B -5'* L Ramuranium And

B -5'* L ramuranium and

2nnualKeport, September 1993 USTUR-00 15-94

Annual Report of the United States Transuranium and Uranium Registries

April 1992 - September 1993

USTUR Washington State University 100 Sprout Road Richland, Washington 99352

Phone: (509)376-6010 FAX (509)375-1817

Prepared by

Ronald L. Kathren, Lynn A. Hanoick, Richard E. Toohey, John J. Russell, Ronald E. Filipy, Scott E. Dietert, Mickey M. Hunacek, Charlene A. Hall TABLEOF CONTENTS

Preface ...... 1 Executive Summary ...... _...... 2 History of Registries ...... 3 Protohistory ...... 3 Origins and Early Operations ...... 3 Scientific Beginnings ...... 4 Administrative Developments ...... 5 1978: A Watershed Year ...... 6 The Uranium Registry ...... 6

The Second Decade ...... ~ ...... 7 1992: A Year of Change ...... 8 Beyond 1992: Goals and Objectives ...... 10 Former Advisory Committees ...... 12 Directors of the USWR ...... 13 Genealogy of the US'T'UR ...... 14 Administrative Progress and Accomplishments...... 15 -

policy and Procedures Manual ...... 15 ::-.* - Physical Facilities ...... 15 Staffingand Organization ...... 15 public wormation ...... 15 Registrant File Audit ...... , ...... 15 Registrant Renewals ..... , ...... 16 Microfilming of Registrant Records ...... 16 Advisory Committee ...... 16 Publications ...... 16 Summary of ScientificProgress ...... 17 USmCase 246: Analyses of Post Mortem Data ...... 17 Soft Tissue Concentrations of mpu, u9P~,240P~ and "'Am ...... 18 Risk Coefficientsfor Alpha Particles ...... 18 Kidney Toxicity of Uranium ...... 19 USmDatabase ...... 19 National Human Radiobiology Tissue Repository ...... 20 USmCase 10%: Thorotrast Whole Body Donor ...... 20 Postmortem issue Analysis for Five Whole Body Donors...... 22CI') Introduction ...... LL Description and Exposure History of USTUR Case 0193 ...... 22CI') USmCase 0208 ...... ~3 USWR Case 0212 ...... 23 USluR Case 0213 ...... 24 USWR Case 0242 ...... 24 Interpretation of the Tabulated Radiourinalysis and Nose Wipe Data ...... 25 Radioassay Data ...... 26 Radiourinalysis and Nose Wipe Data ...... 27 Tissue Weights and Activity Levels ...... 50

Appendices

A. Policy and Procedure Manual Table of Contents ...... 121 B. Functional Organization Chart ...... 123 C. Advisory Committee Report ...... 124 D. Publications ...... 131

Distribution List ...... ;...... ,...... 134

_.~.

e 1081418 ii I. Preface

1081419 f

PROGRESSREPORT OF THE UNITEDSTATES TRANSURANIUM AND URANIUM REGISTRlES APRIL2992-SEPTEMBER 2993

PREFACE This is the second progress report issued since the transfer of the Registries from the Hanford Environ- mental Health Foundation (HEHF) to Washington State University (WSU) under provisions of a grant from the U S Department of Energy (DOE). It is particularly significant for the following two reason: first, it covers the initial period that the management and operation of the Reptries have been transferred from the administration of a DOE contractor to an independent university. Second, 1993 marks the twenty-fifth anniversary of the formation of the Registries, and this report is essentially a silver anniversary commemorative publication. Thus, it provides a brief history of the development of the Registries during their first 25 years, as well as the complete exposure histories and radioanalyticaldata for five whole body donations to the Registries, making these unique and important data available toresearchers concerned with dosimetry and biokinetics of plutonium and americium. Since the transition from contract to grant is now virtually complete, and the Registries fiscal year has been adjusted to coincide with the Federal fiscal year, the regular issuance of an annual report of activities will resume. Future progress reports will cover the period from October 1 through September 30. This report owes much to the able secretarial assistance of June Markel, USTUR Senior Secretary, to whom special thanks are due, and Susan Young whose efforts are also reorganized. -

USTUR Annual Report for 1993 1 Ex~mSWARY The Registries originated in 1968 as the National Plutonium Registry with the name changed to the United States Transuranium Registry the following year to reflect a broader concern with the heavier actinides as well. Initially, the scientific effort of the USTR was directed towards study of the distribution and dose of plutonium and americium in occupationally exposed persons, and to assessment of the effects of exposure to the transuranium elements on health. This latter role was reassessed during the 1970's when it was recogruzed that the biased cohort of the USTR was inappropriate for epidemiologic analysis. In 1978, the administratively separate but parallel United States Uranium Registry was created to carry out slmilar work among persons exposed to uranium and its decay products. A seven member scientific advisory committee provided guidance and scientific oversight. In 1992, the two Registries were administratively combined and transferred from the purview of a Department of Energy contractor to Washington State University under the provisions of a grant, thereby gaining the advantage Qf the independence and other benefits associated with the academic setting. The Advisory Committee was reconstituted at the time of the transfer to include a public member and a member of the academic community, as well as four scientific members. Scientific results for the first twenty-five years of the Registries are summarized, including the 1985 publication of the analysis of the first whole body donor. This was a chemist who had suffered a wound contaminated with 241Am early in his career. On the basis of the analysis of this case, new biokinetic parameters for 241Am were proposed, including a much shorter residence half-time in the liver. Current scientific work in progress is summarized along with administrative activities for-the penod. Preliminary postmortem analysis of USTUR Case 0246, an individual who died 11 y following a massive acute exposure to 241Am from a glove box explosion revealed an estimated deposition of 540 kBq, of whichi90°/~was in the skeleton. Peritrabecular fibrosis and blood count changes are possible deterministic effects from th exposure, but radiation exposure was ruled out as a cause of the cataract suffered by this case. Other scienthc progress discussed includes consideration of risk coefficients for alpha radiation based on evaluation of a whole body donor who had received an injection of Thorotrast some 36 y prior to death. Risk coefficients deterrmned for liver cancer were in good agreement with those published in the BEIR IV port; those for leukemia and osteosarcoma were somewhat greater and lower, respectively. Other work in progress discussed includes a uranium kidney histopathology study, evaluation of actinide concentrations, and the preliminary results of the evaluation of a second whole body donor who had been administered Thorotrast. A major accomplishment was establishment of the National Human Radiobiology Tissue Repository, located in a facility adjacent to the Sacred Heart Medical Center in Spokane. The Repository stores and makes available upon request its collection of unique tissue materials from persons with known intakes of long lived radioactivity for use by Scientists for radiobiological and other studies. In addition to histopathology shda. tissue materials, and extracts from analpcal solutions from USTUR registrants, the Repository includes the complete collection of frozen and other tissue specimens and materials from the radium dial painter study formerly carried out by Argonne National Laboratory. The report includes cases summaries, in-vivo monitoring and dosimetry data, and detailed tabulahons of the results of postmortem radiochemical of the tissues of five whole body donors with occupational exposum to plutonium or americium. Tissue concentrations are pmented for each individual tissue and bone sampk analyzed for =Pu, p9+2(opu,and ulAm. Administrative progress during the period is summarized, and includes publication of a formal pohcla and procedures manual, a physical audit of the registrant files, acquisition of laboratory and office space, and publication of brochures for general public distribution.

1081421 USTUR Annual Report for 1993 2 I' 1 I i L t I i

History of Registries f

the pulmonary lymph nodes of a worker with a his- HISTORYOF THE REGISTRIES tory of occupational exposure. Among the study group however, liver depositions were greater than those in the lung. Data for the bone samples collected were Pro tohistory equivocal, and this concluded with a plea for further In 1949, what was described as 'I. . . a modest investigation and collaboration with other plutonium program of postmortem tissue sampling at autopsy. . handling facilities. ." was begun at the Hanford site of the United States Coincidentally, the concluding paper at that Atomic Energy Commission (AEC) (Nelson et al. 1972; same meeting was given by H. D. Bruner of the AEC Newton et al. 1966; Newton et al. 1968). This early Division of Biology and Medicine. Graciously noting human tissue research program, which was in a sense that the idea was not his or that of one person, but rather the progenitor of the USTLJR, had two basic objectives: ". . .occurred to many men about the same time", 1)to provide dormation regarding plutonium concen- Bruner proposed formation of a national Plutonium trations and doses within the body to hospital pathole Registry and described progress towards that goal gists, thereby enabling them to evaluate the possible within the AEC. As outlined by Bruner, the primary contribution of plutonium deposition to various dis- purpose of such a Registry would be to correlate data ease states; and 2) provide a basis for assessing the ef- from accidental intake of plutonium with the subse- fectiveness of occupational and environmental protec- quent health record of the worker. In addition to sketch- tion measures at the Hanford plutonium production ing the basic information and operating requirements site (Bruner 1968). for such a registry, he also listed seven additional pur- The program called for the collection of poses, presciently noting among these #haUhe Pluto- samples of bone, lung, liver, and occasionally other tis- nium Registry should not be limited to plutoniuni but sues at autopsy from both Hanford workers and other should also consider other transuranium elements as residents of Richland, Washington, where most of the well. Hanford site workers resided. The collected samples were then radiochemically analyzed for plutonium, Origins and Early Operations: The Transu- with the goal being to evaluate sites of preferential US. deposition of plutonium within the body, and to com- ranium Registry pare what was observed in the tissues postmortem with The USTUR thus grew out of a desire to better what was predicted based on the application of understand the potential health effects from plutonium incorporated into the human body, gaining not only biokinetic models to excretion data. A similar study of plutonium in the general population was begun at the improved understanding of the health effects of plutonium, but also of the efficacy of control measures based Los Alamos Scientific (now National) Laboratory (W)in 1959 (Campbell et al. 1972), and in the early on actual human experience. The progenitor of what is now the USTUR was formally established in August 1960's by the U.S.Public Health Service (Magno et al. 1969). In addition, limited postmortem sampling of 1%8 as the National Plutonium Registry by HEHF un- occupationally exposed individuals was carried out at der contract to the United States Atomic Energy Com- the AEC Rocky Flats Facility (RFF) (Lagerquist et al. mission (AEC). In its original request for funds, the 1%9). primary purpose of the Registry was stated as the pro- The first formal presentation of the results of tection of the interest of the workers, employees and the Hanford autopsy study was made at the Seventh pubIic by serving as a national focus for acquisition Annual Hanford Symposium on Biology held in May and dissemination of the newest and best information of 1967 in Richland, nearly twenty years after the study relative to the effects of the transuranium elements on had begun (Newton et al. 1968). Predictably measur- people. able, albeit very low, levels of plutonium were found W. Daggett Norwood, a physician whose un- in the tissues of the local residents and Hanford site dergraduate education was in electrical engineering, workers. Most of the plutonium in the tissues was at- and who had figured prominently in the estabhhment tributable to fallout from nuclear weapons tests rather of the medical program at the Hanford site, was ap- than occupational exposures or environmentalreleases pointed the founding director. He was ably assisted from the Hanford site, although the highest individual by Carlos E. Newton, Jr., a Battelle Pacific Northwest tissue concentrations of plutonium were observed in Laboratories staff member, board certified health physicist who carried the title of consultant, and directed

USTUR Annual Report for 1993 3 1 1081423 ! the health physics aspects of the program. Rounding lishment of working arrangements or agreements with out the staff was Dorothy Potter, who served as secre- the sites having such populations. The stated purpose . tary and general administrative assistant. of the Registry, as given in its 1974 Annual Report, in- Even before the contract award had been fi- cluded following these workers both clinically and epi- nalized, Philip A. Fuqua, then medical director of demiologically to ascertain if there might be any ad- HEHF, invited a number of recognized scientists to verse health effects associated with their exposure to serve as members of a blue ribbon Advisory Commit- plutonium. By June 1974, some 5843 transuranium tee to help guide the fledgling Registry. The six initial workers had been identified, of whom 3880 had signed Committee members included three physicians: medical and health physics records releases and 819 Clarence C. Lushbaugh, Oak Ridge Associated Univer- had given authority for autopsy. A total of 45 autop- sities; Thomas E Mancuso, retired head of the Penn- sies had been carried out, two-thirds of which were on sylvania State Occupational Health program and Uni- Rocky Flats workers. versity of Pittsburgh faculty member; iind J. H. Sterner, a faculty member at the University of Texas medical Scientific Beginnings school; two physicists, Robley D. Evans, the MIT phys- Scientific activities in the first years of the ics professor noted for his studies of the radium dial USTR’s operation were limited by the lack of both au- painters and the prominent medical and health physi- topsy material and staff, and the need to establish pro- cist Herbert M. Parker, Battelle; and toxicologist Lloyd cedures and organizational agreements for what was M. Joshel manager of the AEC (now DOE) Rocky Flats in some respects, a rather bold new type of resew Facility operated by the Dow Chemical Company. program. It was quickly realized that a major aspect Qf Wright Langham, the LANL biophysicist who many the work would be the study of the distribution of pluc acknowledged as ”Mr. Plutonium” was added the fol- tonium in the various tissues, and that the analysis of lowing year. the tissues of whole bodies would be needed to avoid - The Advisory Committee met for the first time errors that were likely to occur if only samples of tis- on October 30 and 31 in Richland. Drs. Joshel and sue were obtained at autopsy. Predictably, the greatest Lushbaugh were unable to attend, but the other four concentrations of plutonium were found in the trachee members were joined by Dr. Bruner of the AEC, Dr. bronchial lymph nodes, lungs and liver. Specific stud- Fuqua of HEHF, and the Registry staff. After electing ies were initiated early on, including comparisons of J. H. Sterner and R D. Evans as Chairman and Vice- systemic plutonium depositions from the first 30 au- Chairman, respectively, the Committee proceeded with topsy cases with the estimates made during life from a thorough and detailed discussion of the scope and urinalysis, a study of fundamental importance to as- planned activities of the fledgling Registry. By the end sessing the adequacy of biokinetic models used for op- of its first year, the Registry had established its basic erational assessment of plutonium depositions and operating methodology and had begun recruitment of hence vital to operational health physics programs. An registrants, signing up three volunteers that year. Forty- examination was also made of the causes of death in five facilities, largely AEC contractors, utilizing tran- the first 30 cases, leading to a conclusion that ”. . . the suranic elements were identified, and cooperative usual causes of death were encountered.” working arrangements were solicited with these facili- Radiochemical data were essential to this pur- ties. Forms for collection of health physics and medi- pose and with the exception of cases originating at cal data were developed, and active recruitment was Rocky Flats, tissues collected at autopsy were initially carried out at the Hanford site. sent to Battelle, Pacific Northwest Laboratories for In 1970, the second year of the Registry, the analysis. Cases from Rocky Flats were recruited by that name was changed to the United States Transuranium organization, acting as an agent of the USTR,and Rocky Registry (USTR), thereby reflecting the broader pm- Flats arranged for the autopsies and performed the ra- grammatic concern with the other transuranic elements diochemical analysis on their own cases. Subsequently, as had been put forth in the original funding request in 1971, N was added to list of ”approved” labora- from HEIIT: lo DOE, as well as suggested by Bruner a tories. An un~rsua‘aspect c\f the laboratory arrange- few years previously. The name change did not affect ments was that both Battelle and LANL were funded the basic mission of the Registry, and operations con- independent of the Registry for analysis of the Regis- tinued much as they had begun. Emphasis was on iden- try samples, and thus submitted their own reseaxrh tification of suitable populations and with the estab- proposals in this regard. Rocky Flats provided the

4 USTUK Annual Report for 1993 108”1424 on its cases from its general operating bud- D. Norwood retired from the directorship and was re- et, %trichotomy of laboratories, more or less inde- placed by a retired U.S.Army physician, John A. g of the fundamental Registry program and with Norcross. After little more than a year, however, on the Advisory Cormnittee, which served Norcross was forced by illness to give up the director- in many respects as a Board oi Directors, played a sig- ship and Norwood reassumed the directorship on an nificant role in shaping the future direction of the Reg- interim basis wlule a search was initiated for a replace- istry. ment. On July 1,1976 Bryce D. Breitenstein, Jr. became Asecond major aspect of the work was related the director of the USTR on a halftime basis; Norwood to the stated purpose of assessing the effects of expo- remained on as a consultant. Breitenstein was an ex- sure to the transuranium elements on health. Accord- cellent choice. An internist with considerable experi- ingly, effort was directed towards the development of ence in private practice, he had recently acquired a a suitable epidemiologicstudy. By 1974, a preliminary master’s degree in public health; possessed a strong study design had been developed for the Registry. clinical background; and had a keen interest and re- coeval with the activities of the Registry in this area searchskills. were much broader studies of the radiation workforce There were changes on the Advisory Commit- at Hanford and LANL, sponsored independently of the tee as well. L. M. Joshel was replaced temporarily by Registry by the AEC and its successors. One such study Emil Putzier (1974)and then by J. H. Hanes (1975),who of which Registry Director Norwood was the principal had succeeded Joshel as manager of Rocky Flats. Louis author, was prrsented in 1975 at a workshop on the H. Hemplemann, a physician at LANL, was added to bioeffstsof plutonium and radium and looked at the the Committee in 1973 to replace Wright H.Langham, health of Hanford plutonium workers. This study and who had died in a tragic airplane craawbuquer- the role of the Registry, with respect to epidemiologic que the previous year. In 1977 the Advisory Commit- investigation, were important discussion topics at a tee was restructured in consonance with the need for USTR workshop held February 27, 1975, in Denver, expansion and development of new areas. Colorado. It was noted that a carefully constructed The “new” committee included two physicians epidemiologic study was planned and would likely be and physicists as holdovers: physician J. H. Stcmer carried out autonomously by LANL under the coordi- and physicist R. D. Evans, who continued as Chairman nation of the Registry. and Vice-chairman, respectively, and physician C. C. Also in that same year, controversy erupted Lushbaugh and physicist H. M. Parker. Four new com- regarding the published results of the first 30 autop- mittee members were added: G. L. Voelz, an occupa- sies performed by the Registry which were detailed in tional physician who headed the plutonium worker epi- a paper in the open peer reviewed scientific literature demiology study at LANL; health physicists Charles (Norwood and Newton 1975). The causes of death of W. Mays, University of Utah and John W. Poston, ini- these cases were evaluated by Sidney Wolfe of the Ralph tially of Oak Ridge National Laboratory, and then the Nader Health Research Group, who concluded in an Georgia Institute of Technology; and biostatistician article in the September 1976 Bulletin offhe Atomic Sci- Donovan J. Thompson of the University of Washing- entists that the cancer death rate among plutonium ton. Thompson was to serve less than a year before workers was twice the cancer death rate for white males resigning; he was replaced by Patricia W. Durbin, in general. This conclusion was refuted by Director Lawrence Berkeley Laboratory, University of Califor- Norwood and others who noted that the Registry popu- nia, a leading research figure on the biological aspects lation was a biased one, and as such not amenable to of the actinide elements. such analysis. The new Committee made a number of important recommendations at its June 1977 meeting. Per- Administrative Developments haps most sigruficant was its observation that both the A number of significant administrative USTR and LANL appeared to have overlapping and changes took place during the early years of operation perhaps even conflicting responsibilities with respect of the USTR. Carlos Newton, the Battelle health physi- to the conduct of epidemiologic studies of transura- cist who provided halftime scientific support to the nium element workers. The Committee recommended USTR, was given the title of Associate Director in 1970, that Drs. Breitenstein and Voelz pursue resoluhon of in observance of the importance of the health physics the epidemiologic study matter and report their fmd- aspects of the program. In 1972, founding director W. ings and conclusions back to the Committee. Accord-

USTUR Annual Report for 1993 5 1081425 I ingly, Breitenstein and Voelz met with Walter W. sory Committee since its inception, resigned as chair Weyzen to discuss the relationships and responsibili- and was replaced by physicist Charles W. Mays. Un- ties of the USTR and LANL,concluding that it was best der Mays' leadership, the Advisory Committee, in ad- to leave the matter unresolved pending better defini- dition to providing general policy and technical guid- tion of the overall DOE Occupational Worker Epide- ance, took a more active role in the detailed scienhfic miology Study. Within a matter of months, however, aspects of the work. This was largely accomplished the USTR was out of the epidemiology research area. through the appointment of a Dosimetry Subcommit- The next Annual Report of the Reptry reflected a ma- tee which initially consisted of Advisory Committee jor change in direction, with greater emphasis on member John W. Poston, who served as chairman, and biokinetics and health physics; epidemiologic study the new Advisory Committee chairman Charles W. was no longer a stated purpose of the Reptry, nor was Mays. Advisory Committee member Patricia W. there any mention of the topic in the Annual Report. Durbin was soon added as the third member. -- The Technical Subcommittee operated in an 1978: A Watershed Year informal collegial manner, in lengthy and intense meet- As the first decade of the Registry drew to a ings in whch the scientific work of the USTR was per- close in mid-1978, progress had been made along sev- formed. It included in its meetings and deliberations eral lines. The purpose and research role of the USTR Dr. McInroy, who now headed the radiochemistry op- had been better and more clearly defined, as well be- erations, Carlos E. Newton, Jr., who provided health coming more circumscribed. A population of more than physics support, and Kenneth R. Heid, another health 15,000 transuranium element workers had been iden- physicist from Battelle who would replace the soon 6- tified, of whom nearly half were at the Hanford site, retire Newton. The subcommittee considered all so&,- with most of .the remainder at Rocky Flats, LANL,and of scientific detail including, what samples should be- the Savannah River Plant. The group also included collected; sample sizes; effects of dehydration, and in - more than 100 individuals at private, non-government addition performed the primary evaluation of the data. facilities. With recruitment procedures and forms de- It also considered and recommended through its par- veloped and refined, authorizations for autopsy had ent Advisory Committee the basic scientific policy and been obtained from more than lo00 workers. A total research direction of the USTR. Thus, it effectivelyaug- of 93 autopsies had been performed, fourteen of which mented the woefully small scientific staff of the USTR, were provided by British collaborators, and findings whose entire cadre of personnel consisted of halftime from these cases were published. In addition to an- physician-directorBryce D. Breitenstein, and halftime nual reports, a total of seven papers funded or other- health physicist Carlos E. Newton, Jr., of Battelle Pa- wise sponsored by the USTR, were published in the cific Northwest Laboratories, and a full time secretary, open peer reviewed literature with four being authod Dorothy Potter. The Technical Subcommittee in large by USTR staff dealing with the operations and find- measure, Rally carried out the scientific mission of the ings of the Registry. USTR. Battelle, which along with Rocky Flats and Additional assistance for the program was ob- LANL,had been performing radiochemicalanalysis of tained from three prosectors - Gerald R. Dagle, tissues collected at autopsy since the beginning of the Battelle; Robert V. Bistline, RRF; and James F. McInroy, Registry, ceased tissue analysis activities September30, LANL, who had been appointed the previous year to 1978,coincident with the end of the Federal fiscal year. assist with the procurement of tissue samples at au- Work in progress at Battelle was transferred to LANL topsy. In addition, Dr. Bistline played a seminal role in under the provisions of a separately funded and ad- developing a program at RRF and Dr. McInroy over- ministered program under the direction of radiochem- saw the radiochemistry operations at LANL. ist James F. Mclnroy. LANL then assumed responsibility for all of the tissue radiochemical analysis except The Uranium Registry for those cases originating at the Rocky Flats Facility, Although uranium had been known to and which continued to carry out its own radiochemistry used by man for more than two centuries, there was analyses. still a great deal to be uncovered regarding the behav- The end of the first decade also presaged the ior and effects in humans of this heaviest naturally oc- start of considerable change in the USTR operation. In curring metal. Accordingly in 1978, the DOE funded April 1978, J. H. Sterner, who had chaired the Advi- the HEHF to establish the United States Uranium Reg-

6 USTUR Annual Report for 1993 \08142b istry (USUR). The USUR was a parallel, but adminis- individual had a long standing deposition of ameri- tratively separate, program whose major goals were cium from a wound incurred during his graduate stu- initially stated as 1)characterization of the occupational dent days, but also posed significant problems due to health aspects of the uranium fuel cycle; 2) measure- the small staff and htedcapabilities of the USTR. The ment of the concentration and distribution of uranium Dosimetry Subcommittee of the Advisory Committee and the uranium decay chain in the tissues of exposed took a leading role and based on their recommenda- workers; and 3) to identify populations suitable for tions, arrangements were made with a number of col- health related studies. Robert H. Moore, an occupa- laborating scientists to assist with the case. In additional physician with some pathology training early in tion, they developed the methodology and techniques his career, was appointed as halftime director and the not only for evaluating this case, designated USTUR USUR shared health physics and clerical staff with the Case 0102, but also for those of future whole body do- USTR. nations. With the exception of the director, the USUR The report on USTUR Case 0102 was published utilized the same staff as its sister USTR and.adopted a as a series of five papers comprising the entire October similar operational strategy, including the maintenance 1985 issue of the peer reviewed journal, Health Physics of their own files and autopsy and medical records re- and represented a sigmficant contribution to the un- lease forms specific to the USUR. Although a strategy derstanding of americium biokinetics in man. It per- of recruiting registrants similar to that of the USTR was mitted comparison with deposition estimates made adopted by the Uranium Registry, the USUR relied during life and indicated refinements to in vivo count- heavily on individual personal contacts. Nonetheless, ing procedures. More sigruficantly, it provided a de- the USUR was not nearly so successful and by Octo- tailed report of the distribution of americim in a hu- ber 1,1991 had only 32 living registrants. The USUR man body and as a result of the biokinetics analysis, had received tissues from one surgical case and 12 post- proposed a two compartment biokinetic model for am- mortem donors, with one being a whole body donor. ericium with sigruficantlydifferent parameters than ex- With technical support from Battelle, the USUR isting models: a residence halftime of only 2y in the initiated a series of studies designed to characterizethe liver and 90 y in the skeleton, along with initial uptake uranium industry and its hazards within the United fractions of 0.115 and 0.835 for these two organs, re- States. These led to four technical reports. The first, spectively. published in 1981, was an overview of occupational About three fourths of the more than 100 pub- exposure to uranium. Two reports published the fol- lished pages were devoted to two papers, one a de- lowing year dealt more specifically with the radiologi- tailed presentation of the preparation and results of the cal health aspects of uranium milling and commercial radiochemical analysis of the body prepared by James uranium conversion, enrichment and fuel fabrication. E McInroy and his coworkers at LANL,and the other The fourth report, also published in 1982, was a com- an extensive analysis of the biokinetics of the case co- prehensive evaluation of the epidemiologic aspects of authored by Advisory Committee member Patricia w. lung cancer in hard rock uranium miners and found in Durbin and her coworker Charles T. Schmidt at its conclusions that histologic study of this group was Lawrence Berkeley Laboratory. The other papers were warranted. In 1984, the USUR also sponsored a suc- devoted to external gamma ray measurements and es- cessful colloquium on the biokinetics and analysis of timates of initial systemic burden by staff members of uranium in man and in conjunction with the Battelle, Battelle and a case overview and description by the two edited and published the proceedings of workshops USTR staff members in collaboration with H. Thomas on uranium nephrotoxicity and ultrasensitive analyti- Norris of the University of Washington. cal techniques. Important administrative and personnel changes also occurred. In May 1980, Margery J. Swmt The Second Decade: The Emerging Scientific assumed responsibility for medical support to the Renaissance USTR and was named Associate Director along with h March 1979, a research chemist who had Battelle health physicist Kenneth R Heid, who replaced worked with transuranium elements since his gradu- the retiring Carlos E. Newton the following year un- ate student days contacted the USTR a few weeks be- der the same halftime work order arrangement with forehis death with the unexpected offer of a whole body Battelle. Swint became director of the USTR in 1982 . donation. This proved to be highly fortuitous, as this and Norwood continued as a consultant until 1984. Ln

108142’1 USTUR Annual Report for 1993 7 1981, the Advisory Committee recommended that the USTLJR Case 0102 papers previously mentioned, but Transuranium and Uranium Registries be combined also publications relating to the distribution of actinide into a single entity, observing that there were no disad- in the skeleton: partitioning of plutonium and ameri- vantages but many scientific and administrativeadvan- cium between liver and skeleton; comparison of whole tages that would accrue from combining the two pro- body depositions determined at autopsy with those grams. Although this recommendation was not acted made during life; and an evaluation of various upon, (the Registries were not combined into a single biokinetic models for plutonium based on postmortem entity until 1992, when they were placed under the findings in several whoIe body donations. purview of WSU) a combined USTR and USUR Advi- As the Reptries moved into their third decade, sory Committee was created and the Committee mem- a series of important administrativechanges began. By bership was expanded to eight by the addition of two 1987, Kathren was workmg full time at the Registries new members with expertise in uranium. These were and in that year transferred from Battelle to HEHF. In eminent biophysicist J. Newell Stannard,former asso- the spring of 1989, Robert H. Moore, the founding di- ciate dean of the University of Rochester School of rector of the Uranium Registry retired and Margery Medicine, and Langan W. Swint, an occupational safety Swint briefly assumed the directorship of both regis- and health expert, and retired vice-president of tries. Upon her promotion to Manager of Occupational Homestake Mining Corporation. Medicine and Medical Director of HEHF at the end of The 1983Advisory Committee meeting was an 1989, Swint was replaced by Kathren, the first person open meeting attended by 28 persons in addition to who was not a physician to head the programs. -The the Registries staff and the Committee. Included in following year, Ronald E. Filipy, a radiobiologist w& this number was an observer from the United King- specific expertise in animal studies with Pluto- dom Ministry of Defense as well as scientistsfrom sev- was added to the staff, effectively doubling the in-housc eral DOE laboratories. The evaluation of a second scientific capability. whole body case to be carried out under the lead of Although the two Registries remained add- Advisory Committee member George Voelz and James istratively separate, Kahnand Swint, along with s. Mdnroy was one important area of discussion. So too E. Dietert, published the first combined Annual Report was the Uranium Registry, whose director, Robert for the Registries in 1990. This was notable as it was Moore, was singled out for his tenacious dedication to the first annual report for the USUR, which heretofore the program. However, in a particularly telling rec- had not published progress or annual reports. Advi- ommendation, the Committee observed that the staff sory Committee Chairman Poston retired and was re- of both Registriesneeded to increase their understand- placed as Chairman by George Voelz. The vacancy left ing of uranium biokinetics and analysis. on the Committee by Poston’s departure was filled As 1983 drew to a close, Ronald L. Kathren, a with radiochemist Kenneth Inn, National Institute of board certified health physicist and senior scientist at Standards and Technology. Appointment of two other Battelle, was added as a two-hour per week consultant new members was necessitated by the death of Herbert to strengthen the scientific capabilities of the Registries Parker and the retirement of Robley Evans. Replace- and assist Associate Director Heid, who was contem- ments were made with noted health physicist Paul L. plating retirement. Within a few months, Kathren re- Ziemer, Purdue University, and the prominent radio- placed Heid as scientific support, although not as As- biologist Roy C. Thompson, who was recently retired sociate Director, and devoted his halftime effort largely from Battelle. Ziemer was to serve only a year before to the analysis of the data accumulated by the Regis- being appointed Assistant Secretary of Energy for tries, with an eye towards publication of papers in the Health Safety and Environment, voluntarily stepping peer reviewed scientific literatwe. down to avoid any potential conflict of interest. He The following years led to a burgeoning num- was replaced by Keith J. Schiager, Director of the Of- ber of publications by Registries staff and collabora- fice of Radiation Safety at the University of Utah, a well tors in peer reviewed scientific journals. Only 13 pub- known expert in uranium health physics. lications by Registries staff or based on Registries data were pubhhed in the peer reviewed literature prior to 1992: A Year of Change 1984, as compared with 47 publications during the pe- In February 1992, the US DOE awarded a three riod 1984-92, plus a number of miscellaneous and an- year grant for $3.76 million to WSU for management cillary publications. These included not only the five and operation of the Registries. This was an important

8 I O8l428 USTUR Annual Report for 1993 step in the continuing evolution of the Registries and available to the Registries a variety of scientists and brought with it sigruficant changes in operations and other research professionals who can provide support research accomplishments, which are described else- or collaboration on an ad hoc basis. Of particular note where in this commemorative Annual Report. The is the administrative location of the Registries within grant called for management and operation of the Reg- the College of Pharmacy, which further enhances the istries as a single entity rather than as parallel but ad- availability of pharmacokineticists and pathologists on ministratively separate research programs, and in- the faculty. Most significant has been the availability cluded a plan to transfer the radiochemistry operations of a proper dissection laboratory for whole body and to WSU within three years, that had been previously other tissue donations, wluch prior to moving to the provided by LANLunder separate contract to the DOE. University had been unavailable to the program. Combined management and operation of the Registries A final benefit attributable to the location of and the radiochemistry operations at LANL would not the program at a major university is enhanced cred- only provide for better integration and centralized con- ibility and academic freedom. In recent years, govem- trol of the programs, but would also reduce overheads ment and government funded programs have been and direct operating costs. One obvious benefit is the subjected to increasing scrutiny from their peers as well elimination of redundant efforts and duplications aris- as the public. This is not surprising, considering the ing from the existence of two separate registries. nature of the research which involves postmortem col- The many sigruficant advantages of the pro- lection and analysis of tissues from workers known to grammatic transfer to WSU, include enhanced oppor- have had intakes of plutonium or other actinides. The tunities for collaboration with a broad spectrum of fac- Registries have not been immune to such &tiny and ulty which are available at a major research university. inquiries by the media therefore, it is dalto en- Perhaps the most potentially advantageous aspect of sure that the scientists performing the work-are unfet- the transfer is the integration of the Registries into the tered by the funding agency in the scientific conduct academic programs of the University, thereby provid- of the program, and that the research is carried out in ing a mechanism for training students in health phys- an open and ethical fashion. As the U.S. DOE has rec- ics and radiobiology, two disciplines historically in ognized, this is best accomplished through a grant to short supply. Conventionally, students in health phys- an independent and recognized research university. ics have been supported directly through grants or fel- Administratively the Registries are centered on lowships, with an equal amount provided to the insti- the Tri-Cities campus of WSU. The grant called for vol- tution. The U.S. DOE fellowship program is by far the untary removal of the HEHF based Registries staff, con- largest and supports about two dozen graduate stu- sisting of the health physicist director, a radiobiologist, dents annually. Each student receives $15,000 per year a physician, and a secretary. Accordingly, Registries for support, with the institution receiving a similar Director Ronald L. Kathren and radiobiologist Ronald amount. Typically, only one or two fellowship students E. Filipy were appointed as Professors in the College attend any given institution and the institutional por- of Pharmacy; together, they began to build a program tion, although generous on a per student basis, is in- at WSU. Initial efforts were directed towards effecting sufficient to support a single faculty member let alone the transfer of the program and to updating and recti- an entire program. fying files and records. Amajor task was development By providing direct faculty research support of a manual of Registries policies and procedures, through grants such as the Registries, a greater num- which previously had not been formalized. For the first ber of faculty can be readily supported and the oppor- year at the University, medical support was provided tunity for student thesis research expanded. Hence, by C. Harold Meilke, a noted hematologist who served students can be more readily informed of and attracted as director of the WSU Health Research and Education to these disciplines. In addition, the grant provides Center, and by Robert Cihak, a pathologist on the Col- support and tuition for two halftime student research lege of Pharmacy faculty Subsequently, Scott E. Detert, assistants, with the annual outlay for each of these stu- a board certified pathologist who had previously dents being only about $15 thousand, or about half the worked with the Registries at HEHF, opted to rejom cost of a conventional fellowship. As a further benefit, the program and was appointed on a halftime basis as these students can provide invaluable assistance in fur- resident medical consultant and a Professor in the Col- thering the research carried out by the Registries. lege of Pharmacy. Location at a major research university makes The transfer of the program to WSU also re-

1081429 USTUR Annual Report for 1993 9 sulted in changes in the composition and operation of registrant file to determine the status all registrant files the Advisory Committee. Within a matter of weeks and to verify that appropriate permissions and docu- after the transfer, a formal policy relating to the Advi- mentation is included. Once this audit has been com- sory Committee was developed. This policy requires pleted, and an attempt made to secure any missing that the majority of members of the Committee have documentation, the records v7ill be microfilmed to pro- no affiliation with the DOE or its prime contractors, vide a backup copy in the event of accidental destruc- and that the Committee -- no more than seven in num- tion of the originals. A second major records manage- ber - include a representative of the academic com- ment task involves evaluation and entry into the community and the general public, in addition to the sci- puterized TUR data base of health physics and other entific members. It also provided for the appointment exposure and medical history data for all registrants. of a representative of organized labor. Accordingly, a This task is expected to take two to three calendar years newly reconstituted Committee was appointed, and to complete. It is planned to add the Registries data included four scientific members as hddwers, physi- base to the Comprehensive Epidemiologic Data Re- cian George Voelz, who was elected Chairman; health source (CEDR) holdings. physicist Keith J. Schiager, elected Vice-chairman; ra- Another short term goal is assumption of the diochemist Kenneth G. w. Inn;and radiobiologist Roy responsibilityfor the radiochemical analysis of donated C. Thompson. Boje K. Gustafsson, Dean of the Col- tissues. The plan calls for this work, now being car- lege of Veterinary Medicine at WSU and MaryBelle ried out by Los Alamos National Laboratory, to be as- Thompson of Spokane were added as the academic and sumed by WSU and camed out at an accelerated rage public members, respectively, and a search was begun to eliminate the serious backlog of unanalyzed tissues for a suitable representative from organized labor to that have accumulated. Given the aging regism round out the Committee. population, it is estimated that two to three calendar- In July 1992, the program was expanded years will be needed to signhcantly reduce the labora- - through the creation of the National Human Tissue tory backlog. Repository (NHRTR)for radiological specimens, un- Anumber of scientificstudies now in progress der the direction of radiobiologist John J. Russell who wiu be completed in the near term. These include the was also appointed to the College of Pharmacy faculty. initial study of kidney toxicity of uranium in humans In addition to extracts of solutions of tissues, histopa- and an animal study of the effect of enrichment on the thology slides and blocks, and remaining analyzed tis- biokinetics uranium. Studies of the distribution and sues from USTUR cases, the NHRTR contains tissues dose distribution of the higher actinides, i.e. Pu and collected by Argonne National Laboratory (ANL) for Am, will be continued. Longer term scientific studies their comprehensiveRadium Dial Painter Study, which include evaluation of the distribution, dosimetry and was in its final phase. This unique collection of hu- pathology in a second whole body donor who had been man tissue materials, plus other donated tissues col- injected with Thorotrast; comparative modelling of the lected from persons with a history of radioactivity in- 238 and 239 isotopes of plutonium; and distribution of take, will be made available to scientists studying the endogenous environmental uranium in the tissues of effects of radioactivity in man. Russell supervised the two whole body donors. removal of the dial painter materials from ANL to the Also in the short term, and in keeping with the 3000 square foot leased facilities of the NHRTR, adja- mission of the Registries as originally defined, histo- cent to the Sacred Heart Medical Center in Spokane. pathology studies using the collection of In addition to a freezer room and storage for tissue histopathologicalslides and other materials and medi- extracts, the NHRTR facilities include a dedicated dis- cal information obtained for registrants will be initi- section room and ancillary laboratory space. ated. Of necessity, these will be limited by the amount of available materials, but should serve as the starting Beyond 1992: Goals and Objectives point for expanded future studies in this area as more Although a history deals with the past, it is materials are obtained and after the medical and au- perhaps appropriate to conclude this section with a topsy history data base is computerized. In both the brief mention of the more immediate specific goals and near and longer term, the Registries will endeavor to objectives of the Registries. Much still remains to be utilize the unique tissue materials and related infor- done in the area of records management, including a mation in the NHRTR for collaborative research in ar- complete and full physical audit of each individual eas related to the mission of the Registries. Accord-

1081430 USTUR Annual Report for 1993 ingly, joint research will be sought with other institu- Nelson, I. C., K. R. Heid, P. A. Fuqua and T. D. Mahoney. tions and investigators in areas related to the primary 1972. Plutonium in Autopsy Tisue Samples. Health mission of the Registries. h addition, the NHRTR will Phys. 22:925930 (1972). be publicized within the scientific community to en- Newton, C. E., Jr., K. R. Heid, H. V. Larson and I. courage collaborativeor individual use of these unique C.Nelson. 1966. "Tissue Sampling for Plutonium materials, especially for the study of oncogenes and through an Autopsy Program", AEC Research and De- biomarkers. velopment Report BNWL-SA-918 (Pacific Northwest In the longer term, the Registries will play an Laboratory, Richland, WA). increasing role in studying the possible bioeffects of exposure through pathology and related studies. More- Newton, C. E., Jr.; Larson, H. V.; Heid, K. R.; Nelson, I. over, the activities of the Registries should naturally C.; Fuqua, P. A.; Norwood, W. D.; Marks, S.; Mahoney, evolve into support of the major program of waste T. D. in Diagnosis and Treatment of Deposited Radic- cleanup and assessment now being carried on at DOE nuclides; Komberg, H.A.; Norwood, W.D., Eds., Proc. and other sites, helping to ensure the adequacy of pro- Seventh Ann. Hanford Biology Symp.; Excerpta Medica tection standards for mixed chemical and radioactive Foundation: Amsterdam, 1968, pp. 460-468. exposures as well as specific chemical exposures associated with the clean up effort through postmortem as- Norwood, W. D. and C. E. Newton, Jr. 1975. U.S.Tran- sessment of exposures and bioeffects. In addition, the suranium Registry Study of Thuly Autopsies. Health Registries can greatly enhance and assist with valida- Phys. 28:669-675. - tion of epidemiologic findings by providing more ac- curate and precise assessment of the radiation exposure and doses incurred during life, along with autopsy findings to verify cause of death. In these ways, the basic mission of the Registries will be expanded and applied to other occupational hazards, with the same basic goal of ensuring adequate protection of workers and the general public from hazardous sub- stances, both chemical and radioactive - in the work- place and in the environment.

Literature Cited

Bruner, H. D. in Diagnosis and Treatment of Depos- ited Radionuclides; Komberg, H.A.; Norwood, W.D., Eds., Proc. Seventh Ann. Hanford Biology Symp.; Excerpta Medica Foundation: Amsterdam, 1968, pp. 661-665.

Campbell, E. E., B. C. Eutsler, J. McClelland, and H. M. Ide. 1969. Plutonium in Man. Health Physics 22.931.

Lagerquist, C. R, Bokowski, D. L., S. E. Hammond and D. B. Hylton. 1969. Plutonium Content of Several In- ternal Organs following Occupational Exposure. American Industrial Hygiene Association Journal 30:417-421.

Magno, P. J., P. E. Kauffman and P. R. Grouix. 1969. Plutonium-239 in Human Tisues and Bone. Radio- logical Health Data and Reports (May 1969).

USTUR Annual Report for 1993 11 ADVISORYCOMMIITEES

1992 USTUR Advisory Committee Meeting Left to Right: Borje Gustaffson, George Voelz, Kenneth Inn, Keith Schiager, MaryBelle Thompson. Not photographed: Roy C. Thompson

1984 USTUR Advisory Committee Left to Right: Langan Swint, Herbert Parker, Pat Durbin, John Poston, Sr., Charles Mays, Robley Evans, George Voeh, Newell Stannard

1968 National Plutonium Registry Advisory Committee Standing Left to Right: Carlos E. Newton, Jr., W. Daggett Norwood, H.D. Bruner, Philip A. Fuqua Seated Left to Right: Thomas E Mancuso, J.H. Sterner, Robley D. Evans, Herbert M. Parker Not photographed: ClmceC. Lushbaugh, Lloyd M. Joshel

12 USTLaz Annual Report for 1993 . 1081432 DIRECTORSOF THE UNITEDSTATES TRANSURANIUM AND URANIUMREGISTRIES

W. Daggett Nonvood Bryce D. Breitenstein -L- NPR 1968-1969 USTR 1976-1982 USTR 1969-1972,1973-1976

JohnA. Norcross USTR 1972-1973 (picture not available)

Robert H. Moore USUR 1978-1989

Margery J. Swint Ronald L. Kathren USTR 1982-1989 USTR 1989-1992 USUR 1989-1989 USUR 1989-1992 USTUR 1992-

USTUR Annual Reportfor 2993 13 1087433 I

GENEALOGYOF THE USTUR

REGWRIES ANALMICALSUPPORT

1968 National Plutonium Registry (HEHF) Rocky Flats Facility Pacific Northwest Laboratory e1969 United States Transuranium Registry (HEHF) 1971 Los Alamos National Laboratory

1978 United States Uranium Registry (HEHF)

e1987

1992 United States Transuranium and Uranium Registries (WSU)

14 USTUR Annual Report for 1993 .

Administrative Progress and Accomplishments

, *.

1087435 -. ADMINISTRATIVEPROGRESS AND and Radiation Biology within the College of Pharmacy at WSU, now reporting directly to the Dean of Phar- ACCOMPLISHMENTS macy. (See attachment B)

Policy and Procedures Manual Public Information Since their relocation to WSU, and for the first Brochures describing the USTUR and the time in the program's history, the USTUR have docu- NHRTR were printed and distributed. These are dis- mented their operations in a formal Policies and Pro- tributed by the scientific staff during site visits and cedures Manual (PPM). The PPM contains three types public presentations and serve not only to provide gen- of mformation: policies, procedures, and forms, which eral information about the Registries, but also as infor- are assigned a three-digit number prefaced by a capi- mative tools for recruiting and collaborative efforts. tal letter and sometimes followed by a lower case let- The Registries brochure includes a postpaid business ter. Policies are statements describing the conduct of reply card which can be used to obtain further infor- operations and are prefaced by the letter P. Procedures, mation on the program. In response to the large num- prefaced by the letter R, are detailed statements which ber of inquiries received from the public and the me- detail the accomplishment of a particular task. Forms, dia, the Registries prepared a seven page information used for collection or distribution of specific informa- packet, organized in a question and answer format, to tion, are included in this manual and prefaced with the give the lay person background on the Registries in letter F. addition to answering some of the most-commonly The PPM was prepared by various staff and asked questions. stresses compliance with university, state, and federal The Registries are now registere&4the Of- regulations as well as bioethical considerations; all fice of Scientific and Technical Information (OSTI) and items within the PPM are reviewed for revision on an are thus, included as a part of the Federal technical in- annual basis. The PPM is a controlled cirulation docu- formation network. Registries publications are as- ment with numbered documents assigned to specific signed the letter designation USTUR followed by a individuals. Assignees are responsible for updating unique four digit number, plus two digits identifying their respective manuals and must return them to the the year of publication (e.g. USTUR-0123-94). Manu- Registries upon request. (See attachment A) scripts and reports which are not submitted to scientific journals for publication are sent to OSTI and thus, Physical Facilities made available to interested persons on request. The Registries building, a 2500 square-foot modular office structure on the WSU Tri-Cities cam- Registrant File Audit pus, was completed and occupied in August. The fa- A four-part file audit was completed on all cility includes an open reception area, eleven offices, a existing USl'"R registrant files. The first part of the small conference room, a secured file room for regis- audit involved an ad hoc committee of Registries' per- trant and other records requiring protection in accor- sonnel that was formed to assess what the audit should dance with the Privacy Act, and a small dry labora- accomplish and design a preliminary, yet comprehen- tory which is used for histopathology and dosimetry. sive, form to nxord the information. Second, the physi- In addition, the Registries lease 3,000 square feet from cal audit was performed on all registrant files and the Sacred Heart Medical Center in Spokane, which houses information checked for accuracy. Third, a computer- the tissue material collection of the National Human ized database form was designed and the audit find- Radiobiology Xssue Repository and the dissection ings were entered into a table within the USTUR data- laboratory. base for reporting and historical purposes. As a final phase of the audit, data missing from the registrant files Stafing and Organization will be requested and relevant information will be up Since the last annual report, there have been dated. The audit was crucial in that over the years the sigruficant changes to the administrative structure of Registries have requested and accumulated many the program and several staff additions. Effective Au- records without having the staffing to track these ex- gust 1992, the Registries are no longer a part of the changes properly and the only other record of a file Health Research and Education Center, but rather part audit was incomplete and did not follow through with of a newly developed program titled Health Physics replacing the informationwhich was identified as ~russ-

USTUR Annual Report for 1993 15 ing. Additionally, the audit identified requests which municating with Registrants, keeping records current had not been fulfilled; to consistently organize those and ensuring file integrity, as well as providing more records which had been received; and to make design efficient operation. adjustments to the TUR database in order to accom- modate all pertinent regstrant information. Microfilming of Registrant Records The results of the audit uncovered approxi- Microfilming the registrant files is a high pri- mately 50 registrant files whch for various reasons and ority, planned project. This will provide the Registries' by current standards, lacked adequate release docu- with two copies of each Registrant file which can be mentation. Each registrant's file was examined on an updated with relative ease and at minimal cost. One individual basis and the necessary paperwork was re- copy of the microfilm will be a working copy stored in trieved from the appropriate DOE site, or registrant/ the Registries' secured file room and used for research registrant's next-of kin. In each case, the file was made purposes. The other copy will serve as a backup and complete and in accordance with U!il"UR policy. be stored in the Max E. Benitz Memorial Library on the WSU Tri-Cities campus. Registrant Renewals Currently as documented in US'IZTRProcedure Advisory Committee R500, registrants are renewed at five-year intervals de- The annual USTUR Advisory Committee pending on their renewal date, which is the day on Meeting was held October 545,1993 in the Max E. Benitz which their authorizations are signed and returned to Memorial Library conference room on the WSU Tri- the Registries. During 1994, the Registries will begin a Cities campus. The meeting was attended by all Com- comprehensive renewal of all Registrantswho had not mittee members and USTUR staff as well as ether been renewed following the USTUR move to WSU. All guests associated with the program. (See attachment registrants will then be renewed simultaneously every C) five-years. This has long been a goal of the administrative office and will enable more time to be spent com- Publications (See attachment D)

REGISTRANTSTATISTICS September 30,1993

Living Regstrants By Birth Decade Total Hanford RockyFlats LosAlamos SavannahRiver Other

1900-1910 15 8 4 2 0 1 1911-1920 101 41 26 12 14 8 1921-1930 192 49 46 26 58 13 1931-1940 72 14 14 6 28 10 1941- 34 5 3 2 20 4 Not available 33 2 15 1 3 12

~~ ~ Total 447 119 108 49 123 48 I Deceased, by Site: 330 86 92 57 17 78

16 USTUR Annual Report for 1993

108U3? __ - - * Summary of Scientific Progress

, SUMMARY OF SCIENTIFICPROGRESS remodelling by radiation, but it may also have been influenced by the subject's advanced age at the time of i Despite the disruption caused by the move of exposure and sedentary life-style, so that minimal bone the Registries from HEHF to WSU,the Registries have remodeling occurred during his remaining life. The i histopathology examination revealed extensive 1 nonetheless made considerable scientific progress. This section summarizes the progress of major research peritrabecular fibrosis of bone marrow, along with de- projects. Postmortem data on USTUR Case 246 have creased cellularity in most samples. Only a few per- been analyzed and prepared for publication; a study cent of the total *'"Am in bone was found in the mar- of the relative distributions of uEPu,239Pu, 2'opu and row. In soft tissues, autoradiography revealed that al- 241Amin tissue has been completed and submitted for most all 241Amwas deposited in an ionic form, i.e. as publication; the analysis of a whole-body donation of single atoms. Only two alpha stars were observed, in- a Thorotrast case has been completed and published, dicative of very small 24'Amparticles, both in lung sec- and the results have been used to revise risk coefficients tions. The general order of alpha track concentrations for cancer induction by Thorotrast; a study of the kid- seen in soft tissues, arranged in decreasing value, was ney toxicity of low-level uranium deposition has been liver, lung, kidney, thyroid,'lymph node, and muscle. nearly completed; and significant progress has been This pattern is certainly consistent with what would made on upgrading the database. be expected from consideration of the exposure condi- USTUR tions, but may well have been affected by the prolonged chelation therapy undergone by the subject. Case 246: Analyses of Post Mortem USTUR Despite the chelation therapy, the subject stdl Data received radiation doses in the range of--seueral Gy to There can be little doubt that USTUR Case 0246, some tissues, leading to the possibility of both stochas- the victim of the 1976 Hanford "'Am accident, is the tic and deterministic effects. With a radiation weight- most "famous" case in the Registries, in terms of both ing factor of 20 for alpha particles, cumulative equiva- scientific and public interest. Not only did this indi- lent doses to the bone, bone surface, liver and lung were I vidual receive the largest internal deposition of a tran- 0.36,10.4,0.16, and 0.32 ksv, respectively. By applca- suranic nuclide ever recorded, but he also became the tion of currently accepted risk factors (NAS 1988), those longest-term case to undergo chelation therapy. The equivalent doses resulted in probabilities of cancer m- details of this case's exposure and the immediate duction of 18,62,24, and 27"/0, respectively. However, sequelae are well known (Thompson 1983) and need those probabilities must be regarded as extreme upper not be repeated here. Following the subject's demise limits for three reasons: first, the doses were protracted, from the complications of presxisting coronary artery second, the subject surviqed only one year beyond the disease in 1985, extensive autopsy samples were do- average 10 year latent period recommended by ICRP. nated to the Registries for detailed study. In addition and third, the risk coefficients are averaged over a to the usual radiochemical analyses performed to de- population aged 0 to 90 years. The probability of not termine the activity concentrations in the samples, mo= observing a fatal cancer in this case was the product of sophisticated measurements were possible, due to the the quantities (1- f,), where f, represents each individual large amounts of residual activity, to investigate the risk factor given above. This computed probabihty wa.. microdistribution and effects of activity in various tis- 17%, so the lack of cminogenesis in this case was nd sues. surprising. Consequently, Registries personnel instituted Deterministic effects were clearly observed m scientific collaborations with colleagues at other re- various hematologic parameters. For the first five yean search institutions with specialized expertise; these in- after exposure, there was statistically significant vestigations have now been completed and the result- neutropenia,lymphopenia, and thrombocytoperua AJ- ing scientific papers are currently undergoing internal though the- was some recovery in these counts. thr, review prior to submission to journals. Some of the never returned to pre-exposure levels. Nevertheit- highhghts of these research projects include the obser- except for a sigrulicant thrombocytopenia immediate'\ vation by both bone-surface alpha spectrometry and prior to death, the counts of the various blood cells near autoradiographythat 241Aminitially deposited on bone the end of his life could simply have reflected a natural surfaces was, in general, not buried by apposition of decrease with age. Cataracts developed bilaterallv and new bone. This may be due to the suppression of bone were removed at 547 and 1030 days post exposure tnwn

i 1081439 USTUR Annual Reportfor 1993 the left and right eyes, respectively. However, estimated A. Soft Tisue Concentrations of Plutonium and Am- radiation doses to the' lenses were below the ericium in Occupationally-Exposed Humans. cataractogenic range, and the attending ophthamologist indicated that the cataracts were trauma-induced. Risk Coeficients for Alpha Particles The total body content of 241Ampost mortem One major accomplishment of the Registries was estimated to be 540 kBq, of which 90% was in the during the transition period from HEHF to WSU was skeleton, 5% in the liver, and 4% in muscle and fat. The the publication of ten papers relating to the analysis of distribution of activity is not well described by ICRP a whole-body donation, case 1001, who had been ad- models, but appears to be reasonably well decribed by ministered an injection of approximately 25 mL of a later model based on animal data and a previous Reg- Thorotrast some 36 years prior to death (Health Physics istry 241Amcase. 63,lO-100,1992). The radiochemical analysis of tissues from this case established a basis for the calculation of Soft Tissue Concentrations of 238 Pu,139'2mPu, radiation doses from 232Th and its progeny to the vari- and Z41Amin Occupationally Exposed Persons. ous tissues and organs of this subject (Kathren and Hill Under the routine autopsy program of the Reg- 1992). Although extensive epidemiological studies of istries, selected tissues are collected from volunteer Thorotrastcases have been conducted in Germany (van donors with a history of occupationalexposure to tran- Kaick et al. 1988), Portugal, and Japan (Mori et al. 1989; suranic radionuclides. The tissue samples are analyzed Isluwaki, Kat0 and Hatekayama 1989), as well as else- for radionuclide content by chemical separation and where, the dosimetric bases of these studies are some- alpha spectrometry; and results are available for mPu, what limited, being generally confined to external body 239+240 Pu and 24*Am.Concentrations of these three ra- radioactivity measurements (whole-body counts- dionuclides in soft tissues (testes, thyroid, spleen, kid- analyses of a few tissue samples. ney, heart, and skeletal muscle) of 82 cases were com- The data from USTUR Case 1001 were used to pared to their concentrations in the livers of each indi- determine the alpha-particle dose rates to various tis- vidual subject. Most of the subjects had never been sues as a function of the amount of Thorotrast injected. involved in a specific incident that led to internal depo- Absorbed doses were computed by assuming latent pe- sition, but rather had long-term, low-level chronic ex- riods of 20 years for liver cancer, 10 years for posure by inhalation. The average age at death of these osteosarcomas, and 5 years for leukemias, as recom- subjects was 65.5 k 7.5 years, and the exposures are mended in the BEIR IV report (NAS 1988). The injected thought to have largely occurred two or more decades amounts reported in the various epidemiologicalstud- prior to death. ies were then multiplied by these dose conversion fac- For any given tissue, the ratio of actinide con- tors to establish average radiation doses to the tissues centration in that tissue to that in the liver proved to be at risk for tumor induction: liver, bone, and bone mar- essentially constant over a wide range of liver concen- row (leukemia). The observed numbers of excess can- trations. The spleen had consistently high actinide con- cers in the study populations were then divided by the centrations relative to the liver; however, the heart had average doses to compute risk factors in terms of can- the highest concentration ratio for 241Am.Testes exhib- cers per person-Gy. The results are compared with the ited relatively high concentration ratios for the pluto- published values from the German, Japanese, and Por- nium nuclides, but low concentration ratios for "'Am; tuguese studies, and with the values given in the BEIR conversely, striated muscle had low concentrations of IV report (NAS 1988) in the table below: plutonium relative to liver, but high concentrations of 241Am.In general, for the tissues studied, the concen- ~~ ~~ tration ratios of 241Amwere greater than those of the Cancer Reported BEIRIV USTUR plutonium nuclides, most probably because of more values value risk factor rapid loss of 241Amthan plutonium from the liver. These results are consistent with a revised metabolic model Liver tumors 0.013-0.059 0.026-0.030 0.018 for 241Amthat includes a relatively short (2-3 y) halftime in the liver. The following paper describing these Bone cancers 0.0012-0.0055 0.0055-4.012 0.0035 results has been submitted to the journal Health Phys- ics: Filipy, R E.; Kathren, R. L.; Mchoy, J. E; Short, R. Leukemias 0.002-0.06 0.0050-0.0060 0.032

18 USTUR Annual Report for 2993 i 0814UO

__- - _"__. L.r Although all three risk coefficients based on the USTUR not only contain all available data on registrants, but data fall within the ranges of values reported in the also facilitate collation, mathematical, and statistical epidemiological studies, the USTUR leukemia risk co- analyses of the data. The format would also permit efficient exceeds almost all other reported values. How- incorporation into the DOE Comprehensive ever, the absorbed dose rate in red marrow computed Epidemiologic Data Repository (CEDR). In the past, from the USTUR data agrees well with other published two separate databases were maintained, one by the values (Kaul and Noffz 1978; Priest et al. 1992). Conse- Registries containingadministrative data, primarily for quently, the assumption of a five-year latent period for the purpose of communicating with registrants, and leukemia induction may be an underestimate. the other by LANL containingthe radiochemical analy- Obviously, the major weakness of this study is ses data. Unfortunately, the two databases could not that it depends on the analyses of tissues from only communicate. Other important data, including medi- one case, who may or may not have been typical of the cal and radiation exposure records, were not comput- Thorotrast-exposed population. The USTUR has re- erized. ceived the willed body of a second Thorotrast patient, Selection of a commercial software package USTUR Case 1054, and radiochemical analyses are un- rested upon several criteria, including write-protection, der way. The results will be combined with those from data security, statistical analyses and graphics, and eas- USTUR Case 1001 and the resulting risk coefficients ily accessible query and table generation. PARADOX re-evaluated. was selected as the system best meeting these requirements. Data tables were created for administrative, ra- Kidney Toxicity of Uranium diochemical, and medical/health physics data. The ad- In 1985, Robert H. Moore, then Director of the ministrative table contains registrank'-aames, ad- USUR, initiated a pilot study, using light microscopy, dresses, work site identification, and various status in- to assess the histopathologic changes in the kidneys of dicators. The radiochemical table contains the results seven registrants as compared with six reference cases of all analyses provided by LANL on tissue samples of similar age and year of death. The study results were collected by the Registries. Samples are identified by orally presented at two scientific meetings, but never registrant case number, so that the data can be made refined into a manuscript suitable for submission to a accessible to anyone with a legitimate interest without peer-reviewed journal. In the meantime, radiochemi- regard to privacy considerations. The health physics cal analyses data from the kidney tissue of the regis- table contains exposure and bioassay data, and a medi- trants has become available. cal table is being developed for both premortem and Comparisons are now possible between 1) the postmortem diagnoses using ICD-9 coding. in-vivo and in-vitro bioassay data on the registrants The database has recently been transferred to versus the actual tissue contents determined postmor- PARADOX for Windows on a local area network ac- tem, and 2) the presence or absence of kidney cessible only to Registries staff. The administrative data histopathologicalterations in registrant versusnon-reg- table is complete and has been audited. The radio- istrant cases. Thirteen sets of kidney tissue slides were chemical table is complete for analyses performed to submitted to an independent consulting pathologist at date however, some minor discrepancies remain with a major American university without identrfylng the the LANL data, due to reanalyses of samples or varia- registrant status of each set. Preliminary review of the tion in sample weights Lsed to compute radionuclide consultant's final evaluation shows similar mild to concentrations. These discrepanciesare being resolved moderate arterionephrosclerosis in both groups; the with the assistance of Los Alamos personnel. Data are consultant was unable to distinguish between uranium currently being entered into the health physics table registrants and reference cases on the basis of kidney and data entry is about 5% complete. This is a time- histopathologic findings. The data are being further consuming process as the data must be extracted by evaluated and a manuscript describing this project is hand from the case files and frequently need extensive now in preparation. interpretation. Nevertheless, the data management ca- pabihties of the Reptries have sigruficantlyimproved USTUR Database in the past few years, and the completion of the first A long-term goal of the Registries is to estab- phase, the computerized administrative database has lish a comprehensive, automated database that would yielded great efficiencies in daily operations.

108-144 I USTUR Annual Report for 1993 19 National Human Radiobiology Tissue Repositoy USTUR Case 1054: Thorotrast Whole Body Activities of the NHRTR began on July 1,1992 Donor with the occupancy of a newly remodeled 3,000 square- In late 1992, USTUR Case 1054 was obtained foot laboratory and storage facility located in Spokane by the Reptries. Thorotrast, a colloidal suspension adjacent to the Sacred Heart Medical Center and receipt of 232Th dioxide was widely used as an x-ray con- of a collection of frozen specimens and other human trast medium primarily for the visualization of the tissue materials from the recently concluded Radium vascular system prior to about 1960. Epidemiologic Dial Painter Study at ANL,. Eight 20 cubic-foot ultracold studies of persons injected with Thorotrast have been freezers containing tissue samples were installed and a carried out in several countries and have clearly dem- 24-hour alarm service was added as a precautionary onstrated a large excess of liver tumors, leukemias, measure against mechanical failure and possible loss of and other RES tumors and effects. Although thou- these unique and valuable tissues. The radium dial sands of people worldwide were administered painter tissue collection also includes numerous boxes Thorotrast, to date only a single whole body dona- of dried bone samples; formalin-fixed tissue specimens; tion has been available for comprehensive radio- and a number of radium artifacts and nostrums i.e. dial chemical, biokinetic, pathological, and autoradio- painter paint brushes, watch dials, revigators, radium graphic studies, and to verify the risk coefficientses- tonic water, and radium tablets. In addition, approxi- tablished by the epidemiolop studies. USTUR Case mately 1100 cardboard boxes containing an estimated 1001 has been evaluated and the results published in 20,000 acid extracts of tissue solutions from Registries the open literature. and other cases processed at LANL were received, un- In 1947, at the age of 15, USTUR Case 1054 loaded, and stored for possible future studies. had a brain abscess surgically removed followingim- The NHRTR assumed responsibility for rede- aging by Thorotrast. On examination in 1971, there signing and documenting routine and whole body au- was no evidence of a thorotrastoma or remaining - topsy protocols with an eye towards streamlining and Thorium deposits in the neck regon near the injec- improving the procedures; reducing the number of tis- tion site. In 1991, a CT scan revealed a large tumor in sues collected; and archiving a portion of every tissue the right hepatic lobe. The patient died of liver can- collected for future study and collaborative research. Past cer approximately one year later. An autopsy team practice was to perform destructive analysis on the en- led by Yuichi Ishikawa and J. A. M. Humphreys, both tire sample. In addition, a policy requiring that every of the Harwell Laboratories in Great Britain, per- new tissue donor be tested for HBV/HIV before the Reg- formed the autopsy approximately one year follow- istries will accept their tissues or organ samples was in- ing the patient's death. At autopsy, the liver was stituted; no HIV positive tissues are accepted. found to be almost completely occupied by a large A total of 16 routine or whole body autopsies tumor7- 9 an indiameter. On dissection, the tu- was performed on USTUR registrants during the pe- mor grossly appeared to be a cholangiocarcinoma. riod from July 92 through September 93. Due to the Great care was exercised in identdymg and newly established policies and procedures regarding the removing all of the lymphatic nodes of the neck re- acceptance of donors or tissues therefrom, one of the gion, and the abdominal and thoracic viscera. Fol- whole body donors was rejected due to a positive test lowing gross examination, each organ sample was for hepatitis-B. Another new policy dictates that a por- weighed and weighed aliquots were removed for ra- tion of every tissue or bone sample collected be saved diochemistry and histopathology; the remaining and frozen at -7O'C to protect their biochemical integrity sample was packaged individually in plasticbags and for future use in oncogene, biomarker, or immunocy- frozen for future studies i. e. oncogenes, biomarkers tochemistry studies. Thus, portions of every tissue and etc. Selected tissue samples were also taken for the bone collected from each of the sixteen autopsies were Harwell investigators and G. van Kaick of the Ger- saved and frozen, with the remaining tissue pieces used man Cancer Research Center. An abstract describing for radiochemistry. During this same time period, the the prehinary results of this study was submitted backlog of whole body cases stored in the freezers await- for presentation at the Intematimal Seminar on Health ing dissection was reduced from five to three, however, Effects of lntemally Deposited Radionuclides: Emphasis this has only increased the number of samples awaiting on Radium and Thorium on April 18-24,1994, in Heidel- radiochemical analysis at LANL. berg, Germany. When completed, the results from this case will be used to help elucidate the long-term

USTUR Annual Report for 1993 organ retention, pathology and risk coefficients of Thorotrast. Proceedings of a workshop held under joint Thorotrast and its radioactive daughters in humans. sponsorship of the U.S.Department of Energy, the U.S. National Cancer Institute, and the Radiation Protection Literature Cited Programme of the Commission of the European Com- munities. London: British Institute of Radiology. BIR da Motta, L.C., J. da Silva Horta and M.H. Tavares. Report 21:119-124. 1979. Prospective Epidemiolog-d Study of Thorotrast- Exposed Patients in Portugal. Environ. Res. 18:152- National Academy of Sciences. 1984 Health Risks of 172. radon and other internally deposited alpha-emitters (BEIR IV.) (Waslungton, D.C.: NationalAcademy Press). International Commission on Radiological Protection. 1990 recommendations of the International Commis- Priest, N.D., J.A.Humphreys, RL. Kathren and C.W. sion on Radiological Protectiofi. Oxford: Pergamon Mays. 1992. The Distribution of Thorotrast in Human Press; ICRP Publication 60, Ann. ICRP 21(1/3):1-201. Bone Marrow: A Case Report. Health Phys. 6346-53.

International Commission on Radiological Protection. Thompson, R. C. (ed.)Special Issue on the 1976 Hanford The metabolism of plutonium and related elements. Americium Exposure Incident. 1983 Health Phys. 45, Oxford: Pergamon Press; ICRP Publication 48, Ann. 837-947. ICRP 16(2/3):1-98; 1986. van Kaick, G., H. Wesch, H. Luhrs, D. Liebermann, A. Ishikawa, Y., Y. Kat0 and S. Hatakeyama. 1989. Late Kaul and H. Muth. 1989. The German Tholotust Study Effects of Particles on Thorotrast Patients in Japan. In: - Report on 20 Years Follow-up. In: Taylor, D.M., C.W. Taylor, D.M., C.W. Mays, G.B. Gerber and R.G. Tho- Mays, G.B. Gerber, R.G. Thomas, eds. Risks from Ra- mas, eds. Risks from radium and Thorotrast, Proceed- dium and Thorotrast, Proceedings of a Workshop held ings of a Workshop held under joint sponsorship of under joint sponsorship of the U.S.Department of En- the U.S.Department of Energy, the U.S.National Can- ergy, the U.S.National Cancer Institute, and the Radia- cer Institute, and the Radiation Protection Programme tion Protection Programme of the Commission of the of the Commission of the European Communities. Lon- European Communities. London: British Institute of don: British Institute of Radiology. BIR Report 21:129- Radiology. BIR Report 21:98-104. 131.

Kathren, R. L.; Hill, R. L. 1992. Distribution and Do- simetry of Thorotrast in USUR case 1001. Health Phys. 63/72.

Kathren, R. L.; McInroy, J. F. Implications of Post Mortem Human Tssue Analysis on Biokinetic Models for Actinides. J. Radioanal. Nucl. Chem. 156:413-424; 1992.

Kaul, A., and W. Noffz. 1978. TsueDose in Thorotrast Patients. Health Phys. 35:113-121.

Mori, T., T. Kumatori, S. Hatakeyama, H. Me, W. Mori, K. Fukutomi, K. Baba, T. Maruyama, A. Ueda, S. Iwata, T. Tamai and Y. Akita. 1989. Current (1986) Statue of the Japanese Follow-up Study of the Thorotrzst Pa- tients, and its Relationships to Statistical Analysis of the Autopsy Series. In: Taylor, D.M., C.W. Mays, G.B. Gerber and R.G. Thomas, eds. Risks from radium and

USTUR Annual Report for 1993 21 Postmortem Tissue Analysis for Five Whole Body Donors

I081444 POSTMORTEMTISSUE ANALYSIS, IN-VIVO because of changes in job responsibilitiesthat removed him from direct contact with Pu operations. BIOASSAY,AND EXPOSUREINFORMATION On at least four separate occasions, USTUR FOR FIVEWHOLE BODY DONORS Case 0193 was involved in some manner in contamination incidents involving Pu. The dates of these incidents were: August 16,1957;February 3,1959;July 15, Introduction 1959; and October 21, 1964. The first two involved This section presents the results of postmor- minor explosions that resulted in sigruficant airborne tem radiochemical analysis for five whole body donors Pu levels in the workroom; as indicated in Table 1, na- to the USTUR along with brief cases summaries and sal contamination was detected in both instances. Fe- dosimetry and bioassay data. Two other whole body cal sampling followingthe first instance revealed a sig- donors to the Registries, USTUR Cases 0102 and 1001, nificant quantity of Pu, suggestive of inhalation or in- not included here as these cases have previously been gestion of insoluble material. These bioassay data are described in detail in the openliterature{Roessler and suggestive of a small intake of soluble Pu. The latter Magura, 1985; Mays and Guilmette, 1992). two incidents were apparently of minor sigruficance, without recorded indication of intake. Description and Exposure Histoy of USTUR Over the course of his working lifetime, the Case 0193 donor had been credited with a documented external The Caucasian male died at age 62 from respi- exposure of 132 mSv (13.2rem) to the skin of the whole ratory failure associated with pneumonia. The clinical body and 93 mSv (9.3 rem) from neutrons. Various bie history of this case included a coronary occlusion in assay measurements were made over the course of his 1968 and a coronary insufficiency event in 1976; a his- employment including 178 radiourinaly- Pu; in- tory of hyperlipidemia; pneumonitis in 1974; and sev- vivo counting on 12 occasions subsequent to 1970; and eral surgical procedures. The donor had a clinical his- nasalwipes on a routine basis during the early months tory of congestive heart failwe that was consistent with of employment and following possible acute acaden- the finding of left ventricular dilation observed at au- tal inhalation exposure. The Pu urinalysis data from topsy. Autopsy findings also reveal4 Chranic lrtng con- 1945-1977have been reported elsewhere (Voelz et aL gestion with changes typical of congestive heart fail- 1979) but are reproduced for convenience and com- ure and generalized moderate to severe atherosclero- pleteness in Table 1, along with subsequent urine dah sis of the coronary arteries. There was multifocal fi- and nasal wipe ~~ultsas reported in 1991 by MWy brosis of the left ventricle, which was consistent with a et al. The urinalysis data for 1945.1946 have high vd- clinical history of the two previous myocardial ues and are consided indicative of valid intake of Pu infarctions. during that time period and are consistent with the The subject was one of 26 males occupation- nasal wipes during the same time frame. ally exposed to Pu and medically followed for 37 y as Not all available nasal wipe data are given in USTUR Case 0027 in that study carried out by LANL the table. Nasal wipes were taken from mid-Febnury (Hempelmann et al. 1973; Voelz et al. 1979,1985). Ex- 1945 to mid-hhy 1946 somewhat routinely, and as frc cept for the period August 1946 to November 1949 quently as several times daily, depending on the wort when he was in college, the donor was continuously They are indicative of potential exposure to airboDnr employed at LANL and involved in operations with Pu particularly during June to August 1945 when q- potential for exposue to Pu from Janua~y1945 until nificant activity was noted on 11 diffmt occ- February 1982, approximately 10.5 months prior to his During these months, the typicalnasal wipe count WY death. Exposum potential was judged to be greatest in also elevated by about an order of magnitude, rummg the early years of employment by the operationalhealth a few tens of counts per minute. Subsequently, the physics staff at the place of employment. This was es- counts dropped back to a few counts per minute. ud peaally probable in the first year and a half of his em- then to near zero shortly before the program was trr ployment when he was engaged in making Pu fluo- mjnated. Air monitoring data for this period are n~l ride by fluorination of PuO in a chemical hood. Subse- available. quent work was done in glove boxes, which would be A crude order of magnitude estimate of mt.lu expected to afford a greater measure of protection. during this period, based on the limited data av&& After 1970,exposure potential was markedly reduced and in accordance with operational health physio ex -

USTUR Annual Revort for 1993 22 I 1 a perience and practice, indicates that several hundred man in a Pu duction and dry chemistry operation becquerels, and perhaps as much as 1 kBq, may have and later was employed as an animal handler at the reached the T-B (tracheobronchial)and P (pulmonary) same site. He experienced a potential for inhalation regions of the respiratory tract For the purposes of exposure to Pu during the period from May 1946 this estimate, the counting efficiency was assumed to through March 1947, showing on only one occasion, be =YO, and the particlesize distribution was such that August 1946, positive nose wipes for plutonium. Vari- WOof the inhaled activity was deposited in the nose ous bioassay data include 51urinalysis and numerous, and subsequently removed by the nasal wipe. These almost daily, dwipes from June 1946 through Feb- assumptions may or may not be valid. Iuary 1947. In JUly 1949, accident involving 369 In-vivo counts were taken at irregular inter- pounds of 'W ocdwhen a vacuum pump on a vals on 12 occasions, the last being in January 1982 large furnace failed, letting combustible gas explode * The first count, taken in April 1970, showed no detect- and released uranium oxide into the room. The donor able activity, but the state of the art at that time rend- was listed as being involved in the acadent, but th- this result questionable in that the lowe level of detec- is no record of urinalysis or other bioassay for uranium. tion (LLD) was likely to be at least several tens and Film badge readings in November 1955 indi- perhaps even more than 100 Bq. The next chest count, cated whole body acposure of 0.26 rep beta and 0.78 R taken in August 1973, indicated 20 Bq (0.55 nci) of gamma,which was an overexposue of 0.48 R gammk WAm. subsequent chest counting results were posi- In January 1956, badge readings indicated 0.78 R tive, mdicating approximately 13-19 Bq (0.35 -0.5 nCi) gamma with an overexposure of 0.10 r gamma. A lung of %Am. The lower detection limit for ='Am chest count on April 17,1970 indicated a less than detectable counting during this time was 13 Bq (0.34 nCi). The amoUnf of PJPU. In vivo estimates based urinaly- chestc~tsinrecentyearsweremadeusingtwin127- sis results indicated xetention of 574 Bq %at &Si5 mm (5 inch) diameter phoswich detectors and a count- of death (McInroy et al. 1989). There are 14 histopa-? ing time of 2000 s. At the 95% confidence level, the thology slides available on USKR Case 0208. lower level of detection for this system is approximately 1 kBq (26 nci) for =Pu and 2 k8q (55 nci) for W. USTUR Case 0212 The LLD for Tuis greater than the activity measured This 56 year old male Caucasian plumber mea- in the respiratory tract (130 Bq) by postmortem radie suring 1.81 m and weighing 89 kg died in 1984 from chemicalanalysis,anditisthusnotsurprisingthatthis acute left pneumothorax and associated complications nuclide was not detected by chest counting. A count of severe pulmonary emphysema. Autopsy also re ofthehandswasmadewiththissamedetectorsystem vealed moderate cardiac hyperkuphy chronic passive in 1981 and revealed no detectable Wpu activity congestion of the liver, moderate fatty change of the [LLD--Iu) Bq (1 nci)]. Other in-vivo counts were made liver, and nodular hyperplasia of the prostate gland. with a hyperpure germanium detector and included a He had a history of smoking cigarettes for at least 35 liver count, in which the detector was positioned over years. the organ. No activity above the LLD for %of ap During his period of employment he was in- proximately 40 Bq (1 nci) was detected. volved in two radiation incidents with the potential for Seven histopathology slides are available for acute internal deposition of plutonium. The first oc- USTUR Case 0193, for heart, luns liver, spleen, gas- curred on 17August 1956 and resulted in an estimated trointestinal mucosa, kidney, adrenal, pancreas, pros- deposition based on urinalysis data of approximately tate, and testicles. 0.8 Bq of p9pu. On 23 March 1%7 the donor was at- tempting to cut a pipe which was located at the back USTUR Case 0208 of the solvent extraction hood. The end of the cut pipe This male Caucasian, age 69 y at the time of struck his hand ensuing a wound to the back of the death in April 1984 from pulmonary embolus, was 1.78 middle finger. "he maximum level of contamination m in height and weighed approximately 59 kg. He on his hand at the wound site was 167 Bq, which was WMa w?bd vascular accident (stroke) eight years decontaminated to 33 Bq. He was sent to a wound cen- prior to death and was physically inactive after that ter for treatment and the initial deposition in the wound event. The donor had a clinical history of hyperten- was estimated as 2220 Bq. Surgical excision reduced sion. No autopsy report was available. this to 370 Bq at the wound site. The donor was also He began work in 1946 as an operations fore- treated by chelation with DTPA A total of 265 g of

urnAnnual Report for 1993 23 1081hhb I DTPA was administered in 47 treatments during the entered the room through an acid waste line in which six month period following the injury. the traps in the drain line had dried up, allowing contamination to enter into the room atmosphere. The External dosimetry summary for this case: automatic air sampler and alpha alarm were activated. Room personnel immediately left the room or donned Non-penetrating Penetrating full face masks. Exactly what action the donor took at 1955- 1981 10690 mrem that time was not recorded, but a nose wipe taken after that incident indicated no detectable activity. Urinaly- Evaluation of this case resulted in an estimated sys- sis done after that date for mPu did not indicate levels temic deposition, based on urinalysis data, of 535 Bq of mPu above 0.02 mBq. of Tuand 4.3 kBq "*Pu (McInroy et al. 1989). Seven in vivo chest measurements were made Histopathology slides are available from the between 1970 and 1979. All were below the minimum autopsy of this case, for the following tissues: heart, detection levels for Tu. Whole body deposition at lung, liver, kidney, prostate; testis, spleen, adrenal the time of death, based on radiourinalysis data, was gland, thyroid, and brain. estimated at 585 Bq % (Mdnroy et al. 1989). There an? no histopathology slides available for th.scase. USTUR Case 0223 This donor was a 68 year old male Caucasian USTUR Case 0242 who measured 1.72 m and weighed 64 kg when he died This 78 year old Caucasian male was 1.80 m in of lung carcinoma in 1984. He had a health history of height and weighed 85 kg in January 1987 at the time skin cancers on his eyelid, one of which had been sur- of death from left ventricular hypertrophy and con gically removed and the other had been bated with nary arteriosclerosis. In 1958, he had be&iWnically radiation. He smoked approximately one pack of ciga- diagnosed with hypertensive vascular disease with rettes daily for twenty years. No autopsy report was hypertensive retinopathy, grade I plus, with no defi- available. nite evidence of cardiac or renal involvement. Exami- He began working with Pu in July 1946 as a nation at autopsy also revealed moderate chronic ob- chemist and had potential airborne Pu exposures until structive lung disease, nodular hyperplasia of right his retirement in January 1979. Five potential acute adnmalcortex,inactive chronicintmstitialnephritisand inhalation accident events were nxorded between 1946 moderate generalized atherosclerosis. and 1967, including three occasions in 1946 and 1947 He began working with Pu in 1946 as a pluto- when positive nasal wipes for plutonium were ob- nium chemical operator and had potential exposure to tained. December 30,1947 a contamination report in- airborne plutonium until his retirement in June1972, dicated that the donor was p-t when a transfer tank with the exception of a brief layoff from September to developed a leak at a weld on the bottom of the tank. November of 1952. Six potential accidents were re No other details were indicated about that incident. In corded during 1947-1948;allwereexposurestoaihorne March 1947 high nose counts were recorded, 82/76 plutonium except an acid bum in 1947, having a IP- counts per minute, left and right nostrils respectively, corded surface contamination level of >4O,OOO cpm with a record note that the donor could not account for (countingeffiaency not stated). One additional expo- the high nose count in any way. While wearing a half sure to airborne Pu was recorded in 1958. mask particulate respirator in April 1955, the donor was The 1947 accident occurred when he was at- exposed to an air concentration of 1245 counts per tempting to withdraw some solution of plutonium, an minute/m3. Subsequent nose swipe were reported as acid medium from a paroxidizer, and the line became 2 counts per minu*, the efficiency was not given, nor plugged. When loosening the diaphragm valve, the was conversion to activity made. pressure foxed the solution out, splattering his face In February 1957, the donor was working with- and neck. He immediately washed with soap and out a respirator in a room where a gas explosion oc- water, and was subsequently decontaminated. Decon- curred in which the airborne alpha count of 498 counts tamination procedure consisted of an application of per minute/m3 was recorded for the room air filter ad- ammonium citrate paste (4 grams of ammonium tit- jacent to the drybox. In August 1%7, an airborne al- rate in 100 cc distilled water mixed with koalin) which pha contamination occurred in the room in which the was applied to the contaminated parts and allowed to donor worked. 238pu contamination is believed to have remain there for approximately 5 minutes, before re-

USTUR Annual Report for 1993 24 1081441 moval with water. Readings taken before and after de- 0242. These are SUPUIIiViZed below: contamination with a Pee-Wee air proportional alpha survey meter showed a decrease from 45,000 to 26,000 counts per minute on his forehead and from 26,000 to Date nci Vu nCi %'Am . 11,oOO counts per minute on the left side of his neck The efficiency of the instrument is unk.lo~n.Read- May 1970 4 .00 0.16 ings from twelve different locatims on his face, neck, Mar 1972 21.00 208 hands and upper body were noted. May 1972 non4etectable 207 An accident occurred in 1952 in which the do- nor was present in the room where an evaporator gas- ketwasbeingreplacedwhilestillunderpressure. Plu- A note in this file indicates that all in-vivo counting tonium was released throughout the room contaminat- results prior to 1978 a~ of questionable value due to ingtheroomandthedonorto20,000countsperminuk; possible detector problems or statistid considerations. neither efficiency nor conversion fo ac%vity is known. External exposure, as obtained by whole body film 'Ihedanorwasweaxingfullpmtectiveclothingand~ badges, was given as 1.91 R for the period December pirator at the time. In 1953 a filtered batch of pluto- 1946 to August 1950. nium wasbeingloadedin~ashippingcontainerwhen At the time of his Mirement in 1972, his Pluto- a violent reaction occurred between the alcohol in the Num deposition was estimated as 37 kBq and his ex- bomb and hot nitric acid in the dissolved plutonium ternal whole body dose given as 48.02 mn. There are solution, which forced a plutonium mist out of the air a total of 16 histopathology slides available for USTUR lock and into the room. Urinalyses for plutonium was Case 0242, including coronary arteries, thyroid, medi- dune after these accidents, but nose wipes were not astinal lymph node, lung, spleen, liver, a-d- takenatthosetimes ney, and brain.. In 1956 and 1957 minor accidents occurred in the laboratory where the donor was working in which Intnptetation of the Tabulated Radiollrinalysis air concentrations were reported as 1029,2925, and and Nose WpeData 3360 counts per minute/m3 for the three events. He The urinalysis data presented in tabular form was wearing a full face mask during the two incidents are as reported by #heemployer for each speafic case that occuned in 1956, but was not wearing a respirator and need to be caddyconsidd and evaluated for at the time of the acadent in 1957. Nose wipes take!n devancy and accuracy with respect to exposump aftexthoseincidentsindicated6,1,and U(left),2qright) tential. There are serious questions that can be raised counts per minute, respvely Again, the conversion withrespecttothevalidityoftheearkmeastmments. to activity is not known. In their history of the Pu bioassay program at Los Early in 1958, the donor was wearing a half Alamos from 1944 to 1972, Campbell and co-workers mask respirator with ultra filter when a leak m a vapor (1972)reported marked differences in the sensitivity line gasket occurred. Measured room air activity was and reliability of radiourinalysesperformed in the early 3282 counts per minute/m3. Nasal swipes were not years when compared with those performed more re taken at that time. In yet another incident in 1958, the cently. The speafic urinalysis data for USTUR Case glass lining of a steam-jacket evaporator was broken 0193 up through 1977, were examined by Lawrence and and a solution of Pu in Ha blew out a hole in the steel included as Appendix I in the paper by Voelz et aL liner, filling the room with acid fumes. The subject (1979). Lawrence notes that prior to 1957, urine assay donned a full face respirator; turned off the steam; and results were recorded in tenns of counts per minute cleaned up the solution on the flwt His booties, shoes, per 24-h sample, without correction for chemical re- and coveralls were contaminated to 20,OOO counts per covery, chemical reagent background, or counting ge- minute. The highest mom count was reported as ometry (Lawrence 1978; Voelz et aL 1979) Blank and 142,057 counts per minute/m3. Nasal wipes showed 8 chemicalrecoverypncedureswereperfomedperiodi- counts per minute, but the conversion to activity is not cally, but not m a mgrdar basis (Lawrence 1978). Con- known. Plutonium urinalyses were performed after version of the count per minute values to activity was all these potential accidental exposures. made on the basis of statistical evaluation of the raw Over his 26 year period of employment, data data recorded in laboratory notebooks (Lamce 1978); are available for only three in-vivo lung counts on Case

25 USTURAnnual Report for 1993 108Iirlr8 I

these are the data that appear in Table 1, along with Literature Cited data from the other cases. In all cases, Urinalysis data prior to 1957 may Campbell, E. E.; Milligan, M. E; Moss, W. D.; Schulte, be of questionablevalidity in that the detection limit at H. E History of the Plutonium Bioassay Program at the 95% confidence level for 239Pu in a 24-h urine the Los Alamos Scientific Laboratory, 1944-1972. Los sample was greater than about 7 mBq (0.1 pCi). After Alamos, NM: Los Alamos National Laboratory; January 1957, the urine assay procedures were refined Report LA-5008;October 1972. and the urinalysis results after that are considered sat- isfactory and achieved a detection hitof 1mBq (0.03 Hempelmann, L. H.; Langham, W. H.; Richmond, C. pCi) per 24-h urine sample. R.; Voelz, G. L.; Manhattan Project Plutonium Work- Nasal wipe data for all cases, as given in the ers: A Twenty-seven Year Follow-up Study of Se- table, are incomplete. Nasal wipes were taken some- lected Cases. Health Phys. 25:461479; 1973. what routinely and as frequently as several times daily, depending on the work; theresults were recorded in Lawrence, J. N. P. AHistory of PUQFUA. Los counts per minute. Typically, nasal wipe levels were Alamos, NM: Los Alanios National Laboratory; LA- on the order of a few - less than 10 - counts per 7403-H; October 1978. minute, but in some instances significantly higher counts were recorded. Only those instances in which Mays, D.; Guilmette, R. A., eds. Special Issue: Total- the levels for either nostril exceeded 100 counts per body Evaluation of a Thorotrast Patient. Health minute are included in Table 1. Exact interpretation of Phys. 63~1-100;1992. the nasal wipe results cannot be made, as counting techniques, geometries, efficiencies, background level, and Mc Inroy, J. E; Boyd, H. A.; Eutsler, B. C.;hero, D. other necessary data are lacking, including particlesize Part N. Preparation and Analysis of the Tssues and distributions, solubility, respirator usage, and whether Bones. Health Phys. 49:587-621; 1985. the individual in question was a mouth breather. They are, however, indicative of potential exposure to air- McInroy, J. F.; Kathren, R. L., Swint, M. J. Distribu- borne Pu during the donors working years. tion of Plutonium and Ameriaum in Whole Bodies Donated to the United States Transuranium Registry. Radioassay Data Radiat. Protect. Dosim. 26:151-158;1989. Tables of radioanalyticaldata axe presented for the analysis of these five whole body cases. The radio- Mchoy, J. F.; Kathren, R L.; Voelz, G. L.; Swint, M. J. chemical analysis procedures, as well as sample divi- U.S. Transuranium Registry Report on the =Pu sion protocol, have been described by McInroy et al. Distribution in a Human Body Health Phys. 60507- (1985). Data for USTUR Case 0193 were, in part, previ- 333; 1991. ously published (Mclnroy et al. 1991) and where these data have been reported again heFein, weights have Roessler G. S.; Magura, B., eds. Speaal Issue: The been rounded to three sigruficant figures, where avail- U.S. Transuranium Regisby Report on the 241Am able. For soft tissues, concentrations reported 5ue in Content of a Whole Body Health Phys. 49:559-661; dtsof Bq/kg of wet weight. For bone, reported con- 1985. centrations are in Bq/kg of ash weight. In a few instances, minor revisions or corrections of previously Voelz, G. L.; Grier, R. S.; Hempelmann, L. H. A 37- published values or estimates of weights were made; year Medical Follow-up of Manhattan Project Work- these are noted in the tables. ers. Health Phys. 48.249-259;1985. ACKNOWLEDGEMENT Voelz, G. L.; Hempelmann, L. H.; Lawrence, J. N. P.; Radiochemical analyses were carried out by LANL Moss, W. D. A 32-year Medical Follow-up of Man- under the direction of James F. McInroy, assisted by hattan Project Pu Workers. Health Phys. 37445-485; Edward Gonzales and other members of the staff. 1979.

1081449 USTUR Annual Report for 1993 26 Radiourinalysis and Nose Wipe Data

1081450 Table 1. Radiourinalysis and nose wipe data.

Other including Date in Urine Nose Wipe cpm mBq124h p Ci/24 h (Left/Right)

Case 0193 27 Mar 1945 168123 20 Apr 1945 -3.7 -0.10 6 Jun 1945 3061187 14 Jun 1945 225140 6 Jul 1945 80016 16 16 Jull945 186 31 Jull945 1681146 l-Aug 1945 156150 3 Aug 1945 153126

12 Aug 1945 1562/ 156 20 Aug 1945 769614598 28 Aug 1945 124/106 30 Aup; 1945 374188 ...- 6 Sept 1945 102 2.75 7Feb 1946 224 13 Feb 1946 169 25 Mar 1946 102 2.75 12 Jun 1946 28.9 0.78 8 Aup; 1946 93.6 2.53

26 Apr 1950 -7.8 -0.21 23 Sep 1951 -1.1 -0.03 ~ 5 Nov 1951 -1.9 -0.05 27 Jan 1952 -7.8 -0.21 29 Jan 1952 -4.8 -0.13 15 Mar 1952 -4.1 -0.11 30 Apr 1952 13.7 0.37 23 May 1952 -0.4 -0.01 29 Aug 1952 -1.1 -0.03 27 Oct 1952 -4.8 -0.13

9 Dec 1952 -6.3 -0.17

~ 20 Jan 1953 4.8 0.13 3 Jun 1953 4.8 0.13 10 Aug 1953 5.2 0.14 11 Feb 1954 -6.3 -0.17 19 May 1954 5.2 0.14 22 Jul 1954 3.7 0.10 Table 1. Radiourinalysis and nose wipe data.

Other including

Date =gPU inurine Nose Wi~er - mm-r--- mBqf24h pCi/24h (Left/Right)

Case 0193 (cont’d) 24 Aun 1954 3.3 0.09 27 Sep 1954 -6.7 -0.18 26 Oct 1954 5.6 0.15 20 Nov 1954 -1.1 -0.03

29Dec 1954 1.1 0.03 18 Feb 1955 6.7 0.18 8 Mar 1955 -3.3 -0.09 19 Apr 1955 4.8 0.13 26 May 1955 12.2 0.33 27 Jun 1955 -1.1 -0.03 13 Jul1955 3.3 0.09 27 Jul1955 -5.2 -0.14 23 Aug 1955 -7.8 -0.2 1 23 Sep 1955 -4.1 -0.11

20 Oct 1955 3.3 0.09 12 Nov 1955 4.1 0.11 23 Dec 1955 -2.2 -0.06 25 Jan 1956 -1.1 -0.03 20 Feb 1956 -1.9 -0.05 22 Mar 1956 -4.1 -0.11 19 Apr 1956 2.2 0.06 10 May 1956 4.1 0.11 7 Jun 1956 -7.0 -0.19 12 Jull956 10.7 0.29

16 Aug 1956 -2.6 -0.07 17 Sep 1956 -1.9 -0.05 16 Oct 1956 -1.9 -0.05 16 Nov 1956 -1.1 -0.03 14Dec 1956 -4.1 -0.11 14 Jan 1957 -6.3 -0.17 18 Feb 1YS7 3.0 6.08 20Mar 1957 3.0 0.08 22 Apr 1957 3.7 0.10 23 May 1957 1.9 0.05

28 1081452 Table 1. Radiourinalysis and nose wipe data.

Other including

Date in Urine Nose Wioe cam- c --- mBq/24h pCV24h (Leititight)

Case 0193 (cont’d)

20- __Jun 1957 2.6 0.07 22 Jul 1957 2.6 0.07 16 Aug 1957 2.6 0.07 Involved in acute accidental exposure incident. Nasal wipe 413 cpm (7 Bq or 185 pCi) ~ ~~~ 17 Aug 1957 7.8 0.21 18 Aug 1957 0.0 0.00 Fecal sample 15 Bq

23 Sep 1957 5.6 0.15 24 Oct 1957 4.8 0.13 -2- 26 Nov 1957 1.9 0.05 6 Jan 1958 4.4 0.12 17 Feb 1958 4.1 0.11 28 Mar 1958 0.0 0.00 14 Mav 1958 3.7 0.10 23 Jun 1958 3.7 0.10 28 Jul 1958 5.2 0.14 10 Sep 1958 1.9 0.05 3 Nov 1958 4.4 0.12 18 Dec 1958 2.6 0.07

26 Jan 1959 5.2 0.14 3 Feb 1959 Involved in acute inhalation exposure while wearing respirator; nasal wipe contained 18 cDm 9 Feb 1959 7.8 0.21 24Feb 1959 2.6 0.07 8 Apr 1959 3.7 0.10 21 May 1959 3 .O c.05 29 Jun 1959 4.1 0.11 15 Jul 1959 Involved in possible acute inhalation exposure; no record of nasal wipe(s). 29 1081453 c

Table 1. Radiourinalysis and nose wipe data. Other including Date "'pu in Urine Nose Wipe cpm mBqf24h p Ci/ 24 h oLeft/Right)

Case 0193 (cont'd) 20 Jul 1959 3 .O 0.08 11 Sep 1959 1.5 0.04 19 Oct 1959 3.0 0.08 30 Nov 1959 3.0 0.08

25 Jan 1960 2.2 0.06 2 Mar.1960 3.7 0.10 15 Apr 1960 2.6 0.07 26 May 1960 2.2 0.06 12 Jull960 0.0 0.00 26Aig 1960 3.3 0.09 6 Oct 1960 3.3 0.09 16 NOV1960 0.4 0.01 ... 17 Jan 1961 3.3 0.09 27Feb 1961 0.4 0.01 13 Apr 1961 2.2 0.06 29 Mav 1961 1.9 0.05 17 Jull961 1.2 0.03 5 Sep 1961 1.9 0.05

19 Oct 1961 3.0 0.08 7 Dec 1961 2.6 0.07 26 Jan 1962 3.3 0.09 15 Mar 1962 1.9 0.05 24 Apr 1962 2.6 0.07 13 Jun 1962 3.0 0.08 16 Jull962 0.7 0.02 31 Aug 1962 0.0 0.00 17 Oct 1962 0.7 0.02 23 Jan 1963 0.0 0.00

13 Mar 1963 3.3 0.09 26 Apr 1963 2.6 0.07 18 Jun 1963 4.1 0.11 2 Aug 1963 1.9 0.05 23 Sep 1963 1.1 0.03 21 Nov 1963 4.8 0.13 13 Jan 1964 3.3 0.09

30 1081454 PI Table 1. Radiourinalysis and nose wipe data.

Other including Date "Vu in Urine Nose Wipe cpm mBql24h p Ci/24 h (Left/Right)

Page 0193 (cont'd) 5 Feb 1964 4.1 0.11 1 Apr 1964 3.3 0.09 25 May 1964 4.1 0.11 6 Jul 1964 0.0 0.00

31 Aug 1964 3.7 0.10 24-Sep 1964 1.9 0.05 26 Oct 1964 3.0 0.08 High room air count; possible acute inhalation exDosure. 17 Dec 1964 1.9 0.05 25 Jan 1965 2.2 0.06 8 Mar 1965 3.3 0.09 __.- 22 Apr 1965 3.3 0.09 19 Jull965 2.2 0.06 18 Oct 1965 1.1 0.03 20 Jan 1966 0.4 0.01 18 Apr 1966 4.4 0.12 29Nov 1966 4.4 0.12 22 May 1967 3.3 0.09 30Nov 1967 3.3 0.09 6 June 1968 3.3 0.09

2 Dec 1968 6.7 0.18 12 Jun 1969 0.0 0.00 11 Dec 1969 5.6 0.15

11 June 1970 8.9 0.24 12 Nov 1970 3.7 0.10 18 Jan 1971 1.9 0.05 19 Jul1971 5.9 0.16 6 Jan 1972 5.2 0.14 6 Jan 1972 4.4 0.12 6 Jan 1972 4.8 0.13 18 Jan 1972 4.4 0.12 8 Jun 1973 4.8 0.13 18 Jul 1973 4.1 0.11 7 Jan 1974 3.3 0.09

31 IO81455 Table 1. Radiourinalysis and nose wipe data.

Other including Date "%I in Urine Nose Wipe cpm mBqI24h pCV24h (Left/Right)

Case 0193 cont'd) 10 Jun 1974 3.3 0.09 11 Sen 1974 1.5 0.04 ~ 5 Dec 1974 5.6 0.15 5 Mar 1975 5.2 0.14 9 Jun 1975 4.8 0.13 5 1975 1.5 0.04 AUP ~~ 8 Dec 1975 3.3 0.09 12 Mar 1976 3.7 0.10 14 Jun 1976 4.1 0.11 7 Seo 1976 1.9 0.05

6Dec 1976 1.5 0.04 10 Mar 1977 1.9 0.05 10 Jun 1977 2.2 0.06 12 Sep 1977 3 .O 0.08 13 Jull978 3 .O 0.08 12 Oct 1978 2.2 0.06 8 Dec 1978 1.1 0.03 14 Mar 1979 4.1 0.11 8 Jun 1979 2.2 0.06 18 Sep 1979 1.9 0.05 12 Dec 1979 1.5 0.04

19 Mar 1980 3.3 0.09 11 Jun 1980 4.4 0.12 10 Sep 1980 1.1 0.03 5 Jan 1981 2.2 0.06 8 Mar 1981 1.9 0.05 12 Jun 1981 3.0 0.08 2 Sep 1981 4.1 0.11 7Dec 1981 2.2 0.06 13 Jan 1982 2.2 0.06 0208 9 Julv 1946 - 9 &g 1946 242169 30 Aun 1946 12.6 0.34 9 Oct 1946 28.9 0.78

32 I O814Sb r Table 1. Radiourinalysis and nose wipe data. Other including Date "9pu in Urine Nose Wipe cpm mBqt24h p CV 24 h Oft/Right)

Case 0208 (cont'd) 4 Dec 1946 37.0 1.oo 4 Oct 1955 0.4 0.01 24 Oct 1955 25 Nov 1955 3.3 0.09 9 Jul 1956 1.9 0.05

4 Jan 1957 2.6 0.07 2 Jd 1957 10.8 0.29 26 & 1957 6.8 0.18 2 Feb 1958 3.2 0.09 3 Feb 1958 3.2 0.09 4Feb 1958 4.5 0.12 5 Feb 1958 3.7 0.10 6Feb l958 4.5 0.12 7 Feb 1958 5.6 0.15 8Feb 1958 4.7 0.13 --- 9Feb 1958 5.6 0.15 10Feb 1958 2.8 0.08 11 Feb 1958 2.8 0.08 12Feb 1958 4.1 0.11 13 Feb 1958 4.7 0.13 14Feb 1958 4.4 0.12

16 Feb 1958 5.2 0.14 29 &r 1958 3.2 0.09 30 m1958 4.1 0.11 1 w958 4.4 0.12 7 Jul 1958 3.7 0.10 8 Jull958 1.5 0.04

7&g 1958 1.1 0.03 24 Sep 1958 4.0 0.10 25 Sep 1958 3 .O 0.08 26 SeD 1958 3 .O 0.08 1 mv 1959 4.0 0.11 5 Oct 1959 3.3 0.09 6 Oct 1959 3.3 0.09 2-32_.__-...Q.!! ._- 0 Oct 1959 2 ILQv 1960 0.4 0.01 20 &p 1960 2.6 0.07

IO81451 33 Other includinnY t Date inurine Nose Wipe cpm mBq/24h P Ci/ 24 h (Left/Right)

case 0208 (cont’d) 20 Sep 1960 2.6 0.07 10 Nov 1960 7.7 0.21 17- 1961 3.2 0.09 21 Nov 1961 8.0 0.22 28 mv 1962 6.3 0.17 7 Jun 1962 8.0 0.22 7 Jun.1962 4.8 0.13 62 5.2 0.14 62 4.8 0.13 15 S? 1962 4.0 0.1 1 16 Sen 1967 5.8 0.16 17 Sep 1962 5.5 0.15 29 Mar 1963 2.5 0.07 3 Oct 1963 10.2 0.27 --- 8 Jul 1964 4.5 0.12

1965 0.0 0.00 18 1965 4.5 0.12 6& 1966 0.0 0.00 5 0.07 6 Feb 1967 2.5 0.07 2 &g 1967 3.5 0.09 2Feb 1968 2.0 0.05 29 Jan 1969. 2.5 0.07 17 Jul 1969 4.5 0.12 15 Jan 1970 3.3 0.09 16 Jull970 4.7 0.13 14 J-71 4.2 0.11 19 Ja1971 4.2 0.11 19 IpD 1971 5.0 0.14 Case 0212 No nose wipe data. 23 Mar 1967 73410.0 1982.0 24 Mar 1967 35890.0 969.0 25Mar 1967 30220.0 815.9 26 Mar 1967 24580.0 663.7 27 Mar 1967 54500.0 --1471.5 28 Mar 1967 25430.0 686.6 29 Mar 1967 50050.0 1351.4 30 Mar 1967 20690.0 558.6 31 Mar 1967 9973.0 269.3

34 1081458 I r Table 1. Radiourinalysis and nose wipe data. i Other including Date "9pu in Urine Nose Wipe cpm mBqf24h pCi/24h (Left/Right)

Case 0212 (cont'd) 1 Apr 1967 8527.0 230.2 2 Apr 1967 6191.0 167.2 3 Apr 1967 48200.0 1301.4 4 Apr 1967 20320.0 548.6 5 Apr 1967 9416.0 254.2 6 Apr 1967 29620.0 799.7 -7 ADr 1%7 10710.0 289.2 8 Apr 1967 7747.0 209.2 9 Apr 1967 5182.0 139.9 10 ADr 1967 21540.0 581.6 11 Apr 1967 6339.0 171.1

12 Apr 1967 5042.0 136.1 ---* 13 Apr 1967 16830.0 454.4 14 ADr 1967 3966.0 107.1 IS Apr 1967 12900.0 348.3 16 Apr 1967 4337.0 117.1 17 Apr 1967 3211.0 86.7 18 Am 1967 4704.0 127.0 19 Apr 1967 3075.0 83 .O 20 Apr 1967 11410.0 308.1 21 Apr 1967 4788.0 129.3 22 Am 1967 3 105.0 83.8 23 Am 1967 2301 .O 62.1 24 Apr 1967 16450.0 444.0 25 Apr 1967 5554.0 150.0 26 Apr 1967 3562.0 96.2

. -.

35 1081459 Table 1. Radiourinalysis and nose wipe data.

Other including Date =9Pu inurine Nose Wipe cpm mBq/24h p Ci/24 h (Left/Right)

Case 0212 (cont'd) 27 Apr 1967 965.3 26.1 28 Apr 1967 5165.0 139.5 29 Apr 1967 3268.0 88.2 30 Apr 1967 2530.0 68.3 1 Mav 1967 15470.0- 417.8 2 May 1967 45 14.0 121.9 3 May 1967 2761.0 74.5 4 May 1967 93 14.0 251.5

5 Mav- €967 4337.0 117.1 6 May 1967 1248.0 33.7 7 May 1967 1909.0 51.5 8 May 1967 15130.0 408.4

9 May 1967 4337.0 117.1 -== 10 May 1967 281 1.0 75.9 -. 11 May 1967 13350.0 360.5 12 May 1967 4300.0 116.1 13 May 1967 2346.0 63.3 14 May 1967 1769.0 47.8 15 May 1967 11420.0 308.3 16 May 1967 3893.0 105.1 17 Mav 1967 2376.0 64.2 ~ 18 May 1967 8935.0 241.2

19 May 1967 3088.0 83.4 20 Mav 1967 2276.0 61.5 ~ ~ 21 May 1967 1543.O 41.7 22 May 1967 11900.0 321.3 23 May 1967 3696.0 99.8 24 May 1967 975 1.O 263.3 25 May 1967 7193.0 194.2 26 May 1967 2877.0 77.7 27 May 1967 1206.0 32.6 29 May 1967 9527.0 257.2

30 Mav 1967 2346.0 63.3 ~ 31 Mav 1967 130.3 3.5 1 Jun 1967 . . 626.3 16.9 2 Jun 1967 2280.0 61.6 3 Jun 1967 1197.0 32.3 a t'"o8440 i Table 1. Radiourinalysis and nose wipe data.

other including Date 239puin Urine Nose Wipe cpm mBqf24h p Ci/24 h (Left/Right)

Case 0212 (coot’d) 4 Jun 1967 474.3 12.8

5- Jun- ___ 1967- - 6673.0 180.2 6 Jun 1967 1875.0 50.6 7 Jun 1967 2209.0 59.6 8 Jun 1967 5449.0 147.1

9 Jun 1967 1695.0 45.8 10 Jun 1967 1328.0 35.9 11 Jun 1967 1049.0 28.3 12 Jun 1967 4040.0 109.1 13 Jun 1967 160.3 4.3 14 Jun 1967 55.1 1.5 15 Jun 1967 7527.0 203.2 -*e* 16 Jun 1967 2246.0 60.6 17 Jun 1967 881.8 23.8 18 Jun 1967 1000.0 27.0

19 Jun 1967 1604.0 43.3 21 Jun 1967 7.5 0.2 26 Jun 1967 203.7 5.5 27 Jun 1967 267.2 7.2 28 Jun 1967 185.4 5.0 29 Jun 1967 678.0 183 30 Jun 1967 148.6 4.0 1 July 1967 46.8 1.3 2 July 1967 78.5 2.1

3 Julv 1967 452.6 12.2 4 July 1967 325.7 8.8 5 July 1967 444.2 12.0 10 July 1967 6673.0 180.2 11 July 1967 1942.0 52.4 12 Julv 1967 890.1 24.0 ~ ~~ 13 July 1967 4078.0 ------110.1 15 July 1967 1565.0 42.3 16 July 1967 1139.0 30.7 17 July 1967 3930.0 106.1

~~ 18 Julv 1967 1012.0 27.3 19 July 1967 920.2 24.8 37 .10814bl Table 1. Radiourinalysis and nose wipe data.

Other including Date =9Pu inurine Nose Wipe cpm mBq124h p Ci/24 h CLeftflRight)

Case 0212 (cont’d) 20 July 1967 41 15.0 111.1 21 July 1967 953.6 25.7 22 July 1967 653.0 17.6 23 July 1967 653.0 17.6 24 July 1967 3 133.0 84.6 25 Julv 1967 1316.0 35.5 23 July 1967 397.5 10.7 27 July 1967 3333.0 90.0

28 Julv 1967 562.8 15.2 10 Aug 1967 131.9 3.6 11 Aup: 1967 83.5 2.3 12 Aup; 1967 93.5 2.5 13 Aun 1967 81.8 2.2 14 Aup: 1967 113.6 3.1 18 Aug 1967 1072.0 28.9

19 Jull946 150.4 4.06 25 Jull946 13 1/17 29 Jul 1946 667142 14 &- 23 & 1946 68/86 27 Sen 1946 12.6 0.34 4 Oct 1946 62/44 13 Nov 1946 8.5 0.23 21 Nov 1946 144ffo 10Dec 1946 5-

20 1947 4 10/5 5Feb 1947 6 1614

28 Bpr 1947 20511 16 mv 1947 - 23 &v 1947 011 13 18 Jun 1947 12.6 0.34 25 Jul 1947 16.7 0.45 1947 89610 29 &g 1947 12.6 0.34 24 Sep 1947 - 24 Oct 1947 - Table 1. Radiourinalysis and nose wipe data.

~~ other including Date inurine Nose Wipe cpm mBq124h pW24h (Left/Right)

Case 213 (cont’d) 12 Nov 1947 230142 78 Nov 1947 17 6 0.34 77 Ds1947 8311 8 30Dec 1947 Involved in contamination accident. 4Feb 1948 0.4 0.01 lo& 1948 - 6 & 1948 - -0 71 5 1948 - -0.21 4 Oct 1948 - 3 Nov 1948 4.4 0.12

9Dec 1948 53/0 9 - -0.43 771/1 9 t9 - 11712 21.9 0.59 t9 80/1 I I -0.21 I - -0.03 , - -0.21 I 13.0 0.35 16.7 0.45 2 3 1.9 0.86 4 18.0 0.49 9 0 4 - -0.14 15.4 0.41 - -0.02 P - 9 3 -03 -0.01 3 7.0 0.19 76.7 2.07

26 &g 1953 -0.7 -0.02 19 Oct 1953 0 - 1 1Ju 1954 - 8 1954 2.2 0.06 23 Jul 1954, 0.7 0.02 27 &g 1954 - -0.07 f0814b3 39 Table 1. Radiourinalysis and nose wipe data.

Other including Date "9pu in Urine Nose Wipe cpm mBq/24h pCV24h (Left/Right)

Case 213 (cont'd) 4 Oct 1954 - 19 Oct 1954 1.9 0.05 4Nov 1954 2.6 0.07 6Dec 1954 1.1 0.03 10 1955 1.1 0.03 11 Feb 1955 5.6 0.15

11 Mar 1-955 -4.8 12 qPr 1955 - 28Bpr 1955 2.2 0.06 9Mpv 1955 5.2 8 Jun Lps5 2.2 0.06 11 & 1955 - 1.9 0.05 6 Oct 1955 0.7 0.02 4Nov 1955 7.8 0.21 6Dec 1955 1.9 0.05 10 b 1956 - 20 Feb 1956 1.1 0.03 26 1956 3.7 0.10 24 qPr 1956 2.2 0.06 14 &v 1956 2.2 0.06 14 Jun 1956 12.6 0.34 34uo1956 2.2 0.06 29 &g 1956 73 0.19 28 Sep 1956 5.2 0.14 26 Oct 1956 12.2 0.33 27 Nov 1956 1.9 0.05 31 Da1956 19.6 0.53 9 Jan 1957 5.6 0.15 8 Feb 1957 4.1 0.11 2 Feb 1957 3.8 0.10 30 4pr 1957 8.2 0.22 12 Jun 1957 5.6 0.15 29 Jull957 35 0.09 9 Sep 1957 5.4 0.15 10 Oct 1957 2.6 0.07 14 Nov 1957 7.5 0.20 19 Dee 1957 10.1 0.27 27 Jan 1958 6.5 0.17 13 Mar 1958 3.4 0.09 19 May 1958 3.3 0.09

40 10814b4 ? Table 1. Radiourinalysis and nose wipe data.

other includmnY Date =9Pu in Urine Nose Wipe cpm mBq/24h p Ci/24 h (Left/Right)

Case 213 (coat’d) 4 Jun 1958 7.0 0.19 11 Jul 1958 6.1 0.16 18 & 1958 6.2 0.17 3 061958 3.9 0.10 12 Nov1958 5.1 0.14 12 Iao 1959 11.3 0.3 1 12 Mar 1959 17.7 0.48 17 &r 1959 6.5 0.17 16 1959 7.4 0.20

9 Jul 1959 7.8 0.21 20 Jul 1959 7.2 0.19 4 Sep 1959 8.3 0.22 23 Oct 1959 10.2 0.27 2Dec 1959 4.5 0.12 22 Jan L960 0.5 0.01 .-SI 8 1960 19 &r 1960 6.5 0.18 25 1960 7.5 0.20 11 u60 5.0 0.14 26 & 1960 6.0 0.16

7 Oct 1960 8.7 0.23 18 Nov 1960 4.8 0.13 28 -61 5.7 0.15 11 &g 1961 4.7 0.13 26 0.06 15 &g 1961 0.0 0.00 18 1961 8.8 0.24 7 Dec 1961 3.3 0.09 19 Jan p62 4.8 0.13 8 -62 2.3 0.06 26 &g 1962 5.5 0.15 5 Ju62 14.0 0.38 16 Jull962 3.7 0.10 2,oo .oo .12 224 163 4.7 .13 163 7.2 ( 163 7.7 (2 .21 163 11.0 4 - .30 163 5.0 ( 163 0.0 (2

31 10814b5 Table 1. Radiourinalysis and nose wipe data.

Other including Date in Urine Nose Wipe cpm mBql24h pCV24h (Left/Right)

Case 213 (coat’d) 15 1964 6.2 0.17

10.0 0.00 0.14 1964 10 Jul 1964 3.5 0.09 19hn1964 4.7 0.13 1 oct-1964 6.5 0.18 11 Nov 1964 3.5 0.09 23 &c 1964 1.7 0.05 10Feb 1965 5.2 0.14 25 Mar 1965 7.7 0.21 5 1965 8.5

27 Oct 1965 1.5 0.04 29 @r 1966 4.0 0.11 21 Qclt 1966 0.0 0.00 12 May 1967 3.2 0.09 30 Aug 1967 Involved in high airtmme %i contamination. Nose wipe 0.0 cpm. 70 & 1967 28.3 0.77 12 QEt 1967 2.5 0.07 15 Nov 1967 20.0 0.54 19Dec 1967 5.8 0.16 18 Jan 1968 10.8 0.29 16 Feb 1968 14.3 0 39 15 & 1968 55.0 1.49 18 @ 1968 30.2 0.82

16 Jan 1969 11.8 03 15 Jull969 1.0 0.29 15 Jul 1969 0.0 0.00 -15 Jull969 0.0 0.00 15 Jan 1970 8.3 0.23 16 Jul1970 6.3 0.17 14 Jan 1971 6.3 0.17 17 Ipll1972 3.5 3

42 10814bb Table 1. Radiourinalysis and nose wipe data.

Other including Date z~ in Urine Nose WiDe mm mBqf24h p Cil24 h (LeftjRigilt)

Case 0242 12 Mar 1947 0.4 0.01 26 Mar 1947 126-273 2 May 1947 -7.8 -0.2 1 6 Jun 1947 4.4 0.12 9 Jul 1947 -28.1 -0.76 18 Jull947 122 22 Jul 1947 139 8 Aug 1947 -3.7 -0.10 5- __Sen 1947- -3.7 -0.10 2 Oct 1947 4.4 0.12

7 Nov 1947 -20.0 -0.54 8 Dec1947 -15.9 -0.43 6 Jan 1948 4.4 0.12 ~ .U 4 Feb 1948 8.5 0.23 4 Mar 1948 -1 1.9 -0.32 2 Apr 1948 8.5 0.23

5 Mav- ~. 1948 -1 1.9 -0.32 17 May 1948 1427-625 1 Jun 1948 12.6 03.4 7 Jull948 20.7 0.56 16 hg1948 -15.9 -0.43

19 Aug 1948 399-220 3 Sep 1948 171-130 7 Sep 1948 1281-328 21 Sen 1948 16.7 0.45 200ct 1948 -11.9 -0.32 2Dec 1948 -3.7 -0.10 6 Jan 1949 -3.7 -0.10 7Feb 1949 4.4 0.12 10 Mar 1949 8.5 0.23 13 Ant 1949 -28.0 -0.76

18 May 1949 -7.8 -0.21 16 Jun 1949 -7.8 -0.21 13 Jull949 -3.7 -0.10 ~~ 15 Aun 1949 4.4 0.12

43 Table 1. Radiourinalysis and nose wipe data.

Other including Date =%I in Urine Nose Wipe cpm mBqI24h pCil24h (Left/Right)

Cast 0242 cont'd) 16 Sep 1949 -28.0 -0.76 5 Oct 1949 384-1 17 18 Oct 1949 21.9 0.59 31 Oct 1949 264-853 4 Nov 1949 127-1 15 Nov 1949 2.2 0.06 30 Dec 1949 27.0 0.73

19 Jan 1950 7.0 0.19 20 Feb 1950 2.6 -O.O? 16 Mar 1950 -6.3 -0.17 if-hi 1950 -1.1 -0.03 17 May 1950 13.0 0.35 20 Jun 1950 18.1 0.49 21 Aup: 1950 -0.37 -0.01 21 Sa 1950 20.0 0.54 21 Oct 1950 2.2 0.06 22 Nov 1950 25.9 0.70

21 Jan 1951 18.1 0.49 21 Feb 1951 19.6 0.53 28 Mar 1951 -1.1 -0.03 26 Jun 1951 25.6 0.69 13 Aup; 1951 -7.8 -0.21 20 Sa 1951 34.0 0.92 6 Dec 1951 14.4 0.39 26 Jan 1952 -1.9 -0.05 26Feb 1952 -2.6 -0.07 24 Mar 1952 17.0 0.46 25 Abf 1952 2.2 0.06

17 Jun 1952 10.0 0.27 18 Jull952 15.2 0.41 18 Aup: 1952 21.9 0.59 17 Sm 1952 18.9 0.51 9 Dec 1952 34.8 0.94 31 Dec 1952 2.2 0.06 20 Jan 1953 7.0 -0.19 7 May 1953 2.2 0.06 r Table 1. Radiourinalysis and nose wipe data. Other including Date in Urine Nose Wipe cpm mBq/24h p Ci/ 24 h &eft/Right)

Case 0242 (cont’d) 3 Jun 1953 21.9 0.59 ~ 7 Jul 1953 5.5 0.19 23 Jul 1953 17.3 0.46 11 Aug 1953 66.7 1.80 2 Sep 1953 -7.8 -0.21 19 Oct 1953 -4.8 -0.13 11 Mav 1954 17.4 0.47 ~ 22 Jull954 14.6 0.39 24 Aug 1954 3.7 0.10

27- Seor 1954 12.6~ 0.34 26 Oct 1954 8.1 0.22 30 Nov 1954 6.3 0.17 29 Dec 1954 -2.6 -0.07 - -- 18 Feb 1955 5.2 0.14 ~ 8 Mar 1955 10.0 0.27 29 Mar 1955 -5.6 -0.15

26 Apr 1955 15.0 0.39

27 Mava 1955 9.6 0.26- 5 Jun 1955 13.7 0.37 29 Aug 1955 1.9 0.05 27 Sep 1955 12.2 0.33 27 Oct 1955 4.8 0.13 28 Nov 1955 7.8 0.2 1 29Dec 1955 9.3 0.25 30 Jan 1956 7.0 0.19 23 Feb 1956 51.9 1.40 1 Mar 1956 21.5 0.58 12 Mar 1956 16.0 0.43 20 Apr 1956 16.7 0.45 11 May 1956 9.6 0.26 8 Jun 1956 20.0 0.59

~~ ~ 21 Jun 1956 21.9 0.43 27 Jull956 0.7 -0.02 30 Aug 1956 8.2 0.22 28 1956 -5.2 -0.14 Sep i 26 Oct 1956 21.1 0 57

I 45 10814tq Table 1. Radiourinalysis and nose wipe data,

Other including Date inurine Nose WiDe cDm mBqI24h pCV24h (LeftjRight)

Case 0242 (cont’d)

7 Nov 1956 5.6 -0.15 7 Dec 1956 15.2 0.41 8 Jan 1957 10.7 0.29 8 Feb 1957 16.7 0.45 8 Mar 1957 5.9 0.16 28 Mar 1957 8.9 0.24 19 Apr 1957 16.7 0.45 20 Mav 1957 6.4 0.17 19 Jun 1957 11.7 0.32 19 Jull957 7.1 0.19 22 Aug 1957 6.7 0.18 24 Sen 1957 10.2 0.27 ~~

25 Oct 1957 ~ 8.3 0.22 26 Nov 1957 10.7 0.29 6 Jan 1958 42.2 1.14 17 Jan 1958 21.9 0.59 10 Feb 1958 0.5 0.01

26 Mar 1958 7.9 0.21 5 May 1958 20.6 0.56 1 Jun 1958 22.5 0.61 11 Jun 1958 13.4 0.36 25 Jull958 15.2 0.41 5 Sep 1958 9.9 0.27 20 Oct 1958 14.6 0.39 3 Dec 1958 10.2 0.28 16 Jan 1959 11.5 0.3 1 5 Mar 1959 35.8 0.97 23 Mar 1959 12.9 0.35

4 Mav 1959 9.8 0.27 15 Jun 1959 2.8 0.08 4 Aug 1959 8.4 0.23 17 Sep 1959 13.5 0.36 29 Oct 1959 3.2 0.09 14 Dec 1959 8.7 0.23 29 Jan 1960 0.0 0.00 17 Mar 1960 10.0 0.27 19 Apr 1960 8.2 0.22 46 1681410 P t Table 1. Radiourinalysis and nose wipe data.

Other including Date "9hr inurine Nose Wipe cpm mBq/24h p Cil24 h (Left/Right)

Case 0242 (cont'd) 19 Apr 1960 8.2 0.22 5 Jun 1960 7.4 0.20 18 Jull960 8.5 0.23 25 Jul 1960 8.0 0.22 8 Sep 1960 7.0 0.19 28 Oct 1960 13.7 0.37 1 Dee 1960 8.5 0.23 19Dec 1960 5.2 0.14 30 Jan 1961 7.5 0.20 20Feb 1961 5.9 0.16 10 Apr 1961 6.1 0.18 18 May 1961 11.7 0.32 30 Jun 1961 3.2 0.09 14 Aug 1961 9.9 0.27 -'- 5 Oct 1961 0.0 0.00 24 Nov 1961 4.2 0.11 ~~~ 15 Jan 1962 10.9 0.29

2 Mar 1962 8.7 0.23 23 Apr 1962 7.5 0.20 31 May 1962 7.4 0.20 ~~~ ~~ 9 Jul 1962 8.5 0.23 27 Aug 1962 1.o 0.03 16 Oct 1962 8.0 0.22 28 Nov 1962 10.0 0.27 14 Jan 1963 3.2 0.09 11 Mar 1963 5.0 0.14 15 Apr 1963 9.4 0.25

3- Jun____ 1963- 1.0- 0.03 18 Jul 1963 8.9 0.24 9 Sep 1963 12.5 0.34 28 Oct 1963 10.5 0.28 16Dec 1963 14.4 0.39 31 Jan 1964 11.4 0.3 1 ~~ 19 Mar 1964 0.7 0.02 3 May 1964 4.5 0.12 17 Jun 1964 15.4 0.42

10811111 Table 1. Radiourinalysis and nose wipe data.

Other including Date =9pU in urine Nose Wipe cpm mBqf24h p Ci/ 24 h (Left/Right)

Case 0242 (cont’d) 30 Jul 1964 1.3 0.04

10 Sep 1964 6.5 0.18 5 Nov 1964 11.7 0.32 14 Dec 1964 29.7 0.80 28 Jan 1965 26.7 0.72 5 MU-1965 12.5 0.34 16 Apr 1965 10.9 0.29 19 Jull965 0.0 0.0 18 Oct 1965 2.5 0.07 17 Jan 1966 3.7 0.10 14 Apr 1966 3.7 0.10 19 Jul 1966 12.4 0.33 21 Nov 1966 15.0 0.41 -e* 20 Feb 1967 25.4 0.69 22 May 1967 10.7 0.29 21 Aug 1967 7.0 0.19 20 Nov1967 10.9 0.29 21 Feb 1968 13.7 0.37

24 May 1968 4.3 0.12 21 Aug 1968 16.4 0.44 21 Nov 1968 4.5 0.12 20 Feb 1969 12.9 0.35 8 May 1969 15.4 0.42 8 Aug 1969 15.4 0.42 ~~ 8 Aug 1969 8.0 0.22 8 Aug 1969 11.2 0.30 8 Aug 1969 10.7 0.29 8 Aug 1969 11.2 0.30 5 Feb 1970 12.9 0.35

7Feb 1970 19.5 0.53 6 Aug 1970 9.4 0.25 5 Nov 1970 22.7 0.61 4 Feb 1971 17.4 0.47 12 May 1971 15.4 0.42 5 Aug 1971 0.0 0.0 4Nov 1971 1.o 0.03 7Feb 1972 22.3 0.60 48 t081412 Table 1. Radiourinalysis and nose wipe data.

Other including I Date "9pu inurine Nose Wipe cpm mBq/24h p Ci/ 24 h (Left/Right)

Case 0202 (cont'd'

- 26 May 1972 23.5 0.63 23 Jun 1972 8.5 0.23 7 Mar 1975 11.2 0.30

49 IO81413 .-

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d d - c d * i B 5 a 8 !E! E E s i2 d s s I Appendix A

Policy and Procedure Manual Table of Contents . 4 h

United States Transuranium and Uranium Registries

POLICIESAND PROCEDURESMANUAL

Table of Contents

Organizational Chart

PlOl Purpose and Objectives

P102 Positions 102.1 Director 102.2 Administrative Manager 102.3 Student Research Assistants 102.4 Medical Consultant 102.5 Scientific Staff 102.6 Curator, NHRTR 102.7 Research Technologist, NHRTR 102.8 Research Technologist 102.9 Associate Director 102.10 Computer Support Analyst 102.11 Secretary Senior

P103 CommunicationsPolicy

P104 Advisory Committee

P105 Authorship on Manuscripts

P106 Scientific Collaboration and Data Access

F106 Statement of Confidentiality

P107 Publications Policy

R107 Publications Numbering System

Pl08 Classified Timesff Policy

FlO8 Request for Timesff

P109 Building and Records Safety and Security

P150 Handling Donated Human Tissue

United States Transuranium and Uranium Registries 121 1081541 Table of Contents Revised 3/94 Page 2

P151 Acquisition of Tissues

P20 1 Registrant Enrollment and Renewal

P202 Criteria for Registrant Acceptance

P203 Autopsies on Registrants

F203 Autopsy Prosector Form

P204 Classification of Registrant Status

P205 Visitor Access to the NHRTR

F205 Information and Informed Consent

R40 1 Instructions to Pathologist

F40 1 Autopsy Checklist

R402 Arranging for the Autopsy of a Deceased Registrant

F402a Whole Body Specimen Worksheet

F402b Routine Specimen Worksheet

R403 Off Hours Notification

United States Transuranium and Uranium Registries 122 108-1548 Appendix B

Functional Organization Chart I

! *.-*.e Appendix C

Adviso y Committee Report

1081551 Keith J. Schiager, PhD, CHP 3671 S. Millbrook Terrace Salt Lake City, UT 84106

1 March 1994

TO: USTUR Advisory Committee Members and Meeting Attendees

RE: Final Report on the Committee Meeting held on 5-6 October 1993

The attached report is for distribution to all who attended the October meeting. It contains minor changes from the draft version that was circulated to the Committee members. The most significant change is some degree of prioritization of the Committee’s recommendations is indicated in the introductory paragraph on page 3 under “Advisory Committee Recommendations. ” ’**

124 1081552 1993 REPORT OF THE ADVISORY COMMITTEE TO THE U. S. TRANSURANIUM AND URANIUM REGISTRIES

The Advisory Committee met in the Max Benitz Library Conference Room on the Washington State University Tri-Cities Campus in Richland, Washington, on 5 and 6 October 1993. * Attendance;

The meeting was called to order by Chairman Voelz at 8:30 am on 5 October 1993 with i .everyone introducing themselves. Advisory Committee members present: Bode K. Gustafsson, Kenneth G. W. Inn, Keith J. Schiager, MaryBelle Thompson, Roy C. Thompson and George L. Voelz.

Registries staff members present for part or all of the meeting: Ronald L. Kathren, Director and Professor of Health Physics; Ronald L. Filipy, Professor of Radiobiology; John J. Russell, Curator, National Human Radiobiological Tissue Repository (NHRTR); Richard E. Touhq, Professor of Health Physics; Scott E. Dietert, Medical Consultant and Professor of Pathology; Cheryl L. Love, Research Technologist; Minh Pham, Computer Consultant; Lynn A. Harwick, Administrative Assistant; Charlene A. Hall, Gpduate Research Assistant; and Mickey Hunacek, Graduate Research Assistant.

The Department of Energy was represeated during part or all of the meeting by: Barbara G. Brooks, USTUR Program Manager, office of Epidemiology and Health Surveillance; Dan White, Lead Contract Specialist for Administration; Robert Petty, Contract Specialist; Donald R. Segna, Program Manager, Richland Field office; Darryl Green, safety Engineer; and Hollie Mooers, Health Systems Specialist. Cooperating DOE laboratories were represented by: Robert W. Bisthe, Rocky Flats Plant; and James F. Mclnroy, Los Alamos National Laboratory.

Additional Washington State University personnel in attendance for part or all of the meeting: M. M. Abdul-Monem, Dean, College of Pharmacy; and Diana Scoles, Manager, Finance and Administration, College of Pharmacy. Ahmed Nevassi, Professor of Fisheries, University of Washington, was also present.

tive S-

As the first order of business, immediately after introductions, outgoing chairman V& convened an executive session of the Advisory Committee. Keith Schiager and Roy Thompson were elected Chairman and Vice-chairman, respecbvely, each for a two-year term. 'Continuing in the tradition of the outgoing Chairman, Schhger agreed to prepare the report of the meeting, with Roy Thompson serving as a backup.

12' 12' 1081553 7 Staff hesen-

The activities and accomplishments of the Registries during the preceding year were presented by various members of the staff, closely following the agenda (copy attached). The presentations afforded ample opportunity for Committee members to raise questions and engage in dialog with the staff members. in the report of the 1992 Advisory Committee meeting, we commented on the "remarkable administrative changes" that had taken place during the previous year. Again this year, the Committee was very favorably impressed with the accomplishments of the Registries staff.

In surnmhzing the activities of the year, Director Kathren noted spcific conmbutions of individual staff members and the new activities being planned. The database has been started using Paradox; the adminismtive and post mortem data have been entered. The sraff expects to have all the radioanalytical and health physics data entered within two years. However, the coding schemes for the data have not been developed. Ronald Fiiipy will be eswblishing a histopathology laboratory; Scott Dietert plans an investigation of uranium effects in the kidneys. As a master's thesis topic, Charlene Hall plans to develop a method to determine total skeletal content of actinides from a limited number of samples. Mickey Hunacek has completed a literature search and tabulation of risk coefficients for internal alpha emitters. *- There were a number of contacts with the news media during the year. As expected, several of the siories resulting from media attention were less than favorable. However, one noteworthy exception was an article in the March 1993 issue of the monicles of werFdm.

John Russell reported on the Whole Body Donor Program. From 1 July 1992 through 1 October 1993, six autopsies were performed on whole-body donors in addition to ten regular autopsies. The laboratory is now saving half of each sample for future studies in areas such as radiobiology, genetic alteration, retrospective dosimetry and validity of neoplasia markers.

kchard Toohey discussed plans for setting up a new radioanalyticai laboratory at WSU. He presented the goals for the radiochemisby program and the justifications for conducting this aspect of the Registries mission at WSU. The figures presented by Toohey indicated that for 2.000 samples per year, the cost per analysis at WSU would be approximately $150, compared with $270 at LANL and more than $300 by other (non-DOE)laboratories. The lab could conceivably be established in the Nuclear Radiation Center at Pullman, which has under utilized radiochemistry laboratones and counting rooms. The major new need would be for alpha sqxctroscopy equipment, at an es~matedcost of approximately $1OO,ooO. The s-ff proposal is for a 6-12 month period to phase out the LANL operation and phase in the work at WSU.

The Five Year Plan was presented by Ronald Kathren. The Plan contains three primary short- term goals: (1) relocation of radiochemistry support to WSU, (2) organization of Registries files, and (3)updated computerized data base. In addition to several secondary short-termgoals, a few scientific studies were identified as already in progress or to be initiated soon. Plans for longer- term sxudies were somewhat less detailed, dthough several specific topics were listed, e.g.

USTUR Advisory Committee 1993 Report - Page 2

I26 1081554 comparative biokinetics of Pu-238,239 and 240; correlation of measured depositions with health physics data; examination and/or validation of respiratory tract models; etc.

Facility Tour:

During the morning break, the staff provided c tour of the office space that was acquired during the last year. Committee members were given an opportunity to observe sample input screens in the new database and to examine the nature of the paper files pertaining to regis.trants.

Advisorv- Committee Recommend-

The following list of recommendations contains some that are new this year, as well as several that are repeated from previous years. The recommendations are listed in approximately the order of importance that the Committee placed on them during discussion, but without strict ranking for priority. The recornmendations are numbered to correspond to the first year in which the recommendation was made, although the emphasis of some recommendations may have changed over the years. The Committee reviewed progress made on the recommendations contained in the 1992 report to determine if they should be retained‘or removed from the list. All recommended actions that have not been substantially completed or resolved, and which are still of concern to the Committee, are retained on the list. The Committee feels that all ohhe recommendations are very important and should be addressed even though their resolution may take several years.

1993- I MAINTAIN FULLY FUNCTIONALRADIOCHEMISTRYANALYTICAL CAPABILITIES AND ADEQUATE FOR ALLOWI PERIOD TRANSITION The’Committee is greatly concerned over the current proposal for phasing out the LANL i radiochemistry laboratory concurrently with Setting up a laboratory at WSU within 6 to 12 months. It is essential that the LANL laboratory be kept fully functional until the WSU laboratoxy demonstrates the capability to produce equivalent analytical results. The quality control program for the laboratory should be operational aud comparability of results should be verified before the LANL laboratmy is phased out. It is also important to develop and maintain a depth of analytical capability to ensure against unexpected demands or disasters. The period of overlap of laboratory facilities should be used to complete the backlog of whole-body donor cases. 1991-2 FIVE-YEAR PLAN

A five-year plan has been prepared, although it does not yet contain all of the essential elements recommended by the Committee. The plan presented this year discusses general activities and goals, both for the immediate future and for the long term. However, the plan does not yet contain estimated work loads based on projected death rates of registrants, nor does it yet address the optimum numbers of registrants to be sought for each category of exposure or body burden. The Commjttee believes that the five-year plan should explicitly address the fundamental mission of the Registries, the major scientific questions that could and should be answered by the Registries, and the steps that need to be taken to address those questions. The five-year plan should be based on and guided by the overall mission of the Registries.

1990-3 RECRUITMENT OF REGISTRANTS AND RELATIONSHIP WITH DOE CONTRACTORS

The Commjttee was pleased to note that visits had been made to some of the DOE laboratories, but believes that much more effort needs to be placed on this task. Recruitment of registrants should be focussed, based on the research needs identified by the mission statement and the five- year plan. The Committee recommends that the Registries establish targets for the number of cases needed for each category of exposure and set priorities for recruitment on that basis.

To encourage site personnel to cooperate in identifyingappropriate cases, the regismt's consent statement should be modified to authorize sharing of data with depersonnel. Site personnel I should be invited and encouraged to participate in the analysis of data and the publication of the research conducted by the Registries.

19914 DETERMINATION OF SUITABILITY OF WHOLE-BODY CASES"

To avoid a last minute determination that a case is unsuitable, the Committee recommends that regiswants for whole-body donations be evaluated at an early stage using limited screening data. If the donation is not acceptable, the registrant should be notified immediately. The decision regarding suitability should not be deferred until the time of death, as it may not then be possible to obtain the necessary data to make an appropriate decision.

1992-5 QUALITY MANAGEMENT AND WRI'ITEN PROTOCOLS

Development of written protocols has been initiated; the Committee noted that procedures R401, R402 and R403, relating to initial autopsy, had been completed. However, other standard operating procedures that should be in place before new projects are initiated are still lacking. Operating procedures should be part of a quality management program.

1990-6 FILE OF PROCEDURES

Although this is the fourth year in which this recommendation bas been repeated, there has been limited progress in developing a comprehensive file of procedures. This file should contain documentation of the procedures for all Registry activities, including sample preparation, storage, radiochemical separation and sample counting.

108155b 128 1990-7 DEVELOPMENT OF REGISTRY DATABASE

The database has been started, using Paradox as the platform. The administrative and post mortem files have been created, but the radioanalyhcal and health physics data files have not been started. The fact that a coding scheme has not yet been developed for these data is of concern to the Committee. Although the staff indicated that all data would be in the database within two years, this seems unlikely, considering the uncertainties related to coding of the data.

1993-2 EFFECTIVE USE OF THE WSU PUBLIC RELATIONS STAFF

The Committee recommends that the Registries staff obtain more assistance from the WSU public relations staff to develop positive responses and images for the news media. These communications professionals may be able to guide a more proactive, promotional relationship with the press. The Committee recognizes the importance of good public relations in presenting the Registries’ program to the public. However, this in no way implies that public relations considerations should play any role in determining what research should be done, or how that research should be conducted.

er Observatrons bv the Commim ’* Collaborative and expanded research is commendable, but it should not be conducted at the expense of the primary mission of the Registries. A concise mission statement for the Registries i might help to clarify the appropriate emphasis to be placed on various categories of research.

The Committee members felt that it would be highly beneficial to them in serving the needs of the Committee, and also be of benefit to the Registries, if each member were to receive a copy of every technical report and publication prepared under the auspices of the Registries. The technical reports would be of even greater value than the monthly administrative summaries that are currently sent to each member.

est to the Adv iso- from the Remes- -9 staff:

The Registries’ staff asked the Advisory Committee for suggestions on how to contact potential regisaants more effectively. They also asked the Committee for suggestions on how to reimburse sites for the costs of recruitment, extraction of records, etc.

The only initial suggestion from the Committee is that allowing site personnel to share the data and the opportunities for analysis and publication might be one method of compensation for their effort. This would require some change(s) to the registrant’s consent statement.

USTUR Advisory Committee 1993 Report - Page 5

129 1081551 The timing and duration of the meeting this year, ;.e. 1% days in early October, was ideal. However, to complete an appropriate review of Registries activities in that time, the agenda must concentrate on the activities of the -, with less time devoted to peripheral activities of the staff. As was done this year, there should be a brief executive session at the beginning of the meeting, as well as on the second day. There should be a review of responses to previous recommendations early in the agenda, to assure that progress on those items will be addressed during the subsequent detailed presentations by the staff. 1 Dates for the next meeting were not set, or even discussed.

Attachment:

Agenda

1081558 130 Appendix D ’-

Publications

1081559 USTUR Publications, April 1992-September 1993

1992

Collart, F.R., M. Horio, R.A. Schlenker, R.L. Kathren, and E. Huberman. ”Alteration of the c-fms Gene in a Blood Sample from a Thorotrast Individual.” Health Phys. 63: 27-32 (1992).

Dagle, G.E., E.P. Moen, R.R. Adee, T.E. Hui, A. C. James, R.E. Filipy and R.L. Kathren. “Macrodistribution and Microdosimetry of Thorium Deposited in the Liver.” Health Phvs. 63:41-45 (1992).

Filipy, R.E., R.L. Kathren and J.F. McInroy. ”Relative Concentrations of Plutonium and Americium in the Liver, Testes, and Thyroid Gland.” (Abstract) Health Pb62:(Suppl.) S17 (1992).

Graham, S.J., R.B. Heaton, D.F. Gamin and J.D. Cotelingam. ”Whole Body Pathologic Analysis of a Patient with Thorotrast-Induced Myelodysplasia.” Health Phvs. 63:20-26 (1992). ’11 Kathren, R.L. Book review: Environmental Health by D.W. Moeller. Health Phvs. 63~238-239(1992).

Kathren, R.L. and R.L. Hill. “Distribution and Dosimetry of Thorotrast in a Whole- body Donation to the U.S. Uranium Registry.“ (Abstract) Health Phvs. 62: (Suppl.) S7 (1992).

McInroy, J.F., E.R. Gonzales and J.J. Miglio. ”Measurement of Thorium Isotopes in the Soft Tissues and Skeleton of a Deceased Thorotrast Patient.” (Abstract) Health Phvs. 62:(Suppl.) S48 (1992).

Mays, C.W., R.L. Aamodt, K.G.W. Inn, D.R. Brown, R.R. Greenberg, V.G. Iyengar, F.J. Schima, L.S. Slaback, J.W. Tracy, T.P. Lynch and K.L. Mossman. ”External Gamma-Ray Counting of Selected Tissues from a Thorotrast Patient.” Health Phys. 63:33-40 (1992).

Medley, D.W., R.L. Kathren, R.E. Filipy and A.G. Miller. “Diurnal Variation in Urinary Uranium Levels.” (Abstract) Health Phvs. 62:(Suppl.) 57 (1992).

Priest, N.D., J.W. Haines, J.A.M. Humphreys, H. Metivier and R.L. Kathren. ”The Bone Volume Effect on the Dosimetry of Plutonium-239 and Americium-241 in the Skeleton of Man and Baboon.” J. Radioan. Nucl. Chern. 156:33-53 I (1992).

Tauber, W.B. “Clinical Consequences of Thorotrast in a Long-Term Survivor.” He.63:13-19 (1992).

131 10815b0 Travis, L.B., R.L. Kathren and J.D. Boice, Jr. ”Cancer Risk Following Exposure to Thorotrast: Overview in Relation to a Case Report.” Health Phys. 63:89-100 (1992).

Travis, L.B., R.L. Kathren, D. Mays, and C.W. Mays. ”Comprehensive Evaluation of a Thorotrast Patient: An Overview.” Health Phys. 63:lO-12 (1992).

1993 I Filipy, R.E., C.A. Hall, R.L. Kathren and J.F. McInroy. ”Relationships of Soft Tissue Concentrations of Plutonium and Americium in Occupationally Exposed Humans.” (Abstract) Health Phvs. 64:(Suppl) S54 (1993).

Filipy, R.E., R.L. Kathren, J.F. McInroy and R.A. Short. ”Soft Tissue Concentrations of Plutonium and Americium in Occupationally-Exposed Humans.” (In press) USTUR-0003-93.

Kathren, R.L. Book review: Respiratory Tract Dosimetry. R.A. Guilmette and B.B? Boecker, eds. Health Phvs. 64:92-93 (1993).

Kathren, R.L. Book review: On the Home Front: The Cold War Legacy of the Hanford Site by M.S. Gerber. Health Phys . 64:553-554 (1993).

Kathren, R.L., D.J. Strom, C.L. Sanders, R.E. Filipy, J.F. Mchroy and R.E. Bistline. ”Distribution of Plutonium, Americium and Uranium in Human Lungs and Lymph Nodes and Relationship to Smoking Status.” Rad. Protect. Dosim. 48:307-315 (1993).

Kathren, R.L., D.H. Denham and K. Salmon, Eds. Environment a1 Health Physics, Proceedings of the Twenty-sixth Mid-year Topical Symposium of the Health Physics Society. Richland: Research Enterprises Publishing Segment (1993). .. Kathren, R.L., M. “Mickey” Hunacek and T. Gervais, Eds. Publicabons Listinp of IstriesTh i at T 1968-1993. USTUR-0002-93.

Kathren, R.L., M.M. Hunacek and T. Gervais, Eds. Publications of The ‘IJnited States Transuranium and U ranium Registries 1968-1993. V1-3, July 1993. USTUR-0004-93.

Kathren, R.L. -IIK 1 ates Transur Radiation and Society, Proceedings of American Chemical Society Symposium, April 1992 (in press) 1993. 7

Kathren, R.L. The United States Transuranium and Uranium ReEistries: RePort for the Period Oc tober 1, 1990 - Ami1 1992. USTUR-0001-93.

Nelson, I.C., W.V. Thomas, Jr. and R.L. Kathren. “Plutonium in South Central Washington State Autopsy Tissue Samples 1970-1975.” Health Phys. 65:422- 428 (1993).

Toohey, R.E. ”Measurement and Analysis Techniques for Direct Assessment of Body Radioactivity.” (In press) USTUR-0005-93.

133 10815b2 Distribution List

10815b3 DISTRIBUTIONLIST Dr. Mahmoud M. Abdel-Monem, Dean P. Bannasch College of Pharmacy, Wegner 105E Department of Cell Pathology Washington State University German Cancer Research Center Pullman, WA 99164-6510 Im Neuenheimer Feld 280 62120 Heildelburg, GERMANY Dr. S. Abrahamson RERF, 5-2 Hijiyama Park Don C. Barg Minami-Ku, Hiroshima Radiologcal Engineer 732 JAPAN P.O.Box 1469 Idaho Falls, ID 83403 Captain David Adams A.F. Radiation Assessment Team Office of the Director USAF OEHL/RZA Brookhaven National Laboratory Brooks AFB, TX 78235-5501 Associated Universities, Lnc. Building 490 Steven Adams " Upton, NY 11973 EG&G Mound P.O. BOX3o00, MS A-271 Mrs. Alton S. Beck Miamisburg, OH 453433000 2508 Main St. Holt,AL 35404 Robert Alvarez Environmental Policy Institute Dr. Dan Beninson 218 D. Street SE Comision de Energia Atomica Washington,DC 20003 Avenida Libertador 8250 Buenes Aires Andor Andrasi ARGENTINA KFKI Atomic Energy Research Institute H-1525Budapest, P.O. Box 49 Dr. Luiz Bertelli HUNGARY ERTL University of Utah Office of the Director 1771 South 900 West #lo Argonne National Laboratory Salt Lake City, Utah 84104 9700 South Cass Avenue ArgoMe, n, 60439 Dr. Max W. Biggs Lawrence Livermore Laboratory Atomic Energy of Canada Limited P.O. Box 808 scientific Document Distribution Office Livermore, CA 94550 Sta. 14, Chalk River Nuclear Labs Chalk River, KOJ1JO Ontario, CANADA Dr. R W. Bistline EG&G Rocky Flats Plant Office of the Diredor Medical Department AEDR P.O. Box 464 1600 Clifton Rd., MS E-56 Golden,CO 80401 , Atlanta,GA 30333 Billy Black 1 Dr. Irina A. Avonova 1006 Bathmanor Dr. Department of Radiology Montgomery, AL 36109 RSFSR Ministry of Public Health 8, Mira, St. Dr. B.B. Boecker, Director 197101, St. Petersburg Inhalation Toxicology Research Institute RUSSIA P.O. Box 5890 Albuquerque, NM 87185

134 10815b4 Albuquerque, Nh4 87123 Dr. JohnBoice Radiation Branch, National Cancer Institute Roger Cloutier Executive Plaza North M08 Oak Ridge Associated Universities Bethesda, MD 20892 P.O. Box 117 Oak Ridge, TN 37830 Dr. B.D. Breitenstein, Jr. Dr. Norman Cohen Brookhaven National Laboratory Bldg. 490 Director of Radiation Studies P.O. Box 83 New York University Medical Center Upton, NY 11973 Institute of EnvironmentalMedicine Sterling Lake Road Dr. Allen Brodsky Tuxedo, NY 10987 Allen B. Consultants 2765 Ocean Pines Gail Cole Berlin, MD 21811-9127 EG&G Mound Applied Technologies P.O. BOX3000 . Dr. Antone L. Brooks Miamisburg, OH 45343 Pacific Northwest Laboratory MS P7-53 Dr. Daniel E. Conrad Richland, WA 99352 Martin Marietta Energy Systems, Inc. P.O. Box 2009 Dr. Barbara Brooks Oak Ridge, TN 37831 US DOE Office of Health, EH-42, GTN J.P. Corley -- Washington, DC 20585 2213 Torbett Street Richland, WA 99352 Dr. David Bruner Route 1, Box 3397 Dr. David Coulston Bonita Springs, FL 33923 British Nuclear Fuels, Ltd. 1002607 England Regd. Office Dr. L.A Buldakov Risley Warrington Deputy Director Cheshire WA3 6AS Institute of Biophysics ENGLAND Zhivopisnaya 4 Moscow, USSR Dr. W. W. Crosbie Authority Chief Medical Officer Dr. William Burr Buildiing 147, Harwell Lab Oak Ridge Associated Universities oxfordshire, 0x11 ORA P.O. Box 117 ENGLAND Oak Ridge, TN 37830 David G. Culbertson Dr. E.A.Carbaugh Manager, Technical Control Pacific Northwest Laboratory Babcock & Wilcox P.O. Box 999, MS A3-60 Apollo, PA 15613 Richland, WA 99352 Jean Pierre Culot Dr. Howard Charboneau Boeretang 200 EG&G Mound Applied Technologies E2400 MOL P.O.Box 300 BELGIUM Miamisburg,OH 45343 Dr. Marina 0.Degteva Dr. Larry P. Clevenger Urd Research Center Sandia Laboratories - 3300 Medgorodok Chelyabinsk P.O. Box 5800 454076 RUSSIA

135 1081Sb5 Dr. Patricia W. Durbin Kathleen Del Giorgio Lawrence Berkeley Laboratory Safety & Environmental Branch 1 Cyclotron Road, Bldg. 74B US DOE Berkeley, CA 94720 Rocky Flats Area Office Golden, CO 80401 Dr. Keith Eckermann Martha DeMarre Medical Sciences Division REECO ORISE P.O. Box 98521 P.O.Box 117 Las Vegas, NV 89193-8521 Oak Ridge, TN 37831-0117

Dr. Marc F. Desrosiers Dr. Merrill Eisenbud U.S. Department of Commerce 711 Bayberry Dr. National Institute of Standards and Technology Chapel Hill, NC 27514 Building 245, Room C229 Gaithersburg, MD 20899 Dr. Robley D. Evans 4621 E. Crystal Lane Bruce B. Dicey Scottsdale, AZ 85253 US Environmental Protection Agency Environmental Monitoring Systems Laboratory Jill Fitch, Director Radiation Sciences Division Radiation Protection Branch P.O. Box 93478 61 Hindmarsh Square Las Vegas, NV 89193-2929 P.O. Box 6, Rundle Mall 5000 Adelaide, South Australia ’- Office of the Director AUSTRALIA Brookhaven National Laboratory Upton,NY 11973 Dr. John R Frazier Auxier and Associates Office of the Director 412 Executive Tower Dr., Suite 402 Lawrence Berkeley Laboratory Knoxville,TN 37923 1 Cyclotron Road Berkeley, CA 94720 Dr. Marvin Friedman St. Lukeis-Roosevelt Hospital Office of the Director 428 w. 59th. Street, Nw Los Alamos National Laboratory New York, NY 10019 P.O. Box 1663 Los Alamos, NM 87545 Dr. Thomas Fritz kgonne National Laboratory Office of the Director 9700 S. Cass Ave. Oak Ridge National Laboratory Argonne,IL 60439 P.O. Box 2008 Oak Ridge, TN 37831-6105 Dr. Shirley Fry Medical Services Division Dr. Hans Doerfel OWE HS/D P.O. Box 117 Kerforschumgszentrum Karlsruhe Oak Ridge, TN 37831 Postfach 3640 D-7500Karlsruhe 1 Dr. F. J. Furman, Director GERMANY Medical Department, Bldg. 122 EG&G Rocky Flats Plant Dr. Mildred A. Donlon P.0.Box 464 Armed Forces Radiobiology Research Institute Golden,CO 80402 Bethesda, MA 20814-5145 Maric Galiagher Richard Griffith ATSDR Division of Nuclear Safety, IAEA 1600 Clifton Rd., MS E-56 Wagramerstrasse 5, PO.Box 100 Atlanta, GA 30333 A 1400 Vienna AUSTRIA Dr. A. Seaton Garrett Oak Ridge National Laboratory Dr. W.C. Griffith P.O. Box X Inhalation Toxicology Research Institute Oak Ridge, TN 37831 P.O. Box 5890 Albuquerque, NM 87185 Dr. G.B. Gerber Corn. of the European Communities Dr. David H. Groth Rue de a1 Loi 200 Robert A. Taft Laboratories B-1049, Brussell, 4676 Columbia Parkway BELGIUM Cincinnati, OH 45226

Dr. J.A. B. Gibson Dr. RA. Guilmette Environmental & Medical Sciences Inhalation Toxicology Research Institute UKAEA Harwell Laboratory, Div. E364 P.O. Box 5890 Didcot, Oxon OX 11 ORA Albuquerque, NM 87185 ENGLAND Dr. Borje K. Gustafsson, Dean Dr. Ethel Gilbert College of Veterinary Medicine Pacific Northwest Laboratory Bustad 110 BOX999, MS P7-82 Washington State University Richland, WA 99352 Pullman, WA 99164-7010

James A. Giplin Fred Harrison 1062 Bell Lane 128 Russel Drive Rio Rico, AZ 85648 Selma,AL 36701

Professor Marvin Goldman Dr. J.O. Hightower Department of Radiological Sciences Westinghouse Savannah River Co. University of California Davis Bldg. 719-A Davis, CA 95616-8742 Aiken,SC 29808

Dr. Robert Goldsmith Dr. Leo J. Hoge 902 Beacon Square Port #405 P.O. Box 563 Gaithersburg, MD 20878 Saratoga Springs, NY 12866

Abel J. Gonzales, Deputy Director Holland Library Division of Nuclear Safety, IAEA Washington State University Wagramerstrasse5, P.O.Box 100 Holland First Floor A 1400 Vienna Pullman, WA 99164-5610 AUSTRIA Dr. E. Huberman Dr. W. Gossner Argonne National Laboratory Institute for Strahlenbiologie 9700 South Cass Ave. GSF-Forxhungszentrum Argonne,IL 60439 D-85764 Oberschileimbheim GERMANY 1. IIClll1phreys Biomedical Research Department Harvey Gover AEA Environment & Energy Washington State University Harwell Lab, E551 100 Sprout Road OXON OX11 ORA Richland, WA 99352 ENGLAND

137 10815bl Jerry B. Hunt Health Physicist Dr. A. Karaoglou Oak Ridge Y-12 Plant Commission of the European communities P.O. Box Y DG XlI.F.6 Oak Ridge, TN 37831 200, rue de la Loi B-1049 Brussels Dr. J. Inaba BELGIUM National Institute of Radiological Science Anagawa,49-1, Chib-shi, 263 Professor Alexander Kaul JAPAN Bundesamt fur Strahlenschutz Albert-Schweitzer-Str. 18 Dr. Kenneth G.W. Inn D-3320 Salzgitter 1 Center for Radiation Research FEDERAL REPUBLIC OF GERMANY US Department of Commerce, NIST Bldg. 245, Rm C-229 Hisao Kawamura Gaithersburg, MD 20899 Laboratory for Radioecology 3609 Isazaki, Nakaxxunato Dr. Seymour Jablon Ibaralu 311-12 National Cancer Institute JAPAN Radiation Epidemiology Branch Executive Plaza North #408 Robert W. Keys Bethesda,MD 20014 Los Alamos National Laboratory P.O. Box 1663, MS M888 Dr. Webster S. Jee Los Alamos, NM 87545 University of Utah Salt Lake City, UT 84112 Esther Kim 456 Crossroads Dr. Dr. O.W. Jones N. Augusta, SC 29841 Martin Marietta Energy Systems, Inc. P.O. Box 2009 valentin FY. Khokhryakov Oak Ridge, TN 37831-8103 Branch Biophysics Institute Public Health Ministry of Russia Stan Jones 454065 Chelyabinsk-65 Martin Marietta Energy Systems, Inc. RUSSIA P.O. Box 628, MS 5020 Piketon, OH 45661 Dr. Arnold Kramish 2065 Weathersfield Court Amy E. Johnson Reston, VA 22901 Rocky Flats Workers Studies 4300 Cherry Creek Dr. S. P.W. Kruger Denver, CO 80222-1530 US DOE P.O. Box 550, A590 LCol J. Christopher Johnson Richland, WA 99352 HQAMC; AMCSG-R 5001 Eisenhower Ave. Ramney Koul Alexandria, VA 22333-OOOl Department of Public Health P.O. Box 637 Dr. John R Johnson Dover, D.E. 19803 Pacific Northwest Laboratory Box 999, MS K3-57 Dr. Thomas LaBone Richland,WA 99352 4% Crossroadslk. N. Augusta, SC 29841 Dr. Susan D. Lambert 26 Pasho St. Andover, MA 01810

138 I0835108 belie S. Lamothe Jerome B. Martin, CHP AECL Research Battelle-Pantex Chalk River Laboratories P.O. Box 30020 Chalk River, Ontario KOJ1 JO Amarillo,TX 79177 CANADA Desiree Mays Office of the Director Radiation Epidemiology Branch, NCI Lawrence Livermore National Laboratory EPN-408 P.O. Box 808 Bethesda, MD 20892 Livermore, CA 94550 Dr. J.F.McInroy J.N.P. Lawrence 580 E. Lake Drive Los Alamos National Laboratory Rio Rancho, NM 87124 P.O. Box 1663, MSK483 Los Alamos, NM 87545 Dr. Roger 0. McClellan President, CIIT Dr. Adam Lawson P.O. Box 12137 British Nuclear Fuels Ltd. Research Triangle Park, NC 27709 2 Sellafield Cumbria CA20 1 PG ENGLAND Medical Department, 30-248 AT&T Bell Labs Dr. Dorothy Legarretta Murray Hill, NJ 07974 National Association of Radiation Survivors 78 El Camino Real Charles B. Meinhold, President Berkeley, CA 94705 National Council on Radiation Protection and Measurements Dr. Walter S. Leggett 7910 Woodmont Ave, Suite 800 Medical Sciences Division Bethesda,MD 20814 ORISE P.O. Box 117 Sheldon Meyers Oak Ridge, TN 37831-0117 US EPA 3506 Dundee Dr. Dr. Edward T. Lessard Chevy Chase, MD 20815 Brookhaven National Laboratory AGS Department, 911-B Dr. William A. Mills Upton, NY 11973 Program Committee Risk Assessment, AD HOC Dr. Ray D. Lloyd 2915 Ascott Lane Radiobiology Division OlneyMD 20832 University of Utah Salt Lake City, UT 84132 Hollie Mooers Richland Field Office Robert Loesch US DOE US DOE P.O. Box 550, Ms A555 EH-41, GTN, 27OCC Richland, WA 99352 Washington,DC 20585 David S. Meyers Tmothy P. Lynch Lawrence Livermore Laboratory Pacific Northwest Laboratory Hazards Control Deparment, L-383 P.O. Box 999, B1-60 P.O. Box 5508 Riaand, WA 99352 Livermore, CA 94550

Dr. David Marsden National Institute of Radiation Science St. Lukeis-Roosevelt Hospital Division of Radiation Hazards 428 w. 59th Street, Nw 9-1,4-Chrome Anagawa, Chiba New York, NY 10019 JAPAN

139 Dr. James W. Neton Dr. J.E.Phillips Westinghouse Materials Company Martin Marietta Energy Systems, Inc. P.O. Box 398704 Paducah Gaseous Diffusion Plant Cincinnati,OH 45239 P.O. Box 1410 Paducah,KY 42001 Dr. Lee S. Newman Pulmonary Division Dr. D.S. Popplewell National Jewish Center for Immunology Radiological Protectional Board and Respiratory Medicine Chilton, Didcot 1400 Jackson St., D-104 Oxfordshire OX 11 ORA Denver,CO 80206 ENGLAND Dr. W.R. Ney S. Wynne Porter, CHP National Council on Radiation Porter Consultants Protection & Measurement 125 Argyle Road 7910 Woodmont Ave MOO Ardmore,PA 19003 Washington, DC 20014 Dr. JohnPoston, Sr. Occupational Health Researcher Department of Nuclear Engineering Public Citizen Health Research Group Texas A&M University 2000 P Street Nw College Station, TX 77843 Washington,DC 20036 Howard M. Prichard

Office of scientific and Technical Information Auxier & Associates, Inc. -e* US DOE 412 Executive Tower Dnve, Suite 402 P.O. Box 62 Knoxville, TN 37923 Oak Ridge, TN 37831 Dr. Nicholas D. Priest Peter Olsen Biomedical Research Department 5201 Blue Jay Lane AEA Environment & Energy W. Richland, WA 99352 Harwell laboratoryf E551 ' OXON OX11 ORA Dr. Donald Paine ENGLAND Nuclear Fuels Services, Inc. P.O. Box 218 Dr. Jerry Puskin Erwin,TX 37650 USEPA 11103 Old Coach Rd. Dr. Norris J. Parks Potomac,IvfD 20854 Laboratory for Energy-Related Health Research University of California Dr. Merton A. Quaife Davis,CA 95616 University of Nebraska Medical Center 42nd Street and Dewey Ave. Dr. John P. Peters Omaha,NB 68105 Deputy Director Occupational Medicine Programs Division Robert M. Quillin US DOE rj Radiation Control Division EH431,27OCC, GTN Colorado Department of Health Washington,DC 20585 4300 Cherry Creek Drive South Denver, CO 80222-1530 Dr. Gerald Peterson US WE Dr. Otto G. Raabe Office of Health, EH-42, GTN Laboratory for Energy-Related Health Research Washington,DC 20585 University of California Davis, CA 95616

140 ' 1081510 i

Dr. I. Riaboukhine Dr. Robert Schlenker Radiation Scientist Argonne National Laboratory World Health Organization 9700 South Cass Ave. Geneva 2F Argonne,IL 60439 SWITZERLAND M.C. Schumacher Dr. Chester R. Richmond US NRC,Region 3 Science Education Programs & Ext. Relations 799 Roosevelt Road P.O. BOX2008-Ms 6250 Glen Ellyn, IL 60137 Oak Ridge National Laboratory Oak Ridge, TN 37831-6250 Dr. Glenn T. Seaborg Lawrence Berkeley Laboratory Dr. S.A. Roberts 1 Cyclotron Road, Bldg. 70A, Room 3307 Martin Marietta Energy Systems, Inc. Berkeley, CA 94720 P.O. Box 2003 Oak Ridge, TN 37831-7422 Dr. Fritz A. Seiler 5301 Central Ave, NE Alan R. Roecklein Suite 700 Office of Nuclear Regulatory Research Albuquerque, NM 87108 US Nuclear Regulatory Commission 5650 Nicholson Ln Hugo Simenson Rockville, TN 37831-7422 Sunhedsstryrelsen Statens htitut for Stralehygiene Dr. G.R. Roessler Frederikssundsvej378 Health Physics Newsletter 2700 Bronshoj, DENMARK Route 1, Box 139H Elysian,MN 56028 Dr. N.P. Singh University of Utah Harold Rogers 4412 Fortuna Way 860 Folsom Court Salt Lake City, UT 85117 Carson City, NV 89705 Dr. Kenneth W. Skrable Dr. RE. Rowland Department of Physics 700 W. Fabyan Pkwy, # 8C University of Lowell Batavia, IL 60510 Lowell,MA 01854

Sheldon Samuels, Director Dr. A. J.M.Slovak Health, Safety and Environment British Nuclear Fuels Ltd. m-ao 2 Sellafield Cumbria 815 16th. Street NW ENGLAND CA20 1PG Washington,JX 20006 Dr. James M. Smith D. Michael Schaeffer Centers For Disease Control Defense Nuclear Agency 4770 Buford Hwy NE, MS F-35 Radiation Policy Division Atlanta, GA 30341-3724 6801 Telegraph Rd. Alexandria, VA 22310-3398 Grover Smithwick US DOE Dr. Keith J. Wager Federal Building University of Utah Oak Ridge, TN 37830 Department of Radiation Health 100 Orson Spencer Hall Dr. A. Spiethoff Salt Lake City, UT 84112 Department of Cell Pathology German Cancer Research Center Im Neuenheimer Feld 280 69120 Heidelburg, GERMANY 7

Dr. Henry Spitz Professor David Taylor University of Cincinnati 5, Branwen Close 8802 Castleford Cardiff CFS 4NE Cincinnati, OH 45242 UMTEDKINGDOM

Dr. JohnStather Dr. Robert G. Thomas National Radiologial Protection Board P.O. Box 279 Chilton, Didcot Bigfork, MT 59911 OXON OX11 ORA ENGLAND Lisa J. Thompson Westinghouse Savannah River Co. Dr. J. Newell Stannard Medical Department, 719A 17441 Plaza Animado, #132 Aiken,SC 29808 San Diego, CA 92128 Dr. MaryBelle Thompson, Director Dr. Andrew E Stehney Empire Health Services 1132 Curtiss Street, #ED P.O. Box 248 Downers Grove, IL 60515 Spokane, WA 99210-0248

Lynn Stembridge Dr. Roy C. Thompson HEAL 10820 Court 1408 W. Broadway Pasco, WA 99352 Spokane, WA 99201 Dr. R E. Toohey Dr. E.T. Still Medical Sciences Division Kerr-McGee Corporation ORISE P.O. Box 25861 P.O. Box 117 Oklahoma City, OK 73125 Oak Ridge, TN 37831-0117 Dr. Heather G. Stockwell, Director Dr. Lois B. Travis Epidemiological Studies Division Radiation Branch, National Cancer Institute US DOE Executive Plaza North #408 EH-421, GTN Bethesda,MD 20892 Washington,DC 20585 George E. Tucker Dr. Clifford Strader Sandia National Laboratory US DOE P.O. Box 5800 Office of Health, EH-42, GTN Albuquerque, Nh4 87185 Washington, DC 20585 United Steel Workers Union, LU 8031 Dr. Daniel JStrom 4510 Indiana St. Pacific Northwest Laboratory Golden,CO 80403 P.O. Box 999, MS K3-56 Richland, WA 99352 St. Lukeis Roosevelt Hospital Am: Dr. Gordon DePuey Langan w. Swent 428 w. 59th street, Nw Number 1 King Ave. New York, NY 10019 Piedmont, CA 94611 Dr. G. Van Kaick Dr. Margery J. Swint German Cancer Research Center Hm-@ Im Neuenheimer Feld 280 MS H1-02 D-69120 Heidelberg Richland, WA 99352 GERMANY

142 1081512 Dr. George L. Voelz World Health Organization Los Alamos National Laboratory EnvironmentalHealth Criteria & Standards Group HSE-2-Epidemiology 1211 Geneva 29 P.O. Box 1663 SWITZERLAND Los Alamos, NM 87545 Dr. McDonald E. Wrenn Dr. N. Wald EnvironmentalRadiation Department d University of Pittsburgh school of Medicine Department of Radiation Health The University of Utah A-512 Crabtree Hall 1771 South 900 West, #lo Pittsburgh, PA 152621 Salt Lake City, UT 84104

Dr. Ronald A. Walters Dr. S.S. Yaniv Pacific Northwest Laboratory Office of Nuclear Ragulatory Research MS K1-50 Nuclear Regulatory Commission Richland, WA 99352 Washington, DC 20555

G.A.M. Webb Alvin L. Young Secretary, NRPB Radiation Research and Policy Coordination Chilton Didcot 1019 Nineteenth St., NW, Suite 700 t OXON OXO11 QRQ Washington,DC 20036 ENGLAND Dr. Maria Limson Zamora Christian Wed, Dipl. Phys. Bureau of Radiation and Medical Divices -L- Paul scherrer Institute Department of National Health and Welfare Wurenhgem and Vigen 775 Brookfield Road f CH - 5232 Viligen PSI Ottawa, Ontario KIA IC1 CANADA Robert A. Wessman TMA/NORCAL Dr. Paul L. Ziemer c 2030 Wright Ave. School of Health Sciences Richmond,CA 94804 Purdue University 4 Lafayette, IN 47907 t C.M. West Oak Ridge Associated Universities Dr. JohnD. Zimbrick P.O. Box 117 National Research Council OakRidge,TN 37380 National Academy of Sciences 2101 Constitution Ave, NW, Suite 342 Daniel White Washington, D.C. 20418 Richland Field Office US DOE P.O.BOX 550, MS A7-80 Richland, WA 99352 it Dr. Gregg Willcinson University of Texas Department of Preventive Medicine f and Community Health Galveston, TX 77550 7 r Dr. Robert W.Wood t US DOE EV-31-Ger~~iant0~ Washington, DC 20545

143 IO81513