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Lung fibrosis in plutonium workers.
Newman LS; Ruttenber AJ; Mroz MM
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-CCR-811855, 1999 Dec; :1-19
There have been few systematic studies of the non-malignant health effects of a-radiation in humans. Animal studies and a recent report from the former Soviet Union suggest an association between plutonium exposure and the development of fibrotic lung disease. Prompted by a case of lung fibrosis in a retired plutonium worker in the United States, we sought to explore whether plutonium inhalation increases the risk for developing chest radiograph abnormalities consistent with pulmonary fibrosis. We conducted a retrospective study of nuclear weapons workers. To date, our study population consists of327 plutonium-exposed workers with absorbed lung doses from 0 to 2,800 rem and 194 workers who had no estimated plutonium exposure. Participants were predominantly male (97.6%) with a mean age of 63.8 years. There were no significant differences in time working at the plant, hire year, or smoking habits between the two groups, although plutonium workers were older at the time of chest x-ray (67.4 years vs. 57.7 years). Absorbed lung dose was calculated as part of an internal dose assessment. We compared severity of posteroanterior chest radiograph interstitial abnormalities between the two groups using the International Labour Organization (ILO) profusion scoring system. There was a significantly higher proportion of abnormal chest radiographs among plutonium workers (17.4%) as compared to non-plutonium workers (7.2%), p = <0.01. Plutonium workers were older at time of x-ray than were unexposed workers. However, the proportion of plutonium workers with abnormal chest x-rays remained significantly higher when we restricted analyses to those individuals older than 60 years. Of those plutonium workers with absorbed lung doses greater than 500 rem, 29% had an abnormal chest x-ray compared to other plutonium workers (16%), p = 0.06. Thus, inhaled plutonium may cause lung fibrosis in humans at absorbed lung doses above 500 rem.
Humans; Case studies; Mortality data; Mortality rates; Radiation effects; Radiation exposure; Lung fibrosis; Lung disease; Plutonium compounds; Radiographic analysis; Nuclear radiation; Respiratory system disorders; Pulmonary system disorders; Heavy metals
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