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climbski2
Mountain climber
Anchorage AK, Reno NV
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It has been terribly underreported. What little info i have been able to gather has been one of two types.
Rediculous hype by the rabidly anti-nuke groups.
And just a few well written articles by well informed folks that say there are some real but managable risks with the one reactor that needs to have it fuel removed from the pond.
Detected radiation outside the reactors buildings is at surprisingly safe levels. Inside the melted down units it's insanely bad but fairly well contained such that the amount being lost is less than a coal plant puts out from what I've heard. I imagine these will be expensive major headaches for perhaps a few generations.
I have heard nothing about particulate plutonium however. I'm not sure how easy it is to detect.. but I'd be damn surprised if almost any unsheilded amount can exist without our various incredibly sophisticated detection systems noticing it very rapidly. detection may be simple but I'm not sure how quickly the public would be informed.. I'm guessing it would be hard to hide but who knows?
from wikip
Unlike the other five reactor units, reactor 3 ran on mixed core, containing both uranium fuel and mixed uranium and plutonium oxide, or MOX fuel (with the core comprising ~6% MOX fuel[37]), during a loss of cooling accident in a subcritical reactor MOX fuel will not behave differently to UOX fuel. The key difference between plutonium-239 and uranium-235 is that plutonium emits fewer delayed neutrons than uranium when it undergoes fission.[38]
While water-insoluble forms of plutonium such as plutonium dioxide are very harmful to the lungs, this toxicity is not relevant during a Loss Of Coolant Accident (LOCA) because plutonium is very involatile and unlikely to leave the reactor in large amounts. Plutonium dioxide has a very high boiling point. The toxic effect of the plutonium to the public under these conditions is much less than that of iodine-131 and caesium. During a loss of cooling accident, the fuel is not subject to such intense mechanical stresses, so the release of radioactivity is controlled by the boiling-point of the different elements present.[39]
Abstract from scientific reports an online source
http://www.nature.com/srep/2013/131018/srep02988/full/srep02988.html
The contamination of Japan after the Fukushima accident has been investigated mainly for volatile fission products, but only sparsely for actinides such as plutonium. Only small releases of actinides were estimated in Fukushima. Plutonium is still omnipresent in the environment from previous atmospheric nuclear weapons tests. We investigated soil and plants sampled at different hot spots in Japan, searching for reactor-borne plutonium using its isotopic ratio 240Pu/239Pu. By using accelerator mass spectrometry, we clearly demonstrated the release of Pu from the Fukushima Daiichi power plant: While most samples contained only the radionuclide signature of fallout plutonium, there is at least one vegetation sample whose isotope ratio (0.381 ± 0.046) evidences that the Pu originates from a nuclear reactor (239+240Pu activity concentration 0.49 Bq/kg). Plutonium content and isotope ratios differ considerably even for very close sampling locations, e.g. the soil and the plants growing on it. This strong localization indicates a particulate Pu release, which is of high radiological risk if incorporated.
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TomCochrane
Trad climber
Santa Cruz Mountains and Monterey Bay
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My uncle points out that a particle of plutonium in a rain drop will not be detected by a radiation counter held right next to it, because the surface tension of the rain drop will prevent emission of the alpha particles. However if you inhale that particle in fog or smog, you have a major health problem.
This is when I stopped being impressed by radiation counter readings around the country.
However I occasionally detect rather hot spots around the property with mine, don't know if it's cesium or iodine or whatever.
http://themindunleashed.org/2013/08/at-very-least-your-days-of-eating.html
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climbski2
Mountain climber
Anchorage AK, Reno NV
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My understanding is that decay of plutonium causes RF emmisions at specific frequencies (thus the term radioactive) that are highly monitored with some of the most sensitive instruments ever made.. of course there is plenty of background plutonium around the world due to nuclear tests but I'd imagine they account for that and can recognise new sources.
The reason is simple. This apparently allows tracking of nuclear subs or perhaps more importantly even a device trying to be smuggled somewhere around the world.
Climbers should be familiar with this as it is a part of our history with the rishi gorge incident..Wish Tom Frost would talk about it lol.
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TomCochrane
Trad climber
Santa Cruz Mountains and Monterey Bay
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The problem of accurately detecting extremely low levels of plutonium is rapidly gaining increasing importance in applications of nuclear counter-proliferation, verification, and environmental and waste management. If methods to confidently detect trace signatures of plutonium based on gamma-ray spectra alone could prove sufficiently effective, remote-monitoring systems could be greatly simplified and confidence levels and throughput of environmental and waste management systems could be greatly increased. Relative to signal from very low levels of 239Pu, the background from natural terrestrial sources is so high that, as in space applications, consideration of Compton anticoincidencing is compelling. However, its use in materials management applications requires demonstration that the increased sensitivity be sufficiently high to overcome added cost and weight. In this paper we report the results of a laboratory experiment to determine sensitivity that can be gained in detecting low levels of 239Pu from Compton anticoincidencing in combination with newly-developed spectral analysis methodology, in which we collected a logarithmically-varying time series of spectra both with and without Compton anticoincidencing from a 98-nCi laboratory source. It was found that by using Compton anticoincidencing the collection time needed to achieve the same level of confidence could be decreased by a factor of 1.8.
http://www.phys.ufl.edu/~coldwell/Fittery/robfit/reno/INMN/inmm5.html
Have fun with these:
http://www.amptek.com/pricelist.html
Mastercard, Visa, American Express and Eurocard Accepted
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climbski2
Mountain climber
Anchorage AK, Reno NV
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So it seems that a dificulty of detection is widespread background contamination by nuclear tests. I suppose that means that any new contamination would have to rise above the level of the background in it's area to be easily detectable by rf emmision. Then again I would not be surprised if there are not detection methods that can account for ratios of plutonium isotopes and the differences in rf emeision due to that..
I guess the question for those concerned about health effects would be this question.
Is the current background level of plutonium contamination a significant health concern?
Anyway I am way out ahead of my real knowledge of the subject and am halfway talking out my ass. Perhaps Hartouni could chime in here.
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TomCochrane
Trad climber
Santa Cruz Mountains and Monterey Bay
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It is extraordinarily difficult to make reliable health risk assessments, particularly since there are major industry investments and state secrets involved in withholding critical information.
Radiation at 'natural' levels is everywhere, from the sun, from space, from minerals in the soil, etc. Our bodies and ecosystems evolved with this.
Large amounts of man-made radiation sources have been added to this mix during our lifetimes.
There are no safe limits for radiation effects on our bodies. Radiation damages biology.
Radioactive materials taken into our bodies create cancers, but these can take 10-50 years to develop. This delay provides convenient plausible deniability to 'authorities' regarding the global cancer epidemic.
The impact to our immune systems of released radioactive substances adds to the effects from thousands of industrial chemicals, pharmaceutical products and hygiene products.
The best protection is a strong immune system and protective diet:
http://thewonderofchildhood.com/2011/05/natural-radiation-detoxification/
And follow the lead of Guido and Nancy.
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goatboy smellz
climber
लघिमा
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I would like to believe Ed, I would like to believe the other scientists that have weighted in with their opinions on this subject.
However this sounds a lot like the same news that it was safe for all those folks downwind when they exploded hundreds of nukes in NV.
Or the area around the World Trade Center was safe after 9/11 despite the obvious fallout.
Or the Rocky Mountain Flats is cleaned up despite the high radiation levels they continue to register outside neighborhoods of Wheat Ridge.
BP and the EPA have said the Gulf is clean and the wildlife has not been affected but the majority of the oysterbeds in LA are dead and the shrimp and gamefish are down by 70%.
I am reading a lot of conflicting reports over this and it's hard to think this disaster is not going to have some impact on the west coast.
So when certain private companies and the government says "hush hush nothing is wrong here", I get a bit skeptical.
Here is another scientific study to add to the pile.
http://www.sciencedirect.com/science/article/pii/S096706371300112X
Abstract
Following the March 2011 Fukushima disaster, large amounts of water contaminated with radionuclides, including Cesium-137, were released into the Pacific Ocean.
With a half-life of 30.1 years, Cs-137 has the potential to travel large distances within the ocean. Using an ensemble of regional eddy-resolving simulations, this study investigates the long-term ventilation pathways of the leaked Cs-137 in the North Pacific Ocean.
The simulations suggest that the contaminated plume would have been rapidly diluted below 10,000 Bq/m3 by the energetic Kuroshio Current and Kurushio Extension by July 2011.
Based on our source function of 22 Bq/m3, which sits at the upper range of the published estimates, waters with Cs-137 concentrations >10 Bq/m3 are projected to reach the northwestern American coast and the Hawaiian archipelago by early 2014.
Driven by quasi-zonal oceanic jets, shelf waters north of 45°N experience Cs-137 levels of 10–30 Bq/m3 between 2014 and 2020, while the Californian coast is projected to see lower concentrations (10–20 Bq/m3) slightly later (2016–2025).
This late but prolonged exposure is related to subsurface pathways of mode waters, where Cs-137 is subducted toward the subtropics before being upwelled from deeper sources along the southern Californian coast.
The model suggests that Fukushima-derived Cs-137 will penetrate the interior ocean and spread to other oceanic basins over the next two decades and beyond. The sensitivity of our results to uncertainties in the source function and to inter-annual to multi-decadal variability is discussed.
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Ed Hartouni
Trad climber
Livermore, CA
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I think the claim that there is "no safe level of radiation" is certainly undefensible given the long history of life on the planet and the levels of natural radiation exposure. Chemicals pose a much larger hazard to life, they are much more wide spread, and in many cases, chemical compounds are created by some life to defend itself against other life.
10 Bq/mł is a very low activity, lower than the natural activity of sea water. It represents 10 radioactive decays per second per cubic meter of water (to get the scale, a cubic meter of water is a bit more than a ton of water).
The beta-radiation is relatively low energy and expends it in the water itself... and doesn't create any more radiation.
the ął⁷Cs will decay away in 30 years after having been diluted in the ocean. It has a rather low biological half life of 70 days.
The Pu and other actinides, if they escaped the containment, would contaminate the surfaces of the building and the ground and are typically detected by taking "swipes" and counting the activity of the swipes. This are generally sensitive at the picogram level.
I haven't found any discussion actinide contamination, possible because the levels of other radioactive isotopes are so great as to obscure the radiations due to actinides. There is also the expectation that conditions in the cores of the reactors were not so extreme as to cause dispersal of the fuels beyond the containment vessels (except where the damaged fuel burned through that vessel into the secondary containment).
You can read this interesting commentary on Pu toxicity:
http://en.wikipedia.org/wiki/Plutonium#Toxicity
the etymology of the word "radiaoctive"
radioactivity (n.)
1899, from French radioactivité, coined 1898 by the Curies; see radioactive.
radioactive (adj.)
1898, from French radio-actif, coined by Pierre and Marie Curie from radio-, comb. form of Latin radius (see radiation) +actif "active" (see active).
radiation (n.)
mid-15c., "act or process of radiating," from Middle French radiation and directly from Latin radiationem (nominative radiatio) "a shining, radiation," noun of action from past participle stem of radiare "to beam, shine, gleam; make beaming," from radius "beam of light; spoke of a wheel" (see radius). Meaning "rays or beams emitted" is from 1560s. Meaning "divergence from a center" is 1650s.
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climbski2
Mountain climber
Anchorage AK, Reno NV
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So, I'm sitting here at Pismo Beach cause I just wanted to get away from Reno. It occurs to me that I am risking all that Fukushima radiation out here in the sun. Then as I scan around with my binoculars I notice of all things a nuclear reactor in the distance.
YEP
IM GUNNA DIE!
or maybe I should just rent a Dune buggy for the day!
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McHale's Navy
Trad climber
From Panorama City, CA
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It is extraordinarily difficult to make reliable health risk assessments, particularly since there are major industry investments and state secrets involved in withholding critical information.
I like the balance you add to the thread Tom.
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TomCochrane
Trad climber
Santa Cruz Mountains and Monterey Bay
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Thank you, Ed!
Key question: What health effects can be anticipated if the Building Four fuel pool collapses into a worst case scenario. Do we know enough to make valid predictions?
Link from Ed:
http://en.wikipedia.org/wiki/Plutonium#Toxicity
Toxicity
Isotopes and compounds of plutonium are radioactive and accumulate in bone marrow. Contamination by plutonium oxide has resulted from nuclear disasters and radioactive incidents, including military nuclear accidents where nuclear weapons have burned.[90] Studies of the effects of these smaller releases, as well as of the widespread radiation poisoning sickness and death following the atomic bombings of Hiroshima and Nagasaki, have provided considerable information regarding the dangers, symptoms and prognosis of radiation poisoning, which in the case of the Japanese Hibakusha/survivors was largely unrelated to direct plutonium exposure.[91]
During the decay of plutonium, three types of radiation are released—alpha, beta, and gamma. Alpha radiation can travel only a short distance and cannot travel through the outer, dead layer of human skin. Beta radiation can penetrate human skin, but cannot go all the way through the body. Gamma radiation can go all the way through the body.[92] Alpha, beta, and gamma radiation are all forms of ionizing radiation. Either acute or longer-term exposure carries a danger of serious health outcomes including radiation sickness, genetic damage, cancer, and death. The danger increases with the amount of exposure.
Even though alpha radiation cannot penetrate the skin, ingested or inhaled plutonium does irradiate internal organs.[32] The skeleton, where plutonium accumulates, and the liver, where it collects and becomes concentrated, are at risk.[31] Plutonium is not absorbed into the body efficiently when ingested; only 0.04% of plutonium oxide is absorbed after ingestion.[32] Plutonium absorbed by the body is excreted very slowly, with a biological half-life of 200 years.[93] Plutonium passes only slowly through cell membranes and intestinal boundaries, so absorption by ingestion and incorporation into bone structure proceeds very slowly.[94][95]
Plutonium is more dangerous when inhaled than when ingested. The risk of lung cancer increases once the total radiation dose equivalent of inhaled plutonium exceeds 400 mSv.[96] The U.S. Department of Energy estimates that the lifetime cancer risk from inhaling 5,000 plutonium particles, each about 3 µm wide, to be 1% over the background U.S. average.[97] Ingestion or inhalation of large amounts may cause acute radiation poisoning and death; no human is known to have died because of inhaling or ingesting plutonium, and many people have measurable amounts of plutonium in their bodies.[81]
The "hot particle" theory in which a particle of plutonium dust radiates a localized spot of lung tissue is not supported by mainstream research — such particles are more mobile than originally thought and toxicity is not measurably increased due to particulate form.[94]
When inhaled, plutonium can pass into the bloodstream. Once in the bloodstream, plutonium moves throughout the body and into the bones, liver, or other body organs. Plutonium that reaches body organs generally stays in the body for decades and continues to expose the surrounding tissue to radiation and thus may cause cancer.[98]
A commonly cited quote by Ralph Nader[99] states that a pound of plutonium dust spread into the atmosphere would be enough to kill 8 billion people. However, calculations show that one pound of plutonium could kill no more than 2 million people by inhalation. This makes the toxicity of plutonium roughly equivalent with that of nerve gas.[100] Nader's views were challenged in 1976 by Bernard Cohen, as described in the book Nuclear Power, Both Sides: The Best Arguments for and Against the Most Controversial Technology. Cohen's own estimate is that a dose of 200 milligrams would likely be necessary to cause cancer.[101]
Several populations of people who have been exposed to plutonium dust (e.g. people living down-wind of Nevada test sites, Nagasaki survivors, nuclear facility workers, and "terminally ill" patients injected with Pu in 1945–46 to study Pu metabolism) have been carefully followed and analyzed. These studies generally do not show especially high plutonium toxicity or plutonium-induced cancer results, such as Albert Stevens who survived into old age after being injected with plutonium.[94] "There were about 25 workers from Los Alamos National Laboratory who inhaled a considerable amount of plutonium dust during 1940s; according to the hot-particle theory, each of them has a 99.5% chance of being dead from lung cancer by now, but there has not been a single lung cancer among them."[100][102]
Plutonium has a metallic taste.[103]
Here's what Nightline has to say, posted today on Yahoo:
http://news.yahoo.com/blogs/nightline-fix-abc-news/japan-fukushima-power-plant-still-threat-161010680.html
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Roger Brown
climber
Oceano, California
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Climbski2,
Your probably seeing a large woman laying on her back at Pirate's Cove.
Take the 1/2 day fishing trip out of Aliva, and you can see the plant pretty clear. It is called Diablo Canyon. (Canyon of the Devil)
Diablo creek flows year round.
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TomCochrane
Trad climber
Santa Cruz Mountains and Monterey Bay
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I think the claim that there is "no safe level of radiation" is certainly undefensible given the long history of life on the planet and the levels of natural radiation exposure. Chemicals pose a much larger hazard to life, they are much more wide spread, and in many cases, chemical compounds are created by some life to defend itself against other life.
I certainly agree with this statement by Ed, which has to be taken in perspective. Radiation impacting life forms causes damage. Our bodies are constantly at work repairing various levels of damage from electromagnetic, chemical, viral, bacterial, hormonal imbalance, preservatives and radioactive intrusions. The fact that we don't immediately die from the poisons used as food preservatives, doesn't mean that they are a good idea for our health.
I was first told about the following by Yvon Chouinard, who learned about it when staff in his Patagonia stores were getting sick. Did you know that most clothing is treated with formaldehyde (a known carcinogen) to prevent mildew during shipping? Watch David Suzuki's Queen of Green on Dr. Oz this Thursday for a full explanation and demo! http://bit.ly/1bSBsvg
Plutonium, when entering the body through air, food or blood (e.g. a wound), mostly settles in the lungs, liver and bones with only about 10% going to other organs, and remains there for decades. The long residence time of plutonium in the body is partly explained by its poor solubility in water. Some isotopes of plutonium emit ionizing α-radiation, which damages the surrounding cells. The median lethal dose (LD50) for 30 days in dogs after intravenous injection of plutonium is 0.32 milligram per kg of body mass, and thus the lethal dose for humans is approximately 22 mg for a person weighing 70 kg; the amount for respiratory exposure should be approximately four times greater. Another estimate assumes that plutonium is 50 times less toxic than radium, and thus permissible content of plutonium in the body should be 5 µg or 0.3 µCi. Such amount is nearly invisible in under microscope. After trials on animals, this maximum permissible dose was reduced to 0.65 µg or 0.04 µCi. Studies on animals also revealed that the most dangerous plutonium exposure route is through inhalation, after which 5–25% of inhaled substances is retained in the body. Depending on the particle size and solubility of the plutonium compounds, plutonium is localized either in the lungs or in the lymphatic system, or is absorbed in the blood and then transported to the liver and bones. Contamination via food is the least likely way. In this case, only about 0.05% of soluble 0.01% insoluble compounds of plutonium absorbs into blood, and the rest is excreted. Exposure of damaged skin to plutonium would retain nearly 100% of it.[87] Note that radioactive materials are also 'chemicals' with biochemical effects besides their release of radioactive particles.
It is amazing that we survive so well as we do, considering all the insults to our physical existence. All the electromagnetic, chemical, pharmaceutical, hygienic, biochemical warfare, and radioactive materials released into the environment in the past century are certainly not helpful to our health. And their combined effects are certainly not well understood.
We barely even understand the short term effects and side effects of the initial ingestion of FDA approved pharmaceuticals. Never mind their combined effects in pill cocktails and flushed into our water supplies and accumulated in our food supplies and round and round in a combinatorial explostion.
Attitude is one of the primary drivers of good health, and fear is not a positive attitude. And monopolistic profit/power motives are not enlightened drivers for ecological health and balance.
Following up on this point probably belongs on another thread.
(all of which impact our climbing abilities...)
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TomCochrane
Trad climber
Santa Cruz Mountains and Monterey Bay
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Jan 10, 2014 - 09:08pm PT
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Sickened by service: More US sailors claim cancer from helping at Fukushima
By Perry Chiaramonte
Published December 20, 2013
When the USS Ronald Reagan responded to the tsunami that struck Japan in March 2011, Navy sailors including Quartermaster Maurice Enis gladly pitched in with rescue efforts.
But months later, while still serving aboard the aircraft carrier, he began to notice strange lumps all over his body. Testing revealed he'd been poisoned with radiation, and his illness would get worse. And his fiance and fellow Reagan quartermaster, Jamie Plym, who also spent several months helping near the Fukushima nuclear power plant, also began to develop frightening symptoms, including chronic bronchitis and hemorrhaging.
“I get so angry. They said as long as the plume was avoided we would be fine." - Navy sailor Jamie Plym
They and 49 other U.S. Navy members who served aboard the Reagan and sister ship the USS Essex now trace illnesses including thyroid and testicular cancers, leukemia and brain tumors to the time spent aboard the massive ship, whose desalination system pulled in seawater that was used for drinking, cooking and bathing. In a lawsuit filed against Tokyo Electric Power Company (TEPCO), the plaintiffs claim the power company delayed telling the U.S. Navy the tsunami had caused a nuclear meltdown, sending huge amounts of contaminated water into the sea and, ultimately, into the ship's water system.
“At our level, we weren’t told anything,” Plym told FoxNews.com. “We were told everything was OK.”
Now, Plym, Enis and dozens of others wonder if their service to their country and to Japan has left them doomed.
“I get so angry," Plym said. "They said as long as the plume was avoided we would be fine. But we knew then that something was going to happen. Common sense tells you that the wind would blow it everywhere. You don’t need to be a nuclear scientist to figure that out.”
San Francisco Attorney Charles Bonner,who is representing allegedly cancer-stricken sailors, initially filed a federal suit in the Southern District of California more than a year ago on behalf of a dozen sailors. The lawsuit was initially dismissed, when the court ruled that any ruling would hinge on interpreting communication between the Japanese and U.S. governments, which could violate the separation of powers. But Bonner is amending the suit to add new allegations that would fall under the court's jurisdiction. And the number of plaintives has more than quadrupled as more service members come forward with radiation-related illnesses, he said.
“They went in to help with rescue efforts," said Bonner, who plans to refile the suit on Jan. 6. "They did not go in prepared to deal with radiation containment.”
The plaintiffs don't blame the U.S. Navy, which they believe acted in good faith, Bonner said. It was the plant's operators who sat on the meltdown information during the crucial hours following the March 11, 2011 disaster, he said.
“TEPCO pursued a policy which caused rescuers, including the plaintiffs, to rush into an unsafe area which was too close to the [Fukushima nuclear power plant] that had been damaged,” Bonner charged in an April filing now being updated to add more plaintiffs. “Relying upon the misrepresentation regarding health and safety made by TEPCO, upon information and belief, the U.S. Navy was lulled into a false sense of security.
“The officers and crew of the U.S.S. Reagan (CVN-76) and other vessels believed that it was safe to operate within the waters adjacent to the FNPP, without doing the kinds of research and testing that would have verified the problems known to the defendant TEPCO at the time.”
Nathan Piekutoski, 22, who served aboard the USS Essex, which was in the same deployment as the Reagan, said sailors had no choice but to trust what they were told.
“They did say it was safe at the time,” Piekutoski said. “We had to take their word for it.”
Piekutowski says he suffered from leukemia and, while he is currently in remission, Doctors have told him that he may need a bone marrow transplant.
“Within a few months I started getting all these weird symptoms," he recalled of the months following the disaster response. "Night sweats. Not sleeping. I started losing a lot of weight.
“It’s one of those things," he added. "You’re angry that it happens but we had to go. It was our duty. I joined the military to help people in need.”
A spokesperson for the Department of Defense declined to comment on the pending lawsuit, but told FoxNews.com the Pentagon has been monitoring and collecting data on radiation exposure in the region.
TEPCO officials did not respond to requests for comment. But a recent admission before members of the Japanese press on Dec. 12 during a meeting at the Tokyo Press Club, former Prime Minister Naoto Jan said the first meltdown occurred five hours after the tsunami, not the next day as reported at the time.
Bonner alleges that the statement means that the Japanese government knew radiation was being leaked and did not inform the U.S. Navy.
“They knew there was an active meltdown and they deliberately hid it from the public as well as the Navy,” Bonner said. “Those sailors went in there totally unaware and they were contaminated as a result.”
Plym says she is prepared to have her symptoms question in court, should the case go to trial. But with so many U.S. sailors coming forward, she believes justice will prevail.
“People will say that out lawsuit is fake and that we are doing this for money, but it’s really about getting the correct information out there,” Plym said.
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tuolumne_tradster
Trad climber
Leading Edge of North American Plate
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Mar 26, 2014 - 01:22am PT
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In a report released earlier this month, the Department of Public Health determined the culprits are small amounts of uranium, thorium and potassium contained in deposits of black sand. These elements, known as "primordial radionuclides," arrived on Earth during the planet's creation and are widely distributed throughout its crust.
The black sand likely contains monazite and zircon, heavy minerals found in granite and other igneous rocks that comprise much of the California coast, Long said. As the coastline erodes, those minerals wind up in the sand. Because they are denser than other sand particles, they tend to accumulate on beaches when lighter particles are sucked out to sea.
http://www.contracostatimes.com/news/ci_25404988/fukushima-radiation-near-half-moon-bay-state-health
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