The Goiânia incident, the semiotics of danger, and the next 10,000 years.

In September 1987, two men in Goiânia, Brazil, discovered an abandoned international standard capsule containing less than 100 g of cesium-137 chloride. The material was unguarded, and the warning systems were inadequate and inscrutable. The men took the capsule and sold it for scrap, and within days the city would be contaminated with highly radioactive material. Within weeks, 112,000 individuals would be screened for radioactive contamination, 249 would be exposed to radioactive materials, 46 would receive medical treatment for radioactive contamination, and four would die from acute radiation sickness. The citywide radioactive contamination occurred, in part, due to arbitrary and unfamiliar written warning systems. The individuals who discovered the cesium-137 capsule were illiterate and unfamiliar with the radiation trefoil logo, which was first used in 1946 in California, United States of America. As a result, written language and visual symbols were useless warnings against the dangerous contents of the capsule. Cesium-137 enters the body through ingestion or inhalation. This isotope emits beta and gamma radiation, both forms of ionizing radiation which damage living tissues. The radiation dose lethal to 50% of an exposed population within 60 days (LD50/60) is approximately 3.5 to 4 Gray (Gy) without medical intervention. However, this dose increases to around 6-7 Gy when medical support is provided, which typically includes antibiotics, blood transfusions, granulocyte-macrophage colony-stimulating factor, and Prussian blue. Prussian blue binds to cesium, thereby facilitating its elimination from the body. The radiological disaster in Goiânia was due in large part to the failures of various agencies to warn of danger and minimize access to radioactive material. Barriers to risk communication included a lack of a universal semiotic language regarding radioactive hazards, which was compounded by the illiteracy of the scrappers and their inability to recognize the radioactivity warning trefoil. There is no society in which every member understands written language or recognizes every symbol. Given that the teletherapy unit was abandoned in an urban environment, there were no administrative or engineering controls in place to prevent human beings from becoming exposed to radioactive material. As little as 100 g of highly radioactive material, such as cesium-137, may lead to massive environmental contamination, fatalities and permanent disability due to acute radiation sickness, wreak havoc, and disrupt society on a scale that is challenging for public health officials to manage. Thousands of tons of radioactive materials from the waste products of nuclear weapons and power plant manufacture will have to be stored for at least 100,000 years to prevent danger to human life and society. Public health officials and governments must build systems to keep humans safe and physically isolated from these radioactive materials for as long as possible.