EN ISO 20031:2022

SLOVENSKI STANDARD
01-september-2022
Radiološka zaščita - Nadzorovanje in dozimetrija notranje izpostavljenosti zaradi
kontaminacije rane z radionuklidi (ISO 20031:2020)
Radiological protection - Monitoring and dosimetry for internal exposures due to wound
contamination with radionuclides (ISO 20031:2020)
Strahlenschutz - Überwachung und Dosimetrie für innere Expositionen aufgrund von
Wundkontaminationen mit Radionukliden (ISO 20031:2020)
Radioprotection - Surveillance et dosimétrie en cas d'exposition interne due à la
contamination d'une plaie par radionucléides (ISO 20031:2020)
Ta slovenski standard je istoveten z: EN ISO 20031:2022
ICS:
13.280 Varstvo pred sevanjem Radiation protection
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

EN ISO 20031
EUROPEAN STANDARD
NORME EUROPÉENNE
August 2022
EUROPÄISCHE NORM
ICS 13.280
English Version
Radiological protection - Monitoring and dosimetry for
internal exposures due to wound contamination with
radionuclides (ISO 20031:2020)
Radioprotection - Surveillance et dosimétrie en cas Strahlenschutz - Überwachung und Dosimetrie für
d'exposition interne due à la contamination d'une plaie innere Expositionen aufgrund von
par radionucléides (ISO 20031:2020) Wundkontaminationen mit Radionukliden (ISO
20031:2020)
This European Standard was approved by CEN on 24 July 2022.

CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this
European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references
concerning such national standards may be obtained on application to the CEN-CENELEC Management Centre or to any CEN
member.
This European Standard exists in three official versions (English, French, German). A version in any other language made by
translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management
Centre has the same status as the official versions.

CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia,
Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway,
Poland, Portugal, Republic of North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Türkiye and
United Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION

EUROPÄISCHES KOMITEE FÜR NORMUNG

CEN-CENELEC Management Centre: Rue de la Science 23, B-1040 Brussels
© 2022 CEN All rights of exploitation in any form and by any means reserved Ref. No. EN ISO 20031:2022 E
worldwide for CEN national Members.

Contents Page
European foreword . 3
Annex H (informative)  A-deviations . 4

European foreword
The text of ISO 20031:2020 has been prepared by Technical Committee ISO/TC 85 "Nuclear energy,
nuclear technologies, and radiological protection” of the International Organization for Standardization
(ISO) and has been taken over as EN ISO 20031:2022 by Technical Committee CEN/TC 430 “Nuclear
energy, nuclear technologies, and radiological protection” the secretariat of which is held by AFNOR.
This European Standard shall be given the status of a national standard, either by publication of an
identical text or by endorsement, at the latest by February 2023, and conflicting national standards
shall be withdrawn at the latest by February 2023.
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. CEN shall not be held responsible for identifying any or all such patent rights.
Any feedback and questions on this document should be directed to the users’ national standards body.
A complete listing of these bodies can be found on the CEN website.
According to the CEN-CENELEC Internal Regulations, the national standards organizations of the
following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria,
Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland,
Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Republic of
North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Türkiye and the
United Kingdom.
Endorsement notice
The text of ISO 20031:2020 has been approved by CEN as EN ISO 20031:2022 without any modification.
Annex H
(informative)
A-deviations
A-deviation: National deviation due to regulations, the alteration of which is for the time being
outside the competence of the CEN-CENELEC national member.
This European Standard does not fall under any Directive/Regulation of the EU.
In the relevant CEN-CENELEC countries, these A-deviations are valid instead of the respective
provisions of the European Standard until the national situation causing the A-deviation has
changed.
Clause Deviation
General Germany
Incorporation monitoring in Germany is legally regulated by the German
Guidelines on physical radiation protection control for determination of
the body dose part 2: Determination of the body dose of internal
exposition (incorporation monitoring) of January 12, 2007.

Regarding the measurements and the quality control described in this
standard shall comply with the guideline on physical radiation protection
control for determination of the body dose part 2: Determination of the
body dose of internal exposition (incorporation monitoring) of January 12,
9.5 Germany
Measurement uncertainties as described in this clause are legally not
taken into account in Germany.

INTERNATIONAL ISO
STANDARD 20031
First edition
2020-02
Radiological protection — Monitoring
and dosimetry for internal exposures
due to wound contamination with
radionuclides
Radioprotection — Surveillance et dosimétrie en cas d'exposition
interne due à la contamination d'une plaie par radionucléides
Reference number
ISO 20031:2020(E)
©
ISO 2020
ISO 20031:2020(E)
© ISO 2020
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting
on the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address
below or ISO’s member body in the country of the requester.
ISO copyright office
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Phone: +41 22 749 01 11
Fax: +41 22 749 09 47
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii © ISO 2020 – All rights reserved

ISO 20031:2020(E)
Contents Page
Foreword .v
Introduction .vi
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Symbols and abbreviated terms . 5
4.1 Symbols . 5
4.2 Abbreviated terms . 5
5 Purpose and need for special monitoring programmes for internal exposures due
to wound contamination with radionuclides . 5
6 General aspects of wound contamination . 6
6.1 Introduction . 6
6.2 Category of wound contaminants . 6
6.3 Types of wounds and their specific retention of radionuclides. 7
7 Monitoring programmes to assess contamination via a wound . 7
7.1 Introduction . 7
7.2 Main steps for the monitoring and dosimetry for internal exposures due to wound
contamination with radionuclides . 7
7.3 Collection of information to characterize the contaminated wound . 8
7.3.1 General. 8
7.3.2 Information concerning the type of wound . . 9
7.3.3 Information concerning the radioactive contaminant . 9
7.4 In vivo wound measurements . 9
7.5 Systemic activity monitoring .10
8 Performance criteria for radiobioassay measurements .11
9 Procedure for local and systemic dose assessment .11
9.1 Local (wound site) dose assessment .11
9.2 Systemic dose assessment .11
9.3 Impact of medical intervention on dose assessment .13
9.3.1 Local chelation therapy and/or the excision of contaminated tissue from
the wound .13
9.3.2 Decorporation therapy .13
9.4 Software tools for bioassay data interpretation .13
9.5 Uncertainties .14
9.5.1 General.14
9.5.2 Uncertainties on local dose assessment .14
9.5.3 Uncertainties on internal dose assessment .14
9.6 Quality assurance.14
10 Recording .15
10.1 Recording in vivo measurement results.15
10.2 Recording in vitro radiobioassay and treatment waste results .15
11 Documentation of the dose assessment .16
12 Reporting .16
Annex A (informative) Schematic representation of NCRP wound model, default
parameters for retention equations and default transfer rates for the wound
model for the various categories of radionuclides in wounds (adapted from NCRP
[3]
report 156 (2007) ) .17
Annex B (informative) Types of wounds and their specific retention of radionuclides .20
ISO 20031:2020(E)
Annex C (informative) Example of a summary sheet that should follow the contaminated
worker during his initial care .23
Annex D (informative) Overview of typical methods used for in vitro bioassay measurements .24
−1 −1
Annex E (informative) Equivalent dose rate in a contaminated wound (mSv·h ·kBq )
−1 −1 2
and equivalent dose rate received by the skin (mSv·h ·kBq ·cm ) for selected
radionuclides .25
Annex F (informative) Committed effective dose coefficients for intake of selected
radionuclides via a contaminated wound for all wound model categories (adapted
[11]
from Toohey RE et al., 2014 ) .27
[14]
Annex G (informative) The IDEAS Guidelines provide guidelines for the estimation of
committed doses from incorporation monitoring data in case of wound .30
Bibliography .31
iv © ISO 2020 – All rights reserved

ISO 20031:2020(E)
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out
through ISO technical committees. Each member body interested in a subject for which a technical
committee has been established has the right to be represented on that committee. International
organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.
ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of
electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are
described in the ISO/IEC Directives, Part 1. In particular the different approval criteria needed for the
different types of ISO documents should be noted. This document was drafted in accordance with the
editorial rules of the ISO/IEC Directives, Part 2 (see www .iso .org/ directives).
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of
any patent rights identified during the development of the document will be in the Introduction and/or
on the ISO list of patent declarations received (see www .iso .org/ patents).
Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.
For an explanation on the voluntary nature of standards, the meaning of ISO specific terms and
expressions related to conformity assessment, as well as information about ISO's adherence to the
World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT) see the following
URL: www .iso .org/ iso/ foreword .html.
This document was prepared by Technical Committee ISO/TC 85, Nuclear energy, nuclear technologies,
and radiological protection, Subcommittee SC 2, Radiological protection.
ISO 20031:2020(E)
Introduction
In the course of their employment, radiation workers may be exposed to radioactive materials that
could be incorporated into the body. Intakes of radionuclides need to be monitored to determine that
any exposures are at expected levels. Internal doses resulting from intakes of radionuclides cannot be
measured directly. Estimating the dose requires decisions to be made about the monitoring techniques
and frequencies along with methodologies for dose assessment. The criteria governing the regimes of
such a monitoring programme or for the selection of methods and frequencies of monitoring usually
depends upon regulations, the purpose of the radiation protection programme, the probabilities of
potential radionuclide intakes, and the characteristics of the materials handled.
[1]
For these reasons, ISO standards for monitoring programmes (ISO 20553 ), laboratory requirements
[2]
(ISO 28218), and dose assessment (ISO 27048 ) have been developed and can be applied to many
workplaces where internal contamination may occur. Their application for internal exposures due to
wound contamination with radionuclides requires account to be taken of special aspects resulting from
the type of wound and the associated specific biokinetics of radionuclides at the origin of contamination.
This document offers guidance for the design of a special monitoring programme and for dose
assessment in the case of wound contamination with radionuclides. Recommendations of international
expert bodies and international experience with the practical application of these recommendations
in radiological protection programmes have been considered in the development of this document. Its
application facilitates the exchange of information between authorities, supervisory institutions and
employers.
vi © ISO 2020 – All rights reserved

INTERNATIONAL STANDARD ISO 20031:2020(E)
Radiological protection — Monitoring and dosimetry for
internal exposures due to wound contamination with
radionuclides
1 Scope
This document specifies the requirements for personal contamination monitoring and dose assessment
following wounds involving radioactive materials. It includes requirements for the direct monitoring
at the wound site, monitoring of uptake of radionuclides into the body and assessment of local and
systemic doses following the wound event.
It does not address:
— details of monitoring and assessment methods for specific radionuclides;
— monitoring and dose assessment for materials in contact with intact skin or pre-existing wounds,
including hot particles;
— therapeutic protocols. However, the responsible entity needs to address the requirements for
decontamination and decorporation treatments if appropriate.
2 Normative references
The following documents are referred to in the text in such a way that some or all of their content
constitutes requirements of this document. For dated references, only the edition cited applies. For
undated references, the latest edition of the referenced document (including any amendments) applies.
ISO 5725-1, Accuracy (trueness and precision) of measurement methods and results — Part 1: General
principles and definitions
ISO 5725-2, Accuracy (trueness and precision) of measurement methods and results — Part 2: Basic method
for the determination of repeatability and reproducibility of a standard measurement method
ISO 5725-3, Accuracy (trueness and precision) of measurement methods and results — Part 3: Intermediate
measures of the precision of a standard measurement method
ISO 28218, Radiation protection — Performance criteria for radiobioassay
ISO/IEC Guide 99, International vocabulary of metrology — Basic and general concepts and associated
terms (VIM)
3 Terms and definitions
For the purposes of this document, the terms and definitions given in ISO/IEC Guide 99, ISO 5725-1,
ISO 5725-2, ISO 5725-3 and the following apply.
ISO and IEC maintain terminological databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at http:// www .electropedia .org/
ISO 20031:2020(E)
3.1
absorption
movement of material into blood regardless of mechanism, generally applied to the uptake (3.32) into
blood of soluble substances and material dissociated from particles
3.2
activity
number of spontaneous nuclear disintegrations per unit time
Note 1 to entry: The activity is stated in becquerels (Bq), i.e. the number of disintegrations per second.
3.3
biokinetic model
model describing the time course of absorption (3.1), distribution, metabolism and excretion of a
substance introduced into the body of an organism
3.4
clearance
net effect of the biological processes by which radionuclides are removed from the body or from a
tissue, organ or region of the body
3.5
contamination
activity (3.2) of radionuclides present on surfaces, or within solids, liquids or gases (including the
human body), where the presence of such radioactive material is unintended or undesirable
3.6
decision threshold
value of the estimator of the measurand which, when exceeded by the result of an actual measurement
using a given measurement procedure of a measurand quantifying a physical effect or quantity, it is
decided that the physical effect or quantity is present
Note 1 to entry: Otherwise, this effect is assumed to be absent.
3.7
decontamination
complete or partial removal of radioactive contamination (3.5) by a deliberate physical, chemical, or
biological process
3.8
decorporation
method aiming to accelerate the elimination from the body of an incorporated radionuclide
3.9
detection limit
smallest true value of the measurand which ensures a specified probability of being detectable by the
measurement procedure
Note 1 to entry: With the decision threshold, the detection limit is the smallest true value of the measurand for
which the probability of wrongly deciding that the true value of the measurand is zero is equal to a specified
value, β, when, in fact, the true value of the measurand is not zero. The probability of being detectable is
consequently (1 − β).
Note 2 to entry: The terms detection limit and decision threshold are used in an ambiguous way in different
standards (e.g. standards related to chemical analysis or quality assurance). If these terms are referred to one
has to state according to which standard they are used.
3.10
dose coefficient
committed tissue equivalent dose per unit acute intake h (τ) or committed effective dose per unit acute
T
intake e(τ), where τ is the time period in years over which the dose is calculated [e.g. e(50)]
2 © ISO 2020 – All rights reserved

ISO 20031:2020(E)
3.11
effective dose
sum of weighted equivalent doses (3.13) in all tissues and organs of the body
3.12
committed effective dose
sum of the products of the committed organ or tissue equivalent doses and the appropriate tissue
weighting factors
Note 1 to entry: In the context of this document, the integration time is 50 years following any intake.
3.13
equivalent dose
product of the absorbed dose and the radiation weighting factor for the specific radiations at this point
3.14
local dose
equivalent dose (3.13) in a defined volume or area at the wound site
3.15
systemic dose
committed effective dose (3.12) excluding the local dose at the wound site
3.16
event
any unintended occurrence, including operating error, equipment failure or other mishap, the
consequences or potential consequences of which are not or suspected not to be negligible from the
point of view of protection or safety
3.17
internal exposure
exposure to radiation from a source inside the body
3.18
intake
act or process of taking radionuclides into the body by inhalation, ingestion, absorption (3.1)
through the skin or through wounds
3.19
monitoring
measurements made for the purpose of assessment or control of exposure to radioactive material and
the interpretation of the results of such measurements
3.20
incorporation monitoring
monitoring (3.19) of radionuclides incorporated into the bodies of individual workers by measurement
of the quantities of radioactive materials in the bodies of individual workers, or by measurement of
radioactive material excreted by individual workers
3.21
individual monitoring
monitoring (3.19) by means of equipment worn by individual workers, by measurement of the quantities
of radioactive materials in or on the bodies of individual workers, or by measurement of radioactive
material excreted by individual workers
3.22
special monitoring programme
monitoring programme performed to quantify significant exposures following actual or suspected
abnormal events (3.16)
ISO 20031:2020(E)
3.23
quality assurance
planned systematic actions necessary to provide adequate confidence that a process, measurement or
service satisfy given requirements for quality such as those specified in a licence
3.24
quality control
part of quality assurance (3.23) intended to verify that systems and components correspond to
predetermined requirements
3.25
radiobioassay
procedure used to determine the nature, activity (3.2), location or retention of radionuclides in the body
by direct (in vivo) measurement or by indirect (in vitro) analysis of material excreted or otherwise
removed from the body
3.26
in vitro radiobioassay measurement
analyses that include measurements of radioactivity present in biological samples taken from an
individual
3.27
in vivo radiobioassay measurement
measurement of radioactive material in the human body utilizing instrumentation that detects
radiation emitted from the radioactive material in the body
Note 1 to entry: Normally, the measurement devices are whole-body or partial-body (e.g., lung, thyroid) counters.
3.28
responsible entity
person, body or service that is in charge of the monitoring (3.19) and dosimetry
3.29
retention function
function describing the fraction of an intake present in a biological compartment (whole body, tissue,
organ or excreta) after a given time has elapsed since the intake occurred
3.30
time of measurement
time at which the biological sample (e.g. urine, faeces) is taken from the individual
concerned
3.31
time of measurement
time at which the in vivo measurement begins
3.32
uptake
translocation of material from deposition site [wound (3.33), lung, etc.] into blood and subsequently to
systemic organs and tissues
3.33
wound
injury to the body in which the skin or other tissue is broken, cut, pierced, torn, scraped, burned, etc.
4 © ISO 2020 – All rights reserved

ISO 20031:2020(E)
4 Symbols and abbreviated terms
4.1 Symbols
A activity (Bq)
measured activities (Bq)
H equivalent dose to skin (Sv)
−1

equivalent dose rate to skin (Sv·h )
H
E(50) committed effective dose integrated over 50 years (Sv)
e(50) dose coefficient: committed effective dose integrated over 50 years per unit intake,
−1
E(50)/I (Sv·Bq )
−λt
f(t) function describing the decay of a radionuclide, e
I intake (Bq)
m(t) predicted fraction of the measured quantity at time t for unit intake (excretion or retention
function at time t per unit intake)
4.2 Abbreviated terms
CIS Colloid and Intermediate State
DTPA Diethylenetriaminepentaacetic acid (Zn and Ca salts)
IAEA International Atomic Energy Agency
ICP-MS Inductively Coupled Plasma Mass Spectrometry
ICRP International Commission on Radiological Protection
ICRU International Commission on Radiation Units and Measurements
NCRP National Council on Radiation Protection and Measurements
PABS Particles, Aggregates and Bound State
TPA Trapped Particles and Aggregates.
5 Purpose and need for special monitoring programmes for internal exposures
due to wound contamination with radionuclides
Under normal circumstances, workers should not have wounds. There is thus no requirement for
[1]
routine monitoring, as defined in ISO 20553 , for intakes of radioactive materials from wound events.
However, accidents leading to wounds are an occupational hazard in nearly all workplace situations.
The risks of accidents can be much higher in situations where manual tasks such as cutting, machining
and drilling or medical injection of radioisotopes are taking place. Thus there is a potential need for
special monitoring following wound events.
The aims of monitoring and dose assessment are to aid in decisions regarding decontamination and
treatment such as irrigating with water/saline, excision of the wound or decorporation therapy, to
assess health consequences, and to ensure compliance with dose limits. For radionuclides that are
highly retained by the body when absorbed through a wound but poorly absorbed through other intake
ISO 20031:2020(E)
routes, significant doses can be received when compared to the inhalation or ingestion of similar
amounts.
Accidents, and thus wound events, can occur at any time. As part of the internal dosimetry programme,
the responsible entity shall:
a) consider the possible types of wounds (e.g., puncture wounds, lacerated skin) and contaminants
(e.g., involved radionuclides, chemical species) in specific work environments;
b) design appropriate special monitoring programmes for these wound events;
c) make arrangements in the special monitoring programme for the measurement methods to be
available on demand if a wound event should occur.
The special monitoring programme shall set a target to be able to detect a minimum committed
effective dose following a wound event. It is recommended that target not exceed 1 mSv if technically
feasible.
The responsible entity shall define the circumstances under which special monitoring is to be initiated.
The sorts of circumstances which might lead to special monitoring include:
— wounds occurring or identified in designated contamination areas;
— wounds from contaminated objects.
6 General aspects of wound contamination
6.1 Introduction
Wounds act as routes by which radionuclides can enter the systemic circulation. While some of the
material can be retained at the wound site, soluble material can be transferred to the blood and
hence to other parts of the body. Insoluble material can be slowly translocated to regional lymphatic
tissue, where it can gradually dissolve and eventually enter the blood. A variable fraction of insoluble
material can be retained at the wound site or in lymphatic tissue for the life of the individual. Thus,
a contaminated wound can result in an acute intake or a chronic uptake. The National Council on
Radiation Protection and Measurements (NCRP) developed a compartment-based biokinetic model
[3]
for wounds (NCRP Report 156 ), in order to assess internal exposure resulting from a contaminated
wound. The NCRP wound model is a compartmental model that deals with material at the wound site
and transfer to blood. This wound model has to be coupled with the appropriate ICRP systemic model
to assess exposure due to radionuclides entering the body through a wound. This document uses this
system to assess internal exposure due to a contaminated wound.
The NCRP wound model has seven compartments: fragment; particles, aggregates and bound state
(PABS); trapped particles and aggregates (TPA); colloid and intermediate state (CIS); soluble; lymph
nodes; and blood (see Figure A.1). The applicable compartments depend on the category of contaminant
to be considered for a particular wound case.
6.2 Category of wound contaminants
[3]
Seven retention categories of wound contaminants are defined in the NCRP wound model . Four of
these categories describe the retention at the wound site of radionuclides injected in soluble form.
Solutions can be weakly, moderately, strongly or avidly retained, in order of increasing retention half-
time. Soluble wound contaminants can translocate to the blood with a time course that depends on
their dissolution rate in vivo.
Three additional categories are considered to describe the behaviour of radioactive material introduced
into a wound in colloidal, particulate or fragment form. Both particles and fragments are solids. They
differ in that fragments are too large to be ingested by connective tissue macrophages because their size
is greater than 100 µm in any dimension. As opposed to soluble compounds, colloids and solids with low
6 © ISO 2020 – All rights reserved

ISO 20031:2020(E)
solubility can have significant clearance from the wound site to the lymph nodes. Furthermore, due to
the presence at the wound site of significant masses of materials, inflammatory reactions can occur in
the wound tissue, leading to biological sequestration and capsule formation. These phenomena provide
a biological barrier that entrap colloids, particles and fragments at the wound site. Default parameters
for equations describing the retention at the wound site for the seven retention categories are detailed
in Table A.1.
Radionuclides that are initially in a solution and are injected subcutaneously or intramuscularly can
enter the blood directly from the soluble compartment. Wound contamination with a radioactive
material is simulated through a direct deposition in the CIS compartment if a colloidal form is
considered, through a direct injection in the PABS compartment if a particulate form is considered, and
through a direct deposition in the fragment compartment if fragments are considered. Default transfer
rates between compartments in the wound model for the various categories of radionuclides in wounds
are detailed in Table A.2.
6.3 Types of wounds and their specific retention of radionuclides
The NCRP wound model does not differentiate between the different types of contaminated wounds,
for example between puncture wounds and abrasions, because of a lack of relevant data. All
contaminated wounds are assumed to be direct injection or direct deposition of radioactive material
into a compartment of the wound model. Biokinetics of a given physicochemical form of radionuclide
incorporated through contaminated wound depends largely on the type of wound and its physiological
evolution (e.g., healing). Based on existing literature, it may be assumed that, in general, absorption of
a given soluble radionuclide from wounds or skin contamination is in the order (from greatest to least):
[3]
intravenous injection > puncture wound ≈ laceration ≈ abrasion > burned skin ≥ intact skin . Types of
wounds and their characteristic retention of radionuclides are detailed in Annex B.
7 Monitoring programmes to assess contamination via a wound
7.1 Introduction
Monitoring depends on the type of wound as well as the category of wound contaminant and the
biokinetics and physical decay properties of the radionuclide. A contaminated wound can result in
an acute uptake and/or in a chronic uptake decreasing or increasing with time. Thus the monitoring
program may need to be adapted with time following the wound event. If medical treatment is
implemented, it should be taken into account when designing the monitoring program.
In the case of a contaminated wound or a wound suspected to be contaminated, a special monitoring
[1]
programme shall be implemented, as described in ISO 20553 . This special monitoring programme
shall include measurements of local activity of the wound. In vivo and/or in vitro measurements shall
be used to detect and quantify systemic contamination. In order to implement a special monitoring
programme, information is required on the wound event, including identification of radionuclides
present in the workplace.
7.2 Main steps for the monitoring and dosimetry for internal exposures due to wound
contamination with radionuclides
Medical treatment of any serious injuries should take priority over dealing with radiological aspects of the
contaminated wound. The sequence of actions in dealing with a potentially contaminated wound are to:
— collect information concerning the type of wound and the type of contaminant;
— assess the level of contamination of the wound;
— implement decontamination treatment, decorporation treatment and excision treatment as
necessary.
ISO 20031:2020(E)
Figure 1 summarises the main steps for monitoring and dosimetry of internal exposures due to wound
contamination with radionuclides. These steps are discussed in more detail in the next clauses of this
document.
Figure 1 — Proposed response to a contaminated wound
7.3 Collection of information to characterize the contaminated wound
7.3.1 General
The special monitoring programme shall take into account the characteristics of the contaminated
wound (type of wound, involved radionuclide(s), chemical species of radionuclide(s), radionuclide
activity, surface area of the contaminated wound, depth of the contaminated wound). The collection of
information should be proportionate to the potential dose consequences of the wound event.
Whatever the type of radiological contamination, medical management shall take priority over
[4]
radiological assessment . It may be necessary to consider protection of responders and medical
personnel during the handling of contaminated items. Multiple participants may be involved during
this phase of initial care of a contaminated wound, including radiation protection, medical, internal
dosimetry and in some extent operational personnel. Data of interest concerning the wound case should
be collected by all these participants. To facilitate data collection, a summary sheet should follow
8 © ISO 2020 – All rights reserved

ISO 20031:2020(E)
the contaminated worker during its transfer from one department to another. An example of such a
summary sheet is presented in Annex C.
7.3.2 Information concerning the type of wound
Information regarding the type of wound is important for monitoring and dose assessment of workers
in case of a wound involving radioactive materials.
The type of wound should be described in as much detail as possible in order to categorise it into one of
the categories described in 6.3.
The following information should be recorded if available:
— for puncture wounds, location, depth and diameter of the puncture;
— for lacerated skin or abraded skin, location, depth and contaminated surface area of the wound;
— for thermally-burned skin, location, grade, contaminated surface area of the burn and type of
material involved in the burn (e.g., cotton, polyester, other workplace materials, etc.);
— for chemical-burned skin, the type and concentration of the chemical that induced the burn, location,
grade, contaminated surface area and type of material involved in the burn (e.g., cotton, polyester,
other workplace materials, etc.).
Whatever the type of wound, the presence and abundance of bleeding should be recorded. Apart from
the haemorrhagic risk, bleeding has a mechanical action which tends to remove the radioactive material
present at the wound site.
7.3.3 Information concerning the radioactive contaminant
If assessment of the dose is required, information concerning the radioactive contaminant should
be described in as much detail as possible in order to determine which category of contaminant, as
described in 6.2, along with associated parameters, is most appropriate.
Details of the radionuclides at the origin of the radioactive contamination should be collected. The
following information should also be collected if available:
— the chemical species;
— for liquids: concentration and total activity of radionuclide(s); chemical form and concentration of
the carrier;
— for solids: granulometry/size of particles/fragments and total activity of radionuclide(s);
— for vapours or gases: total activity of radionuclide(s).
If a contaminated object caused the wound, the radionuclides present on the object should be identified
and their activity measured.
If the wound is surgically excised, any excised tissue and treatment wastes (e.g., compresses) shall be
analysed for radioactivity. In case of a bleedin
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