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Are Hospitals Soft Targets?

WHEN EXPERTS consider how terrorists could obtain radioactive material for a “dirty” bomb, they note that hospitals represent a prime target because they are far less secure than nuclear facilities but house some radioactive materials needed for medical procedures.

Beyond components in x-ray machines and other scanning devices, the radioactive isotopes used to treat cancer, such as cesium chloride, pose the greatest risks. In its talc-like powdered state, cesium chloride presents an ideal component for dispersal in a dirty bomb.

Most radioactive materials are stored in secluded areas to limit the risk of contamination in an accident, but that could make it easy for someone who had fraudulently obtained clearances to remove inventory unobserved.

Federal guidelines currently restrict access to persons deemed “trustworthy and reliable,” but that might be an easy hurdle for a determined terrorist to overcome. Consider the revelation that five of the eight original suspects in last June’s failed bombing attempts in London’s nightclub district and at Scotland’s Glasgow Airport were physicians. Later, it was reported that two of the five had inquired about working in the United States through the Philadelphia-based Educational Commission for Foreign Medical Graduates. They might easily have passed for “trustworthy and reliable.”

In recognition of the risk, the Nuclear Regulatory Commission (NRC) will strengthen clearance requirements by mandating background checks and fingerprinting of all persons granted access this year according to a new NRC order.

The NRC already sets guidelines for healthcare facilities’ handling and storage of radioactive materials in six areas: access control, capability to monitor and respond, transportation security, portable or mobile devices, documentation, and information protection.

Enforcement is performance-based and the guidelines do not mandate exact security methods, says Duncan White, NRC branch chief for state and industry safety. A facility may satisfy the access control requirement using lock and key or card swipe with CCTV, or they may post a guard at a storage location.

Facilities are subject to surprise audits, while enforcement actions range from written notices of violations to fines and license revocation. Top U.S. hospital security officials who spoke to Security Management expressed confidence in the security levels protecting radioactive materials both at their own facilities and others, based on both internal measures and government-imposed security and record-keeping requirements.

Hospitals keep close tabs on these materials due to safety and disposal requirements, says Bernard J. Scaglione, director of security at New York Presbyterian Hospital and a member of ASIS International’s Healthcare Security Council. Beyond the general guidelines White described, federal regulators have tightened requirements post-9-11 to require improved access controls, such as mandatory video surveillance and hardening at some facilities.

Nationally, 34 states directly regulate radiological equipment and materials under agreement with the NRC, while the remaining states’ facilities are directly regulated by the agency, says White.

Ultimately, regulators hope to rid hospitals of this hazard altogether. As with other sectors that deal in hazardous materials, the healthcare sector can expect a push toward inherently safer technology, says NRC spokesman David McIntyre.

The National Academies of Science this year is expected to finalize a study that was mandated by Congress in 2005. The study is examining new, less hazardous alternatives to substances like cesium chloride, McIntyre says.