A METHOD TO IDENTIFY AND LOCALIZE A SINGLE HOT PARTICLE IN THE LUNGS USING AN ARRAY OF HIGH-PURITY GERMANIUM DETECTORS FOR IMPROVED ESTIMATE OF THE DEPOSITED ACTIVITY.

A new method has been developed to identify and localize a single hot particle in the lungs using an array of four high-purity germanium detectors. The method is based upon calculating a set of three count rate ratios (generated by each individual detector in the array) that are evaluated in sequence to designate whether the measured deposition can be associated with a hot particle rather than the default assumption of a uniform activity distribution. Identification and localization of the hot particle are determined from a single in vivo measurement in which detectors are positioned above and below the thorax. The method was tested using an anthropomorphic thorax phantom in which point sources of 241Am, 137Cs and 60Co were individually inserted in the lungs at 15 different locations and were measured using a scanning bed whole-body counter. Depending upon source location and photon energy, a bias of -35% up to +76% could be introduced by falsely assuming a uniform activity distribution in the lungs. This bias would directly translate to an erroneous dose estimate to the lungs. It was demonstrated that by using the appropriate detector efficiencies for the single hot particle, the bias associated with the activity determination is reduced to <10% and ~2% in average.

RETENTION OF 7Be IN THE LUNGS FOLLOWING INTAKE BY INHALATION.

Several workers were internally exposed to 7Be particles following their dispersion in air from a damaged electrodeposited source. A series of in vivo measurements performed with one worker up to 108 days post exposure determined that retention of 7Be in the thoracic region of the respiratory tract was best described by a two-component exponential function with half-lives of ~0.4 and ~109 days. The initial deposition in the thoracic region was estimated to be 6.8 kBq. The concentration of 7Be in single void urine samples collected from this worker up to 3 days post intake ranged from 1 to 10 Bq/l. In the absence of specific knowledge about the physical and chemical characteristics of the inhaled particles, the committed effective dose was estimated to be 0.3 µSv.

Response of a Shadow-Shield Whole-Body Counter to a Variety of Physical Phantoms.

The performance characteristics of a shadow-shield whole-body counter system with an array of four high-resolution germanium detectors using whole-body and organ-specific (lungs, liver, head, knee and thyroid) physical phantoms are described. Detection efficiency and minimum detectable activities for selected radionuclides and several measurement configurations are presented. Results demonstrate that the system meets the requirements for direct radio bioassay and that detection efficiency and minimum detectable activities are similar in magnitude to other whole-body (or organ) counting systems installed in fully shielded structures.

Characterization of internal exposure to enriched uranium at a former gaseous diffusion plant.

The National Institute for Occupational Safety and Health (NIOSH) is conducting a nested case-control study of mortality from multiple myeloma involving 581 subjects who worked at the Oak Ridge K-25 Gaseous Diffusion Plant. Internally-deposited uranium is the primary agent being considered in the exposure assessment. Routine operation and maintenance of the plant presented the potential for inhaling uranium of various enrichments. As part of the exposure assessment, records describing the various plant processes and procedures, documentation on the medical monitoring program, uranium urinalysis data, and procedures and analytical methods for monitoring uranium exposure were retrieved and reviewed. Uranium urinalysis data consisted of 161,055 uranium urinalysis results obtained by fluorometry and 171,914 results obtained by alpha particle counting. Approximately 20% of the workers were monitored for internal exposure using urine sampling. Mean and median uranium concentrations in urine for the monitored study subjects were slightly lower than for the entire population of monitored K-25 workers. The specific activity of uranium excreted in urine was determined by comparing results obtained using fluorometric and alpha activity measurements and indicate that the majority of internal exposure involved uranium that was depleted or enriched to no more than 4% U.

Estimating active bone marrow dose from occupational exposure to uranium at a former gaseous diffusion plant.

Active bone marrow absorbed doses were estimated for 581 workers as part of a nested case-control study of multiple myeloma mortality at the Oak Ridge Gaseous Diffusion Plant (K-25). Uranium urinalysis results obtained by fluorometric and gross alpha measurements were available for about 20% of the 581 study subjects. These data were used to determine intakes of uranium as a result of occupational exposure during operation of the K-25 facility. Uranium solubility was inferred from the observed urinary excretion rate, job titles, and department codes. Data suggest that most study subjects were exposed to uranyl fluoride, a relatively soluble uranium compound. The median cumulative bone marrow dose determined for subjects with bioassay data was 0.06 mGy with a geometric standard deviation of 4.48. Subjects without bioassay data were assigned cumulative bone marrow dose based upon job titles and department codes.

In vivo measurements of 210Pb in skull and knee geometries as an indicator of cumulative 222Rn exposure in a underground coal mine in Brazil.

Cumulative exposure to radon can be evaluated by measuring 210Pb in bone. The skull and knee are two convenient parts of the skeleton for in vivo measuring 210Pb because these regions of the body present a high concentration of bone, the detectors are easily positioned and the likelihood of cross contribution from other organs or tissues is low. A radiological survey of non-uranium mines in Brazil indicated that an underground coal mine in Paraná, located in the south of Brazil, exhibited a high radon concentration. In vivo measurements of 32 underground coal miners were performed in the IRD-CNEN Whole Body Counter shielded room using an array of four high-resolution germanium detectors. Estimations of 210Pb in the total skeleton were determined from direct in vivo measurements of 210Pb in the head and knees. In vivo measurements of 210Pb in 6 out of 32 underground coal miners ranged from 80 to 164 Bq, suggesting that these workers were significantly exposed to 222Rn.

Assessment of plutonium exposures for an epidemiological study of US nuclear workers.

An ongoing case-control study evaluating the association between workplace external radiation exposures and leukaemia mortality required an assessment of internal plutonium exposures as a potential confounder. Of the study participants, 1,092 were employed at four Department of Energy sites where plutonium-bearing materials were processed or stored. Exposures were assessed by first categorising exposure potentials based on available bioassay data, then estimating doses for workers in the highest categories using recent recommendations of the International Commission on Radiological Protection. Given the aetiology of leukaemia, equivalent dose to active bone marrow was chosen as the exposure variable. There were 556 workers each with at least one plutonium bioassay result, assigned to one of three evaluation categories. Dose estimates were made for 115 workers resulting in a collective equivalent dose of 2.1 person-Sv for 2,822 exposure-years, compared with 29.8 person-Sv estimated from photon exposures. Modelling uncertainties were examined by comparison of results from independent analyses and by Monte Carlo simulation.

Significance of radiation exposure from work-related chest X-rays for epidemiological studies of radiation workers.

BACKGROUND: Previous epidemiologic studies of workers at nuclear weapons facilities have not included X-ray exposures as part of the occupational radiation exposure. The research objective was to determine the contribution of work-related chest X-ray (WRX) exposure relative to the cumulative occupational radiation exposure. METHODS: Cases and controls were identified from a cohort of workers whose employment began as early as 1943. Medical records for 297 subjects were used to determine the bone marrow dose from their X-ray examinations. Individual dose data, however, were only available for 45 workers. Bone marrow dose estimates were calculated by converting the entrance-skin-exposure (from X-ray procedures) and occupational exposure (from monitoring data) to dose. RESULTS: Stereoscopic photofluorography delivered a bone marrow dose nearly 100 times that delivered by today's chest X-ray technique. Photofluorography was the predominant radiation source during the 1940s and 1950s. The cumulative WRX dose was, on average, 50 times their occupational doses. No correlation between occupational and WRX dose was found, but may be due to the small study size and incomplete dose data. CONCLUSIONS: These findings illustrate the importance of including WRX doses in retrospective epidemiological studies of radiation workers, especially if photofluorographic chest X-rays were performed and occupational exposure to ionizing radiation is low.

Solubility of airborne uranium compounds at the Fernald Environmental Management Project.

The in vitro solubility of airborne uranium dusts collected at a former uranium processing facility now undergoing safe shutdown, decontamination, and dismantling was evaluated by immersing air filters from high volume samplers in simulated lung fluid and measuring the 238U in sequential dissolution fractions using specific radiochemical analysis for uranium. X rays and photons from the decay of uranium and thorium remaining on the filter after each dissolution period were also directly measured using a planar germanium detector as a means for rapidly evaluating the solubility of the uranium-bearing dusts. Results of these analyses demonstrate that two distinct types of uranium-bearing dusts were collected on the filters depending upon the location of the air samplers. The first material exhibited a dissolution half-time much less than 1 d and was most likely UO3. The dissolution rate of the second material, which was most likely U3O8, exhibited two components. Approximately one-third of this material dissolved with a half time much less than 1 d. The remaining two-thirds of the material dissolved with half times between 230 +/- 16 d and 1,350 +/- 202 d. The dissolution rates for uranium determined by radiochemical analysis and by gamma spectrometry were similar. However, gamma spectrometry analysis suggested a difference between the half times of 238U and its initial decay product 234Th, which may have important implications for in vivo monitoring of uranium.

Group psychotherapy of substance abuse in the era of managed mental health care.

The changes in health-care financing that have taken place over the last decade have spurred interest in finding innovative ways of delivering services at manageable cost levels. It comes as no surprise that increased interest and research have focused on group therapies as a major vehicle for reaching large numbers of people in need of psychological care that is brief, effective, and cost-efficient. More specifically, practitioners in the field of substance abuse have long recognized the value of group experiences as an integral part of the recovery and rehabilitative process. The influence of managed care to contain costs has added new incentives to expand the existing knowledge base in group treatment of addictions to comply with reduced funding and time constraints.

[Osseous avulsion injury of the extensor carpi radialis brevis tendon from the base of the 3rd metacarpal bone]. / Knöcherne Ausrissverletzung der Extensor carpi radialis brevis-Sehne von der Basis des dritten Mittelhandknochens.

An uncommon case of a closed avulsion fracture to the base of the third metacarpal bone by the extensor carpi radialis brevis tendon is described. The dislocation of the small bony fragment was reduced by open reposition and internal fixation with two Leibinger mini-screws.

A new anthropometric phantom for calibrating in vivo measurements of stable lead in the human leg using x-ray fluorescence.

A new anthropometric phantom has been developed for calibrating in vivo measurements of stable lead deposited in bone using x-ray fluorescence. The phantom reproduces the shape of the mid shaft of the adult human leg and is fabricated using polyurethanes and calcium carbonate to produce materials that exhibit the same density, energy transmission, and calcium content as cortical bone, bone marrow, and muscle. The phantom includes a removable tibia fabricated using simulants for cortical bone and bone marrow to which a precise amount of stable lead has been added to cortical bone. The formulations used in fabricating the new anthropometric phantom are much more uniform in density and composition than the conventional phantom made from Plexiglas cylinders filled with plaster-of-Paris. The energy spectrum from an x-ray fluorescence measurement of the phantom using a 109Cd source is indistinguishable from an in vivo x-ray fluorescence measurement of the human leg, demonstrating that the materials used in the phantom exhibit the same radiological properties as human tissue. Likewise, results from x-ray fluorescence measurements of the phantom exhibit the same positional dependency as the human leg and vary by approximately 36% when, for example, the phantom containing 54 ppm of stable lead in the tibia was rotated by only 15 degrees. The detection limit for a 30 min 109Cd K shell x-ray fluorescence in vivo measurement is approximately 20 ppm determined from a background measurement using the new phantom containing no added lead in the muscle, bone, or bone marrow. The new anthropometric phantom significantly improves in vivo x-ray fluorescence calibration measurements by (1) faithfully reproducing the anatomy of the human leg, (2) having components that exhibit radiological properties similar to that of human tissue, and (3) providing a realistic calibration standard that can be used for in vivo x-ray fluorescence intercomparison measurements.

Effect of leachability on environmental risk assessment for naturally occurring radioactive materials in petroleum oil fields.

Elevated concentrations of naturally occurring radioactive material (NORM), including 238U, 232Th, and their progeny found in underground geologic deposits, are often encountered during crude oil recovery. Radium, the predominant radionuclide brought to the surface with the crude oil and produced water, co-precipitates with barium in the form of complex compounds of sulfates, carbonates, and silicates found in sludge and scale. These NORM deposits are highly stable and very insoluble under ambient conditions at the earth's surface. However, the co-precipitated radium matrix is not thermodynamically stable at reducing conditions which may enable a fraction of the radium to eventually be released to the environment. Although the fate of radium in uranium mill tailings has been studied extensively, the leachability of radium from crude oil NORM deposits exposed to acid-rain and other aging processes is generally unknown. The leachability of radium from NORM contaminated soil collected at a contaminated oil field in eastern Kentucky was determined using extraction fluids having wide range of pH reflecting different extreme environmental conditions. The average 226Ra concentration in the samples of soil subjected to leachability testing was 32.56 Bq g(-1) +/- 0.34 Bq g(-1). The average leaching potential of 226Ra observed in these NORM contaminated soil samples was 1.3% +/- 0.46% and was independent of the extraction fluid. Risk assessment calculations using the family farm scenario show that the annual dose to a person living and working on this NORM contaminated soil is mainly due to external gamma exposure and radon inhalation. However, waterborne pathways make a non-negligible contribution to the dose for the actual resident families living on farmland with the type of residual NORM contamination due to crude oil recovery operations.

Isolation and detection of Listeria monocytogenes using fluorogenic and chromogenic substrates for phosphatidylinositol-specific phospholipase C.

The BCM Listeria monocytogenes detection system (LMDS) consists of a selective preenrichment broth (LMPEB), selective enrichment broth (LMSEB), selective/differential plating medium (LMPM), and identification on a confirmatory plating medium (LMCM). The efficacy of the BCM LMDS was determined using pure cultures and naturally and artificially contaminated environmental sponges. The BCM LMPEB allowed the growth of Listeria and resuscitation of heat-injured L. monocytogenes. The BCM LMSEB, which contains the fluorogenic substrate 4-methylumbelliferyl-myo-inositol-1-phosphate and detects phosphatidylinositol phospholipase C (PI-PLC) activity, provided a presumptive positive test for the presence of pathogenic Listeria (L. monocytogenes and L. ivanovii) after 24 h at 35 degrees C. An initial inoculum of 10 to 100 CFU/ml of L. monocytogenes in BCM LMSEB yielded a fluorogenic response after 24 h. On BCM LMPM, L. monocytogenes and L. ivanovii were the two Listeria species forming turquoise convex colonies (1.0 to 2.5 mm in diameter) from PI-PLC activity on the chromogenic substrate, 5-bromo-4-chloro-3-indoxyl-myo-inositol-1-phosphate. L. monocytogenes was distinguished from L. ivanovii by either its fluorescence on BCM LMCM or acid production from rhamnose. False-positive organisms (Bacillus cereus, Staphylococcus aureus, Bacillus thuringiensis, and yeasts) were eliminated by at least one of the media in the BCM LMDS. Using a pure culture system, the BCM LMDS detected one to two L. monocytogenes cells from a sponge rehydrated in 10 ml of DE neutralizing broth. In an analysis of 162 environmental sponges from facilities inspected by the U.S. Department of Agriculture (USDA), the values for identification of L. monocytogenes by BCM LMDS and the USDA method were 30 and 14 sites, respectively, with sensitivity and specificity values of 85.7 and 100.0% versus 40.0 and 66.1%, respectively. No false-positive organisms were isolated by BCM LMDS, whereas 26.5% of the sponges tested by the USDA method produced false-positive results.

Analysis of electret ion chamber radon detector response to 222Rn and interference from background gamma radiation.

Environmental radon (222Rn) monitors that incorporate electret detectors are confounded by background gamma radiation, which may cause the electret to discharge by as much as 7.5 volts per mR. Although background gamma corrections were formerly made by multiplying the known background gamma exposure rate with a constant conversion factor, this research demonstrates that doing so introduces an error ranging up to about 20%, especially in high gamma background areas. A new, more accurate method of background gamma correction has been developed that uses an average, voltage-dependent discharge factor, Dgamma (V Kg C(-1)). This factor and its coefficients were experimentally determined by separately exposing groups of electret radon detectors to photons from 60Co and 137Cs. Statistical analysis shows that Dgamma is independent of the orientation of the electret during irradiation but that some dependency on dose rate or energy of the irradiating photons may be expected. The discharge of the electret due only to gamma irradiation, Vgamma is determined by multiplying the total integrated gamma exposure by Dgamma. The discharge of the electret during a radon measurement can then be corrected for background gamma radiation by subtracting Vgamma from the total discharge of the electret resulting in a net discharge due solely to radon. A new equation has also been developed in this study for the radon discharge factor, D(Rn)(V m3 Bq(-1) s(-1)), that is entirely consistent with the gamma discharge factor and was thoroughly evaluated by exposing the electret radon detectors to known concentrations of radon.

Analysis of coal slag for naturally occurring radioactive material.

Samples of aerosolized coal slag were collected during an abrasive blasting operation to determine the concentration of naturally occurring radioactive materials (NORM) in the respirable and nonrespirable fractions. Each slag fraction was analyzed using alpha and gamma spectrometry. Since the slag is insoluble, it was necessary to dissolve samples completely by fusion with potassium fluoride and, after additional transposing and separation, mount the precipitate containing radium (Ra), the main radioactive component in NORM, on a membrane filter for alpha counting. The concentration of 226Ra in coal slag was independent of the particle size fraction and equal to 2.28 picocuries/gram (pCi/g) +/- 0.43 pCi/g, which is approximately twice the typical concentration of NORM in uncontaminated soil. Analysis of NORM by gamma spectrometry identified low concentrations of uranium, thorium, and potassium, all primordial radioactive materials that are commonly encountered in normal background soil. Integral exposure to workers from inhalation of NORM during abrasive blasting with coal slag is extremely low and could be essentially eliminated by use of appropriate respiratory protection. External radiation exposure to workers handling large quantities of NORM-contaminated coal slag during shipping or storage is also low, but would vary depending on the concentration of NORM in the slag.

Refractory ceramic fiber exposure and pleural plaques.

Refractory ceramic fibers (RCF) are manmade vitreous fibers (MMVF) manufactured for high-temperature applications. Between 1987 and 1992, a retrospective cohort and nested case-control study evaluated chest radiographs from 652 workers involved in the manufacture of these fibers for plausibility of a causal relationship between exposure to RCF and chest-radiographic changes. The exposure-response relationship was modeled with three variables: years since first fiber production job, years in fiber production, and cumulative fiber exposure to date of study X-ray. The case-control study used a comprehensive characterization of possible asbestos exposure to investigate asbestos as the potential causative agent of chest-radiographic changes. Chest radiographs of 20 workers (3.1%) demonstrated 19 pleural plaques and one diffuse pleural thickening. Nine of 72 workers (12.5%) with more than 20 yr since their first fiber-production job had plaques (odds ratio [OR] = 9.5; 95% confidence interval [CI] = 1.9 to 48.2). Five of 19 workers with more than 20 yr in fiber-production work (26.3%) had plaques (OR = 22.3; 95% CI = 3.6 to 137.0). Similarly, adjusted ORs demonstrated a progressive relationship between cumulative fiber-months per milliliter (fiber-mo/ml) exposure and plaques. The case-control study confirmed that asbestos exposure did not account for the observed association between fiber exposure and plaques. A validity review of historical films demonstrated biologic plausibility for the association, since sufficient latency existed from the time of first RCF exposure to the development of plaques. There was no significant increase in parenchymal changes consistent with interstitial fibrosis.

Statistical analysis of real-time, environmental radon monitoring results at the Fernald Environmental Management Project.

A comprehensive real-time, environmental radon monitoring program is being conducted at the Fernald Environmental Management Project, where a large quantity of radium-bearing residues have been stored in two covered earth-bermed silos. Statistical analyses of radon measurement results were conducted to determine what impact, if any, radon emitted by the radium bearing materials contained in the silos has on the ambient radon concentration at the Fernald Environmental Management Project site. The distribution that best describes the outdoor radon monitoring data was determined before statistical analyses were conducted. Random effects associated with the selection of radon monitoring locations were accommodated by using nested and nested factorial classification models. The Fernald Environmental Management Project site was divided into four general areas according to their characteristics and functions: 1) the silo area, where the radium-bearing waste is stored; 2) the production/administration area; 3) the perimeter area, or fence-line, of the Fernald Environmental Management Project site; and 4) a background area, located approximately 13 km from the Fernald Environmental Management Project site, representing the naturally-occurring radon concentration. A total of 15 continuous, hourly readout radon monitors were installed in these 4 areas to measure the outdoor radon concentration. Measurement results from each individual monitor were found to be log-normally distributed. A series of contrast tests, which take random effects into account, were performed to compare the radon concentration between different areas of the site. These comparisons demonstrate that the radon concentrations in the production/administration area and the perimeter area are statistically equal to the natural background, whereas the silo area is significantly higher than background. The study also showed that the radon concentration in the silo area was significantly reduced after a sealant barrier was applied to the contents of the silos.

Measurement of the attenuation coefficient for Livermore Thoracic Phantom lungs fabricated using contemporary materials.

The University of Cincinnati has reproduced the original formulation for the Livermore Thoracic Phantom lungs using contemporary materials and has adopted the linear attenuation coefficient as the primary quality assurance parameter for evaluating the performance capabilities of these new lung phantoms. The Livermore Thoracic Phantom was originally fabricated in 1978 to intercalibrate detector systems used to measure plutonium and other low-energy, photon emitting radionuclides deposited in the respiratory tract. The linear attenuation coefficient is a critical performance indicator for these phantom lungs since the presence of any material with a high effective atomic number (where Z > or = 20) will make a significant change in the photoelectric cross section, the predominant mode of interaction for plutonium x rays. A set of test lungs was fabricated with KCl to introduce a known quantity of 40K in the phantom and to determine, by measurement and calculations, what change would be made to the attenuation coefficient at photon energies below 100 keV as a result of the modified formulation. The KCl increased the linear attenuation coefficient below 60 keV by more than a factor of two, which would produce a substantial systematic error in any subsequent calibration measurements performed with these modified phantom lungs. These results support use of the attenuation coefficient as an important performance indicator for the Livermore Thoracic Phantom lungs and also suggest that KCl not be added to the lung tissue substitute formulation as a means to incorporate 40K in the phantom for low energy calibrations.