Hospitals threatened by theft of radiological material

Wanted for use in 'dirty bombs,' valuable material invites crime, violence

By Greg Freeman

The Government Accountability Office (GAO) recently issued a warning to hospitals about the risk of the theft of radiological materials, which could be used to make a dirty bomb. Experts caution that the presence of radiological materials in a hospital brings a significant obligation to provide security.

Nearly four out of five hospitals across the country have failed to put in place safeguards to secure radiological material that could be used in a dirty bomb, according to the report, which identifies more than 1,500 hospitals as having high-risk radiological sources. Only 321 of these medical facilities have set up security upgrades, according to the GAO review, which found some surprising lapses of security in 26 hospitals.

At one facility, a device containing potentially lethal radioactive cesium was stored behind a door with a combination lock. The combination was written on the door frame.

The National Nuclear Security Administration spent $105 million to complete security upgrades at 321 of more than 1,500 hospitals and medical facilities that were identified as having high-risk radiological sources, the report says. The upgrades include security cameras, iris scanners, motion detectors, and tamper alarms.

While it is not known that terrorists have stolen radiological material from hospitals, there have been suspected incidences of "probing" in which criminals seek to determine a hospital's security weaknesses. A series of incidents in 2005, in which people posed as inspectors from The Joint Commission to gain access, was attributed to terrorists planning attacks on hospitals, looking for radiological material, and assessing hospitals' capacity for emergency response.

Hospitals' ability to protect radiological material is likely to vary greatly, says Bryan Warren, CHPA, senior manager for corporate security at Carolinas Healthcare System in Charlotte, NC, and president of the International Association for Healthcare Security and Safety in Glendale Heights, IL. Larger hospitals with a robust security program probably have policies and procedures in place that will at least make radiological theft difficult, he says. "But if the plant operations and maintenance people are handling security, they are likely not even aware of the issue, much less acting in a proactive way to protect this material," Warren says. "Unfortunately, being a smaller hospital does not mean you won't have radiological material."

Help is available

Hospitals can improve their radiological security by working with the Global Threat Reduction Initiative (GTRI) in the federal Office of Defense Nuclear Nonproliferation, Warren says. GTRI helps identify, secure, remove, and/or facilitate the disposition of high risk vulnerable nuclear and radiological materials around the world that pose a threat to the United States and the international community. (For information on contacting GTRI, see the resource at the end of this article.)

"GTRI has been working with hospitals for a number of years to help protect any kind of radiological materials so that the bad guys can't get it and turn it into a dirty bomb," Warren says. "Once hospitals are aware of it, they can get a preliminary analysis of their infrastructure to see if they have enough radiological source material to pose a threat, and what they can get through this federally funded program to protect it."

Once a hospital requests assistance, GTRI sends a survey team to a site assessment concerning radiological materials, Warren explains. Most of the resources and assistance are provided at no charge to the hospital. The free aid can include surveillance equipment and other physical improvements to security.

"They also will train your staff and first responders from your local jurisdiction," Warren says. "They will pay for everything to send you to Oak Ridge, TN, for some very intensive training to mitigate the risk at your facility."

More than just high-grade at risk

The GAO report was not surprising to Zachary Goldfarb, EMT-P, CHSP, CHEP, CEM, principal with Incident Management Solutions, a company in Uniondale, NY, that helps hospitals and other organizations prepare for and respond to emergencies. Radiological material in hospitals has been a primary concern for homeland security professionals after the 2001 terrorist attacks, Goldfarb says.

Hospital risk managers should realize that terrorists might be interested not only in high-grade radiological material such as cobalt, Goldfarb says. That type of material is found in fewer facilities, but many hospitals have less radioactive substances that still could be a target, he says.

"For years we've been building scenarios that involve mixing low-level radioactive source material, like medical waste, with a bomb," Goldfarb says. "The real objective of a dirty bomb could be accomplished with low-level medical waste because if any radiation, even at a very low level, were detected after an explosion, it would be the first time for this country. It would create the intended effect of scaring the daylights out of many, many people."

Sources/ Resources

Bryan Warren, CHPA, Senior Manager for Corporate Security, Carolinas Healthcare System, Charlotte, NC. Telephone: (704) 512-7744. Email:

Zachary Goldfarb, EMT-P, CHSP, CHEP, CEM, Principal, Incident Management Solutions, Uniondale, NY. Telephone: (516) 390-4670. E-mail:

For more information on Global Threat Reduction Initiative (GTRI), go to To apply for assistance from GTRI, go to