Power Function Retention of Radionuclides in a Wound.

NCRP Report 156 describes soluble radionuclide retention kinetics in a wound, segregated into four retention categories: weak (W), moderate (M), strong (S), and avid (A). An alternate single-parameter model, the negative power function, t, is presented in this paper to describe the time behavior of radionuclide retention. With this mathematical description, γ is a single parameter that can be used to assign the wound retention category rapidly. Using the power function description of wound retention, the various wound categories present as straight lines on log scales with different slopes corresponding to the various retention categories. Regression analysis of average retention values in NCRP 156 shows γ = 0.735 ± 0.132, 0.514 ± 0.015, 0.242 ± 0.016, and 0.053 ± 0.023 for the weak, moderate, strong, and avid categories, respectively. A case study is presented (REAC/TS Registry case 1284) where a power function is shown to fit retention data in a Pu/Am hand wound up to 2,000 d (5.4 y) post-accident.

Direct and bystander effects in human blood lymphocytes exposed to 241Am alpha particles and the relative biological effectiveness using chromosomal aberration and micronucleus assay.

Purpose: It is important to understand the significance of alpha (α) radiation-induced bystander effects (RIBE) and its relative biological effectiveness (RBE); this is because the phenomenon is not universal and the mechanism is unclear and because the RBE is widely varying and projected to be very high. Materials and methods: Isolated lymphocytes from healthy volunteers (n = 10) were exposed to either low fluence α-particles (241Am), γ-rays (60Co), or X-rays (225 kVp and 6 MV). Co-culture methodology was employed to investigate bystander effects (BEs). Chromosomal aberrations (CA) and micronucleus (MN) formation were used to study the BE and calculated RBE. Results: Lymphocytes directly exposed to the types of radiation used showed a dose-dependent increase in the frequency of CA and MN; dose independent increases in the frequency of these chromosomal damages in co-cultured bystander cells, implies that all three types of radiation-induced a BE. The calculated RBE at the level of 5% induced aberrations varied between 9 and 20. Conclusion: The magnitude of low fluence α-particle induced RIBE is higher than in low LET (linear energy transfer) radiation. The RBE also varies depending upon the endpoints used and adds up to targeted effects. Since the endpoint of CA is considered as an important and early marker of risk prediction, the RIBE and RBE using CA as a marker are relevant for radiation protection purposes.

Screening Internal Contamination of Inhaled and Ingested Radionuclides with Hand-held Survey Meters.

During the aftermath of a radiological accident or attack, the rapid identification of individuals who have internalized medically significant amounts of material is paramount to guide medical and public health decisions. This paper explores the utility of hand-held, pancake GM detectors to determine if an individual has inhaled Sr, Cs, Pu, Pu, or Am in quantities requiring treatment. Additionally, ingestion of Sr or Cs was considered. Both Sr and Cs were modeled in equilibrium with their progeny, but the progeny of Pu, Pu, and Am were excluded. Treatment thresholds are defined using the National Council on Radiation Protection & Measurements' (NCRP) clinical decision guides (CDGs). Using Monte Carlo N-Particle (MCNP) modeling software, a human phantom and detector were modeled to determine the activity required to achieve a detector reading of twice background 1, 7, or 30 d post-ingestion or post-inhalation. Modeling found that inhaled Pu, Pu, and Am are detectable only if the contaminated individual inhaled thousands-fold more material than the CDG. This lack of detectability means that hand-held GM detectors are inappropriate for initial screening for americium or plutonium and that more intensive screening is necessary to confirm suspected contamination. Cesium-137, by contrast, could be detected at levels 10- to 100-fold lower than the amount requiring treatment, allowing quick differentiation between contaminated and uncontaminated individuals. Surprisingly, Sr was detectable within a factor of 2 of the amount requiring treatment. Detection of Sr was due primarily to bremsstrahlung radiation from beta interactions with calcium in bone. While rapid screening could identify individuals contaminated by Cs and possibly with Sr, further screening of identified individuals is necessary to establish medical need. However, these contaminated individuals could still be prioritized for further testing and possible presumptive treatment. Based on the findings of this study, concepts of operation for the use of hand-held survey meters should be developed for the screening of individuals potentially internally contaminated with Cs and Sr.

AN ACCIDENT OF INTERNAL CONTAMINATION WITH PLUTONIUM AND AMERICIUM AT A NUCLEAR FACILITY IN JAPAN: A PRELIMINARY REPORT AND THE POSSIBILITY OF DTPA ADMINISTRATION ADDING TO THE DIAGNOSIS.

This article introduces the first accident of internal contamination with plutonium (Pu) or americium (Am) in Japan for which treatment was carried out. An accident of internal contamination with Pu and Am occurred at a Pu research facility at Oarai-town of Ibaraki prefecture in Japan. A plastic bag containing these radionuclides ruptured when five workers were inspecting a storage container in a hood. As a consequence, these workers were internally contaminated with Pu and Am. Although contamination on the body surface was observed in all five workers, a positive nasal swab was detected in only three of them. A chelating agent, calcium diethylenetriaminepenta-acetate (CaDTPA), was administered to all of them including the two workers without a positive nasal swab. However, bioassay detected a significant amount of Pu and Am in urine after administration of DTPA in these two workers, whereas the levels of these nuclides were below minimum detectable levels in urine before the administration. Since the prevalence of adverse reactions in DTPAs is low, the present results suggest that administration of DTPA can be used for the diagnosis of internal contamination even when a nasal swab is negative or contamination around body orifices is not detected.

ENCAPSULATED 3,4,3-LI(1,2-HOPO) IN CHITOSAN NANOPARTICLES FOR DECORPORATION VIA INHALATION.

3,4,3-LI(1,2-HOPO) has been identified as an excellent alternative for DTPA for decorporating actinides, such as Pu and Am, after internal contamination. Efforts have been focused on its application through oral administration. When 3,4,3-LI(1,2-HOPO) was encapsulated with biocompatible, biodegradable nanoparticles made of chitosan, its release from the nanoparticles to lung fluid, observed in in vitro experiments, exhibited an extended release profile. These observations were very encouraging, as this nanomedicine could lead to a reduction in the dosing frequency required to achieve the decorporation efficacy of unformulated 3,4,3-LI(1,2-HOPO) itself. In vivo release tests as well as actinide decorporation experiments, using an inhalation exposure animal model, will follow.

Design and functionalities of the MADOR® software suite for dose-reduction management after DTPA therapy.

A software suite on biokinetics of radionuclides and internal dosimetry intended for the occupational health practitioners of nuclear industry and for expert opinions has been developed under Borland C++ Builder™. These computing tools allow physicians to improve the dosimetric follow-up of workers in agreement with the French regulations and to manage new internal contaminations by radionuclides such as Pu and/or Am after diethylene triamine penta-acetic acid treatments. In this paper, the concept and functionalities of the first two computing tools of this MADOR(®) suite are described. The release 0.0 is the forensic application, which allows calculating the derived recording levels for intake by inhalation or ingestion of the main radioisotopes encountered in occupational environment. Indeed, these reference values of activity are convenient to interpret rapidly the bioassay measurements and make decisions as part of medical monitoring. The release 1.0 addresses the effect of DTPA treatments on Pu/Am biokinetics and the dose benefit. The forensic results of the MADOR(®) suite were validated by comparison with reference data.

[Emergency care for acute wound entering of plutonium and americium into the body (real case)].

The article describes a case of slowly soluble plutonium and americium compounds entering human body via skin wound. During the wound healing, the authors followed features of biokinetics of the radioactive substances, determined the major route of their excretion, evaluated efficiency of surgical d-bridement and complexation medicine (pentacin). clinical and biophysicdata collected could serve to increase efficiency of urgent therapeutic and prophylactic measures aimed to individuals with wounds contaminated with radioactive substances.

In vivo measurement of 241Am in the lungs confounded by activity deposited in other organs.

Radioactive material deposited in multiple organs of the body is likely to confound a result of an in vivo measurement performed over the lungs, the most frequently monitored organ for occupational exposure. The significance of this interference was evaluated by measuring anthropometric torso phantoms containing lungs, liver, skeleton, and axillary lymph nodes, each with a precisely known quantity of 241Am uniformly distributed in the organs. Arrays of multiple high-resolution germanium detectors were positioned over organs within the torso phantom containing 241Am or over proximal organs without activity to determine the degree of measurement confounding due to photons emitted from other source organs. A set of four mathematical response functions describes the measured count rate with detectors positioned over each of the relevant organs and 241Am contained in the measured organ or one of the other organs selected as a confounder. Simultaneous solution of these equations by matrix algebra, where the diagonal terms of the matrix are calibration factors for a direct measurement of activity in an organ and the off-diagonal terms reflect the contribution (i.e., interference or cross-talk) produced by 241Am in a confounding organ, yields the activity deposited in each of the relevant organs. The matrix solution described in this paper represents a method for adjusting a result of 241Am measured directly in one organ for interferences that may arise from 241Am deposited elsewhere and represents a technically valid procedure to aid in evaluating internal dose based upon in vivo measurements for those radioactive materials known to deposit in multiple organs.

Induction of osteosarcoma and acute myeloid leukaemia in CBA/H mice by the alpha-emitting nuclides, uranium-233, plutonium-239 and amercium-241.

PURPOSE: To compare tumour induction in CBA/H mice, principally osteosarcoma and acute myeloid leukaemia, resulting from exposure to the alpha-emitting nuclides, uranium-233, plutonium-239 and americium-241, and to relate differences between the three nuclides to the pattern of dose delivery within tissues. MATERIALS AND METHODS: Each nuclide was administered intraperitoneally in citrate solution to three groups of adult male CBA/H mice at levels of activity which gave estimated life-time average skeletal doses of about 0.25-0.3 Gy, 0.5-1 Gy and 1-2 Gy. Animals were carefully monitored and sacrificed as soon as they showed signs of ill health; tumours were identified by standard histopathological techniques. RESULTS: Statistical modelling by Cox regression showed that, considering all three nuclides together, there was a highly significant increase in risk of death from osteosarcoma or myeloid leukaemia with increasing dose rate. For osteosarcoma, the effect was significantly greater for 239Pu than 241Am, while separate analysis for 233U showed no significant increase with increasing dose rate. For example, the increase in relative risk of death from osteosarcoma for an increase in life-time average dose rate to bone of 1 mGyd(-1) was 4.2 (2.7-6.5) for 239Pu, 2.3 (1.4-3.4) for 241Am and 1.1 (0.4-3.1) for 233U. For myeloid leukaemia, there was no significant difference between 239Pu and 241Am in the effect of dose rate. The increase in relative risk from myeloid leukaemia for an increase in average dose rate of 1 mGyd(-1) was 1.8 (1.1-2.8) for 239Pu, 2.0 (1.4-2.9) for 241Am and 1.5 (0.8-2.7) for 233U. Significant increases in renal and hepatic carcinomas were also recorded in animals exposed to 233U and 241Am, respectively. Studies of the distribution of the nuclides within the skeleton, published separately, have shown differences in their retention in individual bones and within bone. The proportions of decays occurring near to endosteal bone surfaces and throughout bone marrow were in the order: 239Pu> 241Am>233U. CONCLUSIONS: For osteosarcoma, the relative effectiveness of the nuclides in terms of average bone dose, in the order 239Pu>241Am>233U, is consistent with the proportion of dose delivered near to endosteal surfaces. For myeloid leukaemia, the greater effectiveness of 239Pu and 241Am than 233U is consistent with their accumulation in marrow.

Cytogenetic evaluation of occupational exposure to external gamma-rays and internal 241Am contamination.

Chromosome analyses were performed on peripheral lymphocytes from seven radiation workers exposed to external gamma-radiation within maximum annual permissible dose limits during 11 to 22 years of employment. Five years prior to blood sampling, six workers had additionally incorporated the alpha-emitting radionuclide 241Am which contributed between five to 25% of the total accumulated whole body dose in five workers and about 70% in one worker. For the radiation workers as a group, both the mean frequencies of symmetrical translocations measured by fluorescence in situ hybridisation (FISH)/chromosome painting and dicentrics + ring chromosomes scored in first division metaphases of conventional preparations were significantly elevated compared with respective controls. The mean biodosimetry estimate for the group was 270 mSv when based on stable translocations which compares well with the mean dose of 247 mSv based on official dosimetry records. The lower mean dose estimate of 160 mSv based on unstable dicentrics is compatible with the well-known loss of dicentrics from the circulating blood with time after exposure.

The U.S. Transuranium Registry report on the 241Am content of a whole body. Part II: Estimate of the initial systematic burden.

The estimated systemic burden of 0.3 muCi 241Am, made by the resident health physicist, has been compared to postmortem measurements using in-vivo counting equipment and radiochemical analysis of the donor's body. The health physicist's estimate was based on in-vivo measurements and urine excretion data obtained while the donor was still working, and it was logically assumed that the intake occurred about 1954 as a result of inhalation of Am-contaminated air. Based on additional data obtained by postmortem analysis, it seems more reasonable to assume for the purpose of scientific study and evaluation that the intake occurred in 1953, primarily as the result of a contaminated wound. Evaluations of the systemic burden using that assumption and three models indicate that the amount initially deposited could have been in the range of 0.2-1.1 muCi 241Am.

Deterministic effects of 241Am exposure in the Hanford Americium accident case.

Lifetime follow-up of USTUR Case 246 demonstrated the lack of severe biological effects resulting from his exposure to 241Am. Deterministic effects observed were limited to hematological changes, including lymphopenia and thrombocytopenia. These hematological changes were consistent with those observed in experimental animals following actinide exposure. Cataracts were removed from the left and right eyes at 547 and 1,030 d after the accident, respectively, but were considered to be trauma-induced rather than radiation-induced. No abnormal findings were reported from gross or histological examinations of tissue samples removed at autopsy, other than those resulting from the subject's preexisting cardiovascular disease.

1976 Hanford americium exposure incident: accident description.

An accident is described which involved the explosion of an ion-exchange column containing about 100 g of 241Am. A chemical operator was injured in this accident, receiving acid burns and superficial cuts on the upper part of his body. From 1 to 5 Ci of 241Am is estimated to have been deposited on the injured worker and on his clothing.

The U.S. Transuranium Registry report on the 241Am content of a whole body. Part III: Gamma-ray measurements.

The 241Am measurements on the donor's body, followed by an analysis of each bone of the skeleton, have provided the best available calibration factors for measuring the 241Am content in the skeletons of the living. These calibration factors have already been useful in measuring the skeletal burden of several workers in the nuclear industry. This study has shown that differential linear scanning provides good results on the content of various parts of the skeleton. Previously used methods of head or leg counting for estimating total skeletal content of 241Am were also found to provide good results. These studies confirm previous recommendations that in-vivo measurement of the skull probably provides the best estimate of 241Am in the skeleton; however, other positions such as the knee are also found to be bilaterally symmetrical for identical bones on the right and left sides of the body. A comparison of measurements on the donor's body with those of other people with skeletal burdens of 241Am shows that differences in skeletal distribution do exist and are probably due to the age of the person, the duration of the skeletal 241Am burden,and perhaps the physical activity of the person. Additional measurements and studies are planned on the remaining half of the skeleton and they should further improve the accuracy of in-vivo measurements of 241Am in the human skeleton.

An internal dosimetry intercomparison study.

Pacific Northwest Laboratory performed a study to evaluate the consistency of internal dosimetry assessments. A total of eleven laboratories, including DOE sites and NRC licensees, participated in this intercomparison study. Participants were asked to respond to five actual exposure scenarios, previously used in a similar European study. The participating dosimetrists assessed the data of the test scenarios and calculated results in terms of estimated radionuclide intake and the resulting internal doses. To maintain confidentiality, results are given without identifying any site. Except for one scenario, the results showed that the standard deviation of the final results on committed effective dose equivalent for each exposure scenario was about 30-50% of the mean value, giving a consistency slightly greater variant than that of the European study. The discrepancies can be attributed to variations in 1) the interpretation and statistical treatment of the bioassay data; 2) the biokinetic models applied; and 3) the computational tools used. This represents a preliminary study; further intercomparison testing is needed to fully evaluate the problem of dose-assessment inconsistency.

Overview and dosimetry of the Hanford Americium accident case.

Postmortem examinations of selected tissues from an individual who received a massive internal exposure to 241Am and succumbed to pre-existing cardiovascular disease 11 y later are summarized. Significant findings include acellularity of the marrow, marked peritrabecular fibrosis, and a lack of bone surface remodeling, confirmed by bone-surface alpha-spectrometry; tissue concentrations of 241Am that indicate bone and liver as the primary deposition sites, in general agreement with the new ICRP model, but not with the older models; a distribution of 241Am in soft tissues in general agreement with that observed in animals; and the absence of any other gross or microscopic pathological findings attributable to the exposure. Cumulative absorbed doses to the bone, bone surface, liver, and lung were 18, 520, 8, and 1.6 Gy, respectively. The probability of not observing a fatal cancer based on BEIR-IV risk factors for these absorbed doses was 12%.

Histopathology and 241Am microdistribution in skeletal USTER Case 246.

Histopathology and qualitative autoradiography studies were undertaken on bone removed at autopsy from USTUR Case 246. The histopathology examination revealed extensive bone marrow peritrabecular fibrosis and decreased cellularity in most samples. In addition, histological indicators suggest that bone cell turnover was suppressed at most sites, although turnover was found to be essentially normal in a vertebral body sample. The autoradiographic studies showed that bone turnover that had occurred resulted in the redistribution of americium within bone. However, surface deposits of americium remained conspicuous at many sites, particularly those with low bone growth activity. A few percent of the americium was present in the bone marrow. The dosimetric and toxicology findings indicate that current assumptions about the metabolic behavior of bone-seeking radionuclides are likely to be unrealistically simplistic.

1976 Hanford americium exposure incident: overview and perspective.

Salient features of the 1976 Hanford americium exposure incident are discussed. Comparisons are made with previous human and animal exposure data, and conclusions drawn relative to the injured workman, to health physics practices, and to the adequacy of current exposure limits.

1976 Hanford americium exposure incident: medical management and chelation therapy.

A chronological account is given of the general medical management of a patient involved in an americium exposure incident.

1976 Hanford americium exposure incident: psychological aspects.

Accidents involving exposure to radiation or radioactive materials may involve an unusual degree of emotional trauma. Methods that may be employed in dealing with such trauma are discussed in relation to a specific accident in which a radiation worker was injured and seriously contaminated with 241Am.