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Radium in Humans: a Review of US Studies

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Radium in Humans: a Review of US Studies Disclaimer This document was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of its employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof. Argonne National Laboratory is operated by The University of Chicago for the United States Department of Energy under contract W-31-109-Eng-38. Available to the U.S. Department of Energy and its contractors from the Office of Scientific and Technical Information, P.O. Box 62, Oak Ridge, TN 37831; prices available from (615) 576-8401. Available to the public from the U.S. Department of Commerce, Technology Administration, National Technical Information Service, 5825 Port Royal Road, Springfield, VA 22161, telephone (703) 487-4650. Contents Notation.................................................................................................. vi Preface.................................................................................................... vii Foreword................................................................................................. xi 1 Introduction...................................................................................... 1 2 Historical Background....................................................................... 3 The Medical Uses of Radium............................................................. 3 The Dial Painting Industry................................................................. 11 Early Findings on Health Effects of Radium...................................... 23 The Role of the Radium Cases in Radiation Protection....................... 28 3 The Postwar Studies of Radium Cases................................................ 31 The Program at the Massachusetts Institute of Technology................ 31 Argonne Radium Studies, 1945-1960................................................ 35 The New Jersey Radium Research Project.......................................... 51 Argonne Cancer Research Hospital and the Argonne Radium Studies................................................................ 53 The Center for Human Radiobiology................................................. 64 Review, Ad Hoc, and Advisory Committees........................................ 72 The Study of Plutonium and Thorium Cases...................................... 76 4 The Hazards of Internally Deposited Radium..................................... 79 Bone Sarcomas.................................................................................. 80 Head Carcinomas............................................................................... 87 Multiple Myeloma............................................................................. 91 Breast Cancer..................................................................................... 94 Leukemias......................................................................................... 99 Life Shortening in the Dial Worker Population.................................. 100 Bone Changes.................................................................................... 102 5 Risk Estimates for Radium-Induced Malignancies.............................. 106 6 The Termination of the Radium Studies Program.............................. 113 References............................................................................................... 116 Appendix: Measured Radium Cases........................................................ 131 iii Figures 1 The April 1914 issue of the journal Radium carried this title page........................................................................ 5 2 This advertisement for radium preparations, which appeared in the May 1915 issue of the journal Radium, included a statement of acceptance by the American Medical Association......................................................... 6 3 This advertisement for radium preparations to be used internally and externally appeared in the June 1916 issue of the journal Radium.............................................................. 10 4 Dial painters in a studio in Peru, Illinois, pause in their work............. 16 5 A large number of dial painters worked in this studio in Ottawa, Illinois, in 1925.................................................................... 17 6 This photograph of a studio in Ottawa, Illinois, shows variations in the placement of the radium-containing paint on the desk of each dial painter............................................... 20 7 Buildings 202 and 203, in the 200 area at Argonne National Laboratory, housed Argonne’s radium studies after 1952................ 44 8 Inside the whole-body counter in Argonne’s Center for Human Radiobiology, a patient is ready for a measurement of gamma rays emitted from her body........................ 46 9 Three radium retention functions are plotted for comparison........... 64 10Appearance times of bone sarcomas are grouped by five-year periods......................................................................... 82 11This plot of appearance time versus initial systemic intake for radium-induced bone sarcomas does not support the practical threshold hypothesis........................................................... 83 12Appearance times for radium-induced head carcinomas are grouped by five-year periods...................................................... 90 13Appearance times for radium-induced head carcinomas are plotted against initial systemic intake levels................................. 91 iv Tables 1 Employment Statistics for Measured Dial Workers.......................... 21 2 Employment Statistics for Identified but Unmeasured Dial Workers................................................................................... 23 3 Argonne Periodic Reports Including Information about Radium Studies............................................................................... 36 4 Growth in the Number of Measured Radium Cases......................... 68 5 Comparison of Patients Treated at Two Midwestern Institutions...... 70 6 Female Dial Workers Named on Lists.............................................. 72 7 Bone Sarcomas by Sex................................................................... 81 8 Distribution of Bone Sarcomas between Dial Workers and Other Radium-Exposed Subjects.............................................. 81 9 Measured Radium Cases with Bone Sarcomas................................. 84 10 Unmeasured Cases with Bone Sarcomas.......................................... 88 11 Head Carcinomas by Sex................................................................ 88 12 Distribution of Head Carcinomas in Dial Workers and Other Radium-Exposed Subjects.............................................. 89 13 Radium Cases with Head Carcinomas.............................................. 92 14 Radium Case Deaths Coded to Multiple Myeloma........................... 95 15 Radium Subjects with Multiple Myeloma Who Were Alive at Last Contact or Whose Deaths Were Coded to Another Cause............................................................................ 96 A.1Exposure Data for Radium Subjects to the End of 1990, Calculated with the Modified ICRP 20 Retention Function.............. 135 A.2Codes Describing Types of Exposure to Radium................................ 232 v Notation ACBM Advisory Committee for Biology and Medicine (of the AEC) AEC Atomic Energy Commission ALD Associate Laboratory Director (of Argonne) BIM Biological and Medical Research (Argonne division) CHR Center for Human Radiobiology (of Argonne) DBER Division of Biomedical and Environmental Research (of the AEC) ER Environmental Research (Argonne division) ESH (Assistant Secretary for) Environment, Safety, and Health (of the U.S. Department of Energy) ICD International Classification of Diseases ICRP International Commission on Radiological Protection JCAE Joint Committee on Atomic Energy MIT Massachusetts Institute of Technology NBS National Bureau of Standards (now the National Institute of Standards and Technology) NCRP National Committee on Radiation Protection and Measurement NJRRP New Jersey Radium Research Project OER Office of Energy Research (of the U.S. Department of Energy) RER Radiological and Environmental Research (Argonne division) RPY Radiological Physics (Argonne division) SNOP Systematized Nomenclature of Pathology vi Preface This document was originally conceived as a compilation of activities at Argonne National Laboratory that were directed toward the study of radium in humans. However, it soon became obvious that this was a very limited approach, because such a compilation would include no background on the widespread uses of radium in industry and in the medical profession, nor would it address the early history of the discovery of the hazards of radium. Such an approach would also ignore contributions to the
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