Search

The radiochemical analysis of plutonium activity in urine is the main method for indirect estimation of doses of internal exposure from plutonium incorporation in professional workers. It was previously shown that late-in-life acute diseases, particularly those that affect the liver, can promote accelerated rates of release of plutonium from the liver with enhanced excretion rates. This initial study examines the relationships of some chronic diseases on plutonium excretion as well as the terminal relative distribution of plutonium between the liver and skeleton. Fourteen cases from former workers at the Mayak Production Association (Mayak PA) who provided from 4-9 urine plutonium bioassays for plutonium, had an autopsy conducted after death, and had sufficient clinical records to document their health status were used in this study. Enhanced plutonium excretion was associated with more serious chronic diseases, including cardiovascular diseases and other diseases that involved the liver. These chronic diseases were also associated with relatively less plutonium found in the liver relative to the skeleton determined by analyses conducted after autopsy. These data further document health conditions that affect plutonium biokinetics and organ deposition and retention patterns and suggest that health status should be considered when conducting plutonium bioassays as these may alter subsequent dosimetry and risk models., Competing Interests: The authors have declared that no competing interests exist.

Stomach cancer is a widespread health condition associated with environmental and genetic factors. Contribution of ionizing radiation to stomach cancer etiology is not sufficiently studied. This study was aimed to assess an association of the stomach cancer incidence risk with doses from occupational radiation exposure in a cohort of workers hired at main Mayak production association facilities in 1948-1982 taking into account non-radiation factors including digestive disorders. The study cohort comprised 22,377 individuals and by 31.12.2013 343 stomach cancer diagnoses had been reported among the cohort members. Occupational stomach absorbed doses were provided by the Mayak Worker Dosimetry System- 2008 (MWDS-2008) for external gamma ray exposure and by the Mayak Worker Dosimetry System- 2013 (MWDS-2013) for internal exposure to plutonium. Excess relative risks (ERR) per Gy for stomach cancer were estimated using the Poisson's regression. Analyses were run using the AMFIT module of the EPICURE software. The stomach cancer incidence risk in the study cohort was found to be significantly associated with the stomach absorbed dose of gamma rays: ERR/Gy = 0.19 (95% CI: 0.01, 0.44) with a 0 year lag, and ERR/Gy = 0.20 (95% CI: 0.01, 0.45) with a 5 year lag. To estimate the baseline risk, sex, attained age, smoking status and alcohol consumption, chronic diseases (peptic ulcer, gastritis and duodenitis) were taken into account. No modifications of the radiogenic risk by non-radiation factors were found in the study worker cohort. No association of the stomach cancer incidence risk with internal exposure to incorporated plutonium was observed., Competing Interests: The authors have declared that no competing interests exist.

The US Transuranium and Uranium Registries is a human tissue program that collects tissues posthumously from former nuclear workers and radiochemically analyzes them for actinides such as plutonium, americium, and uranium. It was established in 1968 with the goal of advancing science and improving the safety of future workers. Roundtable participants recalled various aspects of this multidisciplinary research program, from establishing consistent autopsy protocols to comparing the registries' findings to those of other programs, such as the historical beagle dog studies and the Russian Radiobiological Human Tissue Repository. The importance of meeting ethical and legal requirements, including written consent forms, was emphasized, as was the need to know whether workers were exposed to nonradiological hazards such as beryllium or asbestos. At Rocky Flats, a bioassay program was established to follow workers after they terminated employment. The resulting data continue to help researchers to improve the biokinetic models that are used to estimate intakes and radiation doses. After 50 y, the US Transuranium and Uranium Registries continues to contribute to our understanding of actinides in humans, which is a testament to the vision of its founders, the generosity of its tissue donors, and the many dedicated scientists who have worked together to achieve a common goal.

In this study, lung cancer risk from occupational plutonium exposure was analyzed in a pooled cohort of Mayak and Sellafield workers, two of the most informative cohorts in the world with detailed plutonium urine monitoring programs. The pooled cohort comprised 45,817 workers: 23,443 Sellafield workers first employed during 1947-2002 with follow-up until the end of 2005 and 22,374 Mayak workers first employed during 1948-1982 with follow-up until the end of 2008. In the pooled cohort 1,195 lung cancer deaths were observed (789 Mayak, 406 Sellafield) but only 893 lung cancer incidences (509 Mayak, 384 Sellafield, due to truncated follow-up in the incidence analysis). Analyses were performed using Poisson regression models, and were based on doses derived from individual radiation monitoring data using an updated dose assessment methodology developed in the study. There was clear evidence of a linear association between cumulative internal plutonium lung dose and risk of both lung cancer mortality and incidence in the pooled cohort. The pooled point estimates of the excess relative risk (ERR) from plutonium exposure for both lung cancer mortality and incidence were within the range of 5-8 per Gy for males at age 60. The ERR estimates in relationship to external gamma radiation were also significantly raised and in the range 0.2-0.4 per Gy of cumulative gamma dose to the lung. The point estimates of risk, for both external and plutonium exposure, were comparable between the cohorts, which suggests that the pooling of these data was valid. The results support point estimates of relative biological effectiveness (RBE) in the range of 10-25, which is in broad agreement with the value of 20 currently adopted in radiological protection as the radiation weighting factor for alpha particles, however, the uncertainty on this value (RBE = 21; 95% CI: 9-178) is large. The results provide direct evidence that the plutonium risks in each cohort are of the same order of magnitude but the uncertainty on the Sellafield cohort plutonium risk estimates is large, with observed risks consistent with no plutonium risk, and risks five times larger than those observed in the Mayak cohort.

The results of the examination and monitoring of the personnel at the Siberian Chemical Plant (SChP) and adult population of Seversk are presented. The results of primary examination of the personnel who professionally contact the ionizing radiation (IR) from external sources and incorporated 239Pu showed that clinical symptoms of dysfunction of the immune system manifested themselves with a frequency of 75.30%. Infectious-inflammatory diseases (46.95%) and the combined pathology of infectious and allergic character (20.12%) were the most widespread. The allergic diseases (AD) without manifestations of an infectious component were observed not often (7.62%). The monitoring which was carried out for 10 years revealed a decrease in a percentage of persons with clinical signs of disorders of the immune system up to 60.68% among the personnel at the Chemical-Steel Plant and even more among the whole group of the studied personnel at SChP--49.68% (389 : 783). Among the population their frequency made up 51.78%. Features of clinical manifestations of dysfunction ofthe immune system depending on accumulation of 239Pu in the organism are established. Similar dynamics of infectious and infectious and allergic syndromes is revealed when the activity of 239Pu is 40 nCi. AD frequency reliably increased .when the activity of 239Pu is 20 nCi, but if accumulation is higher than 20-40 nCi it decreases and again increases when the activity is over 40 nCi. Pathologies of infectious and allergic genesis are most often observed when the content of 239Pu in an organism is over 40 nCi. Indicators of the immune status (IS) of the personnel at SChP with incorporated 239Pu are analyzed. 59 people--carriers of 239Pu and 408 people without 239Pu accumulated in an organism are examined. In comparison with the control, IS indicators characteristic for all dose loading groups are revealed: increase of lymphocytes, existence of dissociation in indicators of relative and absolute values of the T-cellular link, CD16+56+(-) NK-cells and B-lymphocytes with increase of absolute values, decrease in markers of activation of HLA-DR+ and CD95+, increase of B-lymphocytes and low level of serum IgM. Features of IS in comparison with the group of the personnel with the absence of 239Pu in an organism and indicators of IS which depend on the activity of 239Pu are established. Among them are a decrease in the percentage of persons with increased number of lymphocytes with increased beam loading; increase of NK-T-cells when the activity of 239Pu is 10-20 nCi and the highest value at doses over40 nCi; the dynamics of CD16+56(+)-lymphocytes with the increase of the contents and a percentage of persons with the increase of the activity above 40 nCi; the highest frequenc of a regulatory imbalance with high frequency decrease of CD8(+)-T-lymphocytes at the content of 239Pu > 0-10 nCi; decrease in indicators of B-lymphocytes and serum IgA with an increase in the activity of 239Pu with the lowest values under internal radiation over 40 nCi; decrease in the percentage of persons with a weakening expression of HLA-DR+ with the increase in dose loading.

A detailed analysis of cerebrovascular diseases (CeVD) for the cohort of workers at Mayak Production Association (PA) is presented. This cohort is especially suitable for the analysis of radiation induced circulatory diseases, due to the detailed medical surveillance and information on several risk factors. The risk after external, typically protracted, gamma exposure is analysed, accounting for potential additional internal alpha exposure. Three different endpoints have been investigated: incidence and mortality from all cerebrovascular diseases and incidence of stroke. Particular emphasis was given to the form of the dose-response relationship and the time dependence of the radiation induced risk. Young attained age was observed to be an important, aggravating modifier of radiation risk for incidence of CeVD and stroke. For incidence of CeVD, our analysis supports a dose response sub-linear for low doses. Finally, the excess relative risk per dose was confirmed to be significantly higher for incidence of CeVD compared to CeVD mortality and incidence of stroke. Arguments are presented for this difference to be based on a true biological effect.

We present an updated analysis of incidence and mortality from atherosclerotic induced ischemic heart diseases in the cohort of workers at the Mayak Production Association (PA). This cohort constitutes one of the most important sources for the assessment of radiation risk. It is exceptional because it comprises information on several other risk factors. While most of the workers have been exposed to external gamma radiation, a large proportion has additionally been exposed to internal radiation from inhaled plutonium. Compared to a previous study by Azizova et al. 2012, the updated dosimetry system MWDS-2008 has been applied and methods of analysis have been revised. We extend the analysis of the significant incidence risk and observe that main detrimental effects of external radiation exposure occur after more than about 30 years. For mortality, significant risk was found in males with an excess relative risk per dose of 0.09 (95% CI: 0.02; 0.16) [Formula: see text] while risk was insignificant for females. With respect to internal radiation exposure no association to risk could be established.

Background: Cancer incidence in the Mayak Production Association (PA) cohort was analysed to investigate for the first time whether external gamma-ray and internal plutonium exposure are associated with raised incidence of solid cancers other than lung, liver and bone (other solid cancers)., Methods: The cohort includes 22,366 workers of both sexes who were first employed between 1948 and 1982. A total of 1447 cases of other solid cancers were registered in the follow-up period until 2004. The Poisson regression was used to estimate the excess relative risk (ERR) per unit of cumulative exposure to plutonium and external gamma-ray., Results: A weak association was found between cumulative exposure to external gamma-ray and the incidence of other solid cancers (ERR/Gy=0.07; 95% confidence intervals (CIs): 0.01-0.15), but this association lost its significance after adjusting for internal plutonium exposure. There was no indication of any association with plutonium exposure for other solid cancers. Among 16 individual cancer sites, there was a statistically significant association with external exposure for lip cancer (ERR/Gy=1.74; 95% CI: 0.37; 6.71) and with plutonium exposure for pancreatic cancer (ERR/Gy=1.58; 95% CI; 0.17; 4.77)., Conclusion: This study of Mayak workers does not provide evidence of an increased risk of other solid cancers. The observed increase in the risk of cancer of the lip and pancreas should be treated with caution because of the limited amount of relevant data and because the observations may be simply due to chance.

Retrospective study with "case-control" method revealed increased risk of gastric cancer among "Mayak" production association workers subjected to prolonged general external gamma-radiation in overall dose over 3.0 Gy. Major role in gaster cancer among "Mayak" production association workers was played by nonradiation factors: chronic gastritis with hyposecretion, peptic ulcer, cigarette smoking, alcohol abuse.

A collection of software tools developed for the Mayak worker study is described. IMPDOS is software for modelling, data analysis, and activity and dose calculations using the bioassay and postmortem data from Mayak workers provided by Southern Urals Biophysics Institute. The capabilities include: parameter fitting of data for individual cases, Bayesian dose calculations using the fit results for collections of cases with extensive data as a biokinetic prior, and database storage of results for retrieval, analysis and interpretation.

Lung cancer mortality among 5,058 male workers of the Mayak Production Association has been analyzed with emphasis on the interaction of smoking and radiation exposure by using the two-step clonal expansion (TSCE) model of carcinogenesis. The cohort consists of all Mayak workers with known smoking status, who were employed in the period 1948-1972, and who either had the plutonium concentration in urine measured or who worked in the reactors, where plutonium exposure was negligible. Those who died during the first two years after the first urine sampling were excluded. The follow-up extended until the end of 1998. During this time, 2,176 workers died, including 244 lung cancer cases. Mayak workers were exposed to external (gamma and neutron) radiation, and in the radiochemical and plutonium plants to plutonium. In the preferred TSCE model, internal radiation and smoking act on the clonal expansion of pre-carcinogenic clones. Assuming a plutonium radiation weighting factor of 20, the excess relative risk per lung dose was estimated to be 0.11 (95% CI: 0.08; 0.17) Sv(-1). Most of the lung cancer deaths are found to be due to smoking. The second main factor is the interaction of smoking and internal radiation. The model is sub-multiplicative in relative risks due to smoking and radiation. In a multiplicative version of the TSCE model, internal radiation acts on initiation and transformation rates. This model version agrees with conventional epidemiological risk models, because it also suggests a higher risk estimate than the preferred TSCE model. However, it fits the data less well than the preferred model.

The assessment of the relative biological effectiveness (RBE) for alpha-radiation was held in the cases of inhalation of radon progeny and incorporation of plutonium in lungs. It is based on simulation of lung cancer radiation risk for different types of radiation. Specific radiation risk models developed according to the results of direct epidemiological studies are used for the simulation. These include two published risk models for uranium miners and nuclear workers of the Mayak facilities in the former Soviet Union. Additionally two lung cancer risk models are developed and described for the following cases: population indoor radon exposure and low-linear-energy-transfer reference radiation exposure. By the results of lifetime lung cancer risk simulation the RBE values range from 11 to 12 and from 1.7 to 4.9 for the cases of plutonium incorporation and of radon progeny exposure accordingly. The significant uncertainty of radiation risk models results in significant variation of RBE assessments. Rough estimations of RBE values 90% confidence interval are from unit fraction to 25 and from 2 to 50 for the cases of radon progeny exposure and plutonium incorporation accordingly.

A study of frequency of unstable chromosome aberrations in 50 workers of nuclear chemical plants in remote period after beginning or finishing professional contact with ionizing radiation was carried out. 14 persons from this cohort were mainly whole-body exposed to external gamma-rays and 36 were exposed to combined external and internal radiation from incorporated Pu nuclides. In results of this irradiating practically every subject had a chronical radiation sickness. In the 1-st group the frequency of unstable aberrations varied from 0.2 to 3.6 per 100 cells and exceeded reliably control level in 5 persons. In the 2-nd group the frequency of unstable aberrations varied from 0 to 11.6 per 100 cells and exceeded reliably control level in 20 examined workers. The FISH study of frequency of stable aberrations was performed in 13 subjects who were exposed to combined external and internal radiation. Total frequency of complete and incomplete translocations varied from 0.6 to 18.5 aberrations per genome per 100 cells and reliable exceeded control level in 9 subjects. Non-random participation in exchange rearrangements (translocations) was revealed for used set of chromosomes (2, 3 and 8).

The examinees demonstrated definite effects caused by total influence of Am-241 and Pu-239: chronic radiation sickness with diffuse pneumosclerosis, chronic toxic radiation bronchitis and peripheral blood changes (reactive alterations and stable lower platelets and reticulocytes count), microfocal hypoplasia, osteodysplasia, reactive hepatopathy. Frequency of these effects increased with higher radiation exposure and did not depend on the age.

Berylliosis and plutonium pneumosclerosis patients appeared to have two types of pulmonary hypertension: hypervolemic and hypertonic ones. Hypervolemic type of pulmonary circulation was revealed in 31.7% of berylliosis patients and in 53.8% of plutonium pneumosclerosis patients. Hypertonic type of pulmonary circulation was seen in 68.3% of berylliosis patients and in 46.2% of plutonium pneumosclerosis patients mainly at stages II and III. Berylliosis and plutonium pneumosclerosis patients are subjects for early pulmonary hypertension--moderate in most patients at stage I and high at stage II and III. Pulmonary hypertension is a main pathogenetic factor underlying chronic corpulmonale formation.

A new analysis of lung cancer mortality in a cohort of male Mayak workers who started their employment in the plutonium and reprocessing plants between 1948 and 1958 has been carried out in terms of a relative risk model. The follow-up has been extended until 1999, moreover a new dosimetry system (DOSES2000) has been established. Particular emphasis has been given to a discrimination of the effects of external gamma-exposure and internal alpha-exposure due to incorporated plutonium. This study has also utilized and incorporated the information from a cohort of Mayak reactor workers, who were exposed only externally to gamma-rays. The influence of smoking as the main confounding factor for lung cancer has been studied. The baseline lung cancer mortality rate was not taken from national statistics but was derived from the cohort itself. The estimated excess relative risk for the plutonium alpha-rays was 0.23/Sv (95%CI: 0.16-0.31). The resulting risk coefficient for external gamma-ray exposure was very low with a statistically insignificant estimate of 0.058/Sv (95%CI: -0.072-0.20). The inferred relative risk for smokers was 16.5 (95%CI: 12.6-20.5).

Spectrometry was used by means of an alpha-radiometer on a [symbol: see text]porpecc-[symbol: see text] hard-and-software complex to study the radioactive contamination of the surfaces of neutralizers with plutonium 239-based ionizing radiation sources, which are employed to remove electrical charges from electrifiable materials. While using the neutralizers, the operating personnel is shown to be exposed to radiation. The level of removed radioactive contamination during half-a-year exploitation of the neutralizers was greater than the maximum allowable values on the average by several times. Radiation hazard in the use of radioisotopic neutralizers of static electricity is outlined.

Bone cancer mortality risks were evaluated in 11,000 workers who started working at the "Mayak" Production Association in 1948-1958 and who were exposed to both internally deposited plutonium and external gamma radiation. Comparisons with Russian and U.S. general population rates indicate excess mortality, especially among females, plutonium plant workers, and workers with external doses exceeding 1 Sv. Comparisons within the Mayak worker cohort, which evaluate the role of plutonium body burden with adjustment for cumulative external dose, indicate excess mortality among workers with burdens estimated to exceed 7.4 kBq (relative risk = 7.9; 95% CI = 1.6-32) and among workers in the plutonium plant who did not have routine plutonium monitoring data based on urine measurements (relative risk = 4.1; 95% CI = 1.2-14). In addition, analyses treating the estimated plutonium body burden as a continuous variable indicate increasing risk with increasing burden (P < 0.001). Because of limitations in current plutonium dosimetry, no attempt was made to quantify bone cancer risks from plutonium in terms of organ dose, and risk from external dose could not be reliably evaluated.

Liver cancer mortality risks were evaluated in 11,000 workers who started working at the "Mayak" Production Association in 1948-1958 and who were exposed to both internally deposited plutonium and external gamma radiation. Comparisons with Russian liver cancer incidence rates indicate excess risk, especially among those with detectable plutonium body burdens and among female workers in the plutonium plant. Comparisons within the Mayak worker cohort which evaluate the role of plutonium body burden with adjustment for cumulative external dose indicate excess risk among workers with burdens estimated to exceed 7.4 kBq (relative risk = 17; 95% CI = 8. 0-36) and among workers in the plutonium plant who did not have routine plutonium monitoring data based on urine measurements (relative risk = 2.8; 95% CI = 1.3-6.2). In addition, analyses treating the estimated plutonium body burden as a continuous variable indicate increasing risk with increasing burden (P < 0.001). Relative risks tended to be higher for females than for males, probably because of the lower baseline risk and the higher levels of plutonium measured in females. Because of limitations in current plutonium dosimetry, no attempt was made to quantify liver cancer risks from plutonium in terms of organ dose, and risk from external dose could not be reliably evaluated.

The mortality of all 14 319 workers employed at the Sellafield plant of British Nuclear Fuels between 1947 and 1975 was studied up to the end of 1992, and cancer incidence was examined from 1971 to 1986, in relation to their exposures to plutonium and to external radiation. The cancer mortality rate was 5% lower than that of England and Wales and 3% less than that of Cumbria. The significant excesses of deaths from cancer of the pleura and thyroid found in an earlier study persist with further follow-up (14 observed, 4.0 expected for pleura; 6 observed, 2.2 expected for thyroid). All of the deaths from pleural cancer were among radiation workers. For neither site was there a significant association between the risk of the cancer and accumulated radiation dose. There were significant deficits of deaths from cancers of mouth and pharynx, liver and gall bladder, and larynx and leukaemia when compared with the national rates. Among all radiation workers, there was a significant positive association between accumulated external radiation dose and mortality from cancers of ill-defined and secondary sites (10-year lag, P = 0.04), leukaemia (no lag, P = 0.03; 2-year lag, P = 0.05), multiple myeloma (20-year lag, P = 0.02), all lymphatic and haematopoietic cancers (20-year lag, P= 0.03) and all causes of death combined (20-year lag, P= 0.008). Among plutonium workers, there were significant excesses of deaths from cancer of the breast (6 observed, 2.6 expected) and ill-defined and secondary cancers (29 observed, 20.1 expected). No significant positive trends were observed between the risk of deaths from cancers of any specific site, or all cancers combined, and cumulative plutonium and external radiation doses. For no cancer site was there a significant excess of cancer registrations compared with rates for England and Wales. Analysis of trends in cancer incidence showed significant increases in risk with cumulative plutonium plus external radiation doses for all lymphatic and haematopoietic neoplasms for 0-, 10- and 20-year lag periods. Taken as a whole, our findings do not suggest that workers at Sellafield who have been exposed to plutonium are at an overall significantly increased risk of cancer compared with other radiation workers.

Clinical and immunological investigation with immune status evaluation of the group of people who had professionally contacts with Pu-239 in the quantity of 328 persons. The clinical characters of immune deficiency (ID) were defected in 75.3% of examined persons. There are showed that leading clinical syndromes of ID is appeared the infection syndromes (62.5%). The distribution of ID clinical infection characters are increased with increasing of radiation from internal 239Pu contains and seniority of professional contact with them. The particularity of immune status and dependence of the change its indices from the internal radiation dose, seniority of professional contact with Pu-239 and chronic diseases were revealed.

It was shown on the basis of retrospective investigation of 500 workers at a nuclear enterprise (162 cases of lung cancer, 338 persons as matching control) that the interaction of external gamma-irradiation (> 2.0 Gy) and the body-burden of 239Pu (> 9.3 kBq) at lung cancer incidence in multiplicative. Combined influence of smoking and radiation factors was found dependent on smoking index (SI): it changed from additive up to multiplicative and than to antagonistic with the increase of the smoking effect. The received results could be explained on the basis of a two-mutation model of radiation carcinogenesis.

The "dose-response" mechanism has been studied for three main histological types of tumor in a cohort of 500 workers occupationally exposed to different doses of radiation (162 patients with lung cancer and 338 practically healthy persons) using the "case-control" method and multifactorial logic regression procedure. A non-linear threshold dependence was established for incorporated plutonium, with the threshold being at 8 kBq to correspond to 80 kGy. This relationship has been particularly distinct in cases of adenocarcinoma. No significant results have been obtained for the "dose-response" relationship in chronic external exposure to gamma irradiation. Said dependence for tobacco smoking appeared to be linear. Most pronounced variations were recorded for squamous cell carcinoma.

Adenocarcinoma frequency in Pu incorporation-related lung cancer patients among plutonium workers was found to be 74% versus 33% in control. Each histological pattern of lung cancer appeared to be related to several etiological factors but in varying degree. Incorporated Pu proved the strongest factor in adenocarcinoma development. Its odds ratio (OR) was 6.9, while that for smoking-4.3. However, smoking appeared to be the most significant factor in squamous cell carcinoma genesis (OR-6.8). Among other factors were chronic obstructive pathology of the lung (OR-3.9) and reduced body weight (OR-2.1). The OR for Pu incorporation was 3.9. Squamous cell carcinomas were traced to reduced body weight (OR-2.9), heavy smoking (smoking index more than 500) (OR-3.5). However, no significant relationship has been established between carcinogenesis and Pu incorporation.

A case-control study using logistic regression included 500 employees of the nuclear works (162 patients with lung carcinoma and 338 healthy controls). After examination of radiation and nonradiation causative factors 5 proved statistically significant. For them the following chance proportions were obtained: smoking 6.6, plutonium pneumosclerosis 4.6, plutonium incorporation 3.1, chronic nonspecific pulmonary diseases 2.1, external gamma-radiation 1.6. Attributive risk for the total of the radiation factors makes up 25% at the most while of the nonradiation factors at least 70%.

The study covered the metabolic parameters in a total of 390 workers of atomic industry, who received the total surface dose of gamma rays equal to 1.0-7.5 Gy and periodic excessive incorporation of plutonium-239. The authors described age- and sex-matched radiation-induced moderate changes in metabolism of fats, carbohydrates, proteins and the compromised activity of enzymes. The most distinct changes were seem in the people, who had received the total surface dose of gamma rays over 4.0 Gy. The metabolic changes were individually evaluated by an integral biochemical index, which proved the strong correlation with radiation.

Retrospective and prospective epidemiologic studies are being conducted as part of a national survey of plutonium workers at four Department of Energy facilities (Los Alamos, NM; Rocky Flats, CO; Mound Laboratory, OH; and Savannah River, SC). A preliminary analysis of mortality was done for all white males who have worked at the Rocky Flats Plant during the period 1952-79. The 452 observed deaths were significantly fewer than the 831 expected for all causes. The 107 deaths due to all malignant neoplasms were also significantly fewer than the 167 expected from these diseases. Expected deaths were derived from age and calendar-specific death rates for U.S. white males. Deaths reported for benign and unspecified neoplasms numbered eight versus an expected two, a significant elevation. These tumors, all intracranial, are the subject of a case-control study to be reported later. Subdividing the cohort on the basis of plutonium exposures and external radiation exposures results in similar overall findings. The benign and unspecified neoplasms, however, were not significantly high in the plutonium-exposed group.

We conducted a melanoma case-control study at the Los Alamos National Laboratory to investigate whether related occupational exposures or personal characteristics of employees could be identified. This study was prompted by a recent report from the Lawrence Livermore National Laboratory that melanoma was much more frequent than expected among employees and that persons suffering from melanoma more often worked as chemists. Our investigation did not uncover an association with plutonium body burden, cumulative external radiation exposure, or employment as a chemist or a physicist. The major finding was that cases were more educated than controls. Melanoma risk was 2.11 among college-educated employees and increased to 3.17 among those with graduate degrees (Mantel-extension linear trend probability = 0.038). This finding is consistent with the often reported increased melanoma incidence among persons of higher social class. It points to personal characteristics, particular to persons of higher educational attainment, as risk factors for melanoma at the Los Alamos National Laboratory.

In response to an observed excess risk of brain tumor deaths among workers at the Rocky Flats Nuclear Facility (Colorado), a case-control study of all (n = 16) primary brain tumor deaths occurring among white males employed during 1952 through 1977 was conducted to investigate their relationship with occupational radiation/nonradiation exposures. For each case, four controls were individually matched on year of birth and period of employment. Although limited by a small number of cases, our study showed no statistically significant association between brain tumor death and exposure to internally deposited plutonium, external radiation, or other occupational risk factors.

The clinical and histological examination of a cataract in a man of 47 is described together with a review of the deposition of radionuclides in the eye. It is suggested that the cataract was possibly due, at least in part, to irradiation of the sensitive cells in the germinative zone of the lens epithelium by alpha particles deposited in the pigmented tissues of the eye from the 239Pu circulating in the blood.

This paper reports on results from the study initiated by Mancuso into the health risks from low-level radiation in workers engaged in plutonium manufacture at Hanford Works, Washington State, USA, and attempts to answer criticisms of previous reports by an in-depth study. Previous reports have aroused much controversy because the reported risk per unit radiation dose for cancers of radiosensitive tissues was much greater than the risk generally accepted on the basis of other studies and widely used in setting safety levels for exposure to low-level radiation. The method of regression models in life-tables isolates the effect of radiation after statistically controlling for a wide range of possible interfering factors. Like the risk of lung cancer for uranium miners the dose-response relation showed a significant downward curve at about 10 rem. There may, therefore, be better agreement with other studies, conduct at higher doses, than is widely assumed. The findings on cancer latency (of about 25 years) and the effect of exposure age (increasing age increases the risk) are in general agreement with other studies. An unexplained finding is a significantly higher dose for all workers who developed cancers in tissues that are supposed to have low sensitivity to cancer induction by radiation.