Texas Radiation Advisory Board (TRAB) News Update. Pete and Karen Myers

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1 Texas Radiation Advisory Board (TRAB) News Update Pete and Karen Myers TRAB s most recent meeting was held from 9:00 a.m. to 12:00 p.m. on Saturday, June 13, 2009, at the Department of State Health Services (DSHS) Moreton Building in Austin. During the TRAB meeting: Chairperson Kim Howard, MD, introduced an issue that he would like TRAB to pursue: the need for action on the amount of radiation some patients are getting as a part of their medical care. For example, following renal stones with computed tomography (CT, or CaT) instead of radiographic KUBs has really increased patient dose over the last few years. Most MDs have no idea what kind of exposures their patients are getting. While it would be a very formidable task, tracking patient exposure is needed. The Image Gently campaign is already pushing this for children, and the recent white paper from DSHS (Cindy Cardwell) and others discussed at the last TRAB meeting highlights some of the issues that we face. It will take a lot of education up front to bring to light the problems that we are encountering. Because too few TRAB members were in attendance, a quorum did not exist. Those TRAB members in attendance, however, agreed to allow continued coordination of these rules: o Proposed revisions to , General Provisions for Radioactive Material o Proposed revisions to , Exemptions, General Licenses, and General License Acknowledgments o Proposed revisions to , Licensing of Radioactive Material The proposed revisions are required for Texas rules to become compatible with the U.S. Nuclear Regulatory Commission (NRC) Rules. Public comments will be solicited prior to adopting the proposed revisions. The DSHS, Texas Commission on Environmental Quality (TCEQ), & Railroad Commission of Texas (RRC) agency reports were provided; selected items from each agency s report are included here: o DSHS (General Program Information) Bills passed by the Legislature that impact radiation control: Senate Bill (SB) 1 appropriations bill increases program funding from the exceptional item submitted by the department, increases the mammography dedicated appropriation to cover costs of the mammography certification program, provides for reimbursement of TRAB members travel and per diem, and appropriates funds in the Radiation and Perpetual Care Account. SB 527 corrects language in Chapter 401 of the Texas Health and Safety Code regarding Severity-I violations and patient notifications. SB 1082 amends Chapter 401 of the Texas Health and Safety Code to allow the department to use funds in the Radiation and Perpetual Care Account to contract for temporary storage and distribution of patients mammography records and films when a registrant goes bankrupt or abandons their facility or records. House Bill (HB) 449 requires the DSHS to license all laser and intense pulsed light source use facilities, certify laser hair removal technicians, and provide or recognize training and testing programs to certify laser hair removal technicians.

2 The NRC will conduct the Texas Integrated Materials Performance Evaluation Program (IMPEP) review in February o DSHS, Radiation Safety Licensing Branch The Radiation Safety Licensing Branch, Operations and Records Group, currently has one clerk position vacancy in the radiation file room due to the death of Godfrey Chima on February 28, We expect to have this position filled in June DHSH, Radioactive Material Licensing group activities: The group is in the process of determining the impacts of the NRC expanding the National Source Tracking System (NSTS) to include Category 3 sealed sources. The state currently has one of the largest concentrations of sealed sources. Any increase in the number of tracked sources will result in an equivalent need for staff; The group is assessing the current financial assurance in place. Staff has requested information from licensees in order to update financial assurance amounts and decommissioning plans; and The group will send a letter to Increased Control licensees along the Texas Gulf Coast requesting additional emergency contact information. This information will be used to augment current contact information in the event of an evacuation during the upcoming hurricane season. Radiation Machine Source Group activities: The mammography certification staff has issued 382 Certified Mammography Facility certifications since the implementation of the States as Certifiers program under the guidance of the U.S. Food and Drug Administration (FDA), Mammography Quality Standards Act (MQSA). The FDA will conduct its first onsite annual audit of the Mammography Certification program on August 25, The FDA performed their annual performance evaluation of the State of Texas Mammography Accreditation Program on August 2, The State of Texas received positive feedback based on the evaluation of the accreditation program. Sue Jean was hired April 1, 2009, for the environmental specialist IV position in the Industrial X-ray and Non-Ionizing Program. The Radiation Machine Source Group is now fully staffed. o DSHS, Radiation Policy, Standards, and Quality Assurance Group (PSQA) PSQA has an empty health physicist I position. The position has the responsibility for x-ray quality assurance review. It is posted. The technical position that had been under audit has been filled. Chris Myers is the newest PSQA staff member and his job responsibilities will include several involving TRAB. Several PSQA staff members participated in an emergency response exercise at Comanche Peak, the RDD exercise in Waco, and the Hostile Action Drill at South Texas. In addition, one PSQA staff member worked a shift answering phones during the MACC activation for the swine flu event. PSQA staff members were heavily involved in the department's responsibilities during the Legislative session, such as coordinating bill analyses and cost estimates, and attending hearings. Cindy Cardwell briefed the NRC Commissioners during a security briefing in April The briefing was in regard to Texas' experience with implementation of the NSTS

3 and several issues were identified. The program has offered to host a workshop in Texas as a more directed outreach to the industrial radiography licensees, who are required to make multiple entries into NSTS. PSQA staff members are working with NRC to make arrangements for a late summer/early fall workshop. Two rulemakings will be required to implement recently passed legislation. The mammography rules will be amended to clarify when notifications are required for certain violations, as required by SB1082. Implementation of the laser hair removal bill, HB 449, will also require rulemaking. HB 449 requires that rules be adopted by March 1, Attached is a draft white paper outlining the reasons the program is drafting rules with some new concepts regarding interventional fluoroscopy. This is not presented as an action item on your agenda, but we would appreciate any input you may have on the document. This will be used as a tool in doing stakeholder outreach during the promulgation of the rule. We would appreciate hearing from you by July 6, Please any comments you have to cindy.cardwell@dshs.state.tx.us o DSHS, Radiation Inspection Branch Mammography Inspections Group All mammography inspector positions are filled. One mammography inspection is past due. The facility in question has been closed due to damage from Ike and has just re-opened. X-ray inspector, Julio Torres, of Harlingen, has agreed to take the MQSA inspector certification course. Upon successful completion of the course, Julio will begin performing approximately 22 mammography inspections in the Rio Grande Valley area. This will result in a significant reduction in travel expenses to that area for mammography inspections. No remote inspections are past due. 506 remote inspections have been issued since 9/01/ of those inspections are closed. The program is currently waiting on responses from the remaining 47 registrants. One remote inspector position remains open. A candidate has been selected and we are currently waiting on approval to make the offer. X-ray Inspections (XRI) Group Mobile tomography-therapy/accelerator units are being released to the market in the U.S. The units are housed inside mobile clinical vans that are designed to provide service at single accelerator facilities, allowing these facilities a temporary way to treat patients while replacing their existing unit. The clinical van is designed to remain parked for 8 to 12 weeks at a facility to allow the change out their older accelerator. The challenge for the Radiation Control Program will be to register the providers of the units and inspect the temporary setups within the short time they are expected to be in the state. Lisa Bruedigan, the inspector/trainer from the XRI Group, attended the Conference of Radiation Control Program Directors (CRCPD) annual conference in Ohio during May As chair of the CRCPD s H-32, Committee on CT, Ms. Bruedigan participated in a working meeting, gave a committee update at the conference and presented a poster that was awarded 1 st place for design and content. Ms. Bruedigan received training and updates on computed radiography/digital radiography (CR/DR) inspection methods. Using learning from the training, Texas will begin developing

4 methods for our x-ray inspectors to measure entrance exposures on automatic exposure control (AEC) units for the abdomen/lumbar spine radiographic procedures. This will involve creating a phantom or working with MD Anderson (Dr. Jones) on a light-weight modified phantom version. Texas x-ray inspectors from throughout the state gathered in Austin from June 1 through June 5, 2009, for staff meetings and training sessions. X-ray inspectors are required to receive 24 hours of continuing education during each two year period in order to perform inspections. Staff received continuing education related to Image Gently, interventional fluoroscopy, picture archiving and communications systems (PACS), digital mammography, CR/DR, and tomosynthesis. The X-Ray Group has one vacancy for an x-ray inspector in Houston. They expect to fill the position within the month of July Radioactive Materials Inspections Group Vanessa Danese began working as RAM inspector June 1, Unlike other RAM inspectors, this position will not be responsible for one specific region of the state. She will be housed in Austin and will be responsible to coordinate inspections in all regions. The region 5 RAM inspector resigned at the end of May. That position will be posted for hire in Beaumont; currently that is the only RAM inspector vacancy. Two inspectors-in-training were released as independent inspectors in May Upon implementation of increased controls (IC) for the security of radioactive material, the NRC set a June 2, 2009, deadline for completing initial IC inspections for licensees in receipt of the initial IC order. Texas met this deadline by performing IC inspections, in addition to routine inspections, of 247 licensees at approximately 500 licensed sites. Environmental Monitoring Group Emergency Planning Program o Radiological Dispersal Device (RDD) Exercise: A DSHS RDD exercise was conducted in Waco, TX on May 21, 2009, which included approximately 700 participants. Participating agencies included 8 regional hospitals, 4 EMS providers, and 5 county/city emergency management agencies. The combined state response team in the field included DSHS, the TCEQ Strike Team, and the 6 th Civil Support Team (CST). DSHS provided support at the local Emergency Operation Center (EOC), Disaster District Council (DDC), and a Joint Information Center (JIC). This exercise was preceded by a large scale table top exercise conducted in Waco on February 4, 2009, to help prepare emergency response organizations for the field exercise on May 21. The exercise was funded by a Department of Homeland Security grant to DSHS. Texas Engineering Extension Service (TEEX) provided scenario development, exercise evaluation, and the after-action report in support of the DSHS grant. DSHS Radiation Control Program staff provided much needed technical support to TEEX s efforts. In addition, the Federal Emergency Management Agency (FEMA), Region VI office provided staff to assist in the evaluation of some locations.

5 DSHS gained significant experience and learned many lessons working in an incident command structure exercise reporting to an incident command post, working with a unified command and using Web EOC, a Web-based system allowing real time sharing of information among emergency response organizations. Public monitoring and decontamination was exercised at the scene for first responders and the public. Public monitoring of approximately 60 personnel occurred at a reception center set up by Waco Public Health, DSHS, Benbrook Fire Department, and the Texas Military Rangers. Additional public monitoring occurred at two of the hospitals that received a majority of the patients. o Comanche Peak Nuclear Power Plant: On April 7 and 8, 2009, DSHS participated in an exercise testing the emergency response capabilities of onsite as well as offsite emergency response organizations at Comanche Peak Nuclear Power Plant (CPNPP). The exercise involved demonstration of radiological response and protective action decision making for the plume phase on day one and the ingestion pathway and recovery phase on day two. The exercise was evaluated by FEMA Region VI. A draft exercise report has been submitted and comments have been prepared responding to the report. A final report will be prepared by Region VI staff and submitted to FEMA headquarters for approval. o South Texas Project (STP): On April 1, 2009, DSHS Radiological Emergency Response Team staff participated in a hostile action based drill with STP. The exercise was a demonstration of STP and offsite response organizations abilities to respond to an emergency involving a terrorist attack. The attack involved hijacked air freight airplanes. Damage to the fuel handling building as a result of an airplane crash resulted in the eventual release of radioactive material, which required a protective action response to safeguard residents downwind from the plant. Incident Investigation Program o On October 13, 2008, the Agency was notified by Ludlum Measurements, Inc. that a 50-millicurie cesium-137 ( 137 Cs) source was breached. The source was breached when a technician used a grinder to shorten the source holder. The technician believed the metal was a spacer. The four individuals directly involved with the source breach received in vivo and in vitro bioassay analyses. The exposure assigned to each of the four individuals was less than 10 millirem. Service contractors were hired to perform area decontamination and radiological surveys of the facility. All areas of the facility were decontaminated and released by May 1, o On April 17, 2008, the Agency was notified by Wal-Mart that a physical inventory at one of their stores did not locate a tritium exit sign (TES) containing tubes of tritium ( 3 H). The licensee broadened their inventory to all of their stores containing TES, including more than 2,300 stores in Texas. A total of 73 signs were reported to Texas as either lost, or containing damaged or missing tubes of 3 H. All stores containing lost or damaged tubes were surveyed for contamination and released for unrestricted use. All TES were removed from their stores and returned to the manufacturer. o On January 13, 2009, Wal-Mart reported that approximately 1,558 tritium exit signs (TES) were lost from stores located throughout the U.S. This information was gathered during a nationwide inventory of TES located at Wal-Mart stores.

6 The report included specific information for each TES reported as lost. Wal-Mart is continuing its inventory of the signs and is providing updated reports as necessary. o On February 20, 2009, during an internal audit/inspection, it was discovered that two Filtec Model FT 50 level detection devices, each with 100 mci of Am-241, were missing from inventory at a Dr. Pepper bottling plant in Irving, Texas. They had apparently been removed from the facility with scrap metal. Notification of the loss was not reported to incident investigation staff until March 12, The subsequent investigation has determined that the metal scrap, along with these devices, was subsequently shipped to a steel mill in India and may have been melted. The NRC was notified and provided notice to the Department of Atomic Energy, the Indian regulatory authority. Specific details of the shipping, route taken, mode of transport, vendors, as well as actual location in India was gathered and provided to appropriate Federal authorities. Environmental Monitoring Program o Repairs to the environmental thermo-luminescent dosimetry (TLD) equipment were completed and data has been generated to complete the environmental annual report. It will be ready to print in the next couple of weeks and should be available for distribution in July. o There are two vacant positions in the program. Reclassification requests were submitted for the two positions last summer and are still being considered. o TCEQ, Low-Level Radioactive Waste Disposal: The TCEQ reviewed the Waste Control Specialist, LLC (WCS) license application for low-level radioactive waste and mixed waste disposal. The technical review was completed on August 11, 2008 and the executive director filed the draft license, environmental analysis, and technical summary with the Office of the Chief Clerk. The chief clerk mailed the Notice of Completion of Technical Review and Public Meeting to WCS and adjacent land and mineral rights owners. WCS published the notice in the Andrews County News on August 17, A public meeting was held on September 8, 2008 in Andrews to receive formal comments on the draft license. The public comment period ended September 16, On January 14, 2009, the TCEQ Commissioners approved an order granting the application of WCS for Radioactive Material License, No. R The license will be issued after condemnation proceedings are completed and the applicant has acquired the mineral rights on the underlying land where the site will be located. Final offers for mineral rights were mailed to the remaining five mineral rights owners in April 2009; no response was received. A petition for condemnation was filed May 5, 2009, in the 109 th District Court in Andrews County. The presiding judge has appointed three commissioners who will conduct a hearing in Andrews, Texas sometime in the future. They appointees are Darrell Jackson, Gary McCullough, and Larry Brewer. No date for hearing has been set. o TCEQ By-Product Material Disposal: By a vote of 2-1, the license for WCS to dispose of by-product material was approved on May 21, The license was signed by the TCEQ Chairman on May 29, A motion for re-hearing was received on June 24, 2008 and was overruled on July 25, The TCEQ is being sued by the Sierra Club on the issuance of this license. WCS has begun construction activities. Staff geologists visited the site on October 27 30, 2008 and again on December 1 4, TCEQ staff participated in a meeting with the Water Quality Division on November 18, 2008, and throughout the

7 week of December 1, 2008, regarding the TPDES permit application submitted by WCS affecting the by-product material disposal facility. Comments on the draft TPDES permits have been sent to the Waste Quality Division. On April 6 8, 2009, division staff completed the first baseline sampling event for the WCS by-product facility. o TCEQ Rulemaking: The division has no active rulemaking at this time. o TCEQ Uranium Mining: A new radioactive material license was been requested by Rio Grande Resources for a processing plant site in Karnes County. The license application was received on October 24, Staff received and began review for administrative completeness the UEC in situ Goliad license application on Monday December 1, Staff met with Karen Pettigrew of the Attorney General s Office on the IEC reclamation project on November 20, An initial status hearing was held on January 20, 2009 to discuss the reclamation. A follow-up hearing is scheduled for June 10, o TCEQ, American Smelting And Refining Company (ASARCO): An Agreed Order has been finalized to transfer the site from ASARCO to Electra Gold Ltd. (ELT). On October 15, 2008, staff traveled to the Federated Metals site at the request of the Remediation Division. The TCEQ staff has met with representatives of Energy Solutions to discuss the remediation of the site and the establishment of standards for unrestricted use. Comments have been provided to TCEQ Remediation on the proposal. o TCEQ, Buried Waste: TCEQ continues to work on closing the historical buried radioactive waste sites that exist under TCEQ jurisdiction in Texas. o TCEQ, Memorandum of Understanding (MOU): TCEQ s work with the RRC on possible amendment to the MOU between the two agencies has resumed and the drafting of language for an amendment is progressing.

First Quarter 2010 Program Reports to the Texas Radiation Advisory Board February 6, 2010

Department of State Health Services (DSHS) General Program Information First Quarter 2010 Program Reports to the Texas Radiation Advisory Board February 6, 2010 Beginning January 20, 2010, the Department