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Meltdown of nuclear medicine industry a potential health crisis

On Monday, the Talisman Group released its long-awaited review of last December’s shutdown of the NRU nuclear reactor at Chalk River.

Appropriately, it was called A Lessons Learned Report.

But when one considers the findings of the report, the facts surrounding the shutdown and the events that followed, the biggest lesson is abundantly clear: Canada’s nuclear medicine industry is in a nuclear meltdown.

That’s extremely unfortunate, since Canada is widely acknowledged as the world leader in nuclear medicine and the production of radioactive isotopes for medical procedures. AECL (Atomic Energy of Canada Ltd.), the Crown corporation in charge of the NRU reactor, has a glowing global reputation for its made-in-Canada Candu reactors.

It has delivered six reactors—on time and on budget—to international customers over the past 12 years.

But that image was significantly tarnished last December when, during a routine maintenance shutdown, the Canadian Nuclear Safety Commission reportedly found that recommended safety upgrades had not been implemented. The commission refused to allow the reactor to start up until the upgrades were complete. But when the resulting isotope shortage placed medical procedures around the world in jeopardy, that decision was overruled by Parliament.

Hence, a routine technical upgrade became a huge medical problem for doctors and thousands of patients worldwide who rely on the isotopes for diagnostic procedures and treatments.

The NRU reactor is the world’s largest single supplier of isotopes, and produces enough to treat more than 76,000 people per day. In Canada alone, the isotopes are used in about 30,000 diagnostic tests and 300 treatments each week.

More than that, the shutdown became a major political issue as Canadians realized the medical procedures that we depend on are dependent on the NRU, the world’s oldest nuclear reactor, and our health care will be in serious jeopardy should another crisis arise.

Since then, these fears have been greatly exacerbated by AECL’s decision to stop construction on Maple 1 and Maple 2, two reactors that were intended to replace the NRU back in 2000.

The reactors were eight years overdue, up to $500 million overbudget and crippled by technical flaws and bureaucratic setbacks.

AECL mercifully pulled the plug on the project in May, but the inability to get the job done raises questions about its management and leaves Canada’s medical system with no backup plan or alternate source for isotopes.

It takes years to build nuclear reactors, so the decision has significant short- and long-term implications.

That’s when MDS-Nordion, the company that sells and distributes the NRU’s medical isotopes, filed a $1.6-billion lawsuit against AECL and the government. It had invested $350 million in construction of the Maples and claims it wasn’t consulted before the plug was pulled. It claims the decision threatens the medical isotope supply and has asked for a court order that would compel AECL to live up to its 2006 agreement to provide MDS with a 40-year supply of isotopes.

Frankly, it can compel AECL all it wants, but if the NRU reactor goes down, there still won’t be any isotopes.

Finally, the Talisman Report suggests that a poisoned relationship and poor communication between the AECL and the commission both contributed to the shutdown of the NRU reactor. Communication between and within these groups was so bad that AECL managers didn’t even understand they were supposed to make the suggested safety upgrade, while the commission staff knew the 2005 upgrade hadn’t happened but didn’t think it mattered enough to pass that information on to their bosses.

Health Minister Tony Clement called all this a “massive dysfunctionality” in communication. I don’t know what a “massive dysfunctionality” is, but it certainly doesn’t sound good in the context of nuclear safety.

With safety issues, a 50-year old reactor, a bungled project costing taxpayers hundreds of millions, a billion-dollar lawsuit, and the above-mentioned “massive dysfunctionality,” Canadians have every right to be concerned about the future of nuclear medicine in Canada.

According to a report by a medical panel, nuclear medicine was “teetering on the brink of disaster” during the NRU shutdown. Surely, that disaster looms far closer now that we have no backup reactors and a greatly diminished confidence in both AECL and the commission to keep the supply of isotopes flowing.

For six months, reviews, committees and reports have attempted to figure out what went wrong. It’s time for our leaders to change the focus and figure out what to do.

If we secure isotopes from another source, it will be costly. AECL has always supplied MDS with cheap isotopes that allow MDS to make large profits. If MDS gets isotopes elsewhere, those higher prices will be passed on to our health-care system.

If AECL won’t build a reactor or modify an existing reactor to produce medical isotopes, the opportunity is ripe for some entrepreneur to do so.

If AECL is going to do it, the time is now. Canada’s reputation and Canadian lives are at risk.

Susan Martinuk
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