Radiation protection management for the deceased patients in a nuclear medicine.Part 2: crematorium staff

In France, in 2007 and 2008, a few deaths occurred among patients who had recently undergone nuclear medicine treatments. Following these events, since there were few guidelines, the French Institute for Radiation Protection and Nuclear Safety (IRSN) investigated radiation protection measures applicable for cremation after the death of such patients. An initial study conducted between 2008 and 2014 was updated in 2022 to account for new clinically introduced radionuclides. This article consolidates these efforts to provide a comprehensive overview of operational guidelines for crematorium staff. Dose assessments were performed using conservative assumptions based on visits in several crematoriums. Radionuclides were classified according to estimated doses per cremation: above 1 mSv, between 300 µSv and 1 mSv, and below 300 µSv. Only iodine-131-MIBG (metaiodobenzylguanidine) fell into the first category and only in two specific situations: operator for fume filtration system maintenance, and office staff located next to the fume filtration systems or to the drum storage area. The second category included iodine-131-NaI for thyroid cancer treatment, therapeutic indium-111-pentetreotide and actinium-225. Finally, practical recommendations were proposed to reduce radiation doses for crematorium staff to below 300 µSv.