27
PLUTONIUM
3. HEALTH EFFECTS
Table 3-2. Summary of Human Epidemiology Studies of Health Effects of
Plutonium
Reference, study location,
period, and study description Dose
measurement
a
Findings and interpretation
United States:
Reference: Brown et al. 2004
Location: Denver (Rocky Flats),
Colorado
Period: 1951–1989
Design: retrospective case control
Subjects: workers at Rocky Flats
Plant; cases (n=180, 7 females);
controls (n=720, 24 females) who
also worked at the plant and were
matched with cases for age, birth
year, and gender
Outcome measures: lung
cancer
mortality
Analysis: incidence OR for
cumulative
internal lung dose,
cumulative penetrating dose, period
of first hire, and employment years
(logistic regression models, adjusted
for birth year and smoking)
Reference: Gilbert et al. 1989b
Location: Hanford, Washington
Period: 1944–1981
Design: retrospective
cohort
Subjects: workers at the Hanford
plant (n=31,500, 12,600 females)
who were
hired during the period
1944–1978.
Outcome measures: cancer mortality
Analysis: trend test for mortality
ratios stratified by external radiation
dose or internal Pu exposure
(adjusted for age, calendar year,
sex, and number of years
monitored)
Internal lung
dose (mSv) Percent
0
54
0–100
18
>100–400
13
>400–644
5
>644–900
5
>940
5
98% internal lung dose from
plutonium or inbred
241
Am
Internal Pu
exposure
(kBq)
Percent
<0.074
28.7
0.074–1.47
30
>1.48
1.3
In full cohort, OR for lung cancer mortality
significant at dose strata 400–644 mSv, but
was not significantly elevated at higher doses;
there was no significant trend with dose. When
restricted to subjects employed for 15–
25 years, OR was significant at dose strata
>644 mSv with
significant dose trend;
however, there was no evidence of a positive
trend for those employed <10 years or
≥
25 years.
Internal
lung
dose
(mSv)
OR (95% CI) full
cohort
OR (95% CI)
employed 15–
25 years
0
1.0 (reference) 1.0 (reference)
0–100
1.42 (0.87–2.33) 1.14 (0.46–2.86)
>100–400 1.60 (0.83–3.10) 2.11 (0.86–5.20)
>400–644 2.71 (1.20–6.09) 2.74 (0.92–8.19)
>644–900 2.30 (0.96–5.53) 3.20 (1.15–8.94)
>940
1.48 (0.56–3.89) 5.04 (1.55–
16.40)
No evidence for statistically significant excess
cancer mortality or trend in cancer mortality
with external radiation or Pu internal deposition
(i.e., all cancers, digestive tract, lung,
lymphatic and hematopoietic, prostatic).
28
PLUTONIUM
3. HEALTH EFFECTS
Table 3-2. Summary of Human Epidemiology Studies of Health Effects of
Plutonium
Reference, study location,
period, and study description Dose measurement
a
Findings and interpretation
Reference: Newman et al. 2005
Location: Denver, Colorado
Period: 1951–1998
Design: retrospective cohort
Subjects: male workers at Rocky
Flats plant (n=326) hired between
1951 and 1958 with lifetime doses
>0.1 Sv; unexposed controls
(n=194, 12 females)
Outcome measures: lung opacity
profusion score (based on most
recent x-ray) for assessment of
pulmonary fibrosis
Analysis: multivariate logistic
regression to
test association
between plutonium radiation dose
categories and disease prevalence
(covariates: age at x-ray, smoking
status, evidence of pleural
abnormalities [surrogate for
asbestos exposure])
Reference: Voelz et al. 1997
Location: Los Alamos, New Mexico
Period: 1943–1990
Design: retrospective cohort
Subjects: adult male
workers at Los
Alamos National Laboratory
exposed to plutonium in 1944–1945
(n=26); controls (n=876) workers not
exposed to plutonium
Outcome measures: mortality
Analysis: incidence rates of exposed
group compared to controls
(adjusted for age and year of death)
Reference: Wiggs et al. 1994
Location: Los Alamos, New Mexico
Period: 1944–1990
Design: retrospective cohort
Subjects: male workers at Los
Alamos National Laboratory
(n=15,727 employed 1943–1973).
Plutonium worker cohort consisted
of 3,775 workers ever monitored for
plutonium exposure
Outcome measures: mortality
Analysis: incidence
rates for workers
with plutonium whole-body
deposition
≥
74 Bq compared to
<74 Bq (adjusted for age and year of
death)
Plutonium lung radiation dose
in exposed group:
Dose (Sv)
n (percent)
0–28
326
0
194 (37%)
>0–1
187 (36%)
1–<5
101 (19%)
5–<10
22 (4%)
≥
10
16 (3%)
Pu body burden (Bq)
mean
970
median
565
range
50–3,180
Pu body dose (mSv)
mean
2.08
median
1.25
range
0.1–7.2
Pu body
burden (Bq) n
<74
3,472
≥
74
303
Significant elevated risk for abnormal lung
profusion score in lung dose strata
≥
10 Sv:
Lung dose (Sv)
OR (95% CI)
>0–<1
1.5 (0.6–3.8)
1–<5
0.9 (0.3–2.6)
5–<10
1.7 (0.5–6.6)
≥
10
5.3 (1.2–23.4)
SMR and MRR not significantly elevated in
plutonium workers (compared to controls):
SMR
MRR
Category Deaths
(95% CI)
(95% CI)
All deaths 7
0.43 (0.17– 0.77 (0.36–
0.88)
1.6)
All
3
0.75 (0.15– 1.5 (0.46–
cancers
2.18)
4.9)
Lung
1
0.68 (0.01– 3.31 (0.44–
cancer
3.79)
25)
Prostate 1
3.42 (0.04– No data
cancer
19.04)
Bone
1
96.4 (1.26– No data
cancer
536.0)
MRR not significantly associated with
plutonium body burden (<74 Bq compared to
≥
74 Bq):
Category
MRR (95% CI)
All deaths
0.89 (0.69–1.14)
All cancers
1.07 (0.67–1.69)
Respiratory tract cancer 1.77 (0.79–3.96)
Lung cancers
1.78 (0.79–3.99)
Bone cancer
not reported (n=0)
Lympho/hematopoietic
0.34 (0.05–2.24)
cancer