MSE CONTROLLED DOCUMENT Decontamination of Personnel Document No: Supersedes Revision no: 1 Date:1/10/2004 Custodian: MSE Revision no: 1 Date: 1/10/2006 Filename: NORMMGT. DOC Administered by: Verified: Date: Verified: Date: Approved: Date: Approved: Date: MSE RPA OND/OSD GD/UWD Date: 1/10/2004 Date: Date: Date: Reason for revision: This document contains proprietary information and is intended for use by PDO and Contractor staff only. The contents of this controlled document shall not be changed without formal approval of the document custodian.
Contents 1. Introduction... 2 1.1 Objective:... 2 1.2 Scope... 2 2. Responsibility... 2 2.1 CRFP... 2 2.2 Chief Medical Officer (MCC)... 2 2.3 Job Supervisor... 2 2.4 RPS... 2 2.5 RPT... 2 3. Decontamination of intact skin at work site... 2 3.1 General... 2 3.2 Initial checks and decontamination procedure... 3 4. Decontamination of person in clinic... 3 4.1 Decontamination of Intact Skin... 3 4.2 Decontamination of Damaged Skin... 4 4.2.1 Flushing... 4 4.3 Decontamination of Skin Surrounding a Wound... 5 4.4 Eyes... 5 4.5 Hair / Beards... 5 4.6 Fingernails... 5 4.7 Ears... 5 4.8 Nose... 5 4.9 Mouth/teeth/dentures... 6 5. Internal contamination, corrective actions... 6 5.1 General... 6 5.2 Bioassay and Internal Dose Assessment... 6 APPENDICES Appendix 1: Glossary of Abbreviations... 7 Page 1
1. Introduction Operational controls to prevent the spread of contamination are specified whenever work on contaminated equipment takes place. If a breakdown of controls occurs during operations it may result in personal contamination. 1.1 Objective: To define the methodology for successful decontamination of personnel. 1.2 Scope All personnel working on PDO premises shall use this procedure. 2. Responsibility 2.1 CRFP The CRFP is responsible for specification of decontamination procedures for personnel in consultation with the Chief Medical Officer (MCC) and Radiation Protection Advisor. 2.2 Chief Medical Officer (MCC) MCC is responsible for ensuring nursing staff are trained in decontamination procedures. 2.3 Job Supervisor The job supervisor is responsible for initial decontamination of hands or trunk following advice from the RPT. If initial decontamination fails, he shall contact the local Clinic. 2.4 RPS Once involved, the RPS is responsible for recording details of the event, supervising decontamination operations and assessing future work procedures to minimise contamination risk to individuals. 2.5 RPT The RPT is responsible for carrying out initial checks on personnel at the work site. 3. Decontamination of intact skin at work site 3.1 General If skin contamination is suspected the job supervisor should initiate and oversee initial decontamination. This should only involve hand or trunk decontamination. He shall then contact the RPT. If initial decontamination is not successful, or if other parts of the body are contaminated, the Contractor HSE Advisor (RPS) should be contacted. Special care should be given to the mental concerns of the person, it is important to reassure him that it is not life threatening, and that if contamination is external (i.e. on the skin), it can be removed relatively easily. If the contamination is internal (i.e. breathed in or swallowed), some of it may be removed and the body itself will also expel some contamination that has entered the stomach or lungs. Contamination from a cut may be flushed out in most cases. Page 2
3.2 Initial checks and decontamination procedure RPT to check for contamination over all body surfaces using a Mini 900 with 44A Probe. Any count rate greater than background is an indicator for contamination. There is some limitations when using the Mini 900 meter with the 44A probe. It is good practice to keep personal contamination as near to background as possible and ongoing monitoring by he RPT is essential.if contamination is indicated the following actions should be carried out. Inform Job Supervisor, stop the work to prevent spread of contamination. Take the contaminated person away from the installation (but still within the Controlled/ Supervised area) and perform a second measurement. If no contamination is found, work may progress. If clothing or PPE are contaminated, the person shall be assisted in removing the items by the RPT. Take care that contaminated clothes don not touch bare skin. Prevent spread of contamination by turning clothing inside out and rolling up. Contaminated clothing should be regarded as NORM waste and disposed of properly. Escort the person to the washing facility (Localised washing wherever possible should be given preference over showering). Prevent internal contamination: no eating, drinking, chewing of gums and/or smoking is allowed. Also avoid self-spread. Allow the person to wash contaminated hands or trunk up to three times, using soap and warm water. Dry contaminated areas carefully with towels, using a dabbing rather than rubbing action and then recheck the skin. If contamination is still present, repeat the washing process. If still contaminated after three washes, the RPS and clinic shall be contacted and the person escorted to the nearest clinic for decontamination. 4. Decontamination of person in clinic The decontamination kit at each clinic contains all materials relating to this procedure. The clinic shall maintain records of all decontamination procedures for clinical purposes. The RPS or nurse may also use this information in determining further actions. The decontamination procedures below should be used if initial decontamination measures have not reduced levels to below background with the Mini 900 with 44A probe or if contamination affects areas other than the hands or trunk. 4.1 Decontamination of Intact Skin Decontamination shall be carried out by or under the direct supervision of trained nursing staff and in the presence of the RPS: Cover non contaminated parts of the skin with polythene bags or sheet taped to clean skin. Page 3
Wearing gloves, wash the contaminated skin by water/soap first, then rub the skin thoroughly with Dekodusch S (or equivalent) for about one minute. Rinse the skin with water. Dry carefully with paper towels avoiding rubbing the affected skin and recheck for contamination. If decontamination has been successful, treat the skin with Hakavit (or equivalent). If contamination remains, repeat the process up to two more times. If activity is still high, continue efforts with Dekontafix (or equivalent) When using Dekontafix the following shall be considered. Dekontafix is a harsher cleaning substance, caution shall be used in its use to prevent skin damage. Wearing gloves, rub the skin thoroughly with Dekontafix and massage for 2 minutes. Rinse the skin with running water. Dry carefully with a towel avoiding rubbing the affected skin and recheck the skin for contamination. If contamination remains, repeat the process up to two more times. If decontamination has been successful, treat the skin with Hakavit (or equivalent). Quit treatment: A If no radioactivity above background can be measured with the Mini 900 Meter with 44A probe. A If damage to the skin threatens or the activity level remains high, even after intensive treatment. Then the RPS, Nurse and interpreter if necessary should accompany the person to the designated hospital. Local hospitals must only be used in life threatening situations. The Area Coordinator must be informed immediately as local authorities will need to be appraised of the situation. 4.2 Decontamination of Damaged Skin In the case of wounds, always assume contamination until measurement of the affected areas proves otherwise. Caution should be used to ensure no further contamination enters the wound from other affected areas. 4.2.1 Flushing Only minor wounds shall be flushed. Wearing gloves rinse the wound with water of moderate temperature, this stimulates the bleeding which can help clean any contamination from the wound. Major wounds shall NOT be flushed. N.B. DECONTAMINATION MUST NOT OVERRIDE LIFESAVING TECHNIQUES. Carefully recheck the wound and cover with sterile bandages. Swabs, bandages and dressings shall be retained for analysis (spectrometry) on removal. Page 4
4.3 Decontamination of Skin Surrounding a Wound Treat the wound and cover with a waterproof dressing (such as blue catering plasters). Decontaminate the skin by the method described in Paragraph 4.1. 4.4 Eyes To remove contamination from the eyes: Firstly get the person to incline his head backwards. Next, wearing gloves and using an eyewash bottle, gently squeeze room temperature water or saline onto the eye, asking him to move the eye about slowly in all directions, checking with him that he can tolerate the procedure. Allow the person to dry the eye carefully with a clean towel and recheck for contamination. If contamination remains, repeat the process up to two more times. If the contamination remains, the RPS/RPT and if necessary an interpreter shall accompany the person to the designated hospital for further treatment. 4.5 Hair / Beards Instruct the person to lean his head back over a wash basin. Wearing gloves, wet the hair or beard, apply soap or shampoo, wash gently avoiding damage to the scalp, rinse and dry thoroughly then recheck for contamination. If contamination remains on hair or beard it may be necessary to cut the affected parts away. 4.6 Fingernails Wearing gloves scrub the affected areas with a brush, soap and water, then dry carefully and recheck for contamination. If contamination remains, it may be necessary to cut the overhang away. Caution should be used not to damage soft tissue around the nail. 4.7 Ears Proceed with caution as the inner structures of the ear are very delicate. Ears should be decontaminated by nursing staff using moist swabs, or a very gentle jet of water. The ear shall then be rechecked and the process repeated if contamination is still present. 4.8 Nose Ensure that the nose is blown immediately on arrival (ask the person to do this). Page 5
Bag up the tissue and retain for possible further analysis. Ensure the person mouth breathes during the procedure to prevent further inhalation of radioactive substances. Any remaining contamination should be removed by nursing staff who shall carefully swab or irrigate the opening of the nostrils with warm water. 4.9 Mouth/teeth/dentures Ensure the person is aware of the procedure before commencing, this will prevent ingestion of radioactive substances. Offer the person a diluted mouthwash solution which should be swilled around the mouth and ejected into a suitable container as the sample may need to be retained for analysis. Repeat the process if necessary. If the teeth are contaminated they must be brushed gently, away from the gum, using mouthwash. If dentures are worn, remove and brush with mouthwash solution or warm water. 5. Internal contamination, corrective actions 5.1 General Try to get as much information as possible on the internal contamination (type, amounts, specific activity) Pay special attention to the mental state of the contaminated person. In general, the mental concerns exceed the actual risk. Evaluate the incident as soon as possible with the contaminated person, the RPS/RPT and Area Coordinator if necessary. 5.2 Bioassay and Internal Dose Assessment The Nurse and/or MCC will decide the need for bioassay sampling (urine or faecal sampling and analysis). Internal Dose assessments will be carried out by the RPA. Page 6
Glossary of Abbreviations Appendix 1 PPE RPA RPS RPT CRFP MCC Personal Protective Equipment Radiation Protection Adviser Radiation Protection Superviser Radiation Protection Technician Corporate Radiation Focal Point Chief Medical Officer Page 7