Radioactive Artifacts: Historical Sources of Modern Radium Contamination.

Radium has been distributed in a wide variety of devices during the early part of this century. Antique objects containing significant amounts of radium turn up at flea markets, antique shows, and antique dealers, in a variety of locations. These objects include radium in devices which were used by legitimate medical practitioners for legitimate medical purposes such as therapy, as well as a wide variety of "quack cures." These devices may contain anywhere from a few nanocuries to as much as several hundred microcuries of radium. In addition to medical sources, a large variety of scientific instruments utilize radium in luminous dials. These instruments include compasses, azimuth indicators, and virtually any object which might require some form of calibration. In addition, the consumer market utilized a large amount of radium in the production of wrist watches, pocket watches, and clocks with luminous dials. Some of these watches contained as much as 4.5 µCi of radium, and between 1913 and 1920 about 70 gm was produced for the manufacture of luminous compounds. In addition to the large amount of radium produced for scientific and consumer utilization, there were a number of materials produced which were claimed to contain radium but in fact did not, further adding to the confusion in this area. The wide availability of radium is a result of the public's great fascination with radioactivity during the early part of this century and a belief in its curative properties. A number of objects were produced in order to trap the emanations of radium in water for persons to drink in order to benefit from their healing effects. Since the late 20s and early 30s the public's attitude towards radiation has shifted 180° and it is now considered an extremely dangerous and harmful material. However, even as late as the 1950s, there were still some items produced containing radioactivity which today would be unthinkable. The "Buck Rogers Mystery Ring" of the 1950s was activated with polonium. With the shift in public attitudes towards radioactivity, and increasing problems in disposal of radioactive materials, the disposal of radium presents a particularly perplexing problem. The radium which was produced in the early part of the century is still around in various forms and is extremely difficult to dispose of. All objects discovered claiming to contain radium should be taken seriously and should be properly surveyed. They then should either be stored in some area where the environment is protected from the radioactivity or if a very small amount of radium is present, they may be disposed of through one of several commercial sources. Any significant amount of radium is extraordinarily difficult and expensive to dispose of and there are only limited sites which will accept these materials. No clear cut, uniform mechanism for the handling of radioactive materials which turn up outside of the usual institutional sources, is currently in place.

Professor Anastas Kocarev, First Macedonian Oncologist with Worldwide Reputation and Pioneer in Cancer Diagnostics and Treatment with Radium.

PhD. Anastas Kocarev (Kotzareff in French) is one of the most prominent Macedonian doctors and experts, prolific contributor to the cancer research in Switzerland and France in the first decades of the 20th century. He was born in Ohrid on May 5th, 1889. He graduated from the Faculty of Medicine in Geneva where he defended a doctorate in medicine in 1915. In 1916 he was elected Assistant Professor (Private Docent) at that Faculty. He was a prominent scientist and professor of experimental medicine at the Faculty of Medicine in Geneva and the Sorbonne University in Paris, with a wide reputation in Europe and the United States. PhD. A. Kocarev is one of the pioneers of oncology and radiology in the world, a forerunner of modern nuclear medicine and positron emission tomography. He was a close associate of Nobel laureate in chemistry and physics Maria Sklodovska-Curie and at her invitation moved to Paris in 1925 to continue the research on the diagnosis and treatment of cancer using radium. He was fully devoted to science and published numerous scientific papers and books with high citations and dissemination in many medical libraries in Europe and beyond. In addition to his professional teaching and scientific work as a top oncologist-radiologist, he was a great patriot with advanced political ideas. He founded the Academic Society "Macedonia" in Geneva, in 1915, and united it with other Macedonian political associations from Zurich and Lausanne, in 1918, into a joint "Alliance of Macedonian Societies for Independent Macedonia", with commitments, activities and initiatives to the Society of Nations, based in Geneva, Switzerland, for the proper resolution of the Macedonian national issue by creating a united and independent state "Macedonia" or the formation of a "Balkan Federation". He died suddenly in Paris on March 29, 1931.

Universal Expositions, physics-chemistry and new occupational diseases: the case of Marie Sklodowska Curie and radium girls. / Esposizioni universali, la fisica-chimica e le nuove malattie da lavoro: il caso di Marie Sklodowska Curie e le ragazze del radio.

BACKGROUND: Radium discovery by Marie and Pierre Curies caused previously unknown diseases. Marie Sklodowska Curie (1867-1934) suffered from radiations effects, as did girls in the radium dial watches factories. Therapeutic effects of radium were soon discovered, its unhealthy effects were as yet unheard of. OBJECTIVES: Analysis of Marie Sklodowska Curie (Marie) and radium girls occupational exposure, taking scientific debate on radium dangerous effects into account. METHODS: analysis of occupational exposure and diseases of Marie and radium girls in major documents, including Curie archive letters. RESULTS: Marie had dermatitis, radiodermatitis, tinnitus, one abortion, cataracts, tubercolosis, aplastic anemia. She also was a victim of mobbing. Women employed in the New Jersey radium dial watches factories, often immigrants, died of jaw necrosis, sarcoma of femur, anemia, leukemia and other radium related diseases. Marie was first asked about radium adverse effects by the New Jersey Department of labour (1925), Lise Meitner (1928) and the American Society for Cancer Control (1929). In 1928 Alice Hamilton organized a radium conference in order to find a solution to the radium girls' new disease. In 1929, during her second visit to the United States of America (USA), Marie declared how only prevention could save "radium girls". In 1934 she died of aplastic anemia, just like many radium girls. That year International Labour Office listed the new disease as due to "radium, radioactive substances, X-rays"; it was followed in 1937 by five USA states. CONCLUSIONS: Unheard of knowledge, conflict of interest, scientific delay, incompetence and no prevention were yesterday, as they are today, the cause of many preventable women deaths.

Nasopharyngeal radium irradiation: The lessons of history.

In the Netherlands, nasopharyngeal radium irradiation was started in 1945. The indications included refractory symptoms of otitis media with effusion and other adenoid-related disorders after adenoidectomy. It was considered a safe and effective therapy. Its use decreased sharply in 1958, following a worldwide media avalanche around the dramatic events in the treatment of a 5-year-old child in Utrecht, enhancing the widespread fear of radioactivity. This case history illustrates the powerful role of the media in medical decision-making.

Painting Dose: The ART of Radiation.

The discovery of X rays in 1895 captivated society like no other scientific advance. Radiation instantly became the subject not only of numerous scientific papers but also of circus bazaars, poetry, fiction, costume design, comics, and marketing for household items. Its spread was "viral." What is not well known, however, is its incorporation into visual art, despite the long tradition of medicine and surgery as a subject in art. Using several contemporary search methods, we identified 5 examples of paintings or sculpture that thematically feature radiation therapy. All were by artists with exhibited careers in art: Georges Chicotot, Marcel Duchamp, David Alfaro Siqueiros, Robert Pope, and Cookie Kerxton. Each artist portrays radiation differently, ranging from traditional healer, to mysterious danger, to futuristic propaganda, to the emotional challenges of undergoing cancer therapy. This range captures the complex role of radiation as both a therapy and a hazard. Whereas some of these artists are now world famous, none of these artworks are as well known as their surgical counterparts. The penetration of radiation into popular culture was rapid and pervasive; yet, its role as a thematic subject in art never fully caught on, perhaps because of a lack of understanding of the technology, radiation's intangibility, or even a suppressive effect of society's ambivalent relationship with it. These 5 artists have established a rich foundation upon which pop culture and art can further develop with time to reflect the extraordinary progress of modern radiation therapy.

Geoffrey Keynes's Two-Fold Vision: Medical Savant-Connoisseur and Literary Bibliographer.

During the 1920s and 1930s, the British surgeon Geoffrey Keynes (1887-1982) treated breast cancer with radium instead of the hegemonic radical mastectomy, while vehemently attacking the "radicalists" for mutilating women. Keynes was also a leading bibliographer of literary figures from Sir Thomas Browne to William Blake through Jane Austen. This article argues that these endeavors did not inhabit separate worlds, but rather his bibliographic methods of collecting and sorting were deeply interwoven with his therapeutic practices and medical ways of knowing. The article also examines the profound influence his engagement with the works of William Blake had on his battle against the reigning medical orthodoxy and on the humanity of his relationship with his patients. It concludes that Keynes' story sheds light on a now distant medico-cultural world where literary studies, often centered on book collecting and critique, were not only highly valued, but were influential in guiding the vision and behavior of a number of physicians.

[The development of radiation technologies since Maria Sklodowska-Curie]. / Od Marii Sklodowskiej-Curie do wspólczesnych technologii radiacyjnych.

The article was written on the occasion of the 100. anniversary of the Nobel Prize in Chemistry awarded to Maria Sklodowska-Curie. The United Nations General Assembly honoured this event by announcing the year 2011 the International Year of Chemistry. Maria Sklodowska-Curie was i.a. the initiator of radiation chemistry, a branch of science analyzing the chemical effects that matter shows when exposed to ionizing radiation. The development of this branch resulted in radiation technologies' applications in many fields of industry, medicine, agriculture, protection of the environment, space research and science. Our point of departure was the article Sur l'etude des courbes de probabilité relatives a l'action des rayons X sur les bacilles that Maria Sklodowska-Curie published in 1929 in the Bulletin of the Académie des sciences. In this study, she presented--for the first time ever--the curves of the so called radiation inactivation, i.e. the relationship between the bacteria life expectancy and the dose of radiation absorbed by it. From the today's point of view, it can be stated that the researcher laid the foundations of the methods of radiation sterilization and material processing by means of radiation. In this context, we recall the history of the first accelerator installation devised and built in 1968 at the Institute of Nuclear Chemistry and Technology in Warsaw. Basing on experiences with the linear electron accelerator, the LAE 13/9 was completed in 1992 as the so far only Polish industrial installation for radiation sterilization of medical products and transplants as well as for food irradiation.

Robert Abbe: early American brachytherapist.

PURPOSE: To assess Robert Abbe's career and contributions to brachytherapy, in the context of the work of contemporary European and American investigators. METHODS AND MATERIALS: Examination of his lectures and journal articles, as well as contemporaneous newspaper accounts, textbooks, and archival material. RESULTS: Although not the first American to apply radium therapeutically, Robert Abbe was among the earliest to acquire and systematically use a clinically significant quantity. He replicated early European experimental and clinical work, and published a large series of cases treated with generally favorable results. Abbe was the first American to emphasize the role of radiobiology in optimizing therapeutic ratio. His eloquence and stature helped legitimize the new therapeutic modality. CONCLUSIONS: Robert Abbe was probably the nation's most influential early brachytherapist.

From the lost radium files: misadventures in the absence of training, regulation, and accountability.

PURPOSE: Radium was the foundation of brachytherapy in the early decades of the 20th century. Despite being a most precious and perilous substance, it was mislaid with surprising frequency. This essay explores how it was lost, the efforts taken to recover it, and measures instituted to prevent mishandling. METHODS AND MATERIALS: Review of contemporary literature, government publications, archives, and lay press. RESULTS: Radium is a particularly dangerous substance because of its long half-life, its gaseous daughter (radon), and the high-energy emissions of its decay products. Despite the hazard, it was unregulated for most of the century. Any physician could obtain and administer it, and protocols for safe handling were generally lacking. Change came with appreciation of the danger, regulation, mandated training, and the institution of a culture of accountability. Unfortunately, careless management of medical radionuclides remains a global hazard. CONCLUSION: Responsible stewardship of radioactive material was not a high priority, for practitioners or the federal government, for much of the 20th century. As a result, large quantities of radium had gone astray, possibly subjecting the general public to continued radiation exposure. Lessons from the radium era remain relevant, as medical radionuclides are still mishandled.