Andreeva Bay in northwest Russia hosts one of the former coastal technical bases of the Northern Fleet. Currently, this base is designated as the Andreeva Bay branch of Northwest Center for Radioactive Waste Management (SevRAO) and is a site of temporary storage (STS) for spent nuclear fuel (SNF) and other radiological waste generated during the operation and decommissioning of nuclear submarines and ships. According to an integrated expert evaluation, this site is the most dangerous nuclear facility in northwest Russia. Environmental rehabilitation of the site is currently in progress and is supported by strong international collaboration. This paper describes how the optimization principle (ALARA) has been adopted during the planning of remediation work at the Andreeva Bay STS and how Russian-Norwegian collaboration greatly contributed to ensuring the development and maintenance of a high level safety culture during this process. More specifically, this paper describes how integration of a system, specifically designed for improving the radiological safety of workers during the remediation work at Andreeva Bay, was developed in Russia. It also outlines the 3D radiological simulation and virtual reality based systems developed in Norway that have greatly facilitated effective implementation of the ALARA principle, through supporting radiological characterisation, work planning and optimization, decision making, communication between teams and with the authorities and training of field operators.
The nuclear accident at Chernobyl accounted for an acute radiation syndrome in 237 persons on the site. Triage was the initial problem and was carried out according to clinical and biological criteria; evaluating the doses received was based on these criteria. Thirty one persons died and only 1 survived a dose higher than 6 Gy. Skin radiation burns which were due to inadequate decontamination, greatly worsened prognosis. The results of 13 bone marrow transplantations were disappointing, with only 2 survivors. Some time after the accident, these severely irradiated patients are mainly suffering from psychosomatic disorders, in the USSR, some areas have been significantly contaminated and several measures were taken to mitigate the impact on population: evacuating 135,000 persons, distributing prophylactic iodine, establishing standards and controls on foodstuff. Radiation phobia syndrome which developed in many persons, is the only sanitary effect noticed up to now. Finally, in Europe, there was only an increase in induced abortions and this was totally unwarranted. If we consider the risk of radiation induced cancer, an effect might not be demonstrated.
A cross-Canada survey of 38 university-affiliated hospitals with over 250 beds was undertaken to examine the procedures for cleaning anaesthetic tubings and circuits. Twenty-eight (74 per cent) hospitals responded. Gluteraldehyde was the most commonly used method (13/28), and pasteurization was the second most used method (9/28). These two methods are described and recommendations are made for basic requirements for disinfection.
Both the farm-specific and regional costs of clean feeding as a countermeasure to reduce ingestion of contaminated grass when there is insufficient supply of other types of roughage were estimated for dairy farming in Finland in the first year after contamination. The cost estimation considered expenditures and revenues associated with milk production and were calculated using farm models developed for economic planning. A hypothetical contamination scenario was designed using RODOS models for atmospheric dispersion and transfer in terrestrial food chains. Costs for intervention after two similar hypothetical atmospheric dispersion and deposition scenarios in early June and in July were estimated. As a reference, the cost of complete replacement of fodder throughout the area was also calculated. Feed substitution costs were higher in June than in July, due to the availability of some harvested silage in the later scenario. In the first case, the additional costs of clean feeding amounted to one-fifth of the normal production costs. Effective advisory/support services, available to farmers, can substantially improve the implementation of countermeasures. However, high costs and insufficient sources of clean feed would restrict the use of clean feeding as the sole countermeasure after serious contamination during the growing season.
Although CJD is certainly infectious, like other unconventional viruses (slow viruses) it demonstrates a low potential for transmissibility to humans who are exposed accidentally to infected material. This may be due to a low dose of prion exposure or to reasons which are unknown at this point. When effective decontamination techniques are available, the processing of tissue from a suspected or confirmed case of CJD can be handled with confidence. Careful application of techniques makes the possibility of acquiring the disease remote, while not interfering with the diagnosis and care of patients.
The Montreal Urban Community (MUC) treatment plant produces approximately 270 tons of dry sludge daily (tds/day) during physicochemical wastewater treatment. The sludges are burned and contribute to the greenhouse effect by producing atmospheric CO2. Moreover, the sludge emanates a nauseating odour during its thermal stabilisation and retains unpleasant odours for the part (25%) that is dried and granulated. To solve this particular problem, the treatment plant authorities are currently evaluating an acidic chemical leaching (sulfuric or hydrochloric acid) process at a pH between 2 and 3, using an oxidizing agent such as ferric chloride or hydrogen peroxide (METIX-AC technology, patent pending; ). They could integrate it to a 70 tds/day granulated sludge production process. Verification of the application of METIX-AC technology was carried out in a pilot plant set up near the sludge production plant of the MUC. The tests showed that METIX-AC technology can be advantageously integrated to the process used at the MUC. The residual copper (274 +/- 58 mg/kg) and cadmium (5.6 +/- 2.9 mg/kg) concentrations in the treated sludge meet legislation standards. The results have also shown that odours have been significantly eliminated for the dewatered, decontaminated, and stabilized biosolids (> 97%) compared to the non-decontaminated biosolids. A high rate of odour elimination also was obtained for the liquid leached biosolids (> 93%), compared to the untreated liquid biosolids. The fertilising value (N and P) is well preserved by the METIX-AC process. Dissolved organic carbon measurements have showed that little organic matter is brought in solution during the treatment. In fact, the average concentration of dissolved organic carbon measured in the treated liquid phase is 966 +/- 352 mg/l, whereas it is 1190 +/- 325 mg/l in untreated sludge. The treated sludge was first conditioned with an organic polymer and a coagulant aid. It was successfully dewatered with various dehydration equipments (filter press, rotary press, centrifuge).
Cleaning of flexible endoscopes is most commonly performed using manual methods that are often performed inadequately. The aim of this study was to validate the sample collection protocol and the Rapid Use Scope Test (RUST) and then assess its usefulness in clinical use.
To characterize the recommendations of the medical directors of North American poison information centres for gastrointestinal decontamination of a hypothetical poisoned patient, and to examine the extent to which those recommendations agree with the advice previously issued by their poison information centres for the same scenario.
The medical directors of 72 poison centres in the United States and Canada were contacted and invited to participate in a survey. Each participant was asked to provide specific advice for gastrointestinal decontamination of a hypothetical patient presenting 1 h after a potentially life-threatening ingestion (32.5 g) of enteric-coated acetylsalicylic acid. The directors were then presented with the recommendation their poison centres had previously issued for the same overdose scenario. The main outcome measures were perceived agreement with their own centre's recommendation and director-centre concordance for each method of gastrointestinal decontamination.
Sixty-seven of 72 (93%) medical directors participated in the survey. They issued 30 different management suggestions for our hypothetical patient, and were in full agreement with their own centres 27% of the time. Concordance was moderate for recommendations on syrup of ipecac (k=0.468, P
AIM: To assess whether Danish doctors use gastrointestinal decontamination (GID) in non-drug poisoning in accordance with recommendations for restricted application. METHOD: Doctors telephoning the Danish Poisons Information Centre about non-drug exposures were surveyed prospectively. The doctor's intention to treat, the age and sex of the patient, and information about poison, amount and time since exposure, were assessed. RESULTS: Of the 138 telephone calls, 64% concerned children below 5 years of age and 24% patients above 15 years of age. The risk was estimated as insignificant in 63%, minor in 30%, significant in 6% and severe in only 1%. The insignificant risk was found mainly in children and the severe risk solely in those above 15 years of age. GID was proposed in 33% with the highest frequency in children with minor or insignificant risks, and the time since exposure did not influence the frequency of GID. Charcoal was not proposed. CONCLUSION: It is clear from this small sample that Danish doctors tend to use GID more often than is recommended. Activated charcoal was apparently not used. GID was in most cases used in children with insignificant and minor risks, where it is likely to do more harm than good.
Health care-associated infections are closely associated with different medical interventions which interrupt the balance of human microbiota. The occasional predominance of opportunistic pathogens may lead to their translocation into the lymph nodes and bloodstream, causing endogenous (primary or secondary) hospital infections. The question is raised as to if there is a possibility for prevention of the imbalance of GI microbiota during medical interventions in critically ill patients. Prophylactic selective decontamination of the digestive tract (SDD) simultaneously applies three to four different antimicrobials for the suppression of enteric aerobic microbes, which are potentially pathogenic microorganisms. However, there is no convincing evidence that the indigenous beneficial intestinal microbiota are preserved, resulting in reduced mortality of high-risk patients. In this overview, we have evaluated the antimicrobial treatment guidelines of the Infectious Diseases Society of America (IDSA) for intra-abdominal infections in adults and seniors according to their safety for different Lactobacillus spp. The data from our group and in the literature have shown that all tested lactobacilli strains (nearly one hundred) were insusceptible to metronidazole while different species of lactobacilli of the three fermentation groups expressed particular antibiotic susceptibility to vancomycin, cefoxitin, ciprofloxacin and some new tetracyclines. We have relied on microbial ecology data showing that the GI tracts of adults and the elderly are simultaneously colonised at least with several (four to a maximum of 12) Lactobacillus species expressing variable intrinsic insusceptibility to the aforementioned antimicrobials, according to the provided data in table. This finding offers the possibility of preserving the colonisation of the intestine with some beneficial lactobacilli during antimicrobial treatment in critically ill patients with health care-associated infections. Several probiotic Lactobacillus spp. strains are intrinsically resistant to antimicrobials and can be used during antibacterial therapy, however, their application as an additive to antimicrobial treatment in critically ill patients needs to be investigated in well-designed clinical trials.