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Boston hospitals have devices that could be used to make dirty bombs. Why won’t they ditch them?

Boston hospitals have an opportunity to receive tens of thousands of dollars of cost savings toward the purchase of new equipment that is just as effective for medical and research purposes as the radiological devices they have been using for decades.

One of the estimated 1,000 blood irradiators in the United States that use a highly radioactive substance known as cesium chloride. The Department of Energy, concerned about terrorists stealing the material, wants hospitals and blood banks to replace the machines with newer technologies.US National Nuclear Security Administration/US National Nuclear Security Adm

Boston Strong turned 10 this year. In April 2013, two improvised pressure-cooker bombs were detonated at the finish line of the Boston Marathon, killing three people and injuring more than 200. But imagine if those bombs — or a bomb set off in Back Bay or Beacon Hill, the South End, or the Seaport — had spewed radiation. Imagine if the blast required mass evacuations and a cleanup that cost billions of dollars and was still going on 10 years later.

The risk of such attacks is real around the world, as thousands of medical devices that contain radioactive materials remain vulnerable to theft by terrorists looking to build radiological dirty bombs. Although these sources enable life-saving blood transfusions and cancer treatments, they can pose a threat to public safety if misused. In particular, cesium-137, a radioactive isotope used for blood irradiation, medical device sterilization, and research, poses major risks because of its widespread use, its presence in low-security environments, and its powder form, which lowers the bar to widespread dispersal. If not properly handled, cesium-137 sources can cause permanent injury or even kill someone who comes in contact with them for more than a few minutes.


Concerned about the risk, hospitals across the United States have been working with the federal government for nearly a decade to replace these radioactive sources with safe and effective alternative X-ray technologies that do not rely on radiological isotopes. But not Boston; we remain an outlier with several dozen cesium-137 devices — more than any other city — still in place across our vast medical and hospital systems.

Although these devices are eligible for replacement under a Department of Energy assistance program that provides grants toward the purchase of new non-radioisotopic devices and the removal and disposal of cesium-137 irradiators at the federal government’s expense, none of the institutions housing them — including Brigham and Women’s Hospital, Massachusetts General Hospital, Dana-Farber Cancer Institute, Boston Children’s Hospital, Tufts Medical Center, and other local universities — have been willing to make the switch.


Some institutions are simply complacent; others have expressed concerns about the disruption it would pose to their organization. But if one of their radioactive sources was stolen and used for nefarious means, a brief operational disruption would be the least of their worries. In 2019, the danger was brought into sharp relief in Seattle, when just a miniscule amount of cesium-137 was accidentally released at a loading dock of a medical research building, a cleanup that cost well over $100 million and took more than two years. The liability taken on with a full-fledged cesium dirty bomb would dwarf that of the Seattle incident.

At the Nuclear Threat Initiative, we partnered with the New York City Department of Health and Mental Hygiene and the mayor’s office several years ago to raise awareness of the risks associated with cesium-137 devices, leading to the replacement of 30 such devices in the city. NTI engaged in similar efforts with the University of California and Emory University in Atlanta, resulting in the replacement of a combined 65 devices in California and Georgia.

Highlighting the ongoing threat, the Biden administration earlier this year identified radioactive source security as one of three main pillars of its new strategy to counter weapons of mass destruction terrorism. A radioactive bomb would not cause the catastrophic levels of death and destruction that would result from a nuclear detonation, but depending on its chemistry, form, and location, it can easily have devastating consequences.


On Tuesday NTI released its sixth Nuclear Security Index, which evaluates global efforts by governments to secure both nuclear and radiological materials, to prevent them from falling into the wrong hands. The Index finds that political momentum to reduce the risks posed by these materials has diminished over the last several years in many countries, including the United States.

Boston hospitals have an opportunity to receive tens of thousands of dollars of grants toward the purchase of new equipment that is just as effective for medical and research purposes as the radiological devices they have been using for decades — while shedding the liabilities and security costs associated with cesium sources. Just as in the aftermath of the Marathon bombing, let’s keep Boston strong and safe.

Former US Secretary of Energy Ernest J. Moniz is cochair and chief executive officer of the Nuclear Threat Initiative and professor emeritus of physics at MIT.