1 56 th Annual Meeting of the Health Physics Society June 27, 2011, Palm Beach, FL Slide 1 Distribution of Terminal Lung and Liver Dose Rates in United States Transuranium and Uranium Registries Registrants Stacey L. McCord, Anthony C. James, Sergei Y. Tolmachev Learning from Plutonium and Uranium Workers
2 Objective Slide 2 A status report on progress made toward determining the distribution of terminal dose rates in U.S. Transuranium and Uranium Registries (USTUR) registrants. Liver Lung
3 United States Transuranium and Uranium Registries Slide 3 Initiated in 1968 to use human data to verify biokinetic and dosimetric models. Consists of former nuclear workers (volunteer Registrants) who had accidental intakes of uranium and transuranium elements. Tissues are obtained at autopsy, preserved, and made available for future research. Tissues are radiochemically analyzed to determine organ content and activity concentration at the time of death.
4 USTUR: Registrant Status Slide 4 As of June 24 th, 2011 Total Active (Living) and Deceased Registrants: 413 Living Registrants: 82 Deceased Registrants: 334 Partial-body Donations: 291 Thorotrast (medical exposure) 3 331
5 Slide 5 Terminal Lung and Liver Dose Rates in USTUR Registrants 1. Starting Point: Average Activity Concentration, Bq/kg, in the Right Lung and half of the Liver. e.g. Conc Rt lung = Activity Rt lung /Mass Rt lung 241 Am, 238 Pu, 239/240 Pu, 234 U, 235 U, 238 U 2. Calculated Terminal Dose Rates (TDR), mgy/y, from the Activity Concentrations. Alpha only Absorbed Dose Rate Average Dose Rate 3. Total TDR = sum of individual radionuclide TDRs
6 Why Terminal Dose Rates? Slide 6 Calculated directly from the radiochemistry results (high degree of confidence in the data points). No modeling is involved. Uncertainties arise when applying models to calculate the total dose to an individual: Intake date, especially for multiple intakes. Solubility of the material (Nitrate? Oxide?) Limitations of the models themselves (e.g. Super S material).
7 Underlying Cause of Death Slide 7 The Centers for Disease Control (CDC)* defines Underlying Cause of Death as the disease or injury which initiated the train of morbid events leading directly or indirectly to death or the circumstances of the accident or violence which produced the fatal injury. 3 Underlying Causes of Death will be discussed: Liver Cancer Lung Cancers (non-mesothelioma) Mesothelioma Associated with Asbestos exposure not plutonium. * Instructions for Classifying the Underlying Cause-of-Death, ICD-10,
8 Slide 8 Liver Cancer and Other Causes of Death by TDR Liver cancers occurred only in LOW α-dose cases note log scale on abscissa
9 Smoking Rates in Lung Cancer Cases Slide Number of Smokers Among Lung Cancer Cases Completed smoking histories indicate: Mesothelioma: 63% smokers Non-mesothelioma lung cancer: 97% smokers Lung Cancer (nonmesothelioma) Mesothelioma Smoker Never Smoked Unknown
10 Slide 10 Mesothelioma and Other Lung Cancers by TDR Self-selection 16 of 42 donors who died from lung cancer registered with the USTUR less than 1 year prior to death. 2 were in mesothelioma cases.
11 Conclusions Slide 11 Terminal Dose Rate was selected as the basis for comparing the results from the 331 donors because it had the fewest uncertainties of the alternatives. Although not representative, alpha dose does not appear to cause excess lung cancer or liver cancer in USTUR registrants. Exposure to tobacco smoke and asbestos appear to be important lung cancer factors in the USTUR population.
12 Future Directions Slide 12 Calculate Terminal Dose Rates for other tissues such as the skeleton and lymph nodes. Ideally, apply biokinetic modeling techniques to calculate the cumulative alpha dose to the lung from urinalysis results, invivo measurements, and post-mortem radiochemistry results. Compare these results to the distribution of lung and liver cancers in the Pacific Northwest National Laboratory (PNNL) and Inhalation Toxicology Research Institute (ITRI) lifespan beagle dog studies. Carry out a statistical analysis of the presented data to confirm the finding that alpha dose does not cause excess lung cancer or liver cancer in USTUR registrants.
13 Acknowledgements Slide 13 Thank You to colleagues from: The In-Vivo Radiation Effects Work group (a PNNL/USTUR collaboration).
14 Disclaimer: This presentation was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of their employees, makes any warranty, expressed or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof. Slide 14
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