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1[r 27, 1983
- UNITED STATES OF AMgFICA4,,
NUCLEAR REGULATORY COND ISSION) h
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- { r! e ,S BEFORE THE ATOMIC SAFETY AND I, NSING GOA In.the Matter of )
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UNION ELECTRIC COMPANY ) Docket No. STN 50-483 OL
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(Callaway Plant,-Unit 1) )
AFFIDAVIT OF ROGER E. LINNEMANN, M.D.
ON REED CONTENTION-10 (MEDICAL TREATMENT)
-City of_ Philadelphia- )
. ) ss.
Commonwealth of Pennsylvania )
ROGER E. LINNEMANN, being duly sworn, deposes and says as
,. follows:
'1. I am a medical doctor with particular expertise in the area of radiological health. I am certified by the American Board of Radiology and-the American Board of Nuclear Medicine.
I am Clinical Associate Professor of Radiology at the
- University of Pennsylvania School of Medicine and a visiting Clinical Associate Professor of; Radiology at Northwestern
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University School'of-Medicine. I-am also Vice Chairman of Radiation Management Corporation-("RMC"), a. consulting-firm
.which I' established in 1968 to provide emergency medical I
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l expertise and support in the event of an accident involving injury to employees of nuclear power plants and to provide routine radiological health consulting on radiation health and safety to workers in nuclear facilities. Presently, RMC's Emergency Medical Assistance Program provides 24-hour emergency support to some 20 nuclear power plant sites throughout the country. Additionally, we have laboratory capability to measure radiation in the working environment of a nuclear power plant as well as in the outside environment. We did extensive analysis of the environment around Three Mile Island during the TMI-2 accident. This analysis included, among other things, Iodine concentrations in the food pathway chain. On behalf of Union Electric Company, RMC is currently developing a training program for medical personnel who might be called upon in tne event of a radiological emergency at the Callaway Plant. This program involves the developing of the proper facilities, supplies, equipment and personnel at the Callaway Memorial Hospital to enable the hospital to provide emergency treatment and care of the radiation injury as well as the contaminated and injured patient. In addition, plant personnel will be trained in the first aid and rescue of radiation injuries, and the local ambulance support will be trained in the transporta-tion of radiation injuries. This will be annual training combined with an exercise to mainta$~. proficiency at the Callaway Memorial Hospital in the event of a radiation injury occurring at the site. A summary of my professional l
I qualifications and experience is attached hereto as Exhibit i "A". I have personal knowledge of the matters stated herein and believe them to be true and correct. I make this affidavit in response to Reed Contention 10 (Medical Treatment) in this proceeding.
- 2. The purpose of this affidavit is to establisn that adequate facilities for the handling of contaminated and injured and exposed people from either an accident on-site and/or accident off-site exists in the area of the Callaway Plant, consistent with the requirements of 10 C.F.R. Section 50.47(B)(12).
STATEMENT OF THE ISSUE
- 3. Medical response resources would be required for basically two types of problems in the event of a radiological emergency at the Callaway Plant: (1) the contaminated and injured patient; and (2) the externally exposed person.
Radiation injuries result from either exposure to radiation or contarination by radioactive materials. It is important to; clearly understand the difference in order to develop realistic procedures for responding to radiation accidents.
- 4. In the case of radiation exposure, the radiation passes through the body as it does in medical x-rays. The patient suffers injury as a result of the energy deposited in the cells during the period of radiation, but the patient is not radioactive and presents no hazard to response personnel.
Once the body has been irradiated, a predictable clinical course ensues which is directly correlated with exposure dose and dose rate. This clinical course cannot be interrupted and will evolve over a period of days and weeks.
- 5. Contamination, on the other hand, results from loose radioactive particles adhering to the body. By definition, these particles emit radiation, and so exposure hazards remain until these particles are removed. Fortunately, radioactive contamination is easy to detect with instruments, and deconta-mination is easily accomplished through removal of clothes and bathing of the affected areas. Again, whatever exposure is suffered through contamination will follow a predictable clinical course based on the exposure level of the dose and the dose rate. This course cannot be interrupted and will evolve over a period of time.
- 6. It is most important for medical response personnel to be able to differentiate between the exposed and traumatically injured or the contaminated and injured patient. Should the patient be exposed and injured, no special emergency facilities are necessary. The patient that has been exposed to an external radiation source does not give off radiation, is not a radiation hazard to rescue or hospital personnel, and can be handled and treated as any other traumatically injured patient in a normal emergency room setting.
- 7. If, however, it is determined that the patient is injured'and contaminated, procedures are modified to reduce - - -
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attendant. exposure and to control any spread of contamination.
These procedures are not unique to medical radiological response planning. They are philosophically the same as used in dealing with chemical contamination or septic cases.
- 8. Because of the characteristics of radiation injuries
.they are one of the easiest medical emergencies to handle, r
Radiation injuries are seldom if ever life-threatening. The consequences of exposure unfold over a period of time with predictable sequence. Therefore, treatment of the traumatic injury always takes precedence over treatment of the radiation injury. Once the patient is resuscitated and stabilized he can be decontaminated and placed in a regular hospital bed. There
.is time then for assessment and treatment of the radiation injury.
- 9. A " disaster" at a nuclear power plant differs signifi-cantly from the usual sense of disaster. Nuclear power plants do not blow up like atomic bombs.
Therefore, unlike many disasters, there is no loss of facilities or communications, or j
generation of large numbers of traumatic casualties. From a medical and public health point of view this makes planning for and responding to nucicar facility accidents much easier.
- 10. Most importantly, I do not see a need.for large numbers of hospital beds for an injured population. The only
, lway-in which an off-site population can be affected by an accident-is through overexposure to radiation. This conclusion can best be understood by summarizing the basic principle: that ---
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come into play. A " Rem" is the unit to describe the biological effect'of ionizing radiation. To measure smaller doses of radiation, dose equivalents are often expressed in millirems.
One Rem equals 1,000 millirems. The measurements during an accident are usually expressed in terms of dose rates, that is, so many millirems per hour. Being exposed to a constant level of 30 millirems per hour, for example, would result in a total dose of 30 millirems after an hour's time.
- 11. The table below shows an acute dose-effect relation-ship for total body exposures from penetrating radiation delivered over a period of a few hours:
75,000 millirem - symptom threshold 150,000 millirem - hospitalization 600,000 millirem - fatality without treatment To put these figures in perspective, the average dose from natural background radiation to the United States population is about 100 millirem per year. The average annual dose to the United States population from medical diagnostic activities is also about 100 millirems per year. A single chest x-ray exposes the patient to a dose of about 10 millirems. At Three Mile Island, the population within-the radius of 50 miles received a cumulative average exposure over 10 days of 1.5 millirem.
- 12. The characteristics of a release of radiation from an accident and those of radiation itself mitigate against the l
possibility that anyone off-site-would-eeceive-en pher w ear-.a4 - -
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dose of radiation resulting in symptoms of radiation sickness, much less a hospitalization dose. Radioactive atoms would be released in tha_ form of an-invisible plume. To a person at a specific location on the ground there are a number of factors working simultaneously that reduce both the dose and dose rate
.from exposure to this plume. During a release the medically significant exposure is due to the penetrating gamma radiation from the passing plume. This exposure, however, is limited to the. time the plume is over a specific location (a function of meteorology). The exposure is further limited by the disper-sion of the radioactive atoms (reducing the intensity) as the plume moves away from its source. Since radiation intensity falls off dramatically with distance, the exposure is limited by the height of the plume and the distance over which a ray must travel from its source in the nucleus of an atom to the ground. Finally, since radiation is absorbed by all materials, moving under cover will also reduce a person's exposure. For example, the first floor of an ordinary house can reduce the outside exposure by 50%.
- 13. Given a public education program and the disaster response program that is already in place in Missouri (which has demonstrated its ability to warn and move large numbers of people under more life-threatening conditions than radiation:
floods, chlorine gas, fires, etc.), I see.no reason for anyone off-site receiving a large enough exposure to initiate the first symptoms =of-redi-etion richn : 3--inuch-less -- - -
hospitalization. .
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- 14. In.the event of an accident at Callaway involving the release of substantial radiation off-site, what I do see is the
--- possibility that there would be large numbers of people who would be slightly contaminated and lightly exposed to radia-tion. To the extent monitoring of individuals for contami-
[ nation is appropriate, it does not need to be and should not be done at hospitals. It can be done at the predetermined-reception and care centers. The local emergency plans now call for monitoring to be done in this manner.
- 15. There should be no " skin burns" as a result of radioactive atoms depositing on a person's skin.
The skin is one of the more resistant organs to radiation damage. To effect a redness (" sunburn") with fission product radiation requires-a total dose of about 800,000 millirem to an area of the skin; to cause skin breakdown, about 1,500,000 millirem to a
an area of the skin. One would literally need to have visibly caked highly radioactive dirt on the skin for hours to deliver these kinds of doses. Consequently, simple instruction to remove outer clothing and shower within a reasonable time will suffice to prevent skin damage.
, 16. In lieu of observable signs and symptoms, the affected population needs.to be. identified and selective medical tests performed along with environmental dosimetry and demographic studies of the population and area within the exposure boundaries to determine the actual exposure. This
....J ..et be J... 11nmediatelyr-but can be performed in an unhurried, organized manner in the days following the accident.
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- 17. In the case of serious exposure levels, medical testing that should be considered includes: history and physical examination, complete blood counts, thyroid uptake studies, chromosome analysis of the circulating lymphocytes, whole body counts and bioassay as required. Depending on the suspected dose and the nature of the exposure, these tests could be done on a selective basis.
ON-SITE RADIATION INJURIES
- 18. All nuclear reactors including the Callaway Plant must develop adequate emergency programs prior to actual operation. This medical emergency program must demonstrate three basic levels of care: adequate rescue and first aid at plant site; emergency treatment at a nearby hospital; and definitive evaluation and treatment at a large medical center equipped to do so. This system must be capable of handling the contaminated injured and/or seriously ill patient which might occur as a result of an accident on-site. This type of patient suffers the only kind of radiation injuries that require special procedures and facilities for handling at the plant, in the course of transportation by ambulance groups, and handling in the emergency room at the hospital. The Callaway Plant is in the process of becoming part of a national emergency medical assistance program which was developed by Radiation Management Corporation in 1968. The RMC system is being tailored to the needs of the Callaway Plant. In this system the procedures,
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facilities, equipment and supplies for first aid and rescue at the'Callaway Plant are being developed. In addition, training and exercises will be provided annually to maintain efficiency.
The local ambulance group, Callaway County Ambulance District will be trained, equipped, and have procedures for transporting contaminated and injured patients to the Callaway Memorial Hospital. The system also includes a selection of a special area at the hospital for the reception of the contaminated and injured patient so that the traumatic injury or serious illness can be attended to while the contamination is controlled to this one part of the hospital. The procedures for training and annual exercises will be reviewed and conducted to maintain this proficiency at the Callaway Memorial Hospital. Finally, RMC will back up this support at both the plant and the Callaway Memorial Hospital with 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> medical and health physics expertise to consult on any type of radiation injury that may occur at the Callaway Plant. This expertise consists of radiation medical physicians, certified health physics technicians and special instrumentation which can be trans-ported immediately upon notification to the Callaway Plant or the Callaway Memorial Hospital. In addition, RMC maintains laboratory support for evaluation of a patient's exposures. If necessary, and in due time,.the patient can be transported to Northwestern Memorial Hospital in Chicago, and/or the Hospital of the University of Pennsylvania in Philadelphia for defini-tive evaluation and treatment. RMC's support system has been
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in operation for some 20 nuclear power sites throughout the 1
country for the past 14 years and has. demonstrated its ability '
to function adequately for problems that have' existed. RMC has l-l the largest experience in the country (if not in the world) in handling radiation problems at nuclear power plant sites. Our l experience shows that in the fifteen years of operating the I
l emergency medical assistance program at each site about one l contaminated / injured or ill patient is transported to a hospital such as Callaway Memorial Hospital once approximately
! every 5 to 10 years. An outline for the Callaway Memorial Hospital training program is attached as Exhibit "B" and.will be conducted upon completion of the facility requirements for handling the contaminated and injured patient. The hospital staff will be trained annually as well as exercised in conjunc-tion with.the plant and the support ambulance group.
- 19. Semi-annually the equipment at the hospital, ambu-lance and the plant will be audited to insure its readiness in the event of a radiation injury. In addition, appropriate staff of'the hospital will be invited periodically to the annual' program conducted by RMC in association with Northwestern University Medical School in Chicago or the i
University of Pennsylvania School of Medicine of Philadelphia.
This seminar is a one or two day seminar-for physicians and nurses and is designed to maintain proficiency in the emergency evaluation and treatment of radiation injuries. The definitive care centers at both Northwestern Memorial Hospital in Chicago q
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'O and the Hospital.of the University'of Pennsylvania in Philadelphia are'also trained and exercised annually to insure i
that'their state of readiness for emergency response and definitive evaluation and care is maintained. It is my opinion ,.
that one hospital prepared as described, such as the Callaway Memorial Hospital, would be adequate to handle the radiation injuries expected from the Callaway Plant. The hospital is approximately 10 miles from the plant and it is highly unlikely
- that its operations would be disrupted from any accident that "
may occur at the plant.
1 I HOSPITAL CARE FOR OFF-SITE PERSONNEL 1
- 20. As described above, the most likely accident from any nuclear power plant site is that a large number of people may l be slightly contaminated and slightly exposed as a result of an i accident at a nuclear power plant. As indicated above, it is highly unlikely that this external exposure would be severe enough to initiate acute symptoms in patients (nausea and vomiting). These doses are highly unlikely in an off-site release of radiation and especially could not occur if the population has been informed about radiation and shelter and l
shielding from radiation. In the event that some members of i the population d '.o receive high doses of radiation, the medical problem would be such that it would not overwhelm resources' 4
normally present in the counties surrounding the nuclear power plant. At:most,'these patients would suffer from nausea and L
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vomiting which can be treated on an outpatient basis. These symptoms would relent within 24 to 48 hours5.555556e-4 days <br />0.0133 hours <br />7.936508e-5 weeks <br />1.8264e-5 months <br /> and the patients would not require hospitalization. If the exposure turns out to be severe enough to require hospitalization, this can be done-in two to three weeks at centers that are equipped for treating temporary bone-marrow depression. Most large medical centers are equipped to do this. The few people requiring this treatment could be treated at University Medical Center, Columbia, Missouri, Northwestern University in Chicago, the Hospital of the University of Pennsylvania in Philadelphia, and other major medical centers. Arrangements for this type of treatment could be made in a timely manner without jeopardizing the patient's health and could be done on an ad-hoc basis after an accident has occurred. There is no need, in my opinion, to set up any special arrangements with centers to treat these types of patients.
- 21. As indicated above, the population will have their exposure evaluated over the course of the subsequent few days or weeks. Medical tests are available which can be done by the hospitals in the area or sent to special laboratories such as Northwestern University in Chicago and the University of Pennsylvania in Philadelphia. The population would be ade-quately evaluated within a few days and definitive care can be arranged within an appropriate time period.
- 22. Because nuclear power plants do not explode like atomic bombs we should not expect to see off-site traumatic
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- injuries from blasts or burns as a result of an accident from a
. nuclear power plant. It is theoretically possible that normal traumatic injuries can occur as the result of an accident at a nuclear power plant (for example, an automobile accident on a highway or the normal routine traumatic injuries that may occur in a community). Though this accident may be complicated by contamination it is likely that the contamination would be a nuisance problem and not a major medical problem. The handling of this accident would be in the normal routine manner used to handle any traumatic accident in the community and the patient i
would be taken to the nearest hospital. It is unlikely that you would have a number of traumatic accidents occur at the same time as an accident at a nuclear power plant site.
- 23. In summary, I am of the opinion that Callaway Memorial Hospital could adequately handle any off-site contami-nated and injured patients that may result from the course of an accident at a nuclear power plant site. Furthermore, other hospitals in the area (St. Mary's Health Center, Boone County Hospital, and the University of Missouri Medical Center) will also be able to respond to a contaminated and injured patient.
This is a requirement of the Joint Committee of. Hospital Accreditation for all hospitals in the country.. In addition, these hospitals will have an opportunity for additional training for response to'the radiation accident victim through participation in Union Electric's Qff-Site Training Program. ;
l In conclusion, there is adequate off-site support for I
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- anticipated medical problems arising as a result of an accident at the Callaway-Plant. ,
AMBULANCE SUPPORT
- 24. In the event of an off-site release of radiation all emergency services will operate in the counties surrounding
'Callaway Plant. Their primary duty will be to respond to '
i normal requests (such as fire department for fire, police for accidents and ambulances for emergency medical services).
The Callaway County Ambulance. District will be adequately trained to handle contaminated and' injured patients that would occur at the site.- As indicated above, they will be trained and exercised annually. This training will also suffice for them oto handle any type of contaminated and associated-accidents
' hat t would occur off-site during the course of a major accident at the'Callaway Nuclear Power Plant. Their priority of treatment in this case would be for the traumatic injury and-1
.the contamination would be ignored. As in the normal course of operations, they would take the patients to the closest
- hospital adequate for the treatment of traumatic injury. In
- most cases,.this would be Callaway Memorial Hospital. However, all hospitals must have plans for handling contaminated and injured patients in accordance with the Joint Committee 1for
- Accreditation. In addition to the Callaway County Ambulance
' District, the off-site training program provides training for all ambulance services that potentially will be required to l
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respond to radiological emergencies as a result of an accident ,
at the Callaway Plant, i
- 25. In conclusion, upon completion of the planned training program, the Callaway Memorial Hospital will provide adequate local medical resources available for handling all types.of radiation injury including the contaminated and injured patient in the event of a radiological emergency at the Callaway Plant. This hospital capability will be supported by expertise that is readily available on a 24-hour basis to assist in the evaluation of the radiation status of the patient and to assist in the transportation of the contaminated patient to a definitive care center where complete evaluation and treatment of patients will occur. 0 / '
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R6gei E. W nnemann A
Subscribed and sworn to before me this.jO R day of ho m L , 1983
. !r l l r?u t- UM Notary Public
- SHELLY KCFFLER Notary Public. Phila Phila Co.
My Commission Expires Maren 23, '985
-My Comraission Expires . .
EXHIBIT A e
9 CURRICIEUM VITAE ItOGER E. LINNEMANN, M.D.
Vice Chairman Radiation Management Corporation 1-1 4
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ROGER E. LINNEMANN, M.D.
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I. Radiction Manrgement Corporntion 3508 Market Street University City Science Center
. Philadelphia, PA 19104 (215)243-2950 EDUCATION c
University of Minnesota, Minneapolis, MN; B.A. (Cum Laude) 1952 University of Minnesota, Minneapolis, MN; B.S., M.D. 1956 Walter Reed Army Hospital, Washington, D.C.; INTERNSHIP 1956-1957 Walter Reed Army Hospital, Washington, D.C.; RESIDENCY (Radiology) 1962-1965 Certified by American Board of' Radiology 1964 Certified by American Board of Nuclear Medicine 1972 Licensed to practice Medicine in 1) c'emannwealth of Pennsylvania; 2) Illinois; and 3)' Minnesota Sandia Base, New Mexico;. Nuclear Weapons Orientation Course 1961 Walter Reed Army Institute of Research, Washington, D.C.; Medical Aspects of Nuclear Warfare 1962
. US Department of Agriculture Graduate School (Evening), Washington, D.C.
Russian Language 1963-1965 I PROFESSIONAL EXPERIENCE 1981-present Vice Chairman and Chief Medical Officer, Radiation Management Corporation 1969-1981 President / Chief Executive Officer, Radiation Management Corporation 1974-present Clinical Associate Professor of Radiology, University of Pennsylvania School of Medicine 1977-present Visiting Associate Professor, Clinical Radiology, Northwestern University Medical. School 1969-1974 Assistant Professor, Clinical Radiology, University of Pennsylvania School of Medicine 1968-1969 Nuclear Medicine Consultant, Philadelphia Electric Company 4
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PROFESSIONAL EXPERIENCE (Continued)
Jan-Aug 1968 Assistant Professor, Radiology, thiversity of Minnesota School of Medicine (investigated use of isotopes in kidney function evaluation) 1957-1968 Euployed by thited States Army .....
1965-1968: e- - =M ag Officer, Nuclear Medicine Research Detachment, Europer Radiological Health Consultant, US Army-Europe.
(responsible for plans, procedures and training of military hospitals and personnel in the evaluation, evacuation and treatment of radiation casualties. In January, 19G6 sent to Palomaris, Spain for evaluation of medical and environmental aspects of the mid-air collision involving nuclear weapons) 1961-1962: Research Associate, Department of Radiobiology, Walter Reed Army Institute of Research, Washington, D.C. (investigated' use of anti-radiation drugs in treatment of cancer) 1957-1961: General Medical Officer, Europe Languages: German, Russian i PROFESSIONAL APPOINTMENTS L 1982-present American Medical Association Council on Scientific Affairs Subconunittee on the Management of Radiation Accident Victims 1979-present Health Physics Society Standards Committee 4
1978-present General Dynamics Electric Boat Division Radiological Health Cbasultant 1978-present Edison Electric Institute Utility Radiation Standards Group 1973-present Universitv of, Pennsylvania Radiation Safety ennenittee 1973-present he Atomic Industrial Forum, Inc. Public Affairs & Information Connaittee i 1970-present Be American Nuclear Society Subecennittee for Writing Bnergency
.i Procedures Standards l 1969 a 1975 Atomic Energy Camaission ad hoc Comunittee on Medical Aspects of Radiation Accidents ,
j 1966-present American College o_f, Radiology ......
i 1969-present Comunission on Radiologic Units, Standards and Protection 1969-present Ccauaittee on Radiation Exposure of Women 1969-present connaittee on Radiological Aspects of Disaster Planning 1967-1978 International Affairs Countittee i
,1965-1968 U.S. Delegate 'tg NATO Radiation ' Protection Comunittee & Medical )
Aspects of Nuclear Warfare Connaittee 1
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-PROFESSIONAL APPOINTMENTS (Continu:d) 1971-present Department of Defense & Environmental Protection Agency Medical Liaison Officer's Network (MLON)-State of Pennsylvania Representative PROFESSIONAL MEMBERSHIPS American College of Radiology American Public Health Association ,
.American Medical. Association Society of Nuclear Medicine.
' Philadelphia Roentgen Ray Society Pennsylvania Medical Society College of Physicians of Philadelphia Radiological Society of North America, Inc.
American Institute of' Physicists /Alperican Association of Physicists in Medicine American College of Nuclear Physicians
- American Council on Germany Union League of Philadelphia AWARDS & HONORS 1978 Association o_f.f Medicine & Security, Madrid, Spain (Honorary Member) 1968 University o_f,f Minnesota Radiological Research Scholar (National Research Council) 1968 United States Army Iagion of Merit PRESENTATIONS 1980 Korea Women's Association (Seoul, Korea)
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presented paper, " Energy: The Basis for Health in Developing and Developed Countries", at International Symposium on the ,
i Expulsion of Environmental Pollution ,
1980 Korean Associatien for Radiation Protection (Seoul, Korea) presented s -4nar on caergency management of radiation injuries 1980 Ministry g Health (Madrid, Spain) presented paper, " Definitive Treatment of Radiation Injuries",
at First Seminar on Assistance to Those Wounded by Radioactive Elements and Ionizing' Radiations
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! ,' 4 PRESENTATIONS '(Continued) I Reinisch-Westfalisches Elekrizitatswerk (Essen, Germany) 1979 The Basis for Health in Developing presented paper, " Energy:
and Developed Countries", at The Seventh Energy Workshop 1978 The Swedish State Power Board (Vallingby, Sweden) j presented seminar, " Management and Treatment of Radiation l
Injuries", and conducted radiation emergency medical exercise at the Ringhauls Nuclear Power Plant Deutsche Gesellschaft fur Wiederaufarbeitung (Hannover, Germany) 1978 appeared before the Prime Minister and Parliament of '
Lower Saxony as an International expert to testify on the safety of a reprocessing plant at Gorleben, Germany 1978 International Atomic Energy Agency (Vienna, Austria) presentation at Symposium on Late Effects of Ionizing Radiation 1978 Associacion de Medicina 1 Seguridad en el Trabajo de Unesa para la Industria Electrica (Madrid, Spain) presented one-day seminar entitled, " Primary Management of Radiation Injury" j
'1977 International Atomic Energy Agency (Vienna, Austria) presented paper, " Emergency Medical Assistance Programs for Nuclear Power Reactors", at Symposium on Handling of Radiation Accidents 1967 University o_f,Freiburg f Institute of Radiobiology (Freiburg, Germany); presented seminar on diagnosis and treatment of radiation injuries i
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PUBLICATIGE
- 1. T.4re- -u1, Ibger E. " Berlin: 'Ihe Young-Old City". Senior Citizen (Septenber 1961)
- 2. Linrwmann, Ibger E. "'Ihis Way to helin". '1he American Benedictine Review:14, No. 4 (r+ ;er 1953)
- 3. T.4r.r_ _ .i, Ibger E. "'Ihe Acute Pad 4* ion Syralmute and its Impact cn the Chain of Evacuaticn". Mim1 Bulletin, U.S. g Europe:22_, No.12
( h el 1965) ,
- 4. Lirnmann, Ibger E. and Ibbert T. Wanenn. "Madiral Support of Nuclear Waanmn kr-idants". Madir-al Bulletin, U.S. Amy Europe (November 1967)
- 5. Linnemann, Roger E. and O. Maa=+=nidt. "Frhot:o:gsvorgaenge bei Grosatieren nach Ganzkoerperbestrahl:o:g", :dem 6, Jahrbuch von der vereinigung Duetscher Strahlenschutzaerzre (196T)
- 6. Lirr-taui, Ibger E. "hna Padi*im Guidance". Military Medicine: 33, pp. 771-716 (SwL =tLer 1968)
- 7. Icken, Merle K. , r. ire __ ua, Ibger E. ard Geottje S. Kush. " Evaluation of Renal Functicn Using a Scin+411*im camara atxi Ctmputer". Radiology: 9 3_,
No. 1, pp. 85-94 (July 1969)
- 8. Lirr=tmus, Roger E., Icken, Merle K. and Colin Markland. "Cm puterized W1Lumital Esrugca.= to Study Kidney Function". Journal of Urology: 103, pp. 533-537 (May 1970)
- 9. Linnemann, Ibger E. and J.W. 'Ibiamaan. " Regional A W to the Manag= =it i
of Pad 4 *4m Mr'idants". Journal of the American Public Health Amant-4aticn:
61, No. 6, pp. 1229-1235 (June 1971T
- 10. Lirr=tmai, Ibger E. and Ibbert H. Holmes. "Ntv laar Accidents and 'Iheir Mana-nant" . Dnergency Madir-al Care, pp. 281-292, Spitzer, Stanley and Wilbur W. Oaks (eds.) New York: Brune and SLiaL'si, Inc. (1971)
- 11. r.4re - - ui, Ibger E. , Rasmssen, N.C. and F.K. Pittman. Ntriear Ensrgy:
Issues and Answers. Atcruic Industrial Forixn, Inc. in Wat1.cn with Pennsylvania Power & Light Carpany (April 1973)
- 12. Lirr-umni, Roger E. " Accentuate the Positive". Trial: 10, No. 4, p. 13 (July / August 1974)
- 13. T.4re_... ui, Ibger E. " Accentuate the Positive". Ccngressional Record: 109, pp. 4964-4967. Washingtcn, D.C." Uhited States of America Prne'aadings and Debates of the 93rd Congress, hr'md Sessicn (July 23, 1974)
- 14. Lirr-imui, Ibger E. and J.W. 'Ihiessen. Edi+nrial, "In Defense of Radiaticn and Cells". 'Ihe New York Times (May 23, 1974)
(Ccntirniad)
Ibger E. Linnemann - Publications
! 15. Linnemann, Ibger E. M elmar Radiation and Health. Springville, NY lerlaar Fuel Services, Inc. (SEEP-*=r 23, 1974)
- 16. Linneennn, Ibger E. EdiM rial, "In Defense of Nuclear Power Plants",
l Se Ib41=dalehia Inquirer, p. llA (Mardi 6,1975)
- 17. Linnemann, Ibger E. " Nuclear Power Plants Pose Minimal Heali:h Risks", l Pm . w iive. News Bureau of the University of Pemsylvania, Phi 1=dainhia, E
PA (February 1975) .
- 18. Lirr-s-us, Ibger E. " Medical Aspects of Power Generation". Inpulse.
Maaaae+1usetts: Elechit-=1 Conv il of New England (June 1975)
' 19. Linnenann, Ibger E. " Bugs in the Nuclear Fuel Cycle". Spectrun, p. 59, Gadi Kaplan (ed.) Piscataway, NJ: % e Institute of Electrical and Els.i.swic 1h Jinaara, Inc. (Septaser 1975)
- 20. Lirr-i-ni, Ibger E. and Fred A. Mettler, Jr. "Bnergency Madical Assistance Internaticnal Atanic Energy Agency Pr%== for Ntelaar Power Reactors".
Synposiun on the Handlirx3 of Radiaticn Amidants, IAEA-SK-215/22, Vienna Austria (1977)
- 21. Lirra:n=ra, Ibger E. "W1y AIARA?" Transactions of 1979 American IAx: lear Society Conference, Atlanta, GA (June 3-7,1979) , Vol. 32, TANS AD 32 1 832 -'-
ISSN 0003-018x (1979)
- 22. Linnemann, Ibger E., Hackbarth, C.J. and Ray Crarv1=11 "% e Contaminated and Injured Patient". Promadings of 'IWenty-fourth Annual Meeting of the Health Physics Society, July 9-13,1979 (Philadalnhi=, PA)
- 23. Lirror-ui, Ibger E. "% e % ree Mile Island Incident in 1979:'2 e Utility
- Respcmse". % e Medical Basis for Radiation A miMarit Preparedness, K.F. Hubner and S.A. Fry (eds.) , Elsevier/E.u.i.ii "'lland, pp. 501-509 (1980)
- 24. Liar - mi, Roger E. " Initial Man =r==nt of Radiaticn Injuries". Journal of Radiation Fivw.t.icm, 5_, No.1, pp 11-25 (December 1980)
I 25. r.4 . - n a , Roger E. "FA'-ilities for Handling the Ccntaminated Patient".
Radiation Accident Preparedness: Medical and Manar=Aal AsW-i , Science-l B ru-Madla Canpany: New York (1980)
- 26. Lirr-i.uus, Ibger E. "A Systems Approach to the Initdal Manag==1t of Radiation Injuries". Systems Approach g Ehung Medical Care, Appleton- l Century Crofts: New York (1980) '
- 27. Ti v = r-i, Roger E., Staghen M. Kim and Frazier L. Bronscn. "Bree fille Island: ftvlit-al and Public Health Amwi of a Radiaticn Accident".
Journal of Radiation Faci nicm, 6_, No.1, pp. 45-52 (C+r*=r 1981)
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EXHIBIT B THE HANDLING OF A RADI0 ACTIVELY CONTAMINATED AND INJURED PERSON AT A NUCLEAR POWEP. FACILITY ,
IOSPITAL PERSWNEL PROGRAM OF INSTRUCTION Topic Time Objective INTRODUCTION 30 minutes To explain the need for special procedures when dealing with the contaminated and injured patient and to present an overview of the lecture.
DETECTION, 30 minutes To familiarize the audience with PROTECTION, AND radiation instruments and provide INSTRUMENTATION personal protective actions which can be used to minimize radiation exposure.
HOSPITAL FACILITIES 60 minutes To define the specific facilities and equipment required to handle and treat the contaminated and
- injured patient (s) .
HANDLING AND TREATING 30 minutes To present the specific procedures i THE INJURED AND CON- for dealing with the injured and '
TAMINATED PATIENT contaminated patient, including ds. contamination and sample taking. ;
DEMONSTRATION: USE 60 minutes To provide an opportunity for OF SPECIAL EQUIPMENT *** attendees to become familiar with AND PROCEDURES the techniques and equipment used l for patient care while minimizing l attendant exposure and controlling contamination.
NCTIE: ** 15 minute break after Hosoital Facilities
- Health Physics Technicians frcn Callaway should carticioate in this portion of the presentation Total presentation time is 3 hours3.472222e-5 days <br />8.333333e-4 hours <br />4.960317e-6 weeks <br />1.1415e-6 months <br />, 45 minutes
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THE HANDLING OF A RADI0 ACTIVELY CONTAMINATED AND INJURED PERSON AT A NUCLEAR POWER FACILITY IOSPIBL PERSC21NEL LECTURE OUTLINE INTRODUCTION Introduction of self and firm Need for Radiation Emergency Area Overview of Lecture DETECTION, PROTECTION AND INSTRUMENTATION Introduction to survey. instrumentation Contamination vs Exposures Personal Protective Actions time distance shielding HOSPITAL FACILITIES Floor plan requirements Special supplies REA set-up Considerations for use HANDLINC AND TREATING THE INJURED AND CONTAMINATED PATIENT (S)
Administrative Procedures Role of the health physicist Patient care Contamination control techniques Sample taking Decontamination procedures Moving the patient
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DEMONSTRATION: USE OF SPECIAL EQUIPMDir AND PROCEDURES Catents and use of sanple taking kit Caltants and use of dewaicauination supplies Denning guisa t.ive attire Contaminaticm ccritrol techrdques Dew iioudnation techniq2es Int-recticm with plant health physicist Patient transfer yv-wbres Attendant exit s uci:dares
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