EPA 520/4-76-013
           HEALTH EFFECTS
  OF ALPHA-EMITTING PARTICLES
    IN THE RESPIRATORY TRACT
      Report of Ad Hoc Committee on
  "Hot Particles" of the Advisory Committee
on the Biological Effects of Ionizing Radiations

       National Academy of Sciences
         National Research Council
    OFFICE OF RADIATION PROGRAMS
U. S. ENVIRONMENTAL PROTECTION AGENCY

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This report was prepared as an account of work sponsored by the
Environmental Protection Agency of the United States Government
under Contract No. 68-01-2230.  Neither the United States nor
the United States Environmental Protection Agency makes any
warranty, express or implied, or assumes any legal liability or
responsibility for the accuracy, completeness or usefulness of
any information, apparatus, product or process disclosed, or
represents that its use would not infringe privately owned rights.

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Health Effects
of Alpha-Emitting Particles
in the Respiratory Tract
Report of Ad Hoc Committee on "Hot Particles"
of the Advisory Committee on the Biological Effects
of Ionizing Radiations
 October 1976
NATIONAL ACADEMY OF SCIENCES
NATIONAL RESEARCH COUNCIL
Washington, D.C. 20006

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                       NOTICE
    The project that is the subject of this report was approved
by the Governing  Board  of the National  Research Council,
whose members are drawn from the Councils of the National
Academy of Sciences, the National Academy of Engineering,
and the Institute of Medicine. The members of the Committee
responsible  for the  report were chosen for their  special
competences and with regard for appropriate balance.

    This report has been reviewed by a group, other than the
authors according to procedures approved by a Report  Review
Committee consisting of members of the  National Academy
of Sciences, the  National Academy of Engineering, and the
Institute of Medicine.

    The  work .presented in this report was  supported  by
the Office of  Radiation Programs, Environmental Protection
Agency, under Contract No. 68-01-2230, Modification Nos. 2
and 5.

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                     FOREWORD
    In the summer of 1974,  the Environmental  Protection
Agency asked the National Academy of Sciences for informa-
tion and evaluation of the  health  effects  of  alpha-emitting
particles  ("hot  particles")  in  the  respiratory  tract.  This
report was prepared in response to that request.

    The report presents  a summary and analysis of current
knowledge concerning health effects of alpha-emitting par-
ticles in  the respiratory tract. The  report  also reponds to
the questions raised by Drs.  T. B. Cochran and A. R. Tamplin
of the Natural Resources Defense Council about the adequacy
of presently existing standards for "hot particles."

    We want to  thank the several  people who helped  in
preparation of this report and who have contributed material
for consideration by the Committee. We particularly want to
thank Ms.  Leila Counts, Editor,  Battelle, Pacific Northwest
Laboratories,  who  assisted  in  the preparation of the  final
report.
                           lii

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                       PREFACE
    This analysis of the cancer hazard to the lung from inhaled
plutonium  particles was  done  under the  auspices of the
National  Academy of Sciences (NAS)  at the request of the
Environmental Protection Agency (EPA). The report defines
the overall problem, describes its historical background, and
summarizes  relevant current knowledge. Supporting docu-
mentation is included as Appendix A.

    The  Committee has  endeavored to  ensure  that  no
sources of pertinent knowledge or expertise were overlooked
in its study. During the course of its deliberations, the Com-
mittee  solicited the opinions and  counsel of several individual
scientists and others with information needed for a complete
overview of the problem.

    Of special  note  is  that   the  Committee met  with
Drs. T. B. Cochran  and A.  R. Tamplin to specifically receive
their views and to discuss these views with them. A complete
transcript of this meeting is part  of the NRC/NAS file of the
Committee.

    Appendix B  describes the  procedure used to select the
Committee  and  gives  biographical data about Committee
members. A  listing  of all meetings held and the participants
is given in Appendix C. Complete  documentation, including
working papers used to prepare the report, is in the NRC/NAS
files.
                           IV

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            MEMBERS OF AD HOC COMMITTEE ON "HOT PARTICLES"
Roy E. Albert, Chairman*
  Institute of Environmental Medicine
  New York University Medical Center
  New York, NY

Edward L. Alpen
  Donner Laboratory
  University of California
  Berkeley, CA

William J. Bair
  Battelle, Pacific Northwest Laboratories
  Richland, WA

George W. Casarett
  Department of Radiation Biology
    and Biophysics
  University of Rochester Medical Center
  Rochester, NY

Edward R. Epp
  Department of Radiation Medicine
  Massachusetts General Hospital
  Boston, MA

Marvin Goldman
  Radiobiology Laboratory
  University of California
  Davis, CA
Earle C. Gregg
  Department of Radiology
  University Hospital
  Case Western Reserve University
  Cleveland, OH

Edward B. Lewis
  Biology Division
  California Institute of Technology
  Pasadena, CA

Roger O. McClellan
  Inhalation Toxicology Research Institute
  Lovelace Foundation
  Albuquerque, NM

Edward P. Radford
  Department of Environmental Medicine
  Johns Hopkins University School of Hygiene
   and Public Health
  Baltimore, MD

Albert W. Hilberg, Senior Staff Officer
  Division of Medical Sciences
  Assembly of Life Sciences
  National Academy of Sciences
  National Research Council
        *After  the Committee had completed the study and formulated  its
        conclusions but before the final draft of  the manuscript was com-
        plete,  Chairman Albert assumed  a post with the Environmental Pro-
        tection Agency.  Although he  remained a member of the Committee,
        Dr. Albert thereafter limited his participation in  the Committee's
        activities.  The Committee then asked Drs.  Bair, Alpen, and  Lewis
        to assume responsibility for  the task of incorporating into  the
        final manuscript the Committee's responses to the suggestions of
        external reviewers.   The entire Committee  reviewed  and assumes
        responsibility for  the final  manuscript.

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                                CONTENTS

NOTICE  	  ii
FOREWORD 	  iii
PREFACE	  iv
COMMITTEE MEMBERSHIP 	 v
SUMMARY AND CONCLUSIONS	 1
DEFINITION OF THE PROBLEM  	 2
HISTORICAL BACKGROUND  	 3
THE COCHRAN-TAMPLIN RATIONALE AS THE BASIS FOR THE NRDC PETITION	 5
   A Critique of the Cochran-Tamplin Proposal	 6
   Summary Evaluation of the Cochran-Tamplin Rationale 	 8
CURRENT STATUS OF THE RADIATION BIOLOGY OF INHALED ALPHA-EMITTERS	 9
   Factors in Dose-Response  Relationships  	 9
   Animal Experiments  	 12
   Experience with Human Beings 	 15
REFERENCES 	 16
APPENDIX A
   I.  RELEVANT PHYSICAL AND BIOLOGICAL DATA  	 A.I
   II.  FACTORS IN DOSE-RESPONSE RELATIONSHIPS	 A.19
APPENDIX B PROCEDURES FOR COMMITTEE APPOINTMENTS AND
   CONSIDERATION OF POTENTIAL BIAS OF MEMBERS 	 B.I
APPENDIX C COMMITTEE MEETINGS AND ATTENDANCE	'... C.I
                                    vi I

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              HEALTH  EFFECTS OF ALPHA-EMITTING PARTICLES
                           IN THE RESPIRATORY TRACT
                            SUMMARY AND CONCLUSIONS
Since  the  early  1950's, various groups with
responsibility for  determining  the effects of
radiation sources on human health have recog-
nized the  possibility that radioactive material
deposited in tissues of the body as high specific
activity  particles might  be a greater  health
hazard than the same source distributed more
homogeneously. This has been referred to as
the "hot particle" problem [1-5].

In 1974 Cochran  and Tamplin  hypothesized
that the intense  and highly localized dose
from  inhaled  insoluble  plutonium particles
larger  than a  specified  size causes greater
tissue damage, and is therefore more carcino-
genic,  than more  uniformly-delivered  irradi-
ation [6]. On this basis Cochran  and Tamplin
advocated  a 115,000-fold reduction  in  the
current radiation  standards governing expo-
sure to insoluble  alpha-emitting  ("hot") par-
ticles. With the support  of the 1974 Cochran
and  Tamplin report, the Natural  Resources
Defense  Council  (NRDC)  petitioned   the
Environmental  Protection Agency (EPA)  to
reduce the  current radiation protection guides
accordingly.

The National Academy  of  Sciences-National
Research Council Ad Hoc Committee on "Hot
Particles" has  concluded that the evidence
does not support  the  NRDC  petition  for a
special, lower  radiation  protection standard
for inhaled alpha-emitting particles. The cur-
rent state of knowledge about the "hot particle"
problem can be summarized as follows:

1.  In  animals,  all experimental data  so  far
    obtained  indicate  that  when insoluble
    plutonium particles are inhaled, the major
    radiation dose  in the lungs occurs in the
    pulmonary  (i.e.,   alveolar)  region.  The
    principal  delayed  effect in  the lung of
    breathing  these  particles is induction  of
    alveolar cancers. An analysis  of  mortality
    from these cancers in beagle dogs indicates
    that  if  there  is  a  hot-particle  effect,
    Cochran and  Tamplin have overestimated
    the cancer risk per particle by at  least two
    orders  of  magnitude. However,  analyses
    indicate that the observed lung cancer mor-
    tality in these  dogs can  be adequately
    accounted for by the conventional method
    of  averaging the  absorbed alpha  radiation
    dose over the entire lung. Therefore, it is
    concluded that if there is a  "hot  particle"
    risk, it is small by comparison with the lung
    cancer risk attributable to the generalized
    alpha radiation.

2.   In human beings, epidemiological evidence
    gained from experience with inhalation of
    alpha-emitting radon daughters and with
    external  X  or gamma irradiation of the
    thorax strongly  suggests that the  radio-
    carcinogenic sensitivity of  the  tracheo-
    bronchial region is  greater than that of
    the alveolar regions where inhaled plu-
    tonium  is retained.  Therefore, we would
    not expect  the  human cancer risk from
    alpha irradiation  of the deep  lung tissues
    to  be  underestimated  by  applying  risk
    factors obtained  from  human  experience
    with cancer induced by irradiation of the
    lining of the bronchial tree.

3.   Current evidence indicates that the cancer
    hazard  from insoluble paniculate pluto-
    nium deposited in the lungs is not markedly
    greater than would be caused by the same
    quantity of  radioactivity distributed more
    uniformly.   The  experimental evidence
    suggests that the  carcinogenic response  is
    more a function  of the amount of  radio-
    activity in the lung than of its distribution.

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                             DEFINITION OF THE PROBLEM
In its simplest terms, the question addressed
by  the Committee is:  Does an insoluble,
highly radioactive  particle  small  enough to
be taken into body tissues, especially  the lung
tissues, have a greater probability of producing
a significant biological  effect, such as cancer
induction,  than does an  internal source of
radiation of equivalent  physical dose  which is
distributed more uniformly?

Although  the issue of  the  hazard from non-
uniform  distribution of radioactive  particles
is pertinent to all types of  radiation, it is most
relevant to alpha radiation from the transuranic
elements, such as plutonium, americium, and
curium.  Particles  containing  these  elements
irradiate  small  regions around  themselves,
extending not more than 50 /urn in solid tissues
and about 200 jum in the alveolar tissues of the
lungs. Moreover,  many of these  transuranic
elements  have long half-lives and form highly
insoluble  oxides which may persist  in tissues
for long periods, even years. Local doses from
discrete  small  sources  can reach very  high
values, even when the computed mean tissue
dose in  the organ is very low. Under these
conditions, the concept of dose  as  generally
used in radiation  protection is not applicable.
The energy from a single  alpha decay event,
with its  short and well-defined range, will be
absorbed  by one or,  at  most,  several cells,
which may  be  killed  or  severely damaged.
Other cells, not  actually traversed by alphas,
will suffer no direct alpha radiation injury.

 Although insoluble particles move about within
 the lungs as a  result of  cellular and other
clearance  processes, it is not known how rap-
idly  or freely the  particles  move. Since the
degree  to  which  insoluble  particles  move
about  in the lungs is unknown, the distribu-
tion of radiation dose within the lungs is uncer-
tain, but  it probably varies  from  nearly uni-
form to highly localized, depending upon the
physical properties  of  the particles and the
degree of  cellular interaction with the particles.
The "hot  particle" issue arises from the possi-
bility that there  might be  no movement, or
relatively  slow movement,  of  high specific
activity particles within the lungs.

Although  radioactive particles may  enter the
body through the integument or the intestinal
wall,  the  principal  concern in  this report is
with inhaled particles. This is so because inhal-
ation  is  likely to  be  a  principal source of
exposure  and because respiratory tissues are
particularly vulnerable to radioactive particles,
being  directly exposed to airborne material
with immediate direct contact between parti-
cles and  cells. In  this report, therefore, the
hot particle problem is considered in relation
to  the respiratory tract  only. However, this
discussion could apply  to any tissue where
particles  may  be  translocated  and  retained
for a significant time.

In preparing this report the Committee drew
upon all  relevant published data and the cur-
rent  experience  of  nearly all  laboratories
throughout the world doing research on this
problem.  The data base used by the Committee
was far broader than that upon whfch the
Cochran-Tamplin rationale was developed.

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                               HISTORICAL BACKGROUND
During the early stages of the development of
radiation biology from a descriptive to a quan-
titative science, one of the  first problems to
emerge was that of predicting the effects of
radiation exposure delivered in a nonuniform
manner.  An early attempt to account for  the
nonhomogeneous  distribution of  radioactive
substances  deposited in body  tissues was  the
concept of "critical  organ/' as  explicitly stated
in National Council on Radiation Protection
and  Measurements (NCRP)  Handbook  52
(1953) [1] and in International Commission on
Radiological Protection (ICRP) recommenda-
tions  (1955) [2]. The critical  organ concept
assumes that different organs vary in uptake of
radionuclides  and   radiosensitivity.  It  also
assumes  that the radionuclides are  deposited
uniformly throughout the organ.

However, early  NCRP and ICRP reports  recog-
nized that  for certain radionuclides the dose
may not be homogeneously deposited in critical
organs (NCRP  Handbooks  52 [1953] [1] and
69 [1959] [3]). In 1961  the  paniculate source
problem was noted  explicitly by the NAS/NRC
Subcommittee on  Inhalation Hazards of  the
Committee on  Pathologic  Effects  of  Atomic
Radiation [4]. The  Subcommittee considered
the issue of whether "mean dose to the lung" is
relevant  when  the  source  is  particulate and
nonuniformly distributed.  This of  course  in-
volves the  distinction between  the micro-
scopic dose in the paths of the ionizing particles
and the macroscopic dose which results from
averaging such  events  over the whole  organ.
The Subcommittee also recognized the possi-
bility  that  radioactive  material deposited as
high specific activity particles  might be more
damaging to tissue than the same source homo-
geneously  distributed.  The  Subcommittee
referred  to the work of Passoneau [7], which
indicated  that   the  carcinogenic  potential
for 90Sr-90Y was  lower when the activity  was in
high specific activity beads. This model, which
was  based on  beta-emitting  isotopes  and
tumor production  in  rat skin,  may  not be
relevant  to the  case of much smaller  alpha-
emitting particles in lung tissue.
In  1969,  the  International  Commission  on
Radiological  Protection  (ICRP)  [5]  defined
three categories for nonhomogeneous exposure
to ionizing radiation:  Class 1 (Partial  Irradi-
ation of Representative Tissue) - in which the
part irradiated  is representative of the  whole
organ  or  tissue,  as in external irradiation of
skin or bone marrow; Class 2 (Partial  Irradi-
ation of Nonrepresentative Tissue)  - in  which
the part irradiated is not  representative  of the
whole; and Class 3 (Irradiation from Radio-
active  Materials in  Particulate  Form)  -  which
includes   irradiation from   discrete  particles
containing radionuclides or  from  a  highly
focal accumulation of radionuclides.

Again  in  1972, the Committee on Biological
Effects  of  Ionizing Radiation  (NAS/NRC) in
their report [8] raised the issue of "hot spots",
or  particulate  sources, as  inducers  of lung
cancer. The BEIR Committee referred to the
work of Grossman  et  al. [9], who compared
the carcinogenicity  of 210Po in the lung when
the  agent  was administered by intratracheal
instillation  with  and  without a  particulate
carrier. Grossman et al. concluded that  tumor
production was a function of total  alpha dose,
whether the isotope was given with or without
a  particulate  carrier.  The  inference drawn
by  the BEIR  Committee was that  "a higher
localized  dose from alpha particles was  not
more cancerogenic  than the same mean tissue
dose delivered more uniformly  to critical
cells"  [8]. However, the  biological effects of
intratracheally instilled  polonium, which has a
relatively  short  half life  (138 days),  may  be
quite different from those of inhaled insoluble
particles  of  plutonium,  which has a  much
longer  half life.

In November of 1974 a report was published by
Cochran and Tamplin [6] in  support of a peti-
tion made by the Natural Resources  Defense
Council   to   the   Environmental   Protection
Agency and  the Atomic Energy Commission.
The petition requested a  reduction in the cur-
rent radiation standards governing the internal
exposure  of  man to insoluble alpha-emitting

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particles. The authors reviewed certain existing
data on carcinogenesis  from  point  sources
of alpha radiation and  drew on selected pub-
lished   biological  experiments  to  conclude
that the radiation protection guides should be
reduced by a factor of about 115,000.

Following  publication  of  the Cochran  and
Tamplin report, the question of alpha-emitting
particles in  the  lungs  was addressed  by Bair,
Richmond,  and  Wachholz [10],  the British
Medical Research Council [11], the  National
Council on Radiation Protection and Measure-
ments  [12],  and  the National  Radiological
Protection  Board in the United Kingdom [13].
All of these sources have concluded that there
is no evidence that the risk  of lung  cancer
from  alpha-emitting particles  in the lungs is
greater than from equivalent amounts of alpha
radiation  more  uniformly distributed. They
also agreed that there is no compelling reason
to abandon the average lung dose  convention
for  radiation  protection  practices, which is
the same convention currently used to quantify
the radiation doses associated with  plutonium-
induced  lung cancer in experimental animals.
However, Cochran and Tamplin did not accept
these reports as refutation of  their "hot par-
ticle thesis" [14].

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                         THE COCHRAN-TAMPLIN RATIONALE
                         AS A BASIS FOR THE NRDC PETITION
As Cochran and Tamplin  noted in their 1974
report  [6],  the  current  ICRP  occupational
exposure standard for insoluble plutonium in
air  is 4 x  KT11 juCi/mfi. This  level  of atmo-
spheric  contamination would lead to  a maxi-
mum permissible lung  burden  (MPLB)   of
0.016 juCi  and  would  be  associated  with a
maximum permissible lung dose of 15  rem/yr,
averaged over the entire lung.

Cochran and Tamplin [6]  pointed out that in
the  case  of insoluble  plutonium  particles,
the  dose  is  not  delivered uniformly to the
entire lung:

    It would take 53,000 particles . . .  (1 M
    in diameter, 0.28 pCi) ... to reach  the
    MPLB  of 0.016 fiC\  which  results in
    15 rem/yr to the entire (1000 g)  lung.
    However  . .  these particles would
    irradiate  only 3.4 g of this 1000 g to
    the  lung, but  at a dose rate of 4000
    rem/yr . . .  these particles result  in an
    intense but highly localized  irradia-
    tion. A fundamental question is, then:
    is this intense  but localized irradiation
    more  or less  carcinogenic than uni-
    form irradiation?

The  Cochran-Tamplin approach to predicting
the cancer risk  from hot particles is  based  on
the  Geesaman  Hypothesis [15,16],  which   in
turn is  based almost wholly on the rat skin
irradiation  experiments of Albert and  his co-
workers   [17-20].   Cochran   and   Tamplin's
interpretation of  these experiments and the
rationale  for  their  proposed  standard   are
described by the following excerpts from their
1974 report [6]:

     A high incidence of cancer was  ob-
    served after  intense  local doses of
    radiation,  and  the  carcinogenesis
    was proportional to  the damage or
    disordering of a critical  architectural
    unit of the tissue, the hair follicles.
    (Page 23)
Certainly  a  reasonable  interpretation
of  these  experimental  results  is:
when  a  critical architectural  unit of
a tissue (e.g., a hair follicle) is irradi-
ated at a sufficiently high dosage, the
chance of it  becoming  cancerous is
approximately  10~3 to 10"". This has
become  known   as  the  Geesaman
hypothesis. (Page 26)

Geesaman  indicates  that  the tissue
repair time in the lung is on the order
of one year. It therefore seems appro-
priate, but   not  necessarily   conser-
vative, to  accept as guidance that
this  enhanced  cancer  risk  occurs
when particles  irradiate the surround-
ing lung  tissue at a dose rate  of 1000
rem/yr or more. (Page 33)

.  . .  using Geesaman's lung model, a
particle with  an  alpha  activity  be-
tween  0.02  pCi and  0.14 pCi is re-
quired to give a dose of 1000  rem/yr
to irradiated lung tissue. For purposes
of establishing a  maximum  permis-
sible  lung particle burden we will
use  0.07  pCi  from  long half-lived
(greater than one year) isotopes  as
the limiting alpha activity to  qualify
as a hot particle. (Page 34)

The  existing standards   for uniform
radiation exposure of  the whole body
or lung can be used  as  the basis for
establishing  particle  exposure stan-
dards by equating the risk of  cancer
induction between the two types  of
exposure   (uniform   versus   grossly
nonuniform). The most recent assess-
ment of  the  risk associated with uni-
form  irradiation  of  man  was per-
formed by  the  NAS-NRC  Advisory
Committee on the Biological   Effects
of Ionizing  Radiation.  Their  report,
published in 1972, is referred to as the

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   BEIR Report . . . the existing occupa-
   tional exposure standard for uniform
   whole body  irradiation  is  5  rem/yr
   and for the lung, 15 rem/yr. The BEIR
   Report estimates that exposure of the
   whole body of an individual to 5 rem/yr
   would lead to a cancer risk between
   4.5 x  irr4 and  2.3 x IQ-Vyr. Their
   best estimate is 10'Vyr. (Pages 41-42)

   It is recommended here  that the best
   estimate  of  the  effects  of uniform
   exposure  by  the  BEIR Committee be
   used  together  with a risk  of cancer
   induction of 1/2000 per  hot  particle
   in determining the MPLPB for insolu-
   ble alpha-emitting radionuclides in hot
   particles. This is a somewhat arbitrary
   compromise and  is not the  most con-
   servative value that could be recom-
   mended.  Thus,   the  recommended
   MPLPB  for  occupational  exposure
   from hot particles of alpha-emitting
   radionuclides in  the deep respiratory
   zone is 2 particles. This  corresponds
   to a MPLB of 0.14 pCi and  represents
   a reduction of 115,000 in the  existing
   MPLB. (Pages 43-44)

In February  1975,  in a  supplemental sub-
mission  [21]  to  the Environmental Protection
Agency's Public Hearing  on  Plutonium and
the  Transuranium  Elements,  Cochran  and
Tamplin added to their  definition of a "hot
particle:"

    In our petition and Hot Particle Report,
    we  concluded  that, consistent  with
    the whole body exposure standard of
    5 rem/year,  the alpha-emitting  hot
    particle standard should be 2 particles
    in the human lung. Using the estimated
    minimum hot  particle activity of 0.07
    pCi, this resulted in the  suggested
    reduction of the MPLB by  115,000.
    However, as we  stated in our Hot
    Particle Report, this  factor of 115,000
    would  apply only when it was  not
    determined  that  the activity  was  not
    on  hot  particles.  Using the  particle
    size  distribution  determined  for  the
    Rocky  Flats  fire,  and  allowing  only
    2 particles above  0.07 pCi would still
    have  required  a  reduction  of the
    MPLB by a factor  of 16,000. (Page 22)

Based on their development of particle size
statistics for the exposure of personnel at the
time of the plutonium facility fire  at  Rocky
Flats, Colorado, Cochran and  Tamplin "see
little  justification  for selecting a  minimum
hot  particle activity  greater  than  0.6 pCi/
particle ... a  2-particle  limit  at   0.6 pCi/
particle would  still  require  a  reduction  of
the  MPLB  by  a  factor approaching  2000."
(Pages 22 and 24) [21].

A CRITIQUE OF THE COCHRAN-TAMPLIN
PROPOSAL

The Committee views  the Cochran-Tamplin
thesis as based on three assumptions. Assump-
tions 1 and 2  together form the Geesaman
Hypothesis and Assumption 3 is the Hot Parti-
cle Hypothesis. The assumptions are described
and commented on below.

Assumption 1

The correlation  between  the  induction  of
atrophic hair follicles and the  induction  of
tumors  in rat skin with ionizing radiation [17-
20]  is assumed  by Cochran  and Tamplin  to
indicate that the atrophic  hair follicle causes
the skin tumors and  that the role of ionizing
radiation  is  only  to  produce the  structural
damage to the hair follicles.

Comment

Atrophic  follicles  are structures which have
lost the ability to produce hair, for any of a
number of reasons. When radiation is involved
in  atrophy, however, the atrophy results from
the radiation-induced death of the hair germ
cells, which are the stem cells for hair produc-
tion normally found at the base of the resting
hair follicles. The most likely explanation for
the association  between follicle atrophy and
tumor  induction  is  that  ionizing  radiation
causes  concomitant cell death and neoplastic
cell transformation.

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 It is  a  generally established  concept in the
 etiology of cancer that the disease is initiated
 by the  neoplastic transformation  of  single
 cells. The  transformation  of  single  cells  by
 carcinogens can  be shown in tissue  culture
 studies, where it is evident that  cell lethality
 and cell transformation are concurrent effects.
 However, the dose-response relationships for
 the  two effects  vary sufficiently  to indicate
 that  the processes are  independent.  It has
 been  shown   that  carcinogen-induced  cell
 death can be  prevented  without affecting the
 yield of transformed cells  [22].  And, while
 tissue damage is commonly seen in association
 with cancer formation, there is strong evidence
 that the two effects represent different aspects
 of carcinogenic action.

 Assumption 2

 Geesaman  [15,16] generalized (Assumption 1)
 that  follicle  atrophy causes  skin  tumors in
 the  rat. He expanded this assumption to con-
 clude (as Assumption 2) that the probability of
 cancer  due to focal tissue damage in the lung
 caused  by a  microscopic  plutonium particle
 will be  1/2000, which is the hypothesized ratio
 of tumors-to-atrophic follicles in  the rat skin.

 Comment

 This  Geesaman  Hypothesis,  on  which  the
 Cochran-Tamplin  proposal  is  based,  revives
 one  of the oldest cancer  theories; namely,
 that the cause of cancer  is chronic tissue dam-
 age.  This is the chronic  irritation theory pro-
 pounded by Virchow in 1863. The theory, as
 reviewed by Oberling [23], was in vogue for
 about 50 years.  It stemmed  from  the  early
 clinical observations that cancer rarely appears
 in healthy tissue and is almost always pre-
• ceded  by  chronic  inflammatory  conditions
 such as scars,  ulcerations  or fistulas.  Post-
 mortem observations  in this era  suggested
 that  the same association  applies to internal
 organs.

 Virchow pointed  out that every injury to tissues
 is followed by a state of irritation in which
 the cells are  stimulated  to multiply in order
 to repair the  damage. If the'  injurious condi-
 tions prolong  the irritation, the  cell prolifer-
ation grows more and more excessive and
irregular. Virchow argued that if such a condi-
tion persists year after year, cancer will occur.

The Virchow  theory  claimed  that  chronic
irritation was the sole,  nonspecific cause of
cancer:  i.e., that cancer was the  outcome of
many  widely  differing  conditions with  no
features in common  except chronic damage.

As   related   by  Berenblum  [24],  Virchow's
theory  was  eventually  demolished.  Experi-
ments  begun  in  1918  showed  that cancer
can  be  produced  by  some  potent substances
that vary  widely  in  their capacity to cause
damage; on the  other  hand,  many agents
which cause  substantial  damage were shown
not to cause cancer.

Regarding radiation,  analysis of the data  on
induction  of  skin  tumors  in  rats  by alpha
rays [17-20]  indicates that  nearly  all  of the
potentially  dividing  cells (>99.9%)  in  each
hair follicle were sterilized by even the lowest
dose used. This means that increasing the dose
will  produce  only  a negligible increase in the
number of destroyed  cells. Since the number
of tumors increased very much  more rapidly
with dose,  these data negate the  assumption
that follicle atrophy (or a nidus of dead cells)
is the  only  cause of  tumor  formation in  rat
skin.

Assumption 3

On  the basis of Assumption 2, Tamplin extend*
the  Geesaman  Hypothesis to make Assump-
tion 3:  when  the dose  to  the surrounding
tissue from the  alpha-emitting particle exceeds
1000 rad/yr,  focal damage will be produced
with a cancer  risk of 1/2000. This is the Hot
Particle Hypothesis.

Comment

It is stated that 1000 rad/yr was  selected as
the  critical dose at which  cancer risk from
ionizing  radiation  could  be quantitatively
assessed in  man because this dose  is the mini-
mum that produces cancer in the rat skin and
lung, and the  life span  of lung cells  is  nor-
mally about one year. However, the logic of

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this reasoning is obscure because no system-
atic relationships are  known  to exist between
the rate of cell turnover and tissue damage
by alpha  radiation  in the lung or any other
organ.  The selection  of parameters appears
to have been arbitrary.
SUMMARY EVALUATION OF THE COCHRAN-
TAMPLIN RATIONALE

The exposure pattern in the deep lung to insol-
uble alpha-emitting particles always involves
focal  irradiation.  Particles  deposited in the
alveoli are transported through the lymphatics
and concentrated  around the respiratory and
terminal  bronchioles [25]. Hence, the problem
for insoluble  particles does not  represent a
comparison  of uniform  and focal exposures,
but a  comparison of the  relative  effects of
greater numbers of small  particles compared
to smaller numbers of large particles for the
same total lung burden.

Radiobiologic theory supports  the concept
that for respirable-sized particles distributed
in a tissue,  the  number of cells traversed by
alpha radiation, and probably also the carcino-
genic  risk,  increases with  increasing particle
size or particle activity and reaches a maximum
at a given   particle  size  or particle activity.
At particle  sizes  or  particle activities above
this maximum  the  probability  of multiple
traversals of  single  cells  increases, thus in-
creasing lethality.  This  results  in a reduced
carcinogenic  risk  since dead  cells cannot
become cancer cells [12,26].

On the  other hand,  radiobiologic theory also
supports the concept that if the alpha activity
is distributed  throughout the tissue, the num-
ber of cells that receive only single traversals
or sublethal events of some nature increases
with the amount  of  alpha-emitters present in
the lungs and the cancer risk increases simi-
larly.  Of course,  at very high concentrations
of alpha-emitters the number of cells receiving
multiple traversals increases and  the risk  of
radiation pneumonitis and fibrosis becomes
more  significant,  while the cancer risk de-
creases.  Experimental efforts to  verify  these
concepts are continuing,  but results to date
do not contradict  this description  [27].
 In experimental animals the carcinogenic risk
 is reasonably independent of the geometric
 distribution of the particles in the lungs. In a
 complex organ like the lung it is possible that
 particle size may affect the distribution, and
 hence the risks,  among various tissues. How-
*ever,  experimental  evidence  suggests  that
 because of competing tendencies in this distri-
 bution, the overall tumorigenic response for
 a variety  of particle sizes  is a function of the
 total radioactive dose involved and is  relatively
 insensitive to  differences  in the distribution
 in various tissues.

 The  Geesaman  Hypothesis,  on   which  the
 Cochran-Tamplin  rationale is based,  has merit
 only to the extent that tissue damage which
 results in permanent structural disorganization
 can have an enhancing effect on the tumori-
 genic response to carcinogen exposure. The
 postulate  that structural disorganization, per
 se, produces tumors has been shown to be true
 only in the endocrine system where hormonal
 feedback-regulating    mechanisms   operate
 from one organ to another (e.g., the ovary and
 pituitary  glands). Under these circumstances
 gross  destruction of organs (not  microscopic
 focal derangements) can be a condition  for a
 tumorigenic response.

 Geesaman's   postulate,   that  the   damage
 produced in  the lung by a single plutonium
 particle would  have  the  same  probability
 of causing lung  cancer  as that  observed in
 the irradiated rat skin, makes the  following
 unwarranted  assumptions  about  the patho-
 genesis of radiation-induced tumors in the
 rat  skin:  a) that atrophic follicles, per  se,
 cause  skin tumors  (i.e.,  that  structural  dis-
 organization  of  this type is tumorigenic) at
 a relatively low  probability of 1 in 2,000; and
 b) that focal  irradiation  of  hair follicles, as
 would occur from stationary plutonium par-
 ticles adjacent to hair follicles, causes atrophic
 follicles and  skin tumors. Since the Geesa-
 man  Hypothesis  could hardly  be  taken as
 the basis  for predicting the yield of tumors,
 even in the rat skin, from imbedded plutonium
 particles,  it would be purely fortuitous if it
 accurately  predicted  the  response  of the
 human lung to plutonium particles. Therefore,
 the rationale for the NRDC petition appears
 indefensible.

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                   CURRENT STATUS OF THE RADIATION BIOLOGY
                            OF INHALED ALPHA-EMITTERS*
The potential health effects caused by inhala-
tion  of  alpha-emitting  radioactive particles
depend  on the  properties of the  particles.
Particles  released from the nuclear fuel cycle
may  vary  widely  in  radionuclide content,
from low specific activity particles  (largely of
uranium) to high specific activity particles of
nearly  pure plutonium, curium or americium.
The particles may contain beta and gamma-
emitting  radionuclides   in  addition  to  the
alpha-emitting  transuranics.  Other  particle
properties  (such as  chemical  composition,
density, and  size) can also  vary over a wide
range,  depending upon the mode of formation
and the route of release.

Only   in  extraordinary  circumstances  would
human beings  be exposed  to particles  of a
fairly homogeneous size distribution (such as
pure  plutonium  oxide  particles). Accidental
exposures would be to aerosols comprised of
randomly shaped particles with  a  variety of
physical and  chemical properties and a wide
variation in sizes [28,29]. The  particles would
most   likely  contain  mixtures  of  uranium,
transuranic  elements  and  fission  products.
Thus,  it  is very difficult  to  assess the health
effects that could result from such an exposure.

FACTORS IN DOSE-RESPONSE
RELATIONSHIPS

Variations  in   anatomical  and  physiological
properties of the respiratory tract increase the
complexity of  assessing  the potential health
effects of  exposures to  aerosols containing
transuranic  elements  [30-35].  These  differ-
ences, compounded  by respiratory diseases,
exposures  to other sources of radiation  and
nonradioactive  toxic  substances,  and differ-
ences in  physical activity and (possibly) genetic
*More  detailed  supporting  discussions  are
 included in Appendix A.
constitution  among  individuals,   influence
susceptibility to the biological effects, includ-
ing lung  cancer, of  inhaled transuranic ele-
ments. Furthermore, since data on  the effects
of transuranic  elements in human  lungs  are
lacking,  the assessment  of  potential health
effects depends largely on the results of animal
experiments.

Fate of Inhaled Particles

The chemical and  physical properties of in-
haled alpha-emitting particles and their depo-
sition  sites in the respiratory tract  determine
the eventual fate of particles in the lung and
subsequent  biological  effects. Clearance of
particles  deposited  in  the  respiratory  tract
occurs  through  the   gastrointestinal  tract,
through  the lymphatic system  or  by disso-
lution and absorption into the blood. Clear-
ance from the  upper respiratory tract is very
rapid,  within  a  few  hours, but   clearance
from the lower respiratory tract and the alveo-
lar region may require weeks or even years.
Particles  are cleared  from the nasal  regions
to the external environment  or to the gastro-
intestinal  tract within  the first  hours  after
inhalation [36].  The  process  may  be accel-
erated by  sneezing  and  other mechanical
functions. Since  absorption  of  transuranics
from  particles  in the gastrointestinal  tract is
usually much less than 0.1% [37],  nearly all
particles cleared from the respiratory passages
to the gastrointestinal tract are excreted.

Particles  deposited  in  the tracheobronchial
region of the  lungs are  transported in the
layer  of  mucus,  propelled by ciliary action
toward   the  esophagus.   Interpretation  of
experimentally-determined clearance  curves
indicates  that plutonium  oxide particles are
probably  cleared from the tracheobronchial
region with a  half-time  of  up  to about 3
days [38].

Particles deposited  in the  alveolar region may
be  cleared   by  dissolution  and  absorption

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into the blood, by mucociliary action through
the tracheobronchial  tree, or by transport via
the lymphatic  system. The  relative  impor-
tance  of  each  pathway  for given  particles
depends upon many factors, such as the parti-
cles' chemical and physical properties, specific
activity, cytotoxicity,  and  the state  of health
of  the  respiratory   tract.  Estimates of  the
retention  half-time of plutonium in  the lungs
of  human  beings accidentally exposed to
plutonium aerosols range from about 300 to
650 days [39]. The ICRP recommends that the
value of 500 days be used  for radiation protec-
tion purposes [40].

Cigarette smoking has been reported to inhibit
ciliary activity  of the respiratory tract, which
is an  important  mechanism for clearance of
particles from  the lungs  [41]. This  raises the
question  of whether  plutonium  would be
retained in the lungs of smokers to a greater
extent  than  in  the lungs  of nonsmokers.
Slowing of mucus flow along the major bronchi,
where movement is normally very rapid,  does
occur in human  smokers  [42]. However, no
significant  effects have  been observed,  in
 human beings free  of bronchitis,  on  mucus
transport in .the  smaller bronchi where move-
 ment  is  normally  very  slow [43].  There are
 no data relating the  effects of cigarette smok-
 ing to clearance of particles from the human
 alveolar region.  There also is no information
 available  on  residence   times of particles
 deposited in areas  of the  bronchial mucosa
 which have been denuded of cilia, particularly
 the bifurcations of the  bronchi. However,  a
 recent report  gives  preliminary evidence for
 long-term residence  of 210Pb on the bronchial
 epithelium  of  cigarette  smokers   [44].  How
 this might relate to inhaled plutonium particles
 is not known.

 Particles  are cleared from the lungs to re-
 gional lymph nodes  via the lymphatic vessels,
 probably  those  adjacent to bronchioles and
 bronchi. In experimental  animals  plutonium
 particles have  been identified in  lymphatic
 vessels  beneath the pleural  surface  [25].
 Evidence from experimental animals and from
 human  beings accidentally  exposed to plu-
 tonium  indicates that  plutonium particles
accumulate  and are  largely retained  in  the
lymph  nodes. Thus, plutonium concentrations
in  lymph  nodes  are usually  several  times
greater  than those in lungs.  However,  lym-
phatic  tissues have not been the site  of  pri-
mary  cancers  in  experimental  animals   that
inhaled plutonium  [45],

Physics of Energy Absorption

Heavy  ions, such as  alpha particles,   lose
energy rapidly and produce a dense column of
ionization as they penetrate cells and  tissues.
Because of this  high  rate of energy loss, their
range  in cells and tissues is short. A 5.3  MeV
alpha particle emitted from plutonium has a
range in water of about 41 ^m with an average
ion density of  about 3500 ion  pairs//im.  Due
to slowing of the alpha particle, the ion density
increases by about a  factor of 2 at the end of
its  range.  Thus,  compared with electrons,
energy from alpha  particles is  deposited in
cells  and  tissues  in  a  highly  concentrated
manner.  An alpha  particle which  traverses
the  nucleus of a cell  deposits more  than
enough energy, by several orders of magnitude,
to  destroy the  cell's reproductive capability.
Traversal  through  the  cytoplasm,  however,
can damage the cell but leave its reproductive
capacity  unimpaired  [46]. Therefore, when
dealing with the  biological effects of alpha
irradiation,  it  is appropriate to  consider the
probability that a  cell, especially the nucleus,
might be traversed by an alpha particle, rather
than the amount of energy (usually expressed
in rad) deposited per  unit mass of cells.

Calculations  of the  probability  of  epithelial
cells  in  the lung being traversed by alphas
emitted  from plutonium  particles lead to the
conclusion that the number of cells killed or
affected by such particulate sources will reach
a maximum after a  relatively  short  interval,
regardless  of the  total activity involved,  be-
cause a single traversal of a cell nucleus by an
alpha  particle should be sufficient to kill or
affect  the cell  [25,26]. Thus, the probability
that plutonium particles will induce  a  lung
cancer is more likely to depend on the .number of
particles than  on  the specific  activity of the
particles. This   supports  the hypothesis  that
                                               10

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greater  tumorigenicity  per  unit  of  absorbed
dose results as the plutonium is  more widely
distributed throughout the  lungs in  smaller
particles.

Cellular and Subcellular Effects

Knowledge  of  the  mechanisms by which
cancer is  induced by alpha  irradiation would
help to resolve questions about the relative
hazards of  inhaled  alpha-emitting   particles
of different sizes and specific activities. Unfor-
tunately,  most of our  knowledge about the
action  of  alpha  irradiation at  the cellular
and subcellular levels concerns cell  mortality,
rather  than  cell transformation.  Nevertheless,
since the  physical processes leading  to alpha-
induced cell transformation can be assumed to
be similar to those  related to cell death, data
obtained  from studies  of cell mortality  and
chromosomal  aberration  can  be  useful  in
examining questions of spatial distribution of
alpha dose and carcinogenesis.

These data suggest that single alpha particles
that traverse  the cytoplasm of a cell will have
minimal,  if  any,  impact on  the  cell's ability
to survive and reproduce. Theoretical deduc-
tions, supported  by studies of cells in tissue
cultures,  indicate that  when a  single alpha
particle traverses  a  cell  nucleus,  it causes
sufficient   irreparable   molecular   damage
to destroy the cell's reproductive  capability
[47,48]. These killed cells do not become can-
cers. When a cell nucleus receives only a por-
tion of the energy from an alpha traversal and
survives, the cell may retain its  reproductive
capability  and  pass on  to its progeny certain
genetic alterations which  may have  a bearing
on  subsequent  events  leading  to  cancer
induction.

Brooks  et al. [49]  studied  the  frequency of
chromosomal  aberrations  in  the  livers  of
Chinese   hamsters  following   injection  of
239Pu  citrate  or 239PuO2  particles of  various
sizes and  numbers. The dose-response curves
for aberrations per  cell were similar for low
total doses  of 239Pu particles  and  uniformly
distributed 239Pu. However, with 239Pu particles
a large portion of the aberrations occurred in a
few cells that were considered by Brooks to be
reproductively  dead.  Brooks et al. concluded
that  the 239Pu particles posed a lesser  hazard
than did the more uniformly distributed 239Pu.
Insofar  as cell  death  and chromosomal aber-
rations  are  related to cancer risk, the  data
suggest that the more  uniform the distribution
of the  alpha  flux, the greater the radiation
effect.

Mechanisms of Carcinogenesis

Because the  basic  mechanisms  of carcino-
genesis are still essentially unknown, a  discus-
sion  of this subject can give little insight into
the hot particle problem. It is recognized, how-
ever, that the efficiency of carcinogenic action
depends upon the carcinogen  reaching bio-
logical  targets  within  cells, the susceptibility
of cells to transformation, and the extent to
which  transformed cells acquire properties of
neoplasia,  including   unrestrained  prolifera-
tion, invasiveness, and  antigenicity.

The progeny of transformed cells have a  variety
of neoplastic and  non-neoplastic  characteris-
tics;  therefore, not all transformed  cells  lead
to tumor  formation.  In  addition,  selection
processes breed out  some  aberrant races  of
cells and other transformed cells die naturally
(although this could conceivably facilitate the
election process for tumor cells).

Within the present insufficient body  of knowl-
edge about carcinogenic processes and  tumor
biology, the concept of "precancerous lesions"
has developed. Precancerous lesions are those
which may precede and may favor the  devel-
opment of cancer but do not possess the essen-
tial elements  of the  disease [50].  However,
although most  so-called precancerous  lesions
have some neoplastic  properties, such  as cell
proliferation  and distortion, it  is  impossible
to predict  whether they will  in fact develop
into  cancer. Tumor induction is the result  of
a series of critical events which are still  imper-
fectly understood.  The terms precancerous,
pre-adenoma,  etc.  are  used  to  indicate
changes reminiscent  of those  preceding  or
concomitant with tumor development, but they
do not have precise scientific meanings.
                                              11

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ANIMAL EXPERIMENTS

Animal  experiments [51,52] have shown two
responses  at  low  levels of  inhaled  PuCh:
a reduction in the number of circulating lym-
phocytes and  induction of lung cancer. Lung
cancer, the long-term consequence of greatest
concern, has been demonstrated in  mice, rats,
dogs, and baboons. Although studies are limited
and still in  progress, hamsters appear to be less
susceptible  to induction of lung cancer  by
inhaled  plutonium than rats or dogs.

In  all  the animal  experiments with  inhaled
transuranic    elements,   bronchiole-alveolar
carcinoma,  a  variant  of adenocarcinoma,  is
the predominant  resulting cancer  type.  The
tumors  appear to  originate  in the periphery
of  the  lungs  where, according to  autoradio-
graphic  evidence,  the main portion  of the
radiation dose is delivered.

In  studies  of  inhaled plutonium it has  been
the general practice to relate biological effects
to  the  total radiation doses delivered to the
lungs. The doses  are calculated on the basis
that the deposited energy is absorbed by the
total lung mass, including the blood. Although
it has always been recognized that  absorption
of alpha radiation energy emitted by plutonium
particles is not uniform,  the actual distribution
of  the  absorbed  energy  has  not  been  well
enough known to  develop a more defensible
 practice. On  the  positive side, there  is  merit
 in  using  the same method  for  calculating
 dose in  animal  experiments as is  used  in
 setting  standards for human exposure.

Animal   experiments  with inhaled  plutonium
have involved  both  relatively  soluble  and
insoluble compounds. However, it  should be
recognized that  although  both soluble  and
insoluble compounds are deposited uniformly
throughout the  lungs after inhalation,  both
tend to become  localized in "hot spots" as  a
result  of cellular  action  and other processes
acting to remove the foreign material. Soluble
plutonium  compounds   are   removed  from
the lungs  more  rapidly  than  insoluble  com-
pounds, mostly by absorption  into  the blood.
The portion  of  soluble plutonium  retained
in the lungs continues to be localized for long
periods  of time.  Even  so, soluble plutonium
compounds are distributed more widely than
insoluble  plutonium  oxide particles and  it
is  reasonable  to  believe  that  the absorbed
radiation  is  also  more  widely  distributed.
Thus, it  is difficult, if not impossible, to com-
pare experimentally the effects of completely
uniformly-distributed  alpha  irradiation with
irradiation   from   particulate  sources.  It  is
possible,  however, to  perform  experiments
comparing  more-uniform  with  less-uniform
irradiation,  or more-particulate  with  less-
particulate  irradiation.   Experiments   have
been completed  which allow these kinds  of
comparisons. The details of those experiments
are described in Appendix A.

The  carcinogenic   effect  of   ammonium-
plutonium pentacarbonate  in  rats has  been
found  to  be  no  greater than that of less-
aggregated  plutonium  citrate [53].  Plutonium
nitrate  given  by  intratracheal  injection [54],
which  results  in  highly localized deposition
in  the  lungs,  was significantly  less effective
than inhaled plutonium nitrate [55], plutonium
citrate,  and ammonium-plutonium pentacar-
bonate. However, intratracheally administered
210Po in hamsters  [56] has  been more carcino-
genic than inhaled 210Po in rats [57] (although
the significance of this is  difficult to  assess
because of the different animal species  used).
In  another experiment in  which  Pu  micro-
spheres of varying number and specific activity
were distributed  throughout the vasculature
of  the  lungs of hamsters, no specific activity
particle or dose distribution was found to  be
more carcinogenic than another, but a high
incidence  of  lung cancer was not observed
in  any  of the experimental  groups [58].  A
recent analysis [59] shows that the risk of lung
cancer  in  rats from  insoluble  PuCh is  about
double   that  from relatively  soluble  alpha-
emitters.  In this  analysis, data from experi-
ments with relatively soluble  americium and
plutonium compounds were pooled. However,
the lung cancer risk per unit of absorbed dose
from some soluble  alpha-emitters, such  as
241Am(NO3)4, appeared to  be equivalent to  or
greater  than that from PuO2 [59].
                                              12

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These  animal experiments  indicate that the
carcinogenic response of lung tissue to alpha
irradiation  is largely  dependent on the total
amount of radioactivity without regard to its
distribution. The maximum difference between
the  cancer  risk  from more  particulate  and
from less  particulate  sources appears to be a
factor  of  about  2.  On  the  basis  of these
lifespan experiments,  mostly  with  rats, it  is
possible to estimate  that the absolute risk of
lung cancer to rats exposed to inhaled trans-
uranic  elements  is about 0.1% per rad over
the dose  range studied  [59].  At  the present
time there is no basis for direct extrapolation
of this risk  estimate  to  the human  being.

Studies [60] extending over the entire lifespan
of beagle  dogs conducted by Battelle, Pacific
Northwest   Laboratories   have  shown  that
bronchiole-alveolar cancer  is  the  principal
type of lung tumor that develops in dogs after
inhalation of an  aerosol containing insoluble
239PuO2 particles.  More recently this same type
of cancer has also been found in dogs exposed
to aerosols of insoluble  clay particles  tagged
with 90Sr, 144Ce, and 91Y. In these experiments
[61-63], which were conducted at the Lovelace
Inhalation Toxicology  Research Institute, the
beagle lung received a diffuse, low  LET (linear
energy transfer)  radiation exposure, as com-
pared  to  the  localized,  high  LET exposure
produced  by the 239Pu particles.

The  likelihood of a hot particle effect such as
that envisioned by Cochran and Tamplin can be
directly assessed from the results of the Battelle
beagle dog  study. The study was designed to
simulate the kind of exposure which occupa-
tional workers involved in processing Pu might
encounter;  namely,  inhalation of  aerosols of
239PuO2 particles  generated  during  processing
or accidental combustion of the metal. A group
of 40 dogs was exposed at a relatively early age
to an aerosol containing insoluble 239PuO2.

Lung cancer in the Battelle group may for the
purposes of the present discussion be thought
of as derived from two sources: 1) generalized
alpha  irradiation  of  the  lungs from 239PuO2
 particles and 2) any hot particle effect of the
 type proposed by Cochran and Tamplin.  The
 extent to which  any such  hot particle  effect
 contributed to lung  cancer mortality  in  the
 dogs can be judged by comparing the observed
 number of lung cancer deaths with the number
 expected on the basis of Cochran and Tamplin's
 risk  factor  of  1/2000 per  hot  particle.  The
 results of  the  analysis,  details of which  are
 presented in Appendix A, indicate that if there
 is a hot particle effect the cancer risk per par-
 ticle is lower by at least several orders of mag-
 nitude than Cochran and Tamplin estimated.
 The  analysis also shows that all of the lung
 cancer deaths in the Battelle group are readily
 attributable to  the  absorbed lung dose from
 the alpha  radiation. In other words, if there is
 a hot particle effect the beagle experience indi-
 cates  that it is dwarfed  by  the effect of  the
 generalized alpha irradiation the dogs experi-
enced. The results are summarized below.

 As previously discussed, Cochran and Tamplin
 have defined the hot particle in two different
 ways. They originally  described a hot particle
 as one with an associated lung cancer death
 risk of 1/2000 per particle and a specific activ-
 ity of 0.07  pCi or more per particle. For brevity,
 we shall refer to this as the Type 1 hot particle.
 Later Cochran and Tamplin redefined the parti-
cle as one having the same cancer risk (1/2000
 per particle) but they required that it  have
 nearly  ten  times the  specific activity, namely
0.6 pCi or more, to produce that risk. We shall
 refer to this redefined particle  as their Type 2
 hot particle. In order to avoid ambiguities in
the following discussion, cancer risks will be
assessed for both types of hot  particles,  since
 it is not clear that Cochran  and Tamplin have
completely abandoned the Type 1 definition.

The average animal in the Battelle group that
died of lung cancer is estimated to have had
deposited   in  the  pulmonary   lung regions
approximately 1.3 million Type  1 particles and
200,000 Type 2 particles. These numbers  are
calculated on the basis of the measured particle
size  distributions of  the aerosols  the  dogs
 inhaled.
                                             13

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On the basis of Cochran and Tamplin's assumed
risk  constant of  1/2000 per  hot  particle,  it
follows that the average  dog would be capable
of developing 650 lethal lung cancers, if they
were produced by the 1.3 million Type 1 parti-
cles, or 100 lethal lung  cancers if  they were
produced by the 200,000 Type 2 particles.  It is
important to realize that the actual  number of
primary  lung cancers  in  an  animal is  not
directly observable, even at autopsy,  because
lung tumors frequently metastasize, producing
multiple foci which cannot be distinguished
from multiple  primary  tumors. Nevertheless,
since primary tumors are expected to arise as
rare independent events and therefore to be
distributed  in  accordance  with  the  Poisson
distribution [64],  the mean number of lung
cancers  can be  indirectly  inferred from the
observed cancer death rate. Thus, a lung cancer
death  rate is a measure of the probability of
dying of lung cancer in a specified time period.
More  precisely,  it is the probability  of dying
from at least one lung cancer in that period.

Cochran and Tamplin do not appear to have
specified over what time period their proposed
risk  constant of 1/2000 would be realized. For
the  purpose  of testing  their  hot   particle
hypothesis the mean life span of the normal
unirradiated beagle, about  11.5 years, may be
considered  ample time  for that constant to be
fully realized. Since the average animal in the
 Battelle group  was 560 days of age  at the time
 of inhalation of the aerosol, the mean life span
would  be  reached roughly  3600  days post-
 inhalation.  By  Life Table  methods it can be
 calculated (as shown in Appendix  A-ll) that  if
 the  average animal  in the  Battelle group had
 lived for 11.5 years, it would have had 1.9 pri-
 mary lung cancers. According to the Cochran
 and  Tamplin  hypothesis  there  should have
 been 650 or 100 death-causing lung cancers in
 such a dog depending on whether  the cancers
 were produced by Type 1 or Type  2 hot parti-
 cles, respectively.

 Thus the beagle data indicate that if there were a
 hot  particle  effect and if that  effect were
 responsible for all of the lung cancer  deaths in
 the animals, the associated risk of a  lung cancer
 would  still only  be  one chance per 670,000
per Type 1 particle, or one chance per 100,000
per Type 2  particle.   These risks  must be
compared with the risk of one chance per 2000
which  Cochran and Tamplin have postulated
for either a Type 1 or Type 2 particle.

It remains  to be  considered  whether  the
observed lung cancer mortality in the Battelle
group can be accounted for solely on the basis
of the dose received from the generalized alpha
radiation. The effective half-life  of this radio-
activity in their lungs averaged 960 days. For the
animals that died of lung cancer between 0 and
3600 days postinhalation, the initial lung bur-
dens averaged 1.07 yCi. The resultant total ac-
cumulated dose to the lungs at 3600 days post-
inhalation was 2575 rad. For chronic exposures
of this type, Marinelli  has shown that tumor
response is expected to be a function of the
average  accumulated dose  [65],  namely 1841
rad in the present case. Hence, the lung cancer
risk extending over the period 0-3600 days was
0.1%  per rad (1.9/1841), or 0.01% per  rem (if
a quality factor of 10 is assumed for the alpha
radiation from  239Pu).  This estimate  agrees
well  with  corresponding  estimates  for other
species  under exposure conditions in which
hot particles would  be   absent  [59].  Thus,
lung  cancer  mortality  in  the  Battelle group
appears  to be adequately  accounted for by
the conventional  method  of averaging the
absorbed  alpha  dose  over  the entire  lung.
Therefore it  is concluded  that if there is a hot
 particle  effect the lung cancer risk per  par-
ticle  has not only  been greatly  overestimated
 but,  more  importantly, such a  risk is  small
 by comparison with the lung cancer risk attri-
 butable  to the generalized alpha radiation.

It could be contended that the Cochran-Tamplin
risk constant of  1/2000 per hot  particle still
applies  to human beings,  even though  that
factor is  too  high by orders of magnitude to be
consistent with  the beagle dog  experience.
However, such a contention loses its force when
it is realized  that Cochran and Tamplin derived
that constant on the basis of induction of tumors
in the rat. Moreover, these were not lung tumors
but skin  tumors, and they were induced not by
localized alpha sources of the insoluble 239PuC»2
type but by a diffuse alpha irradiation.
                                               14

-------
It could also be contended that the beagles had
far fewer hot particles in their lungs than esti-
mated.  Although such a possibility  cannot be
rigorously  excluded,  the beagle experiment
simulated in many ways the worst possible type
of exposure, in that the dogs inhaled a poly-
dispersed aerosol of 239PuC>2 particles immedi-
ately after the aerosol was generated. Thus, there
was a maximum opportunity for relatively large
particles, such as Type 2 particles, especially, to
reach the  deep lungs. In contrast, in occupa-
tional accidents a worker would generally tend
to  inhale   aerosols  depleted  rather  than
enriched in hot particles.

Finally, it should be stressed that sound radiation
protection practice requires that the limits of ex-
posure specified in a standard be expressed in
quantities  which can be relatively easily mea-
sured. In the case of alpha emitters of the 239Pu
type, the amount of radioactivity, and in turn ex-
posure dose, which a person might acquire  can
be assessed by determining excretion rates sup-
plemented  where possible with whole  body
scanning. On the other hand, there is no way of
measuring the number of hot particles which a
worker might have inhaled short of extirpation
of relatively large amounts of lung tissue.

It is further concluded on the basis of the Battelle
beagle  study  that  the  current  method  of
measuring  the  generalized  alpha  radiation
provides an adequate and practical  method of
estimating potential lung cancer hazard. Studies
in progress involving lower levels of inhalation
of 239Pu in  the beagle  should  help to  settle
the question of whether there is any appre-
ciable residual lung cancer risk that  cannot be
accounted   for by  the  generalized   alpha
radiation.

EXPERIENCE WITH HUMAN BEINGS

The predominant types of lung cancer observed
in human  beings are epidermoid carcinomas,
small and  large cell undifferentiated cancers,
adenocarcinomas, and mixtures of these types.
All of these generally occur in the hilar region
of the lungs and are more frequent in smokers,
persons exposed to chemical carcinogens, and
uranium miners [66].

Cancers in human beings have only rarely origi-
nated,  under any circumstances, in  the bron-
chiolo-alveolar   regions  [67].  Therefore,  an
excess incidence of carcinomas in these tissues
as a result of occupational exposure to carcino-
gens  would  probably  have   been  readily
detected. Data  on the relative frequencies of
different tumor types in uranium miners and
Japanese atomic bomb survivors suggest that the
radiosensitivity  of the bronchial epithelium for
cancer induction may be greater than that of
the alveolar or bronchiole-alveolar tissues.

in animals, it has been determined  from ex-
periments that the bronchiole-alveolar  epithe-
lium is  the  most likely  site  of primary lung
cancer  following inhalation of plutonium, as
well as  the  predominant site  of  naturally-
occurring lung  cancer. Since  plutonium is not
known to have caused lung cancer in  human
beings, we do  not know where such cancers
might originate. The  bronchial  epithelium is
the predominant site of  human lung cancers,
while cancers of the bronchiolo-alveolar epi-
thelium,  the region of the lung expected to
receive  the majority of the alpha dose from
inhaled  plutonium, are rare [66-68]. Thus, the
site of plutonium-induced cancers in the human
being will depend upon the relative cancer sus-
ceptibilities of the bronchial epithelium and the
bronchiolo-alveolar epithelium, as well as the
magnitude of the radiation dose to these two
regions.  If in human beings the region of the
bronchiolo-alveolar epithelium (where pluto-
nium is retained) is much less sensitive than the
bronchial epithelium (which may be subjected
to possible radiation exposure only during the
brief period when plutonium  particles enter or
leave the lungs), then human beings  might be
less sensitive to cancer induction by plutonium
than are experimental animals.
                                              15

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                                                   18

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                                 APPENDIXES
APPENDIX A — i.  RELEVANT PHYSICAL AND BIOLOGICAL DATA
PARTICLES — R. O. McClellan  	  A.1
RESPIRATORY TRACT STRUCTURE AND FUNCTION — R. O. McClellan  	  A.7
REFERENCES  	 A.14
APPENDIX A — II.  FACTORS IN DOSE-RESPONSE RELATIONSHIPS
FATE OF INHALED PARTICLES — R. O. McClellan  	 A.19
PHYSICS OF ENERGY ABSORPTION — E. C. Gregg	 A.23
BIOLOGICAL EFFECTS
    Cellular and Subcellular Effects — M. Goldman  	 A.30
    Animal Experiments — W. J. Bair 	 A.36
    Analysis of Lung Tumor Mortality in the Battelle Beagle Lifespan Experiment —
    E. B. Lewis 	 A.54
    Human Beings — E. P. Radford  	 A.63
    Comparison of Human and Animal Radiocarcinogen Effects — M. Goldman 	 A.66
MECHANISMS OF CARCINOGENESIS — G. W. Casarett 	 A.72
REFERENCES  	 A.73
APPENDIX B — PROCEDURES FOR COMMITTEE APPOINTMENTS AND CONSIDERATION
            OF POTENTIAL BIAS OF MEMBERS 	  B.1
APPENDIX C — COMMITTEE MEETINGS AND ATTENDANCE  	  C.I

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                                      APPENDIX A

                  I.   RELEVANT PHYSICAL AND BIOLOGICAL DATA
PARTICLES*

A number  of characteristics of inhaled alpha-
emitting particles  influence their  potential
for producing deleterious health effects. These
factors  (such as real  size,  aerodynamic  size,
chemical form,  specific activity, density, his-
tory  of  the material and solubility) may influ-
ence particle deposition, retention, transloca-
tion  and  ultimately the  alpha dose to  cells
and organs.

The  elemental  contents  of alpha-emitting
aerosol  particles that may  be  encountered
under  accident  conditions  vary  greatly.  For
example,  the  elemental  content  depends
upon where in  the  nuclear fuel  cycle  the
aerosol  is  generated. At some stages in  the
cycle transuranic  elements  are  handled  in
relatively pure forms; in other stages the mass
of the materials may be dominated by uranium.
Obviously, the elemental and isotopic contents
will  change as  functions of  the specific fuel
cycle and the radiation history of the material,
including elapsed time since discharge from
the reactor.

The  range of variations in the potential ele-
mental  and isotopic content of particles that
might be released may be better understood
by  considering  various  stages  in  different
fuel  cycles.

1.  An  accident involving  a uranium-fueled
    light water  reactor  shortly  after fueling
    with fresh fuel would likely result in release
     of  low specific activity particles consist-
     ing  largely  of  uranium,  with  modest
    quantities of beta-gamma-emitting fission
    products  and  very  small  amounts  of
    alpha-emitting transuranics.
 *Prepared   for   the   Committeejs   use  by
 R. O. McClellan and the staff of the Inhalation
 Toxicology Research Institute'
2.  An  accident involving  a uranium-fueled
    reactor after a period of extended opera-
    tion  would  likely  release  particles  of
    modest  specific  activity largely consisting
    of  uranium  and   beta-gamma-emitting
    fission  products  with moderate  amounts
    of alpha-emitting transuranics. The  alpha
    specific  activity might be on the  order of
    a few mCi/g.

3.  An accident during certain  stages of fuel
    reprocessing   could    release   material
    similar to  that described above;  at  other
    stages it could yield  relatively pure ele-
    ments,  including pure  transuranics  with
    specific  activities related  to the nuclide
    contents.

4.  An accident involving uranium-plutonium
    fuel assemblies,  either during their  fabri-
    cation or during  reactor operations, could
    yield particles that are  largely  uranium
    with  significant  quantities of  plutonium
    and,  after  irradiation,  other transuranics
    and fission products. The  alpha specific
    activity  could  be on the order of  a few
    mCi/g,   perhaps   approximately  that of
    pure 239Pu.

5.  During   reprocessing  of  the uranium-
    plutonium  fuel elements, releases  could
    be  encountered  at  various  stages  that
    would yield particles approximating the
    fuel elements in radionuclide composition.
    At some stages of the reprocessing rela-
    tively pure elements with specific  activi-
    ties  related to the radionuclide contents
    might be handled.

The  foregoing  descriptions  indicate   that
accidents  in  most  stages  of  nuclear  fuel
cycles  will  probably  yield   particles   with
specific  activites  no  greater than  that  of
239Pu, and in many cases lower.
                                             A.1

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The  aerosol  particles  may  vary  greatly  in
chemical  form,  depending upon the nuclear
fuel  cycle stage  from which they are released.
The  forms being handled in  the nuclear fuel
cycle  vary  from  a  nitrate  solution  to  an
oxalate to an oxide  of the various elements.
Aerosols  released from  these processes  have
not  been extensively studied but are likely to
be  equally diverse. Conventional  processes
and accident  situations may also involve  heat,
resulting  in release of materials with varying
thermal histories.

Aerosols  usually  consist  of  particles  with  a
variety of physical and  chemical properties.
 In particular, a whole  spectrum  of physical
 particle sizes  is  usually  present  in a given
 aerosol, even when  all the particles have the
 same  chemical  composition. The'  important
 property, physical density, may differ among
 different-size particles  of a  given chemical
 form [1]. Hence, the density distribution with
 respect to particle size must be considered in
 characterizing  an aerosol. Also,  the  specific
 activities of  particles  may  be different  for
 different sizes  [2].  Due  to  lack  of detailed
 information,  however,  it is usually assumed
 that all  particles in a given  actinide  aerosol
 under consideration are  composed of material
 of  the same chemical  form, specific activity
 and physical density.

 If particles in an aerosol  are spherical or nearly
 spherical in  shape, their sizes  can be con-
 veniently described in terms of their respec-
 tive  diameters.  However,  for   irregularly
 shaped particles, physical size is more difficult
 to  describe  satisfactorily. It  is customary to
 refer to  irregular particles in terms of  the
 projected area diameter; that is, the diameter
 of  a  circle whose  area is  the same as  the
 area of the particle as seen in two dimensions,
 as  in  an  optical  or  electron  microscope
 (Figure A.1-1).

 The size distribution,  using either  the  diam-
 eter (D)  of spherical particles or the projected
 area diameter, is most conveniently described
 as  a  mathematical function C(D) which  is a
 probability density with
                     OUTLINE OF PARTICLE
                FIGURE A.I-1

Illustration of the Determination of the Projected
   Area Diameter, Dp, of an Irregular Particle
             /0°°C(D)dD=1                (1)

One such  function which has been generally
useful   in   describing  aerosol  particle  size
distribution  is  the  log-normal  function  [3]
given by:
 d(D) =
         D/(2ir)lnag
  (InD- lnCMD)2
e	  (2)
       2(lnog)2
 with  In  the natural logarithm,  D the particle
 diameter,  CMD  the  median  diameter of the
 distribution  (count median diameter or geo-
 metric mean), and Og the geometric standard
 deviation of the distribution.

 Other physical characteristics of the  particles
 can be  similarly described.  For example, the
 surface area of the particle  is important to a
 number of particle properties, including dis-
 solution. An areal  distribution with respect
 to diameter might be described as log-normal
 with  an appropriate surface area median diam-
 eter  (SAMD) and ag. If  the  volume or mass
                                               A.2

-------
distribution  of the particles  is being consid-
ered with respect to diameter, these might be
described with appropriate values for volume
median diameter (VMD) or mass median diam-
eter (MMD)  and  respective a g  values.  For
actinides and  other radioactive materials, the
radioactivity  distribution  may  be similarly
described in terms of an appropriate activity
median diameter (AMD).

Use of the log normal distribution function to
describe aerosol property distributions with
respect to size  provides a number of  useful
mathematical transformations, including:

     In VMD = h  CMD + 3(ln eog)2        (3)
     In SAM = In CMD + 2(ln«ag)2        (4)
If the relationships among the volume,  mass
and/or specific activity of particles are known,
Equation 3 can be used to calculate the MMD
or AMD from the CMD and Og.

Aerodynamic  properties  of aerosol particles
depend upon  a variety of physical properties,
including  the sizes and shapes of the particles
and  their physical  densities. When particles
are inhaled, their aerodynamic properties com-
bined with various aspects of  respiratory me-
chanics determine their deposition in the res-
piratory tract,  both in terms of fraction  of
those inhaled  which are deposited and the
location  in  the respiratory tract where  they
deposit.

Two   important  aerodynamic   propeties  of
aerosol  particles  are  the  inertial properties
(describable in terms of  the settling speed
in air under  the influence of the earth's gravity
under normal conditions) and the diffusional
properties (describable in terms of the diffu-
sion  coefficient).

It has been  customary to use an aerodynamic
equivalent diameter  (aerodynamic  diameter,
AD)  to describe the inertial properties of aero-
sol   particles.   The  aerodynamic equivalent
diameter  most  generally used  is  defined as
the diameter  of a  unit density sphere which
has the same settling speed under gravity as
the particle under consideration. Such an aero-
dynamic equivalent diameter is affected by all
the factors (including shape, size and density)
that determine  the  inertial properties of  a
particle. Under Stokes' Law for viscous settling
conditions, the  settling speed of a spherical
particle is given  by:
                                         (5)
                   18n
                                                  and  the aerodynamic equivalent  diameter is
                                                  given as
                                                         'aeri -
                                                                  /C(Daen)
                                         (6)
with Dr  the geometric (or real) diameter of
the sphere,  p its density, C(Dr) its slip correc-
tion,  Daen  the  aerodynamic  diameter  and
C(Daen) the slip correction associated with a
unit density  sphere of diameter
The  slip  correction, C,  is  a semiempirical
factor  that corrects the Stokes'  Law  of vis-
cous resistance for the effect of "slip" between
the air molecules when the aerosol particles
are almost as small  as or  smaller  than the
free  paths of the  air molecules.  The slip
correction  is  approximated  for  spheres  by
with
       C(Dr) = 1 + A
          A=a+$exp
(7)
(8)
with X the mean free path  as gas molecules,
aM.26, g ^0.45 and 8 M.08. At sea level the
mean free path, X, for air molecules is equal
to about 0.0646 ym for air at 21 °C.
                                             A.3

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Another definition for aerodynamic equivalent
which  has proved  useful because of its sim-
plified form is:
                                          (9)
 Daeri and  Daer2 are  nearly equal  (within
 0.1  urn), as approximately given by
      Daen=/[(Daer2.)2+(AA)2]-AX
(10)
where all  dimensions  are in micrometers, X
is the mean free  path of air molecules and
A is a constant equal to about 1.26 (from Equa-
tion 8).

The geometric diameter of spherical particles
can also be calculated from  the  aerodynamic
equivalent  diameter as  approximately  given
by:
- AA
                                          (11)
 All  properties  of the  geometric diameter
 described also apply to the aerodynamic diam-
 eter. For example, one can refer to the count
 median aerodynamic  diameter (CMAD),  the
 mass median aerodynamic diameter (MMAD)
 and  radioactivity  median  aerodynamic
 diameter (AMAD).

 The rate  of solubility of  small, relatively in-
 soluble particles  is affected  by the  physical
 property, surface-to-mass ratio. For  a small
 particle, the surface area is high relative to the
 mass  and  this  greater  relative exposure to
 the solvent will  enhance  dissolution.  This
 effect  can  be  important  in  describing  the
 dissolution  of  inhaled particles deposited in
 the lung.

  Mercer [4]  discussed the importance  of parti-
  cle size   distribution  in  determining  the
  solubility   of  inhaled  aerosol  particles  of
  relatively   insoluble  forms.   According  to
           Mercer, film diffusion kinetics do not control
           the dissolution of  sparingly soluble materials;
           rather, the dissolution rate for a single parti-
           cle is given by:
                         dM
                         dt
                                                                      = -ks
                                                              (12)
                      where M is the particle mass, s is the particle
                      surface area, t is time and k is the dissolution
                      rate  constant of  specific  solubility  which
                      has  units  of  mass or radioactivity dissolved
                      per  unit  time per unit  surface area  of  the
                      particles.  Equation  12 is equivalent to  Equa-
                      tion 13:.
                                      dt
                                 D
                                                   (13)
           where F is  the mass fraction, D  the particle
           diameter and k' a constant equal to kas/pam
           with k the rate constant of specific solubility,
           DS the particle surface shape factor, am  the
           particle mass shape factor and p the particle
           density.

           Unfortunately, dissolution rate constants  for
           various chemical forms of familiar  materials
           are not readily available at this time because
           chemists have customarily described solubility
           in terms of  the equilibrium solubility product,
           which does  not  apply  to   nonequilibrium
           dissolution as described by Equation 12. How-
           ever,  dissolution  rate  constants  have been
           measured   under   certain   conditions   [5].
           Results reported by Raabe et al. [6] indicate
           significant  differences  related to  the specific
           elements as  well  as  differences  between
           238Pu and 239Pu (Table A.I-1) [7].

           Aerosols  usually  consist  of particles with
           widely varying sizes,  such  as  those  which
           might be described with log normal size distri-
           butions.  Such particle dispersions  are called
           polydisperse, to  emphasize  the various sizes
           and types of  particles that  may  be present.
           When an aerosol  consists of  particles of only
           one size, shape and type, it  is referred to as
           monodisperse. A practical  definition of mono-
                                               A.4

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                TABLE A.M.

          172 Reload Fuel Assemblies
              (in g/1000 MW[e])
    Nuclides


      234(J

      235U

      236U

      238U
      238pu

      239pu

      240pu

      241 pu

      242Pu


      Total
BWR
Uranium
7.57 x 10«
8.40 x 105
2.10 x 10*
3.14 x 107





1.15 SCR*
Recycled Pu
4.64 x 10*
5.93 x 105
1.26 x 10«
3.10 x 107
2.03 x 104
2.46 x 105
1.60 x 105
8.98 x 10*
6.92 x 1(H
3.22 x 107
3.22 x 107
 *Self generating recycle assumes blending old plu-
 tonium that has been recycled three times with new
 plutonium formed in uranium fuel rods.
disperse  is  that  the coefficient of variation
of the size distribution does not exceed 20%.
For a log-normally distributed aerosol, this is
about  equivalent  to a
less than 1.2.
      distribution  with a
                        g
Aerosol dispersions also depend for their prop-
erties on  the  state of the medium gas.  Such
environmental conditions as relative humidity,
temperature,  barometric pressure  and  fluid
flow conditions (wind velocity, for example)
will affect the aerodynamic phenomena  asso-
ciated with aerosol particles.

Another property of a given aerosol dispersion
that  can be of great importance in affecting
particle behavior is  the  state of electrostatic
charge. In some cases,  aerosols released in
the  nuclear industry might be expected to
have  a significant  charge  per particle  that
could be  a major factor in determining their
deposition, collection or coagulation.

The  most  basic dispersion properties of aero-
sols are those that relate to the particle concen-
tration  in air  or other gaseous  medium. The
number of  particles per unit volume of gas
(#/cm3) indicates the coagulation rate of the
particles. The mass concentration (mg/m3) and
radioactivity concentration (pCi/2) provide the
quantitative information on which  inhalation
exposure levels may be calculated.

Our knowledge of the specific characteristics
of aerosols encountered within containment
systems for normal  operations  is limited and
that  of  the  characteristics  of  accidentally
released  aerosols is  even more limited.  Elder
et  al. [8]  measured   some  parameters for
aerosols collected from the process or glove-
box ventilation ducts that make major contri-
butions to overall activity concentrations inci-
dent  on exhaust HEPA filters. They found  a
spectrum of aerosol  sizes. A plutonium recov-
ery plant  yielded aerosols in  which over 70%
of the particles were under 1 //m AD; a fabri-
cating plant produced aerosols in which over
50% of the total activity was associated with
particles in the 1-5 ym AD range; and research
and development facilities produced a  broad
spectrum  of  particle sizes, usually in the 1-2
pm AD range (Table  A.I-2).

Raabe et al. [6] recently evaluated the aerosols
present in a  glovebox during a  plutonium
oxide  and uranium oxide  mixing  operation
and found the Activity Median Aerodynamic
Diameter  to be  1  to  3  /j.m  with  a  ag less
than 2 when the aerosol was drawn through an
electrostatic discharger (Table A.I-3). Prelimi-
nary studies  by Raabe et al. have  indicated
that the plutonium in these industrial aerosols
is much more soluble than laboratory-produced
23<>PuO2.

Mann  and Kirschner  [9]  reported  limited
data  obtained  from a  fire  in  a  plutonium
facility. They measured a Mass Median Diam-
eter of 0.32 pm with  a geometric  standard
deviation  of 1.83 using an  autoradiographic
technique  on  particles collected  15,  25 or
50  feet  from  the   fire. Kanapilly et  al. [10]
reported solubility data on a plutonium aerosol
collected  in  another  accident  and reported
that the plutonium was much more soluble than
laboratory-produced 239PuCh aerosols.
                                              A.5

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                                      TABLE A.I-2.

                         Plutonium Aerosol Size Characteristics [8]

                      Activity median aerodynamic diameter (AMAD)
At
Location — ,
A
B
C
D
E

— %
86
62
92
89
84

of — Observations
77
26
48
18
49
Fall in the Range
— ym — ym
1.0-3.0
1.0-4.0
3.0-5.0
0.1-1.0
2.0-4.0
Geometric Standard Deviation ( a g)
At
Location — ,
A
B
C
D
E

— %
86
81
92
67
71

of — Observations
77
26
48
18
49

Fall in this Range
1.5-3.0
1.5-3.5
1.5-2.5
1.5-4.0
1.5-3.0
                                      TABLE A.I-3.

           Data Summary for Samples from an Industrial Plutonium Glove Box [6]

                    Sample
                     Time              AMAD                                   Cone.
 Day-Run            (min)               (y m)                 °g                 (nCi/l)
                                 I.  IMPACTOR SAMPLES

   2-2                 3               1.70 ± 0.05 S.E.        1.62 ± 0.04 S.E.           25
   3-2                 3               2.26 ±0.11            1.63+0.05              85
   3-3                 3               1.80 ±0.06            1.51 + 0.04              44
   3-4a                3               5.02 ± 0.89            3.20 ± 0.53               2
   3-5a                3               3.80 ±0.32            2.16 + 0.14               1

                                    II.  LAPS SAMPLES

   1-1                 45              1.56 ±0.03 S.E.        1.51 ± 0.02 S.E.           20
   2-1                 60              1.44 ±0.07            1.54 ±0.06              41
   3-1                 90              2.56+0.11            1.70+0.05               8
1 No 85Kr discharger, sample data not used.
                                            A.6

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RESPIRATORY TRACT STRUCTURE AND
FUNCTION*

Basic Anatomy

Many anatomical features  of  the respiratory
tract influence deposition  and  retention  of
inhaled  aerosols, including  lung volume, alve-
olar  surface  area, and  structure and  spatial
relationships  of conducting airways and alve-
oli. The distribution  of  radiation doses and
effects of the inhalation of radioactive aerosols
depend  on the characteristics  of  the aerosol-
emitted   radiation  and  upon  the  deposited
particles' proximity to the cells  at risk.

The  respiratory tract may  be considered  as
having three  major regions: the  nasopharyn-
geal,  the tracheobronchial, and the pulmon-
ary. The nasopharynx filters out large inhaled
particles and  is the region  in which the rela-
tive humidity is increased and the  temperature
of the air is moderated. The trachea, bronchi,
and  bronchioles serve as conducting airways
between the  nasopharynx and alveoli, where
gas exchange occurs. The conducting airways
are lined with ciliated epithelium and coated
with a thin sheet of mucus. In addition to con-
ducting air to the regions of gas exchange, the
airways increase  the  relative humidity of air
and  moderate its temperature. The surface of
the airways serves as a mucociliary escalator,
moving particles  from the deep lung to the
oral  cavity so  that they  may be swallowed.
The  branching patterns  and physical  dimen-
sions of the airways are critically important in
determining deposition of particles in the lung.
They can be  best demonstrated by a plastic
cast of the airways (Figure A.I-2).

An early model describing the physical  dimen-
sions of the  airways  was developed by  Fin-
deisen  [11].  These early  data  (Table A.I-4)
were based more upon air flow considerations
than anatomical measurements.  Landahl [12],
Davies [13] and Weibel [14] followed Findeisen
with improved anatomical models based upon
symmetrical airway branching. Weibel's model
i« shown in Table A.1-5.
                                                                  FIGURE A.I-2

                                                     Front View of Human Lung Cast Trimmed Down
                                                         to the Level of Respiratory Bronchiole
*Prepared   for  the   Committee's  use   by
R. O. McClellan and the staff of the Inhalation
Toxicology Research Institute'
                                            A.7

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                                            TABLE A.M.

                               Model of the Human Bronchial Tree [11]
                 Region
      Trachea
      Main Bronchi
      First Order Bronchi
      Second Order Bronchi
      Third Order Bronchi
      Terminal Bronchi
      Respiratory Bronchioles
      Alveolar Ducts
      Alveolar Sacs
      aTotal surface of the spherical alveolar sacs.

Number
1
2
12
100
700
5.4 x 10*
1.1 x 105
2.6 x 107
5.2 x 107
Diameter
cm
1.3
0.75
0.4
0.2
0.15
0.06
0.05
0.02
0.03
Length
cm
11.0
6.5
3.0
1.5
0.5
0.3
0.15
0.02
0.03
Total
Cross-Section
Area, cm2
1.3
1.1
1.5
3.1
14
150
220
8200
(147,000) a
                                             TABLE A.I-5.

                       Weibel's Model of Regular Dichotomy [14] (Average Adult Lung
                           with Volume of 4500 mg at about 3/4 Maximal Inflation)


Region
Trachea
Main Bronchus
Lobar Bronchus

Segmental Bronchus


Bronchi with
cartilage in wall


Terminal Bronchus

Bronchioles with
muscle in wall

Terminal Bronchiole
Resp. Bronchiole
Resp. Bronchiole
Resp. Bronchiole
Alveolar Duct
Alveolar Duct
Alveolar Duct
Alveolar Sac
Alveoli
Genera-
tion
z
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23

Number per
Generation
n(z)
1
2
4
8
16
32
64
128
256
512
1,024
2,048
4,0%
8,192
16,384
32,768
65,536
131,072
262,144
524,288
1,048,576
2,097,152
4,194,304
8,388,608
300,000,000

Diameter
cm
1.8
1.22
0.83
0.56
0.45
0.35
0.28
0.23
0.186
0.154
0.130
0.109
0.095
0.082
0.074
0.066
0.060
0.054
0.050
0.047
0.045
0.043
0.041
0.041
0.028

Length
cm
12.0
4.76
1.90
0.76
1.27
1.07
0.90
0.76
0.54
0.54
0.46
0.39
0.33
0.27
0.23
0.20
0.165
0.141
0.117
0.099
0.083
0.070
0.059
0.050"
0.023
Total Cross
Section
cm2
2.54
2.33
2.13
2.00
2.48
3.11
3.96
5.10
6.95
9.56
13.4
19.6
28.8
44.5
69.4
113.0
180.0
300.0
534.0
944.0
1,600.0
3,220.0
5,880.0
11,800.0

Total
Volume
cm3
30.50
11.25
3.97
1.52
3.46
3.30
3.53
3.85
4.45
5.17
6.21
7.56
9.82
12.45
16.40
21.70
29.70
41.80
61.10
93.20
139.50
224.30
350.00
591.00

Accumul.
Volume
cm3
30.5
41.8
45.8
47.2
50.7
54.0
57.5
61.4
65.8
71.0
77.2
84.8
94.6
106.0
123.4
145.1
174.8
216.6
277.7
370.9
510.4
734.7
1,084.7
1,675.0

aAdjusted for complete generation.
                                                  A.8

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The acinus is the basic functional unit of the
mammalian  lung and the primary location of
gas exchange  between the environment  and
blood. Anatomically,  the  acini consist of the
structures distal to  and  including  the  first-
order  respiratory  bronchiole, which is  the
first  bronchiole with  alveoli.  The  acini, of
which  there are about 200,000 in the adult
human, include 3 or 4 orders of respiratory
bronchioles, several  orders of alveolar ducts
and  alveolar sacs,  hundreds  of alveoli  and
associated  blood  vessels, lymphatic tissues,
supportive tissues and nerve enervation.  Air-
containing portions of the acinus are depicted
in Figure A.I-3  from reference to published
drawings  [15-17] and from  examination of
replica casts of the human lung [18]. Quanti-
tative anatomical information  for these  struc-
tures includes estimates of airway tube num-
bers,  diameters, lengths, alveolar  numbers
and diameters, surface areas and mean thick-
nesses  for the  air-blood barrier [13,14,19-23].
Variations in the acini from individual to indi-
                FIGURE A.I-3

      Air-Containing Portions of "the Acinus
vidual  and  from species to  species  during
growth, during breathing, and in healthy and
unhealthy  states have been described quanti-
tatively by  a number of authors [24-30].

Respiratory bronchioles are tubular structures
with  diameters  of about  0.5 mm  and lengths
of  about  1.0  mm  in the  adult man  [15].
Bronchioles are lined with low cuboidal epi-
thelium and  at times with ciliated epithelium.
Their walls contain collagen, smooth muscle,
and  elastic fibers, but no  cartilage,  which
makes them  quite distensible. One or  more
alveoli open to their  lumens along one side
while the other side  is relatively smooth and
in contact with  branches of the  pulmonary
artery. In man, the  number of alveoli open-
ing into the lumen  increases with each  sub-
sequent divison [15-17,20,31,32].

The  alveolar ducts and sacs  are thin-walled
tubes, literally  covered  with  alveoli on all
sides.  In adults their diameters  are  about
0.5 mm  and lengths  are  about 0.7 mm  [15].
Alveolar sacs, which are clusters of two or more
alveoli terminating in one or more alveolus,
branch from  alveolar  ducts and are essentially
closed-end versions of ducts. The total number
of alveolar ducts and  sacs in man is estimated
to be about 10-25 million [13,14,33,34].

Alveoli  are thin-walled,  polyhedral pouches
with  one side open  to  either  a  respiratory
bronchiole, alveolar duct or alveolar sac. Thin,
squamous  pulmonary  epithelial  cells  form
most  of the continuous  inner lining of the
alveolus. More  rounded septal cells  are  also
located  within  the  walls  and  free  motile
phagocytic cells often lie  in contact with the
inner surface of the alveolus. A dense capillary
vascular  plexus covers the  alveolus  [31,35].
In man, the number of alveoli increases rapidly
after  birth  until about 8 years of  age  [24,30],
when approximately 300 million  are  present.
The value  of 300  million  alveoli  in the  adult
man is consistently reported, although recent
estimates have ranged from 100 million [22]
to over 500 million [13,36].

The  alveolus  of the  adult  human, though
not strictly spherical,  has an equivalent diam-
eter  of about  150-300 ym [13,14,21,22,24,37].
                                             A.9

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The values of 250-350 ym given by Weibel [14]
are  probably  the  most  realistic.  Alveolar
dimensions vary with degree of lung inflation
[38-40] and with their vertical positions within
the thorax [41].

The total  surface area of the alveoli  in the
adult man was  reported by  Von  Hayek [37]
as 35 m2 during expiration and 100 m2 during
deep inspiration. Weibel [14]  reported  70-
80  m2 at about  3/4 total lung capacity. The
alveolar  surface  areas for several mammals
are given by Tenney and Remmers [42].

The  thickness  of  the  air-blood  barrier  is
variable,  even  for  an  individual  alveolus.
Weibel [43] summarized values for man from
the work  of Meessen [44] as -follows: endo-
thelium,  0.02-0.4 jum;  basement  membrane,
0.11-0.16  Mm; alveolar epithelium, 0.04-0.065
urn;  and  total thickness,  0.36-2.5  Mm. Tissue
thickness  between  adjacent  alveoli  is deter-
mined  by thicknesses of the  alveolar  wall,
basement membrane,  interstitium  and  any
interposed capillaries. Weibel estimated that
the capillary  diameter  is 8 /im and that 90
to 95% of  the alveolar  surface  is  covered
by capillaries. Based on these data the mean
tissue thickness  between adjacent  alveoli  is
about 9 Mm.  However,  Weibel may be over-
estimating the  abundance   of  the  alveolar
 capillary network.

 Lung Cytology

 In addition to its major role as an organ for
 external gas exchange, the lung  also performs
 numerous nonrespiratory  functions [45],  A
 variety of cell types and systems are required
 to perform these diverse physiologic functions.
 One author [46] has listed  well over 40 cell
 types as identified  by  ultrastructure,  not  in-
 cluding the circulating corpuscular elements
 of  blood. Although  some  of  the cell  types
 are  unique to  the lung, many  are  present
 elsewhere within the organism.  These include
 17 types of epithelium, 9 types of unspecified
 connective tissue, 2 types of bone and  carti-
 lage, 7 types of cells related to  blood vessels,
 2  distinctive types of muscle  cells, and 5
 types associated with the pleural or nervous
tissue elements. The cells of greatest interest
are those that are  unique to the respiratory
tract, such  as ciliated  bronchial  epithelium,
nonciliated   bronchiolar  epithelium   (Clara
cells),  squamous alveolar  (type I)  pneumo-
cytes,  great  alveolar (type  II)  pneumocytes,
and  alveolar macrophages. In addition, three
other cell types are of special interest:   endo-
thelial cells  and interstitial  cells (fibroblasts
or fibrocytes), which  comprise the greatest
percentage  of total cells present; and lining
cells of the trachea and bronchi, which com-
prise only a  small portion of the  mass of the
total  respiratory tract.  These latter three cell
types are extremely susceptible to various types
of injury.

Ciliated Tracheobronchial Epithelial Cells

The  ciliated  tracheobronchial  epithelial cells
are  the  predominant  cells  in the trachea,
bronchi  and  bronchioles down to  1  mm  in
diameter, where they outnumber goblet cells
5  to 1. In the smaller airways they become
more  cuboidal  and smaller  and  decrease  in
relative number. As the terminal bronchiole
diminishes  in  diameter and terminates  into
the  respiratory bronchiole,  the cilia-bearing
cells gradually disappear. These cells are poly-
gonal and extend  from the  basal  lamina  to
the  lumen.  About  500 cilia  are  present  on
each cell.

The ciliated epithelium functions to move a
fluid film, and  thus particles that deposit on
it, from  the  lung to the nasopharynx [47-49].
Direct observations have shown that transport
rates in the trachea or large bronchi in several
species range from 1  to  3.5  cm/min.  Thus,
mucociliary  transport  is capable  of cleaning
inhaled particles from the conducting airways
in a few hours.

A number  of cytokinetic studies of airways
have revealed a turnover time in the bronchial
epithelium  of 7 to 28 days in both  mice and
rats [50,51].  The turnover times of  the bron-
chioles  were  generally  longer.  One  study
 identified specific  cell types  in  the  bronchi
and  determined that  the ciliated cell in  the
 rat has a turnover time of about 130 days [53].
                                             A.10

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Nona/fated Bronchiolar Cells (Clara Cells)

Nonciliated bronchiolar cells are present only
in small bronchioles and usually can be identi-
fied  with  light  microscopy by their bulging
into  the bronchiolar  lumen, by the absence
of cilia, and by the presence of apical cyto-
plasmic granules  identified  as  peroxisomes
[53,54].  The ultrastructural  characteristics  [53]
reveal  the  presence  of plasma  membranes
that  form  complex interdigitations,  including
desmosomes,  with adjacent epithelial  cells.
The  general cytoplasmic features correspond
to those of most secretory cells.

The  cytochemistry of  Clara cells [53-56] shows
that  lipids are present  in  cellular  organelles
in the form of bound lipids and probably as
phospholipids. These,  in turn, are firmly bound
to a  nonlipid  component, probably protein
in nature.  Enzyme histochemical studies  have
shown  high activities of  oxidative enzymes
[55-57] and the presence of acid phosphatase,
alkaline    phosphatase,    and   nonspecific
esterase [56].

The  function of the Clara cells is not known,
although   ultrastructural   and  cytochemical
evidence indicates that they are  metabolically
active, probably  secretory  and  have charac-
teristics  like  merocrine-type  secretory  cells
[53].   It has  been  suggested [58]  and  later
supported  [55] that Clara  cells produce pul-
monary surfactant. However,  there is also  a
considerable body of evidence which supports
the  premise  that pulmonary  surfactant  is
largely  a  product of  alveolar type  II cells.
Recently it has been proposed that  Clara cells
are the source of the hypophase (base layer)
components of the  alveolar lining layer, as
opposed to the surface  film (superficial layer)
containing  the surface-active  phospholipids
[53].  Another  suggestion  is that  Clara  cells
supply surfactant for bronchioles [59].

Type /  Pulmonary Epithelial Cells (Squamous
Alveolar, Membranous Pneumocyte)

The surface of the pulmonary alveoli is largely
covered by the continuous exceedingly atten-
 uated  (0.1-0.2 ;um) cytoplasm of the squamous
 epithelium, which has nuclei resembling those
 of capillary endothelium. This cell  is located
 on  the epithelial side of the basement mem-
 brane  and, together  with  the type  II  cells,
 completely  lines the  alveolus. The junction
 between the type I and type II cell is "tight",
 forming a  zonulae  occludens.  The  surface
 area of the type I  cell has been calculated
 as 2290 /urn2 and that  of type II as  63 ;um2.
 Thus, even though the ratio of type I to type
 II  cells in the alveolus is  40:60, the type I
 cell  makes up  most  of the  barrier of  the
 blood/gas pathway [60].

 The  cytoplasm of type I cells is barely visible
 with light microscopy and is equally unimpres-
 sive  with  electron microscopy because  of its
 sparseness  and   paucity  of organelles  [61].
 Except for pinocytotic vesicles, the cytoplasmic
 extensions are practically devoid of organelles
 except  those concentrated in the perinuclear
 cytoplasm.

 The squamous alveolar cells function as a  path-
 way  for  gas  exchange. Although  they  are
 relatively  inactive  metabolically,  as  shown
 by  cytochemistry and electron  microscopy,
 much activity  must be involved in maintaining
 the membranes of such a large cell. Because
 they are in close contact  with the environ-
 ment,  the squamous  alveolar  cells serve  as
 the major epithelial barrier. Transport across
 the squamous epithelial cell is  presumably by
 the pinocytotic vesicles [62]. Squamous  alve-
 olar cells have also been credited with phago-
 cytic  abilities under  certain  circumstances,
 both for substances from the blood [63] and
 from the alveolar lumen [64].

 Type II Pulmonary Epithelial Cells (Great
Alveolar, Granular Pneumocyte)

With the light microscope type II pulmonary
 epithelial  cells are cuboidal. They are usually
 located in corners of the alveoli. The  nucleus
 is spherical and the  cytoplasm  abundant with
 vacuoles. Great alveolar cells from a number
 of species  have  basically  similar  ultrastruc-
 ture [65-67].  The  cytoplasm   has a  loosely
                                            A.11

-------
ordered  granular  endoplasmic reticulum, an
extensive Golgi apparatus, numerous  multi-
vesicular bodies and many large osmophilic
multilamellated   inclusions   or   cytosomes.
Together with  the type I  cell they  line the
pulmonary  alveolus, with  "tight"  junctions
between the cells.  The surface  area of the
alveolus  covered  by the  type II cell  is not
large compared to that covered by the type
I;  11,000 /urn2  versus  259,000 urn2  [60].  The
plasma  membrane of the  type II has charac-
teristic microvilli.

The numerous  cytochemical  studies of  type
II  cells  [65,68-72]  show that they  are  rich
in  oxidative enzymes,  acid  hydrolases  and
esterases and  have peroxidase  activity.  This
indicates that the  glycolytic scheme and the
pentose cycle  are active  pathways  of  carbo-
hydrate  metabolism.

Type II  cells are  strongly implicated as  pro-
ducers of pulmonary surfactant. The evidence
is   .cytochemical    [65,70,72],  ultrastructural
 [59,73,74],   autoradiographic  [74-77],   and
functional   [78,79].  The  ultrastructural  and
cytochemical   characteristics  indicate  that
type II  cells are very metabolically active and
are  also secretory. The  formation of the multi-
 lamellated  bodies from multivesicular  bodies
with their subsequent excretion into the lumen
 has been  ultrastructurally determined.  The
 multilamellated bodies and associated enzymes
are  found  at  the  same  time  in embryonic
development of the individual that surfactant
 is first   detected.  Radiolabeled precursors  of
 dipalmityl   lecithin are found to concentrate
 rapidly  in  the  type  II  cells.  Radiolabeled
 leucine  is rapidly  taken up in the endoplasmic
 reticulum and  multilamellar bodies, indicating
 that intracellular  protein  transport  occurs
 and that   the  lamellar  bodies  are storage
 granules.

 Other  functions  of this  cell have not been
 documented;  however, the  type  II  cell  is
 frequently  the  proliferative  cell  in  the repair
 of subtle diffuse  injury to the squamous pul-
 monary  epithelium,   such   as  results  from
 beryllium   and oxygen toxicity  [80-82]. The
type II cells have been classified as a renewing
cell  population  by several  investigators [83],
with  relatively long  turnover  times  ranging
from 20 to 84 days.

Alveolar Macrophages

Alveolar  macrophages are the phagocytic cells
of the lung and  are found free in the alveoli.
With  light microscopy, alveolar  macrophages
in tissue  sections  are  ovoid  mononuclear
cells, 7-10 ^m in diameter. The nucleus  is
5-6 jum in diameter and round, oval or kidney-
shaped.   Macrophages  washed  from  the
lungs  look similar  except they are  larger
(15-25 jum) and flatter and have  more defini-
tive cytologic detail.

Many authors have  described the ultrastruc-
ture of the alveolar macrophage [84-90]. The
most notable features are the numerous single
membrane-bound vacuoles, which are  either
scattered through the cytoplasm or arranged
about the centrosome.  These vacuoles vary
in size, shape, internal structure  and electron
density.  While  some have  a  homogeneous
matrix, others are multivesiculated and still
others are composed of concentric layers  of
osmophilic  membranes.  The  cytoplasmic
membrane characteristically has  many  broad
irregular extensions or pseudopodia.

The cytochemistry  has been well studied by
a number of  authors [65,71,91-94].  Alveolar
macrophages  exhibit  a  high  respiratory ac-
tivity and depend on  oxidative metabolism
for  energy  required  in  phagocytosis.  The
abundant  lysosomes  present  contain acid
deoxyribonuclease,  acid  phosphatase, acid
ribonuclease,  arylsulfatase,  DPN  hydrolase,
 j3 galactosidase,  /3 glucuronidase, /3-N-acetyl-
glucosaminidase,  cathepsin   D,  lipase  and
 lysozyme.

The origin of alveolar macrophages has been
the subject of several recent reviews [93,95,%].
The  relationship of the type II  alveolar cell
and  the alveolar  macrophage has not been
definitively determined.  Recent  work  using
 radiation chimeras and chromosome or enzyme
                                               A.12

-------
markers for determining the origin of pulmon-
ary washout  cells shows that  a majority  of
cells come from  the  bone  marrow [96-99].
A  four-compartment  scheme has been  pro-
posed for the origin and maturation of alve-
olar  macrophages  based  on evidence derived
by following  blood leukocyte counts, number
of macrophages  in  lung  washings  and the
tritiated thymidine labeling  of  alveolar  cells
after  whole-body irradiation [100,101],  The
postulate  is  that  a  stem  cell  in the  bone
marrow produces  a cell  which  travels by the
blood stream to  the  lung interstitium.  Here
the cell  divides,  matures and  then  migrates
to the alveoli as a functional alveolar macro-
phage. Based on the radiographic indices,  it
was estimated that the time from cell division
in the bone   marrow  to arrival  in the  lung
interstitium is about  10 days,  with  approxi-
mately 10 more  days  required for maturation
in the interstitium and arrival in the  alveolus.

Cell  renewal  in the  lung has  been studied
with tritiated thymidine labeling techniques
[102,103]  and   with    colchicine-stimulated
mitotic  indices.  Both  techniques show two
populations   in the  alveolar wall, one  with
a turnover time  of 7 days and another of 28-
35 days.  The cells in  these populations  have
not been definitively  identified but the  7-day
cycle probably is representative of alveolar
macrophages. The 35-day cycle may represent
the type II or, less likely, the type I  pulmon-
ary epithelial  cells.

The  major function of alveolar macrophages
is the ingestion of inhaled particulate material
[104]. Infectious  particles  are  usually  killed
by the macrophages,  except  in some chronic
bacterial and fungal infections, such  as tuber-
culosis,  and in some viral diseases where the
virus  actually replicates in  the  macrophage
[105-107].

The  ability   of  pulmonary  macrophages  to
ingest inanimate  particulates has been docu-
mented many times [48,84,85,108-111]. Direct
semiquantitative  relationships  between the
number of phagocytes washed from lungs and
the amount  of  dust cleared  from  the  lungs
have been demonstrated.

Endothelial Cells

The endothelial  cells form a continuous cyto-
plasmic tube lining the pulmonary vasculature.
They  have thin  cytoplasmic extensions which
originate from a thicker central portion where
the nucleus  is located  and are unimpressive
with light  microscopy.  With electron micro-
scopy [60,61,112] the endothelium shows few
organelles  except for numerous  pinocytotic
vesicles. At the intercellular junctions the two
adjoining  cells become closely approximated
or may interdigitate and overlap.  In  either
case,  a  narrow  cleft   exists  which allows
the passage of small protein molecules  from
the plasma to the extracellular space [112,113].
A  small amount  of  protein is transferred via
pinocytotic vesicles.  The  endothelium of the
alveolar septa is separated from the epithelium
by an  interstitial space of variable thickness.

Cytochemical  studies [57,114,115] show  that
the oxidative enzymes of the pulmonary endo-
thelial cells are similar to those in the type  I
cells and  are  much  less than those in other
pulmonary cells.

The pulmonary capillary endothelium functions
to exchange  gases  and  volatile  metabolites
between the blood  and  air. However, these
cells may also interact with the  blood  that
perfuses  them and  perform  functions  with
significant implications.  For example,  a  lipo-
lytic system in or on  the surface of endothelial
cells may  be the source of  a circulating  lipo-
protein  lipase [116]  and  fibrinolysin  is  acti-
vated by  substances in   or on  the  vascular
endothelium [117]. Five-hydroxytryptamine  is
removed from circulation by pulmonary endo-
thelial cells, as indicated  by autoradiographic
studies [118].

The  pulmonary  endothelial cells  have been
classified as stem-cell,  renewing cell popula-
tions  [83].  The  turnover  time  has not been
determined  but must  be  long, a matter of
years [119].
                                             A.13

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Pulmonary Fibroblast

The fibroblast  is a cell of mesenchymal origin
which is  responsible for production of inter-
cellular   substances  of  connective   tissues.
These are relatively undifferentiated cells and
it  is  probable  that  the fibroblasts found  in
the lung  are similar to those elsewhere in the
body. The young fibroblast, when viewed with
the light  microscope, has abundant cytoplasm
surrounding the nucleus  and less cytoplasm
in the attenuated processes which extend from
each  end, giving  the  cell  a spindle-shaped
appearance. The nucleus  of  the active fibro-
blast  generally has  a  prominent nucleolus
and  is somewhat  elongated and oval-shaped.
Older fibroblasts or fibrocytes tend to have little
or indistinct cytoplasm; often all that can  be
seen  is  a  pale, ovoid  nucleus' with a little
chromatin  encased in  the surrounding con-
nective tissue.

Ultrastructurally, the cytoplasm of active fibro-
blasts is  rich  in rough-surfaced endoplasmic
reticulum and free ribosomes.  Mitochondria
and  lysosomes are also common. The  promi-
 nence of ergastoplasm is clear  evidence for
the secretory  function of this cell and the cis-
ternae  of  the  endoplasmic  reticulum  are
 probably the sites of formation of the secretory
 precursors.  There is  also a  well-developed
Golgi  apparatus.  The secretory  products  are
 extra-cellular   and  represented  by  collagen
 and  intracellular  ground  substances. Pinocy-
 totic vesicles  indicate  active  exchanges  of
 materials between this cell and its environment
 [120].

 In  cytochemical  observations  of  fibroblasts,
 Thompson noted the presence of chondroitin
 sulfates  and hyaluronic acid, both of which are
 generally believed to  be synthesized  by the
 fibroblast. Fibroblasts  also   produce proteo-
 glycans.  Fibroblasts have been demonstrated
 to contain stainable enzymes, including alka-
 line  phosphatase,  beta-glucuronidase   and
 leucine  amino peptidase, but they have been
 shown to be  negative for stainable acid phos-
 phatase. Fibroblasts, when placed  in a mixed
 tissue culture, tend to overgrow other  cell
 types  in the  same culture, to synthesize col-
lagen  [121-123],  and  to extrude  synthesized
procollagen from the cell into the surrounding
media [124].

Functionally, it is  evident  that  the fibroblast
is  an active  cell whose main function is the
production   of  collagen   and  intercellular
ground subtances.  Extensive  work has been
performed on these  functions,  both  in  vitro
and  in v/vo [121,122,124,125].

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                                                   A.18

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                                      APPENDIX  A

                  II.   FACTORS IN DOSE-RESPONSE RELATIONSHIPS
FATE OF INHALED PARTICLES*

A report of the Task Group on Lung Dynamics
of the  International Commission  on Radio-
logical Protection [1] describes models for the
deposition  and retention  of  particles in the
human  respiratory tract. In this  report, the
respiratory  tract  was viewed  as consisting of
three   basic  compartments:  a)  the  naso-
pharynx, b)  the tracheobronchial  compart-
ment, and c) the  pulmonary compartment. The
nasopharynx.  (NP) begins with the  anterior
nares  and extends to the level of the larynx or
epiglottis. The tracheobronchial  (TB) compart-
ment  consists of the trachea and bronchial
tree,  including   terminal  bronchioles.  The
pulmonary  compartment (P)  consists of the
more  distal portions of the  lung  which are
involved in functional gas exchange.

The model  includes estimates of both the frac-
tional  deposition  of  inhaled particles  with
respect  to aerodynamic size and the clearance
of deposited particles from the various regions
of the respiratory tract based on the  particle
properties.  Deposition, defined as the process
which accounts for the amount of inhaled or
inspired material that remains after expiration,
is accomplished by inertia! impaction, gravita-
tional  settling  and  diffusion  by Brownian
movement. Inertial  impaction  is greatest for
particles 5 /nm  and  larger in diameter and
occurs primarily  in  the  NP and TB compart-
ments.  Gravitational  settling,  involving parti-
cles in  the range of 0.5 to 5 /im, is  of some
significance in the NP and TB compartments
but is even more significant in the P compart-
ment.  Diffusion, involving  particles  smaller
than about 0.5 pm, is of great significance for
deposition in  the P compartment and, for very
small  particles, may be the process by which
large  quantities of radioactivity  are deposited
in the N-P compartment.
*Prepared  for  the  Committee's   use  by
R. O. McClellan and the staff of the Inhalation
Toxicology Research Institute
A comparison of the Task Group's deposition
model for inhaled particles with recent experi-
mental  data  from  man  has  recently  been
completed by Mercer [2]. In Figure A.II-1 the
total  body deposition  for two tidal volumes
(solid curves), based on the predictions of the
task  group model, is compared with experi-
mental  data, with  good  agreement.  Fig-
ure A.11-2, which  compares deposition in the
pulmonary compartment  based on  the task
group model to the very limited experimental
data available, suggests that  the task group
model may underestimate somewhat the frac-
tion  deposited in the pulmonary region from
nasal breathing. However, the model provides
a good  working  basis for estimation of the
deposition of  inhaled  particles,  including
alpha-emitting radionuclides.  Mercer's paper
also  presents similar  figures for the nasal and
tracheobronchical regions.

The  retention of  inhaled  particles  in  the
respiratory tract  was also addresssed by the
Task Group  on  Lung  Dynamics  Report [1].
               FIGURE A.II-1

   Total Deposition During Nasal Breathing [2]
                                           A.19

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  0.4
z
o
t
U)
g
g 0.2
            O  O
 OLIPPMAN'S DATA

— TASK GROUP: 750 cm3 TIDAL VOLUME

-—TASK GROUP. 1450 cm'TIDAL VOLUME
                                                              NASOPHARYNGEAL REGION
                 FIGURE A.II-2

     Deposition in the Pulmonary Region During
                Nasal Breathing [2]
 However,  their model has been expanded by
 others  to  include  the retention  of  inhaled
 material in the total body as well as in the lung.
 Figure A.II-3 illustrates the application of such
 a general model to transuranic elements in the
 environment (both  inhalation and ingestion
 exposures) for  man  [3].  The  cross-hatched
 areas represent deposition of very insoluble
 particles (i.e.,  239PuO2) as opposed to moder-
 ately soluble (i.e., 239Pu[NO3]4) aerosols which
 are shown in the open compartments. Percent-
 ages   in   each   respiratory   compartment
 represent  those portions of deposited aerosols
 transferred  by  the  associated pathways,  as
 indicated  by the arrows.

 Paniculate material  deposited in  the respira-
 tory tract must eventually be  cleared either
 through the gastrointestinal tract, through the
 lymphatic system, or by dissolution and absorp-
 tion  into blood.  Clearance  of  the upper
 respiratory tract is very rapid compared to that
 of the deep pulmonary spaces. Nasal clearance
 occurs  within  the  first  hour after particle
 deposition in  man [4] and during the first two
  hours in  dogs [5]. Eating, sneezing and other
  mechanical functions speed nasal clearance,
  either to  the environment or (by  swallowing)
                                                 FIGURE A.II-3

                                   Inhalation and Ingestion Model for Transuranic
                                               Elements in Man [3]
                                 to  the gastrointestinal  tract.  Absorption  of
                                 transuranic elements from the gastrointestinal
                                 tract is considered to be  very small,  ranging
                                 from 2 x 10~5 to 2 x 10~2 of the amount ingested
                                 for plutonium [6]. Radiation damage to  the
                                 gastrointestinal  tract   itself  from   ingested
                                 alpha-emitters (even  in  enormous quantities)
                                 has not been demonstrated [7,8]. Thus the naso-
                                 pharynx protects  the lower  respiratory  tract
                                 regions  from  inhaled alpha-emitting radio-
                                 nuclides by  diverting  particles  to  clearance
                                 pathways,  such as the  gastrointestinal  tract,
                                 that are not likely to be damaged.

                                 Very  similar  considerations apply to  material
                                 deposited in the tracheobronchial tree. Clear-
                                 ance  times for  these deposits, derived from
                                 studies [9]  in  mouth-breathing  humans,  are
                                 shown in Table A.I 1-1. Similar clearance rates
                                 have  been reported  for donkeys [10], which
                                 showed typical  early  clearance  with a  half-
                                 time  of about 30 minutes followed  by slower
                                               A.20

-------
additional clearance  during the remainder  of
the first day. Beagle dogs exposed to insoluble
oxide  or  fused clay particles showed similar
clearance of the  tracheobronchial  deposits
during the first day  following inhalation  [11].
These  cleared  particles  were  subsequently
swallowed and excreted  in  feces. For long-
lived  alpha-emitting radionuclides, radiation
doses delivered to  components of the respira-
tory tract or gastrointestinal  tract during this
short-term clearance are  of  doubtful signifi-
cance,  especially  as  related  to  long-term
irradiation of deep pulmonary structures.

Particles deposited  in  the pulmonary region
may be cleared via the lymphatic  system, by
mucociliary  movement  through the  tracheo-
bronchial  tree,   or   by  dissolution   and
absorption into blood. The relative importance
of each pathway for a  given  aerosol  depends
upon many factors, such as the chemical form,
particle size  distribution,  specific activity and
elemental form. Mercer  [12] suggested  that
dissolution of deposited particles in the deep
lung region  is the major pathway for clear-
ance  and that dissolution rates are directly
proportional  to  the  surface  areas of  the
particles  and  their  chemical   compositions.
Figure A.II-4 illustrates  the potential influence
of  dissolution  on the retention  of inhaled
transuranic   elements   in  the   lung.   Fig-
ures  A.II-5   through   A.II-8  illustrate  the
variability in  retention time in experimental
animals and  man for various forms and  par-
ticle size distributions of some  transuranic
elements.
                  TABLE A.II-1

     Average Bronchial Mucociliary Transit Times
           (90% Clearance) in Humans [9]
       Subjects
                                                         100
  Male (non-smokers)

  Male (smokers)

  Female (smokers)
Clearance
Times
(min)
494
439
324
No.
Observa-
tions
14
15
6
S.D.
(min)
130
156
55
 Q
 CC
 o
 s
 cc
 5
 o
 tr
                2.000      4,000

                DAYS POST-EXPOSURE

                FIGURE A.II-4
6.000
Theoretical Lung Retention Curves for Monodisperse
   Plutonium Dioxide Aerosols of Various Sizes,
  Assuming Lung Retention is Solely Dependent
           Upon Particle Dissolution
ISOTOPE   COMPOUND
13«pu
aipu
ORGANIC
COMPLEXES
NITRATE
FLUORIDE
DIOXIDE
NITRATE
DIOXIDE
                       200  400 600  SOO 1000 1200

                       LUNG RETENTION HALF TIME (DAYS)


                FIGURE A.II-5


   Retention of Plutonium in Pulmonary Region
                 of Lung [13]
                                               A.21

-------
                    - »PuO,
                                                        100
 1000
      1OOO°   360°    450°   123°   900°    760°
      OXALATE OXALATE METAL  METAL  OXALATE OXALATE
                                                                                      2 - 350°C
                          .46     .06     .05
                          1.3      .12     .1
                               1160 DAYS)
                   PARTICLE SIZE./
-------
lung burden per day and may be closer to 0.1%
per day [11]. Differences reported for effective
pulmonary clearance  in the  two experiments
with beagle dogs probably relate to differences
in particle solubility, although  the  effect of
alpha  radiation upon  pulmonary clearance
cannot  be  totally  ruled  out.  Material  that
leaves  lung tissue  by absorption  into  blood
distributes  throughout other  body tissues and
is excreted. For absorbed plutonium and other
actinide elements, ICRP Report 19 [15] suggests
that 45% deposits in liver, 45% in skeleton and
10% goes  into  other tissues or is excreted.
Effective half-times  for  plutonium  in skeleton
and liver were  recommended as 100 years and
40 years, respectively.
PHYSICS OF ENERGY ABSORPTION*

Basic Particle Dosimetry

Whenever  a  charged  particle  traverses  a
medium, it leaves in  its wake a number of ions,
directly  broken molecular  bonds  and, ulti-
mately,  free  radicals   (if  the  medium   is
aqueous).  In  turn,  these free radicals also
break molecular bonds, resulting in  the largest
portion of biologic  effects attributed to such
"indirect" causes.

The path of the particle and the distribution of
the ions and resultant  radicals are determined
by  the  charge,  mass,  and  velocity of the
original particle. Electrons, being of relatively
small  mass and unity charge, produce some 6
ion  pairs/jum  of  path  (an   energy loss  of
210 eV/jum)  when  traveling  with  a velocity
near that of light (say,  for a particle energy of
1 MeV and higher).  However, as the electron
gradually loses energy, the path becomes very
tortuous due to atomic and nuclear deflections.
Also, the rate  of energy loss increases because
of the decreased velocity and increased time
spent in the vicinity of atoms along the  path.
This  loss increases to  about  66 ion pairs/Aim
(2300 eV/j;m)  at an energy of 10 keV, which is
near the end of its range. However, by this
*Prepared   for   the  Committee's   use  by
E. C. Gregg
time, the electron has migrated many hundreds
of micrometers from a co-linear projection of its
original direction.

Thus, for a circular beam of electrons incident
on a given medium, one visualizes a cylindrical
volume  filled  with  a  reasonably  uniform
density of ions and/or free radicals. Consider
a one-square-centimeter,  0.01  microampere
beam  of  5 MeV electrons incident on a water
medium for one second, resulting in a delivery
of 0.01 microcoulomb  of  charge. Thus,  some
6 x 1010 electrons are delivered,  depositing a,
total energy of 5 x 10s ergs. The range of these
electrons  is  about  2.4  cm,  leading to  an
irradiated volume of 2.4  mfi or an irradiated
mass of 2.4 g. Since the  ions are distributed
uniformly due to scattering, this corresponds
to an  energy deposition  of 2 x 10s ergs/g or
2000 rad. The average energy loss is 5 MeV/2.4
cm or 5.6  ip///m, which implies that the end of
the range contributes little to the total loss.

One last  figure of importance is that the total
beam  produces 9 x  1015 ion pairs, which leads
to a spacing of about 0.06 /zm between ion pairs.
This in turn  may be used  to judge  biologic
effects relative to critical biologic structure.
These  considerations for  electrons also hold
for  x-rays or  gamma  rays whose  biologic
actions are due  to electrons produced  by
photon absorption.

Since   alpha  particles  are  some  7200   times
heavier than  electrons,   their  velocities are
much  lower  for  the  same   initial  energy.
Because of this, these  heavy ions at nonrela-
tivistic energies lose energy quite rapidly and
produce  a very dense column of ionization
with very little deflection  from their original
path.   Their  range  is  also relatively   short
because of this high rate of loss along the path.
In addition, due to statistical variations,  there
is about  a 2% spread in  the overall range of
individual  particles  (straggling).  A  5.3  MeV
alpha  particle with a range of 41  jum in water
also has  an  average of  of 129 keV/^m, or
about  3500 ion pairs///m.  However, due to
slowing down (with little deflection) the ion
density increases by about a factor  of  2 for
5 MeV particles at the end of their range. This
                                             A.23

-------
is known as the Bragg effect and is much more
predominant  for  alpha  particles  than   for
electrons.

The alpha particle track is  cylindrical, 90% of
the  ions  remaining  within  a  diameter  of
0.01 /urn. The remaining 10% are recoil electrons
with sufficient energy to  produce  their  own
ionizations (delta  rays). Such ions are present
out to about 0.2  /urn.  This concept can  be
illustrated by  considering a  5  MeV alpha
particle beam of 6 x 1010 particles and an area
of  1 cm2, as for the  electron beam discussed
previously. Since  the number of particles and
the per particle energy are the same as for the
electon beam, the same  total energy of 5  x 105
ergs should  be deposited.  However, because
the range is only 40  jum, a smajler volume is
irradiated, resulting  in  a  dose of  1.25 x 106
rad. To produce the same 2000 rad delivered by
the electrons only 108 particles/cm2 would be
needed,  which  is a spacing of  1  /zm,  on the
average,  between incident particles.  At the
same time, the ion pairs are only about 3  Ang-
stroms apart along the path of the particle.

These calculations of the dose in rad for alpha
 particles  assume  that  the ionization  is  uni-
formly distributed throughout the volume, as
with electrons and x-rays. That this restriction
 does not apply  to alpha particles on the semi-
 microscopic  basis  is  rather  obvious,  as
 discussed above. Furthermore, if the energy of
 one   alpha  particle  were assumed  to  be
 deposited only in the volume of its path, this
 would result in  8 x 10~6 ergs deposited in
 4 x 10-"15 cm3, or a local dose of 2 x 107 rad.

 Radiobiologic Effects

 The   dosimetric  considerations  described
 above illustrate that  the  concept of dose  in
 rad is not applicable to biologic effects where
 the volumes that are  sensitive  to radiation
 (i.e., the cell nuclei)  are small  and far apart in
 the milieu being radiated. It  is well  known
 that the  nuclei  of mammalian cells are at least
 a thousand  times more sensitive to radiation
 than  the cytoplasm [20]. Furthermore, heavily
 irradiating  the cytoplasm  seems to  produce
 prompt  cessation of all  cellular functions,
rather than just a loss of reproductive integrity,
as found  with irradiating nuclei.  Regarding
x-rays,  a dose  of 200  rad to  a  typical  mam-
malian cell (e.g.,  Chinese hamster  fibroblast)
will prevent division (a  genetic or reproductive
death)  half the time. Since typical  masses of
cell nuclei are  2 x 10~10g, this corresponds to
a delivery of 4 x 10"6 ergs to the nucleus, which
in turn is 2.5 x 106 eV, or about 71,000 ion pairs.
It is important  to remember that this energy
is distributed reasonably uniformly throughout
the nuclear  volume and  is  not all  used to
destroy critical molecules.  Furthermore,  the
local molecular damage produced by forming
one ion pair in the vicinity of a  key molecule
may be  slight  enough to allow subsequent
repair or rejoining.

On the other  hand, when  an alpha particle
penetrates the nucleus, the  damage in  the
path of the particle is  very high and repair is
quite unlikely. Furthermore, there is  no oxygen
effect  (enhanced production  of free radicals
in  the  presence  of oxygen)  as with  x-rays.
Thus,  small  doses  of energy  from  alpha
particles as averaged over the whole irradiated
volume  will  produce  the same  effects as
larger doses from electrons. A  relative biologic
effectiveness (RBE)  ranging from 2 to 5  has
been  found  for loss of reproductive integrity
in mammalian cells by 5.3 MeV alpha particles,
which  implies  that 50 rad  due  to an alpha
particle averaged  over the whole   irradiated
volume will cause  the  same damage as 100 to
250 rad of x-rays. Since any one 5 MeV alpha
particle is depositing about 2 x 10~7 ergs/^m
of  path  (which amounts  to  about 4000  rad
when averaged over a cubical nucleus [7 jum x
7 (j.m x 7  jum]), even one particle will produce
"overkill."  This  has  been  shown  experi-
mentally,  in which only a 2 jum penetration of
one alpha particle into a  nucleus of approxi-
mately the size described above was necessary
to kill  the cell [20]. This data on "killing" or
destruction of reproductive integrity by alpha
particles can be explained  on the  basis  that
50  rad  corresponds to a  spacing  of 7  //m
between  alpha particles.  This means that on
the average a 7 jum-square nucleus will be hit
by  an alpha  particle just a little  over half the
time.
                                              A.24

-------
Thus, instead of referring to dose in rad when
dealing with  alpha particles, we should more
properly consider  the  probability of a  cell
nucleus being struck by such a particle.

Lung Model and Cells at Risk

To consider the lung, which is of  immediate
concern in the "hot particle" problem, assume
the  pieces of  radioactive  material  are small
enough (about 1 jum) to become trapped at any
point in the lung and subsequently to radiate
alpha  particles  in  all  directions.  While  the
bronchial epithelium is probably more suspect
than the alveoli as the tissue at risk, the follow-
ing model  of the  epithelium in the alveoli is
assumed to approximate the bronchial epithe-
lium equally well.

An alpha  particle  that will traverse 40 /urn of
solid tissue will obviously travel much further
in the less dense lung tissue, as the range varies
inversely with  the density  (p).  In addition,
even though  the  total  mass traversed  along
one  path  remains a constant, the number of
cells within the increased volume determined
by the  range will  be greater. The irradiated
volume (v) varies inversely as the cube of the
density while the  total  mass irradiated  varies
as pv or 1/p2. Since the density of the actual cell
does not vary, the number of cells at risk must
vary as 1/p2.

Because the density of lung tissue changes
during breathing, a number of different values
are  reported in  the   literature  [21]. If  the
average lung (for  men and women) weighs
1000 g, has  a residual  volume of  4.0 I,  and
inspires about  1  Ł  under  light exercise, a
minimum density  of 0.2 g/cm3 is produced at
reasonable inspiration and a maximum density
of  0.25 g/cm3 at expiration.   Rather  than
average the  density at this  point, it will  be
more correct to average the cells at risk later
in the calculations, even though the difference
is small.

Microscopic examination of lung tissue shows
that about 1/3 of  the  tissue traversed  by an
alpha particle located in  an alveolus consists
of epithelial  cells;  the  rest of the tissue mass
 consists  of  blood,  plasma  and  connective
 tissue. In spite  of  the fact that the cells are
 very  irregular  and  widely   dispersed,  the
 volume of the cells and  the  projected  cross-
 sectional  area  of  the  nuclei are  of  more
 concern. These are assumed to be 1500 /urn3 and
 10  jum2, respectively, for typical epithelial cells.
 The average cell, if forced into a cubical shape,
 is 11  fjtm  on a side; if spherical, it is 14 //m in
 diameter. From the previous discussion,

    alpha  particle range (cm) = R = 4 x 10~3/P

    lung volume - V(cm3) = 4500 + 500 sin Wt

    angular respiratory frequency - W
                 = 27r x respiratory frequency

    lung density (g/cm3) = P
                       = 1/(4.5 + 0.5 sin Wt)

    mass of tissue within R = M(g) = 4frR3p/3

                           _ 8 x IP"7


    number of epithelial cells within R = N

                =  M/(3) (1500) x 10-12 = ~

 To find the average number of cells at risk due
 to breathing we must average N:
  Ndt
               2VW
               2TT/W
                      Ndt
  sow  r Z7I/vv
= -T-/        (4.5+ 0.5 sin Wt)2 dt
   *• J 0
and evaluating,
where p is the linear average of the excursion
due to breathing. Thus weighting the influence
of breathing on the lung density only produces
a 1% correction, which is negligible.
                                            A.25

-------
Using  the originally assumed  value for cell
size,

    N = 1240 cells

    R = 4x10Vp"=182Mm

This yields an average volume of lung tissue per
cell of 20,000 jum3, or one cell  in a box 27  urn
on a side.

Probability Considerations

While the above calculations imply that six cells
can  occur sequentially  along a 180  urn path,
only three or four such cells can be penetrated,
since  these  would  completely  absorb  the
energy  of one alpha  particle.  Furthermore,
since  the total effective  tissue  path is  still
40 um, of which only 1/3 is cells, it follows that
on the average only one cell  will actually be
in the  path of an  alpha particle,  but  the
number  hit  can vary between  zero  and three. •
Since  the nucleus is the critical target and it
presents  an area of 10 jttm2  to any  incident
particle,  it would follow that  the probability
of not hitting a nucleus is 1 -  0.014  = 0.986.  In
a 180  urn path there are  roughly 7 (180/27 =
6.6)  possible   positions  of nuclei,  on  the
average.   The   probability  of   not hitting  any
 nucleus  in the total path is (0.986)7 = 0.9; the
 probability of hitting one or more nuclei with
 at least one particle in  the total path is 1 - 0.9
= 0.1.

 One pCi of activity will  emit 0.37 particles/
 sec or 3.2 x 10" particles/day.  Considering the
 calculations above,  we see that if Q  is the
 activity in picocuries of any one source located
 in the alveoli,  D days will be  required on the
 average  to sterilize all 1240  epithelial cells
 within the range of the alpha particles as given
 by QD  = 1240/(3.2 x 104)  (0.1)  = 0.4. This is
 plotted in Figure A.II-9. While  a few cell nuclei
 in the critical volume are hit by more than one
 particle,  delivery times longer  than  D days
 for a given Q simply mean that nearly all  cells
 will be  hit  more than once (overkill region).
 Times  shorter  than  D  days obviously lead  to
 underkill, as shown.

 Since estimates of  cell turnover in the  lung
 range  from 5  days to 80 days, even with cell
      u>
      0.1
      0.01
      0.001
                             OVERKILL REGION
               UNDERKILL REGION
        0.1
                    LO
                               10
                                           100
                       TIME, d


                FIGURE A.II-9

    Time Needed to Sterilize all Epithelial Cells
turnover the effects  of this type of radiation
in terms of  epithelial cell  death will  be the
same for  activities  above   about 0.005 pCi,
as shown  by the graph. There is no reason
to suspect a precipitous change in the biologic
effects at or near 0.07 pCi, as  has  been sug-
gested on  the basis of dose (in rad).  In fact,
this  target  treatment states  that if turnover
is neglected, two plutonium  particles  of a
given activity  located  at different points in
the  lung  will sterilize  twice  as many cells
as one  particle containing  all  the  activity.
While this effect  has been found  to  hold
approximately  for tumor  production  in  rat
skin  [22], extrapolation  to  lungs is  not war-
ranted because of turnover, particle migration,
and dependence of initial distribution on parti-
cle size. Nevertheless, there is  no apparent
reason to  support the concept  of increased
risk with particle activity above a certain level
(-vp.005  pCi).

Irradiation  of Rat Skin—Epithelial Cells

Albert et  al. [23] found that  irradiating the
skin   of  rats  with alpha  particles  produced
tumors  of  the hair  follicles only  when the
range was  0.35 mm or larger. Neither 0.12 mm
penetration  by alpha particles nor 0.16  mm
                                               A.26

-------
penetration  by protons produced any detec-
table tumors. Similarly, 0.2 MeV electrons did
not produce tumors but 0.7 MeV  electrons
did [24].  Since  the papilla  which  produces
the cells  for  the medulla  of the  hair,  the
cortex, the cuticle and the internal root sheath
is  located  at  this depth, it  is most suspect
as the primary  site of the  induced tumors.
(Even  though many of these  cells were in the
telagen  phase, they are  capable  of  rapid re-
generation.)  Some  tumors  also  apparently
arose from the sebaceous gland located further
up  the  hair shaft,  but  these also depended
upon  penetration  of  the radiation  beyond
about 0.35 mm.

It was also observed that no higher production
of tumors  was noted  when  the Bragg peak
(x5 in  dose in  rad) was located  at  or  near
the papilla. The  authors interpreted this to
mean that the whole follicle must be irradiated
to induce a tumor; it  also  seems logical to
accept this as proof of the single particle "hit"
hypothesis, which says that a single  ionizing
event is sufficient to cause a tumor.

Finally,   and   most   interestingly,   it   was
observed  that  no  tumors originated in  the
heavily  irradiated  epithelial  cells  between
the hair follicles. Data [25] on the epithelial
cells in the basal layer  of the  skin  indicate
a population density in normal mouse skin of
1.4 x  106 cells/cm2. This leads to  a  cell  area
of about 100 jum2 or a cell size of about 10 ^m
on  a  side, which is close to that measured
for most epithelial cells. Furthermore,  the
average nucleus is about 3 nm x 3 Aim, which
produces  a cross-sectional area of about 10
jum2. The alpha particle density used by Burns,
Albert and  Heimbach  [26]  was  lOVcm2, or
1 particle//um2, for a calculated  dose of 520
rad. This is  a density of approximately 10
alpha particles per nucleus. If x is the average
number of primary ionizations per target, then
e'x is the probability that no primary ioniza-
fions will  occur  in  the target. It follows  then
for x =  10 that the number of nuclei  not
struck  by an  alpha particle  is Ns  = (1.4  x
106)e-io  = 60 nuclei/cm2.  From Withers'  data
[25],  1300  rad of x-rays to the  mouse skin
will  leave  60  survivors per cm2, which leads
to an  RBE of 2.5 for  the  killing of epithelial
cells by  alpha particles  if  one  measures the
dose in rad as averaged over the whole irradi-
ated volume.  This is reasonably close to RBE
values reported  for reproductive  death and
other biologic effects produced by alpha parti-
cles [26].

In  passing,  it  is  interesting  that  Withers
reported that  10 to  20 surviving  epithelial
cells were  capable of preventing ulceration
by proliferating to cover a  1 cm2  area during
a 10-day postirradiation period. A most impor-
tant  point  in  the alpha particle experiments
by Albert et al.  [23] is  that all doses delivered
to the  rats killed  about  106 epithelial cells
each.  Since  6  cm2 were  exposed  per  rat
and 210  rats  were irradiated, then about  109
cells were killed without producing one tumor.
Thus  the  chance  that one alpha  particle
passing through  one  epithelial  cell will pro-
duce a tumor  is less than one in 109, assuming
that  the probability of producing a  tumor
is proportional to the  number of  cells  irradi-
ated.  This  is equivalent to assuming tumors
result  from  "near"  misses  which  in  turn
produce  appropriate  genetic changes.   Since
a 5.3 MeV alpha particle  in the  lung, will,
on the average, penetrate only one cell, the
probability  of its  producing  a  tumor is less
than 10~9 if the lung epithelial  cells are like
those in mouse skin.

Applying these  findings to  the hot particle
concept, the probability of producing a tumor
near such  a  particle  is  less than  1.2 x 10"6.
Furthermore,  this probability is not dependent
on the activity of the  plutonium oxide parti-
cles, since  for the ranges  discussed no  more
than  1200  cells will  be  killed  per  particle.
Only  the  number of  particles  is  important.
Also,  if  the  density or proximity of similar
cells  is  important  in  tumor formation, the
above  probability limit becomes even smaller
since  the epithelial cells in the skin are much
closer together than in  lung tissue.
                                             A.27

-------
Irradiation of Rat Skin—Hair Follicles

Tumor production in hair  follicles has been
considered as a model for  tumor  production
in the lungs. Even though no structure in the
lungs corresponds to the papilla in  the  skin,
the  epithelial cells  in the  alveoli appear to
be similar in tumorigenicity to the potentially
dividing   cells  in the papilla.  This  can  be
partially  explained on the basis  that the cells
in the bulb of the hair follicle are an epidermal
derivative [27].

The bulb of an  average hair follicle in the
rat is  about 100 ^m in diameter and 150 nm
long, while the  average  cell in  the  papilla is
quite  similar in  size to the  epithelial  cells
described above [28]. Although  not all of the
bulb consists of potentially  dividing cells, cells
with measurable mitotic indices  have  been
found in the root  sheath  extending 170 Mm
upward   from  the  papilla.  Thus  the typical
bulb can be approximated by a sphere 100 ^m
in diameter filled  with  about  1000 closely-
packed, potentially dividing cells.

There are  2500 follicles involving a total of
2.5  x 106 cell per cm2. This means that for an
 incident alpha  particle  dose  of 108/cm2 (520
 rad),  about  100 surviving cells  should  be
distributed  among  2500  follicles.  Even if one
 surviving cell could regenerate  a  follicle, just
 as one  epithelial cell can regenerate mouse
 skin [25], this would account for only  a 4%
 follicle  survival  compared  with an  observed
 85%. The implications, of course, are:  1) that
 many more  cells  are involved  in  a follicle
 than  is  assumed above, 2)  that  active  cells
 migrate from unirradiated  volumes to reform
 follicles, and/or 3)  that  wholly  killed  follicles
 appear  "normal" due to  the fact that  most
 of  the  cells remain in  a  resting phase and
 are  not challenged  to  divide. The latter  is
 probably the  most  acceptable  explanation.

 More importantly,  the alpha irradiation data
 indicate that one tumor is induced  per 9000
 abnormal hair  follicles, or  one tumor per 6 x
 104  equally-irradiated hair follicles.  Further-
 more, for  any  of   the  doses used  in  these
experiments,  virtually   all  the   potentially
dividing cells in each follicle bulb are "killed"
or rendered incapable of division. Thus, if we
assume that 1000 closely packed cells or some
fraction thereof  must be rendered reproduc-
tively inert to form a nidus for a tumor, then
tumor production should not depend on dose
in these  experiments. Since it obviously does
depend  on  dose,  the  assumption  of  the
necessity of a core  of sterilized cells to pro-
duce a tumor is not valid [29].

It is  much  more reasonable to assume that
the probability of producing a tumor is simply
proportional to the  total  number of sterilized
cells, since this  will also  be  a measure  of
near  misses that  may create the  appropriate
genetic aberrations.  The  above  example indi-
cates that for 1000 cells per  follicle,  there
should be a chance of  creating 1  tumor  per
6 x 107 sterilized cells. This leads to a probab-
ility of (1/6.) x 1(T7 = 1.6 x KT8 that  a 5 MeV
alpha particle in the lung will produce a tumor
(assuming, of course, that the epithelial cells
in the human lung are identical  to those in
the  rat skin papilla). Thus, for the plutonium
oxide particles  that kill  at most 1200 cells
per particle, the  probability of tumor induc-
tion is about 1 in 50,000 per particle, regardless
of its activity.

While this  value is much greater than that
observed in either animals or  man [30], most
important is  that this  model  says that uni-
formly distributed activity has a much greater
tumorigenicity than that concentrated  in  a
hot  particle.  The probability  that  a 0.1  pCi
particle  will  induce a  tumor in  lungs con-
taining  cells  like those  in rat skin  papilla
increases from  zero to  2 x 10~5  in 4 days,
after which  it remains constant. If that same
activity is  uniformly distributed in the  lungs,
then the chance  steadily increases with time,
 becoming 2  x  10~4 at  4 days and  5  x  10"3
at  100  days.  This  illustrates  an  important
 difference between  irradiation by hot particles
 and  uniform  distribution of radiation.  In the
 former, for a fixed cell population, the chances
 of tumor production remain constant because
 all viable cells in the vicinity of each particle
                                              A.28

-------
can  be  "killed"  only once.  On  the other
hand, with  uniform distribution the chances
of tumor production increase with  time since
cells  are being  continuously  "killed".  Cell
turnover and  possible particle migration  may
change  the picture, but only slightly. How-
ever,  if  for  no  other reason  than  the  fact
that observable rat  skin tumors appeared as
early  as  30 days after irradiation,  it is most
unlikely  that there are cells of this type and
sensitivity in  the  human and/or dog lungs in
which  the latent period for lung  cancer  is
several years.

An exercise  of interest is  to  determine the
area of  a possible single hit target for  tumor
production  in  the  rat  hair   follicle.  If  A
represents the target area  and D the dose in
particles/unit  area,  then  AD is the average
number  of  primary events occurring  in the
target. As before, the  probability that a target
will  not be  hit  is e'AD,  producing for the
number  of survivors NS -  Noe~AD. From this
we see  A =  I/Da?, where Dn is  the dose
required to reduce Ns  to 0.37 No.

In  the  data  shown in  Figure  A.II-10 (from
Heimbach et al. [31]) the percent of abnormal
follicles is plotted against dose (in rad). Since
the number of  tumors is  directly  (and  lin-
early) related  to the  number of  abnormal
follicles,  one minus the percent of  abnormal
follicles  is a  measure  of the number of  sur-
vivors  (i.e., those that do not  get  tumors).
A plot of Ns versus dose (as shown in  Figure
A.II-10)   shows that although  the  curve has
only a  slight  shoulder (indicating  an  almost
negligible  extrapolation   number   but  still
implying  possible  repair),  the  straight  line
portion  may still be used to  determine A.

From the best straight line fit, Da; = 1000 rad,
or an incident dose of about 2 x 108 particles/
cm2. This leads to A =  0.52 /urn2. The probabil-
ity  of one  cell  producing  a tumor is finite
only when this particular area  is hit by  one
alpha particle. This might  be  an  equivalent
area just outside the whole nuclear membrane
that will allow the  cell to stay viable when
hit,  yet  allow penetration  by free radicals
and/or delta rays to produce nonlethal genetic
abberations.
      LO
     0.9
     0.8
          J	I
I   I   I
         I
             I	I
       0     200     400    600     800     1000
                       DOSE, rad



               FIGURE A.II-10

Relationship Between Abnormal Hair Follicles and
          Radiation Dose (in rad) [31]
Conclusions

Fundamental  dosimetric   and  radiobiologic
considerations  indicate  that  Cochran  and
Tamplin's "hot  particle"  concept  and  the
Geesaman  Hypothesis  are  invalid,  for  the
following reasons:

1.   It is  incorrect to explain mechanisms of
    biologic effects of alpha particles in terms
    of dose in  rad or rem, particularly when
    small, sensitive action  sites are  involved.
    However,  it is appropriate to  use dose
    in  rad  (or  rem) for  gross  comparative
    purposes,    provided   the  microscopic
    characteristics  of  the  biologic media in-
    volved are reasonably similar.

2.   Local  ("point") concentrations of  alpha-
    emitters can  kill  or affect only a  fixed
                                            A.29

-------
   number of cells and their progeny, regard-
   less of the total activity, due to the finite
   range of  the  alpha particles  and  the fact
   that a cell can only be sterilized once.
   Thus, there  is no reason to suspect  in-
   creased   risk   of  tumor induction  with
   activity  of a hot particle above  a certain
   level (-vO.005 pCi).

3.  Had the  proposed mechanism of a nidus
   of dead cells forming a tumor applied to
   tumors  induced by alpha particles in  the
   rat skin,  tumor  production  would  have
   been independent of dose  for the doses
   used  in  the  experiments;  however, this
   was not  observed.  Further, there is  no
   direct experimental  evidence that such a
   nidus  of dead cells will promote tumor
   formation for an  already transformed  cell
   in  the  lung.  In fact, the lung tissue cells
   now  considered  to  be  the initiators of
   carcinogenesis  have  a   reasonably  short
   replacement time without such stimuli.

4. There  is no  evidence—histological  or
    radiobiological—that any structures in  the
    lung are similar to  the cells in the bulb
   of the  rat hair follicle.  Thus, the  proba-
    bility of producing tumors in rat skin can-
    not be extrapolated to the human lung.

5.  Models based on current  radiobiological
    theory  and  experiments imply  that  the
    risk of  carcinogenesis  from a  uniformly
    distributed alpha-emitter in lung  tissue
    is higher than if the activity were concen-
    trated in a few discrete point sources.
BIOLOGICAL EFFECTS

Cellular and Subcellular Effects*

The spectrum of effects on and  in cells tra-
versed by  high  LET radiations  in general and
alpha particles in particular has been studied
in considerable  detail. The general conclusion
* Prepared   for   the  Committee's  use  by
M. Goldman
derived from these studies is that any particle
with  a LET  of about 100  keV/ium has  an
exceedingly  high  probability  of  killing  any
cell whose nucleus it traverses.

Since almost all  studies  on cell  effects  are
performed in vitro on cell suspensions  or  on
single cell  preparations, the effects are gener-
ally "direct" ones, in that any potential  modi-
fication of cell  injury influenced by  the pres-
ence  of adjacent  normal  unirradiated cells is
likely to be absent or at  least  unphysiologic.
An additional  possible complication is that
the  mammalian   cells  studied  in   vitro  are
frequently characterized by a relatively rapid
replication rate and morphologic uniformity.
However,  although   the  "nonphysiologic"
nature of experimental culture media relative
to a mammalian  tissue milieu  may  influence
the degree of  response, in all  likelihood  it is
not of major significance.

Some fifteen years ago Barendsen et al.  [32]
showed that cells irradiated by  alpha particles,
unlike low-LET x-rays, showed in  vitro  sur-
vival  curves  which could  be  described  by
simple  exponentials of the form S =  e-kD,
where S  is fractional  cell  survival,  D  is the
dose in rad and k is a  proportionality constant
describing the curve's slope. Assuming Poisson
distributions, k can be shown  to equal 1/DO
(i.e., one hit per  target)  and if D/Do  equals
1. (e-1), Do, is the 37%  dose. Thus S = e-D/Do =
e~1 =  0.37. The   smaller  the  value for  DO,
the steeper the slope  and the more effective
the  radiation quality.  For  low  LET radiations,
such as  those  of x-rays,  cell  type  often
influences the precise value,  but for  mam-
malian  cells  DO  is generally 100 to 150  rad
and 130  rad  is   a frequently quoted  value
describing the exponential portion of   the
survival curve [33].

Cells irradiated by alpha particles  not only
fail to manifest the low dose shoulder charac-
teristic  of x-ray exposures but also follow a
steeper slope,  with values of Do ranging from
50 to  100 rad. A  graphic  comparison  of cell
survival  following irradiation  by x-rays  and
alpha  particles (measured  by  cell cloning
potential)  is  shown   in  Figure  A.I 1-11 [32],
in which the x-ray Do is about 135 rad and
                                              A.30

-------
that for  alpha  particles is 65 rad (210Po). The
authors  calculated the "cell sensitive"  area
from the survival curve  data  as alphas per
unit area passing through cells. Thus for their
study, at 170 keV/jum (3.4 MeVas),  one a per
 Mm2 is equivalent to an average dose of  2720
rad. At a mean Do of 65  rad, they  calculated
that the sensitive  area was about 42 ;um2,
and if circular  had a 7.4  nm diameter. Since
the human kidney cells used had optical diam-
eters of  6  to 10 Aim and (as will  be  shown
below) the cytoplasm is not the likely "target",
they concluded that

     . . . the  sensitive area is approxi-
     mately equal  to the area of the nu-
     cleus.  This  implies  that  whenever
    one a-particle penetrates the nucleus
    anywhere, the cell is sufficiently dam-
    aged to be  prevented from developing
    into  a clone. This does not imply that
    the sensitive volume is identical with
    the whole nucleus.  It is quite possible
    that  the sensitive structure is  distri-
    buted  inside  the nucleus in such a
    way that the probability  of an a-parti-
                                                cle's  passing  through  the  nucleus
                                                without hitting this  structure is very
                                                low.

                                                .  .  .the passage  of one  a-particle
                                                through the nucleus  of a cell suffices
                                                to inhibit  this cell irreversibly from
                                                developing into a clone, whereas cells
                                                not hit  in the sensitive  volume may
                                                be assumed to be damaged to such a
                                                small  extent  by  a-particles  passing
                                                through cytoplasm only  that  subse-
                                                quent X-radiation  will  act  on  these
                                                cells as if they had not been irradiated
                                                at all.  On the other hand, cells irradi-
                                                ated with  X-radiation first,  but not
                                                damaged sufficiently to be prevented
                                                from  developing  into a  clone, will
                                                be expected to have the  same sensi-
                                                tive area as cells not damaged at all,
                                                i.e., the cross  sectional  area of the
                                                nucleus. Indeed  their  sensitivity  to
                                                a-radiation is  not found to be in-
                                                creased or decreased by the preceding
                                                X-irradiation (curves 3 and  4,  Figure
                                                A.II-12 [32]).
!3
o
tc.
I
u.
O
UJ
I
111
o
DC
K
3
w
oc
UJ
CO
   100
10
    0.1
               V          \> 'J
                -"--V-
                                 —f
           I  .
                            I
           2    4   6    8    10   12   14   16

                        	»- DOSE IN RAD x 100
                                                           FIGURE A.IM1
Effects of a-, 0-, and X-Radiation
    on Colony Formation [32]
                                            Curve 1 obtained with a-radiation;
                                            Curve 1' corrected for cells not adhering
                                              to the bottom of the dishes;
                                            Curve 2 obtained with ^-radiation, RBE 0.85;
                                            Curve 3 obtained with X-radiation;
                                            Curve 3' theoretical n/no = e-D;135 (1 + D/135)
                                            A.31

-------
                            DOSE IN RAD x 100
                                                                    FIGURE A.II-12

                                                         Effects of Combined a- and X-Radiation [32]


                                                    a and b, effects of a- and X-radiation, respectively;
                                                    Curve 1, effects of 50 rad of a-radiation + 0,100,
                                                      150, 200, 300 and 500 rad of X-radiation;
                                                    Curve 2, effects of 100-rad  a-radiation + 0,100,
                                                      150, 200, 300 and 500 rad  of X-radiation;
                                                    Curve 3, effects of 300 rad of X-radiation + 0, 50
                                                      and 100 rad of a-radiation;
                                                    Curve 4, effects of 500 rad  of X-radiation + 0, 50
                                                      and 100 rad of a-radiation
An experiment by Munro [20] vividly illustrates
the relative insensitivity of the cell cytoplasm
to alpha irradiation and shows that Barendsen's
"sensitive  area" is most  likely  the  nucleus.
Using  a micro-manipulator,  Munro was able
to selectively irradiate single  cultured Chinese
hamster ovarian fibroblasts  with 210Po  alpha
particles with a  ballistic  precision  of  about
1 nm (Figure A.II-13). The flux density (a/m2)
was  equivalent to about  2000  rad/jum2  (Fig-
ure  A.I 1-14).  He showed that doses of  25,000
to  100,000 rad to  the cytoplasm alone  had
little effect on subsequent cellular growth and
proliferation, but  that nuclear  alpha  irradi-
ation  was  lethal   (Figure  A.II-15).  Lethality
seemed to  correlate  best  with irradiation
within  ±1 nm of the cell nuclear membrane.
The  "partial"  nuclear radiation doses used
for  the  1.4 nm "tails" at an exposure to 0.18
 a/Mm2 and 180 keV per tail over a 10 jum2
area of nuclear surface of a 200 nm3 volume
resulted in a dose estimate of about 26 rad.

These studies suggest that  if a  small portion
 of the alpha particle energy  is  deposited  at
 or near the nuclear membrane, cell  lethality
 is quite likely.  However, if the energy de-
 posited within  the nucleus is  much  below
100 keV (i.e., <1 nm) some cells may survive.
Thus, "near" or partial cell  nucleus radiation
by alpha  particles may have a lower relative
biologic effectiveness and, although  spatially
different in terms of energy distribution, may
resemble  the effects  of  lower LET radiation
traversals.

This low  probability effect is  inferred in the
recent  work of Hall  [34], in  which synchro-
nized hamster cells manifested varying values
of DO  as a function of the stage of the cell
cycle at  the time  of irradiation.  While the
general response  was  qualitatively similar  to
that  found  following   x-radiation   (Figure
A.II-16), with an  "increase  in  radioresistance
to a maximum  in late S, followed by a sensi-
tive period  in  late G? and  M phases of the
cycle," it  is tempting to speculate  that the
spatial  distribution   of  dose-to-nucleus  may
not  be as significant as  the total number  of
ionizations absorbed. There does not appear
to be an especially sensitive subnuclear volume,
but  perhaps there  is an ionization  density
dependence. The  relation  of LET and  RBE
for  alpha particles  found by Barendsen [35]
is depicted in Figure A.II-17, which compares
the  unit dose  to unit particle effectiveness.
                                                A.32

-------
          POLONIUM
                                                         SCALE OF CELL AND NEEDLE
                                               FIGURE A.II-13
                   Irradiation of Part of the Cytoplasm of an Interphase Cell by Alpha Particles
                                  from a Polonium-Tipped Microneedle [20]
    60
    40
o
x
    20
                   10
                               20
                                               97.000
     83,000    |

              D
              a:
     66,000


     54.000


     35,000
     20,000
                                                                           FIGURE A.II-14
uj   Dose Rate, Rad/min, and Flux Density, Particles/
o   pmVmin, Against Distance for a Typical Needle
   (inset: end of the range on a larger scale, showing
                 the sharp cutoff) [20]
                                           30
                 DISTANCE FROM NEEDLE,
   100 r-
u
DC
01
CO
5
z
    10
                     1

                   DAYS
                FIGURE A.II-15

       Alpha-Irradiation of Cell Cytoplasm
     (Solid line—growth of three cells given
   cytoplasmic alpha irradiation; broken line—
   three similarly selected controls on the same
coverslip; points  give extreme ranges of counts) [20]
                                                   A.33

-------
                               O EX. 121
                               A EX. 124
                               D EX. 142
          10-3
             0  200 400 600 800100012001400

                         DOSE (RAD)  •
                                                         10-3
                                                         Ł
                                                         u
                                                                           I  i  I
      5  0
                                                                       6   8  10
             TIME (HOURS) AFTER
          SYNCHRONIZATION WITH H. U.
                                         FIGURE A.II-16

                          Survival Curves for Asynchronous Chinese Hamster
                        Cells Exposed to 210-keV X-rays or Alpha Particles [34]
He further  calculates that at about  35 eV/
ionization, the  experimental data  are  com-
patible with a track core relative effectiveness
of 10 to ISJpnizations (n) per 100 A but that
this  is small  compared to the effective cross
sections calculated per particle (^2-35 m2).

The  implication is that "although the sensitive
structure, or molecules, in the cell comprises
a  relatively large part of the cell or probably
of the  cell  nucleus,  damage to reproductive
capacity is already produced  if in a small part
of this structure or of such a  molecule a large
amount of energy is deposited." His hypothesis
that a given  number of n or more ionizations
is required  in  a certain  small volume to initi-
ate  the  chain  of events resulting in death of
a  cell may be modified  in  such  a way that
the  total amount of damage produced in a
small volume  must exceed a given minimum
value and that this  total damage is on the
average produced by n ionizations.
The  data  on cell  lethality in vitro  following
alpha irradiation  as predominantly  a  nuclear
event requiring a  high  ionization  density is
further  supported  by the observation of an
efficient production  of a-induced chromo-
somal aberrations. In a recent study by Vulpis
[36]  on  human  lymphocytes in  culture, 2.5
MeV alphas (0.5 rad/min) produced a spectrum
of  aberrations similar to that  following  x-
irradiation.  The   yield  of  aberrations  was
exponential between 3.5 and 17  rad of alphas
and "saturated" at higher doses (Table A.II-2).
Relative to x-rays, for example, the  yield of
dicentrics per  cell (0.1 to 2.5  range)  showed
a reasonably constant RBE of about 23.

The data  on  the effects of  alpha  particles
at the cellular level, as typified  by  the above
studies,  strongly  suggest  that   single alphas
traversing  a cell's cytoplasm will likely  have
minimal,  if any,  impact  on the cell's ability
to survive and reproduce. If, however, a single
                                              A.34

-------
                X

                O
                <
                at
                Z
                UJ
                «J
                UJ
                Of
                      O
                      Q
                      fc  1
                      oc
                      UJ
                      0.
    10
                                                                 I
            LET
                           50    100             500

                              Of UNITY DENSITY TISSUE)
                                                                      1000
      E
                    g
                    O
                    UJ

                    d
                        40

                        30
                    u
                    uj   or*
                    if)   ^U
          10
                                                   I
            10             50    100             500   1000

                    LET (keV//* OF UNIT DENSITY TISSUE)
                                              D37
Energy
(MeV)

  1.8
  2.5
  3.1
  3.6
  4.0
  5.2t
  8.3t
 26.8t
     LET
       of Unit
Density Tissue)
   200
   166
   141
   123
   110
± 40
±20
±15
±10
±10
    85.8 ± 10
    60.8 ±  5
    24.6 ±  2
  Rad

 97 + 13
 79 ± 9
 62 ±
 54 ±
 57 +
 64± 5t
107 ± 12t
197 + 30t
6
7
4
 Particles
 Per mm2
  (x 101)

 3.03 ± 0.41
 2.98 ± 0.34
 2.75 ± 0.26
 3.25 ± 0.36
 3.24 ± 0.23
 4.66 ± 0.36
11.0 ±1.2
50   ±7.6
Relative
Per Unit Dose
(YD* in
ra«H x 10-*)
1.03 ± 0.14
1.27 ±0.14
1.61 ± 0.15
1.56 ±0.17
1.75 ± 0.12
1.56 ± 0.12
0.93 ± 0.10
0.51 ± 0.07
Effectiveness
Per Particle
(Cross Section
in mm2 x 10-')
33.0 ± 4.4
33.6 ±3.8
36.4 ± 3.5
30.8 1 3.4
30.8 ± 2.2
21.4 ± 1.7
9.111.0
2.0 ± 0.3
                                       FIGURE A.II-17

  Mean Lethal Dose and Relative Effectiveness of  a-particles for Impairment of the Proliferative
                            Capacity of Cultured Human Cells [35]
                                              A.35

-------
                                           TABLE A.II-2.

       Chromosome Aberration Frequencies Induced by Thermal Neutrons in Human Lymphocytes [36]

                                                   Chromosomal Aberrations per Cell
       Exposure Time
           (min)

             7.5
            12.5
            25.0
            35.0
            50.0
Dicentrics

   0.09
   0.16
   0.54
   1.40
   3.00
Centric Rings

    0.006
    0.020
    0.050
    0.310
    1.200
Fragments

   0.04
   0.17
   0.50
   0.37
   3.50
alpha particle traverses a cell  nucleus (or its
membrane) so that an ionization density of
about  100 keV/jum is achieved, there is  a
high likelihood of irreparable molecular dam-
age  sufficient to kill the cell. There  is com-
pelling  evidence that a surviving cell whose
nucleus  receives  a  "small"  portion   of  the
alpha track energy may have the opportunity
to pass some nonlethal genetic lesion on to
its progeny, and this possibility may influence
the  sequence of tissue events which  leads to
the  induction of a tumor. Furthermore, if an
ionizing  event  in  a nucleus  is  not  lethal,
the  cell may also have minimal opportunity
for endogenous repair, thus causing  efficient
replication  of the  "lesion"  in  this  special
class of alpha-irradiated cells.

It is of further interest to  speculate  on the
applicability of these high dose rate studies
to a model in which a cell in its entire lifespan
may encounter only a single  alpha  particle.
The  temporal distribution of  dose in living
tissue may produce very different  quantita-
tive  estimates of effect and these  may be
difficult to derive  solely on the basis of in vitro
 high dose rate studies.  In particular, the spatial
distribution  of cells around a  "hot particle",
 in comparison to  the "uniform" distributions
 used  in  cell culture, might  suggest  a major
 sparing effect proportional  to the frequency
 with which a single cell is traversed by multi-
 ple   alpha particles.  Insofar   as  cell  killing
 may be  related  to cancer  risk, the  in  vitro
 data would suggest that  the radiation effect
 is greatest when  the  alpha flux is  diffusely
 distributed.
       Animal Experiments*

       Clinical Responses to  Inhaled Plutonium

       Information  on clinical  responses to inhaled
       plutonium  has been derived  entirely from
       studies with experimental animals.  (Chromo-
       some aberrations have been observed in blood
       lymphocytes  of workers  contaminated  with
       plutonium  [37,38], but  since these workers
       were probably also exposed to external radi-
       ation it is not clear that the aberrations were
       due to the  alpha radiation from the pluto-
       nium.) Since the  biological effects of inhaled
       plutonium have been reviewed in several re-
       cent reports  [13,30,39-43], principal  attention
       will be given to delayed effects here.

       Clinical responses to inhaled plutonium  are
       the result of alpha irradiation of the tissues in
       which plutonium  is transported or  deposited
       (primarily blood,  lung, thoracic lymph  nodes,
       liver, and bone).  The time of  onset and  the
       magnitude of the response have  been shown
       to  be dose-dependent.  The principal  clinical
       responses to inhaled plutonium are  shown in
       Table  A.II-3, with  the approximate  minimum
       alveolar burdens of plutonium and tissue radi-
       ation doses observed to cause these effects in
       experimental animals.  Extremely  high  doses
       of   alpha radiation  from plutonium  cause
       severe  hemorrhage and edema,  resulting in
       early  death due  to  massive destruction  of
       *Prepared   for   the  Committee's  use  by
       W. J. Bair
                                               A.36

-------
                                         TABLE A.II-3

                    Clinical Responses to Inhaled Plutonium in Experimental Animals
                                              Approximate Minimal Dose Observed
                                                     to Cause the Effect
             Biological Effect
       Lung Hemorrhage and Edema
       Respiratory Insufficiency
       Lung Fibrosis
       Lymphopenia

       Lung Cancer

       Bone Cancer
Inhaled Dose
     of lung)
   0.5
   0.02
   0.005
   0.001

   0.002


   0.01
Radiation Dose to Critical
  Tissue or Organ (rad)

       15,000
        1,800
        ^200
(Critical tissue not known)

              (rats)
          000  (dogs)

           3.6 (rats)
          78  (dogs)
functional  tissues.  Lower  doses  may  cause
fibrosis and metaplasia severe enough to lead
to  respiratory  insufficiency   and  eventual
death.

Fibrosis may or may not be accompanied  by
metaplastic  or  neoplastic changes. Pulmonary
neoplasia  has  been observed  in  rats  at cal-
culated cumulative radiation  doses  less than
about 10 rad. However, so far the lowest cal-
culated  dose   associated   with  pulmonary
neoplasia  in dogs  is about 1000 rad. Whether
neoplasia  will occur at lower doses in  dogs is
not yet known, since low  dose experiments
have only been in progress for about five years.
Osteogenic sarcoma has occurred in dogs at
doses of about 78 rad and in rats at doses as
low as 3.6 rad.

In dogs  lymphocytopenia  is so far  the  most
prominent effect of plutonium  deposition in
lungs. The degree to which circulating lympho-
cytes are reduced  and the time span between
plutonium inhalation and lymphocyte  reduc-
tion depend on the dose [44]. This is illustrated
by the results from current  studies of inhaled
239PuO2 and  238PuO2  in   beagle  dogs  [44].
Figure A.II-18 shows the  leukocyte  levels
in control beagle dogs and  in dogs after inhal-
          ation of six levels of 239PuO2. Lymphocytopenia
          occurred in the four highest dose groups and
          was related to  the  plutonium dose in  both
          time of appearance after exposure and magni-
          tude. The  decrease  in  neutrophil  levels was
          gradual and less pronounced than the decrease
          in  lymphocytes.  No differences  occurred  in
          either  monocyte  or   eosinophil   levels   in
          plutonium-exposed dogs and no effects  were
          seen in red cell levels.

          The hematological  changes  in dogs exposed
          to  238PuCh are  similar  to  those  observed  in
          dogs exposed to 239PuO2, except that there is a
          greater decrease in  neutrophil levels. This  is
          probably  the  result of the translocation  of
          238Pu to bone, which occurs more rapidly after
          inhalation of 238PuO2 than after 239PuC>2.

          The mechanism  by which  lymphocytopenia
          occurs is unknown, but  it may be due to direct
          irradiation of lymphocytes  circulating through
          the lungs  in  which plutonium is  deposited.
          Wheiher  the  lymphocytopenia is  related  to
          the accumulation of plutonium  in thoracic
          lymph nodes  is not known, but  lymphocyto-
          penia has been observed in dogs before appre-
          ciable amounts of  plutonium have appeared
          in the lymph nodes.
                                             A.37

-------
   e
   X
   (/I
   Q.
   s
o GROUP 1
• GROUP 2
• GROUP 3
a GROUP 4
A GROUP 5
  GROUP 6
INITIAL ALVEOLAR
DEPOSITION, nCI
     3.5 ± 1.3
     22 ±4
     79±14
     300 ± 62
    1100 ±170
    5800 ± 3300
                  \*_/——
                             A^^ \     A^         .
                                V   A-^A-A
         0   4    8   12   16  20  24  28  32  36  40   44  48

                   TIME.MONTHS AFTER EXPOSURE
                         FIGURE A.II-18

Mean Lymphocyte, Leukocyte and Neutrophil Values from Dogs after Inhalation
 of 239PuO2. (The shaded area represents mean values from age-related control
             dogst the mean 95% confidence interval) [44]
                             A.38

-------
Neoplasia in Experimental Animals After
Inhalation of Plutonium and Other Transuranics

Inhaled  plutonium  and  other  transuranics
have been shown to cause pulmonary neoplasia
and  osteosarcoma  in  several  experimental
animal  species. Pulmonary neoplasia  is  the
dominant  carcinogenic  response when  the
plutonium  is retained in the lung for  a  long
period. Osteogenic sarcoma also occurs when
inhaled plutonium is relatively soluble and is
translocated to  bone. Liver also  accumulates
plutonium   translocated   from   respiratory
tissues, but liver cancer has not been a common
finding  in  studies  of  inhaled plutonium.
Leukemia has rarely been observed in pluto-
nium  studies,  although  plutonium  is trans-
ported  in  blood and deposited in  lymphatic
tissues  and has been  associated with other
effects  on  blood elements, such as a  reduc-
tion of lymphocytes and neutrophils [40].

The  major experiments  performed to date in
which  pulmonary neoplasia has been observed
are summarized below.

Ammonium Plutonium-Rentacar bo nate
and  Plutonium  Citrate  in Rats [45].  Pluto-
nium citrate is relatively soluble and does not
readily  hydrolyze  or form  polymers. There-
fore, inhaled plutonium citrate deposited in
the lung is expected to be widely dispersed,
rapidly translocated to bone and other tissues
in the  body, and excreted. Ammonium pluto-
nium-pentacarbonate   hydrolyzes,   readily
forming  aggregates.  Both  compounds appear
to have similar translocation  characteristics.
Thus, in this study the authors believed  the
total radiation dose to the  lung would be com-
parable for these two plutonium compounds,
but the distribution  would be  different (e.g.,
more  localized  in the case  of ammonium
plutonium-pentacarbonate).   However,  this
difference was not documented in the report.
Throughout the duration of the experiment
autoradiograms showed  plutonium aggregates
associated  with  hemosiderin deposits.  Quan-
titative  descriptions  of this  aggregation were
not  provided by  the authors  for either plu-
tonium  citrate  or  ammonium  plutonium-
pentacarbonate.
The experiment involved  2232  rats, of which
376 were killed  immediately  after exposure
to determine  the  initial  lung  burden. The
characteristics  of  the aerosols  were not pub-
lished. The  experimental  design and  result";
are given in Table A.ii-4.  (he two plutonium
compounds  appeared to be equally effective
at the lower  dose in  causing  lung  cancer.
Differences may have occurred at doses above
500 rad.

Plutonium-239  Nitrate   and  Triacetate  [46].
This experiment consisted of 1097 Wistar rats
weighing  140-160  g.  Solutions  (0.03 mi)  of
plutonium nitrate (pH = 2), 0.01 N nitric acid
(pH  =  2)  and  sodium  plutonyl  triacetate
(pH = 6.5) were given  by intratracheal injec-
tion. From autoradiograms it was determined
that both plutonium compounds were present
for long  times after administration as aggre-
gates in macrophages in sclerotic areas of the
peripheral lung,  in interalveolar septas and
beneath the pleura. Although  the  surfaces  of
the bronchi  and  lumens of  the vessels were
free  of  plutonium, the greatest numbers  of
large  aggregates  were   in scar tissue in the
hilar region  and  were  associated  with  iron-
containing pigment in  connective  tissue cells
or extracellularly between collagen  fibers.

Nitric acid alone  caused  an increased inci-
dence  of adenocarcinomas which was not
observed in the  rats which received  lower
levels of  plutonium (Table  A.II-5).  Thus,  if
nitric acid had any effect on the induction  of
cancer by plutonium it was one of depressing
the response, rather than enhancing plutonium
carcinogenicity.

Intratracheally-injected   plutonium  increased
the total  incidence of  pulmonary neoplasia
but the  response  relative  to dose  was not  as
great  as  observed after inhalation of  pluto-
nium  citrate  and  ammonium  plutonium-
pentacarbonate (Table  A.II-4).  The authors
concluded  that  nitric   acid  scarring  of the
lung tissue was an indirect cause of neoplasia.
However, there was no evidence that  nitric
acid  enhanced  the carcinogenic  effect  of
plutonium.
                                            A.39

-------
                                             TABLE A.II-4

                Frequency of Pulmonary Tumors in Rats After Inhalation of Plutonium Citrate
                             and Ammonium Plutonium-Pentacarbonate [45]
Number of Rats

Mean Survival Time (days)

Initial Lung Content (jLtCi)
Dose (rad)

Incidence of Tumors (%)
  All Pulmonary Tumors
  Squamous Cell Carcinoma
  Adenocarcinomas
  Adenomas
  Hemangiosarcomas
  Lymphosarcomas

Total:  Squamous Cell,
  Adenocarcinoma, and
  Hemangiosarcoma
Number of Rats

Mean Survival Time (days)


Initial Lung Content (juCi)

Dose (rad)

Incidence of Tumors (%)
  All Pulmonary Tumors
  Squamous Cell Carcinoma
  Adenocarcinomas
  Adenomas
  Hemangiosarcomas
  Lymphosarcomas

Total:  Squamous Cell,
  Adenocarcinoma, and
  Hemangiosarcoma
Controls
258 23
570.8 64.2
±









8.3 ± 2.1
0 1.03
0 3820
6.6
—
0.39
1.17
—
5.04
0.39
Controls

258 12
12 94
69.3 123.6
± 4.8 * 9.0
0.80 0.51
3090 2370
2.2
2.2
—
~
~
"
2.2
39
220.7
±12.9
0.362
1740
28.2
7.7
—
20.5
—
~~
7.7
Plutonium Citrate
113
415.6
±11.8
0.249
1390
47.9
16.8
3.6
23.0
3.6
0.9
24.0
105
463.6
±11.8
0.160
852
40.9
7.6
14.3
15.2
3.8
"
25.7
31
546.4
±22.3
0.080
467
48.5
9.7
16.1
6.5
9.7
6.5
35.5
203
544.9
±10.5
0.040
234
25.6
1.5
5.4
10.8
1.5
6.4
8.4
120
585.0
±11.5
0.020
117
18.3"'
—
2.5
8.3
—
7.5
2.5
157
635.0
±3.3
0.008
47
' 15.9
3.2
1.3
3.2
0.7
7.0
5.2
Amonium Plutonium-Pentacarbonate
23 69
22
126
83
126
91
101
48
570.8   77.3   77.8  138.9  247.4   360.9  484.3  581.8  583.9  571.6  570.9
±8.3   ±5.6  ±6.6  ±9.6  ±20.8  ±11.1 ±13.7 ±11.4  ±11.7  ±16.1   ±20.9

    0  1.46   0.77   0.45   0.35   0.245   0.15  0.040  0.020  0.008  0.004

    0  7320   3900   2780   2140   1615  1065    497    186     80    41
 6.6
7.7
9.0   44.4   78.4   63.2   35.2   19.8   16.7
—
0.39
1.17
—
5.04
~
4.6
3.1

4.6
4.5
4.5
—

9.0
11.9
7.9
19.8
48

14.5
24.6
30.1
16.9
2.4
9.5
7.7
17.3
3.9
7.9
5.5
3.8
18.7
--
3.3
1.0
1.0
7.9
2.0
5.9
—
—
4.2
—
8.3
 0.39
            24.6   45.9   38.0   13.2   6.0    4.2
                                                 A.40

-------
                                          TABLE A.II-5

         Frequency of Pulmonary Tumors in Rats after Intratracheal Injection of 239Pu Triacetate [46]
                                     x»Pu
                           Controls Triacetate
                                      2WPu Nitrate
 Number of Rats

 Mean Survival Time (days)


 Initial Lung Content (juCi)

 Dose (rad)

 Incidence of Tumors(%)
   All Pulmonary Tumors
   Squamous Cell Carcinoma
   Adenocarcinomas
   Adenomas
   Hemangiosarcomas
   Lymphosarcomas

 Total:  Squamous Cell,
   Adenocarcinoma, and
   Hemangiosarcoma
 248

672.7
±7.7

   0

   0
   52

 391.5
        36.54
  42
94   110
87
93
93
93
89
586.2  289.6  417.5  535.0  599.4  578.6  586.7  628.0 625.4
 ±20  ±8.7   ±10  ±15.1  ±12.6  ±15.7  ±17.0+13.0 ±15.3
±17.1

  1.0   HNCb   1.0  0.42   0.01  0.048  0.031   0.01 0.0042 0.00042

 1570        0  5855  2756   620   317   205    62    28    2.8
38.45
32.69
1.92
1.92
1.92
0
7.2
0
2.4
0
0
4.8
21.27
19.15
1.06
1.06
0
0
39.07
16.4
12.7
7.27
0.9
1.8
21.84
5.75
3.45
8.05
4.6
0
22.13
1.1
5.38
14.6
1.1
0
8.33
1.04
3.12
2.08
0
2.08
10.76
0
2.15
0
0
8.6
7.54
1.1
0
3.23
0
3.23
11.24
2.25
0
3.37
0
5.62
          2.4 20.21   30.0  13.79   7.53   4.17   2.16   1.08   2.25
The  effect of  plutonyl  triacetate  is difficult
to assess  because  there  was only one dose
group. Since the pH of  the injected solution
was  more compatible with lung tissue than
the 0.01 N nitric acid in  which the plutonium
nitrate was injected, there  was probably less
scarring  due  to chemical  action. However,
the neoplastic response  was not less for plu-
tonyl triacetate than for plutonium nitrate.

It is  impossible to compare  the heterogenicity
of the distribution of plutonium and plutonium
aggregates in the lungs of the rats in these two
experiments; however, it is likely  that  intra-
tracheal  administration of  plutonium nitrate
solutions  led to  more   nonuniformity than
inhalation of plutonium citrate and ammonium
plutonium-pentacarbonate.  Since  plutonium
nitrate given by intratracheal  injection was
less  effective than  inhaled  plutonium  citrate
and  ammonium  plutonyl  pentacarbonate  in
causing  pulmonary  neoplasia,  it  does not
appear that scarring of the  lung by nitric acid
or  the  greater  aggregation of ' plutonium,
                        which  occurred in the  case  of intratracheal
                        injection of plutonium nitrate,  enhanced  the
                        carcinogenic effect of plutonium.

                        Inhaled  Plutonium   Nitrate  and  Ca-DTPA
                        Treatment in Rats [47]. Male Wistar rats were
                        exposed to aerosols of 239Pu(NO3)4 generated
                        from a 0.27 N  nitric acid solution. Beginning
                        after 28 days the rats were treated for one hour
                        at weekly intervals for six weeks by exposure
                        to  aerosols of calcium  diethylenetriamine-
                        pentaacetic acid (Ca-DTPA), a chelating agent
                        given  clinically to  plutonium-contaminated
                        human  beings  to   increase  the  plutonium
                        excretion  rate. The  amount  of  Ca-DTPA
                        given the rats at each treatment was%5 mg/kg,
                        approximately  equivalent to  the dose given
                        human beings.

                        For long-term observation of biological effects
                        the  experiment was comprised  of 261  rats in
                        groups, as  shown  in Table A.II-6. Since Ca-
                        DTPA treatment did not appear to influence
                        the   carcinogenic  effect  of  plutonium,   the
                                              A.41

-------
incidence values were calculated for the com-
bined groups of Ca-DTPA  and sham-treated
rats. In  this experiment inhaled  239Pu(NO3)4
wai  very  effective  in  causing  pulmonary
neopiasia. A 33%  incidence was observed  in
the dose range of 36-100 rad and  a maximum
of 75% in the dose range of 1001-2000 rad.
This response was  much  greater than that
observed by Yerokhin  et al. [46) with  intra-
tracheally-injected   plutonium  nitrate,  also
in Wistar rats. The difference in response may
be due to the method of administration, since
inhalation results in  more uniform distribution
of  plutonium in  the lungs than  does  intra-
tracheal injection,  or to the higher concen-
tration of nitric acid in the solution from  which
Ballou generated his aerosol than in the solu-
tion given  intratracheally  by  Yerokhin. The
distribution of HNOa deposited in  the rat lungs
in the two experiments would also be different
for the two routes  of administration; inhaled
HMOs would be more widely dispersed than
HNOa given by intratracheal injection.

Inhaled 239PuO2, 2MPu(NO*)4, and »»Pu(NO3)4
in  Rats  [48].  Sprague-Dawley S. P.  F.  rats
were  exposed  to   aerosols of  ^PufNOa)^
""PufNOaK and 239PuO2. The normality  of the
nitric acid  solutions from which  the  aerosols
                       were  generated has not been reported.  The
                       results are given in Table A.II-7. In this experi-
                       ment,  about half of the  pulmonary  tumors
                       were   bronchogenic  carcinomas  and  about
                       half   were  bronchiole-alveolar  carcinomas.
                       Plutonium-239  nitrate  appeared  to  be more
                       effective than 238Pu(NOa)4.  Both results agreed
                       better with  the results of  Ballou's  inhaled
                       239Pu(NOa)4  experiment than  with Yerokhin's
                       intratracheally-injected 239Pu(NOa)4.

                       Inhaled 239PuCh resulted in  a high incidence of
                       lung cancer at  doses ranging from 165 to 1300
                       rad. Over this dose range the tumor response
                       appeared to be independent of dose. This may
                       be due  to the  relatively  small  numbers of
                       animals  in each dose group. At comparable
                       doses  239Pu(NOa) appeared to be more effec-
                       tive  than  239PuO2,  while  the  response to
                       238Pu(NOs)4  was similar to that observed  for
                       23«PuO2.

                       Inhaled 241Am Oxide and Nitrate [48]. Sprague-
                       Dawley  rats were  given single exposures to
                       aerosols of  241Am oxide  and  241Am  nitrate
                       (Table A.II-8). Americium-241 oxide is relatively
                       soluble  and is translocated  from  the lung
                       more rapidly than PuO2. Although information
                       about the distribution of these materials  in
                                           TABLE A.II-6

             Lung Tumors in Rats After Inhalation of 239Pu(NO3)4 and Treatment with Ca-DTPA [47]
         Dose Range
            (rad)

            36-100
           101-300

           301-500
           501-1000

          1001-2000

          Ca-DTPA
           Control
Number of
   Rats

  5  (1)a

  13  (3)

  16  (7)
   8  (5)

   1  (3)

 70  (30)
 99
Mean Number
 Days at Risk

  603  (888)

  555  (546)

  657  (608)
  714  (699)

  975  (641)

  604  (591)
  677
Rats with Lung Tumors
Number %b
1
5
5
6
1
1
0
(1)
(1)
(3)
(2)
(2)
(0)

33
38
35
62
75
1
0
    ^Numbers in parentheses are for rats sham treated with Ca-DTPA.
    ^Percentages calculated for combined Ca-DTPA and sham-treated rats.
                                               A.42

-------
                                            TABLE A.11-7
               Lung Tumors in Rats after Inhalation of 239PuOJ( "«PuO(NO3)4 and 238Pu(NO3>4 [48]
Pu Deposited
in Lung
Treatment ( ju Ci)
239PuO2 0.045
0.050
0.080
0.095
0.135
0.170
0.350
239Pu(NO3>4 0.240
238Pu(NO3)4 0.315

Lung Dose
(rad)
165
200
265
340
550
650
1300
560
780
Mean
Survival
Time
(days)
735
720
700
650
550
525
375.
550
450

Number of
Rats
14
9
8
18
10
16
33
18
8
Lung Tumor Incidence

No. of Rats
with Tumor
7
3
5
13
6
9
22
16
4


%
50
33
62
72
60
56
66
89
50
                                            TABLE A.II-8

                     Lung Tumors in Rats after Inhalation of 241Am Oxide and Nitrate [48]
24'Am
Compound
Oxide



Nitrate



J41Am
Deposited
in Lung
(A
-------
Inhaled 238Pu [49].  Female  Sprague-Dawley
rats were  given  a single exposure to  a 238Pu
aerosol generated from a physiological saline
suspension solution of 238Pu  prepared from
the water supernatant of aged 238Pu  crushed
microspheres further ground with mortar  and
pestle.  Electron  micrographs  showed   the
presence  of  amorphous-like  material rather
than the highly dense, sharply defined parti-
cles present  in  suspensions and  aerosols of
PuO2.  Autoradiograms showed few aggregates
in lung samples collected one day after expo-
sure.  The alpha tracks were randomly distri-
buted throughout the  lung. After a year the
small  amount  of 238Pu  remaining was asso-
ciated with hemosiderin-like pigment granules
in  peribronchiolar and perivascular  regions
of  the lungs. The incidences of  pulmonary
neoplasia observed in these rats are shown in
Table A.I 1-9.

An increased incidence of neoplasia, mostly
bronchiolo-alveolar carcinomas, was observed
at 9 rad. However, the 6.6% incidence at 9 rad
was not significantly different from the  1.1%
 incidence in the control group.  At a  dose of
32 rad, the tumor incidence was 20%, which
was significantly different  from the  controls
 at  the 99.9%  confidence  level.  The author
 attributed the high tumor  incidence  at these
 low doses to the  diffuse distribution of the
 238Pu  in the  lungs, compared with PuOz. The
 results from this experiment are  fairly  com-
 patible with  the results obtained by Ballou
 with   239Pu(NOa)4   [47]  and  Lafuma   with
 238Pu(NO3)4 [48].
                    PuOz  in  Lung  After  Intraperitoneal  Injec-
                    tion [50].  In a study of PuCh given to female
                    Sprague-Dawley rats by intraperitoneal injec-
                    tion it was found that some of the Pu particles
                    were transported to the lungs and deposited
                    in capillaries of the alveolar  septae  randomly
                    throughout  the lungs.  Autoradiography indi-
                    cated  the median diameter of these particles
                    to be  0.3 (im. In addition to plutonium, one
                    group of animals  was given benzo(a)pyrene
                    and another  group  asbestos.  However, the
                    presence  of these substances in the  lungs was
                    not confirmed.

                    There was little evidence of  pulmonary path-
                    ology  in these rats, even though the dose to the
                    lungs of one group was estimated to be as high
                    as  600 rad  (Table A.I 1-10).  Pulmonary neo-
                    plasia   was   observed  in  only  one rat.   A
                    bronchiolo-alveolar carcinoma was  found  in
                    one rat 823 days after  intraperitoneal injection
                    'of 72  nCi PuO2. Since pulmonary neoplasia is
                    occasionally seen  in  the control rats, <1%,
                     the finding of one neoplasia cannot  unequiv-
                     ocably be attributed to 239Pu.

                    The author  concluded that the lack of a signifi-
                     cant neoplastic  response  in  this experiment
                    was due  to the immobilization  of  the PuOa
                     particles in the lung capillaries and consequent
                     irradiation  of a limited number of epithelial
                     cells in the lungs, fewer than would be the
                     case with inhaled plutonium.
         Initial Alveolar
          Deposition
             (nCi)

            Control
               5
               18
              207
                                           TABLE A.II-9

                             Lung Tumors in Rats after Inhalation of ^Pu [49]
Lung Dose
  (rad)

     0
     9
    32
   375
Number of Rats

      92
      30
      30
      32
                                        Tumor Incidence
No. of Rats

   1
   2
   6
   8
 1.1
 6.6
20
25
                                              A.44

-------
                                           TABLE A.II-10.
          Effects of Plutonium Deposited in Lung After Intraperitoneal Injection of Pud: in Rats [50]
            "'PuCh
   Controls
   2.9
   0.36
   0.072
   0.36 + benzo(a)pyrene
   0.072 + asbestos
Number of
   Rats
  Survival
Time (days)
   »«Pu in
  Lung (% of
Injected Dose)
108
35
38
36
18
24

200-300
200-500
200-500
200-500
200-500
—
0.39 ± 0.22
0.21 ± 0.13
0.33 ± 0.29
1.5 ±0.94
0.1310.11
Lung Dose
   (rad)
                                             600
                                              40
                                              10
                                             170
                                              20
 No. of
Tumors

   0
   0
   0
   1
   0
   0
intratracheal  Injection  of 253EsCl  [51].  Ein-
steinium is an alpha-emitting  (6.6 MeV) radio-
nuclide with a half-life of 20.5 days. Thus, it is
capable of delivering a dose of alpha radiation
over a  relatively short period  of time com-
pared  with the other transuranics and with
™Po, which has a half-life of 138 days.

Einsteinium-253  chloride in 0.01 N HCI (0.5 mC)
was  given by intratracheal injection  to male
Wistar rats for  long-term  observation  of  bio-
logical effects. Because  of the small  mass of
einsteinium  present  (the  specific activity of
253Es is ~4 x 10-11  g/ju Ci),  and especially the
                      method of administration, the distribution of
                      the einsteinium within the lung was probably
                      limited. The results are shown in Table A.II-11.

                      The incidence of pulmonary neoplasia was 4%
                      in  rats with a lung dose of  38 rad  and 12.5%
                      in  rats receiving 1900 rad. It is highly probable
                      that the peak tumor response  is somewhere
                      between these  two  doses. However,  these
                      results are more comparable to those observed
                      with  intratracheally  administered  239Pu(NCb)4
                      (Table A.II-5) than to those observed in experi-
                      ments where the radionuclide was given by
                      inhalation.
                                         TABLE A.II-11.

                    Lung Tumors in Rats After Intratracheal Instillation of 253EsCI [51]
       «3EsCI Deposited
         in Lung QuCi)

      Control (0.01 N HCI)
             0.05
             2.5
            12
    38
  1900

  9800
 Mean
Survival
 Time
 (days)

  724
  707
  475

  181
 Number
  of Rats

    43
    48
    48
    29
                                        Lung Tumor Incidence
                                         Number of
                                          Rats with
                                          Tumors         %
   0
   2
   6
   0
 0
 4

12.5

 0
                                              A.45

-------
Inhaled 2"PuO2  in  Dogs  [52]. Beagle  dogs
were  given  a single exposure  to  aerosols of
239PuO2.  Thirty-five  were  held  for  lifetime
observation  and  5 were sacrificed at times
after 800 days for determination of the tissue
distribution  of the inhaled 239Pu.  Data  for the
35 dogs are  given in Table A.II-12. Of these
dogs, 27 developed  primary pulmonary neo-
plasia, 6 died of pulmonary fibrosis with  no
evidence  of neoplasia, one died  of  cardio-
vascular disease and  another  of  encephalitis.

The latter two deaths did not appear to be re-
lated to the plutonium exposure. All dogs with
pulmonary  neoplasia  also  showed  extensive
pulmonary fibrosis at time of death. All dogs
with  pulmonary  neoplasia had   bronchiolo-
alveolar carcinomas (histopathology is not com-
plete on 3 dogs). Some dogs had more than one
tumor but it is not known whether they were all
primary tumors or metastasis from a single pri-
mary tumor. Several dogs had  additional neo-
plasms, as shown in Table A.II-12 [53]. Radio-
graphs showed that the tumors originated in the
lung  periphery. Autoradiographs of lung sec-
tions taken from  these and other dogs showed
PuCh had accumulated in subpleural regions of
the lungs in apparent association with the sub-
pleural lymphatics and, to  a lesser extent, in
peribronchiolar and periovascular regions. The
location of  the PuCh in the lungs appeared to
coincide  with the  peripheral origin  of the
tumors.   Although  autoradiographs  seldom
showed high concentrations of 239Pu within the
tumor mass, it was generally observed that rela-
tively large  accumulations of ^Pu occurred in
fibrotic regions near the tumors.

 Because  this experiment involved relatively
 high doses  of plutonium, a large fraction of
the lung tissue was exposed to  alpha irradi-
 ation. This  distribution of radiation dose was
enhanced by mobilization of the plutonium
 in  the lungs  by macrophages,  by transport
 in  the lymphatics, and by slow solubilization.
 However, mobilization also caused plutonium
 to  accumulate  in the  subpleural and peri-
 bronchiolar regions, with the result that these
 regions  of  the lung received relatively  high
 doses. The  results demonstrate the peripheral
 origin  of 239PuCh-induced neoplasia  in  the
 lungs of dogs.
        and Asbestos  [54].  Female Sprague-
Dawley  rats were given a single intratracheal
injection of 0.9 mg chrysotile asbestos, 29 nCi
239PuCh  or 0.9  mg asbestos and 51 nCi 239PuO2
in saline. Asbestos  tended  to  sequester the
PuCh in the  peribronchiolar regions  of the
lungs and  signficantly  reduced the  rate  of
PuO2 clearance from the lungs. The asbestos
tended  to  increase  inflammation  and scar-
ring of the lung tissue. Thus, the PuCh in the
presence of asbestos was located  in areas  of
greater  scar formation  than was the PuCh in
the lungs of rats which received no asbestos.
The mean  cumulative  radiation  doses were
425 rad  to the  lungs of rats given PuCh and 1200
rad to the lungs of rats given PuCh plus asbestos.
The rates of mortality  were similar in the two
groups. Table  A.II-13 shows that there was no
difference in the incidences of pulmonary neo-
plasia in the PuCh and  PuCh plus asbestos rats,
even though the radiation dose was three times
greater in the  latter group.

The results of  this experiment demonstrate that
the effectiveness of 239PuCh is not enhanced by
aggregation in scar tissue in lungs;  rather, they
suggest a greater effectiveness when the239PuCh
is more widely distributed.

210Po Given  by  Intratracheal  Injection  to
Hamsters [55,56].  Syrian golden hamsters were
given intratracheal administrations of 210Po in
saline alone or with hematite.  In  this experi-
ment the hematite tended to cause aggregation
of the 210Po, while 210Po administered  in saline
was more uniformly distributed throughout the
lung. It  is probable that  intratracheal administra-
tion of the 210Po resulted in less uniform distribu-
tion than would have  occurred had the 210Po
been given by inhalation. The results of these
series of experiments are given in Table A.II-14
and Figure A.II-19. Included in Figure A.II-19are
data from  an  earlier experiment in which rats
were exposed  to aerosols of 210Po in saline [57],

Neoplasia was not observed in the control ham-
sters or those given hematite alone.  In rats given
210Po alone or with hematite the incidence of
pulmonary neoplasia ranged from 8 to 9%. At
low doses there does not appear to be any differ-
ence in the effectiveness of 210Po for inducing
neoplasia,  whether it  is given  alone or with
                                             A.46

-------
                                                                   TABLE A.II-12.
                                              Dog Mortality and Distribution of Inhaled 239PuO2 [53]


Dog
Number
1 182F
2 184F
3 272M
4 215F
5 83F
6 268F
7 173F
8 106F
9 183F
10 180F
11 76F
12 246M

13 259M
14 255F

15 213F
16 216F
17 85F
18258M
19 86F
20 281
Zl 81F
22 249M
23 283
24 212F
25 266F
26 273M
27 278M
28 254
29 IF
30 109F
31 252M

32 93F
33 277
34 264
35 267


Survival
(days)
855
933
988
1151
1184
1202
1339
1357
1379
1446
1549
1623

1629
1635

1720
1823
2015
2048
2050
2211
2229
2341
2356
2367
2412
2565
2792
2809
3079
3313
3441

4068
3664
3537
3676



Lesion
F
F
F
FT
FT
E
FT
FT
F
F
F
FT

FT
FT

FT
FT
FT
FT
C
FT
FT
FT
FT
FT
FT
FT
FT
FT
FT
FT
FT

FT
FT
FT
FT

Alveolar
Deposit
frCI)
3.3
3.0
3.6
1.8
2.2
1.4
2.6
3.3
1.1
1.7
1.8
2.3

1.2
1.2

1.5
0.6
1.4
1.8
0.4
2.2
1.2
1.2
0.9
1.0
0.8
1.8
1.0
0.8
0.7
0.6
0.58

0.15
0.19
—
0.86
Final
Body
Burden
(HO)
2.7
2.5
2.9
1.4
1.8
1.1
2.1
2.7
0.9
1.4
1.4
1.8

1.0
1.0

1.2
0.5
1.1
1.4
0.3
1.7
0.9
1.0
0.8
0.8
0.7
1.5
0.8
0.6
0.6
0.4
0.46

0.12
0.15
—
0.67



Lungs
74
75
63
50
59
46
46
50
52
42
47
55

55
42

49
51
36
35
37
30
23
21
26
53
14
7
14
21
9
13
24

26
15
—
11
r«
Thoracic
Lymph
Nodes
21
17
17
42
28
25
48
37
38
49
45
24

23
24

27
26
30
37
49
44
54
32
29
39
41
56
41
45
56
56
36

57
24
—
18
TCcm ui m


Liver
2
5
14
2
6
20
2
6
6
5
3
16

15
26

15
15
21
19
6
15
19
32
23
3
32
21
23
21
21
16
22

8
31
—
61
wu v««7 mvn


Skeleton
1
1
4
4
2
3
2
2
3
3
4
3

6
3

5
7
6
4
5
5
4
6
12
2
7
5
10
5
7
6
9

6
9
—
6
acn
Abdom.
Lymph
Nodes
_
—
2.0
—
0.9
—
—
—
—
—
—
—

—
3.7

—
0.7
5.8
4
—
4
—
8
7
—
3
9
10
6
6
7
6

0.1
17.0
—
1.6



Spleen
_
—
—
0.5
0.1
—
—
—
—
—
—
—

—
1.0

—
0.3
0.7
0.4
—
0.2
—
0.7
1.2
—
1.2
0.6
1.4
0.7
1.0
0.6
0.7

0.1
2.6
—
1.7



Lung Tumors



B-A
B-A

B-A
B-A



B-A, "Bronchial care i^ia.
hemangiosaro. r>.
B-A
B-A, capillary hema •?,.•• .2,
mesothelioma
B-A
B-A
B-A
B-A; Squamous Cell

B-A, Epidermoid
B-A (oat cell) mesothelioma 1)
B-A (2)
B-A, Mesothelioma (2)
B-A
B-A, Epidermoid (3)
B-A
B-A, Epidermoid, Squamous c- ,i i '
B-A
B-A (3)
B-A
B-A, Epidermoid, Oat Cell,
Squamous Cell
B-A (3)
?
?
?


Lung Dose
(rad)»
4400
4600
4300
2700
3600
2000
6200
6700
70,.')
•i .(V|
• '. j

f!
"-;'-C

•.*• •
W
;oo
14Ci'
5>0:i
'70
4 :rri
2JOO
2201)
2«x;
1501:
-,7(X
.'7011
"90C
..DOU
1700
160'

voo
956
907
—
2300
T - Pulmonary Tumor; F - Pulmonary Fibrosis and Metaplasia; C- Cardiovascular; E- Encephalitis; B-A - Bronchiole-Alveolar Carcinoma
Other Tumors:  (1)  Lymphagiosarcoma   in thoracic lymph nodes  (2)  Hemangiosarcoma in thoracic lymph node  (3) Mammary gland adenocarcinoma
•Cumulative dose based on normal lung weight = 1.1% body weight. Retention half time for Pu in lung calculated for each dog based on final whole body burden =
 deposition x r>OJ.

-------
                                             TABLE A.II-13.

    Neoplastic Response of Lung to Intratracheally Instilled Asbestos, 239PuO2 or Asbestos  Plus ""PuOj [54]

                                                        Incidence of Pulmonary Tumors. %
Group
Saline
Asbestos
2MPuO2
"'PuO2 Plus Asbestos
Number
of Animals
26
22
22
27
Adenocarcinoma
0
4
21
21
Squamous
Carcinoma
0
0
11
0
Sarcoma
0
4
0
4
Total
0
9
32
25
                                               TABLE A.II-14.

                    Lung Tumors in Hamsters After Intratracheal Instillation of 210Po [55,56]
                      Group
            Control (no instillation)
            Control - hematite (3 mg)a
            21°Po (0.2 //Ci) in saline +
              hematite (3 mg)a
            210Po (0.2 i*C\) in saline +
              hematite (3 mg)*5

            210Po (0.01 juCi) in saline +
              hematite (3 mg)a
            Benzo(a)pyrene (3 mg) +
              hematite (3 mg)a
            Benzo(a)pyrene (0.3 mg) +
              hematite (3 mg)a

            21°Po (0.005  juCi) + hematite
              (3 mg)a
            21°Po (0.00125 //Ci) +
              hematite (3 mg)a
            ^opo (0.00025 juGi) + hematite
              (3 mg)a
            ™Po (0.1 juCi)b

            21°Po (0.00125 juCi)a
5000
2000
 300
 300

  75

  15
1500

  55
            a15 weekly instillations
            t*7 weekly instillations

hematite.  Compared with the earlier work of
Yuile, inhaled 210Po  in rats  was  less effective
than  the intratracheally-injected 210Po in ham-
sters  (Figure  A.II-19). This is in contrast to the
results  with  239Pu(NO3)4  in  rats,  where  intra-
tracheal injection  appeared to be much  less
effective than inhalation of 239Pu(NO3)4.

Plutonium  Microspheres  Given  Hamsters by
Intravenous  Injection  [58,59].  To determine
Number of
   Rats
Autopsied

    60
    34


    35


    37


    32

    39

    37


    32

    82

    83
    38

   101
Number of
 Rats with
  Tumor

    0
    0

   34


   25


   17

   24

    3


   17

   10

    9
   22

    9
                                                                            Tumor
                                                                           Incidence
 0
 0

97


68


53

62
53

12

11
58

 9
Ref.

 55
 55


 55

 55


 55

 55

 55


 56

 56


 56
 56

 56
            whether the lung is susceptible to tumor induc-
            tion by isolated alpha-emitting particles, 10 jum
            ceramic microspheres  were administered  by
            intravenous injection  to Syrian  golden  ham-
            sters. Various  quantities of ^'Pu or 238Pu micro-
            spheres  of  varying  specific  activity  (Table
            A.II-15) were  administered to over 2300  ham-
            sters. In addition,  about 700 control hamsters
            were given either none; 2,000; 4,000; 10,000;
            100,000; or 500,000 nonradioactive microspheres.
                                                  A.48

-------
                                              in umi
                                o mn IN SAUNE iHAMsnii-iii • unii
                                A  Po IN SALINE IRAT-INHAUD) - YUIU
         IB   400   to   m   TO   BHWB   I"*   »»
                  CAICULAHO CUMULATIVE MEAN DOSE TO LIWCIKADI


                   FIGURE A.II-19

    Lung Cancer after Inhalation or Intratracheal
                 Instillation of 210Po
                                                Results  of this  experiment  are  available  from
                                                all  but  two  groups  of  hamsters.  Only   four
                                                deaths from  neoplastic disease have occurred.
                                                One  animal  that  received  2000 microspheres
                                                (0.84  nCi) developed  a  hemangiosarcoma  in
                                                the left  lung and another  developed  a  well
                                                circumscribed adenoma  in  the  left  lung.  Two
                                                mucinous adenocarcinomas  occurred in ham-
                                                sters that received 6000 microspheres (354 nCi).

                                                This  experiment  indicates   that  the  hamster
                                                lung is not very susceptible  to tumor induction
                                                by  isolated  plutonium particles deposited  in
                                                the capillaries.  The results confirm an  earlier,
                                                smaller  experiment with  rats given plutonium
                                                microspheres by the same technique in which
                                                no  neoplasia was  observed.  The  results  also
                                                agree  with the experiment of Sanders in which
                                                239PuO2 particles  deposited  in   lungs   of  rats
                                                following  intraperitoneal  injection   failed  to
                                                cause  pulmonary neoplasia.*
*On July 29, 1976 additional information was received on this study from Dr. Ernest C. Anderson at  Los Alamos
Scientific Laboratory.
                       Summary of Lung Tumor Incidence (LASL Data on Syrian Hamsters)
                  Specific
                  Activity
                 (pCi/sphere)
             Number
               of
             Spheres
 Lung
Burden
 OiCi)
Approximate
  Dow'
Tumors
Animals
Incidence
(% ± S.D.)
 BA1>
Animals
Incidence
(% i S.D.)
                                    "DIFFUSE" EXPOSURES (greater than 25% of lung mass exposed)
                Intratracheal sol., "°Po
                   N.A.C      N.A.
                Intravenous spheres, iJBPu
                     2       70,000
                Intravenous spheres, "'Pm
                    450       50,000
                Intravenous spheres, iMPu
                     60       6,000
                     60       2,000
                     13       2,000
                     4       6,000
                        0.12°
                        0.14
1-2 krad total

 13 krad/yr
                                              14/47

                                              17/163
           30 ±8

           10 ±3
                                       22.0       28 krad/yr      12/54       2216
                                      LOCALIZED EXPOSURES (less than 3% of lung mass exposed)
                        0.36
                        0.12
                        0.03
                        0.02
 30 krad/yr      2/148       1 ± 1
 10 krad/yr      0/72        0 ± 1
  2 krad/yr      0/70        0 + 1
  2 krad/yr      0/154       0 ± 0.5
       CONTROLS
              3/220      1.4 + 0.8
            12/47

            85/1636

            16/54
                       3/148
                       0/72
                       0/70
                       9/154


                       1/220
                                                           ^Maintained by weekly instillations for 7 weeks.
            24 ±7

            32 ±5

            30±7
                        2±1
                        0+1
                        0+1
                        6 + 2
                                                                                              0.5 + 0.5
aTotal energy/total lung mass.                           	, 	, .
"Bronchiolar adenomatoid lesion; regardless of whether graded   eLow grade BAL 1 to 2+.
 1+, 2+, 3+.
CN. A. = not applicable.

•In this table the tumor incidence observed in hamsters in which  the lungs received relatively diffuse alpha irradiation
exposures is compared with the tumor incidence in hamsters given iMPu microspheres which irradiated less than 3% of the
lung mass. A 10-30% tumor incidence is observed in the hamsters which received relatively diffuse  radiation exposure,
compared with only 1% in the group of hamsters that received JMPu microspheres. No tumors were found in three other
groups. This is taken by the Los Alamos staff as conclusive evidence that highly localized alpha irradiation of the lungs
is less effective in causing lung tumors than more diffuse alpha irradiation. The  same conclusions can be drawn from
the incidences of bronchiolar adenomatoid lesions. It  should  be noted that the  2J*Pu microspheres in all four groups
qualify as "hot particles" according to Tamplin and Cochran's definitions, in that all were above 0.07 and 0.6 pCi/particle.
                                                       A.49

-------
                                           TABLE A.II-15
                   Exposures of Hamsters to Intravenous Plutonium Microspheres [58]
Date of
Exposure
1971 May
May
May
June
June
June
June
Aug
Aug
Nov
Dec
1972 Feb
July
July
Dec
1973 April
April
April
May
June
June
July
July
Oct
Oct
Nov
Nov
1974 Jan
Jan
Jan
May
May
Number of
Animals
69
71
74
71
71
71
72
71
47
154
148
142
20
34
30
109
107
102
104
37
109
97
44
26
15
53
52
52
51
60
76
71
Spheres per
Animal
2,000
2,000
2,000
2,000
2,000
2,000
2,000
2,000
10,000
6,000
6,000
6,000
1,600,000
300,000
6,000
60,000
60,000
80,000
80,000
400,000
150,000
500,000
50,000
900,000
500,000
40,000
20,000
20,000
40,000
60,000
60,000
30,000
Specific
Activity
(pCi per sphere)
0.07
0.22
0.91
0.42
4.30b
13,30b
59.00b
2.10b
0.22
4.30b
59.00b
0.22
0.07
0.42
8.90b
0.91
8.90b
2.10b
0.22
0.42
0-.06
0.03
0.91
0.016
0.016
0.06
0.06
0.19
0.19
1.60
2.10b
0.19
                                                            1.30
                                                           112.00
                                                           126.00
                                                           53.00

                                                           55.00
                                                           710.00
                                                           168.00
                                                           18.00
                                                           170.00
                                                            9.00
                                                           15.00
                                                           45.00
                                                           14.00
                                                            8.00
                                                            2.40
                                                            1.20

                                                            3.80
                                                            7.60
                                                           96.00
                                                           126.00
                                                           11.00
                                                                      Mean
                                                                   Survival Time
                                                                   (days of age»)
                                Other
                                Insults
                     630
                     795
                     765
                     670
                     635
                     620
                     650
                     720
                     830
                     720
                     615

                     695
                     715
                     655
                     (350)

                     490
                     395
                     515
                     680
                     505
                     455
                     470
                     440C
                     480
                     395
                     385
                     450

                     390
                     385
                     455
                      d
                      d
Cytoxin
Clf2C\4
Zymosan
Zymosan
             fAnimals exposed at age 100 days.
             bPlutonium-238; all others contain "»Pu.
^Weanlings exposed at age 30 days.
"No data yet available.
Inhaled  ™PuCh,  "'PuCfe,  and  "CmOz  in
Rats [60].  The carcinogenic  response to in-
haled ^PuOz, 239PuOa, and 244CmO2 was com-
pared in about 830 female PSF Wistar rats. The
experiment included 188 controls. The rats were
given a  single exposure  to  the aerosol and
observed for the  duration  of their  life  span
(Table A.II-16).

The AMAD  ranged from 1.2 to 2.6 urn for
23«PuO2,  1.7  to  3.4 /nm for  239PuO2,  and 0.7
to 1.3 /^m for 244CmO2. Autoradiographs showed
that at  doses  above  10 nCi,  ^PuOa and
239PuO2 were concentrated in subpleural and
peribronchiolar  regions of  the  lungs  within
    several   months  after  exposure.   However,
    single alpha  tracks  in  the 244CmO2  animals
    suggested  a much  more diffuse  distribution
    at all dose levels except for occasional aggre-
    gates  in   macrophages  and  hemosiderin.
    Particles were  still  present in 238PuO2 and
    239PuO2 rats two years after exposure and were
    concentrated in  subpleural regions  of  the
    lung and  less  frequently in  peribronchiolar
    regions.  More than  half the pulmonary neo-
    plasias   observed  were  bronchiole-alveolar
    adenocarcinomas. About  a  third  were  squa-
    mous cell  carcinomas, occurring mostly  in
    plutonium rats at the higher doses. Six heman-
    giosarcomas were seen in  239Pu rats.
                                               A.50

-------
                                           TABLE A.II-16

               Pulmonary Neoplasia in Rats After Inhalation of 238PuO2,239PuO2 or 244CmO2[60]
              1MPuO2*
"'PuOz

Lung Dose
(rad)a

No. of
Rats
Tumor
Incidence

Lung Dose
(rad) a

No. of
Rats
Tumor
Incidence
(%)

Lung Dose
(rad)a

No. of
Rats
Tumor
Incidence
(%)
0
<10
26 ±11
56+11
153 ±81
1720 + 990
8340 + 3240
^10,000
50
118
50
33
34
27
6
26
  0

  2.5
  2.0

  9.1
  5.9

 48.1b
100.0 b
 19.2b
0
<10
27 ±12
78 + 17
255 ±132
680 ±120
2100 ±1210
MO 000
48
134
51
26
38
16
18
15
                                                          0

                                                         1.5

                                                         7.8

                                                        34.6

                                                        44.7b

                                                        31.3

                                                        66.70
                                                        46.7 b
                         0

                        0.4

                        6.0

                       32.0

                       710.0

                      1600.0
20
57

61
54

43
24
  a Cumulative dose to 620 days postexposure:   mean and standard deviation
  bSignificantly greater from controls at P <0.05 level
  *Data shown here were updated by Dr. Sanders from that appearing in the reference cited.
  0

 1.8

 3.3

11.1

32.6

  0
Pulmonary neoplasia was observed in  groups
of rats which received lung doses somewhat
less than  10  rad. However, statistically signifi-
cant increases of tumor incidence  occurred
only at higher  doses.  Of  particular interest
in this experiment  is the apparently  greater
carcinogenic  effectiveness  of  239PuO2  than
238PuCh at   comparable  doses.  Since  both
plutonium isotopes  were present  as particles
in the  lungs, the difference in their effective-
ness may be due to a difference in distribution
of the absorbed energy.  Because the specific
activity of 238Pu  is 280 times greater than that
of 239Pu, if the particles of both  are equivalent
in size, one  might  expect equivalent radio-
active  quantitities of 238Pu  to  be  distributed
among  280  fewer  particles  than  for 239Pu.
Thus, all other factors being equal, a specific
amount of 239Pu  might be  expected to irradiate
more cells  than  an  equivalent  amount  of
238Pu. The same explanation might also apply
to the 244Cm; however,  the results are  still
incomplete.

The  results of  this  experiment with 238PuOz
contrast   markedly  with  Sanders'  previous
      experiment  with  "nonparticulate" 238Pu,  in
      which  a  statistically  significant  increase  in
      lung cancer  incidence (20%) occurred at  32
      rad (Table A.II-9).

      Other Studies

      A  number of animal  studies which bear on
      the hot particle issue are in progress at several
      laboratories. While these studies are not suffi-
      ciently complete  to draw conclusions of  a
      quantitative  nature,  some of the preliminary
      data should be mentioned.

      Ballou  et al.  [61] are studying the late effects
      of  inhaled  238Pu(NO3>4,  239Pu(NO3)4,  and
      253Es(NO3)3  in about 1,000 male  Wistar  rats.
      Preliminary results indicate that the number
      of lung tumors in these  rats which  inhaled
      relatively  soluble  transuranic   compounds
      greatly exceeds the number of skeletal tumors.
      Also,  253Es, which has a very  short  half-life
      of 20.5 days, appears  to be  less  effective  in
      causing cancer than the  much longer half-
      life 238Pu and 239Pu. This  suggests a possible
      dose rate effect. Ballou [62] is also conducting
                                             A.51

-------
a similar experiment with 241Am(NO3)3. Com-
parison of the  results  of these experiments
with relatively  soluble  transuranics with the
results from  the experiments  with insoluble
transuranics will provide  information relevant
to the  hot particle issue.

Two current  studies  of  inhaled  transuranic
compounds  in  Syrian  hamsters  at Battelle,
Pacific  Northwest  Laboratories  [63]  and  at
the  Lovelace Foundation Inhalation Toxicology
Research  Institute [64]  are  of  special interest
to the general problem of  the toxicity of in-
haled  radionuclides.  Sanders  [63] at Battelle
has  seen only  three  malignant lung tumors
in  about  300  hamsters  after inhalation  of
238PuO2  or  239PuC»2.  Mewhinney and  Hobbs
[64] at Lovelace have not reported any malig-
nant lung tumors in experiments  with about
2,500 hamsters which  were exposed to Pu or
Am aerosols; however, it must be noted that
some  of these experiments have not been in
progress  very  long.  Nevertheless,  the  data
from both laboratories  are adequate to suggest
that Syrian  hamsters  are much  less suscep-
tible to the carcinogenic  properties of inhaled
 alpha-emitting  transuranics  than  rats. These
 negative  results with  hamsters  are also in
 contrast to the high incidences of lung tumors
 in hamsters reported  in  the polonium intra-
 tracheal  injection  experiments   at  Harvard
 [55,56]. The reason for this difference is not
 known, but it may be  related  to the mode of
 administration  of  the  radionuclide;  i.e.,  a
 single inhalation of the transuranics as opposed
 to multiple intratracheal injections of polonium.

 Conclusions

 Experiments with animals have  demonstrated
 that  alpha-emitting  radionuclides deposited
 in lungs have  carcinogenic  properties.  Both
 particulate  as well as  less paniculate radiation
 sources have been found to cause pulmonary
 neoplasia in rodents and dogs. None of these
 experiments  have  indicated  that  the  trans-
 uranic alpha-emitting radionuclides are  far
 more effective in  causing  lung cancer when
 the radiation dose to  lung tissue  is delivered
 by particulate, as compared to less particulate,
 sources.
Recently, attempts have been made to describe
mathematically   the  relevant  experimental
animal data [65,66].  Because the data  exhibit
a wide  range even  within an experiment, it
is  not possible  to argue  for any  particular
dose-response relationship. However, a linear
model was used in an analysis of the rat data
[67]. Only data  from groups  of animals  for
which there was not an appreciable shorten-
ing of lifespan were used in the analysis; thus,
only data for doses  less than about 800  rad
were included. The results are summarized in
Figure A.11-20,  a  and  b,  which  shows the
relationship between the  incidence of lung
cancer and radiation  dose for inhaled  soluble
transuranics and inhaled insoluble  plutonium
dioxide,  respectively.  If the  slope  estimates
are taken as the best available, then the risk
of  lung  cancer  for  rats that  inhaled  soluble
transuranics  was  about 8  x   10~4  cases  per
rad, while for rats that  inhaled relatively  in-
soluble PuO2 the  risk  was about 16 x 10'4.
Therefore, the  risk  to rats  from  insoluble
plutonium was about double that from soluble
alpha-emitters.   Although   the   difference
is  statistically significant,  the  authors cau-
tioned that "because of the biological problems
characteristic of these  kinds  of experiments,
the quality of the data and evidence of non-
linearity,  the  statistical  power of  such a test
is questionable."

An  analysis of  experimental  animal data  for
induction of lung cancer  by  external irradi-
ation and by internally deposited alpha and
beta-gamma-emitters has been recently com-
pleted [66]. Lung cancer effectiveness factors
were calculated for each  type of radiation
exposure. Values of the ratio of effectiveness
 of alpha irradiation  compared with uniform
 irradiation ranged from 0.35 to  110 with  a
 geometric mean  of 4.  For  alpha-irradiation,
 compared with  beta irradiation, values ranged
 from 0.06 to 25  with  a geometric mean of
 2.5. The wide range of values resulted from the
 large  variability of  the data. While  alpha
 irradiation  was  generally   more   effective
 than uniform irradiation and  beta  irradiation,
 for all dose levels and all animal species the
 mean  differences were less than 10, the value
 usually taken as the quality  factor for  alpha
 irradiation.
                                             A.52

-------
s
8
  MO
   90
   n
   TO
   60
   50
   40
   30
   20
   10
          A(6)
       •(30)
                                             TUB
                                                                0(20)
                                                           A(13t
                                                             VBM)
                                               >u CITRAH : KOSHHUBNIKOV*

                                               fa AMMONIUM-Pu-PENTACARMNATt • KOSHNUDNIKOVA

                                               S>u ' SANKRS
         FIGURE A.ll-20a

Incidence of Lung Cancer in Rats
after Inhalation of Soluble Alpha-
   Emitting Radionuclides [67]
 (The number of animals in each
  group is given in parentheses)
             108     200     300400     500      600700     800
                           CALCULATED CUMULATIVE MEAN DOSE TO LUNGS, red
                                                                     900     1000
        FIGURE A.ll-20b

 Incidence of Lung Cancer after
 Inhalation of Insoluble Alpha-
  Emitting Radionuclides  [67].
(The number of animals in each
 group is given in parentheses)
                                                        100     200     TOO     400      500     600      700     800

                                                                 CALCULATED CUMULATIVE MEAN DOSE TO LUNGS, rad
                                                                                                                900
                                                       A.53

-------
Analysis of Lung Tumor Mortality in the Battelle
Beagle Lifespan Experiment*

Forty  beagles in  the Battelle  group between
12 and 43 months of age (mean age = 562 days)
were  given "single,  10-30  minute inhalation
exposures to 239PuCh aerosols via a mask" [52].
Eighteen of the original 40 dogs died with lung
tumors as the primary cause of death. Seven-
teen died of other causes, primarily pulmonary
fibrosis,  and  in  nine  of these  lung  tumors
were  in  evidence even though they had not
developed to the point of  causing death. Fi-
nally,  five dogs  were  sacrificed  for analysis
of tissue distribution of plutonium.  Sacrificed
animals  were asymptomatic for lung tumors
and none had lung tumors  at autopsy. Details
of  the experimental procedures and  results
are given by  Park et al.  [52].

In order to use the Battelle  beagle experiment
to test the Cochran and Tamplin Hot Particle
Hypothesis it is  necessary to assess the  lung
tumor mortality rate in these beagles in  rela-
tion to the estimated number of hot particles
deposited in their lungs. It must first be noted
that the Cochran and  Tamplin risk factor  of
1/2000 per hot particle is a  risk of death from
lung   cancer.  Thus,  Cochran  and  Tamplin
used   cancer death  risks given in  the  BEIR
report [68]  to calculate their estimate that
1/1000 is the lung  cancer death  risk which
would result from continuous  lung exposure
at the current maximum permissible level for
workers. Since they went on  to calculate that
such  a risk  would be  generated by two hot
particles with a risk of 1/2000 each, it is clear
that the  latter figure is a risk  of death  from
lung cancer, as opposed to a risk, for example,
that an  individual  will  have an incipient lung
cancer developing.

For the  purposes of the present analysis, the
risk of beagles in the Battelle study dying from
lung  cancer  will be assessed for a risk period
 •Prepared  for  the  Committee's  use   by
 E. B. Lewis
extending from the time of the initial exposure
to the aerosol to 3600 days thereafter. At the
end of the risk  period the animals would be
expected to have  averaged 11.5 years of age,
since  the average  animal was 562 days of age
at the time of initial  exposure. Although the
mean life span  is not known  accurately for
the normal unirradiated beagle in the Battelle
colony, 11.5  years is probably  a  reasonable
estimate.

Two methods  will  be  used to derive the accu-
mulated  risk of death from a lung cancer in
the Battelle group at 3600 days postinhalation.
The  first  method  involves construction  of a
survival table  and analysis of the cumulative
proportion  of  survivors  at  3600  days.  The
results are shown in  Table  A. 11-17. Without
any  assumptions  about the  nature  of the
cancer induction process, the estimated cumu-
lative probability  of dying from lung cancer,
Qx,  at x days after inhalation of the aerosol
can be derived from the relationship:
where  Px is  the  cumulative  probability of
surviving x days after inhalation of the aerosol.

It is  evident from Table A.II-17 that for the
animal  that died of lung cancer at 3537 days
postinhalation, the probability of dying from
lung  cancer  was high enough, 0.82 (1-0.178),
to  make  it likely that the animal could have
had more than one primary lethal lung cancer.
A lethal  lung  cancer  is defined as one that
has developed to the  point  at  which  it  is
capable of causing the animal's death.

The probability of dying from lung cancer is
more strictly the probability of dying from  at
least  one lethal lung  cancer.  Since cancers
are expected  to arise  as  rare  independent
events  it  is  appropriate to use the Poisson
distribution to  estimate the frequency of multi-
ple primary  cancers. It should  be  noted that
the actual number of primary cancers cannot
be directly  observed since  multiple cancer
foci  may  result  either from  metastases of a
single primary  cancer or from multiple primary
cancers.
                                             A.54

-------
                                             TABLE A.II-17

                              Survival Table for the Battelle Group of Beagles
       (1)
(2)
(3)
(4)
                                         (5)
                                         mx(a)
dx                  Px           Calculated mean number
Time in days
after inhalation
of 239PuO2
1629
1635
1823
2211
2229
2341
2356
2412
2565
2792
2809
3079
3313
3441
3537
3664
3676
4068
"x
No. of dogs alive at
the start of the day, x
24
23
20
16
15
14
13
11
10
9
8
7
6
5
4
3
2
1
No. of dogs dying
of lung cancer
during the day, x
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Cumulative
probability of survival
at the end of day, x
0.958
0.917
0.871
0.816
0.762
0.708
0.653
0.594
0.534
0.475
0.416
0.356
0.297
0.238
0.178
0.119
0.059
0.000
of lethal lung cancers
per dog alive at end of
day, x
0.043
0.087
0.138
0.203
0.272
0.346
0.426
0.521
0.627
0.744
0.878
1.032
1.214
1.438
1.725
2.131
2.824
—
(a)mx=(-)loge(Px)
                                                 A.55

-------
The probability of surviving to x days without
a lung cancer is given by the first .term of the
Poisson distribution, e~m or [exp (-m)], where
m is the mean number of lethal lung  cancers
that  the  average animal  in  the  population
would possess at x days.  It follows that the
cumulative probability of dying from  at least
one lung cancer at x days is

           Qx = 1 - [exp (-mx)]            (2)

Combining Equations 1 and 2 gives
           mx=(-)loge(Px)
(3)
 Values of m calculated in this way are shown
 in column  5 of Table A.II-17. For the animal
 that  died  at  3537 days  postinhalation  the
 value of  m is 1.7. The next death occurred
 at 3664 days, for which time the corresponding
 value  of  m  is  2.1  cancers.  At  3600 days,
 therefore,  the  average  number  of  lethal
 cancers per animal would  have been approxi-
 mately two.

 For  the purpose  of making comparative  risk
 evaluations, it  becomes essential to determine
 also the  rate  at  which the  beagles  died of
 lung cancers as a function of the  duration of
 risk; that is, the elapsed time, t, since the initial
 day of exposure to the  radioactive  aerosol.
 For  this purpose a life table method of analysis
 was chosen, since this method has considerable
 power  to  dissect  the  time course of tumor
 development  even when,  as in the present
 case,  there are  relatively  small  numbers of
 animals at  risk  [69].  The  probability of  a
 beagle in the  Battelle group dying from lung
 cancer,  qx, in  a given  interval  (arbitrarily,
 100 days  in length) is found to be adequately
 expressed in terms of a simple power  function
 of t, namely:
               q  =a(t)b
(4)
 where a  and  b are constants. Actually the
 analysis has been carried out using the more
 precise relationship,
                qx=1-exp[-a(t)b]
(5)
where the quantity, a (t)b, is equivalent to mx
of Equation 2 and can be thought of as a rate,
Rm, at which lethal lung cancers develop in
a given interval. For a sufficiently small inter-
val, qx will in fact be equivalent to Rm for all
practical  purposes, and  in  the present case
it turns out that a choice of an interval of 100
days  in  length satisfies  this  condition.  By
analogy with Equation 2, Equation 5 allows for
the contingency that no matter how small the
interval in the life table there is a finite chance
that more than one lethal  lung cancer will
develop in that interval.

Briefly,  the method  of  fitting the  constants
involved use of a computer to generate  a life
table for each pair of values of a and  b to be
tested and then to test goodness of fit between
observed and expected numbers of lung cancer
deaths by the Chi-squared criterion, first group-
ing such numbers into  six successive  800-day
intervals.  In  this way the  values of a and b
that result in a  minimum value of Chi-squared
are found to be 9.0 x 10~15 and 3.2, respectively,
for t expressed in  days. The life table based
on these values is shown in Table A.II-18 and
the  resultant Chi-squared  value  is 3.8, which
for three degrees of freedom is not statistically
significant (P = 0.3). Even when a finer group-
ing  into 400-day intervals  is used, in none of
the  12 intervals does the difference between
observed and expected numbers of deaths give
cause for  concern. If Equation 4 is used instead
of   Equation  5,  identical   results,  including
identical values of a and b, are obtained. Sub-
stitution of these values of  a and b in the right
hand side of Equation 4 and integration over
the limits  of 0 to 3600 days gives 1.9 for the
mean number of lethal lung cancers per animal
at  3600  days after  exposure to the  aerosol,
which is in good agreement with the  number
calculated from the survival table (Table A.II-
17); namely, two, as shown above.

An  approximate  upper limit for  the mean
 number of lethal  lung cancers  at 3600 days
 postinhalation  has  been derived by first esti-
mating an upper  limit for the  constant  b.
When b is as high as 4.5,  Chi-squared is at  a
                                             A.56

-------
             TABLE A. 11-18

Life-Table Analysis of Lung Tumor Mortality
   in the Battelle Group of Beagle Dogs
(1)
X
Mid-point in
days of each
successive
100-day inter-
val beginning
on the day of
exposure to
»PuO,
50
150
250
350
450
550
650
750
850
950
1050
1150
1250
1350
1450
1550
1650
1750
1850
1950
2050
2150
2250
2350
2450
2550
2650
2750
2850
2950
3050
3150
3250
3350
3450
3550
(2)
',
No. of dogs
alive at the
start of
interval




40
40
40
40
40
40
40
40
40
36
34
34
32
31
27
26
25
21
20
19
19
16
16
14
11
10
9
9
8
7
7
6
6
6
5
4
(3)
w«
No. of dogs dead
due to cause
other than cancer
(No. of dogs with
lung cancer which
was not the
primary cause
of death )
0
0
0
0
0
0
0
0
1
2
0
2(2)
1
3(2)
1
1
M1)
1(1)
0
0
3(2)
0
0
1(1)
0
0
0
0
0
0
0
0
0
0
0
0
(4)
»»
No. of dogs
sacrificed




(5)
d,
No. of dogs
dead with
primary lung
cancer during
interval

(6)
[d,]
Expected no.
of dogs dead
with lung
cancer (*)
[dx]
Mi'xiiqxi
(7)
[l.l
Expected no.
(8)
P'x]
No. of dogs
of dogs alive at al risk of
the start of
interval (b)


dying of lung
cancer during
interval (c)

(9) (10)
[qj d,
Probability Observed no.
that dog will of dogs dead
die of al least with primary
one lung lung cancer
cancer during in 400 day
interval(d) interval
(11)
[d,J
Expected no.
of dogs dead
with lung
cancer in
400 day
interval
during interval

0
0
0
0
0
0
0
0
3
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
0
0
0
2
2
1
1
0
1
1
0
1
0
0
1
1
1

0.00+
0.00+
0.00+
0.00+
0.01
0.02
0.04
0.06
0.08
0.11
0.14
0.18
0.22
0.26
0.30
0.35
0.39
0.43
0.49
0.57
0.59
0.60
0.66
0.70
0.72
0.77
0.80
0.83
0.84
0.85
0.83
0.81
0.77
0.72
0.66
0.60

40
40.0-
40.0-
40.0-
40.0-
40.0-
40.0-
40.0-
39.9
35.8
33.7
33.5
31.4
30.1
25.9
24.6
23.2
20.8
19.4
18.9
18.3
14.8
14.2
13.5
12.3
11.1
10.3
9.5
8.7
7.8
7.0
6.2
5.3
4.6
3.9
3.2

40
40.0-
40.0-
40.0-
40.0-
40.0-
40.0-
40.0-
37.9
34.8
33.7
32.5
30.9
28.1
25.4
24.1
22.2
20.3
19.4
18.9
16.8
14.8
14.2
13.0
11.8
11.1
10.3
9.5
8.7
7.8
7.0
6.2
5.3
. 4.6
3.9
3.2

0.00+
0.00+
0.00+ u
0.00+
0.00+
0.00+
0.00+ U
0.00+
0.00
0.00
0.00 °
0.01
0.01
0.01
0.01 °
0.01
0.02
0.02
0.03
0.03
0.04
0.04
0.05 4
0.05
0.06
0.07
0.08 J
0.09
0.10
0.11
0.12 L
0.13
0.14
0.16
0.17 J
0.19


A /\.
U.V+



0.1


n c
U. J


1 1
1 . 1


1Q
.y



2.6



3.1



3.3



2.8

                  A.57

-------
                                           TABLE A.II-18 (Continued)
(1)
X
Mid-point in
days of each
successive
100-day inter-
val beginning
on the day of
exposure to
wpuo,
3650
3750
3850
3950
4050
4150
4250
4350
(2)
U
No. of dogs
alive at the
start of
interval




3
1
1
1
1
0
0
0
(3)
*x
No. of dogs dead
due to cause
other than cancer.
(No. of dogs with
lung cancer w. >ch
was not the
primary cause
of death.)
0
0
0
0
0
0
0
0
(4)
4X
No. of dogs
sacrificed






0
0
0
0
0
0
0
0
(5)
d,
No. of dogs
dead with
primary lung
cancer during
interval



2
0
0
0
1
0
0
0
(&)
[d,i
Expected no.
of dogs dead
with lung
cancer la'
[dxl
•nviiqj
during interval

0.52
0.45
0.38
0.31
0.25
0.20
0.15
0.11
(7\
[Ix]
Expected no.
(«)
[I'xl
No. of dogs
of dogs alive at at risk of
the start of
interval (b)




2.6
2.1
1.6
1.2
0.9
0.7
0.5
0.3
dying of lung
cancer during
interval 



2.6
2.1
1.6
1.2
0.9
0.7
0.5
0.3
(9)
hxl
Probability
that dog will
die of at least
one lung
cancer during
interval 
-------
minimum when a = 3.2 x 10~19 but the corres-
ponding value of P has dropped to 0.1; owing
to the small numbers involved,  such a pro-
cedure  can only provide  a  rough  estimate
of 4.5 as the upper 90% confidence limit for b.
When these latter values of a and b  are sub-
stituted   in Equation A, integration over the
limits of 0 to  3600  days gives  a  value of 2.1
tumors.  In a similar way an upper limit for the
constant a, when b is 3.2, is found to  be 1.3 x
10~14, which yields  an estimate of 2.7 lethal
lung  cancers  at 3600 days.  By  analogous
methods a lower limit for  the mean  number
of lethal lung  cancers per animal at that time
is 1.2.

If the age of the  animal is  substituted for t in
Equation 4 by adding the mean  age of the
animals  at the  time of exposure to the aerosol
(namely, 562 days), then the best fitting power
of the age is found to be 4.0. The purpose of
introducing age, as opposed to duration of risk,
is solely  to permit comparison of  these results
with the behavior of other  cancer rates. Thus,
the natural  incidence rates of many  types of
cancers   [70],  including lung cancers  [71],
have been shown to vary also in accord with
a power of  the age  of 4.0  or more. Doll [72]
has also  shown that  radiation-induced leuke-
mia  rates  in  spondylitic  patients increased
steeply as age  at time of irradiation increased
and  in  a manner paralleling  the increase in
natural  leukemia incidence  rates  with  age.
It is concluded that, in the case of lung cancer
induced  by alpha radiation,  risk evaluation
probably  should  be  based upon the relative
risk  rather  than  the absolute risk  method.
This will  be discussed more  fully below.

The  significance  of  the beagle findings will
be assessed first in relation  to the Hot Particle
Hypothesis and then in relation to the  problem
of estimating  radiation-induced  lung cancer
risks in human population groups. It is instruc-
tive to use the beagle experience to derive an
upper limit for the lung cancer death risk per
hot  particle and  then  to  compare that risk
with the  one  Cochran and Tamplin  derived
from  skin  tumor data  in  rats. The  estimate
based on the  beagle experience is an upper
limit, in the sense that it is  based on the arbi-
trary assumption that the average of two lethal
lung  cancers  per animal  at  3600  days post-
inhalation  results entirely from a hot particle
effect. For  the animals that died of lung cancer
before that time, the mean initial lung burden
was 1.07 juCi.  As shown in Table A.II-19, the
average  animal  with such a  burden is likely
to  have  had deposited  in  its deep  lungs at
least  1.3 million  Type 1  particles  or at  least
200,000 Type 2. (Type 1  and  Type 2 refer to
particles defined  by  Cochran and  Tamplin
as  having  specific  activities  of 0.07  pCi and
0.6 pCi, respectively.)

It follows that if the beagle experience  is used
to derive an estimate of the accumulated lung
cancer  death   risk  associated with  any  hot
particle effect, then the upper limit for such a
risk per Type 1 hot particle is roughly 1.5 per
million   (2  lethal   lung  cancers/1,300,000
particles), or one per 100,000 (2/200,000)  per
Type 2 particle. These hypothetical  risks could
be  one  or more orders of magnitude  lower,
if not zero, if the bulk of the  lung cancer  risk
experienced by the beagles resulted from the
generalized alpha irradiation  from the total
a9Pu activity in their lungs. These risk estimates
based on the beagle experience are thus strik-
ingly  lower than the  risk of one per 2,000 per
hot particle of either Type 1 or Type 2 which
Cochran and Tamplin derived on the basis of
their  analysis of data on skin tumors in  rats.

It is especially instructive to assess the induced
lung cancer risks experienced by the Battelle
beagle group in relation to estimates of lung
cancer risks in human beings  based upon the
experience of occupational groups exposed to
alpha radiation. At  the  outset it should be
noted that  the BEIR Committee suggested the
use of two methods  of assessing cancer death
risks,  including  those  from  lung  cancer;
namely, an absolute  risk  and a  relative  risk
method. There were insufficient data to decide
between  the two methods and the committee
therefore calculated risks by both methods.

The BEIR  Committee suggested that  if the
absolute  risk method is adopted a risk constant
of one lung cancer death per million person-
years  per rem  should be used, this  constant
                                             A.59

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                                           TABLE A.II-19
   Estimated Number of Hot Particles Deposited in the Pulmonary Regions of the Battelle Group of 15 Beagles
     That Died Between 0 and 3600 Days of Lung Cancer. [Calculated on the assumption of (1) a log normal
     frequency distribution with respect to particle size before inhalation of the aerosol; and (2) a constant
        deposition frequency in the pulmonary regions; that is, any particle is equally likely to reach the
                                pulmonary regions regardless of its size.]
                                               Type of Aerosol
   Number of Dogs Exposed That
   Died of Lung Cancer

   Mean Initial Lung Burden (ILB),juCi

   Estimated Number of Type 1
   Hot Particles (> 0.07 pCi)

   Estimated Number of Type 2
   Hot Particles (>0.6 pCi)
      A

CMDb = 0.5,

  ag c = 2.3
  1.01

4.1 x 10s


1.4 x 105
                                                                   B

                                                             CMD = 0.25 urn

                                                               a a = 2.1
                             10


                            1.10a

                          1.8x10*


                          2.1 x 10=
                                            Weighted
                                              Means
  1.07

1.3 x 106


1.9 x 105
    aFor one of the dogs exposed to aerosol "B" the initial lung burden has not been determined. Therefore,
    the initial lung burdens and particle number estimates are based upon 10 instead of 11 dogs; the omitted
    dog died with a lung cancer as cause of death 3537 days after exposure to the aerosol.
          = Count Median Diameter

    c O  = Geometric Standard Deviation
     NOTE:  When allowance is made for" differential pulmonary deposition (see Figure A.II-2), the numbers
     of Type 1 and Type 2 particles deposited in the deep lungs are likely to have been higher than those
     shown in this table.
to take  effect after a 15-year  latent period
and to remain in effect for either (a) a 30-year
period  or (b) indefinitely. An estimate can
then  readily be  derived  for the accumulated
lung  cancer  risk a person  might be expected
to acquire by  age 70, for example, if he had
been continuously exposed over his working
life to the maximum permissible occupational
level  as  currently set (15 rem per year to the
lung). The accumulated  dose  over a 48-year
work span extending from age 18 to 65 inclu-
sive amounts  to  720 rem  (48  x 15) and the
duration  over which the  risk  constant   is
            assumed  to apply  is either (a) 30 years or (b)
            36 years  (from age 34, after  a  15-year latent
            period, to the start of age  70).  For  present
            purposes the more conservative assumption (b)
            is  desired. The resultant accumulated  lung
            cancer death risk is 0.026  (1 x 10'6 x 720 x 36).
            (Strictly speaking,  for  chronic exposures  at
            a constant dose rate the effective dose is  one-
            half of the total accumulated dose, as shown
            by  Marinelli  [73]; however,  since  the risk
            constant  used in the BEIR Report was derived
            on the basis  of the accumulated rather  than
            the effective  dose, it is necessary to  use the
                                               A.60

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accumulated  dose   in   applying  that   risk
constant.)

The  BEIR  Committee suggested  that  if  the
relative risk method is used, a value of 0.29%
should  be  adopted  for  the   incremental
relative risk  per rem. For  present  purposes,
before the relative risk constant can be applied
it  is necessary  to estimate the  accumulated
lung cancer  death  risk  by age  70 for  adult
males  in   the  general  population.  That  is,
such  males  constitute the population  from
which  the  occupational groups under consid-
eration are  expected to  be largely drawn;
namely, groups that mine or process heavy
alpha-emitting   elements.  From  age-specific
death  rates  that  have  been averaged over
the years 1962-1967 and tabulated by Burbank
[74], the accumulated lung cancer death  risk
by age 70  can be estimated from  the cumula-
tive proportion  of survivors at that age and is
found  to be 0.036. Such an estimate must be
used with  caution since it is  known that  it is
markedly  influenced by  such factors as  the
smoking habits  which characterized different
age groups in the population  at risk. With  this
reservation  in  mind,  the accumulated lung
cancer death risk at age 70 can be estimated
as 0.075 (0.036 x 720 x 0.0029) for the hypo-
thetical  case  of  continuous   occupational
exposure  of  the lungs at  the maximum  per-
missible level.  It should  be emphasized that
in applying  the relative  risk as  well as  the
absolute risk method the underlying assump-
tion is that of a linear dose-response relation-
ship over the range of exposures being consid-
ered. (Again it  should be stressed  that since
the BEIR Committee used the cumulative dose,
as opposed to the effective mean dose, to derive
the relative risk constant in the case of chronic
exposures,  it  obviously  is  necessary when
applying their estimate of that  constant to
use the cumulative  dose experienced by  the
population under consideration.)

To  recapitulate, 0.026 and 0.075 are estimates
based  on  absolute risk and relative risk meth-
ods, respectively,  of the  accumulated death
risk from lung cancer by  age 70 for the case
of continuous occupational exposure  of the
lungs at  15 rem per year. As already indicated,
the steepness  with which  lung  cancer death
rates in the Battelle beagles rose as a function
of age strongly suggests that the relative risk
estimate is the appropriate  one  to use in the
present  context of assessing lung cancer risk
from alpha emitters.

The  relative   risk  of  0.075,  calculated  for
humans, will  be used  as  a basis for  testing
whether the  generalized  alpha   radiation  to
which  the beagle's lungs  were  exposed can
account for the observed lung cancer mortality
in those animals. The effective  lung dose of
alpha radiation which the beagles had accumu-
lated by  3600 days postinhalation  amounted to
approximately  51  times*  the corresponding
dose accumulated by age 70 in the hypothetical
case of a worker exposed  continuously at the
occupational   maximum    permissible   level
(that is, the dose upon which the estimate of
0.075  is based). Hence  on the basis of linear
extrapolation  (0.075 x 51)  there  should have
been  an  average  of 3.8 lethal  lung cancers
*The  mean initial lung burden  of the 15 animals
that died of lung cancer between 0 and 3600 days
postinhalation was 1.07 nC\, which corresponds to
an initial dose rate of 2.05 rad per day. The effective
half-life of this activity in the lungs of these beagles
averaged  970  days.  The total  accumulated lung
dose at 3600 days is found to be 2575 rad, or 25,750
rem if a quality factor of 10 is used for converting
rad of alpha radiation to  rem.  Marinelli [73] has
shown that,  in determining a  linear dose-response
relationship, the effective  dose is  given by the
mean   accumulated dose,  which in  the  present
case is found to be  18,410 rem. For occupational
exposure at  15 rem per year for 48  years the total
accumulated dose to the lungs  is 720  rem, which
corresponds to a  mean accumulated dose of 360
rem. Hence  the ratio of the effective dose to the
lungs of the Battelle beagles that died of lung cancer
and the effective dose to human lungs from occupa-
tional exposure at the  maximum permissible level
is 51 (18,410/360).
                                              A.61

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per animal at 3600 days compared to. the two
previously  calculated tumors per animal  esti-
mated by  the  life table method. Since  the
relative risk constant is itself subject to consid-
erable uncertainty, being based on sets of data
for which the calculated values of that constant
ranged from  0.0016  and  0.0068 [68],  it  can
be inferred that the expected number of lethal
lung  cancers for the case of exposure of the
human lung could have  ranged from 2 to 9.
For present purposes it suffices to note that
the  beagle  lung cancer death  risk  is  not
markedly different from, and may have been
less than, that  which would be calculated on
the basis of averaging alpha radiation doses
over the entire lung.

Finally,  it  may  be of  interest  to analyze
Cochran   and   Tamplin's original  statement
that  the  maximum  permissible lung burden
(MPLB)  should  be  reduced by a  factor of
115,000. This factor, it  will be recalled, was
derived by dividing the maximum permissible
 lung  burden of  ^'Pu required  to give a dose
 rate  of 15 rem per year  (0.016 juCi)  by the
total  activity contained in two of their Type 1
 hot particles (0.14 pCi).  Their  choice of two
 particles, as already  noted, was based on two
 assumptions:  1) that the  lung cancer death
 risk associated with continuous lung exposure
 at the rate of 15 rem  per year was 1/1,000,
 and 2) that the lung cancer death risk per hot
 particle  was  1/2,000.  The  present analysis
 indicates  that the  appropriate  value for the
 first   of  these  risks is  1/13  (0.075),  rather
 than  1/1,000;  while  the  value for the second
 risk  is not 1/2,000  but instead  has  an  upper
 limit of 1.5/1,000,000 per Type 1 and 1/100,000
 per Type 2 hot particle.  It follows that at least
 50,000 Type 1 particles  would  be required  to
 give  the predicted lung cancer death risk  of
 0.075.  That number of  particles would  con-
 stitute a  total activity of  0.004 juCi or  more
 and  therefore would represent a factor  of no
 less  than 1/5, rather than  one of  1/115,000,
 of  the  maximum  permissible  occupational
 level. Nor is the problem changed appreciably
with the more recently defined Type 2 particle,
since at least 7,500 of such  particles  would
be  required, corresponding to a total activity
of 0.005 /xCi or  a factor of no  less than 1/4,
not  1/115,000. Since all of  the lung  cancer
deaths  in the Battelle  group of beagles can
be accounted for on the basis of the generalized
alpha  radiation, the  actual  risks  associated
with any hot particle effect may be so low as to
be  negligible when compared to the risk from
the generalized  alpha radiation.

Radiation standards, as currently applied,  are
not tied directly to  any particular  method of
calculating  risks but instead are set  in terms
of various absorbed dose  levels to the whole
body or to critical organs, depending upon the
type of population group exposed. In relating
such levels to  risks, it is  appropriate  to  use
the methods outlined  in  the  BEIR  Report.
Indeed, the relative risk method in the present
case may be  expected to predict  adequately
not only lung  cancer  risks  from generalized
alpha  radiation  but  also those from insoluble
particulates.

Summary

An  analysis of  lung cancer  mortality rates in
the Battelle group of beagles indicates  that (1)
the  generalized  alpha radiation from  the
total a9Pu  activity in  their lungs is sufficient
to  account for  all of  the  lung  cancer deaths
which  occurred in  these  animals, and (2)  if
there is a hot particle effect of the type postu-
 lated  by  Cochran and Tamplin, the risk of a
 lung cancer death per particle when calculated
 on the basis of the beagle  experience is orders
 of   magnitude  smaller than they estimated
 and could well be so small that the contribution
 from any hot particle  effect  to the total lung
 cancer  mortality is  negligible.  The  beagle
 results also  indicat<>   that  the relative  risk
 method of asse  .& risks, as opposed to the
 absolute risk method, is likely to be the appro-
 priate one  for  estimating  lung  cancer  risks in
 human populations exposed to radiation.
                                               A.62

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Human Beings*

Lung cancer is the  common  designation for
a number  of  types  of  cancer arising in  the
respiratory tract. By far  the  most  frequent
type in man is cancer arising  from bronchial
epithelial cells in the first few  branches of the
bronchial tree. On histological grounds, these
bronchial tumors are divided into epidermoid
cancers, small and large cell undifferentiated
cancers,  adenocarcinomas, and  mixed types.
There  are  also  rare tumors,  carcinoids, that
arise from  argentaffin  cells in the bronchial
wall.  .

There  remains a controversy about the origin
cells of the epidermoid and undifferentiated
cancers and  adenocarcinomas. Most authors
believe that  these all  derive  from epithelial
stem  cells, with the  final histological  type
depending on the  degree of differentiation
achieved by the  cell line  that makes up the
tumor [75]. Regardless of whether these can-
cer cells have different parent cells, the impor-
tant point  is that all  three  types are increased
in  those  exposed to  certain environmental
agents, such   as  cigarette smokers  [76,77]
or persons occupationally exposed to  carcino-
gens  [78].  Smokers  have an  especially large
increase in epidermoid cancers while undiffer-
entiated  cancers  usually predominate among
persons who develop bronchial cancers from
occupational exposures.

Tumors also  arise  from  alveolar  cells [79]
and cells  in the bronchiole-alveolar region.
Some  authors have  concluded that the bron-
chiolo-alveolar tumors arise from terminal bron-
chial cells such as the Clara or the argentaffin
cells [80]. These are  rare cancers in  man [81]
and, unlike the bronchial epithelial  cancers,
have not been found  to be increased in smokers
or  in  groups  exposed to environmental car-
cinogens.  Thus they constitute a higher pro-
portion of tumors  in  nonsmokers  than  in
smokers, but  they  represent  at present no
more than a few percent of all lung cancers
observed in the population at large.
*Prepared  for  the  Committee's   use  by
E. P. Radford
Finally, there are cancers derived from plural
elements  such  as  the  mesotheliomas. Recent
work has shown that  these rare tumors are
nearly  always  associated  with   exposure  to
asbestos.  In addition,  and very rarely in the
lung tissues, tumors may occur from connec-
tive tissues or other cell types, such as fibro-
sarcomas,  leiomyomas,  and  angiosarcomas.
These tumors are not now known  to be related
to environmental exposures to carcinogens.

The number of agents known to induce human
bronchial cancers  continues  to  grow.  With
the past few years, evidence has been obtained
that    occupational   inhalation    of    bis-
chloromethyl ether, nickel compounds and
arsenic compound is associated with  increased
risk  of  bronchial  cancer. Bis-chloromethyl
ether,   an  extremely  potent  carcinogen  in
experimental animals, leads especially to  small
cell  undifferentiated  bronchial   cancers  in
man.  Thus, these  agents  join  exposure  to
ionizing  radiation,  asbestos,  mustard  gas,
chromate dust and, of course, cigarette smoke
as environmental  agents  capable of causing
bronchial cancer, now the most common cause
of cancer in males  in the United States.

Sensitivity of Lung Tissue  Cells to Induction
of Cancer by Environmental Agents, Including
Ionizing Radiation

Exposure of lung tissues to most of the numer-
ous chemical and physical agents associated
with increased  lung cancer risk has been by
inhalation; an  exception,  discussed  below, is
exposure  to  ionizing  radiation  experienced
by the  Hiroshima  survivors and patients who
received x-ray treatment for ankylosing spon-
dylitis.  The exposure dose of the gases  (e.g.,
mustard gas  or  bis-chloromethyl ether)  to
various  tissues  of  the  lungs will  depend on
their  water solubility  (highly  soluble  gases
will be removed in the  upper respiratory tract)
and the surface area of the tissues exposed
(since   diffusion  governs  uptake).  Mustard
gas is sparingly soluble in  water  and thus its
uptake  is  determined by  the surface  area.
Similar  considerations  apply to  the poorly-
soluble respirable dusts such as arsenic trioxide
and  chromates. In  the  particle  size range
                                            A.63

-------
which  can  reach  the  lungs  and.  tracheo-
bronchial tree,  diffusion also  governs  most
of the deposition  process. This means that,
on   inhalation,  initial  deposition  of  these
materials occurs predominantly in  the alveoli
of the lung, rather than in the ciliated  bron-
chial region, because of the very much  larger
surface area  of  the alveoli  (more than  100
times greater).

The important datum, however,  is the dose
delivered to cells. Since the cells of the alveolar
surface are  much more attenuated than those
of the ciliated epithelium,  if deposition of a
carcinogen  is proportional to  the gas-liquid
surface area then obviously the alveolar cells
will  receive a larger dose of a diffusing agent
than the bronchial  epithelial  cells.  On  the
basis of  this reasoning, therefore, if the sensi-
tivity  to cancerous  transformation  of  the
epithelial cells of the respiratory tract is equal
throughout,  then the  cells  of  the alveoli,
especially the type  I cells (since they receive
the highest dose  of these agents) should give
 rise to many  more cancers than the bronchial
 epithelium.   This  reasoning  applies equally
 to cigarette smoke. In fact, there is no evidence
 that alveolar or  bronchocell cancers  are
 associated  with  inhalation of  these  carcino-
 genic gases, submicron  dusts,  or   cigarette
 smoke. Although the groups exposed to occu-
 pational  carcinogens  have  been  relatively
 small, if alveolar or bronchiolo-alveolar cancers
 had increased they would  have been immed-
 diately detected because these cancers  are so
 rare in  the  general population.  (Pleura!  and
 peritoneal  mesotheliomas, the first  type of
 cancer  shown  conclusively to be related to
 asbestos exposure,  were  noted   precisely
 because they are so rare and  thus the increase
 observed  in  workers  handling asbestos  was
 especially striking.)

 This report,  of course, is concerned  with the
 hazard  from inhaled apha-emitting  elements.
 We have extensive evidence, both for  cancer
 risk and site of cancer origin, in  one human
 group exposed to alpha-emitters, underground
 uranium miners.  Data on origin and  cell type
 of  the  cancers  are  especially complete  for
 the U.S. uranium  miners  studied by  Sacco-
manno and  his associates {77]. Before consid-
ering this group  in  some  detail, however, it
is  worthwhile  to  review  the  lung  cancer
experience in populations exposed to external
radiation.

In  British  studies  of patients  treated  with
x-rays  for  ankylosing   spondylitis  [82]  the
x-ray was directed  principally at the thoracic
and lumbar spine. From analysis of the dose to
the  lung tissues,  it  is reasonable to  conclude
that much of the lung  parenchyma  received
the  same  x-ray  dose as  did  the  bronchial
tissues.  In the  Hiroshima survivors who  were
exposed to  both neutrons  and penetrating
gamma   radiation, the neutron dose to the
bronchial tissues, because of shielding effects,
would have been  somewhat lower than to
the  alveolar tissues closest  to  the  direction
of the bomb. In  both groups, with  well over
100  excess cancers  observed, there  is only a
slight indication  of  an  increase  in alveolar
cancers [83].

The U.S. uranium miner study offers the best
quantitative  evidence of  the  relative sensi-
tivities of different lung tissues to alpha irradi-
ation [84]. These miners are exposed to radi-
ation from the daughters of radon; the half-
lives of  these  daughters are short,  up to 30
minutes,  and most  of  them are  inhaled on
respirable  dust  particles  in the submicron
size range.  These  particles  are deposited  in
the respiratory  tract,  where   movement  is
primarily by diffusion. The time  period during
which they  move   about  in the respiratory
tract is  limited by  their physical  decay  rate.
Calculation  of the  alpha  dose to  bronchial
epithelium  and  lung tissue is  complex but
Albert  estimates that the number  of alpha
emissions in the alveoli  from inhalation  of a
typical   mine  atmosphere   is   approximately
10  times higher than   that released in the
bronchial tree in the regions where tumors
form.

Saccomanno   has   examined  histologically
the lung tissues of approximately  200  lung
cancer cases among these  miners and reports
that only one bronchiolo-alveolar  cancer has
been observed.  Considering the population
                                               A.64

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at risk,  this is somewhat  Fess than might be
expected on the basis of the frequency of these
cancers  in the male population but, even if we
accept  this  case  as a radiogenic  cancer,  it
would appear that the radiosensitivity of the
bronchial  epithelium  in  man is  at  least  100
times that of the alveolar or bronchiole-alveolar
tissues.  In fact, the relative sensitivity may be
much greater.

For alpha irradiation therefore, as well as for
exposure to dusts and chemical agents in man,
alveolar and bronchiole-alveolar tissues appear
to be very much more resistant to cancer induc-
tion  than the bronchial  epithelial  cells. This
conclusion  varies somewhat  from experience
with cancer induction in experimental animals
(discussed  in the  previous  section).  Some
possible explanations for the  special sensitivity
of  the  bronchial epithelium  in  man  are:
a) the  bronchial  epithelium  is more rapidly
renewed by cell division than are the alveolar
epithelium  or connective tissue elements and
radiosensitivity  is  related  to  this  quality;
b) most (but not all)  occupational bronchial
cancers   have been  observed   in  cigarette
smokers who had been  exposed to irritants
in smoke and  many  of  whom   had chronic
bronchitis,  both of which may make the epi-
thelium  more   sensitive   to   carcinogens;
c) human   populations are  commonly  and
repeatedly  exposed to viral  infections of the
respiratory   epithelium which  cause  rapid
loss  of  epithelial  cells, requiring rapid  pro-
liferation  of stem cells  to  repopulate  the
mucosa. Moreover, these viruses could directly
contribute  to the process of transformation
to a cancer; and d) other inhaled pollens, dusts,
and  gases  in  the general  environment  may
contribute  to bronchial irritation. Regardless
of the  reasons for this sensitivity, the tissue
at special risk in man from inhaled transuranic
elements is probably the bronchial epithelium,
especially in the  more proximal regions  of
the bronchial tree.

Dose-Response Data for  Cancer Induction by
Alpha Radiation Exposure in Man

An extensive  review  of  dose-response data
for cancer  induction  by  alpha  radiation was
presented  in  the  BEIR Report in  1972 [68].
The Committee's position as reflected in that
document  is  summarized  below, followed  by
an account of recent developments  relevant
to the issue of toxicity of alpha-emitters.

Dose-response data have been  obtained from
a number of  underground mining groups ex-
posed to relatively high levels of radon daugh-
ters in  the past and to individuals exposed
to thoron  exhaled as a daughter from body
burdens of thorium  salts given for  diagnostic
purposes. The best data have been from the
U.S. uranium miners [84] and the Newfound-
land fluorspar miners [85]. From the  analysis
done in 1972, these two groups showed similar
risk estimates per  rem of  exposure  to  the
bronchial epithelium, although the fluorspar
miners  gave  an  estimate of 1.65 excess  lung
cancer cases/rem/106 person-years, while the
figure for the uranium miners was 0.63 cases/
rem/106  person-years.  It was pointed out in
the BEIR Report that all of these populations
are still  at increased lung  cancer risk  and,
thus, these figures are likely  to  be  revised
upward. The  similarity  of risk estimates for
lung cancer based on the gamma and neutron-
irradiated Hiroshima survivors and the miners
supported  the conclusion  that the radiosensi-
tivity of the  lung  tissues was consistent  with
well-known radiobiological principles.

Documentation of new underground mining
populations exposed to elevated radon daugh-
ter concentrations  and an  updating  of the
experience of the  U.S. uranium miner group
have contributed new evidence on  the ques-
tion of  risk from alpha irradiation. The  new
mining populations that have been studied are
in iron   and  zinc  mines  in  Sweden  [86,87].
The cumulative dose response data in these
miners are comparable to those of the other
groups but the most significant aspect  of these
mines is that  the radon daughter concentra-
tions were relatively low, with exposures  in
some cases below  1  Working Level. This evi-
dence, therefore, extends  our documentation
of increased  cancer  risk to lower dose rates
than had  been observed  previously  in the
uranium and fluorspar miners.
                                            A.65

-------
Finally,  it has been possible  to update the
U.S.  uranium miners  study group to 1972
[88]. As expected, the cancer incidence rate
has remained high, at  roughly  30  times the
rate in the remainder of the U.S. population.
Adding the new lung cancer cases,  modifying
the definition of period at risk  from 5 years
after beginning of mining  (used in  the Inter-
agency and  BEIR  Reports)  to 10 years after
beginning of mining, and  eliminating three
cases which  occurred during the  5-10 year
period  (which is probably  less time than the
latent  period for lung .cancer) results in  a
revised absolute  risk of about  2 cases/rem/
106 person-years. The new data suggest that
the straight-line fit of the dose-response curve
used  in the  BEIR Report  is in error, with
the risk in the lower dose categories, higher
per  rad than  in  the  highest dose groups.
Since the lowest dose category  (<  120 WLM)
contains few cases  and the statistical  range
of uncertainty  is very large as a result, there
is a corresponding uncertainty in  the exact
basis for calculating the risk in this group.
It should be noted that these  risk estimates
may continue to increase if more cases occur,
especially  if with  advancing  age, relative
risk compared  to  the general  population
remains high.
 Comparison  of Human and Animal  Radio-
 carcinogen Effects*

 While responses to "toxic" levels of external
 radiation and internal emitters in  people and
 experimental animals have been studied over
 the past 75 years, uncertainties regarding the
 quantitation of effect and appropriate methods
 to  scale  dosage,  time and  effect  (risk) still
 exist.  Furthermore,  human  experience has
 been limited  and usually has been observed
 through epidemiological, retrospective studies
 while laboratory studies on animals are  pros-
 pective  in nature. There is no  radionuclide
 *Prepared  for  the  Committee's  use  by
 M. Goldman
(or  any other agent) for which  toxic levels
cannot  be determined. The lungs in which
the radionuclide  is deposited do not appear
to  be  uniquely  sensitive   or  resistant to
radiation-induced  effects,  including  cancer,
when compared to other comparably exposed
tissues.  However,  despite   intensive  study,
the  exact  mechanisms  of radiation-induced
cancer are still unknown. Many theories have
been proposed, usually  invoking  a series of
initiating  and promoting factors  for which
some data are available, but it appears likely
that no single model is  universally acceptable
[89].

In the absence of human data, the relationship
between radiation dose and  biological effects
determined in animal experiments have been
used to  predict  human  consequences [90].
The most common parameters used have been
the organ-averaged cumulative radiation dose
and the crude excess incidence of effect (i.e.,
the number of animals  manifesting the effect
divided by the total  number of dosed or dead
animals at each exposure level).  This statistic
provides  an  estimate of fraction  or  percent
effect per unit dose, but is fairly species (e.g.,
lifespan)  dependent. While  some  long-lived
animals, such  as dogs and nonhuman primates,
have been and are being studied, most of our
animal data have been derived from relatively
short-lived rodents [91,92].

A  comparison  of  the  interspecies radio-
biology of inhaled alpha particles is hampered
by the lack of direct human experience. Several
indirect approaches can be used which attempt
to "normalize" the  spatial and temporal dose
and  metabolic and  anatomic factors as well
as differences in pathologic appearance, spon-
taneous disease and life expectancy. People
are  larger and live  longer than experimental
animals in the laboratory; however, there are
 probably fewer differences  than similarities.
The  special case of lung cancer  in people  is
somewhat obscured by problems relating to
 use of tobacco products and  perhaps other
occupational  and environmental atmospheric
 pollutants. Table A.II-20 gives some quantita-
 tive interspecies comparisons.
                                             A.66

-------
     Life Span (yr)
     Adult Mass (kg)

     Lung Mass (g)

     Bone Mass (g)

     Liver Mass (g)
     Lymph Node (TB) Mass (g)
     PuO2 Lung Ret., ?b (da)
       TABLE A.II-20

Some Species Intercomparisons


             Mice

               3
               0.03

               0.4

               3

               4
200-
500
             Rats
            ^•Wi^B^^H

              4

              0.4

              2

             40

             10?
                          250
                          550
Dogs

  13

  10

  75

1000

 375

  35
 300-
1000
Human
Beings

  72

  70

 1000

 7000

 1700
  250
  240-
  650
Conventional Approach

The interspecies comparison most used in risk
assessments  is time independent and attempts
to use  the  linear dose  to  risk approach to
calculate  the  absolute  percent  increase in
effect per unit of dose [68,93]. For bronchial
lung cancer, absolute estimates range from 0.6
(ABCC) to 1.61 (fluorspar miners)  cases  per
yr/rem/106  persons, with an average of I/
106/yr/rem.  Since the data are as yet incom-
plete, the risk may  be twice as high in the
final  analysis   (i.e.,  2/106/yr/rem).  If  a  30
year  "plateau"  for risk obtains,  the  total
excess yield  might be 30 yr x 2/106/yr/rem
or about 0.006%/rem;  if a  50 year plateau
obtains, the value could  be about 0.01%/rem.
Since all the  radiation dose  is not absorbed
initially  and  there may be an effective latency
per effective rem of about 20 years, it would
appear  that a  reasonable estimate might  be
about 0.005%/rem.

Rodent inhalation studies with alpha-emitting
radionuclide particles have yielded a variety of
lung cancer  risk estimates.  Bair and Thomas
[67]  recently summarized many of these  and
derived a rodent lung cancer linear estimate
of about 0.1%/rad. The single completed  dog
study at Battelle provides a crude upper limit
of about 90%/1500 rads or 0.006%/rem which,
although derived from very  high doses, is not
markedly different from the human and rodent
 estimates.  In  all  three  estimates, the  lung
 dose is averaged over the entire lung volume
 and, as stated above, does  not  account for
 lifespan differences  in survival rates  at  each
 dose level. Thus the classical approach suggests
 a  rodent-dog-person  risk  of about  10'3  -
 lO-^/rem of lung  irradiation.

 The Radium-Bone Standard Approach

 For many years  the human  experience  with
 radium poisoning  has been a benchmark for
 radionuclide standard-setting.  Based primarily
 on  studies of painters  of watch  dials,  data
 on  this  bone-seeking alpha-emitting  nuclide
 have  been  reviewed often  and  to  date  it
 would appear that doses in excess of several
 hundred  ( > 700) rad of cumulative exposure
 have increased the  risk for induction of skeletal
 tumors [94].  Furthermore,  studies in  rodents
 and  dogs  have  attempted to simulate  the
 human experience and  provide  a basis for
 further interspecies comparisons of the effects
 of alpha particles in mammals [95,%].

 In addition, plutonium has also been admini-
 stered to  animals to provide data on plutonium
 in the skeleton [97,98]. One obvious compar-
 ison, therefore,  would  relate the effects of
 these two nuclides in one organ for different
 species.  Jacobi [99] recently related the  226Ra
 data for bone sarcomas in beagles  and humans
 and attempted to account for temporal factors
                                            A.67

-------
by use  of an age-specific mortality  rate for
beagle bone cancer  and an  estimate of_an
induction period Tj  (Tj  = 2.0  + 5A-°-67; T =
years, A = yCi/kg  injected). His dog-human
comparison is  shown in Figure A.I 1-21 and
suggests  a 5-10-fold lower risk to humans than
to dogs  at each  mean  alpha  rad dose level.

Using a somewhat similar approach, Goldman
et al. [90] compared mouse, dog, and  man.
Results are shown in Figure A.II-22.

Osteosarcomas in animals following injection
of plutonium are summarized in Figure A.II-
23 [40]. Except for the dog data (open circles),
these data are derived from rodents. The dogs
clearly are more responsive per rad than the
rodents. An attempt to quantify the difference
is shown  in Figure  A.II-24, which  compares
the  plutonium in mice studies conducted by
Finkel [100]  at Argonne National  Laboratory
and the beagle plutonium study at  Utah  [101].
There is about a 30-fold difference  between
the  two species over most of the range  of
 plutonium injections, but only  about a 2-fold
 difference for these two species for radium
 [90]. If  one  applies the distribution  factor
   100
 Ł
 *
 tn
 a:
 8
 cc
 O
 oo
10
    0.1
                    BEAGLES
         A EXPERIMENTAL
        	CALCULATED
           /
      10'
             10*          103

            MEAN SKELETON a-DOSE (RAD)
                                        10«
                                              (DF)  of 5 for plutonium  relative  to  radium
                                              and uses,  for example, the 10% risk (in  rad)
                                              estimate for  beagles and humans from Jacob!,
                                              a relationship such as the following  can be
                                              derived.
                                                   Ra dog bone
                                                 Ra human bone
440 = 440/5
1500    X
         ,x ^
                     Pu dog bone

                    Pu human bone
                                                                  rac|/io% plutonium bone
                                                                     tumors in man
                                              If linear, this would be an estimate of about
                                              3 x  10'3%/rem. To further extend the analogy
                                              of  radium:plutonium,  dogrman  to  estimate
                                              relation of lung  cancers according to species
                                              requires  assuming that  both  organs  manifest
                                              the  same ratio of sensitivity to tumor induction
                                              in each species. The comparison might be:
                                                    Ra Dog       .    Pu Dog
                                                    	 (bone)  = 	—
                                                    Ra Man          Pu Man
                             (lung)
                                              The 10% lung cancer incidence due to pluto-
                                              nium  exposure in dogs  is from  the  Battelle
                                              data of  90%/1500 rad. Thus  the 10% yield
                                              I
                                              ui
                                              U
                                                     100
80
                                                   111
                                                   u  60
                                              t  40
                                              3

                                              B  20
                                              5
                                              i
                                                      0"	
                                                       0.01
                                                                       DOG
                                                          0.05 0.1       0.5  1

                                                               INJECTED DOSE,
                                                                  FIGURE A.II-22
                                                                                          10
                FIGURE A.II-21

  Bone Sarcoma Incidence in Humans and Beagle
          Dogs from Exposure to 266Ra [99]
                                                 Estimate of Incidence of Osteosarcomas in Man
                                               Based on Osteosarcoma Data Obtained from Mice
                                                 and Dogs, Allowing for Differences in Radium
                                                                Retention [90]
                                             A.68

-------
100
| 80
1
2 60
8
LL.
o
0 40
S
Q
O
~ 20
0

_

-


•


" 111! ,
1 10









* ,it J








(

b





'

•\
r,l4
100


(






I
r?
I
<







I
1
o
•I
f


k 1
1


V'
p
o
II
i



.


,1 1
(




)







1 1 llllll










1.000 10.000
         CALCULATED CUMULATIVE MEAN DOSE TO BONE (RAD)

                   FIGURE A.II-23

Plutonium-Induced Osteosarcoma in Experimental Animals [40]
                                                         FIGURE A.II-24

                                                     Comparison of Plutonium-
                                                       Induced Osteosarcomas
                                                        in Mice and Dogs [90]
     INJECTED ACTIVITY (pCi/kg)
                        A.69

-------
might  be   10/0.006%/rerTT1   or  1666  rem
(167  rad)*;  440/1500 = 167/x,  or  x  =  570
rad/10%. The human lung  cancer estimate
related  to  the bone comparison  would be
0.0018%/rem.

The Quality Factor Model

The  relative carcinogenicity of  alpha  parti-
cles  in animal  lungs can  be compared to
effects  from  low LET  (B-Y,X)  irradiation,
but the human radionuclide data to complete
the comparison  is lacking. The precision  and
accuracy of the dosimetry  in  the uranium
and  fluorspar miner data are severely  defi-
cient and  the possible role  of inhaled  co-
carcinogens  is unknown [93].  Most  of  the
dose  estimates for  effects  range from. 2,000
to 20,000 rem.

That the incidence of lung tumors in animals
is not  linear with  respect to  dose is seen
in Figure A.I 1-25 for low LET  radiation  and
Figure   A.I 1-26   for  alpha-emitters  [92].  A
comparison  of  the effectiveness  of  the two
types of radiation  is shown in  Figure A.11-27
where  for the  same level  of  effect  the two
types of radiation  differ by a factor of about
5 for  the  low  doses  and by  about 20 for
high doses. If  the QF of 10  is applied  to
the alpha dose curve (and a  QF  of 1 for  0,
Y  and x-rays), it would appear that the two
curves  would almost superimpose. Again noting
the 10%  incidence  merely for  comparative
purposes, the  100  rad  alpha value multiplied
by the QF of  10 is about equal to the  3 - Y
value of about 1000 rad (rem). The inconstancy
of the  relationship is  shown by  the lack  of
complete parallelism between  the two curves
in Figure A.II-27.

As  in  Jacobi's  bone comparison  for  radium,
lungs  also  may respond  nonlinearly  when
subjected to continued low  dose rate  alpha
irradiation.  The  limited  data  on  uranium
miners also suggest a nonlinear response [99].
                                      CALCULATED DOSE TO LUNG (RAD)
                                        FIGURE A.II-25
          Fractional Incidence of Lung Cancer in Animals Exposed to low LET ()3,X,7) Radiation from
                       Implanted Sources and X-Radiation from External Sources [92]
 *ln  computing  this from  the  90%  incidence
 value  in  dogs,  no consideration  is given to
 the  occurrence of multiple tumors in the dogs.
                                             A.70

-------
           10
                                                              100.000
                        100               1000             10.000
                 CALCULATED CUMULATIVE MEAN BETA-GAMMA DOSE TO LUNG. RAD


                             FIGURE A.II-26

    Relationship Between Incidence of Lung Cancer and Radiation Dose to
Lung from Inhaled Beta-Gamma Emitting Radionuclides in  Experimental Animals [4t]
         U
         o
         1
         8
         o
         u
60


50


40


30


20


10
                 ALPHA EMITTERS
               (BASED ON UNIFORM
                 ABSORPTION OF
                    ENERGY)
                                                 ALPHA EMITTERS
                                               (ENERGY ABSORBED IN
                                                CRITICAL VOLUMES.
                                                  0.1% OF LUNG)
               10        100        1.000     10.000     100.000   1,000.000

               CALCULATED CUMULATIVE MEAN BETA-GAMMA DOSE TO LUNG. RAD



                                 FIGURE A.II-27

       Comparative Relationships Between the Incidences of Lung Cancer and
Radiation Doses from Inhafed Beta-Gamma and Alpha Emitters in Experimental Animals [92]
                                      A.71

-------
MECHANISMS OF CARCINOGENESIS*

Carcinogenic Mechanisms at the Intracellular
Level

The cellular processes  that  cause neoplastic
transformations  are  unknown. The efficiency
of  carcinogenic action  is clearly  affected by
factors  that  determine the  extent to  which
a  given  carcinogen actually  reaches  target
cells and the susceptibility to  transformation.
Susceptibility depends on a  variety of factors
which determine the extent of initial injury
and the effectiveness of repair.

At present,  it is not clear  whether  there is
a  common pathway for different carcinogens
for cellular neoplastic transformation, although
this has been suggested in terms of  the acti-
vation of a latent viral  oncogen [102,103]. It is
also not clear whether the inheritable abnor-
malities transmitted to successive generations
of proliferating  cancer cells  are  caused by
genetic  damage or abnormal  differentiation
 involving  deranged expression of the normal
genome.  Neoplastic  transformation  at  the
cellular  level   is  not  a  simple all-or-none
 phenomenon. Transformed cells show  differ-
ences  in  the  extent to which  they acquire
 the several  independent  properties of  neo-
 plasia:  unrestrained   proliferation,  invasive-
 ness, and  antigenicity.

 Neoplasia is also not an immutable  property
 which  is  transmitted equally  to  all  the pro-
 geny  of a transformed cell. The clonal out-
 growth   of  single   cultured  cells   shows  a
 spectrum  of  neoplastic  and nonneoplastic
 properties amongst progeny cells which has
 been  related to chromosomal balance.  Single
 cells isolated  from  malignant  teratomas also
 produce clones of cells,  some of which are
 neoplastic and others of which undergo normal
 differentiation.  The neoplastic character of a
 tumor,  therefore,  appears to  depend  on the
 average behavior of its component cells.
   *Prepared  for  the  Committee's  use  by
   G. W. Casarett
It  is possible that  the carcinogenic  process
will  prove to be  similar to that of species
evolution, in that random genetic damage of
somatic  cells produced  by  carcinogens is
combined with selection  pressures to breed
out a race of cells  having growth advantages
over their normal counterparts.  It would  be
expected that the process would  be generally
slow, progressive  in  character and wasteful
of cells  due  to  lethal injury; cell lethality,
however,  could  undoubtedly facilitate  the
selection  process,  especially  in tissues which
normally have a low proliferative rate.

Pitot and  Heidelberger [104]  have formulated
an epigenetic scheme  for neoplasia based on
abnormal  differentiation. Braun [105] has also
elaborated on this alternative based on plant
tumorigenesis  experiments.  These  studies
show that plant  tumors  can arise from  an
epigenetic differentiation abnormality which
is  characterized by  the  production of large
amounts  of  growth hormone  by the tumor
cells. These  anaplastic  tumors,   after  years
of  propagation  in tissue  culture, can  per-
manently  revert to normal plant  tissue  when
grown under certain conditions.

The  Problem  of  So-Called  "Precancerous"
Lesions

The  problem  of  so-called   "precancerous"
lesions applies also to  terms such as "preneo-
plastic",  "pretumorous",  and "preadenoma-
tous" and to the question of whether benign
tumors  should be considered precancerous
lesions.

According   to   Ewing  [106], precancerous
lesions  are those which precede and  favor
the development of cancer but do not possess
the  essential  elements  of  the  cancerous
process.

It must be  pointed out  that there is nothing
in the histologic  picture of these lesions  that
indicates  which of them will "precede  and
favor the development  of cancer." It  is the
ulterior  development  of similar   lesions  that
is brought to mind when such  a prediction
is made [107]. The concept  of  precancerous
                                              A.72

-------
lesions  is purely  statistical and certainly not
applicable   pathognomonically  in  individual
cases.

Although most so-called  precancerous lesions
are proliferative in nature, there are many other
lesions,  even more  proliferative, which are
not precancerous [108].  Likewise, in  addition
to  proliferative  changes,  many of  the so-
called  precancerous  lesions  are  also  charac-
terized   by  tissue  disorganization,  vascular
changes and fibrosis,  but so are many  other
lesions  which  are not  precancerous.  These
changes, or combinations  of changes, might
have  tumorigenic-enhancing  or  promoting
influence, but they more likely represent the
various  ways in  which  tissues can  respond
to  severe  acute  or  chronic damage  rather
than  essential  changes  that  assure  cancer
development.  If  the   latter  were  true, the
cancer  incidence  would  be  vastly  greater
than it is.

Perez-Tamayo [107] lists many diseases which
have  been  regarded as  precancerous, about
half of  which  (in the total list)  have  been
shown to be incorrect. Not even the presence
of  a  benign tumor  is necessarily indicative
of increased probability of cancer development.

In order to  qualify strictly as a precancerous
lesion,  even  in  the   statistical sense,  there
must  be  a  clear  quantitative  relationship
between the precisely defined lesion (which
must  not possess essential elements  of the
cancerous  process) and consequently  a  signi-
ficantly enhanced incidence of cancer.

Once  the  statistical   relationship  has  been
established  through  observation of behavior
of different lesions,  the microscopic diagnosis
may aid in  assessing  the possibility of cancer
development, but not because of any peculiar
histologic markings.

The terms "precancerous", "preadenoma" and
the like have  been  used  somewhat casually
to indicate  changes  reminiscent of those pre-
ceding  or concomitant with tumor develop-
ment,   to   enhance  descriptions  of  certain
changes by  describing them as "precancerous"
or "preadenomatous", or to imply the possi-
bility of subsequent tumor development when
there  is uncertainty  as  to the  presence  of
essential features  of the  tumorous  process
in the  lesions.
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                                     APPENDIX B

                PROCEDURES FOR COMMITTEE APPOINTMENTS AND
                CONSIDERATION OF POTENTIAL BIAS OF MEMBERS
As a general rule, individuals  are appointed
to NRC  committees by  the  chairman,  staff
officers, and  members of the NRC  division
and assembly concerned.  (Division members
are nominated by  scientific societies  in their
relevant fields and, less frequently, by govern-
mental agencies.)

The appointment process usually involves two
or  three  layers   of  personal consultation
between  the selectors  and people who  are
actively working in the pertinent fields. Typi-
cally,   the   assembly/division  chairman   or
executive  director  approaches an  individual
in academia or industry whom  he  believes to
be well informed about activities  in his field
and solicits  his help in identifying potential
members for the committee or panel. On  the
basis of such suggestions, the chairmen select
a  balanced  membership  and  recommend it
to the  President of the National Academy of
Sciences for his approval.

The President's office examines the nomina-
tion  list with the  following criteria in mind:
balance,  qualifications, and present commit-
ments  of the nominees to other committees
and  panels  of  the Academy  and Research
Council. Although  a number of persons serve
on two or even  more NRC  committees at a
time,  it  is a  general  practice to limit  the
assignments to prevent overburdening a com-
mittee  member.

NRC  committee  members are,  in general,
chosen   for  their  technical  qualifications,
recognized communication skills, and judg-
mental qualities, but  other  more  subjective
factors, such as motivation and temperament,
are not overlooked. The identification of pos-
sible members and the final committee selec-
tion  are  often  preceded  by  an extensive
analysis of the various  competences  needed
to  deal  with the subject and  issues being
considered.

The appointing function is thus carried out at
two levels:  at the assembly and division level,
where there is professional expertise  in the
scientific  fields  and  the  specific problems,
and in the Executive Office  of the Academy,
where the above-mentioned  screening pro-
cedure  takes place.  The  Executive  Office
maintains a complete file of all current task
appointments for all activities of the  National
Academy   of Sciences  and  the   National
Research Council.
CONFLICT OF INTEREST

Organizations  avoid  knowingly appointing a
person to a committee if his interests, or those
of his employer, will be affected  by actions
of the  committee. Awards committees, for
example, should not include scientists whose
academic departments   are  applicants  for
awards  in  the programs being considered.
Industrial scientists should not sit as members
of committees  when the recommendations are
likely to affect the business interests of  their
companies. Other  forms  of conflict of inter-
est—ownership of  equities in a  company,
industrial consultancies,  and  the  like—also
must be considered.

The   problem   becomes  especially  difficult
when  a  field   is so highly specialized that
only a few top quality advisers can be found,
and when the  activities of the agency request-
ing  advice are  so pervasive  in  a  field  of
expertise  that   almost all advisers  with  the
technical competence required are  or  have
                                           B.1

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been related to the agency in some way. This
is a far from rare occurrence;  examples are
the relationship of the Atomic Energy Commis-
sion (now Energy Research and Development
Administration) to the field of nuclear reactor
development,  of the  National Institute of
Health to policies for the support of biomedi-
cal education, and of the National Aeronautics
and Space Administration to exobiology.

Where, for any  reason, conflicts  of  interest
must be accepted in order to obtain adequate
expertise, it is  important that they  be known
to all members of the committee  and to the
sponsoring and requesting agencies. This not
only ensures that possible biases are recognized,
but also assists members who have such con-
flicts  to  make  necessary  compensations  in
their own thinking and judgment.
Clear statements of  the  task  assigned  the
committee, and  of  any possible conflicts of
interest  among its members, can do much to
assure  the likelihood  of  public  confidence
in its conclusion.

The  following brief biographical sketches of
the members  of the  ad hoc Committee on
"Hot  Particles" are included to demonstrate
the expertise and competence of each member.
Some of  these  may,  in  their  background,
demonstrate  sources   of  possible  bias,  as
discussed  above.  However,  NAS/NRC  and
the Committee itself believe that in all official
deliberations,  the  members have  exercised
their  best  scientific judgements.  If any  bias
existed, it was manifested  in a critical exami-
nation of each  member's prior  public state-
ments and positions.
                                              B.2

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ALBERT, ROY E.
DATE OF BIRTH:   1924
EDUCATION:
     A.B.       1944        Columbia College
     M.D.       1946        New York University College of Medicine
                1946-47     Internship, Bellevue Hospital, Third Medical Division
                1949-51     USPHS  Fellowship  in  Cardiovascular  Hemodynamics, New  York
                            University College of Medicine
                1951-52     Residency  in  Medicine,  University of the  State of  New York  at
                            Syracuse University Hospital
PAST POSITIONS:
     1959-66     Associate  Professor,  Institute of  Environmental  Medicine, New York University
                Medical Center.
     1956-59     Assistant Clinical Professor of  Medicine (Geographical Full-Time) and  Assistant
                Director of  the Radioisotope  Laboratory, George Washington  University School
                of Medicine.
     1954-56     Assistant Chief (1954-55),  Chief (1955-56),  Medical  Branch, U.S.  Atomic Energy
                Commission, Division of Biology and Medicine.
     1952-54     Medical  Officer, Health Safety Laboratory, New York Operations  Office,  U.S.
                Atomic Energy Commission.
     1947-49     A.U.S.  Medical  Field Research Laboratory, Fort Knox, Kentucky (Military Service).

PRESENT POSITION:
     Director, Office of  Health Ecological Effects, Environmental Protection Agency (July 1975 -   ).
     Professor of Environmental Medicine (1966 -   )—on sabbatical leave.
     Vice Chairman and Deputy Director of Institute of Environmental Medicine, New York Univ.
     Medical Center (1973 -   )—on sabbatical leave.
PUBLICATIONS:
     Sixty-three journal articles, chiefly on physiology, biology, carcinogenesis, radiation biology, and
     radiation effects.
CONSULTANTSHIPS:
     Task Force II, National Conference on Preventive Medicine (1975 -   ) (American College of
     Preventive Medicine and NIH Fogarty Center).
     AIBS Life Sciences Study Team for Assessment of Ecological Impact (1974-  ) (American Institute of
     Biological Sciences).
     Study on Principles  of Decision-Making for Regulating Chemicals in the Environment (1974 -   )
     (National Academy  of Sciences—National Research Council).
                                             B.3

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CONSULTANTSHIPS (Continued):


     Task Group on  the  Influence of Radiobiological  Factors in the Estimation of  Risks of Cancer
     Induction  for Purposes  of Radiation  Protection (1974 -   )  (International  Commission on
     Radiological Protection).

     Committee on Biologic Effects of Atmospheric Pollutants - Panel on Arsenic (1973 -   ) (National
     Academy of Sciences—National Research Council).
     Advisory Committee to the Radiation Registry of Physicians  (1972 -   ) (National Academy of
     Sciences—National Research Council).
     NCRP Scientific Committee 38 - Task  Group on  Krypton-85 (1972 -   ) (National Council on
     Radiation Protection and Measurements).
     Committee on Biologic Effects of Atmospheric Pollutants - Panel on Airborne Particles (1972 -   )
     (National Academy of Sciences—National Research Council).
     Committee on Toxicology, ad hoc Panel on Carbon Monoxide (1971 -    ) (National Academy
     of Sciences—National Research Council).
     Committee on Biologic Effects of Atmospheric Pollutants, Panel on  Polycyclic Organic Matter
      (1970-72) (National Academy of Sciences—National Research Council).

     Ad hoc Committee on Environmental  Health Research, Panel on  Hazardous Trace Substances
     (1970-72) (Office of Science and  Technology, Executive Office of the President).
     Ad hoc Subcommittee on Asbestos  Hazards (1970)  (Air Pollution  Working Group of the New
     York City Health Research Council).

     Ad-hoc  Committee  on Air Quality  Standards  in Space Flight (1967) (National  Academy  of
     Sciences—National Research Council).
     Committee on Research  in the  Life Sciences, Panel  on Environmental Health  (1967) (National
     Academy of Sciences—National Research Council).
     Air Pollution Advisory Committee (1967-70) (New York City Department of Health).
     Division of Biology  and  Medicine Committee on  Space Nuclear Systems and  Radiological
     Safety Matters (1967 -  ) (U.S. Atomic Energy Commission).
     Technical  Advisory  Committee  on Uranium Mining Studies (1966)  (Department  of Health,
     Education, and Welfare).
     Consultant to the Surgeon General's Advisory Committee on Smoking and Health (1963).
                                             B.4

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ALPEN, EDWARD L.
DATE OF BIRTH:   1922
EDUCATION:
     B.S.          1946       Chemistry, University of California, Berkeley
     Ph.D.        1950       Pharmaceutical Chemistry and Pharmacology, University of California,
                             San Francisco

PAST POSITIONS:
     1972-75     Director,  Pacific  Northwest  Division,   Battelle  Memorial  Institute,  Richland,
                 Washington.
     1971-72     Associate  Director, Pacific  Northwest Laboratories, Battelle Memorial Institute,
                 Richland, Washington.
     1969-71     Manager,  Environmental and Life  Sciences Division,  Battelle  Pacific  Northwest
                 Laboratories.
     1958-69     Head,  Biological and  Medical  Sciences Division,  Naval  Radiological  Defense
                 Laboratory.
     1954-58     Head, Biophysics Branch, Naval Radiological Defense Laboratory.
     1951-54     Scientific Investigator, Naval Radiological  Defense Laboratory.
     1950-51     Assistant  Professor of  Pharmacology,  George Washington  University  School
                 of Medicine, Washington, D.C.
     1946-47     Research Chemist, Cutter Laboratories, Berkeley, California.
PRESENT POSITION:
     Director, Donner Laboratory, University of California, Berkeley, California.
PUBLICATIONS:
     Approximately 70 journal  publications chiefly  on radiation effects, biology, aging,  neuro-
     physiology, psychology, biophysics, and immunology.
HONORS AND/OR CITATIONS:
     Senior Post-Doctoral Fellow  of the National  Science  Foundation, Oxford University, Oxford,
     England (in residence 1958-59).
     Sustaining Members Award for Creative Research of the Association of Military Surgeons (1961).
     Distinguished Achievement in Science Gold Medal  and Citation, Department of the Navy (1962).
     Distinguished Service Gold Medal and Citation, Department of Defense (1963).
                                              B.S

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PROFESSIONAL AFFILIATIONS:
     National Councillor, Radiation Research Society (1952 -  ).
     Member, Board of Editors, Society for Experimental Biology and Medicine.
     Member, American Physiological Society (1952 -   ).
     Member, National Environmental Council, Dept. of HEW (1970-74).
     Chairman, Biological  Effects Advisory Panel, Bureau of Radiological Health (1968-74).
     Member, Sigma Xi. Local  chapter president (1963-64).
     Fellow, California Academy of Sciences.
     Foreign Associate Member, Royal Society of Medicine (1962 -  ).
     Member, Radiation Study Section, National Institutes of Health (1960-72).
     Member, Advisory Panel to Collaborative Radiological Health Laboratory, U.S.  Public Health
     Service (1965-70).
     Member, Quadripartite Technical Cooperation  Panel  (U.S., U.K., Canada,  Australia, Scientific
     Cooperation Group of Defense).
     Councillor, National  Council on Radiation Protection (1955-74).
     Board of Directors, National Council on  Radiation Protection (1972-74).
     Member, NCRP Scientific Committees 14 and 24: Chairman, NCRP SC 39.
     Consultant to the Director, Clinical Investigation Center, U.S. Naval Hospital, Oakland (1956 -  ).
     Member, 'Failla' Panel to the Department of Defense on Radiological Instrumentation (1955-61).
                                              B.6

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BAIR, WILLIAM J.
DATE OF BIRTH:   1924
EDUCATION:

     B.A.    1949        Chemistry, Ohio Wesleyan University
     Ph.D.   1954        Radiation Biology, University of Rochester
PAST POSITIONS:

     1973-75     Director, Life Sciences Program, Pacific Northwest Laboratories, Battelle Memorial
                Institute, Richland, Washington.
     1968-75     Manager, Biology Department, Pacific Northwest Laboratories, Battelle Memorial
                Institute, Richland, Washington.
     1956-68     Manager, Inhalation Toxicology Section,  Biology Department, General  Electric
                Company, Richland, Washington (prime contractor changed to Battelle Memorial
                Institute in 1965 - position unchanged).
     1954-56     Biological Scientist, General Electric Company, Richland, Washington.
     1950-54     Research Associate, Radiation Biology, University of Rochester.
     1949-50     National  Research  Council, AEC Fellowship in  radiological  physics,  University
                of Rochester.
PRESENT POSITION:
     Manager, Environmental and Safety Research Program, Pacific Northwest Laboratories of Battelle
     Memorial Institute, Richland, Washington (March 1975 -  ).
PUBLICATIONS:
     87 journal articles or  books chiefly on radiation biology, with emphasis on toxicity of inhaled
     radionuclides and pulmonary effects in experimental animals.
HONORS AND/OR CITATIONS:
     E. O. Lawrence Memorial Award by the U.S. Atomic Energy Commission for research on radiation
     biology of inhaled radionuclides (1970).
     AEC Fellowship in Radiological Physics, U. of Rochester, 1949-50.
PROFESSIONAL AFFILIATIONS:
     Staff Member, Joint Center for Graduate Study at Hanford (operated by Oregon State University,
     Washington State University,  and University of Washington).  Lecturer in Radiation  Biology
     (1955-  ).
     Member, International Commission on Radiological Protection, Committee  2 (1973  -  ).
                                             B.7

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PROFESSIONAL AFFILIATIONS (Continued):

     Chairman, Task Group on the Biological Effects of Inhaled Radioactive Particles, International
     Commission on Radiological Protection (1969 -  ).
     Chairman, Transuranium Technical Group (organized by the American Institute of Biological
     Sciences to advise the U.S. Atomic Energy Commission on biomedical research on transuranium
     elements) (1972 -  ).
     Member of National Council on Radiation Protection and Measurement (NCRP) (1974 -  ).
     Member, Board  of  Directors, National  Council on Radiation  Protection and Measurement
     (NCRP) (1976 -  ).
     Member of Scientific Committee 1 (NCRP) on Basic Radiation Protection Criteria (1975 -  ).
     Member  of  Scientific Committee 34 (NCRP)  on  Maximum  Permissible Concentration for
     Occupational and Non-Occupational  Exposure (1970-  ).
     Chairman of NCRP ad hoc Committee on "Hot Particles" (1974-75).
     Member  of Subcommittee on Inhalation Hazards of the Committee on  Pathologic Effects of
     Atomic Radiation, National Academy  of Science (1957-64).
     Member  of National Academy of Sciences/National Research Council ad hoc Committee on
     "Hot Particles" of the Advisory Committee on the Biological Effects of Ionizing Radiation (1974 -  ).
     Chairman, Mound Laboratory  Internal  Emitter Working Group, Division of  Biomedical and
     Environmental Research, U.S. Energy  Research and Development Administration (1975-76).
     Member, the Nevada Applied Ecology Group ad hoc Pu  Committee, AEC-ERDA (1970 -  ).
     Member, Joint Space Nuclear System/Biomedical and Environmental Research Working Group,
     Atomic Energy Commission (1967-73).
     Member, Radiation Research Society  (1954 -  ).
     Member, the  Health Physics Society (1956 -  ). Board of  Directors (1970-73).
     Member, Society for Experimental Biology and Medicine (1973 -  ). Vice Chairman, Northwest
     Section (1967-70,1974-76).
     Member, Sigma Xi (1953 -  ). Vice Chairman, Tri-Cities, Washington Club (1973-74).
     Member, Reticuloendothelial Society (1960 - ).
                                            B.8

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CASARETT, GEORGE W.
DATE OF BIRTH:  1920
EDUCATION:
            1938-41      University of Toronto (pre med.)
            1943-45      University of Rochester (pre med.)
            1948-52      University of Rochester (graduate school in medicine)
            1952        Ph.D.
PAST POSITIONS:
     1959-63     Associate  Professor in Radiation  Biology.  Chief,  Radiation  Pathology Section,
                Atomic  Energy Project. Chief,  Radiation Pathology  Section, Radiation Therapy
                Department.
     1957-59     Assistant   Professor in  Radiation  Biology  Department Scientist  (Rad.  Path.)
                Atomic Energy Project.
     1953-57     Instructor  in Radiation Biology  Department. Scientist (Rad.  Path.) Atomic Energy
                Project.
     1947-53     Chief of  Pathology Unit  and Assistant Chief  of  Radiation  Tolerance Section,
                Atomic Energy Project.
     1943-47     Research Assistant in Pathology Division, Manhattan Project.
PRESENT POSITION:
     Professor of Radiology  (secondary appointment). Director of  Experimental Research in Clinical
     Radiation Research Center.
     Professor of  Radiation Biology and Biophysics  (primary appointment). Head of  Radiation
     Pathology Section of Atomic Energy Project.
PUBLICATIONS:
     175 Journal articles, book chapters, reports, or books, chiefly on radiation pathology, radiation
     biology, carcinogenesis, cancer biology, and gerontology.

 HONORS AND/OR CITATIONS:
     Co-winner (with collaborators) of First Award and Silver Roentgen Medal, Meeting of American
     Roentgen Ray Society Meeting, 1959.
     Co-winner (with collaborators)  of First  Award (cum laude) for Fundamental Research, Annual
     Meeting of Radiological Society for North America, 1959,1964,1971.
                                             B.9

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CURRENT CONSULTANTSHIPS:

     Chairman of National Academy of Sciences Advisory Committee on Biological Effects of Ionizing
     Radiations. (Formerly member of NAS Advisory Committee to Federal Radiation Council.)

     Member of Board of Directors of National Council on Radiation Protection and Measurement
     (NCRP).

     Chairman  of  Scientific  Committee  14 of  National Council  on Radiation  Protection and
     Measurement (NCRP).
     Chairman of NCRP ad hoc Committee on Comparison of Radiation Protection Philosophies.
     Member  of National  Cancer  Institute Cancer  Research Training Committee.  (Committee
     inactive at present.)
     Consultant to Task Group on Biological Effects of Inhaled Particulates, of International Commission
     on Radiological Protection.
                                            B.10

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EPP, EDWARD R.
DATE OF BIRTH:  1929
EDUCATION:
     B.A.   1950        University of Saskatchewan
     M.A.  1952        University of Saskatchewan
     Ph.D.  1955        McGill University
PAST POSITIONS:                              _     , _.   ,   .    cl    „  „  .    _.  . .
                                               Dept. of Biophysics, Sloan-Kettermg Division,
             Sloan-Kettering Institute                  Graduate School of Medical Sciences,
                for Cancer Research                          Cornell University
1973—74
1969-74
1968-72
1964-69
1960-64
1957-60
Laboratory Head
Member
Chief, Div. of Physical Biology
Assoc. Member
Associate
Assistant
1970-74
1966-72
1966-70
1960-66
1958-60
1957-58
Professor (Dept.)
Chairman (Dept.)
Assoc. Professor
Asst. Professor
Associate
Assistant
        1967-74  Associate  Attending  Physicist,  Dept.  of  Medical  Physics,  Memorial  Hospital
                 for Cancer and Allied Diseases.
        1956-57  Consultant Physicist, Dept. of Radiology, Montreal Children's Hospital.
        1955-57  Radiation  Physicist,  Department of Radiology, Montreal General Hospital.
        1952-53   Scientific Staff, National Research Council of Canada
        1949-50   Summer Research Assistant, Physics Dept., University  of Saskatchewan.
PRESENT POSITION:
     Radiation  Biophysicst  and Head, Division  of Radiation Biophysics,  Massachusetts  General
     Hospital (1974 -  ).
     Professor of Radiation Therapy (Radiation  Biophysics), Faculty of Medicine, Harvard University
     (1974-  ).
PUBLICATIONS:
     33 Journal articles chiefly on radiation physics and  radiation biology.
CURRENT CONSULTANTSHIPS:
     Radiation Study Section of NIH (1971-75).
     Editorial Board, Radiation Research Journal (1972-75).
     Chairman, Scientific Program Committee-AAPM (1972 -   ).
     Councillor in Physics, Radiation Research Society (1974 -   ).
                                             B.11

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GOLDMAN, MARVIN
DATE OF BIRTH:  1928
EDUCATION:
     A.B.    1949        Adelphi University (Biology)
     M.S.   1951        University of Maryland (Zoology-Physiology)
     Ph.D.  1957        University of Rochester (Radiation Biology)
PAST POSITIONS:
     1972-73     Principal  Investigator,  Studies on  Canine  Bone Density,  NASA, (NAS2-6763),
                 University, of California, Davis.
                 Biophysicist-Physiologist,  Division  of  Biomedical and  Experimental Research,
                 U.S. Atomic Energy Commission.
                 Associate Director for Sciences, UCD
     1971-72  .   Consultant, General Electric Company
     1970-71     Principal Investigator, Studies on 89Sr Toxicity in Mice, USPHS, UCD.
     1968-71     Collaborator, Orbital  Flight  Effects on  Calcium Kinetics and  Fracture Healing
                 Repair, NASA (NAS2-5057), UCD.
     1958-64     Associate Radiobiologist, UCD.
 PRESENT POSITION:
     Director, Radiobiology Laboratory, UCD (1973 -  ).
     Professor of Radiobiology, Department of  Radiological Sciences, School of Veterinary Medicine
     and Department of Radiology, School of Medicine, UCD (1973 -  ).
     Research Radiobiologist, Radiobiology Laboratory, UCD (1964 - ).
 PUBLICATIONS:
     101 Journal articles, book chapters, reports, or books, chiefly on radiation pathology, radiation
     biology and carcinogenesis.
 HONORS AND/OR CITATIONS:
      E. O. Lawrence Memorial Award presented by the U.S. Atomic Energy Commission  (1972).
 CURRENT CONSULTANTSHIPS:
      Council Member, National Council on Radiation Protection and Measurements (1974 -  ).
     Chairman, U.S. Atomic Energy Commission, DSNS/DBER Biomedical Working Group (1973 -  ).
      Member, University of California Cancer Research Coordinating Committee (1973 -  ).
     Co-principal Investigator, Tumor Biology Training Grant, NIH/NCI (1972 -  ).
      Member, Advisory Committee, Crocker  Nuclear Laboratory, University of  California, Davis
      (1971- ).
                                             B.12

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GREGG, EARLE C.
DATE OF BIRTH:  1918
EDUCATION:
     B.S.    1940        Case Institute of Technology, Cleveland
     M.S.   1942        Case Institute of Technology, Cleveland
     Ph.D.  1949        Case Institute of Technology, Cleveland (Physics)
PAST POSITIONS:
     1958-65     Associate Professor of  Radiology  (Radiation Physics),   Case  Western  Reserve
                 University.
     1952-58     Associate Professor of Physics, Case Institute of Technology
     1949-52     Assistant Professor of Physics, Case Institute of Technology
     1946-49     Instructor in Physics, Case Institute of Technology
     1943-46     Research Associate, Columbia University
     1942-43     Research Associate, Massachusetts  Institute of Technology
PRESENT POSITION:
     Professor of Radiology (Radiation Physics), Case Western Reserve University (1965 -  ).
     Chief, Radiologic Physics, Department of Radiology, University Hospitals.
     Chief, Biophysics Section, Division of Radiation  Biology, Case Western  Reserve University.
     Chairman, Biophysics  Graduate Study Program, Case Western Reserve  University.
     Committee on Human Use of Radioisotopes, University Hospitals.
     Chairman, Committee on Biophysics, Case Western Reserve University.
     Visiting Staff,  Metropolitan General, St. John's, Highland View, and Lutheran Hospitals.
PUBLICATIONS:
     107 Journal articles chiefly on biophysics, ultrasonics, radiologic physics and nuclear physics.

HONORS AND/OR CITATIONS:
     Member of Editorial Board, Investigative Radiology.
     Fellow, American Physical Society.
     Standards Committee, American College of Radiology.
     Past Editor, Journal Applied Physics.
     Scientific Committee,  American Association Physics in Medicine.
                                              B.13

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HONORS AND/OR CITATIONS (Continued):
     Registered Professional Engineer, State of Ohio.
     Member, Radiation Study Section, National Institutes of Health.
     Committee on Radiology, National Academy of Sciences.
     Member, Cancer Research Center Review Committee, National Institutes of Health.
     Member, Advisory Committee on the Biological Effects of Ionizing Radiations (BEIR), National
     Academy of Sciences.
     Chairman, Division of Biological Physics, American Physical Society.
                                           'B.14

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LEWIS, EDWARD B.
DATE OF BIRTH:  1918
EDUCATION:
     B.S.    1939        University of Minnesota
     Ph.D.   1942        California Institute of Technology

PAST POSITIONS:
     1956-66     Professor, California  Institute of Technology.
     1949-56     Associate  Professor, California Institute of Technology.
     1948-49     Assistant Professor, California Institute of Technology
     1948-49     Rockefeller Foundation Fellow, School of Botany,Cambridge University, Cambridge,
                England.
     1946-48     Instructor in Genetics, California Institute of Technology.
     1942-45     U.S. Army Air Force meteorologist and oceanographer.
PRESENT POSITION:
     Thomas Hunt Morgan  Professor, California Institute of Technology (1966 -  ).
PUBLICATIONS:
     21 Journal articles chiefly on genetics of drosophila and carcinogenic effects of ionizing radiation
     on human  populations.
HONORS AND/OR CITATIONS:
     Member, National Academy of Sciences (1968 -  ).
     Genetics Society of America (Secretary 1962-64) (Vice President 1966)  (President 1967).
     Fellow, American Association for the Advancement of Science.
     American Academy of  Arts and  Sciences.
     American Society of Human Genetics.
CONSULTANTSHIPS:
     National Council for Radiation Protection and Measurements.
     Advisory Committee on the Biological Effects of Ionizing Radiation, National Research Council -
     National Academy of Sciences.
                                            B.15

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McCLELLAN, ROGER O.


DATE OF BIRTH:  1937

EDUCATION:

            1960        Doctor of Veterinary Medicine with  Highest Honors, Washington  State
                        University

PAST POSITIONS:

     1966-73     Assistant Director of Research and  Director,  Fission  Product Inhalation Program,
                 Lovelace  Foundation  for  Medical  Education  and Reasearch,  Albuquerque,
                 New Mexico.

     1965-66     Scientist, Medical Research Branch, Division of Biology and Medicine, U.S. Atomic
                 Energy Commission, Washington, D.C.
     1965-       Senior  Scientist,  Biology  Department,  Pacific  Northwest  Laboratories,  Battelle
                 Memorial Institute,  Richland, Washington (leave of absence to the U.S.A.E.C.)

     1963-64     Senior  Scientist, Biology  Laboratory,  Hanford  Laboratories,  General  Electric
                 Company, Richland, Washington.

     1959-62     Biological Scientist, Biology Laboratory, Hanford  Laboratories, General  Electric
                 Company, Richland, Washington.

     1957-58     (Summers) - Junior Scientist, Biology Laboratory, Hanford  Laboratories, General
                 Electric Company, Richland, Washington.

     1957-60     Research  Assistant, Department of Veterinary Microbiology, Washington  State
                 University, Pullman, Washington.

 PRESENT POSITIONS:

      Vice President and  Director of Research Administration  and Director,  Inhalation Toxicology
      Research Institute, Lovelace  Foundation for Medical Education and Research, Albuquerque,
      New Mexico.

 PUBLICATIONS:

      192 Scientific  publications, technical reports or abstracts on various aspects of the metabolism,
      toxicity and internal dosimetry of radionuclides in experimental animals.

 HONORS AND/OR CITATIONS:

      Elda E. Anderson Award, Health  Physics Society (1974).

 CONSULTANTSHIPS:
      Member, ad hoc Committee on "Hot  Particles", Advisory Committee on the Biological Effects
      of Ionizing  Radiations  (BEIR), National  Research Council (1974 -   ).

      Member, North American Late Effects Group Steering Committee (1974 -  ).
                                             B.16

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CONSULTANTSHIPS (Continued):

     Chairman, Environmental Radiation Exposure Advisory Committee Member, Scientific Advisory
     Board, Environmental Protection Agency (1974 -  ).
     Member, National Institutes of Health, Animal Resources Advisory Committee (1974-78).
     Member,  Environmental  Radiation  Exposure Advisory  Committee of  the  Environmental
     Protection Agency (1972 -  ).
     Member,  Transuranium  Technical  Group  (Advisory  to  U.S. Atomic  Energy  Commission,
     Division of Biomedical and Environmental Research) (1972 -  ).
     Member, National Council on Radiation Protection and Measurements (1971 -  ).
     Program Committee Member and Chairman, Health Physics Society (1970-73).
     President, American Board of Veterinary Toxicology (1970-73).
     Member, Subcommittee on Whole Animal Radiobiology and Pathology,  Los Alamos Meson
     Physics Facility (LAMPF) (1970 -  ).
     Chairman, Scientific  Committee  #30  of National Council  on  Radiation  Protection  and
     Measurements (1969 -  ).
     Member, Toxicology Study Section, National Institutes of Health (1969-73).
     Consultant, National Institute of Environmental Health Sciences, National  Institutes of Health
     (1968-71).
     Councilman, American College of Veterinary Toxicologists (1968-71).
     Advisor,  Laboratory Animal Biology and Medicine Training  Program, University of California,
     Davis (1968-70).
     Member, Joint  Space Nuclear Systems/Biomedical  and Environmental  Research  Working
     Group (1967-73).
                                           B.17

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RADFORD, EDWARD P.
DATE OF BIRTH:  1922
EDUCATION:
            1937-40
            1940-43
            1943-46
     M.D.   1946
       Phillips Exeter Academy, Exeter, New Hampshire
       Massachusetts Institute of Technology
       Harvard Medical School
       Harvard Medical School
PAST POSITIONS:
     1965-68

     1959-65
     1955-59

     1952-55
     1950-52
     1949-50
     1947-49

     1946-47
Professor and Director, Department of Environmental Health
Director of Kettering Laboratory
Professor of Physiology, College of Medicine, University of Cincinnati.
Associate Professor of Physiology, Harvard School of Public Health.
Physiologist, Haskell Laboratory for Toxicology and Industrial Medicine, E. I. duPont
de Nemours and Company, Newark, Delaware.
Associate, Department of Physiology, Harvard School of Public Health.
Instructor, Department of Physiology, Harvard Medical School.
Teaching Fellow, Department of Physiology, Harvard Medical School.
Active Duty, U.S. Air Force, Chief of Medical Service, Maxwell Air Force Base,
Montgomery, Alabama.
Rotating Internship, Geisinger Memorial Hospital, Danville, Pennsylvania.
 PRESENT POSITION:
     Professor  of  Environmental  Medicine, School of Hygiene and Public Health, Johns Hopkins
     University (1968 -  ).

 PUBLICATIONS:
     Several scientific journal articles and published testimony before legislative bodies chiefly on
     radiation biology, health effects of environmental pollutants, and carcinogenesis.
 HONORS AND/OR CITATIONS:
     National Scholar, Harvard Medical School (1943-46).
     Macy Faculty Scholar Award (1975-76).
 CONSULTANTSHIPS:
     Medical Consultant to Council on Environmental Quality, Washington, D.C. (1975 -  ).
     Consultant in Occupational Health, State of Maryland, Division of Labor and Industries (1973 -  ).
                                             B.18

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CONSULTANTSHIPS (Continued):
     Faculty   Member,  Westinghouse  International   School   of   Environmental  Management,
     Ft. Collins, Colorado (1972 -  ).
     Consultant  to  Department of  Anesthesiology,  Massachusetts  General  Hospital,  Boston,
     Massachusetts (1963 -  ).
     National  Academy of Sciences Committee on Medical and  Biological Effects of Environmental
     Pollutants, Subcommittee on Carbon Monoxide.
     National Academy of Sciences Advisory Committee on the Biological Effects of Ionizing Radiations,
     ad hoc Committee on "Hot  Particles."
     Advisory  Council, Bureau of Air Quality Control, State of Maryland.
     Radiation Control Advisory Board, State of Maryland.
     Chairman, Power  Plants and Human Health and Welfare Studies Group, Department of Natural
     Resources, State of Maryland (1972-73).
     Member, National Academy of Sciences Advisory Committee  on the Biological Effects of Ionizing
     Radiation (1970-72).
     Member, The Governor's Advisory Council on Nuclear Reactors, State of Pennsylvania (1973-74).
                                          B.19

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                                         APPENDIX C

                       COMMITTEE MEETINGS AND ATTENDANCE
              November 14, 1974

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center, New York, N.Y.—Chairman
Alpen, Dr. Edward L, Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Bair, Dr. William J., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R., Massachusetts General Hos-
  pital, Boston, Mass.
Goldman, Dr. Marvin, University of California,
  Davis, Calif.
Gregg, Dr.  Earle  C., University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B.,  California Institute of Tech-
  nology, Pasadena, Calif.
McClellan, Dr. Roger O., Lovelace Foundation,
  Albuquerque, New Mexico

Guests

Ellett, Dr. William H., Environmental Protection
  Agency, Washington, D.C.
Mills, Dr. William A.,  Environmental Protection
  Agency, Washington, D.C.
Wachholz, Dr. Bruce W., Atomic Energy Commis-
  sion, Washington, D.C.

National Academy of  Sciences—Assembly of Life
Sciences—Division of Medical  Sciences

Hilberg, Dr. Albert W., Senior Staff Officer
McConnaughey, Dr. David  A.,  Senior Staff Officer
         January 30 - 31, 1975 - (Jan. 30)

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center, New York, N.Y.—Chairman
Bair, Dr. William J., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett,  Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R., Massachusetts  General Hos-
  pital, Boston, Mass.
Goldman, Dr. Marvin, University of California,
  Davis, Calif.
Gregg, Dr. Earle C., University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B., California Institute of Tech-
  nology, Pasadena, Calif.
McClellan, Dr. Roger O., Lovelace Foundation,
  Albuquerque, New Mexico
Radford,  Dr. Edward P., Johns Hopkins University,
  Baltimore, Maryland

Guests

Alexander, Mr. R. E., Nuclear Regulatory Comis-
  sion, Washington, D.C.
Hobbs, Dr. Charles H., Lovelace Foundation,
  Albuquerque, New Mexico
Nelson, Dr. Neal S., Environmental Protection
  Agency, Washington, D.C.
Park, Dr.  James F., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Sanders, Dr. Charles L., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Wachholz, Dr. Bruce W., Atomic Energy Commis-
  sion, Washington, D.C.

National Academy of Sciences—Assembly of Life
Sciences—Divison of Medical Sciences

Hilberg, Dr. Albert W., Senior Staff Officer
McConnaughey, Dr. David A., Senior Staff Officer
                                                  C.1

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        January 30 - 31, 1975 - (Jan. 31)

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center,  New York, N.Y.—Chairman
Bair, Dr. William }., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R., Massachusetts General Hos-
  pital, Boston, Mass.
Goldman, Dr.  Marvin, University of California,
  Davis, Calif.
Gregg, Dr. Earle C, University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B., California Institute of Tech-
  nology, Pasadena, Calif.
Radford,  Dr. Edward P., Johns Hopkins University,
  Baltimore, Maryland

Guests

Alexander, Mr. R. E., Nuclear Regulatory Commis-
  sion, Washington, D.C.
 Hobbs, Dr. Charles H., Lovelace  Foundation,
  Albuquerque, New Mexico
 Nelson, Dr. Neal S., Environmental Protection
  Agency, Washington, D.C.
 Park, Dr.  James F., Battelle Pacific Northwest
   Laboratory, Richland, Wash.
 Sanders, Dr. Charles L., Battelle Pacific Northwest
   Laboratory, Richland, Wash.
 Wachholz, Dr. Bruce W., Atomic Energy Commis-
   sion, Washington, D.C.

 National  Academy of Sciences—Assembly of Life
 Sciences—Division of Medical Sceiences

 Hilberg, Dr. Albert W., Senior Staff Officer
         March 13 - 14,1975 - (Mar. 13)

 Committee Members

 Albert, Dr. Roy E., New York University Medical
   Center, New York, N.Y.—Chairman
 Bair, Dr. William J., Battelle Pacific Northwest
   Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R., Massachusetts General Hos-
  pital, Boston, Mass.
Goldman, Dr. Marvin, University of California,
  Davis, Calif.
Gregg, Dr. Earle C., University Hospital, Cleveland,
  Ohio
McClellan, Dr. Roger O., Lovelace Foundation,
  Albuquerque, New Mexico
Radford, Dr. Edward P., Johns Hopkins University,
  Baltimore, Maryland

National Academy of Sciences—Assembly of Life
Sciences—Divison of Medical Sciences

Hilberg, Dr. Albert W., Senior Staff Officer
Kennedy, Dr. Thomas J., Jr., Executive Director,
  Assembly of Life Sciences
Vosburg, Dr. Albert C., Associate Executive Direc-
  tor, Assembly of Life Sciences
         March 13 - 14,1975 - (Mar. 14)

 Committee Members

 Albert, Dr. Roy E., New York University Medical
   Center, New York, N.Y.—Chairman
 Bair, Dr. William J., Battelle Pacific Northwest
   Laboratory, Richland, Wash.
 Casarett, Dr. George W., University of Rochester
   Medical Center, Rochester, N.Y.
 Epp, Dr. Edward R., Massachusetts General Hos-
   pital, Boston, Mass.
 Goldman,  Dr. Marvin, University of California,
   Davis, Calif.
 Gregg, Dr. Earle C., University  Hospital, Cleveland,
   Ohio
 Lewis, Dr.  Edward B., California Institute of Tech-
   nology, Pasadena, Calif.
 McClellan, Dr. Roger O., Lovelace Foundation,
   Albuquerque, New Mexico
 Radford, Dr. Edward P., Johns  Hopkins University,
   Baltimore, Maryland

 National Academy of Sciences—Assembly of Life
 Sciences—Division of Medical  Sciences

 Hilberg, Dr. Albert W., Senior  Staff Officer
                                                   C.2

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          May 21 - 22,1975 - (May 21)

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center, New York, N.Y.—Chairman
Alpen, Dr. Edward L, Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Bair, Dr. William J., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R., Massachusetts General Hos-
  pital, Boston, Mass.
Gregg, Dr. Earle C, University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B., California Institute of Tech-
  nology, Pasadena, Calif.
McClellan, Dr. Roger O., Lovelace Foundation,
  Albuquerque, New Mexico
Radford, Dr. Edward P., Johns Hopkins University,
  Baltimore, Maryland

National Academy of Sciences—Assembly of Life
Sciences—Division of Medical Sciences

Hilberg, Dr. Albert W., Senior Staff Officer
         May 21   22, 1975 - (May 22)

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center, New York, N.Y.—Chairman
Alpen, Dr. Edward L., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Bair, Dr. William J., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward  R.,  Massachusetts General Hos-
  pital, Boston, Mass.
Gregg, Dr. Earle  C.,  University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B., California Institute of Tech-
  nology, Pasadena, Calif.
McClellan, Dr. Roger O., Lovelace Foundation,
  Albuquerque,  New Mexico
Radford, Dr. Edward P., Johns Hopkins University,
  Baltimore, Maryland
National Academy of Sciences—Assembly of Life
Sciences—Division of Medical Sciences

Hilberg, Dr. Albert W., Senior Staff Officer
Kennedy,  Dr. Thomas J., Jr., Executive Director,
  Assembly of Life Sciences
Sitton, Mr. Paul L., Special Assistant to the NAS
  President
            July 8-9, 1975 - (July 8)

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center, New York, N.Y.—Chairman
Alpen, Dr. Edward L., Battelle Pacific Northwest
  Laboratory, Richland, Wash.

Bair, Dr. William J., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R.,  Massachusetts General Hos-
  pital, Boston, Mass.
Goldman, Dr. Marivn, University of California,
  Davis, Calif.
Gregg, Dr. Earle C.,  University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B., California Institute of Tech-
  nology, Pasadena, Calif.
McClellan, Dr. Roger O., Lovelace Foundation,
  Albuquerque, New Mexico
Radford, Dr. Edward P., Johns Hopkins University,
  Baltimore, Maryland

Guests

Cochran, Dr. Thomas B., Natural Resources Defense
  Council, Washington, D.C.
Ellett, Dr. William H., Environmental Protection
  Agency, Washington, D.C.
Tamplin, Dr. Arthur  R., Natural Resources Defense
  Council, Washington, D.C.

National Academy of Sciences—Assembly of Life
Sciences—Division of Medical Sciences

Hilberg, Dr. Albert W., Senior Staff Officer
Kennedy, Dr. Thomas J., Jr., Executive Director,
  Assembly of Life Sciences
                                                 C.3

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           July 8 - 9,1975 - (July 9)

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center, New York, N.Y.—Chairman
Alpen, Dr. Edward L, Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Bair, Dr. William J., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R., Massachusetts General Hos-
  pital, Boston, Mass.
Goldman, Dr. Marvin, University of California,
  Davis, Calif.
Gregg, Dr. Earle C.,-University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B., California Institute of Tech-
  nology, Pasadena, Calif.
Radford, Dr. Edward P., Johns Hopkins University,
  Baltimore, Maryland

Guest

 Ellett, Dr. William H., Environmental Protection
  Agency, Washington, D.C.

 National Academy of Sciences—Assembly of Life
 Sciences—Division of Medical Sciences

 Hilberg, Dr. Albert W., Senior Staff Officer
              November 21, 1975

Committee Members

Albert, Dr. Roy E., New York University Medical
  Center, New York, N.Y.—Chairman
Alpen, Dr. Edward L., Donner Laboratory, Univer-
  sity of California, Berkeley, Calif.
Bair, Dr. William J., Battelle Pacific Northwest
  Laboratory, Richland, Wash.
Casarett, Dr. George W., University of Rochester
  Medical Center, Rochester, N.Y.
Epp, Dr. Edward R., Massachusetts General Hos-
  pital, Boston, Mass.
Goldman, Dr. Marvin, University of California,
  Davis, Calif.
Gregg, Dr. Earle C, University Hospital, Cleveland,
  Ohio
Lewis, Dr. Edward B., California Institute of Tech-
  nology, Pasadena, Calif.
McClellan, Dr. Roger O., Lovelace Foundation,
  Albuquerque, New Mexico

Guest

Counts, Ms. Leila, Battelle Pacific Northwest
  Laboratory,  Richland, Washington

National Academy of Sciences—Assembly of Life
Sciences—Division of Medical Sciences

Hilberg, Dr. Albert W., Senior Staff Officer
                                                   C.4

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