29
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: Wing et al. 2004
Location: Hanford, Washington
Period: 1944–1994
Design: retrospective
cohort
Subjects: workers at the Hanford
plant (n=26,389, 8,145 females) who
were hired during the period 1944–
1978. Plutonium worker cohort
consisted of workers in routine
plutonium-associated jobs (n=3,065)
or non-routine jobs (n=8,266).
Outcome measures: cancer mortality
Analysis: multivariate
regression to
test association between length of
employment in jobs with plutonium
exposure potential and mortality rate
(covariates: age, race, gender, birth
date, socioeconomic status,
employment status)
Russia:
Reference: Gilbert et al. 2004
Period: 1955–2000
Design: retrospective cohort
Subjects: workers at Mayak
Production Association (n=21,790,
5,332 female) employed during the
period 1948–1972
Outcome measures: lung
cancer
mortality
Analysis: risk per unit of plutonium
radiation dose (Poisson regression
models, adjusted for age, gender,
year of death, age at hire)
Not reported
Pu lung dose
(Gy)
n
1,560 (25%)
>0–0.2
3,688 (60%)
>0.2–1.0
688 (11%)
>1.0–3.0
163 (2.6%)
>3.0–5.0
39 (0.6%)
>5.0
55 (0.9%)
mean: 0.24 Gy (lung)
mean: 1.84 kBq (body)
Workers in the plutonium-associated jobs
category had lower death
rates from all
cancers, cancers of the lung, and “plutonium
cancers” (lung, liver, bone, and connective
tissue) than other Hanford workers. Trends for
increased mortality and duration of routine
plutonium-associated jobs were as follows:
Percent increase (
±
SE) in
mortality per year in
plutonium jobs (LRT for trend
at 1 df; higher value means
stronger association with job
duration)
Age <50 years Age
≥
50 years
Non-external 0.1
±
0.9 (0.01) 2.0
±
1.1 (3.37)
deaths
All cancers -1.5
±
1.7 (0.79) 2.6
±
2.0 (1.60)
Pu cancers 0.6
±
0.05 (0.05) 4.9
±
3.3 (2.17)
(lung, liver,
skeletal,
lymphatic)
Lung cancers -1.0
±
2.7 (0.14) 7.1
±
3.4 (4.06)
Cancer mortality risk was linearly related to
plutonium radiation dose.
Excess relative risk
per Gy declined strongly with attained age
(Gilbert et al. 2004). Increased ERR for lung
cancer mortality in association with increasing
lung dose (per Gy attained at age 60 years):
Lung dose
RR males
RR females
(Gy)
(95% CI)
(95% CI)
>0–0.2
1.4 (1.0–1.8) 0.91 (<0.91–
3.1)
>0.2–1.0
2.4 (1.5–3.6) 16 (6.1–37)
>1.0–3.0
10 (6.3–15)
>3.0–5.0
19 (9.5–35)
>1.0–5.0
15 (3.0–38)
>5.0
33 (14–67)
250 (110–660)
ERR per Gy 4.7 (3.3–6.7) 19 (9.5–39)
lung dose
ERR per Sv
0.23 (0.16–
0.93 (0.46–
lung dose
0.33)
1.9)
ERR per Gy 3.9 (2.6–5.8) 19 (7.7–51)
lung dose
(for subjects
with
smoking
data,
adjusted for
smoking)
30
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: Gilbert et al. 2000
Period: 1948–1996
Design: retrospective cohort
Subjects: workers at Mayak
Production Association (n=11,000)
hired during the period 1948–1958
Outcome measures: liver cancer
mortality
Analysis: relative
risk for plutonium
body burden (general linear
regression model adjusted for age,
gender, year of death, external
radiation)
Reference: Jacob et al. 2005
Period: 1948–1998
Design: retrospective cohort
Subjects: male workers at Mayak
Production Association (n=5,058)
employed during the period 1948–
1972
Outcome measures: lung cancer
mortality
Analysis: excess relative
risk per
plutonium dose unit (Sv)
(mechanistic multistage regression
model, adjusted for age and
multiplicative or sub-multiplicative
interaction with smoking)
Reference: Koshurnikova et al. 2000
Period: 1948–1996
Design: retrospective cohort
Subjects: workers at Mayak
Production Association (n=11,000)
hired during the period 1948–1958
Outcome measures: bone cancer
mortality
Analysis: relative risk for plutonium
body burden (general linear
regression model adjusted for age,
gender, year of death, external
radiation)
Pu body burden (kBq)
Males
3.78
Females
6.05
Pu liver dose (Gy)
Males
0.47
Females
0.88
n=2,207 (monitored)
Pu lung dose (Sv)
mean (range)
All plants
3.0 (0–24)
Pu production 8.7 (0–81)
Radio-
chemical
2.5 (0–15)
Reactor
0.04 (0–0.40)
Pu body burden (kBq)
Males
3.78
Females
6.05
Pu bone surface dose (Gv)
Males
2.99
Females
5.56
n=2,207 (monitored)
Bone surface dose from
Gilbert et al. (2000)
Significantly increased
RR within highest
plutonium body burden stratum:
Pu body
burden
(kBq)
RR males
(95% CI)
RR females
(95% CI)
0–1.48
1.4–7.40
>7.4
1.0 (reference)
0.9 (0.1–3.2)
9.2 (3.3–23)
1.0 (reference)
7.1 (0.9–59)
66 (16–452)
All workers
>7.4
17 (8.0, 26)
Significant ERR for lung cancer mortality in
association with plutonium dose (per Sv),
adjusted for smoking:
Smoking interaction
ERR per Sv (95% CI)
Multiplicative
0.21 (0.15–0.35)
Sub-multiplicative
0.11 (0.08–0.17)
Significantly increased RR for bone cancer
mortality within highest plutonium body burden
stratum:
Pu body burden (kBq) RR (95% CI)
0–1.48
1.0 (reference)
1.48–7.40
0.9 (0.05–5.5)
>7.4
7.9 (1.6–32)