FAQ - Questions about public health issues related to the Polonium-210 incident
General Questions
What is the level of risk from Polonium-210?
Polonium-210 can only represent a radiation hazard if it is taken into the body - by breathing it in, by taking it into the mouth, or if it gets into a wound. It is not a radiological hazard as long as it remains outside the body. Most traces of it can be eliminated through hand-washing, or washing machine and dishwasher cycles for clothes, plates etc. In the limited public areas where contamination has been found, this has been in small spots, where it is fixed and not easily transferred to hands or clothes.
It is important to remember that very small amounts of Po-210 occur naturally within the environment, in the air we breathe and the food we eat. It is also present in cigarettes. Everybody has low levels of Po-210 in their bodies which are not harmful to health.
Is the level of risk to the general public still low, despite the seven workers in the Pine Bar who were confirmed as having levels of polonium-210?
Our assessment of the risk to the general public remains unchanged - these seven people were identified for testing as they came into closer proximity with Mr.Litvinenko so are not in the same low risk category as other members of the general public. It is important to remember that Po-210 only represents a radiation hazard if it is taken into the body - by breathing it in, by taking it into the mouth, or if it gets into a wound. It is not a radiological hazard as long as it remains outside the body. Most traces of it can be eliminated through handwashing, or washing machine and dishwasher cycles for clothes, plates etc.
How might I be affected by the Polonium-210 involved in this incident?
On the basis of the monitoring results received so far from a range of sites we believe that the risk to the general public of having been exposed to Po-210 is likely to be very low.
If Po-210 is present in the environment, it would need to enter people's bodies to give them a radiation dose, again through ingestion, inhalation or through wound entry. Any people who may have inadvertently ingested or inhaled Po-210 will not present a hazard to other people nearby
Is it safe to travel on public transport in London ?
On the basis of the monitoring results received so far from a number of locations in London as part of the on-going Po-210 investigations, the Health Protection Agency can reassure members of the public that the risk of having been exposed to Po-210 remains low. In the limited public areas where contamination has been found, this has been in small spots, where it is fixed and not easily transferred to hands or clothes.
Therefore all the monitoring data indicates that if a person contaminated with Po-210 travelled on public transport the low transmissibility and the short amount of time someone would spend on public transport, there is no cause for public health concern.
Is anyone at increased risk from polonium-210 because of medical conditions, sex, age group, pregnancy and so on?
Checks on people who may have come into contact with Po-210 from this incident will identify the amounts of material in their body. This in turn can be used to assess what radiation dose they might be expected to receive. The assessment and the priority with which it is done will take account of any conditions, such as pregnancy and medical conditions that might affect their risk.
What should I do if I am worried that I have been contaminated?
If you were in the Pine Bar at the Millennium Hotel on either the 31 st October or the 1 st or 2 nd November, or the Itsu Sushi Bar on 1 st November you should contact NHS Direct on 0845 4647. You will be asked a number of simple questions to determine whether you are at risk of contamination. If there is a possibility that you have been at risk you will be asked to give a 24 hour urine sample.
Are you monitoring people for exposure with Geiger counters/whole body monitors/specialist equipment?
No, because it is not appropriate to do this. If an individual had been exposed, such equipment would not detect this. The only way to check for exposure is with a urine test. Because the levels are likely to be very low, samples have to be collected over a 24 hour period.
Questions for those whose urine is tested
What happens if I am asked to take a test?
You will be asked to provide a urine sample containing all the urine that you produce in a 24 hour period. This will then be tested and you will be contacted with the results by telephone. If we are unable to reach you by phone we will write to you with your results.
If I'm asked to give a sample, can I continue to live normally while I wait for the results of the tests?
Yes. It is unlikely that anyone will have ingested significant levels of Po-210. Even if you have, normal hygiene, such as washing hands after going to the toilet, will reduce the risk of spread of contamination.
What information will be obtained from the sample?
Measurements of your urine sample will enable us to determine whether any Po-210 has been taken into your body. If the measurement is positive, we will be able to calculate the radiation dose you will receive as a result and any treatment you might need to receive.
Can I continue to breastfeed?
The likelihood of significant transfer of Po-210 to the baby from the mother from exposure to contamination is very small and until proved otherwise normal breastfeeding should continue.
Questions on locations that are being tested
Were patients and staff at UCH and Barnet Hospital exposed to radiation?
There is no current or ongoing risk to hospital staff, visitors or patients. All areas in both hospitals were thoroughly checked for contamination and the HPA is satisfied that there is no contamination that would pose a public health risk. All areas are now open for normal activities and to the public and staff.
Public health follow up has identified some 76 health care workers as having been in close contact with Mr. Litvinenko, and as a precaution they were invited to provide urine samples for testing. Of the 76, 69 accepted the offer of urine tests and all were negative.
Are all branches of the sushi bars affected?
No. The only sushi bar affected is the Itsu branch at 167 Piccadilly, London
Have staff at the bars, restaurant and hotels been affected?
Of all the staff from the Itsu Sushi bar who were asked to provide samples, nothing of any concern was found.
Results received from seven members of staff from the Pine Bar at the Millennium Hotel show they have been exposed to low levels of Po-210. There is no risk to their health in the short term and in the long term the risk is judged to be very small on the basis of initial tests. All seven members of staff have taken in lower levels of Po-210 than the adult family member of Mr Litvinenko's family for whom tests also showed levels of exposure.
Following these test results it was felt prudent to assess any other staff working in the Pine Bar of the Millennium Hotel on October 31 st and November 2 nd . We are working with the hotel management to try and identify any other relevant staff. We also advised members of the public who were in the Pine Bar on 31 st October and 2 nd November (in addition to 1 st November) to contact NHS Direct on 0845 4647 who will pass their details onto the HPA for assessment.
A number of planes have been included in the police investigation - are passengers or staff who were on board those aircraft at risk?
The HPA has surveyed a number of planes on which people of interest to the police had travelled. Results of the monitoring carried out on these planes have been risk assessed - taking a precautionary approach to potential impact on public health.
Some remediation has been carried out for patches of activity found on planes, but levels have been appreciably lower than those found in many of the other venues. The levels of Po-210 found in the planes were not sufficient to have caused a public health concern for passengers, flight crew, cleaners or engineers that had been in these planes over recent weeks. If they had been exposed then the highest doses would only have been comparable to normal background radiation.
Is it safe to travel on the planes surveyed for Polonium-210?
Where radiation was found on planes it was at a much lower level than that found in the other venues surveyed by the Health Protection Agency. Consequently there is no risk to public health from travelling on these planes.
What is being done about removing contamination from the various sites?
The remediation work is being led by local authorities in London
Advice to relatives, friends and those who have been in close contact with people who have received positive test results
I live in the same household as someone who has a urine sample result showing elevated Polonium -210 levels. What is the risk to my health?
Normal social and household contact with people who may have elevated Polonium-210 levels in their urine are not a risk to others if good hygiene practices are followed. Only a tiny amount of Polonium -210 is excreted in body fluids and even then you would only be at risk of harm if you ingested the polonium-210.
Polonium-210 on the surface of the body can be removed by washing or by putting clothes through a normal cycle in a washing machine. Normal hygiene practices such as regular changes of clothes, washing dishes, cleaning toilets wearing rubber gloves and disposing of cloths afterwards will remove any residual contamination.
I work with someone who has a urine sample result showing elevated Polonium -210 levels. What is the risk to my health?
You are not at risk, if you work, or have social and household contact with people who may have elevated Polonium-210 levels in their urine. They are not a risk to others when normal hygiene practices are followed. You would only be at risk of harm from Polonium-210 if you have ingested it which is unlikely as only a tiny amount of it is excreted in body fluids.
Is it safe for staff to be at work now if they have a urine sample result showing elevated levels of Polonium -210? And if it is safe now did they previously present a risk to co-workers and customers previously?
They do not pose any risk and need not be absent from work for this reason. Co-workers and customers were and are not currently at risk. Work, social and household contacts with people who may have elevated Polonium-210 levels in their urine are not a risk to others if normal hygiene practices are followed. You would only be at risk if you have ingested it which is unlikely as only a tiny amount of it is excreted in body fluids.
Is it safe for people with elevated levels of Polonium -210 to prepare food and drink and was it safe for them to do so immediately after the radiation exposure?
People need not restrict their daily life including food preparation so long as good hygiene practice is followed.
Is it safe for people with elevated levels of Polonium -210 to mix with family and friends?
Social and household contact with people who may have elevated Polonium-210 levels in their urine is safe if normal hygiene practices are followed.
Do their family and friends need urine tests?
No, the risk of passing on the contamination is too small
Does sweat contain Polonium-210 and if so how much?
Yes, but at very low levels similar to or less than other body fluids. It is typically 10 times less than those found in urine.
How great is the risk of radiation in our surroundings normally?
People are exposed to radiation from a variety of natural sources all the time in normal life, an average annual radiation dose for most UK residents is 2.2 mSv. These naturally occurring sources include radon gas, cosmic radiation (from outer space), terrestrial gamma radiation from natural radioactivity in rocks such as granite and building materials such as gypsum. As a result, the normal annual radiation dose varies in different parts of the UK .
What are the chances of getting cancer?
We all carry a risk of dying of cancer of about 1 in 4. For every additional 1 mSv of radiation dose, for an average person, the lifetime fatal cancer risk rises, on average, 0.005%, increasing the risk for an average person from about 25% to 25.005%. A higher dose of 10 mSv would increase the lifetime fatal cancer risk from 25% to 25.05% and a dose of 100 mSv would only increase the risk from 25@ to 25.5%.
If the dose they were exposed to is the equivalent of several years of normal radiation dosage, does it matter if the dose was received in one go?
No, our risk assessment takes this into account The biological half-life (the time for the level of Polonium-210 in the body to fall by half) of Polonium-210 is approximately 50 days. So in less than a year the levels will have reduced by a factor of about 100. In two years it will be reduced by a factor of about 16,000, and so on.
What can be done to minimise the after-effects of any radiation exposure?
There are no specific antidotes for Polonium-210 ingestion. However, if you smoke, try to stop and follow other advice for a healthy lifestyle.
Is there a number or email address I can have for submitting further queries about radiation?
You can use the following email address: public.information@hpa.org.uk or you can contact NHS Direct on 0845 4647
Advice for Overseas visitors
What about people who have left the country since 1 November?
If you were in the Pine Bar at the Millennium Hotel on either the 31 st October or the 1 st or 2 nd November, or the Itsu Sushi Bar on 1 st November you should contact NHS Direct on 0845 4647. You will be asked a number of simple questions to determine whether you are at risk of contamination. If there is a possibility that you have been at risk you will be asked to give a 24 hour urine sample.
If people have concerns then they should contact NHS Direct on 0845 4647 or via the website www.nhsdirect.nhs.uk
Last reviewed: 9 December 2008
