ENS 57423
ENS Event | |
|---|---|
21:00 Nov 12, 2024 | |
| Title | Overexposure from Radiography Source |
| Event Description | The following information was provided by the Washington State Office of Radiation Protection (the Department) via email:
Radiography was being performed in a tank at the refinery. [A radiation protection boundary was set up around a tank], and the source was secured in the exposure device. One radiographer was outside the boundary and the other radiographer was inside the boundary with another individual (contractor) outside of the tank. The contractor was in a lift moving upwards next to the tank. Unfortunately, due to a miscommunication between the radiographers and the contractor, the two individuals outside the tank and within the radiation boundaries were exposed to the source for 2 minutes. The licensee radiation safety officer (RSO) estimates 1.8 R radiation exposure for the 2 minutes duration right outside the tank as a worst-case scenario. The RSO is currently performing a dose investigation of the affected contract personnel and radiographer. The RSO recommended the contactor to receive medical monitoring (blood draw) as a precaution. The Department set expectations for the licensee to send a full detailed report on findings for this incident. More information to follow for this incident report. Device information: Isotope: 87 Ci of Ir-192 Manufacturer: QSA Global Device Model: 880D Incident number: WA-24-022
The following information was provided by the Washington State Office of Radiation Protection (the Department) via email: On 11/14/2024, inspectors from the Department will be conducting a reactive onsite visit of the overexposure event which occurred on 11/12/2024. The inspectors will be meeting at the refinery site where the overexposure occurred with the licensee representatives including the RSO to gather information on the event related to what and how the event occurred and to review related records. The Department staff will continue to gather information on the event to determine the extent of the exposures, the potential root cause of this incident, any correlation to previous incidents with this licensee, and appropriate corrective actions. This may include potential enforcement actions in addition to the corrective actions. Updates will be provided as additional information is received. Notified R4DO (Young), NMSS MSST Deputy Division Director (Silberfeld), and NMSS (email)
The following is a summary of information provided by the Department via email: The total dose received is 1.7 mrem for two individuals on the lift and 4 mrem for the other individual inside the tank. After the reactive inspection and interviews were performed, a violation letter was sent to the licensee for individuals not wearing proper dosimetry in a radiation area and not contacting the emergency response number after discovery of the unmonitored exposure. All corrective actions have been completed by the licensee and the investigation is closed. Notified R4DO (Drake) and NMSS Events Notification (email) |
| Where | |
|---|---|
| Acuren Anacortes, Washington (NRC Region 4) | |
| License number: | IR067 |
| Organization: | Wa Office Of Radiation Protection |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+24.15 h1.006 days <br />0.144 weeks <br />0.0331 months <br />) | |
| Opened: | John Martell 21:09 Nov 13, 2024 |
| NRC Officer: | Tenisha Meadows |
| Last Updated: | Apr 14, 2025 |
| 57423 - NRC Website | |
Acuren with Agreement State | |
WEEKMONTHYEARENS 574232024-11-12T21:00:00012 November 2024 21:00:00
[Table view]Agreement State Overexposure from Radiography Source ENS 571192024-05-07T17:26:0007 May 2024 17:26:00 Agreement State Stuck Radiography Source ENS 456582009-02-19T05:00:00019 February 2009 05:00:00 Agreement State Agreement State Report - Equipment Failure / Radiography Source Disconnect 2024-05-07T17:26:00 | |