CASE STUDY

THE RADIOLOGICAL ACCIDENT IN GOIÂNIA, BRAZIL (1985)

Group Leader:

RAFANAN, Marianne Faye P,

Members:
AGWAYAWAY, Elmar A.
CLAOR, Kathleen Claire T.
NAVARRO, Wendell Jay R.
RAQUENO, Jessa Mae A.
I. INTRODUCTION
It is now known that around the end of 1985, the Instituto Goiano de Radioterapia in
Goiânia, Brazil, moved to new premises, taking a cobalt-60 teletherapy unit with it and leaving a
caesium-137 teletherapy unit in place, without notifying the licensing authority as required by the
institute's license. Following then, the former premises were partially dismantled. As a result, the
teletherapy unit for caesium-137 became completely insecure. Two persons entered the premises
and removed the source assembly from the machine's radiation head, not knowing what the unit
was but assuming it would have some scrap value. They took it home and attempted to dismantle
it.
The source capsule was ruptured during the attempt. Cesium chloride salt, which is
extremely soluble and dispersible, was used as the radioactive source. The environment was
contaminated, and some people were exposed to external radiation and interior contamination as
a result. As a result, one of the most devastating radiological mishaps in history began.
After the source capsule was ruptured, the remnants of the source assembly were sold
for scrap to a junkyard owner. In the dark, he realized that the source material flashed blue. This
piqued the interest of several people, and over the course of a few days, friends and relatives
came to see the occurrence. Several families received fragments of the source the size of rice
grains. This went on for five days, during which time several persons began to experience
gastrointestinal symptoms as a result of their exposure to radiation from the source. Irradiation
was not immediately suspected as the cause of the illness. However, one of the irradiated
individuals linked the ailments to the source capsule and delivered the leftovers to the city's public
health department. This action set in motion a chain of circumstances that culminated in the
accident's discovery.
A local scientist was the first to identify the scale of the accident by monitoring it and taking
action on his own to evacuate two regions. The authorities were also notified at the same moment,
and the quickness and scope of the response were astonishing. Several other major
contamination sites were quickly identified, and residents were evacuated.
II. DISCUSSION
a. Victims And Casualties

Tragically, 2 men, 1 woman, and 1 child died from acute radiation exposure
to the very high levels of gamma radiation from the breached source; and
a total of 249 human contamination. In addition to the human toll,
contamination had been tracked over roughly 40 city blocks. Of the 85
homes found to be significantly contaminated, 41 were evacuated and 7
were demolished. It was also discovered that through routine travels, within
that short time people had cross-contaminated houses nearly 100 miles
away. Cleanup generated 3,500 m3 radioactive waste at a cost of $20
million. The impacts of this incident continued beyond the health and
physical damage to profound psychological effects including fear and
depression for a large fraction of the city’s inhabitants. Further, frightened
by the specter of radioactive contamination, neighboring provinces isolated
Goiania and boycotted its products. The price of their manufactured goods
dropped 40% and stayed low for more than a month. Tourism, a primary
industry, collapsed and recent population gains were reversed by business
regression. Total economic losses were estimated at hundreds of millions
of dollars

b. Symtptoms And Diagnosis

On 13 September 1987, a radiation accident occurred in the city of Goiânia

in Central Brazil. Approximately 250 people were exposed to a 137Cs
source from an abandoned radiotherapy unit. At least 14 patients showed
some degree of bone marrow depression, and eight developed the
classical signs and symptoms of acute radiation syndrome (ARS). Twenty-
eight people presented local radiation injuries ranging from first to third
degree, and 104 individuals showed evidence of internal contamination.
Cytogenetic dosimetry is an extremely useful technique for estimating the
external whole body radiation dose and the inhomogeneity of dose of the
irradiated person. It is helpful in providing useful information to the
physician responsible for diagnosis and prognosis.

c. Diagnosis

For the most severely irradiated patients, treatment was directed to the
assessment and management of the hematological crisis associated with
the acute radiation syndrome. Through patient interviews, the generation
of homographs and reconstruction of the accident, efforts were directed to
determining the initial day of exposure, the duration of exposure, dose
estimates by cytogenetic techniques, and the severity of internal
contamination with caesium-137. These data were useful in predicting the
degree of hematological depression and the consequent degree of
 susceptibility to infection. Cytogenetic techniques indicated that the
radiation doses of the patients in Rio de Janeiro ranged from 1 Gy to 7 Gy
These cytogenetic dose estimates, although complicated by continuous
radiation from internally deposited caesium-137, were useful in prognosis
and m anticipating medical management problems associated with bone
marrow depression. Medical management was thus based on each
patient's clinical course and not predominantly upon cytogenetic dosimetry.

Cultures were obtained by standard methods from blood, skin, wounds and
body orifices to identify bacterial, fungal and viral infections on the basis of
the results of the cultures and the clinical courses, patients were treated
with systemic or topical antibacterial, antifungal or antiviral agents.

For locally irradiated patients, all skin lesions were contaminated with
caesium-137; dose rates of up to 15 mSv-h~' were measured close to some
lesions. Contamination levels were significantly reduced through sloughing
of necrotic skin and by further attempts to decontaminate In both Rio de
Janeiro and Goiania, localized burns were treated by topical applications
of antiseptic and analgesic solutions, antibiotic creams, neomycin, juice of
the aloe vera (thromboxane inhibitor) and alantoin (an anti-inflammatory
agent) For patients m Goiania, two additional therapeutic approaches were
adopted: injections of antiplatelet activating factor to lessen capillary injury
and injections of vasodilators such as TrentalR and IriduxR . The clinical
course was approximately the same in both hospitals

III. CONCLUSION
Many people incurred large doses of radiation, due to both external and internal exposure.
Four of the casualties ultimately died and 28 people suffered radiation burns. Residences and
public places were contaminated. The decontamination necessitated the demolition of seven
residences and various other buildings, and the removal of the topsoil from large areas. In total
about 3500 m² of radioactive waste were generated.
The accident in Goiânia was one of the most serious radiological accidents to have
occurred. However, it has similarities with a number of other accidents, such as those in Mexico
City (1962), Algeria (1978), Morocco (1983) and Ciudad Juárez in Mexico (1983). Indeed, the last
of these was strikingly similar to the accident in Goiânia.
IV. REFERENCES
https://www.osti.gov/biblio/137586-goiania-incident-case-study
https://pubmed.ncbi.nlm.nih.gov/30389165/
https://www.nrc.gov/docs/ML1100/ML110030911.pdf