Nuclear medicine and the proposed national radioactive waste dump

Jim Green

National nuclear campaigner - Friends of the Earth, Australia

December 2015

To download a 2-page paper addressing these issues right-click here.

“As health organisations, we are appalled that access to nuclear medical procedures is being used to justify the proposed nuclear waste dump. Most waste from these procedures break down quickly and can be safely disposed of either on site or locally.” 

− Dr Bill Williams, Medical Association for the Prevention of War

“Linking the need for a centralized radioactive waste storage facility with the production of isotopes for nuclear medicine is misleading. The production of radioactive isotopes for nuclear medicine comprises a small percentage of the output of research reactors. The majority of the waste that is produced in these facilities occurs regardless of the nuclear medicine isotope production.” 

− Nuclear Radiologist Dr Peter Karamoskos

 

Summary

Proponents of a national radioactive waste facility (a repository for lower-level wastes and a co-located store for higher-level wastes) claim or imply that nuclear medicine would be jeopardised if the facility does not proceed. There is no basis to such claims – they amount to dishonest scare-mongering.

Proponents claim that most or all of the waste that the federal government wants to dispose of or store at a national repository/store arises from medicine, specifically the production and use of medical radioisotopes. However, measured by radioactivity, the true figure is just 10-20%. Measured by volume, the figure may be within that range or it may be higher than 20% − but it takes some creative accounting to justify the claim that most or even all of the waste is medical in origin.

In any case, the fact that some waste is of medical origin doesn't mean that a national repository/store is the best way to manage the waste.

If the plan for a national repository/store does not proceed, medical waste will continue to be stored at the Lucas Heights reactor site operated by the Australian Nuclear Science and Technology Organisation (ANSTO) and, in much smaller volumes, at hospitals. Some waste is used in hospitals and then sent back to ANSTO (e.g. molybdenum 'cows' that have been 'milked' of the daughter radionuclide, technetium-99m − by far the most commonly used medical radioisotope). That is no problem since ANSTO and hospitals continue to produce radioactive waste and thus they have an ongoing need for on-site waste stores and waste management expertise regardless of the options for periodic off-site disposal.

Nuclear medicine is not being adversely affected by the absence of a national radioactive waste repository/store. Nuclear medicine will not benefit from the creation of a national radioactive waste repository/store.

The incessant references to nuclear medicine to 'sell' the proposed radioactive waste repository/store amount to nothing more than emotive propaganda − which is what critics of the proposed national radioactive waste repository/store are routinely accused of.

Scare mongering

Successive governments have engaged in a scare campaign in relation to medical isotopes. Here are some examples:

·         Senator Nigel Scullion, who purports to represent the NT in the Federal Senate, said: "If we don't have a site that is clear of any impediments by April [2006] then by December 2006 Australia will not get access to radio pharmaceuticals that are essential to the early diagnosis of cancer and to deal with many cardiovascular issues in Australia." (13/10/05, abc.net.au/news/newsitems/200510/s1481671.htm) Senator Scullion's scare-mongering was proven to be false.

·         A joint media released by Nigel Scullion and David Tollner, the CLP Member for Solomon in the NT Parliament, said: "A delay [in building the waste facility] would severely limit the availability of life-saving radiopharmaceuticals used in the treatment of cardiovascular disease and early intervention against cancer, particularly breast cancer." That one paragraph contains layers of confusion and misinformation. As the Medical Association for the Prevention of War noted, Senator Scullion and Mr Tollner were "peddling a lie" (ABC, 17/10/05).

·         National MP John Cobb said: "But let me ask this: do people want hospitals, do they want life-saving cancer treatment and equipment ...? ... I must stress how much medical waste is involved. I wonder whether those who have such a problem with it want to close down our hospitals." (House of Representatives, 16 October 2003, pp.21329-30) Needless to say, no hospitals have been closed down, no hospitals will be closed down, no-one wants hospitals closed down.

·         In 2002, science minister Peter McGauran accused WA Premier Geoff Gallop of putting at risk life-saving nuclear medical research by refusing to accept that its waste had to be stored somewhere. ('Premiers dump on waste site', The Australian, August 7, 2002.)

Much of the pro-dump propaganda is somewhat less disingenuous than the comments of Senator Scullion, Mr Tollner, Mr Cobb, and Mr McGauran, implying rather than asserting that nuclear medicine would be jeopardised if the NT dump plan does not proceed. For example federal resources minister Martin Ferguson said in 2010: "We need a repository. We need nuclear medicine. All Australians benefit from the outcome of establishing a low and medium level repository in Australia, because half a million Australians a year demand access to nuclear medicine." (www.abc.net.au/local/stories/2010/03/04/2836622.htm)

David Tollner said he approached then Prime Minister John Howard about funding an oncology unit at Royal Darwin Hospital as compensation for hosting a nuclear waste facility. (16/10/05, abc.net.au/news/newsitems/200510/s1483293.htm) If there is a need for an oncology unit in Darwin, it would be totally unacceptable for federal support to be dependent on acceptance of a nuclear waste dump.

Fraction of the radioactive waste of medical origin

The federal Labor government − as with the previous government − routinely asserts that most of the waste is a by-product of the production and use of medical isotopes. Sadly, that false claim is sometimes echoed in the NT, as with the August 2011 NT News editorial which asserted that the waste arises "almost solely" from nuclear medicine.

Here are some examples of politicians peddling misinformation:

·         Then resources minister Ian Macfarlane said the nuclear waste arises "predominantly from medical services" (6/6/05, www.abc.net.au/lateline/content/2005/s1385915.htm).

·         Then science minister Peter McGauran said: "However, the Government remains totally and utterly committed to the safe and secure storage of low level radioactive waste − the bulk of which is produced from nuclear medicine procedures, and is the necessary by-product of life-saving medicine." (24/6/2004, www.abc.net.au/worldtoday/content/2004/s1139557.htm)

·         Mr McGauran said that the waste destined for the national dump "is largely produced by nuclear medicine" (ABC Radio National, Australia Talks Back, 5/2/02).

·         In 1997, Mr McGauran said that "During this year more than 260 000 Australians will have a nuclear medicine procedure. ... As a result of these procedures, some 35 spent fuel rods are generated by the Lucas Heights research reactor every year." However just 10% of the spent fuel can be attributed to medical radioisotope production.

·         Then science minister Brendan Nelson said on 2/11/05 in Parliament that "... much of [the nuclear waste is] sourced from hospitals around Australia, which is currently stored at ANSTO. We have another 1,800 cubic metres at Woomera, much of that sourced from hospitals. In fact most of this stuff comes from hospitals. ..." Hospitals account for only a tiny fraction of the waste (about 3% by volume). Just over 2000 cubic metres of low-level waste are stored at Woomera and none of it is of medical origin. Mr Nelson had no idea what he was talking about.

For low-level waste (LLW) and short-lived intermediate-level waste (SLILW):

* The claim that most of the waste is of medical origin certainly cannot be true in relation to waste volume, since 54% of the volume is non-medical CSIRO soil.

* A rough estimate would be as follows: say one quarter of ANSTO's waste is medical (1320/4=330m3), and one third of the state/territory waste is medical (151/3=50 m3), so overall perhaps ONE TENTH (380/3700 m3) of the national inventory of LLW/SLILW is a by-product of medical isotope production and nuclear medicine. Or if we assume that one half of ANSTO's waste is medical (1320/2=660m3), the overall figure is 710/3700 or 19%.

For long-lived intermediate-level waste (LLILW):

* Only a small fraction of this waste could be attributed to medical isotope production. Spent fuel accounts for a large majority of the radioactivity of Australia's LLILW (though only a small fraction of the volume), and according to ANSTO (1993 Research Reactor Review submission), just 10% of the Lucas Heights 'HIFAR' reactor's neutrons were used for medical isotope production. Presumably a similar figure applies for the new OPAL reactor − there is no reason to believe otherwise.

* Of the rest of Australia's LLILW (other than spent fuel), about half by volume comprises reactor and isotope production wastes (limited detail is available), but this would account for only a small fraction of the LLILW inventory when measuring by radioactivity.

In sum, for LLW plus SLILW plus LLILW, 10-20% of the current stockpile would be the plausible range for medical waste − closer to 10% if measuring by radioactivity (because spent reactor fuel is such a large contributor to total radioactivity) and closer to 20% if measuring by volume.

For current and future production, roughly 30-40% of the volume could be attributed to medicine, but if measuring by radioactivity the figure would still be in the range of 10-20% (again because the radioactivity figures are dominated by spent fuel).

What should be done?

Two parallel processes should be initiated regarding radioactive waste management in Australia: a radioactive waste audit, and a National Commission or comparable public inquiry mechanism.

The federal government should immediately initiate an audit of existing waste stockpiles and storage. This could be led by the federal nuclear regulator ARPANSA in consultation with relevant state agencies with responsibility for radioactive waste. This audit would include developing a prioritised program to improve continuing waste storage and handling facilities, and identifying non-recurrent or legacy waste sites and exploring options to retire and de-commission these.

A National Commission would restore procedural and scientific rigour, and stakeholder and community confidence in radioactive waste management. It would identify and evaluate the full suite of radioactive waste management options. That would include the option of maintaining existing arrangements, keeping in mind that 95% of the waste is securely stored at two Commonwealth facilities: ANSTO's Lucas Heights facility, and a large volume of very low level waste stored on Defence Department land at Woomera, SA.

The above issues are addressed in detail in a 2014 paper posted at: www.foe.org.au/sites/default/files/Responsible%20Radioactive%20Waste%20Management%20-%20The%20need%20for%20an%20Inquiry-Final.pdf

More information

−−− 'Nuclear Medicine in Australia: a Joint Health Sector Position Statement', March 2011, www.mapw.org.au/files/downloads/JHPS_Nuclear-Medicine-%20in%20Australia%20March%202011.pdf

("Nuclear medicine involves the use of radioisotopes for the diagnosis and treatment of medical conditions. Significant concerns exist within the Australian community and amongst health professionals and scientific experts regarding current research reactor based production and the Commonwealth Government’s position regarding the disposal of these radioisotopes. On the basis of current information, we, the undersigned members of the health sector, recommend that the nuclear medicine industry in Australia undergo a full independent inquiry.")

−−− Medical Association for Prevention of War − nuclear medicine section:
www.mapw.org.au/nuclear-chain/nuclear-medicine

−−− Friends of the Earth webpages on nuclear medicine, radioisotope production, and Lucas Heights: www.foe.org.au/anti-nuclear/issues/oz/lh

−−− Dr Margaret Beavis, 2 Dec 2015, 'Is Australia becoming the world’s nuclear waste dump by stealth?', Sydney Morning Herald, www.smh.com.au/comment/is-australia-becoming-the-worlds-nuclear-waste-dump-by-stealth-20151122-gl4v04.html


Nuclear Waste In Australia: A Few Home Truths

Dr Margie Beavis, 7 March 2016, https://newmatilda.com/2016/03/07/50511/

The Federal government is seeking a location for a nuclear waste facility. But the provision of information to communities has been problematic, with some major flaws.

Claims have been made that provision of nuclear medicine services is a key reason to build it, but existing medical waste makes up a very small proportion of the total waste requiring disposal.

In addition, little has been said about ANSTO's business plan to greatly ramp up Australia's reactor based production of isotopes from 1 per cent to over 25 per cent of the world's market, which will massively increase the amount of long-lived radioactive waste produced in the future.

A new process may reduce the volume of the waste, but the actual quantity of radioactive material to store will be significantly greater, and will become most of the radioactive waste Australia produces.

In Australia nuclear medicine isotopes are indeed useful, but according to Medicare figures represent less than 3 per cent of medical imaging. They are most commonly used for bone scans and some specialised heart scans. They are not needed (as claimed by government) for normal X-rays, most heart scans and the vast majority of cancer treatments (surgery, chemotherapy and radiotherapy).

Government statements that one in two Australians at some point in their life need nuclear medicine stretch credibility.

It is interesting to hear government adviser Dr Geoff Currie's contribution to this debate. But it does not reflect the position of the world leaders in isotope production.

The Canadians, who have been the leading exporters and best practice experts producing 30 per cent of the world's isotopes for many decades, are in the process of phasing out nuclear reactor production.

Canada produced a "Report of the Expert Review Panel on Medical Isotope Production 2009". After this report the Canadian government stated, "Canadians have been left to shoulder a disproportionate amount of the nuclear waste burden associated with reactor-based isotope production. This includes the significant costs associated with long-term management of the waste. The Government favours a new paradigm in which Canadians benefit from Canadian-based isotope production, supplemented if necessary from the world market, and supply is sustainable because of reduced waste and improved economics."

They gave a number of other reasons why Canada wished to phase out reactor use. These included reliability of supply (reactor breakdowns created worldwide isotope supply shortages); investment in reactor production of medical isotopes would crowd out investment in innovative alternative production technologies like cyclotrons; and reactor production was the most expensive option, at no stage commercially viable without major taxpayer subsidies.

The Canadian Triumf research team had a successful pilot project in January 2015. They demonstrated a process that enables the routine production of sufficient Tc-99m (which is 85 per cent of isotopes used) to satisfy the daily demand for a population the size of British Columbia – or 500 patients – from a six-hour run on a common brand of medical cyclotrons.

Clinical trials began in early 2015. There are plans to have 24 cyclotrons operating across Canada by 2018, when they are planning to close down their reactor.

A very comprehensive 2010 OECD Nuclear Energy Agency report found reactor based isotope production requires significant taxpayer subsidies, as the cost of sale does not cover the cost of production.

The report concludes: "In many cases the full impact of Mo-99/Tc-99m provision was not transparent to or appreciated by governments… The full costs of waste management, reactor operations, fuel consumption, etc were not included in the price structure. This is a subsidisation by one country's taxpayers of another country's health care system. Many governments have indicated that they are no longer willing to provide such subsidisation."

Clearly cyclotron production of nuclear medicine is not widely available right now, but planned in Canada in the next three to five years. How rapidly we adopt their technology will determine how long we need to use reactor produced isotopes.

What is needed urgently is a debate about how much waste we make. We have a choice: whether we follow ANSTO's expensive business model to ramp up reactor manufacture (and the long-lived radioactive waste that goes with it), or collaborate with Canada to develop cyclotron manufacture of isotopes that does not produce long-lived nuclear waste.

It is a bit like Australia's stance on coal for energy – with continued reliance on 19th century technology rather than a switch to 21st century renewables – do we continue with 20th century reactor technology and back the wrong horse?

ANSTO is a taxpayer-funded organisation. The decision to ramp up reactor waste production will leave many future generations with radioactive materials that last hundreds of thousands of years. So for the six communities proposed, Australia's future nuclear waste burden is the elephant in the room.

When managing toxic materials, the first principle should be reducing their production at source. We urgently need an inquiry into nuclear waste production in Australia, given we already have more radioactive waste than we know what to do with.