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POLITICS

Terrorists could make a ‘dirty bomb’ from this common medical device; why regulators won’t act

BY DAVID WILLMAN, MELODY PETERSEN

DEC. 27, 2019 6 AM PT

SEATTLE — Scientific experts warned Congress more than a decade ago that just four

teaspoons of radioactive cesium-137 — if spread by a terrorist’s “dirty bomb” — could

contaminate up to 10 square miles of Manhattan.

The material is commonly found across the United States. Hospitals, blood banks and

medical research centers use it in devices called irradiators, which sterilize blood and

tissue. Hundreds of the devices are licensed for use, including at least 50 in Southern

California.

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Each typically contains about twice as much radioactive material as the scientific

panel warned could disrupt much of the nation’s largest city.

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The panel’s warning in 2008 came with blunt recommendations: The government

should stop licensing new cesium-based blood irradiators, and existing ones should

be withdrawn from use. Safer devices that use X-ray technology worked just as well,

the panel found.

But after protests from hospitals, the U.S. Nuclear Regulatory Commission declined

to crack down. Instead, the number of licensed irradiators used for blood — and the

risk they pose — has grown, a Los Angeles Times investigation shows.

Recent emergencies highlight the danger.

Pennsylvania authorities in 2015 intervened after an improperly secured irradiator

was found inside a downtown Philadelphia office building near the planned

motorcade route for a visit by Pope Francis.

Pope Francis visits Philadelphia on Sept. 26, 2015. A few weeks earlier, o�cials found an improperly secured cesium irradiator in a building near the parade route. (Alex Brandon / Associated Press)

In May of this year, the accidental release of a small amount of cesium from an

irradiator in Seattle contaminated 13 people and caused a seven-story medical

research building to be shuttered indefinitely.

The cesium used for irradiators is a dry, talc-like material derived from atomic fuel

left over from nuclear power production.

The material is particularly feared by experts on radiological threats because its fine

particles disperse easily and can migrate through air ducts and bind tightly to porous

surfaces, including concrete. The potential danger is long-lasting: Cesium can keep

emitting radiation for nearly 300 years.

“The amount of cesium in one of these irradiators is enough to contaminate and

create widespread panic over an extremely large area if dispersed by a terrorist,” said

Leonard W. Connell, a nuclear engineer who was among the scientific experts who

issued the 2008 recommendations.

‘The amount of cesium in one of these irradiators is enough

to contaminate and create widespread panic over an

extremely large area if dispersed by a terrorist.’

— Leonard W. Connell, nuclear engineer

Since those recommendations, several developed countries have converted away from

cesium. The Nuclear Regulatory Commission, by contrast, has not only continued to

license new irradiators, it has also declined to require users to post financial bonds

that would guarantee proper handling and eventual disposal of the material. Such

performance bonds are mandatory for utilities licensed to operate nuclear power

plants.

In a memo to the commissioners on April 7, 2016, the commission’s top staff official,

Executive Director for Operations Victor M. McCree, wrote that financial assurance

requirements “should be expanded” to include cesium irradiators and other similarly

significant sources of radiation.

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The commissioners have not acted.

The Times interviewed more than 50 current and former government officials, along

with medical industry specialists and other technical experts and examined

thousands of pages of state and federal records to study the risk posed by cesium

irradiators.

A dirty bomb packed with cesium would not kill large numbers of people. Instead, it

would be a weapon of “mass disruption” — leaving areas uninhabitable for months or

even decades and increasing long-term cancer risks for people who come in contact

with it, atomic experts say.

Though a dirty bomb has not been successfully detonated, terrorists have voiced keen

interest in doing so. For instance, in 2011 an extremist named Anders Breivik, who

killed 77 Norwegians with a fertilizer bomb and firearms, released a manifesto in

which he called for followers to help him acquire cesium and other components “to

construct and detonate a radiological bomb.”

Federal law gives the NRC broad authority to restrict the use of cesium and other

radioactive materials to safeguard national security “or to protect health or to

minimize danger to life or property.”

The agency, however, has declined to take action to limit the irradiators, citing a low

likelihood of immediate deaths or other physical harm. In doing so, the commission

has looked past the mass evacuations, business closures and other economic losses

that a dirty bomb could cause.

Last year, a federal task force headed by the chair of the NRC concluded that no basis

existed for more than voluntary incentives to encourage users to switch away from

cesium irradiators.

As Chair Kristine L. Svinicki wrote in an Oct. 17, 2018, letter to President Trump, “the

Task Force concluded that there are no significant gaps in … radioactive source

protection and security that are not already being addressed.”

Svinicki declined through a spokesman to answer questions for this article, as did

each of the other three sitting NRC commissioners, all of whom are appointed by the

president.

Stephen G. Burns, a former commissioner whose tenure ended on April 30, said the

NRC had sought to balance public safety with the interests of the facilities using the

devices, notably hospitals wary of the commission “regulating the practice of

medicine.”

The NRC’s stance toward regulating cesium contrasts with public warnings about

radiological-weapon threats issued by every presidential administration since the

Sept. 11, 2001, attacks.

Trump, in his own 2017 National Security Strategy report, warned that the threat of a

dirty bomb “is increasing.”

In a series of investigative reports, the U.S. Government Accountability Office has

challenged the commission’s assurances that no meaningful “gaps” exist in how

cesium and other radioactive materials are secured.

In 2012, a GAO report described finding a cesium irradiator on an unsecured wheeled

pallet near a hospital’s loading dock. At a second facility, investigators found the

combination to a lock — intended to secure a cesium irradiator — “clearly written on

the door frame.”

The GAO’s most recent report, issued in April, implored the regulatory commission to

act more forcefully. David C. Trimble, the analyst who supervised the GAO’s work,

recalled that each time his staff has examined uses of cesium and other radioactive

materials, “we have identified a vulnerability.”

“We hope that [the] NRC will recognize the significance of the Seattle incident, and

reassesses its position to not consider socioeconomic costs,” Trimble told The Times.

The U.S. Department of Energy has also diverged from the NRC’s hands-off stance.

The department has worked with users and manufacturers to harden the devices

against theft.

In 2015, the department started giving incentives to convert to safer technologies,

offering to pay 100% of the expense to remove and dispose of any cesium irradiator,

which typically cost up to $200,000 per unit. The department says 108 of the devices

have been replaced. Its announced goal is to “permanently eliminate” cesium

irradiators by 2028.

“Every irradiator that is replaced represents one fewer opportunity for a terrorist,”

the department said in a report to Congress in April.

But, the report added, the “voluntary nature” of the conversions “remains a

challenge” to hitting the 2028 goal.

In February 2018, University of California Chancellor Janet Napolitano called for the

10-campus system to begin converting away from its cesium irradiators.

Yet despite those steps, the number of licenses that the NRC has issued for operating

cesium irradiators for sterilizing human blood has actually grown: The 370

nationwide represent an increase of 4% since 2011, according to statistics provided to

The Times by the commission.

‘Every irradiator that is replaced represents one

fewer opportunity for a terrorist.’

— U.S. Department of Energy April 2019 report to Congress

“We were surprised,” Margaret Cervera, a health physicist at the NRC, said of the

increased numbers. “We expected them to be going down.”

The total may be larger. Cervera and a commission spokesman, David McIntyre, said

the 370 leaves out irradiators that the commission suspected were being used for

animal experiments or other research, rather than sterilizing human blood. In April,

the Department of Energy reported to Congress that an additional 315 cesium

irradiators were being “used primarily for research irradiation.”

A strange glowing material

Evidence of the damage cesium could cause emerged tragically in 1987 in Goiania,

Brazil, an interior city about 800 miles northwest of Rio de Janeiro.

In September of that year, two people entered an abandoned site that had once

housed a radiation-therapy clinic that utilized cesium. After prying loose some of the

metal equipment, they loaded it into a wheelbarrow, hoping to sell pieces as scrap.

That evening, both men began to vomit. It wasn’t until two weeks later — after the

equipment and the strangely glowing material inside it had changed hands through

two scrap yards and become a source of fascination for adults and children — that a

local physicist persuaded authorities to take action.

A monitoring station set up in a local stadium screened more than 112,000 people for

possible cesium contamination. Forty-nine houses were demolished or

decontaminated and about 4,500 tons of soil were hauled away, according to the

International Atomic Energy Agency.

In the end, four people died and hundreds had to be decontaminated.

Soon thereafter, the breakup of the Soviet Union increased the availability of

radioactive materials at military facilities that had become neglected.

As a nuclear engineer and former CIA intelligence officer, Warren Stern had traveled

to the former Soviet republics, seeking to secure loose materials that could have fallen

into the hands of terrorists. By Sept. 11, 2001, he was uniquely positioned to warn the

U.S. government about the potential of a dirty bomb.

That night, after the attacks on the World Trade Center and the Pentagon, Stern and

a colleague began composing an urgent memo to their boss, Secretary of State Colin

Powell, describing this new terrorist threat.

In 2002, Stern joined the staff of then-U.S. Sen. Hillary Clinton (D-N.Y.) as a nuclear

advisor and persuaded her to try to force the NRC to phase cesium out of circulation

and to seek tighter controls on other radioactive materials.

The effort was quickly scaled back in the face of opposition from other senators. But

that year, Clinton introduced a bill calling for the National Academy of Sciences to

study whether any uses of radioactive materials — including cesium — could be

replaced with effective and safer alternatives.

In 2005, the call for a study became law, and in 2008, the National Academy’s

appointed experts sent their report to the NRC and Congress. They ranked cesium as

their top concern.

Cesium irradiators “should be replaced,” the 219-page report said, adding that

effective and safer X-ray irradiators “are already commercially available as

substitutes.”

The experts directed an additional message to the NRC, saying it “should discontinue

all new licensing and importation of these [cesium] sources and devices.”

Users objected, citing concerns about the costs of switching and questioning whether

the X-ray technology would be as effective.

Among those who spoke out was Thomas M. Priselac, president and chief executive of

Cedars-Sinai Medical Center in Los Angeles. Without its cesium irradiator, Priselac

said in an Oct. 14, 2008, letter to the NRC, Cedars might be unable to reliably

irradiate high volumes of blood, possibly compromising patient safety. A Cedars

spokesman declined to say whether the cesium irradiator remains in use.

“What I can say is that Cedars-Sinai has strict policies and procedures in place

governing the use and management of irradiation technology,” the spokesman, Duke

Helfand, wrote in an email. “This oversight has been reviewed and approved regularly

by state and federal regulators.”

The NRC deferred the National Academy panel’s recommendations and called for

further study.

In an interview, Theodore L. Phillips, the chairman of the panel, said he and his

colleagues — including a senior American Red Cross blood-transfusion specialist —

found the evidence for converting away from cesium to be overwhelming.

“There are X-ray irradiators that do blood irradiation with no problem,” said Phillips,

a physician who for 29 years headed the radiation oncology department at UC San

Francisco.

The committee’s conclusions, Phillips said, were influenced by studies showing the

severe impact that small amounts of cesium could cause.

Cesium irradiators typically contain material amounting to about 2,000 curies, a

measure of radioactivity. Scientific “vulnerability assessments” performed by the

Sandia National Laboratories and provided to the committee showed that a bomb

with 1,000 curies, about four teaspoons of cesium, could contaminate up to 10 square

miles of Manhattan if dispersed uniformly. Just 40 curies could contaminate an

urban area of up to 267 acres. Members of Congress and their staffs were briefed on

the details.

The committee’s report also cited a 2005 study of theoretical dirty bomb attacks on

the ports of Los Angeles and Long Beach. The study, paid for by the Department of

Homeland Security, estimated cleanup costs and business losses ranging to more

than $100 billion.

Reached recently, Connell, the nuclear engineer who was a member of the committee

and who had led Sandia’s studies, said any inconveniences of switching away from

cesium irradiators should be weighed against the potential for harm.

“We simply cannot permit a large, successful dirty bomb attack involving cesium to

occur,” Connell said in an email. “There is no longer any reason to keep cesium

irradiators in our hospitals and universities right in the middle of our major cities.”

‘A risk to public health’

From its offices in downtown Philadelphia, Avax Technologies, Inc. was aiming to

develop treatments for cancer — work that utilized a cesium irradiator.

But Avax fell into financial distress and as of 2014 had “essentially ceased operation,”

said Terry J. Derstine, a radiation program manager for the Pennsylvania

Environmental Protection Department. By May 2015, the company had stopped

paying its rent, according to state government records.

On the afternoon of May 27, Derstine’s colleagues inspected the site after learning the

landlord had shut off power to Avax’s offices, which disabled door alarms intended to

buttress 24-hour security for the irradiator, kept inside its own room.

The irradiator “was no longer being maintained in a secure manner … and was liable

to theft, removal or improper usage, consequently posing a risk to public health and

safety through radiation exposure,” according to a formal summary of facts, signed by

Avax’s director of regulatory affairs and by Derstine and another state official.

The landlord restored power to the room on the afternoon of the inspection. In

August 2015, state officials agreed to allow Avax to keep the device on condition that

the company post a $200,000 bond to cover expenses if more trouble arose. Derstine

and his colleagues also alerted city police and the FBI’s Philadelphia field office.

The irradiator was a matter of high concern, Derstine said, because the city was

preparing for the visit of Pope Francis, whose motorcade would travel along

Benjamin Franklin Parkway, just two blocks from Avax’s offices.

Earlier this year, Derstine told NRC commissioners that if a terrorist had set loose the

cesium, “many people could have easily been exposed.”

The pope’s visit went uninterrupted. But on May 3, 2016, state officials learned that

Avax “was no longer capable of continuing operations,” regulatory documents show.

“Several of the security measures that were in place to protect the irradiator were in

jeopardy of being terminated by the supplier for lack of payment,” Derstine told the

NRC.

This time, Philadelphia was preparing for a second major event — the Democratic

National Convention. Soon afterward, state officials forced the removal of the

irradiator.

In an interview, Henry E. Schea III, who was Avax’s regulatory affairs director and its

radiation safety officer, acknowledged the company had been in “arrears in paying its

rent” but said the irradiator had not been jeopardized.

In interviews with The Times, Derstine recalled the ordeal, which has not previously

been publicized.

“Over the last 30 years,” the incident “was probably the No. 1 thing we’ve had to deal

with,” he said.

Tiny spill, huge disruption

Technicians confirmed the accidental release of cesium from the irradiator in central

Seattle at about 9:30 p.m. on May 2.

A company had been hired to remove the device, used for years in experiments on

animals performed by University of Washington researchers. But while the

technicians were preparing the irradiator to be loaded for transport, they nicked its

protective metal shielding, causing a breach.

Thirteen people were contaminated with non-life-threatening levels of cesium: eight

technicians who’d been trying to remove the irradiator, a building custodian and a

radiation safety officer assigned to oversee the removal, two inspectors with the state

health department and an FBI agent who wound up with cesium in his hair.

What unfolded that night — and over the months that followed — demonstrates the

disruption caused by even a tiny, unintentional release of cesium, according to

interviews with those involved and The Times’ review of local, state and federal

documents.

City fire department specialists at first struggled to figure out how to decontaminate

those who’d been inside the seven-story research and training building.

Across the street, at the university’s Harborview Medical Center, emergency room

managers — fearing that cesium could be tracked into the hospital — initially denied

entry to those needing treatment.

A supervising state health physicist, Mark Henry, along with officials from the Seattle

Fire Department and the National Guard, persuaded the hospital to relent. A barrier

could be made from thick sheets of plastic, heavy paper and plenty of tape to protect

staff and other patients, they explained.

“Hospitals aren’t used to dealing with radioactive contamination,” said Mikel J.

Elsen, the Washington health department’s director of radiation protection, who

commented alongside Henry and other state officials in Tumwater, Wash.

The testing of all 13 individuals found their contamination levels “did not pose a

health risk to any of those individuals or the general public,” according to a university

medical school spokeswoman, Susan Gregg.

But more than seven months later, sections of six of the seven floors of the building

remain off limits because of lingering cesium.

Officials believed an elevator near the breached irradiator spread the cesium with

“piston-like” effect. Once it entered the main ventilation system, they said, it

scattered more widely.

Hand-held instruments found cesium within the drywall and in other difficult-to-

reach nooks and crannies.

The heaviest concentrations were around the loading dock where the irradiator had

been positioned; officials pointed to a portion of the concrete surface of an adjacent

parking area that also was contaminated.

The Energy Department is investigating to assess “the root cause of the accident,”

according to a spokesman, Gregory A. Wolf, who said the department spent about

$8.6 million for the cleanup through Sept. 30.

No date has been set for when the building might be restored to its previous uses.

“This has been the worst contamination event we’ve had in this state in the public

domain,” said Elsen, the state health official. “And it could have been much worse,

because that’s a lot of cesium if it all got out.”

Henry, the state health physicist, called the event a foreshadowing of what a dirty

bomb could do.

“If you think that somebody couldn’t get ahold of material like this and make a

weapon of mass disruption, then I think you need to review that again,” Henry said.

“You can see the consequences right now. You’ve got a dead building.”

Times research librarian Scott Wilson in Los Angeles contributed to this report.

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David Willman

David Willman is a former investigative reporter for the Los Angeles Times.

Melody Petersen

Melody Petersen is an investigative reporter covering healthcare and business for the

Los Angeles Times. Send her tips securely on Signal at (213) 327-8634.