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Short Communication *Corresponding author Teresa Cristina dos Santos Leal, Department of Health – College Inspirar- Curitiba, Brazil, Tel: 55-41-988894747; Radioactive : A Email: Submitted: 02 September 2017 Matter of Security and Knowledge Accepted: 30 September 2017 Published: 06 November 2017 1 1,2 Teresa Cristina dos Santos Leal * and Alaercio Aparecido de Oliveira ISSN: 2333-6633 1Department of Health, Curitiba, Brazil Copyright 2 Center for Professional and Business Education of Ctba, Brazil © 2017 dos Santos Leal et al.

OPEN ACCESS Abstract In General, and clinics use equipment that can generate , i.e. Keywords material with content inappropriate for the environment and harmful to public • Medical waste health. The overall objective of this study is to highlight the consequences of incorrect handling • Radioactive waste and disposal of hospital material containing radioactive elements can bring to people’s lives • Storage and to stress the need for more studies and public policies for control and dissemination of • Regulatory agencies knowledge between employees and the public to use such services. • Security

INTRODUCTION stored according to international safety standards recommended To start the discussion, it is necessary to stress that is said as radioactive , any material resulting from human byMATERIALS the International AND Atomic METHODS Energy [7]. activities, which contains radionuclide’s in amounts exceeding The template used in this research was the systematic the exemption limits specified by the standard of the CNEN review of published studies, where the inclusion criteria were collected,(NE-6.02) treated[1], and and/or for which stored the properly use is improper can result or in unexpected accidents, established in advance in the definition of the words of interest “. All materials, products that fit in this specification if it is not and studies acceptable. as has occurred in the case of Brazil the accident with cesium 137 the necessaryA literature information review was and relevant performed to the in study indexed of perceptive journals, in the year 1987 [2]. books, textbooks, theses and dissertations, seeking to obtain all

Health care waste, constitute about 2% of the total volume aboutDISCUSSION risk of radioactive waste, in the last ten years. of waste generated, and risks of exposure, both of workers as It is essential to the recognition of potential risks in the users, primarily by infectious waste and radioactive waste. The handling of radioactive elements, which underlines the need to radioactive waste is generated by health service providers, determine the level of in the activities that require use resulting from the use of radioactive substances non-sealed for therapeutic, diagnostic and research [3]. This generation is due and work areas in case of incident, such as spills and vomiting I is one of the most commonly ofboth patients to the planned treated works with as radioisotope to the tasks investigationof cleaning materials on the of radioactive materials by means131 of monitoring procedures. procedures involving the disposal of radioactive waste generated Since 1950, the radioisotope in some treatments used in nuclear and still a matter used in nuclear medicine, being considered controversy and little discussed, as reports some authors “universal tracer”, and the first radionuclide approved for use in the United States by the National Council of Radiation Protection teams, especially , on precautions and management of limitations,and monitoring dose (National is required Council of the on hospital Radiation unit’s Protection deployment and hospitalization[4,5]. These authors in nuclear point medicine out the examinationsimportance of and the treatments, actions of Measurements [8], in the form of . Because of such

It is important that such teams are aware the values of doses and and execution of a Radioactive Program, as the process of decay and destination of the radioactive waste. Radioactive Waste Management Program. The deployment of a contemplateRadioactive Waste only theManagement experimental Program steps is of the the responsibility procedures toof their effects with internationally established dose limits. the direction of the establishment and health provider must not of professional staff involved in management of radioactive disusedIn Brazil radioactive the body sources responsible from is places the National like hospitals, Nuclear Energy clinics, be adopted, but also to define and document the responsibilities Commission (CNEN) [6] that receives and stores, in his institutes, transported in accordance with special regulations, processed and waste through standard operating procedures. Another tool that research centers and medical industries. These materials are the hospital units must make available to the nursing staff is standard operating Procedures Manual used; discuss Cite this article: dos Santos Leal TC, de Oliveira AA (2017) Radioactive Hospital Waste: A Matter of Security and Knowledge. JSM Chem 5(3): 1047. dos Santos Leal et al. (2017) Email: [email protected]

Central Bringing Excellence in Open Access Class 1: Waste of half life too short order to provide protection to health professionals, patients and basic concepts and operational procedures of these therapies, in Waste with a half-life of 100 days or less, with higher activity the environment. The importance of the training of professionals levels and discharge levels that can meet within a period of 5 involved in the activities of radiation is highlighted by [5], who the drafting of manuals and videos as educational references years the criteria for exemption laid down by the CNEN-NE-6.05 worked with radioactive for 20 years, suggesting [15].Class 2: Low and medium-Level Waste so that they are permanently available at the nursing station in inpatient unit. In Table 1 are the annual equivalent dose limits for Waste with a half-life of 100 days or less, with higher activity workersHowever, and the there public. are clinics and hospitals still do not follow correctly the standards for handling, disposal and interim levels and discharge levels that can meet within a period of 5 storage, internal and external, of the radioactive material used, yearsClass the 3: High-levelcriteria for exemption Waste laid down by the CNEN-NE-6.05. people and the environment run risk of acquiring and

Tailings with concentrations of radionuclides long half-life in contamination, respectively. Surveillance, which should be rigid, excess of the limitations for classification as rejects from short for part of the CNEN, seems not to be appropriate for numerous half-life. Consists of solid and liquid fuel used in factors; such as politics, lack of trained personnel, etc [7]. plants. management, consists in the provision of such waste at And important to note that in Brazil, the national agency of sitesThe structured final destination in accordance corresponds with the to the requirements stage of external of the sanitary surveillance (ANVISA) classifies the waste generated competent environmental agencies, and must receive the prior by the hospital services in five groups. The group is represented by potentially polluting material, biological waste Group B is represented by , the Group C is composed of treatment according to their specific features before they are radioactive tailings, contaminated with radionuclides, in Group forwarded to the final provision [16]. You must evaluate the D are common waste that require no special treatment; and inresidues which forthe checkingradioactive the tailings, degree isof packagedradiation, inand an if appropriate it is above in the Group and are considered sharps waste, as objects and placethe unhealthy to lose your value dangerousness, send to decay. not This showing process more is therisk periodfactor instruments that can cause accidents and contamination [9].The amount of radionuclides that can be contained in the tailings depending on your class, must pass through decay step up to of the Group C is established by the National Nuclear Energy to the individual and the environment. The radioactive waste, Commission (CNEN). These tailings from clinical laboratories, radiotherapy and Nuclear Medicine and cannot be reused under meet the criteria for release to the environment as per the [15] any circumstances. Need to receive prior treatment before being and subsequently the disposal via municipal collection of urban stored, either temporarily, as final and cannot be handled without wasteRISKS: (solid) PERCEPTION or depletion sanitary (liquids) [17]. the compliance with safety regulations [10-13].

According to the law, the CNEN 10,308/2001 is responsible modernity, the perceptive process of individuals including way for initial, intermediate and final deposits of radioactive waste of lookingWith the at the advance environment of new and technologies, prospects thehave advantages changed, the of produced in the national territory, with her design, build and various phenomena that emerged from the technological process install the intermediate and final deposits [14]. Nuclear power dividedplants, hospitals,into the following industries classes: are among the biggest generators of these tailings that following the norm CNEN-NE-6.05 can be theaffecting people the involve environment an additional and valuation these stocks process can facing be perceived the risk, Class 0: Waste Free whichrevealing includes a concept an evaluation of risk for eachin a sense individual. of the Risk seriousness perceptions of the of Feature radionuclides with activity values in mass or volume, risk, no matter where the presence or absence of fairness of the lower than the levels of exemption set out in the standard CNEN- effects. She also corresponds to a certain intuitive estimate of risk NE-6.05 [15]. undertaken by individuals or social groups, namely, an estimate that is not based on mathematical calculations of probability Table 1: or magnitude, but it is a balance of various risk characteristics Equivalent Primary Doseannual equivalent doseWorker Limits. Public and the context in which he If inserts. It is appropriate to point out that the new paradigms of science have been diverted from exclusively scientific tradition. The reflexivity matter driving Effective * - He 50 mSv 1 mSv T scientific initiatives in an analogy between partially objective Skin Organ OR Tissue - HT 500 mSv 1 mSv / W * considerations and partially subjective. Decisions seek to 500 mSv 50 mSv consider for now, too, the ethical issue in studies and scientific Ends 500 mSv 50 mSv discoveries. In doing so, the concerns are focused on minimizing impacts to human health and the environment, giving credibility Lens of Eyes 150 mSv 50 mSv to the acceptability of the risks which depend on the perception *WT: Weighting Factor: considers the degree of damage that an organ of the risk estimated by the opinions and attitudes of the public. would cause independently for the whole body Source: CNEN NE 3.01 (2005) In addition to the alleged contribution, in a parallel vision, it JSM Chem 5(3): 1047 (2017) 2/4 dos Santos Leal et al. (2017) Email: [email protected]

Central Bringing Excellence in Open Access

becomes clear the need to consolidate the following challenge: haveService, your so thatquality the maintainedmanagement over can time,be absorbed where streamlinesinto the routine the usethe implementation services and primarily of public to policies developers in the who nuclear work sector daily for in of service without causing major changes and/or disorders and the development of actions of clarification along to people who documentation required by the CNEN-NE-6.05, seeking a better craveareas ofnew potential search risk.procedures/treatments And, finally, conceive that the aim idea to thatminimize there match.REFERENCES is a constant search for safety in hospital sectors in General who the new policies, and inspection requirements for the procedures the suffering and extending human longevity. However, it is clear 1. CNEN. National Commission of Nuclear Energy. Licensing of Radiating Installations - CNEN Standard NE-6.02. Brazil. 2002. and safety standards to be implemented and followed by such a 2. IEN. Institute of . Receipt of radioactive tailings. wayFINAL to cause CONSIDERATIONS a full benefit. IEN, Products and Services. 2012. 3. dos Santos Leal TC, Crispim VR, Frota M, Kelecom A, da Silva AX. Use quantitative and clinical waste management, “it is necessary of a bioindicator system in the study of the mutagenetical effects in to drawRosa describes up a strategy in your that research results where in an espoem improvement the qualitative, in the the neighborhoods of deposits of radioactive waste. Appl Radiat Isot. 2008; 66: 535-538. 4. Costa WM, Fonseca MCG. The importance of hospital waste management of this waste [18,19]. This improvement has to be management and its positive aspects to the environment. Hygeia. involveddrawn up in line the with implementation existing legislation of solid and wasteguidelines management based on 2009; 5: 12-31. tools that are beginning to make more clear and agile the processes 5. Thompson MA. Radiation Safety Precautions in the Manegement of the Hospitalized 131I Therapy Patient. Journal of Nuclear Medicine in health. And the implementation of a program of continuing Technology. 2001; 29: 61-66. wasteeducation of health, and permanent with a view education to transform to implement practices that efficiently constitute the 6. CNEN. National Commission for Nuclear Energy, 2005. Limits of normative precepts about the appropriate management of solid tolerances - Standard CNEN NN -3.01, Brazil. 7. Oliveira AM, Carvalho PRSF. Analysis of the management of waste the current institutional culture. A transformative process of this of consistent policies that have the function of disseminating the and radioactive waste from a nuclear medicine clinic in Teresina -PI. size can only be possible with the action on the part of managers CONNEPI. 2010. knowledge and educate workers about individual and collective 8. NCPR- National Council on Radiation Protection and Measurements. Limitation of exposure to : recommendations of risksMousquer that inappropriate analyzing themanagement medical services can lead and “. nuclear research theNational Council on Radiition Protection and Measurements. 1993. 9. ANVISA. National Health Surveillance Agency provides for the in Porto Alegre, RS, points out that the results of your study made Technical Regulation for the management of waste of health services. theit possible temporary to analyze storage the of attendance waste, lack of oflegal knowledge restrictions regarding on the 2004. licensing process [20]. Verified the existence of irregularities in 10. NETO GCO, Shibao FY. Management of Infectants and Radioactive Waste in Three Hospitals of São Paulo: Performance Indicators for alertthe quantification to the need for of policies radioactive aimed materials at the monitoring and the radiation and the Process Control. 2013. protection mechanisms adopted. What comes to confirm on the 11. BRASIL. Ministry of Health. Management of health service waste. Brazil. 2006. efficienciesThere is of a theneed existing for that laws. in hospitals and in clinics providing dose rates of gamma radiation, as a consequence of the presence 12. Monteiro IHTS. Determination of the environmental and occupational

Nuclear medicine services to occur greater dissemination of of RDS-111 and the IEN / CNEN Radioactive Waste Repository. knowledge in the field of radiological protection, for all use Dissertation (Sciences in Nuclear Engineering). Rio de Janeiro. 2005. of ionizing radiation, the standards must be laid down and 13. CNEN. National Commission for Nuclear Energy. Management of followed to respect the basic principles of radiation protection Radioactive Rejection of Low and Medium Levels of Radiation_ during their manipulation. It can be concluded that most of the Standard. Brazil. 2014. non-conformity is bureaucratic. The independence between 14. Xavier AM. Radioactive tailings management. Rio de Janeiro: CNEN. monitored and watchdog, the distribution of information and the 2012. maintenance of the inclusive process are bureaucratic problems 15. CNEN. National Nuclear Energy Commission, 2014 Radioactive requiring issuance of regulatory acts to be solved, but also of Rejects. Brazil. knowledge about procedures for radioactive waste drops, where many of the workers have not seen or have little knowledge. 16. Takayanagui AMM. Waste management of health services. In: Procedures such as regular courses and lectures on the subject PHILIPPI JR. A. Sanitation, health and the environment: foundations for sustainable development. São Paulo. 2005; 323-374. onshould radioactive be part of waste the daily management, life of all health propose establishments, a formulation but in 17. National Commission for Nuclear Energy. Radioprotection and safety managing,unfortunately, structuring that does and not in happen. the routine Coelho of inwork your adapting article requirements for nuclear medicine services. Rio de Janeiro. 1996. them to the conditions and limitations of the nuclear medicine 18. Cussiol NAM. Final disposal of potentially infectious waste from health services in special cells and by co-disposal with urban solid waste. Department for her review [21]. Suggests follow-up through Belo Horizonte: 2005. Thesis (Doctorate in Sanitation, Environment “on the job” training for the technicians of the Nuclear Medicine and Water Resources) - Department of Sanitary and Environmental JSM Chem 5(3): 1047 (2017) 3/4 dos Santos Leal et al. (2017) Email: [email protected]

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of radioactive waste from the medical and nuclear research services in

Engineering and Department of Hydraulic Engineering and Water Resources. Federal University of Minas Gerais. 2005. Porto Alegre-RS. Blucher Engineering Proceedings. 2016; 3: 887-896. management system in the nuclear medicine service of unicamp clinic 19. Rosa FR. Diagnosis of waste management in a hospital in the Rio Pardo 21. Coelho. Rosangela Franco. Implementation of radioactive waste Valley. Rio Pardo Valley. Masters dissertation. University of Santa Cruz do Sul. 2016. hospital. Synthesis: SIMTEC Electronic Magazine. 2016; 171-171. 20. Mousquer AC, Garrafiel GF, Rossoni RB. Diagnosis of the management

Cite this article dos Santos Leal TC, de Oliveira AA (2017) Radioactive Hospital Waste: A Matter of Security and Knowledge. JSM Chem 5(3): 1047.

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