The L.A. Times reports that U.S. hospitals have resisted efforts to phase out a dangerous device and even added more of them instead. The device in question, a blood irradiator that sterilizes body fluids and tissue, has a dangerous amount of a radioactive isotope of cesium. Experts say the device can be seamlessly replaced with a device that uses X-rays instead of radioactive raw material.
Cesium 137 is infamously poisonous, and its presence in the environments of places where we’ve tested nuclear reactions and weapons has wreaked havoc in the decades since. The isotope never occurs naturally. Once it’s generated during nuclear reactions, if it’s not carefully and immediately contained, it causes serious illness and injury if even a tiny amount comes in contact with people. Cesium 137 also mixes quickly into water, air, and soil.
With all that in mind, it must be a medical superstar, if these risks are balanced out by the benefits, right? Well, not exactly. It’s true that blood irradiators, which use cesium 137 or other radioactive materials to sterilize blood, have made it possible for patients to receive safe blood transfusions in a way that has surely saved many thousands or even millions of lives. At one time, they were likely the best known and most affordable way to sterilize blood and tissue.
Why is it that cesium or other radioactive materials kill germs? The mechanism is the same as why radiation slows the spread of cancer. The right dose of cesium radiation can kill germs and microorganisms that carry disease through the blood and which could survive the trip from person to person. Foods can also be irradiated to kill germs this way. In the body, radiation targets fast-growing cancer cells as a priority over normal cells.
This is why X-ray technology can safely and securely replace cesium devices. Yes, X-rays are still dangerous with repeated or prolonged exposure, but their efficiency means the time window to sterilize is very short. More importantly, X-rays aren’t sitting in loose powder form inside a device that can be turned into a salt shaker for dirty bombs. In this case, cesium 137 is what makes the bomb “dirty,” and security experts lament that there are hundreds of access points for readymade cesium 137 in hospitals around the country.
A cesium-boosted radiological dispersal device (RDD) would be devastating. “Any type of RDD which includes cesium-137 could cause immediate casualties from the blast, as well as widespread panic, economic disruption, long-term evacuations, exorbitant decontamination costs, casualties from cancer, and overwhelming psychological damage,” nuclear terrorism expert Dr. Sara Z. Kutchesfahani wrote for The Hill in 2018.
Hospitals aren’t resisting the change out of ignorance—as with most healthcare questions in the U.S., the issue is cost. The Nuclear Threat Initiative offers a cost-benefit analysis worksheet for healthcare providers considering a switch to X-ray irradiation. But in the U.S., the Nuclear Regulatory Commission is still licensing new cesium irradiators, and, the L.A. Times reports, won’t even require the same kind of security deposit that other nuclear services must pay in order to operate.