IAEA Training Material on Radiation Protection in Nuclear Medicine Part 10 Radioactive Waste Objective To be aware of the general principles of the handling and the safety of radioactive waste. To be able to identify, store and dispose of the different types of waste generated in a nuclear medicine department Nuclear Medicine Part 10. Radioactive waste 2 Contents Introduction Basic requirements & legal framework Waste collection, segregation and storage Waste treatment and disposal Examples of waste management in nuclear medicine. Local rules. Nuclear Medicine Part 10. Radioactive waste 3 IAEA Training Material on Radiation Protection in Nuclear Medicine Part 10 Radioactive Waste Module 10.1 Introduction Radioactive Waste in Nuclear Medicine The use of unsealed sources in diagnosis and therapy will generate radioactive waste of different kinds during preparation, patient examination and care Nuclear Medicine Part 10. Radioactive waste 5 Radioactive Waste in Nuclear Medicine Sealed sources used for calibration and quality control of equipment, Point sources and anatomical markers, will end up as radioactive waste. Nuclear Medicine Part 10. Radioactive waste 6 Radioactive Waste in Nuclear Medicine Solid waste. Cover papers, gloves, empty vials and syringes. Radionuclide generators. Items used by hospitalized patients after radionuclide therapy. Sealed sources used for calibration of instruments. Animal carcasses and other biological waste. Liquid waste. Residues of radionuclides. Patient excreta. Liquid scintillation solutions. Gaseous waste. Exhausted gas from patients in nuclear medicine Nuclear Medicine Part 10. Radioactive waste 7 IAEA Training Material on Radiation Protection in Nuclear Medicine Part 10 Radioactive Waste Module 10.2 Basic Requirements and Legal Framework Fundamental Principles 1. Radioactive waste shall be managed in such a way as to secure an acceptable level of protection for human health. 2. Radioactive waste shall be managed in such a way as to provide an acceptable level of protection of the environment. 3. Radioactive waste shall be managed within an appropriate national legal framework including clear allocation of responsibilities and provision for independent regulatory functions. 4. Generation of radioactive waste shall be kept to minimum practicable. Nuclear Medicine Part 10. Radioactive waste 9 Waste Management Definitions Exempted waste Interim storage Pre-treatment Treatment Conditioning Radioactive material for reuse/recycle Transportation Disposal Nuclear Medicine Part 10. Radioactive waste 10 Waste Management Framework • • • • • • • • • • Nuclear Medicine Organization and responsibilities Waste inventory Waste management plan Waste minimization Safety assessments Facilities Transports Staff training Documentation and records Quality assurance Part 10. Radioactive waste 11 Quality Assurance •Local rules Normal working conditions Accidents •Waste identification and traceability Record system •Process control Safe handling of radioactive sources Facilities Monitoring Quality of containers Arrangements for storage Documentation •Audits Nuclear Medicine Part 10. Radioactive waste 12 IAEA Training Material on Radiation Protection in Nuclear Medicine Part 10 Radioactive Waste Module 10.3 Waste Collection, Segregation and Storage Radioactive Waste BSS: Interim Edition 3.131. Registrants and licensees, in cooperation with suppliers, as appropriate: (a) Shall ensure that any radioactive waste generated is kept to the minimum practicable in terms of both activity and volume; (b) Shall ensure that radioactive waste is managed in accordance with the requirements of these Standards and the requirements of other applicable IAEA standards, and in accordance with the relevant authorization; (c) Shall ensure that there is separate processing of radioactive waste of different types, where warranted by differences in factors such as radionuclide content, half-life, activity concentration, volume, and physical and chemical properties, taking into account the available options for waste storage and disposal, without precluding the mixing of waste for purposes of protection and safety; Nuclear Medicine Part 10. Radioactive waste 14 Radioactive Waste contd… (d) Shall ensure that activities for the predisposal management of and for the disposal of radioactive waste are conducted in accordance with the requirements of applicable IAEA standards37, and in accordance with the authorization; (e) Shall maintain an inventory of all radioactive waste that is generated, stored, transferred or disposed of; (f) Shall develop and implement a strategy for radioactive waste management and shall include appropriate evidence that protection and safety is optimized. Nuclear Medicine Part 10. Radioactive waste 15 Waste Minimization A good planning of the nuclear medicine activity including selection of radionuclides and good working procedures will result in a reduced volume of radioactive waste. Selection of radionuclides should take into account half-life, type of radiation, activity etc. Working procedures should take into account the number of operations and material involved in the preparation, the risk of contamination etc. Nuclear Medicine Part 10. Radioactive waste 16 Examples of Waste from Nuclear Medicine •Biological waste which may undergo decomposition. •Infectious waste requiring sterilization prior to disposal. •Broken glass-ware, syringes etc, requiring collection in separate containers to prevent personnel being injured. •Radionuclide generators •Bed linen and clothing from hospital wards. •Liquid scintillation solutions •Patient excreta ? Nuclear Medicine Part 10. Radioactive waste 17 Segregation of Waste from Nuclear Medicine Some examples of the different types of waste generated in a hospital •Liquid waste containing short-lived radionuclides capable of being stored for decay (radiopharmaceuticals). •Solid waste containing short-lived radionuclides capable of being stored for decay (contaminated items). •Liquid waste which after proper treatment and conditioning can be handled in the public waste treatment system (long-lived radiopharmaceuticals). •Solid waste which after proper treatment and conditioning can be handled in the public waste treatment system (biological samples, anatomical markers). •Sealed sources. (sources for calibration and QC) Nuclear Medicine Part 10. Radioactive waste 18 Segregation/Waste Containers Containers to allow segregation of different types of radioactive waste should be available in areas where the waste is generated. The containers must be suitable for purpose (volume, shielding, leak proof, etc.) •Glassware with radionuclides (short half-life) •Syringes and needles •Gloves and paper •Glassware with radionuclides (medium halflife) •.. •.. Nuclear Medicine Part 10. Radioactive waste 19 Storage of Radioactive Waste A room for interim storage of radioactive waste should be available. The room should be locked, properly marked and ventilated. Each type of waste should be kept in separate containers properly labeled to supply information about the radionuclide, activity concentration etc. Flammable goods should be kept apart. Records should be kept where the origin of the waste can identified. Nuclear Medicine Part 10. Radioactive waste 20 Storage of Radioactive Waste Nuclear Medicine Part 10. Radioactive waste 21 Storage of Radioactive Waste Nuclear Medicine Part 10. Radioactive waste 22 Storage of Radioactive Waste Nuclear Medicine Part 10. Radioactive waste 23 IAEA Training Material on Radiation Protection in Nuclear Medicine Part 10 Radioactive Waste Module 10.4 Waste Treatment and Disposal Radioactive Waste Registrants and licensees shall ensure that radioactive substances from authorized practices and sources not be discharged to the environment unless: • either clearance has been granted for the radioactive substance or the discharge is within the discharge limits authorized by the Regulatory Authority. Nuclear Medicine Part 10. Radioactive waste 25 Treatment of Solid Waste (general principles) The objective of the treatment process is to reduce the volume of solid waste, reduce or eliminate potential hazards associated with the waste and to produce waste packages suitable for destruction, storage or transportation to and disposal at a licensed repository. Nuclear Medicine Part 10. Radioactive waste 26 Conditioning of Solid Waste Waste packages Public system National plant Solid waste should be conditioned in order to produce a waste form suitable for storage and transportation governed by the properties of the waste, the transport regulations and the specific waste disposal acceptance requirements Nuclear Medicine Part 10. Radioactive waste 27 Disposal of Solid Waste Example of national regulations of disposal of waste from hospitals: Disposal via the public waste treatment system •Maximum 10 ALImin /month and maximum 1 ALImin per package. •The dose rate at the surface of each package should be <5 uGy/h. •The package should not contain any single sealed source with activity >50 kBq. •Each package should be properly labeled with a warning sign containing information on radionuclide and activity. The origin of the waste should also be given on the package. Nuclear Medicine Part 10. Radioactive waste 28 Liquid Waste Effluent Discharges Liquid Waste Treatment Solid Waste Effluents •Liquid waste can be transformed to solid waste by some treatment process such as evaporation. •Liquid waste can be discharged to the environment if either clearance has been granted for the radioactive substance or the discharge is within the limits authorized by the Regulatory Authority. Nuclear Medicine Part 10. Radioactive waste 29 Effluent Discharges: Example of Rules <10 ALImin per month and <1 ALImin or not more than 100 MBq at each occasion. Flush with plenty of water. Use a special sink for the discharge. A label should be posted informing personnel that disposal of liquid waste is allowed at this point. Nuclear Medicine Part 10. Radioactive waste 30 National Discharge Limits Example Radionuclide Se-75 Sr-89 Tc-99m In-111 I-125 I-131 Tl-201 Nuclear Medicine Discharge (MBq each time) 20 5 100 100 1 1 100 Part 10. Radioactive waste Discharge (MBq/month) 200 50 30000 2000 10 10 6000 31 IAEA Training Material on Radiation Protection in Nuclear Medicine Part 10 Radioactive Waste Module 10.5 Examples and Local Rules Short-Lived Radionuclides Radionuclides such as Tc-99m, I-123, Tl-201, I-131 Sm-153, Sr-89 etc. should, after segregation, be stored for decay during a period of time established locally by the RPO, taking into account all applicable national regulations. Nuclear Medicine Part 10. Radioactive waste 33 Patient Excreta Diagnostic Patients: Generally no need for collection of excreta. Ordinary toilets can be used. Therapy Patients: Different policies in different countries: • Use separate toilets equipped with delay tanks or an active treatment system, or • Allow the excreta to be released directly into the sewer system. The Regulatory Authority should define the principles taking the environmental impact into consideration Nuclear Medicine Part 10. Radioactive waste 34 Liquid Dischages I-131 Estimation of the generic clearance value for aquatic release of I-131 is quite complicated. Is all material retained in the sewage sludge at sewage treatment works or is all the activity discharged to a water body? Who will get the highest exposure? Which dilution of the radionuclide concentration will be found etc? Calculations must be made by qualified persons taking into account the guidance given by IAEA (TECDOC 1000) Nuclear Medicine Part 10. Radioactive waste 35 Mo-Tc Generators Store for decay Check for contamination Dismount the generator Return to producer Exempted waste? Nuclear Medicine Part 10. Radioactive waste 36 Mo-Tc Generator (store for decay & dismounting) Assume a generator with 20 GBq Mo-99 at reference time. The half-life of Mo-99 is 2.75 d and the exemption activity is 1 MBq (BSS). The time for interim storage should then be 40 d. The dose rate at 1 m from the unshielded column will then be 0.04 μSv/h. Hence, the external exposure will be very small when dismounting the generator. The dismounted column is exempted waste and the sign of its previous radioactivity should be removed. The column can now be discharged together with similar waste from the hospital. Nuclear Medicine Part 10. Radioactive waste 37 Dismounting Mo-Tc Generator 3. Check for radiation 1. Check for radiation 2. Remove the plastic cover Nuclear Medicine 4. Remove the column Part 10. Radioactive waste 38 Dismounting Mo-Tc Generator 5. Remove the lead shield 7. Check if the column can be classified as exemted waste 6. Separate the different materials Nuclear Medicine Part 10. Radioactive waste 39 Sealed Sources for QC of Equipment • Co-57 flood sources, anatomical markers etc used in diagnostic nuclear medicine • Co-57, Cs-137 etc calibration sources for activity meters. • Ge-68 calibration sources(phantom/rods) for PET scanners Should be transferred to a national plant for final disposal Nuclear Medicine Part 10. Radioactive waste 40 Liquid Scintillation Solutions Small activities of H-3 or C-14 in organic solvents. Glass or plastic vials of 5-10 ml volume. Controlled Incineration in a plant! Nuclear Medicine Part 10. Radioactive waste 41 Biological Waste Incineration Pre-treatment (deep freezing, quicklime, chemical methods) Store for decay Transfer to depository Exempted waste Nuclear Medicine Part 10. Radioactive waste 42 Local Rules Department of Diagnostic Nuclear Medicine Radiation Protection Manual RADIOACTIVE WASTE Gloves, cover paper etc Syringes, needles Vials containing Tc99m Tl-201, In-111, Ga-67 Technetium generator Flood sources, markers Nuclear Medicine Part 10. Radioactive waste 43 Summary The requirements of the BSS and other IAEA publication formulates the general rules regarding waste management. An efficient national infrastructure and policy is required. National regulations regarding disposal of waste should be available and form the basis of local rules in the hospital. A well planned use of radionuclides is fundamental in a waste management system. A system for segregation of the waste should be available in the department. This includes proper containers. A room for storage of waste should be available. A quality assurance programme in nuclear medicine should include management of radioactive waste. Nuclear Medicine Part 10. Radioactive waste 44 Questions? Nuclear Medicine Part 10. Radioactive waste 45 Discussion How should a room for interim storage be classified? Controlled area? Supervised area? Where should the room be localized and how should it be designed? Nuclear Medicine Part 10. Radioactive waste 46 Discussion A physicist is measuring the radionuclide purity of a technetium generator. The measurements reveal small amounts of Pu-239. Will this affect the disposal of the generator? Nuclear Medicine Part 10. Radioactive waste 47 Discussion Discuss the possibilities of incineration of radioactive waste. What basic requirements should be fulfilled by the plant? Nuclear Medicine Part 10. Radioactive waste 48 Where to Get More Information Other Sessions: Part 4 Safety of Sources. Design of Facilities Part 9. Quality Assurance Part 5 Occupational Protection Further Readings: IAEA, International Basic Safety Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources Safety Series No.115, Interim Edition (2011) IAEA, The Principles of Radioactive Waste Management, Safety Series No. 111-F, (1995) IAEA, A Safety Guide on Predisposal management of radioactive waste from medicine, industry and research, Safety Standard Series No 111-G-2.2 (1997) IAEA/WHO Manual on Radiation Protection in Hospitals and General Practice, Volume 4, Nuclear Medicine. Manuscript. Handling and disposal of radioactive materials in hospitals, ICRP Publication No. 25. Oxford, Pergamon Press, 1977 (Annals of the ICRP No. 2) Nuclear Medicine Part 10. Radioactive waste 49 Pre-Treatment Any or all the operations prior to waste treatment such as: •collection •segregation •chemical adjustment •decontamination Collection and segregation of waste are important factors to consider in a system of waste management in nuclear medicine Nuclear Medicine Part 10. Radioactive waste 50 Exempted Waste Storage for decay may release the waste from nuclear regulatory control. Clearance levels should be given by the national Regulatory Authority. All signs of its radioactive origin should be removed and the waste can be treated as any similar waste in the hospital taking into account the possible biological and chemical hazards. This is the most common way to handle radioactive waste in nuclear medicine. Nuclear Medicine Part 10. Radioactive waste 51 Disposal The emplacement of waste in an approved specified facility (for example, near surface or geological repository) without the intention of retrieval ("confine and contain”). Disposal may also include the approved direct discharge of effluents (for example, liquid and gaseous wastes) into the environment with subsequent dispersion ("dilute and disperse”). Both methods are used in disposal of waste in nuclear medicine Nuclear Medicine Part 10. Radioactive waste 52 Treatment Operations intended to benefit safety and/or economy by changing the characteristics of the waste. Three basic treatment objectives are: •volume reduction •removal of radionuclides from the waste •change of composition. After treatment, the waste may or may not be immobilized to achieve an appropriate waste form. Generally not used ín Nuclear Medicine Nuclear Medicine Part 10. Radioactive waste 53 Conditioning Those operations that produce a waste package suitable for handling, transportation, storage and/or disposal. Conditioning may include the conversion of the waste to a solid waste form, enclosure of the waste in containers and, if necessary, providing an overpack. Should be applied to long lived sealed sources used for calibration and QC of nuclear medicine equipment. Nuclear Medicine Part 10. Radioactive waste 54 Interim Storage Storage of waste at different stages of the waste management process, before the final disposal. A room for interim storage of waste should be available in a nuclear medicine facility. It is mainly used for storage for decay to exemption levels. This is the main method of final disposal of waste generated in nuclear medicine. Nuclear Medicine Part 10. Radioactive waste 55 Waste Transportation Transportation of waste at different stages of the waste management process, before the final disposal. The international regulations established by IAEA shall be followed. Note that radioactive waste should be handled similar to any radioactive source. Nuclear Medicine Part 10. Radioactive waste 56 Local Rules 1 Department of Diagnostic Nuclear Medicine Radiation Protection Manual RADIOACTIVE WASTE Gloves, cover paper etc • Shall continuously be collected in the plastic bags placed in the rooms for preparation and injection of radiopharmaceuticals • When the bag is filled, seal it and move it to room 2:13. • Write the expected date of disposal (today's date+14 days) • Before disposal, check the external dose rate on the surface. If the dose rate does not exceed the background,.the bag can be disposed of as ordinary waste. • If the dose rate exceeds the background, write the new date of disposal on the bag and store it for another 14 days. Nuclear Medicine Part 10. Radioactive waste 57 Local Rules 2 Department of Diagnostic Nuclear Medicine Radiation Protection Manual RADIOACTIVE WASTE Used syringes and needles etc • Shall continuously be collected in the shielded container in the rooms for preparation and injection of radiopharmaceuticals • When the container is filled, seal it and move it to the fume hood in room 2:13. • Write he expected date of disposal (today's date+4 weeks) on the container and place it behind the lead shield. • Before disposal, check the external dose rate on the surface. If the dose rate does not exceed the background,.the container can be disposed of according to the ordinary rules for dangerous items • If the dose rate exceeds the background, write the new date of disposal on the container and store it for another 4 weeks, Nuclear Medicine Part 10. Radioactive waste 58 Local Rules 3 Department of Diagnostic Nuclear Medicine Radiation Protection Manual RADIOACTIVE WASTE Vials containing residues of Tc-99m • Shall continuously be collected in the shielded container in the room for preparation of radiopharmaceuticals • When the container is filled, seal it and move it to the fume hood in room 2:13. • Write the expected day of disposal (today's date+4 weeks) on the container and place it behind the lead shield. • Before disposal, check the external dose rate on the surface. If the dose rate does not exceed the background,.the container can be disposed of according to the ordinary rules for glassware • If the dose rate exceeds the background, write the new date of disposal on the container and store it for another 4 weeks, Nuclear Medicine Part 10. Radioactive waste 59 Local Rules 4 Department of Diagnostic Nuclear Medicine Radiation Protection Manual RADIOACTIVE WASTE Vials containing residues of Tl-201, In-111 and Ga-67 • Measure the residual activity • Put the vial in the original lead shield and move it to room 2:13 • If the activity is below 100 MBq, open the vial and pour the content in the sewage system. Use the sink in room 2:13. Flush with plenty of water. Rinse the vial and dispose it as ordinary glass ware. Use protective gloves and clothing during the work. • Check for contamination of the sink. Clean it if contamination is detected • If the residual activity is >100 MBq, calculate the time of storage using the tables posted in the room. Write the date of disposal on the vial and put in the fume hood. Nuclear Medicine Part 10. Radioactive waste 60 Local Rules 5 Department of Diagnostic Nuclear Medicine Radiation Protection Manual RADIOACTIVE WASTE Technetium generator • Put the used generator back into the transport container • Move the container to the room for interim storage of waste (no 01:24 located in the basement). The key to the room is kept by the Chief Technician • Fill in the record (generator no and today's date) • The used generators will be picked up every 8th week by the producer. Check the containers for contamination before they are removed. Fill in the date of removal in the record. • Notify the RPO (NN phone xxxxxx if contamination is detected) Nuclear Medicine Part 10. Radioactive waste 61 Local Rules 6 Department of Diagnostic Nuclear Medicine Radiation Protection Manual RADIOACTIVE WASTE Sealed sources Flood sources, anatomical markers, check sources • Move the used source to the room for interim storage of waste (no 01:24 located in the basement). The key to the room is kept by the Chief Technician • Fill in the record (source id no and today's date) • The final disposal of the source is handled by the RPO (NN, phone xxxxxx) Nuclear Medicine Part 10. Radioactive waste 62