Two years ago, Rajendra Yadav was working at a scrap metal site in New Delhi, India breaking apart discarded metal appliances, car parts, and other electronics. As he used his hammer to disassemble a large machine, he noticed a shiny glimmer of metal unlike he’d ever seen before. It was small enough to put in his pocket before moving on to the next machine. As he finished work that day, he was shocked to discover burns on his hips and thighs. He died 20 days later.

It turns out that the device Mr. Yadav was hammering was an x-ray machine from Delhi University that was accidentally thrown out with the normal garbage. The shiny metal he placed in his pocket was highly radioactive and resulted in his death. Mr. Yadav’s sickness and death highlighted the threat of radioactive materials in scrap metal. But what if he hadn’t noticed the shiny metal? What if the machine was disassembled and, due to luck and shielding, the workers were not injured or alerted to the fact that there was radiation coming off of the scrap metal?

The answer is that the scrap metal would have been melted and used to create new products–like shiny metal tissue box holders.

In January of this year, the retailer Bed, Bath, & Beyond received a shipment of tissue box holders. They shipped some to brick-and-mortar stores and placed the rest for sale on their website. Some of the boxes were placed on a freight truck that was stopped at a truck scale in California when the radiation sensors sounded. This time it wasn’t a false alarm, the tissue boxes were contaminated with cobalt-60 and were definitely radioactive. Somehow, the radiation was not detected by US Customs and Border Protection at the port before it entered the US and, even worse, the product was already for sale at other stores.

Bed, Bath, & Beyond was quickly notified of the incident and began cooperating with the US Nuclear Regulatory Commission (NRC). The NRC usually has authority over nuclear/radioactive material licensees, but clearly Bed, Bath, & Beyond is not a traditional carrier of radioactive material. The retailer has been praised by the NRC for its transparent and full cooperation resulting in the proper removal and disposal of the tissue boxes. Since several tissue boxes were sold to consumers, the retailer has posted notices recalling the item.

In this case, the system worked–not at first inspection at the port, but nevertheless the radiation was detected. By design, we use redundancy to reduce risk. When the shipment evaded detection at the port, it was a truck scale in California that detected the anomaly.

Incidents in other countries show us how disastrous radiation can be when it goes undetected, such as the 1987 Goiânia accident in Brazil or the Taiwanese apartment buildings constructed using radioactive rebar in 1982. In Brazil, children played with, ate, and inhaled a glowing blue substance that later was determined to be highly radioactive cesium chloride taken from a medical facility that was being demolished. In Taiwan, several apartment buildings were constructed using rebar that was contaminated with radioactive medical waste. As the article linked above explains, “Eighty-nine of the 4,100 samples were diagnosed with cancer, including cervical cancer, breast cancer, liver cancer, leukemia and thyroid cancer. Researchers said that high incidence of the disease might be attributed to chronic low-dose radiation exposure. Over the course of the research period, 39 of the 89 cancer sufferers died.”

Radiation is inherently worrisome since it is odorless, invisible, and potentially lethal. While the US has a sophisticated, layered system to prevent the transport and distribution of unapproved radioactive materials, emergency managers and public health planners at the local level may need to ask themselves what courses of action are available to them if radiation was discovered in their municipality. While many agencies plan for a radiological dispersal device (RDD), or “dirty bomb”, the concept that a radiological emergency might develop slowly due to the discovery of latent radiation (in other words, radiation that piggybacks on household products or construction material due to contamination at the foundry or assembly facility) is a fairly new concept.

With the increase in use of nuclear medicine (the graph on the left shows the MRI scans per year in Canada, the US has even more), the amount of radioactive material required for nuclear medicine as well as the amount of radioactive material for disposal increases every year. The need to safeguard radioactive material and prepare for discoveries of radiation (latent or intentional) is more important than ever. A good example of the need to be prepared for unexpected radiological incidents is the “radioactive boy scout” who built his own reactor in his parents’ backyard shed in Michigan–only to have his dreams ruined when the EPA, DoE, FBI, NRC, and other Federal and local law enforcement and public health agencies raided his home.

I encourage all emergency managers and public heath planners to re-examine their radiological emergency response and recovery plans to ensure a confident and knowledgeable response/recovery not just to a RDD, but to all types of radiation and nuclear medicine-related contingencies. Then, we must ask ourselves, when was the last time we exercised these plans to make sure we have the capabilities, coordinating agencies/partners, tools, policy, protocols, procedures, and pre-scripted public information and warning required for an incident of this type?