management will pick up at time of waste pick up) Assure radwaste container labeled to prevent housekeeper from emptying trash Call Environmental Waste Management for any questions at 617-638-8832. 128

121. Radiation Safety Records Are all records filled out and up to date? Inventory Surveys Waste logs 129

122. Inventory Records You record: What material was received When it arrived (day, month and year) Activity received Chemical form When it was used, who used it Running total of activity on hand 130

123. Contacts Dr. George Bousfield [phone] Andrew Clem [phone] 131

124. Contactless Sign-In Use your phone’s camera app to aim at this QR code, then select the link that appears automatically. Or type in the URL below: https://bit.ly/adphsignin Page 1 – For “County”, select “Other” and type in “Elmore.” Page 2 – For “classification”, choose “ERERT.” Page 2 – For organization, choose “000 NOT LISTED 000” and type in “ADPH - <district, county, or CEP> .”

125. Expanded Radiological Emergency Response Team (ERERT) Training Alabama Department of Public Health Office of Radiation Control PHYSICAL: ADPH Training Center & Administrative Complex 208 Legends Court, Prattville, AL 36066 MAILING: P. O. Box 303017, Montgomery, AL 36130-3017 T: 334.290.6244 F: 334.285.9342 www.alabamapublichealth.gov/radiation Michael Hallman, Radiation Physicist, Senior [email protected] 24-hour ADPH ORC Duty Officer 334.324.0076 Jerome Coleman, Radiation Physicist, Supervisor [email protected] Abria Grimmett, Radiation Physicist , Senior [email protected]

126. Role of the ERERT Members in Radiological Emergencies

127. How ERERT can about and purpose! The Expanded Radiological Emergency Response Team (ERERT) was formed in 2007 under Dr. Donald E. Williamson. M.D., former State Health Officer (SHO). According to Alabama law, the State Health Officer or his/her designee is charged with protective actions in event of a radiological emergency. The ERERT members are the first to the scene agents whose primary duty is to provide the SHO with an initial assessment of the radiological conditions and to provide initial assistance in the resolution of radiological hazards. Purpose : If a radiation emergency occurred in an area of the state at a significant distance from Prattville, it will take the Office of Radiation Control staff several hours to physically respond to the incident site to aid in detecting and measuring contamination/radiation. In an effort to provide a more rapid response by ADPH, (2) nurses and (2) environmentalists from each Public Health Area will serve as members of the ERERT.

128. QR codes/URLs for Videos Video: 4 types of ionizing radiation: Alpha, Beta, Gamma, & Neutron https://youtu.be/2fIylibGJYM Video: Time, Distance and Shielding https://youtu.be/2AcqRD5TTpc Video: Radiological Basics https://youtu.be/QiwFg60V5DE Video: Biological Effects of Radiation https://youtu.be/wMySBZ4GwCw Video: Radiological Dosimetry https://youtu.be/qKtKaLkW5fk

129. Radiation Radiation is energy that travels in the form of waves or high-speed particles. It occurs naturally in sunlight and sound waves. Man-made radiation is used in X-rays, nuclear weapons, nuclear power plants, and cancer treatment. gamma rays gamma rays

130. REM (Roentgen Equivalent in Man ) A unit of radiation dose equivalent used to measure the amount of damage to human tissue caused by all types of ionizing radiation 1000 mR = 1 R 1 R ≈ 1 Rad = 1 Rem

131. Average Annual Radiation Exposure ~620 mR/yr ~310 mR from natural radiation ~310 mR from man-made radiation <1 mR from nuclear power generation

132. Radioactive Material in Alabama Nuclear Power Plants Medical Uses Industrial Uses Research Naturally Occurring Radioactive Material (NORM) Waste Isolation Pilot Plant (WIPP)

133. Two Types of Radiation NON-IONIZING : Radio and TV Waves, Infra-Red, Microwaves, UV-A & UV-B rays IONIZING : Alpha & Beta Particles, Gamma Rays , X-rays, UV-C rays

134. Ionizing Radiation Alpha particles Beta particles

135. Controlling Exposure

136. Protection from Radiation: Time Shorten time while being close to radioactive materials Less time with ionizing radiation = Less radiation exposure

137. Protection from Radiation: Distance Greater the distance from ionizing radiation = Less radiation exposure Keep away

138. Protection from Radiation: Shielding Thicker/Denser Material = Less radiation exposure Place something heavy in between

139. Exposure, Contamination & Decontamination Radiation is a type of energy Contamination is material Radioactive contamination emits radiation Exposure to radiation will not contaminate you

140. Avoid Radioactive Contamination Do not: Eat Drink Smoke Chew/Dip Lip balm Make-Up Use PPE while on the scene of an incident involving radioactive material.

141. Contaminated Injured In all cases… the treatment of an injury takes priority over decontamination!!! >>> Saving lives Decontamination Protocols

142. Radiation & Our Five Senses We are aware of our environment through our five senses. You must rely on instruments to detect the presence of radiation.

143. Pocket Dosimeters Look through the dosimeter toward a light source Roentgens 0 5 10 15 20 Roentgens 0 1.0 2.0 3.0 4.0 5.0 Milliroentgens 0 50 100 150 200

144. Radiation Exposure Dosimeter = Odometer It doesn’t go back down once it goes up. Can be used by anyone else after it is zeroed. Accumulated Exposure

145. Thermoluminescent Dosimeter Records radiation dose for legal/permanent exposure records Can not be used by anyone else once issued Results not immediately available Wearer Number

146. Placement of the TLD & Pocket Dosimeter TLD Pencil/Pocket

147. TEDE ( T otal E ffective D ose E quivalent ) Total Dose = External + Internal External = Pocket Dosimeter Reading External = Internal Therefore… TEDE = 2 x Pocket Dosimeter Reading

148. Radiation Dosage Limits for Expanded Radiological Emergency Response Team

149. Reminders for for Expanded Radiological Emergency Response Team

150. ERERT Equipment

151. Questions?

152. BREAK

153. HANDS-ON DOSIMETRY

154. Milliroentgens 0 50 100 150 200 Milliroentgens 0 50 100 150 200 Milliroentgens 0 50 100 150 200 Milliroentgens 0 50 100 150 200 Reload dosimeter onto charger if: Filament won’t move/appear Filament “floats” (keeps on moving while on the charger Get a new dosimeter (or charger) if above cannot be resolved Get a new dosimeter if 1. The filament still moves when off of the charger

155. Milliroentgens 0 50 100 150 200 Milliroentgens 0 50 100 150 200

156. CDV-750 Dosimeter Charger

157. KEEP book KEEP yellow card Turn in TLD Turn in dosimeters Turn in chargers

158. Radiological Survey Meter(s) Ludlum 14C

159. Ludlum 14C Response Audio Reset Battery Check Scale Probe Connector Multiplier Switch Battery Compartment Pancake Probe CPM

160. Radiation Contamination Survey Meter = Speedometer It can go up and down. Look for a sustained reading. Only Use Top Scale (Counts per minute a. k. a. CPM) 0-6,600 CPM Pancake Probe

161. Ludlum 14C What is the Meter Reading ? 240 CPM

162. Ludlum 14C What is the Meter Reading? 40 CPM

163. Ludlum 14C What is the Meter Reading? 66,000 CPM

164. Ludlum 14C What is the Meter Reading? 3,700 CPM

165. Ludlum 14C What is the Meter Reading? OFF-SCALE: Need to change “Multiplier Switch” to x1. Check cable and batteries “RESET” button.

166. Ludlum 14C What is the Meter Reading? 260,000 CPM

167. Survey Meters: Monitoring for Contamination Ludlum 14C Use 44-9 “Pancake” Probe Open windows Hold probe 1 inch away Start at the head Move probe 1-2 inches per second Always monitor “top-side” Avoid having the meter face upward to prevent contamination from falling onto probe Remember soles of feet Contamination 2 X background

168. Notification of State Radiological Authority

169. The REAC /TS RadMed App includes… Updated eGuide for The Medical Aspects of Radiation Incidents Basic health physics and dose estimation (US and SI Units) Treatment of whole body and acute local radiological illnesses and injuries Assessment and treatment of internal contamination with radioactive materials Patient decontamination Delayed effects of exposure to ionizing radiation Risk and psychological issues Dicentric chromosome assay ( DCA ) State, federal and international resource database Assessment tools for radiation incident preparedness REAC /TS courses REAC /TS videos Real-Time REAC /TS news Links to partner resources 24-Hour Emergency Phone: [phone] Ask for REAC/TS Normal Work Hours Phone : [phone] On the Web : orise.orau.gov/reacts Radiation Emergency Assistance Center/Training Site (REAC/TS) Search for “ REAC /TS” CONTACT APP