Seminars in Diagnostic Pathology
Volume 26, Issue 1 , Pages 61-67 , February 2009

Death by Polonium-210: lessons learned from the murder of former Soviet spy Alexander Litvinenko

  • Robin B. McFee, DO, MPH, FACPM

      Affiliations

    • Long Island Regional Poison Information Center, Winthrop University Hospital, Mineola, New York
    • ,
  • Jerrold B. Leikin, MD, FACEP, FAACT, FACP, FACOEM, FACMT

      Affiliations

    • Department of Toxicology, Northshore University HealthSystem-OMEGA, Glenbrook Hospital, Glenview, Illinois
    • Corresponding Author InformationAddress reprint requests and correspondence: Jerrold B. Leikin, MD, FACEP, FAACT, FACP, FACOEM, FACMT, Department of Toxicology, Northshore University HealthSystem-OMEGA, Glenbrook Hospital, 2150 Pfingsten Road, Suite 3000, Glenview, IL 60025

References 

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  2. Day M. Former spy's death causes public health alert. Br Med J. 2006;333:1137
  3. Dyer O. More cases of polonium-210 contamination are uncovered in London. Br Med J. 2007;334:65
  4. Kaplan K, Maugh TH. A restless killer radiates intrigue. The Los Angeles Times, January 1, 2007 http://www.mjwcorp.com/rad_dose_ assessments_poloniumarticle.php
  5. McAllister JFO. The spy who knew too much. Time Magazine. 2006;168:30–38
  6. Smith SM. Imported disease in emergency departments: an undiscovered country?. J Travel Med. 2006;13:73–77
  7. McFee RB, Bush L, Boehm KM. Avian influenza: critical considerations for the primary care physician. Adv Studies Med. 2006;6:431–440
  8. Smith SM. Where have you been? (The potential to overlook imported disease in the acute setting). Eur J Emerg Med. 2005;12:230–233
  9. Scott BR. Health risk evaluations for ingestion exposure of humans to polonium-210. Dose Response. 2007;5:94–122
  10. Leikin JB, McFee RB, Walter FG, et al. A primer for nuclear terrorism. Dis Mon. 2003;49:485–516
  11. Leikin JB, McFee RB, Walter FG, et al. The initial approach to a chemical and nuclear terrorism event. Clin Occup Environ Med. 2003;3:477–505
  12. Dirty bomb” threat puts spotlight on unprepared EDs: do you have a plan?. ED Manag. 2002;14:97–100
  13. Christensen D, Sugarman S. Emergency response to radiological and nuclear terrorism. In:  McFee RB,  Leikin JB editor. Toxico-Terrorism: Emergency Response and Clinical Approach to Chemical, Biological, and Radiological Agents. New York, NY: McGraw Hill Publishing; 2007;
  14. Koenig KL, Goans RE, Hatchett RJ, et al. Medical treatment of radiological casualties: current concepts. Ann Emerg Med. 2005;45:643–653
  15. McFee RB, Leikin JB. Radiation terrorism: the unthinkable possibility, the ignored reality. JEMS. 2005;30:78–92
  16. Leikin JB, McFee RB, Walter FD, et al. Radiation emergencies: a primer to nuclear incidents. JEMS. 2007;32:122–137
  17. Valentin J. International Commission on Radiological Protection (ICRP): Abstract: Protecting people against radiation exposure in the event of a radiological attack. A report of The International Commission on Radiological Protection. Ann ICRP. 2005;35:1–110iii-iv
  18. McFee RB. Preparing for an era of weapons of mass destruction (WMD)—are we there yet? (Why we should all be concerned, Part I). Vet Hum Toxicol. 2002;44:193–199
  19. NTI, The Center for Nonproliferation Studies at the Monterey Institute of International Studies. Radiological Terrorism Tutorial. http://www.nti.org/h_learnmore/radtutorial/index.htmlAccessed May 20, 2008
  20. Military Medical Operations Office Armed Forces Radiobiology Research Institute. Medical Management of Radiological Casualties Handbook. 1999;Bethesda, MD, December
  21. Harrison J, Leggett R, Lloyd D, et al. Polonium-210 as a poison. J Radiol Prot. 2007;27:17–40
  22. Leggett RW, Eckerman KF. Systemic biokinetic model for polonium. Sci Total Environ. 2001;275:109–125
  23. ICRP 2006. Human alimentary tract model for radiological protection. ICRP Publication 100. Ann ICRP 36, 2006
  24. Turai I, Veress K, Gunalp B, et al. Medical response to radiation incidents and radionuclear threats. Br Med J. 2004;328:568–572
  25. Rencova J, Volf V, Jones MM, et al. Mobilization and detoxification of polonium-210 in rats by 2,3 dimercaptosuccinic acid and its derivatives. Int J Radiat Biol. 2000;76:1409–1415
  26. Bogdan GM, Aposhian HV. N-(2,3-dimercaptopropyl)phthalamidic acid (DMPA) increases polonium-210 excretion. Biol Metals. 1990;3:232–236
  27. State of Ohio Department of Health, Office of Radiation Protection. Radiation Detection Equipment for First Responders. April 5, 2006
  28. Rencova J, Volf V, Jones MM, et al. Bis-dithiocarbamates: Effective chelating agents for mobilization of polonium-210 from rat. Int J Radiat Biol. 1995;67:229–234
  29. Gower-Thomas K, Lewis M, Shiralkar S, et al. Doctors' knowledge of radiation exposures is deficient. Br Med J. 2002;324:919
  30. Bushberg JT, Kroger LA, Hartman MD, et al. Nuclear/radiological terrorism: emergency department management of radiation casualties. J Environ Monit. 2007;32:71–85

 This article was adapted with permission from: McFee RB, Leikin JB: Death by polonium-210: lessons learned from the murder of former Soviet spy Alexander Litvinenko. JEMS 33:18-23, 2008.

PII: S0740-2570(08)00114-7

doi: 10.1053/j.semdp.2008.12.003

Seminars in Diagnostic Pathology
Volume 26, Issue 1 , Pages 61-67 , February 2009

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