Radioactivity may be defined as the decomposition of an atom accompanied by the
emission of Radiant energy such as alpha, beta and gamma rays. The gamma rays
and the X-rays have akin properties. Under carefully controlled usage, they are
of therapeutic value.
However, they are destructive to living cells and
especially to those which are rapidly proliferating, such as bone marrow,
lymphoid tissue, intestinal epithelium and cells of reproductive organs.
Chromosome and gene damage and interference with other mitotic mechanism are
known to occur. The foetus is highly susceptible to radiation and the U.N.
Commission on the Effects of Atomic Radiation has suggested that it is prudent
to assume that some genetic damage we follow in the foetus exposure to any dose
of radiation however small. The alpha and beta rays may produce similar effects
but they have little penetrating power as compared to X-rays and they are
therefore less dangerous to that extent.
Thorium, Uranium, Radium and their salts emit radiant energy and are therefore
known as Radioactive Substances. They are exceedingly poisonous. Radioactive
isotopes, used in therapy, emit the same radiation as radioactive elements and
the dangers in their use are also similar.
The unit of dose of radiation is the roentgen, rem, or rad (r) which is a
measure of the radiation as it passes through the air. The unit of radioactivity
is known as the Curie (c) which is a measure of the number of atomic
disintegrations (37 million) taking place per second. The usual biological unit
is the millicurie (mc) which is 1000th of a Curie.
When radioactive isotopes are given to patients either for Diagnostic or
therapeutic purposes, all the soft tissues, organs and mainly the bones show the
presence of radioactive material. Special precautions must therefore be taken in
the disposal of Radioactive corpses by everyone concerned.
The following is a brief account of the points which must receive attention:
Both the body and the accompanying clinical chart should be tagged in such a way
as to make it clear immediately that the patient has been treated with
radioactive material. The tag should give the date of the last treatment, amount
and identity of the isotope given, and also the date when precautionary measures
are no longer necessary. It is desirable to have a Geiger Counter available in
the autopsy room so that the prosector in a pertinent case may know beforehand
the amount of radiation to which he will be exposed during a specific time. It
must be remembered that there is no danger in dealing with bodies that have
received a large dose of external radiation, nor is there any danger in handling
bodies which have received only tracer doses of any isotope whatsoever for
The beta radiations that are normally absorbed by the superficial tissues can
reach the hands of the prosector as he dissects the organs. This radiation is
very intense but falls off rapidly with increasing distance from the radioactive
tissues and is readily absorbed by material interposed between it and the prosector's hands.
It is therefore necessary to use long handle instruments and wear extra thick
rubber gloves for protection. Any delay between death and autopsy reduces the
radiation levels by the natural decay of radioactive material. Temporary
implants, if any, should be removed from the body, before the autopsy is
commenced. If the amount of radioactivity is less than 5 millicuries, no extra
precautions are necessary beyond the wearing of rubber gloves. When our body is
likely to contain more than 5 millicuries of radioactive material, it is
advisable to consult a Radiation Safety Officer to prescribe the working time
for the examiner at various distances from the body. If the Safety Officer is
not available and the body contains less than 30 millicuries of radioactive
material, a Geiger counter showing in advance the radiation exposure must be
employed and the following precautions taken.
Two thick pairs of gloves should be worn to reduce the amount of radiation
reaching the skin and to prevent any chance of skin contamination through
Plastic aprons and plastic shoe covers should be worn to reduce the
contamination of the wearing apparel.
Goggles or spectacles will prevent contamination of the eyes.
Instruments with long handles should be used, especially knives with extra long
handles and oversized forceps.
Organs that are most radioactive are removed first and placed in a glass jar,
properly labelled, and preserved in a fixative or in the refrigerator for
subsequent examination when the radioactivity has fallen to a safe level. If the
isotopes have been injected into the body cavity such as the Thorax or the
abdomen to control neo-plastic disease, it is likely that fair amount of fluid
will be present. Such fluids from the cavity should be removed by means of a trocar and cannula into
a closed system and stored if necessary. A syringe is less suitable for the
removal of the fluids because it is to be held in hand. The cavity should then
be irrigated with saline or water and the fluid disposed off directly into the
The Blood and the Clots may be disposed off without special precautions.
The spillage of the blood, urine and the other fluids, during the autopsy must
The detailed dissection of any organ must be done away from the body. Finer
dissections of the organs showing radioactivity above the permissible level may
be done after a period of Cold Storage or fixation to permit the radioactive
If the body contains more than 30 millicuries of radioactivity, the presence of
a Radiation Safety Officer is essential. If the radiation level is very high,
the use of a team to complete the removal of the organs or fluids may be
necessary to minimize the exposure.
In case of an accidental injury during the autopsy, the procedure must stop
forthwith and the gloves be removed. The wound must be washed with copious
amounts of running water and the Safety Officer notified, so that he may
determine the presence of residual contamination. The autopsy should be
completed as speedily and cleanly as possible by the other members of the team.
After the autopsy, gloves should be washed thoroughly before being removed from
The contaminated wearing apparel and instruments should be cleaned thoroughly
with soap and water.
If towels and gowns contain radioactivity above the permissible level, they
should be stored for decay of the radioactive material before being sent to the
It is important to avoid the contamination of the floor of the autopsy room,
which should be washed thoroughly with water and detergent if necessary.
The Safety Officer should monitor the rooms, tables, instrument, shoes and the
clothes to check that there is no residual radioactivity. The Pathologist
encountering radioactive specimens should equip himself with a monitor and be
properly instructed in its use.
When the body contains more than 30 millicuries of radioactivity after the
autopsy, it should be embalmed in the Hospital Morgue, or disposed off by
burning at a far off place, or in an electric crematorium, or by burying it
under the sea-bed.
The Authors of this Article express the fond hope and a fervent and ardent
desire that all the precautions for the safety of the Doctors, the Prosectors,
the Radioactive Safety Officers, the Safety Officers, the Pathologists, the
Hospital Nursing Staff, the GDA Staff and the General Public are diligently,
religiously, studiously, devotedly and hygienically performed, observed,
followed, practised implemented and executed.
Written By: Navin Kumar Jaggi and Gurmeet Singh Jaggi