EFEK RADIASI TERHADAP MANUSIA PELATIHAN PETUGAS KEAMANAN SUMBER RADIOAKTIF 1

Energy emitted from a source is generally referred to as radiation Energy emitted from a source is generally referred to as radiation. Examples include heat or light from the sun, microwaves from an oven, X rays from an X-ray tube, and gamma rays from radioactive elements.

Perbedaan sinar Gamma dan sinar-X X-rays and gamma-rays have exactly the same properties: they differ only in their origin. X-rays come from the atomic structure outside the nucleus and are produced by excitation and ionization of electrons in the atom whereas gamma-rays are produced from excess energy in the nucleus of the atom. Gamma-rays are emitted from the excited nucleus with discrete energies from well-defined energy levels and are characteristic of the particular radionuclide decaying.

Ionizing Radiation Energy Alpha Low Beta Medium Gamma High Paper Wood April 7, 2017 Ionizing Radiation Beta Particles Stopped by a layer of clothing or less than an inch of a substance (e.g. Wood) Alpha Particles Stopped by a sheet of paper Paper Wood Concrete Alpha Beta Gamma Energy Low Medium High Gamma Rays Stopped by inches to feet of concrete or less than an inch of lead A Small Dose of Toxicology - Overview

PENYEBAB PAPRAN RADIASI/KONTAMINASI Accidents Nuclear reactor Medical radiation therapy Industrial irradiator Lost/stolen medical or industrial radioactive sources Transportation Terrorist Event Radiological dispersal device (dirty bomb) Attack on or sabotage of a nuclear facility Low-yield nuclear weapon 12. Causes of Radiation Exposure and Contamination Accidents—There are several settings or scenarios in which radiation accidents may occur: nuclear reactor accidents; medical radiation therapy accidents or errors in treatment dose; accidental overexposures from industrial irradiators; lost, stolen, or misused medical or industrial radioactive sources; and accidents during the transportation of radioactive material. Terrorist Use of Nuclear Materials—The use of radioactive materials in an RDD or a nuclear weapon by a terrorist is a remote but plausible threat. The medical consequences depend on the type of device used in a terrorist event. An attack on or sabotage of a nuclear facility, such as an irradiation facility or a nuclear power plant, could result in the release of very large amounts of radioactive material. Radiological Dispersal Device (RDD)—An RDD disperses radioactive material for the purpose of terrorism. An RDD that uses a conventional explosive (e.g., TNT or a plastic explosive) to disperse the radioactive material is called a “dirty bomb.” A dirty bomb is NOT an atomic bomb. The initial explosion may kill or injure those closest to the bomb, while the radioactive material remains to expose and contaminate survivors and emergency responders. Low-Yield Nuclear Weapon—A low-yield nuclear weapon or partial failure of a high-yield weapon could cause a low-yield nuclear detonation. For example, if one considers the consequences of a 0.1 kiloton-yield nuclear detonation (less than 1/100 the size of the weapon used on Hiroshima), then the following would occur within one minute surrounding ground zero. The effects listed below do not take into account that multiple injuries caused by the interaction of the various types of injury will increase the probability of fatality. (NCRP Report No. 138) - The range for 50 percent mortality from trauma from the blast is approximately 150 yards. - The range for 50 percent mortality from thermal burns is approximately 220 yards. - The range for 400 rad from gamma and neutron radiation would be approximately 1/3 mile. - The range for 400 rad in the first hour from radioactive fallout would be almost 2 miles in the downwind direction. - As the size of the weapon increases, the effects encompass a greater distance. This will result in the release of widespread contamination and substantial air blast and heat.

Tipe Potensi Bahaya Radiasi Kontaminasi Internal KONTAMINASI - Eksternal: Zat radioaktif menempel di kulit Internal: Terhirup, masuk melalui kulit, tertelan Kontaminasi Eksternal External Exposure 11. Types of Radiation Hazards Patients who have only been exposed to the radiation from a radioactive source or a machine, such as an x-ray machine or a linear accelerator, are not contaminated and do not pose any radiation contamination or exposure potential for hospital personnel. Radiation safety precautions are not needed for patients who have only been exposed and are not contaminated. Patients with radioactive material on them or inside their bodies are said to be contaminated. Contaminated patients require care in handling to effectively remove and control the contamination. Analogy—You can think of radiation exposure and radioactive material in terms of a trip to the beach. Sand is like radioactivity. The sun is like radiation exposure. Once you go inside, you are not in the sun any longer and there is no more exposure (radiation stops). On the other hand, most of the sand came off when you walked off the beach, however, some sand remains on your skin until you physically remove it (brush or wash it off). The same is true for radioactivity contamination on the skin. A small amount may remain on the skin and need to be washed off.

BIOLOGICAL EFFECTS Deterministic effects Stochastic effects Direct Indirect effects Repair Primary damage Cell death Modified cell Damage to organ Somatic cells Germ cells The figure illustrates the connection between the primary effects of ionizing radiation and the clinical observable deterministic and stochastic effects. The time between the physical interaction and the detection of e.g. a cancer may be discussed. Death of organism Cancer Leukemia Hereditary effects Deterministic effects Stochastic effects

Efek Stokastik Stokastik Tidak ada nilai ambang Probabilitas berbanding lurus dengan dosis Umumnya terjadi pada sel tunggal Misalnya: kanker, efek genetik

Efek Deterministik Adanya nilai dosis ambang ( dibawah dosis ini, efek radiasi tidak akan terjadi). Keparahan efek radiasi berbanding lurus dengan dosis Melibatkan sejumlah besar sel Mis; kerusakan lensa mata, kulit terbakar Kemandulan, dll

Luka bakar pada kasus kecelakaan di Thailand 23 Februari 2000

Kecelakaan Industri Radiografi di Yanango, Lima PERU Ir-192 (37 Ci / 1,37 TBq), 20 Feb. 1999 22 Februari 1999 1 Maret 1999 3 Mei 1999

Ir-192 (185 GBq, 5 Ci) selama 2 jam Hari ke-5 Hari ke-21 Hari ke-11

Efek Deterministik / Non Stokastik (Cont’d) ORGAN REPRODUKSI Testis Perubahan jumlah sperma dan waktu pulih Dosis 0,15 Gy : oligospermia Dosis < 1 Gy : steril beberapa bulan Dosis 1 – 3 Gy : steril 1 – 2 tahun Ovarium Bergantung usia:  usia  dosis Dosis 0,65 Gy : steril sementara Dosis 5 – 7 Gy : steril pada usia 40-an Dosis 12 – 15 Gy : steril pada usia 20-an

Efek Deterministik / Non Stokastik (Cont’d) MATA Paling sensitif  lensa mata  katarak Dosis 0,5 Gy  kekeruhan lensa yang teramati Semakin tinggi dosis  semakin singkat masa laten Dosis 2–10 Gy  katarak dalam 6 bulan - 35 tahun

Efek Deterministik / Non Stokastik (Cont’d) CACAT BAWAAN KARENA PENYINARAN YANG TERJADI SEWAKTU JANIN BERADA DALAM KANDUNGAN Bergantung Periode kehamilan: 1. Preimplantasi & implantasi (minggu 0 – 2)  kematian janin (0,05 – 0,1 Gy) 2. Organogenesis (minggu 2 – 7)  malformasi organ, kematian neonatal, kanker masa anak-anak 3. Tahap Fetus (minggu 8 – 40)  retardasi mental, kanker pada masa anak-anak Dosis ambang retardasi mental (penurunan IQ):  0,1 Gy pd minggu 8 – 15 dan 0,4 -0,6 Gy pd minggu 6 – 25

Efek Deterministik / Non Stokastik (Cont’d) SISTEM PEMBENTUKAN DARAH DOSIS AMBANG SINDROMA : 1 GY S. PRODROMAL : MUAL, MUNTAH, LETIH, PUSING, HILANG NAFSU MAKAN DAN DIARE  3 HARI MASA LATEN : 2 – 3 MINGGU EFEK SISTEMIK: PENURUNAN JUMLAH SEL DARAH DOSIS AMBANG KEMATIAN : 3 GY DALAM 3 MINGGU  INFEKSI DAN HEMORRHAGE PENURUNAN SEL STEM SUMSUM TULANG (SAMPAI 8 GY)

Efek Deterministik / Non Stokastik (Cont’d) SISTEM PENCERNAAN Dosis ambang sindrom: 5 Gy Sindroma Prodromal: demam, diare parah + darah, kram perut Masa laten : 3 – 5 hari Efek sistemik: kerusakan sel stem & lapisan mukosa usus halus Dosis ambang kematian: 10 Gy dalam 3 hari – 2 minggu Lethal Dose ( LD 50/60 )individu terpapar berkisar 2,5 – 5 Gy

Efek Deterministik / Non Stokastik (Cont’d) SISTEM SYARAF PUSAT Dosis ambang sindroma : 20 Gy Sindroma Prodromal: hilang keseimbangan, susah bernafas, tremor dan koma Masa laten : 15 menit – 3 jam Efek sistemik: kerusakan parah sistem syaraf dan cardiovascular Dosis ambang kematian : 50 Gy dalam < 3 hari

PROTEKSI RADIASI PENGURANGAN PAPARAN RADIASI Waktu PENAHAN Jarak 14. Reducing Radiation Exposure There are three methods for reducing radiation exposure: time, distance, and shielding. All three of these methods can be used to keep radiation exposure to a minimum. The longer a person is exposed to a radiation source, the higher will be the dose received. To minimize the dose, reduce the time of exposure to the radiation. For example, ED nurses who do not have to stand beside a contaminated patient can minimize exposure by stepping close to the patient only when assistance is needed and stepping away as soon as they are done. In addition to minimizing the exposure time, the nurse can further reduce exposure by taking advantage of distance. Radiation dose rate falls off very quickly as the distance between the radiation source and the individual is increased. Time and distance are effective methods of minimizing dose. Another method of minimizing dose is through the use of shielding. Radiology personnel use leaded aprons to shield themselves from the x rays that are scattered from the patient undergoing an x-ray procedure. Leaded aprons are not recommended and usually provide little shielding protection from the types of radiation expected from contaminated patients. An effective way to use shielding is to place radioactive materials removed from patients into lead containers called “pigs.” The thick lead walls of these containers absorb the radiation from the radioactive material.

Terimakasih