Treatment of Internal Contamination

�Deposition of radioactive materials in the body (i.e., internal contamination), is a time-dependent, physiological phenomenon related to both the physical and chemical natures of the contaminant.

�The rate of radionuclide incorporation into organs can be quite rapid. Thus, time can be critical and treatment (decorporation) urgent.

�Several methods of preventing incorporation (e.g., catharsis, gastric lavage) might be applicable and can be prescribed by a physician.

�Some of the medications or preparations used in decorporation might not be available locally and should be stocked.

�NCRP Report No. 65, Management of Persons Accidentally Contaminated with Radionuclides, addresses the strategies to limit the exposure from internal contamination by radioactive materials. Radiation Protection Dosimetry published a Guidebook for the Treatment of Accidental Internal Radionuclide Contamination of Workers (1992) that provides additional information on patient management.

�In January 2003, the Food and Drug Administration (FDA) determined that Prussian blue had been shown to be safe and effective in treating people exposed to radioactive elements such as Cesium-137.

�In August 2004, the FDA determined that two drugs, pentetate calcium trisodium injection (Ca-DTPA) and pentetate zinc trisodium injection (Zn-DTPA), are safe and effective for treating internal contamination with plutonium, americium, or curium. The drugs increase the rate of elimination of these radioactive materials from the body.