31
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: Kreisheimer et al. 2003
Period: 1948–1999
Design: retrospective
cohort
Subjects: male workers at Mayak
Production Association (n=4,212)
hired during the period 1948–1958
Outcome measures: lung
cancer
mortality
Analysis: excess relative risk per
plutonium dose unit (Gy, Sv)
(general linear regression models,
adjusted
for age and multiplicative
interaction with smoking)
Reference: Shilnikova et al. 2003
Period: 1949–1997
Design: retrospective cohort
Subjects: workers at Mayak
Production Association (n=21,557,
24.2% female) employed during the
period 1948–1972
Outcome measures: cancer mortality
Analysis: regression models,
(adjusted for age, gender, year of
death, age at hire)
Reference: Tokarskaya et al. 2006
Period: 1972–1999
Design: retrospective case-control
Subjects: workers at Mayak
Production Association (n=44
cases); controls (n=111) workers not
exposed
to plutonium matched for
year of birth, gender, year of starting
work, work assignment
Outcome measures: liver cancer
morbidity
Analysis: OR for plutonium liver
dose (Gy) (logistic regression model,
adjusted for alcohol consumption,
-radiation dose)
Pu lung dose (Gy)
Pu production
0.450
Radiochemical
0.140
Reactor
Not reported
Pu body burden
2.9–18.5 kBq
Cumulative lung Pu dose:
0.28–1.92 Gy
(hired 1948–1954)
Pu liver dose
Quartile
(Gy)
1st
0
2nd
0–0.07
3rd
>0.07–0.54
4th
>0.54–16.9
Significant ERR for lung cancer mortality:
ERR unit
ERR (95% CI)
ERR per Gy
ERR per Sv (assuming
-radiation
quality
factor=20)
4.50 (3.15–6.10)
0.23 (0.16–0.31)
Increased risk of plutonium cancers (i.e., lung,
liver or skeletal) in association with increased
internal exposure (p<0.001). Increased risk of
leukemia in association in increasing external
gamma radiation dose (p=0.04), but not for
internal exposure to plutonium.
Significant ORs for liver cancers:
Pu liver dose (Gy)
OR (95% CI)
All liver cancers
0–2.0
1.0 (reference)
>2.0–16.9
11.3 (3.6–35.2)
Hemiangiosarcomas
0–2.0
1.0 (reference)
>2.0–5.0
41.7 (4.6–333)
>5.0–16.9
62.5 (7.4–500)
32
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 Kingdom:
Reference: Carpenter et al. 1998
Period: Before 1976–1988
Design: retrospective cohort
Subjects: workers at U.K. nuclear
facilities during the period before
1976–1980 (n=40,761,
3,366 females). Plutonium worker
cohort consisted of 12,498 workers
ever monitored for plutonium
exposure
Outcome measures: cancer mortality
Analysis: mortality incidence rates in
workers monitored for plutonium
exposure
compared to workers not
monitored (adjusted for age, gender,
year of death, social class)
Reference: McGeoghegan et al.
2003
Period: 1947–1998
Design: retrospective cohort
Subjects: female workers ever
employed at Sellafield plant
(n=6,376). Plutonium worker cohort
consisted of 5,203 workers ever
monitored for plutonium exposure
Outcome measures: mortality and
cancer morbidity
Analysis: mortality and morbidity
incidence rates in plutonium workers
compared to other radiation and
non-radiation workers
Not reported
Pu internal lung radiation
dose:
Dose (mSv)
Mean
3.45
Median
1.59
Maximum
178
5th%
0.36
95th%
8.89
MRR for workers monitored
for plutonium were
not significant (monitored compared to not
monitored):
Category
MRR (95% CI)
All cancers
1.01 (0.90–1.13)
Lung and bronchus
cancer
1.18 (0.97–1.42)
Pleura cancer
1.97 (0.71–5.49)
Liver and gall bladder
cancer
2.00 (0.59–6.38)
Bone cancer
1.01 (0.12–7.35)
Trends for all cancers were statistically
significant (p<0.05), while those for lung and
bronchus cancer were not:
Years since
MRR lung and
first
MRR
bronchus
monitored
all cancers*
cancer
<10
0.79
0.95
10–19
0.95
1.26
≥
20
1.20
1.26
Number of
years
monitored
MRR
all cancers*
MRR lung and
bronchus
cancer
<10
0.85
1.09
10–19
0.92
0.99
≥
20
1.15
1.45
Significant (p<0.05) MRR for plutonium
workers compared
to other radiation workers
(CIs not reported) with no significant trends
with organ-specific plutonium radiation doses:
MRR (*p<0.01;
Category
**p<0.05)
Mortality
All deaths
2.20*
All cancers
3.30*
Breast cancer
3.77**
Circulatory disease
2.18**
Ischemic heart
5.46*
disease
Respiratory tract
4.05
disease
Digestive system
0.65
disease
Morbidity
Breast cancer
2.61**