Toxicological Profile for Plutonium

ix 
PLUTONIUM 
The American College of Occupational and Environmental Medicine
 (ACOEM) is an association of 
physicians and other health care providers specializing in the field of occupational and 
environmental medicine.  Contact:  ACOEM, 25 Northwest Point Boulevard, Suite 700, Elk 
Grove Village, IL 60007-1030 • Phone:  [phone] • FAX:  [phone]. 

---

x 
PLUTONIUM 
This page is intentionally blank. 

---

xi 
PLUTONIUM 
CONTRIBUTORS 
CHEMICAL MANAGER(S)/AUTHOR(S): 
Sam Keith, M.S., C.H.P.  
Eugene Demchuk, Ph.D.  
Robert L. Williams, Ph.D.  
Erik Aufderheide, M.D., M.P.H.  
Charleton Coles, Ph.D.  
ATSDR, Division of Toxicology and Environmental Medicine, Atlanta, GA  
David W. Wohlers, Ph.D.  
Gary L. Diamond, Ph.D.  
Julie M. Klotzbach, Ph.D.  
Lara L. Chappell, Ph.D.  
Amy Hueber, M.L.S.  
SRC, Inc., North Syracuse, NY  
THE PROFILE HAS UNDERGONE THE FOLLOWING ATSDR INTERNAL REVIEWS: 
1.  
Health Effects Review.  The Health Effects Review Committee examines the health effects 
chapter of each profile for consistency and accuracy in interpreting health effects and classifying 
end points. 
2.  
Minimal Risk Level Review.  The Minimal Risk Level Workgroup considers issues relevant to 
substance-specific Minimal Risk Levels (MRLs), reviews the health effects database of each 
profile, and makes recommendations for derivation of MRLs. 
3.  
Data Needs Review.  The Applied Toxicology Branch reviews data needs sections to assure 
consistency across profiles and adherence to instructions in the Guidance. 
4.  
Green Border Review.  Green Border review assures the consistency with ATSDR policy. 

---

xii 
PLUTONIUM 
This page is intentionally blank. 

---

xiii 
PLUTONIUM 
PEER REVIEW
 
A peer review panel was assembled for plutonium.  The panel consisted of the following members: 
1.  
Lynn Anspaugh, Ph.D., Research Professor, Department of Radiology, Radiobiology Division, 
University of Utah, Salt Lake City, Utah; 
2.  
Fletcher Hahn, D.V.M., Ph.D., Scientist Emeritus, Lovelace Respiratory Research Institute, 
Albuquerque, New Mexico; 
3.  
Richard Leggett, Ph.D., Research Scientist, Life Sciences Division, Oak Ridge National 
Laboratory, Oak Ridge, Tennessee; 
4.  
Nicholas Priest, Ph.D., Head, Radiobiology Section, AECL Chalk River Laboratory, Chalk River, 
Ontario, Canada; and 
5.  
Ethel Gilbert, Ph.D., M.P.H., Expert (biostatistician), Radiation Epidemiology Branch, Division 
of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland. 
These experts collectively have knowledge of plutonium’s physical and chemical properties, 
toxicokinetics, key health end points, mechanisms of action, human and animal exposure, and 
quantification of risk to humans.  All reviewers were selected in conformity with the conditions for peer 
review specified in Section 104(I)(13) of the Comprehensive Environmental Response, Compensation, 
and Liability Act, as amended. 
Scientists from the Agency for Toxic Substances and Disease Registry (ATSDR) have reviewed the peer 
reviewers' comments and determined which comments will be included in the profile.  A listing of the 
peer reviewers' comments not incorporated in the profile, with a brief explanation of the rationale for their 
exclusion, exists as part of the administrative record for this compound. 
The citation of the peer review panel should not be understood to imply its approval of the profile's final 
content.  The responsibility for the content of this profile lies with the ATSDR. 

---

xiv 
PLUTONIUM 
This page is intentionally blank. 

---

xv 
PLUTONIUM 
CONTENTS
 
DISCLAIMER ..............................................................................................................................................ii  
UPDATE STATEMENT .............................................................................................................................iii  
FOREWORD ................................................................................................................................................v  
QUICK REFERENCE FOR HEALTH CARE PROVIDERS....................................................................vii  
CONTRIBUTORS.......................................................................................................................................xi  
PEER REVIEW .........................................................................................................................................xiii  
CONTENTS................................................................................................................................................xv  
LIST OF FIGURES ...................................................................................................................................xix  
LIST OF TABLES.....................................................................................................................................xxi  
1.  PUBLIC HEALTH STATEMENT..........................................................................................................1  
1.1  WHAT IS PLUTONIUM? .............................................................................................................2  
1.2  WHAT HAPPENS TO PLUTONIUM WHEN IT ENTERS THE ENVIRONMENT?................2  
1.3  HOW MIGHT I BE EXPOSED TO PLUTONIUM? ....................................................................3  
1.4  HOW CAN PLUTONIUM ENTER AND LEAVE MY BODY?..................................................4  
1.5   HOW CAN PLUTONIUM AFFECT MY HEALTH?...................................................................4  
1.6   HOW CAN PLUTONIUM AFFECT CHILDREN?......................................................................5  
1.7   HOW CAN FAMILIES REDUCE THE RISK OF EXPOSURE TO PLUTONIUM?..................5  
1.8   IS THERE A MEDICAL TEST TO DETERMINE WHETHER I HAVE BEEN EXPOSED  
TO PLUTONIUM? ........................................................................................................................6  
1.9   WHAT RECOMMENDATIONS HAS THE FEDERAL GOVERNMENT MADE TO 
PROTECT HUMAN HEALTH? ...................................................................................................6  
1.10   WHERE CAN I GET MORE INFORMATION?..........................................................................7  
2.  RELEVANCE TO PUBLIC HEALTH ...................................................................................................9  
2.1   BACKGROUND AND ENVIRONMENTAL EXPOSURES TO PLUTONIUM IN THE  
UNITED STATES .........................................................................................................................9  
2.2   SUMMARY OF HEALTH EFFECTS.........................................................................................10  
2.3   MINIMAL RISK LEVELS (MRLs) ............................................................................................17  
3.  HEALTH EFFECTS..............................................................................................................................19  
3.1  INTRODUCTION........................................................................................................................19  
3.2  DISCUSSION OF HEALTH EFFECTS OF PLUTONIUM BY ROUTE OF EXPOSURE.......21  
3.2.1 
Inhalation Exposure ..............................................................................................................22  
3.2.1.1 
Death..............................................................................................................................26  
3.2.1.2 
Systemic Effects.............................................................................................................36  
3.2.1.3 
Immunological and Lymphoreticular Effects ................................................................52  
3.2.1.4 
Neurological Effects ......................................................................................................54  
3.2.1.5 
Reproductive Effects......................................................................................................54  
3.2.1.6 
Developmental Effects...................................................................................................54  
3.2.1.7 
Cancer ............................................................................................................................54  
3.2.2 
Oral Exposure........................................................................................................................64  
3.2.2.1 
Death..............................................................................................................................64  
3.2.2.2 
Systemic Effects.............................................................................................................64  
3.2.2.3 
Immunological and Lymphoreticular Effects ................................................................65  
3.2.2.4 
Neurological Effects ......................................................................................................65  
3.2.2.5 
Reproductive Effects......................................................................................................65  
3.2.2.6 
Developmental Effects...................................................................................................65  
3.2.2.7 
Cancer ............................................................................................................................65  

---