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U.S. Transuranium and Uranium Registries Conference Contributions

Workshop on Internal Dosimetry of Radionuclides, Montpellier France, October 2-5, 2006

USTUR Whole Body Case 0269: Demonstrating Effectiveness of i.v. Ca-DTPA for Pu
Anthony C. James (USTUR), Lyle B. Sasser (USTUR), Dorothy B. Stuit (USTUR), Sam E. Glover (University of Cincinnati), Eugene H. Carbaugh (Pacific Northwest National Laboratory)

This whole body donation case (USTUR Registrant) involved a single acute inhalation of an acidic Pu(NO3)4 solution in the form of an aerosol ‘mist.’ Chelation treatment with i.v. Ca-EDTA was initiated on the day of the intake, and continued intermittently over 6 months. After 2½ years with no further treatment, a course of i.v. Ca-DTPA was administered. A total of 400 measurements of 239+240Pu excreted in urine were recorded; starting on the first day (both before and during the initial Ca-EDTA chelation), and continuing for 37 years. This sampling included all intervals of chelation. In addition, 91 measurements of 239+240Pu-in-feces were recorded over this whole period. The Registrant died about 38 years after the intake, at age 79 y, with extensive carcinomatosis secondary to adenocarcinoma of the prostate gland. At autopsy, all major soft tissue organs were harvested for radiochemical analyses of their 238Pu, 239+240Pu and 241Am content. Also, all types of bone (comprising about half the skeleton) were harvested for radiochemical analyses, as well as samples of skin, subcutaneous fat and muscle. This comprehensive dataset has been applied to derive ‘chelation-enhanced’ transfer rates in the ICRP Publication 67 plutonium biokinetic model, representing the behavior of blood-borne and tissue incorporated plutonium during intervals of therapy. The resulting model of the separate effects of i.v. Ca-EDTA and Ca-DTPA chelation shows that the therapy administered in this case succeeded in reducing substantially the long-term burden of plutonium in all body organs, except for the lungs. The calculated reductions in organ content at the time of death are approximately 40% for the liver, 60% for other soft tissues (muscle, skin, glands, etc.), 50% for the kidneys, and 50% for the skeleton. Essentially all of the substantial reduction in skeletal burden occurred in trabecular bone. This modeling exercise demonstrated that 3-y-delayed Ca-DTPA therapy was as effective as promptly administered Ca-EDTA.

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USTUR Whole Body Case 0262: 33-y follow-up of PuO2 in a skin wound and associated axillary node
Anthony C. James (USTUR), Lyle B. Sasser (USTUR), Dorothy B. Stuit (USTUR), Tanya G. Wood (USTUR), Sam E. Glover (University of Cincinnati), Timothy P. Lynch (Pacific Northwest National Laboratory), Gerry E. Dagle

This whole body donation case (USTUR Registrant) involved two suspected PuO2 inhalation intakes, each indicated by a measurable Pu α-activity in a single urine sample, followed about 1½ y later by a puncture wound to the thumb while working in a Pu glovebox. The study is concerned with modeling simultaneously the biokinetics of deposition and retention in the respiratory tract and at the wound site; and the biokinetics of Pu subsequently transferred to other body organs, until the donor’s death. Urine samples taken after the wound incident had readily measurable Pu α-activity over the next 14 y, before dropping below the minimum detectable excretion rate (< 0.4 mBq d-1). The Registrant died about 33 y after the wound intake, at age 71 y, from hepatocellular carcinoma with extensive metastases. At autopsy, all major soft tissue organs were harvested for analysis of their 238Pu, 239+240Pu and 241Am content. The amount of 239+240Pu retained at the wound site was 68 ± 7 Bq (1 S.D.), measured by low-energy planar Ge (LEGe) spectrometry. A further 56.0 ± 1.2 Bq was retained in an associated axillary lymph node, measured by radiochemistry. Simultaneous mathematical analysis (modeling) of all in vivo urinary excretion data, together with the measured lung, thoracic lymph node, wound, axillary lymph node, and systemic tissue contents at death, yielded estimated intake amounts of 757 and 1,504 Bq, respectively, for the first and second inhalation incidents, and 204 Bq for the total wound intake. The inhaled Pu material was highly insoluble, with an estimated long-term absorption rate from the lungs of 2 × 10-5 d-1. The Pu material deposited at the wound site was mixed: about 14% was rapidly absorbed, about 49% was absorbed at the rate of about 6 × 10-5 d-1, and the remainder (about 37%) was absorbed extremely slowly (at the rate of about 5 × 10-6 d-1). Thus, it was estimated that only about 40% of the Pu initially deposited in the wound had been absorbed systemically over the 33-y period until the donor’s death. The biokinetic modeling also indicated that, in this individual case, some of the parameter values (rate constants) incorporated in the ICRP Publication 67 Pu model were up to a factor two different from ICRP’s recommended values (for Reference Man).

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