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a Tissue shielding assumes that the distance in column 1 is all body tissue.

a Tissue shielding assumes that the distance in column 1 is all body tissue.

exposure. For embalming, removal of organs would reduce exposures but because this procedure involves only short periods of time next to the cadaver and because greater distances are kept during the procedure itself, the embalmer would receive minimal exposure with the organs in place while an individual who might remove the organs could receive higher exposure. The staff must consider exposure to all personnel during each step to keep collective exposure as low as possible. If the embalmer intends to do cosmetic restoration of the face and the thyroid is the highly radioactive organ, removal of the thyroid and adjacent contaminated tissue might be indicated.

Procedures in the Presence of Implants Radioactive implants, sometimes referred to as "seeds," generally are small pieces of radioactive wire or small capsules containing the radioactivity. If the location of the implant is known and no need exists to expose them during the autopsy, removal may involve more radiation exposure than leaving the implants undisturbed and working quickly when near them. Table 13-3 shows unshielded and shielded (with body tissue) radiation exposure rates at chosen distances from radioisotopes that are commonly used as permanent implants. The numbers represent possible extremity exposures. Permanent implants of beta emitters and low-energy gamma emitters—for example, 125I or 103Pd, do not normally present major radiation hazards and therefore typically do not require removal prior to an autopsy (11).

If a prosector wants to remove the radioactive implants, with or without the surrounding tissue, a radiograph of the area should be prepared to show their current location because the implants may have shifted from their original site. After removal of the material, a second radiograph should confirm that all radiation sources had been removed. Source removal should be done rapidly and with long-handled instruments. If an entire organ or a large tissue sample can be removed with the radiation sources intact, individuals performing the procedure would receive much less exposure. Exposures of pathologists at an institution performing procedures on an average of 16 autopsy cases with permanent implants each year remained below maximum permissible limits for the general public (12).

Explanted radiation sources should be placed together in a container and stored in an area not frequented by personnel.

Active sources should be disposed of by approved methods (4,13). This can be accomplished by contacting and returning the sources to the institution where they were implanted, contacting a local institution licensed to receive and dispose of the radioisotope, or contacting the radiation control section at the State Board of Health.

CREMATION Bodies containing radioisotopes will contaminate the crematorium and, in most cases, will leave contaminated ashes. These ashes must be removed and handled by personnel wearing appropriate protective equipment. In three accidents involving contamination in crematoriums, the ash collection worker wore a heat-resistant jacket, leather gloves, and a dust mask, and used long-handled (3-4 m) tools to rake and sweep the ashes toward the front of the oven (14). Because this individual was still found to have internal contamination, most likely from inhalation, it is recommended that respirators be worn while collecting ash.

Whether the radioactive burden should be reduced prior to cremation, depends on the level of radioactivity remaining in the deceased. One consensus group states that no radiation hazard would exist if a crematorium were to handle a total of up to 200 mCi 131I or 2,000 mCi of all other radioisotopes annually (7). Another group would require no special precautions for cremation of individual bodies containing less than 30 mCi 131I or 198Au, or 10 mCi 32P (15). However, both groups state that attempts should be made to remove permanent implants prior to cremation.

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