DOCTORS AND THE DOCTORS AND THE ‘TERRORIST BOMB’: ‘TERRORIST BOMB’:

proliferation dangers associated with proliferation dangers associated with radio-pharmaceutical productionradio-pharmaceutical production

A presentation prepared by the Medical Association for Prevention of A presentation prepared by the Medical Association for Prevention of WarWar

22

Bomb-grade uranium in the marketplaceBomb-grade uranium in the marketplace

‘‘URGENTURGENT…phasing …phasing out the use of highly out the use of highly enriched uranium in enriched uranium in civil commerce and civil commerce and removing weapons-removing weapons-usable uranium from usable uranium from research facilities research facilities around the world and around the world and rendering the materials rendering the materials safe.’safe.’

33

HEU and nuclear medicineHEU and nuclear medicine

Uranium fuel pelletsUranium fuel pellets

> 95% of the world’s > 95% of the world’s radiopharmaceuticals radiopharmaceuticals are derived from are derived from BOMB-GRADE BOMB-GRADE Highly Enriched Highly Enriched Uranium (HEU)Uranium (HEU)

‘‘targets’ +/- reactor targets’ +/- reactor fuelfuel

44

Nuclear terror…Nuclear terror…“… “… terrorist groups have been terrorist groups have been

trying aggressively to obtain trying aggressively to obtain nuclear materials…” nuclear materials…” - From 1993 - 2006, IAEA From 1993 - 2006, IAEA

recorded over 1000 cases recorded over 1000 cases of intercepted smuggling of of intercepted smuggling of radioactive materialsradioactive materials

- By 2005, 18 seizures of By 2005, 18 seizures of stolen HEU or plutonium stolen HEU or plutonium confirmed by states confirmed by states involved involved

– Al-QaidaAl-Qaida agents have tried agents have tried to buy uranium from South to buy uranium from South Africa …Africa …

Helfand et al. Nuclear terrorism. Helfand et al. Nuclear terrorism. BMJ 2002; BMJ 2002;

324:356-9.324:356-9.

55

Uranium enrichmentUranium enrichment Natural uranium = Natural uranium =

0.7% U-2350.7% U-235 Weapons grade - Weapons grade -

usually enriched to usually enriched to greater than 90%, but greater than 90%, but lower percentages still lower percentages still usableusable

66

The fission processThe fission process Each nucleus Each nucleus

undergoing fission undergoing fission must produce a must produce a neutron that splits neutron that splits another nucleusanother nucleus

Complete fissioning Complete fissioning of 1 gram of U-235 of 1 gram of U-235 releases 23,000 releases 23,000 kilowatt-hours of kilowatt-hours of heatheat

77

Detonation techniquesDetonation techniques

Gun technique Gun technique – Only used with HEUOnly used with HEU– Mass of sub-critical Mass of sub-critical

HEU fired (or HEU fired (or dropped) at anotherdropped) at another

– sum of two masses > sum of two masses > “supercritical”“supercritical”

– Hiroshima bombHiroshima bomb– Simple, robust, no Simple, robust, no

testing requiredtesting required

88

Nuclear consequencesNuclear consequences

Within half a millionth of a Within half a millionth of a second:second:– hundreds of millions degrees hundreds of millions degrees

centigradecentigrade– pressures - millions of pressures - millions of

atmospheresatmospheres Flash >>>Flash >>> Fireball >>>Fireball >>> Blast >>>Blast >>> Firestorm >>>Firestorm >>> Acute radiation >>>Acute radiation >>> Delayed radiation Delayed radiation

99

6 August 19456 August 1945HiroshimaHiroshima

15 kiloton bomb15 kiloton bomb Immediate deaths – Immediate deaths –

140,000140,000 Total deaths: Total deaths:

Hiroshima bomb 6 Hiroshima bomb 6 August 2004: 237,000August 2004: 237,000

270,000 270,000 hibakushahibakusha still still living in Japan living in Japan (Mayor Akiba)(Mayor Akiba)

1010

‘‘MEDICAL MESSAGE’:MEDICAL MESSAGE’:12.5 kt explosion: New York City12.5 kt explosion: New York City

DON’T BOTHER DON’T BOTHER RINGING RINGING

000000

• responder accessresponder access• essential servicesessential services• medical suppliesmedical supplies• hospital facilitieshospital facilities

1111

1212

Core requirementsCore requirements

A 20 kt nuclear bomb requires:A 20 kt nuclear bomb requires:– 4-5 kg of weapons grade plutonium OR4-5 kg of weapons grade plutonium OR

– 10-15 kg of weapons grade uranium 10-15 kg of weapons grade uranium (HEU)(HEU)

A 1kt nuclear weapon requires:A 1kt nuclear weapon requires:– 1 kg of weapons-grade plutonium OR1 kg of weapons-grade plutonium OR

– 2.5 kg of weapons-grade uranium2.5 kg of weapons-grade uranium

1313

Suppliers of radiopharmaceuticalsSuppliers of radiopharmaceuticals

4 major competitors4 major competitors

1.1. MDS Nordion (Canada)MDS Nordion (Canada)2.2. TycoHealthcareTycoHealthcare / Mallinckrodt / Mallinckrodt

(Netherlands)(Netherlands)3.3. Institut National des Institut National des

Radioéléments (Belgium)Radioéléments (Belgium)4.4. NECSA/NTP (South Africa)NECSA/NTP (South Africa)

– >95 per cent of the >95 per cent of the global supply global supply

– 7 reactors7 reactors NRU Reactor at Chalk River, NRU Reactor at Chalk River,

Canada, where MDS Nordion Canada, where MDS Nordion irradiates HEU targets to irradiates HEU targets to produce medical isotopesproduce medical isotopes

1414

HEU sourcingHEU sourcing

Canada (Nordion): imports ~ 20 kg/year Canada (Nordion): imports ~ 20 kg/year from USAfrom USA

Europe: France, Russia or UK (or US pre-Europe: France, Russia or UK (or US pre-1992) 1992)

South Africa: uses HEU it produced for South Africa: uses HEU it produced for weapons prior to 1991 weapons prior to 1991

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Isotope productionIsotope production

– Neutron bombardment of Neutron bombardment of HEU ‘HEU ‘targetstargets’ ’

– Process consumes < 3% Process consumes < 3% of the available U-235of the available U-235

– ‘‘used’ target = still used’ target = still bomb-grade uraniumbomb-grade uranium

– 85kg/year HEU used 85kg/year HEU used globally globally

– HEU stockpiled in multiple HEU stockpiled in multiple commercial locationscommercial locations

Unloading fuel from a research Unloading fuel from a research reactorreactor

1616

Medical isotopesMedical isotopesTechnetium-99 (Tc-Technetium-99 (Tc-

99m)99m)– ‘ ‘workhorse’ isotopeworkhorse’ isotope– >75% of medical >75% of medical

isotope procedures isotope procedures worldwideworldwide

– 25 million procedures 25 million procedures per yearper year

– Favoured isotope Favoured isotope tracer in bone scans, tracer in bone scans, thyroid scansthyroid scans

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From HEU to LEUFrom HEU to LEU

Low enriched uranium-LEULow enriched uranium-LEU– Targets < 20 % U-235Targets < 20 % U-235– Suits Mo/Tc-99m Suits Mo/Tc-99m

productionproduction– NotNot viable for weapons viable for weapons – Argentina, Indonesia Argentina, Indonesia

and Australia use LEU and Australia use LEU targets (<5% of market)targets (<5% of market)

New OPAL reactor, Sydney: LEU fuel and New OPAL reactor, Sydney: LEU fuel and targetstargets

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Cleaning upCleaning up

2002, Belgrade: removal 2002, Belgrade: removal of 48 kilograms of HEU of 48 kilograms of HEU research reactor fuelresearch reactor fuel

The fuel in the reactor at The fuel in the reactor at Petten, Netherlands Petten, Netherlands converted in 2005converted in 2005

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ConversionConversionOslo IAEA symposium, June 2006Oslo IAEA symposium, June 2006

‘‘The conversion of radioisotope production, The conversion of radioisotope production, specifically Mo-99, to LEU is technically feasible, specifically Mo-99, to LEU is technically feasible, and … remaining obstacles to conversion of this and … remaining obstacles to conversion of this activity are activity are chiefly of commercial naturechiefly of commercial nature.’ .’

Prof Jose Goldemberg, International Panel on Fissile MaterialsProf Jose Goldemberg, International Panel on Fissile Materials

SummarySummary– Conversion from HEU to LEU is possible Conversion from HEU to LEU is possible – No future needs for HEU identifiedNo future needs for HEU identified– Current conversion programmes: successfulCurrent conversion programmes: successful

2020

Commercial viabilityCommercial viability

Cost to consumers in most applications Cost to consumers in most applications would be in the order of a 1 – 2 % increasewould be in the order of a 1 – 2 % increase

A large cost saving:A large cost saving: eliminating the high eliminating the high security costs necessitated by HEU storage security costs necessitated by HEU storage and transportand transport

Kahn LH, von Hippel F. How the radiological and medical Kahn LH, von Hippel F. How the radiological and medical communities can improve nuclear security. communities can improve nuclear security.

J Am Coll Radiol 2007;4:248-J Am Coll Radiol 2007;4:248-51.51.

2121

Addressing supplier reluctanceAddressing supplier reluctanceNone of the 4 big players are currently using LEU targetsNone of the 4 big players are currently using LEU targets

TimelineTimeline 1978 - Reduced Enrichment Research and Test Reactor 1978 - Reduced Enrichment Research and Test Reactor

programprogram 1992 - US Energy Policy Bill: incentives to convert to LEU1992 - US Energy Policy Bill: incentives to convert to LEU 2005 - Burr Amendment weakens2005 - Burr Amendment weakens the Bill the Bill

Current statusCurrent status S.Africa & Netherlands ‘planning’ to convert to LEU: a S.Africa & Netherlands ‘planning’ to convert to LEU: a

decade away…?decade away…? MDS-Nordion (>50% of the global Tc-99m supply)MDS-Nordion (>50% of the global Tc-99m supply)

– stopped co-operating with the RERTR in 2003 stopped co-operating with the RERTR in 2003 – lobbied Congress to pass Burr Amendmentlobbied Congress to pass Burr Amendment– current stockpile > 45 kilograms HEUcurrent stockpile > 45 kilograms HEU

2222

Other options: Other options: Non-reactorNon-reactor produced produced isotopesisotopes

Cyclotrons and other Cyclotrons and other spallation sourcesspallation sources– fluorine-18: PET fluorine-18: PET

scansscans– thallium-201thallium-201– indium-111indium-111

Potential Potential non-reactor non-reactor routes to Mo-99/Tc-99 routes to Mo-99/Tc-99 exist, but no current exist, but no current commercial projectscommercial projects

2323

Imaging alternativesImaging alternativesTechnetium-99mTechnetium-99m

– Retains important role in Retains important role in medical imagingmedical imaging

– Challenges to Tc-99m:Challenges to Tc-99m: Positron Emission Positron Emission

Tomography (PET) Tomography (PET) Magnetic Resonance Magnetic Resonance

Imaging (MRI), Imaging (MRI), Helical, multidetector, high Helical, multidetector, high

resolution, multislice CT resolution, multislice CT Ultrasound (including Ultrasound (including

echocardiography and echocardiography and Doppler techniques) Doppler techniques)

2424

So … ask:So … ask:

1.1. Where do Where do youryour isotopes originate? isotopes originate?

2. Are they derived from 2. Are they derived from HEUHEU? ?

3. If so, is there an 3. If so, is there an alternativealternative supplier not using supplier not using HEU? If so, please use them. HEU? If so, please use them.

4. If not, what is the current supplier doing to 4. If not, what is the current supplier doing to convertconvert to LEU? to LEU?

2525

Medical strategiesMedical strategies

Educate colleaguesEducate colleagues Encourage clinicians to ask NM-providers where Encourage clinicians to ask NM-providers where

their isotopes come from, andtheir isotopes come from, and urge a non-HEU source whenever possible urge a non-HEU source whenever possible Optimise use of alternative imaging technologiesOptimise use of alternative imaging technologies Promote R & D of non-reactor isotopesPromote R & D of non-reactor isotopes Promote medical association and government Promote medical association and government

policies encouraging elimination of HEUpolicies encouraging elimination of HEU

2626

Other strategiesOther strategies

Nuclear physicians seek LEU-isotopes only Nuclear physicians seek LEU-isotopes only Encourage their suppliers to convert to LEUEncourage their suppliers to convert to LEU +/- switch to a non-HEU source +/- switch to a non-HEU source asapasap Governments of countries with producers using Governments of countries with producers using

HEU and governments providing HEU compel HEU and governments providing HEU compel conversion to LEU by big producersconversion to LEU by big producers

All new isotope facilities to utilize LEUAll new isotope facilities to utilize LEU

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Helsinki 2006: IPPNW campaignHelsinki 2006: IPPNW campaign End medical reliance on HEUEnd medical reliance on HEU Eliminate a likely source for the much-feared Eliminate a likely source for the much-feared

’terrorist bomb’ ’terrorist bomb’ Block vulnerable pathway to fissile materialBlock vulnerable pathway to fissile material Re-awaken profession to threat of nuclear Re-awaken profession to threat of nuclear

weapons weapons Encourage health professionals to engageEncourage health professionals to engage Clean-up ‘our own shop’: Clean-up ‘our own shop’:

First, do no harmFirst, do no harm

2828

The bigger The bigger picturepicture

CollaborationsCollaborations RepresentationRepresentation EducationEducation

talk to talk to colleagues & colleagues & studentsstudents

www.icanw.orgwww.icanw.org

2929

Further reading:Further reading:

– von Hippel F, Kahn LH. von Hippel F, Kahn LH. Feasibility of eliminating the use of Feasibility of eliminating the use of highly enriched uranium in the production of medical highly enriched uranium in the production of medical radioisotopes. radioisotopes. Science and Global Security 2006; 14: 151–62.Science and Global Security 2006; 14: 151–62.

– Kahn LH, von Hippel F. Kahn LH, von Hippel F. How the radiologic and medical How the radiologic and medical communities can improve nuclear security. communities can improve nuclear security. J Am Coll Radiol J Am Coll Radiol 2007; 4: 248–51.2007; 4: 248–51.

– Williams B, Ruff TA. Williams B, Ruff TA. Proliferation dangers associated with Proliferation dangers associated with nuclear medicine: getting weapons-grade uranium out of nuclear medicine: getting weapons-grade uranium out of radiopharmaceutical production. radiopharmaceutical production. Medicine, Conflict and Medicine, Conflict and Survival. October – December 2007; 23(4): 267 – 281.Survival. October – December 2007; 23(4): 267 – 281.

– Williams B, Ruff TA.Williams B, Ruff TA. Getting nuclear-bomb fuel out of Getting nuclear-bomb fuel out of radiopharmaceutical production. radiopharmaceutical production. Lancet 2008; 371 (8 Lancet 2008; 371 (8 March):795-7. March):795-7.