Application of multi-compartment wound models to plutonium-contaminated wounds incurred by former workers at rocky flats.

This paper presents the analysis of urine bioassay data, spanning four decades, from five workers who had wounds contaminated with plutonium at the Department of Energy Rocky Flats Plant during the period 1961-1967. The cases were selected from participants in the Department of Energy-sponsored Former Radiation Worker Medical Surveillance Program at Rocky Flats, which provided medical monitoring, modern bioassay measurements, and internal dose re-evaluations for former Rocky Flats workers. The cases include a variety of wound types, excision treatment regimes, and monitoring information. These wound cases illustrate the use of two multi-compartment wound models and three plutonium urine excretion models for retrospective calculation of internal plutonium depositions resulting from wounds for which no chelation therapy was administered. Wound model compartment fractions and half times are determined for each case and urine excretion model as are composite parameter values. The urine analysis and wound count measurements obtained under the program provide data with state-of-the art measurement sensitivity, as well as the opportunity to include long-term excretion and wound site data that exceed 10,000 d post-exposure for retrospective intake and dose evaluations. These data are provided to the radiation dosimetry community for use in developing and testing improved models for plutonium deposition in wounds.

The beryllium lymphocyte proliferation test: Relevant issues in beryllium health surveillance.

BACKGROUND: The beryllium lymphocyte proliferation test (Be-LPT) measures beryllium-specific cellular immune response, and is useful in medical surveillance of beryllium sensitivity and chronic beryllium disease (CBD). METHODS: Current and former employees (n = 12,194) of 18 United States Department of Energy (DOE) sites were tested for beryllium sensitization at four laboratories with Be-LPT expertise. Beryllium sensitized individuals were offered evaluations for CBD. The sensitivity, specificity, and positive predictive value (PPV) of the Be-LPT were determined, as was inter- and intra-laboratory agreement. RESULTS: False positives were calculated to be 1.09%, with a laboratory range of 0.00-3.35% for the 10-year investigation. Be-LPTs performed on inter-laboratory split blood specimens from sensitized individuals showed a false negative rate of 31.7%. The intra-laboratory repeatability of abnormal Be-LPT results ranged from 80.4-91.9%. The sensitivity of the Be-LPT was determined to be 0.683, with a specificity of 0.969. The PPV of one abnormal Be-LPT was 0.253. CONCLUSIONS: The Be-LPT is efficacious in medical surveillance of beryllium-exposed individuals. The PPV of the Be-LPT is comparable to other widely accepted medical tests. Confirmation of an abnormal result is recommended to assure appropriate referral for CBD medical evaluation.