Eliminating Highly Enriched Uranium From Radiopharmaceutical Production

  • Date: Nov 10 2009
  • Policy Number: 200912

Key Words: Highly Enriched Uranium, HEU, Nuclear Weapons, Toxins

The American Public Health Association (APHA) Governing Council has a long history of policy opposing the proliferation of nuclear weapons.1 In recent years, there has been a concerted global campaign to eliminate the nuclear weapons proliferation hazards posed by the continued use of highly enriched uranium (HEU) as the predominant source to produce radiopharmaceuticals used in a wide variety of clinical practices.

This campaign has been led by a broad coalition of medical and public health organizations conjoined with experts on nuclear proliferation issues. Together, they have called on physicians and public health professionals to take a lead role in eliminating proliferation hazards endemic in the production of radiopharmaceuticals through the continued reliance on HEU sources and to advocate for a shift to the use of proliferation-resistant sources such as low enriched uranium (LEU). In response, the Malaysian Medical Association adopted a resolution in April 2008 calling for conversion of radiopharmaceutical production to LEU sources,2 followed by a similar resolution adopted by the California Medical Association in October 2008.3 In June 2009, leading experts representing medical, academic, and nonproliferation disciplines wrote a letter to the US Congress. They expressed concern about potential shortages of necessary medical isotopes caused by problems with obtaining supplies from unreliable, aging, foreign HEU-based production facilities and called on the US Congress to provide adequate funding to the National Nuclear Security Administration to commence domestic production of medical isotopes using LEU as soon as possible.4

In 2002, the US National Research Council warned that “the primary impediment that prevents countries or technically competent terrorist groups from developing nuclear weapons is the availability of [nuclear material], especially HEU.”5 More than 95% of the world’s major medical isotope, technetium-99m (used in 80% of nuclear-medicine procedures worldwide and derived from molybdenum-99), is produced by reactors that use HEU neutron targets. Approximately 3% of the available uranium-235 in these targets is used up in the production process. The rest of the unrecycled, bomb-grade material, enough for many bombs the size of the one dropped over Hiroshima, is stockpiled in several commercial locations, posing a proliferation hazard.6–8

LEU is not directly usable for weapons. The conversion of such production to processes that do not use HEU, such as those using LEU, is technically feasible and readily achievable, with no significant negative impact on product purity, product yield, or operating costs.9–11 In January 2009, a National Academy of Sciences report concluded that there are “no technical reasons that adequate supplies cannot be produced from LEU targets,” while recommending that producers and the US government consider several steps to improve the feasibility of conversion.12 These recommendations included a call on Mo-99 producers to commit to LEU conversion and to “work with industry organizations and scientific and medical societies concerned with Mo-99 production for marshalling, coordinating, and supporting an industry-wide conversion strategy.”13

Therefore, APHA calls for the following actions:

  1. Radiopharmaceutical suppliers should expedite universal conversion of isotope production targets using HEU to LEU as soon as possible and refrain from developing new isotope production facilities that use HEU, unless HEU is only used temporarily in anticipation of expeditious replacement by LEU fuel.
  2. Radiopharmaceutical distributors and nuclear medicine departments should procure isotopes produced without HEU wherever possible and encourage their suppliers to convert from HEU to LEU sourcing.
  3. There must be further research and development of nonreactor generation of isotopes currently produced in reactors, in particular, molybdenum-99.
  4. A global code of conduct against the civilian production, trade, and use of HEU must be developed whereby stockpiled HEU can be converted into LEU for necessary medical procedures and other civilian uses.
  5. Other national, regional, and international medical and public health organizations, including, the World Health Organization and World Medical Association, should become appraised of this issue, adopt similar policies, and coordinate and lead international medical advocacy to eliminate HEU from radiopharmaceutical production worldwide, as quickly as possible.


  1. American Public Health Association. APHA Policy Statement 9605. Cessation of Nuclear Testing and Abolition of Nuclear Weapons. Washington, DC: American Public Health Association; 1996. Available at: www.apha.org/advocacy/policy/policysearch/default.htm?id=123 . Accessed November 30, 2009.
  2. Malaysian Medical Association. Eliminating Highly Enriched Uranium from Radiopharmaceutical Production. Adopted April 2008. Available at: www.nti.org/db/heu/Malaysian_Medical_Assoc_HEU_Resolution.pdf Accessed November 30, 2009.
  3. California Medical Association House of Delegates. Resolution 705-08: Highly Enriched Uranium in Radiopharmaceutical Production. Adopted October 6, 2008. Available at: www.cmanet.org/member/hod/RepResFINAL.pdf . Accessed November 30, 2009.
  4. Letter to House and Senate Subcommittees on Water and Energy Development, House and Senate Appropriation Committees Re: U.S. Production of Mo-99 for Medical Radioisotopes, June 15, 2009. Available at: http://hps.org/govtrelations/documents/congress_mo99-production_group-letter.pdf . Accessed November 30, 2009.
  5. Committee on Science and Technology for Countering Terrorism. Making the Nation Safer: the Role of Science and Technology in Countering Terrorism. Washington, DC: National Academy Press; 2002:40,45. Available at: www.nap.edu/openbook.php?isbn=0309084814 . Accessed November 30, 2009. 
  6. Von Hippel F, Kahn LH. Feasibility of eliminating the use of highly enriched uranium in the production of medical radioisotopes. Science and Global Security. 2006;14:151–162. 
  7. Kahn LH, von Hippel F. How the radiologic and medical communities can improve nuclear security. J Am Coll Radiol. 2007;4:248–251. 
  8. Cochran TB, Paine CE. The Amount of Plutonium and Highly-Enriched Uranium Needed for Pure Fission Nuclear Weapons. Washington, DC: Natural Resources Defense Council; 1995. Available at: www.nrdc.org/nuclear/fissionw/fissionweapons.pdf Accessed November 30, 2009.
  9. Kahn LH, von Hippel F. How the radiologic and medical communities can improve nuclear security. J Am Coll Radiol. 2007;4:248–251.
  10. Goldemberg J. On the Minimisation of Highly Enriched Uranium in the Civilian Sector. Technical Workshop Report. 2006. Available at: www.nrpa.no/symposium/documents/Oslo_Chair_Workshop_Final.pdf. Accessed November 30, 2009
  11. Vandegrift G. HEU vs. LEU Targets for 99 Mo Production: Facts and Myths. 2006. Available at: www.nti.org/e_research/official_docs/labs/heu_vs_leu_facts.pdf. Accessed November 30, 2009. 
  12. Committee on Medical Isotope Production Without Highly Enriched Uranium, National Research Council. Medical Isotope Production Without Highly Enriched Uranium. Washington, DC: National Academies Press; 2009, pp 2. Available at: www.nap.edu/catalog/12569.html. Accessed November 30, 2009.
  13. Committee on Medical Isotope Production Without Highly Enriched Uranium, National Research Council. Medical Isotope Production Without Highly Enriched Uranium. Washington, DC: National Academies Press; 2009, pp 140. Available at: www.nap.edu/catalog/12569.html. Accessed November 30, 2009.

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