Articles describing Chronic Radiation Syndrome (as distinct from Acute Radiation Syndrome)

Articles describing Chronic Radiation Syndrome (as distinct from Acute Radiation Syndrome)
Incomplete, editing in progress
1.
http://en.wikipedia.org/wiki/Chronic_radiation_syndrome
Chronic radiation syndrome
From Wikipedia, the free encyclopaedia
Chronic radiation syndrome is a constellation of health effects that occur after months or years of chronic exposure to high amounts of ionizing radiation. Chronic radiation syndrome develops with a speed and severity proportional to the radiation dose received, i.e. it is a deterministic effect of radiation exposure, unlike radiation-induced cancer. It is distinct from acute radiation syndrome in that it occurs at dose rates low enough to permit natural repair mechanisms to compete with the radiation damage during the exposure period. Dose rates high enough to cause the acute form (more than approx. 0.1 Gy/h) are fatal long before onset of the chronic form. The lower threshold for chronic radiation syndrome is between 0.7 and 1.5 Gy, at dose rates above 0.1 Gy/yr.[1] This condition is primarily known from the Kyshtym disaster, where 66 cases were diagnosed, and has received little mention in western literature.[1] A future ICRP publication, currently in draft, may recognize the condition but with higher thresholds.[2]
References
^ Jump up to: a b Gusev, Igor A.; Gusʹkova, Angelina Konstantinovna; Mettler, Fred Albert (2001-03-28). Medical Management of Radiation Accidents. CRC Press. pp. 15–29. ISBN 978-0-8493-7004-5. Retrieved 2012-06-11.
Jump up ^ ICRP. “Early and late effects of radiation in normal tissues and organs: threshold doses for tissue reactions and other non-cancer effects of radiation in a radiation protection context”. Retrieved 11 June 2012. end quote
2.
http://umm.edu/health/medical/altmed/condition/radiation-damage
University of Maryland Medical Centre
Radiation sickness or radiation emergency happens after exposure to a large amount of radiation. Acute radiation sickness occurs within 24 hours of exposure. Chronic radiation syndrome is a range of symptoms occurring over a period of time. These symptoms can happen immediately or months or years after exposure to radiation:
Radiation syndrome — fatigue, weight loss, nausea, vomiting, diarrhea, sweating, fever, headache with bleeding and complications affecting the digestive system, nervous system, heart, and lungs
Central nervous system diseases
Kidney, liver, or gastrointestinal problems
Poor growth in children
Skin conditions
Pericarditis (inflammation of the sac around the heart)
Lung infections or conditions, respiratory failure
Vision problems, including cataracts
Problems with the reproductive organs
What Causes It?
Damage happens when radiation interacts with oxygen, causing certain molecules to form in the body. These molecules can damage or break strands of DNA in cells. The cells may die.
Who’s Most At Risk?
People who have been exposed to radiation and who also have the following conditions or characteristics are at risk for developing radiation damage:
High dose of radiation exposure
Young age at time of exposure
Use of chemotherapy, antibiotics
Exposure to radiation before birth (while in the womb)
end quote.
The CDC definition of Acute Radiation Syndrome (which is an internationally accepted description and definition) precludes exposure from localized internal emitters as the primary dose vector:
http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp
Acute Radiation Syndrome: A Fact Sheet for Clinicians
Acute Radiation Syndrome (ARS) (sometimes known as radiation toxicity or radiation sickness) is an acute illness caused by irradiation of the entire body (or most of the body) by a high dose of penetrating radiation in a very short period of time (usually a matter of minutes). The major cause of this syndrome is depletion of immature parenchymal stem cells in specific tissues. Examples of people who suffered from ARS are the survivors of the Hiroshima and Nagasaki atomic bombs, the firefighters that first responded after the Chernobyl Nuclear Power Plant event in 1986, and some unintentional exposures to sterilization irradiators.
The required conditions for Acute Radiation Syndrome (ARS) are:
The radiation dose must be large (i.e., greater than 0.7 Gray (Gy)1, 2 or 70 rads).
Mild symptoms may be observed with doses as low as 0.3 Gy or 30 rads.
The dose usually must be external ( i.e., the source of radiation is outside of the patient’s body).
Radioactive materials deposited inside the body have produced some ARS effects only in extremely rare cases.
The radiation must be penetrating (i.e., able to reach the internal organs).
High energy X-rays, gamma rays, and neutrons are penetrating radiations.
The entire body (or a significant portion of it) must have received the dose).
Most radiation injuries are local, frequently involving the hands, and these local injuries seldom cause classical signs of ARS.
The dose must have been delivered in a short time (usually a matter of minutes).
Fractionated doses are often used in radiation therapy. These are large total doses delivered in small daily amounts over a period of time. Fractionated doses are less effective at inducing ARS than a single dose of the same magnitude. end partial quote.
From Wikipedia we have the statement that “his condition is primarily known from the Kyshtym disaster, where 66 cases were diagnosed, and has received little mention in western literature.” with the article citing Gusev, Igor A.; Gusʹkova, Angelina Konstantinovna; Mettler, Fred Albert (2001-03-28). Medical Management of Radiation Accidents. CRC Press. pp. 15–29. ISBN 978-0-8493-7004-5.
Things appear to be changing as Chronic Radiation Syndrome rates a mention by the University of Maryland Medical Centre above. The draft ICRP report mentioned is accessible on the net but it appears not to have been worked up into a final publication. Perhaps the ICRP has better things to do.
There are contradictions within the CDC definition of ARS which seem to give authorized persons the final say in the diagnosis. Such medicos must think it an impossible task to get through to common people the notion that ARS cannot be caused by internal emitters. (though the CDC definition leaves a glimmer of that possibility occurring) The position of the authorized medicos is not helped by the fact that history provides examples of patients surviving for months with severe radiation symptoms, only to die from the effects of bone marrow ablation caused, only and uniquely, by the administration of Strontium 89 lactate or chloride by injection in the setting of a fully informed and consented trial of Sr89 as a palliative pain relief and life extender in the case of terminal metastatic bone cancer.
To quote from the relevant 1941 (published 1942, posthumously) paper:
“the problem has been studied with respect to: (1) the distribution
of irradiation after the administration of radioactive strontium, (2) the method of
administration of radio-strontium, (3) the chemical toxicity of strontium on the tissues,
(4) the effect of radioactive strontium on the tissues, and (5) the dosage of the substance.”
[1] “ The effect of radio – strontium has been studied in mice, rabbits, and human
beings…..Under the treatment of large doses of radioactive strontium (59 to 200
microcuries) to mice, a definite leucopoenia has been observed. Two weeks after the
administration of approximately 180 microcuries to each of five mice, their average white
cell count was 4200 cells per cm., whereas the normal value for mice is approximately
14,000. Nevertheless, the effect on the blood picture is much smaller than that of a
similar amount of radio phosphorus.
Some transitory leucopoenia and anemia observed in a patient with metastatic prostate
carcinoma and in another………… after a total administration of 8 and 5 millicuries of
radio-strontium, respectively, must be attributed to the treatment….Dosage: The dosage of
radio-strontium when administered therapeutically is still a difficult and largely
empirical problem. The idea has been to give as much strontium as possible without
producing any serious damage to the marrow… Important information has been given
by the radioactivity determination on the tissues of an adult female who died 3 days after
the intravenous injection of a simple dose of 0.3 millicurie of Sr lactate (170mgm. Sr,
August 19, 1940). The activity of the bones ranges from 0.05 to 0.15 microcuries per
gram wet weight….Similar values were observed in a patient with multiple myeloma who
died two months after receiving 1.7 millicuries of radio-strontium per gram of tissue in
one day gives approximately the same ionisation as a dose of 37 r of X rays, according to
Dr. Aebersold, we may calculate that the total dose given to the bones if no Sr was
eliminated from the skeleton would be equivalent to 500 to 1,500 r. These values are
obviously much too high since strontium is continuously eliminated from the skeleton, as
is evident from the other autopsy data. We may assume that an amount of radiation
equivalent to 200 to 600 r is given to the bony tissues when 1 millicurie of Sr is
intravenously injected in an adult. This rough calculation is only interesting as an
indication of the order of the magnitude of the dose of radio-strontium that should be
necessary to obtain a therapeutic effect on bone tumours. [1}
[1] Pecher, C., “Biological Investigations with Radioactive Calcium and Strontium,
Preliminary Report on the Use of Radioactive Strontium in the Treatment of Metastatic
Bone Cancer”, Contributed from the Radiation Laboratory of the University of
California, Berkeley University of California Publications in Pharmacology. Editor: C. D.
Leake, G.A. Alles, T.C. Daniels, M.H. Soley. Volume 2 No 11, pp. 117-150, plates 6-9, 3
figures in text. Submitted by Editors July 21, 1942, Issued October 23, 1942, University
of California Press, Berkeley, Cambridge University Press, London, England. Prefatory
note by C.D. Leake, editor.) pp 135.
[2] ibid. pp 136 – 138.
End Quote.
The attempt to equate the dose received from Sr89 as an internal emitter to an external dose from X rays by Aebersold is important and historic. The deaths of both men by suicide remains a great loss to medicine and justice.
The modern Sr89 Chloride treatment allows for one Sr89Cl injection every few months. In the modern form of the treatment, pain relief is achieved with little risk of negative outcomes.
The CDC definition of ARS precludes that syndrome in the case of the patient described by Pecher above. The time span involved was much longer than 24 hours and there was a total zero external dose. The internal dose was confined to bone, though the skeleton maps the whole body. Further, the nature of treatment relied upon the fact that the Sr89 concentrated at the sites of metastatic activity. The “whole body dose” was not therefore uniform. Further, Sr89 is not an emitter of “penetrating radiation” as described by the CDC.
However the cause of death of the patient described by Pecher was Leucopoenia (lack of blood forming cells due to bone marrow ablation, roughly). However, while we can see the cause of death of some Hiroshima and Nagasaki victims may have included Leucopoenia, it was also the sole cause of death of Pecher’s patient described above.
There is no doubt that Japanese A bomb victims died from ARS and its complications. The leukopenia being mainly the result of external dose. But it was not the only source of dose.
“Hiroshima” First published in the NEW YORKER, August, 1946, was written by John Hersey. The full text of this work is available online at http://archive.org/stream/hiroshima035082mbp/hiroshima035082mbp_djvu.txt
“Twenty-five to thirty days after the explosion, blood disorders appeared: gums bled, white-blood-cell count dropped sharply, and petechiae appeared on the skin and mucous membranes.
The drop in the number of white blood corpuscles reduced the patient’s capacity to resist infection, so open wounds were unusually slow in healing and many of the sick developed sore
throats and mouths. The two key symptoms, on which the doctors came to base their prognosis, were fever and the lowered white-corpuscle count. If fever remained steady and high, the patient’s chances for survival were poor. The white count almost always dropped below four thousand; a patient whose count fell below one thousand had little hope of living.
Toward the end of the second stage, if the patient survived, anaemia, or a drop in the red blood count, also set in. The third stage was the reaction that came when the body struggled to compensate for its ills when, for instance, the white count not only returned to normal but increased to much higher than normal levels.
In this stage, many patients died of complications, such as infections in the chest cavity. Most burns healed with deep layers of pink, rubbery scar tissue, known as keloid tumours. The duration of the disease varied, depending on the patient’s constitution and the amount of radiation he had received. Some victims recovered in a week; with others the disease dragged on for months.
As the symptoms revealed themselves, it became clear that many of them resembled the effects of over- doses of X-ray, and the doctors based their therapy on that likeness. They gave victims liver extract, blood transfusions, and vitamins, especially B. The shortage of supplies and instruments hampered them.
Allied doctors who came in after the surrender found plasma and penicillin very effective. Since the blood disorders were, in the long run, the predominant factor in the disease, some of the Japanese doctors evolved a theory as to the seat of the delayed sickness. They thought that perhaps gamma rays, entering the body at the time of the explosion, made the phosphorus in the victims’ bones radio-active, and that they in turn emitted beta particles, which, though they could not penetrate far through flesh, could enter the bone marrow, where blood is manufactured, and gradually tear it down. Whatever its source, the disease had some baffling quirks. Not all the patients exhibited all the main symptoms. People who suffered flash burns were protected, to a considerable extent, from radiation sickness. Those who had lain quietly for days or even hours after the bombing were much less liable to get sick than those who had been active. .” Hersey, “Hiroshima”, pp 100 – 104.
Hair analysis of reactor workers is one way of calculating dose received by reactor workers. The the neutron induction of phosphorous 32 in the body enables the dose calculations to be made.
Basically, neutron radiation plus bone = Phosphorous 32, as an internal emitter located adjacent to the blood forming cells (the marrow).
There is no doubt most Hiroshima and Nagasaki victims suffered Acute Radiation Syndrome in accord with the CDC definition of the syndrome. But, arguably, not all did. (as distinct from the phases of ARS, the time span of each phase and the time from exposure of onset of each phase, which determines the chances of recovery and survival).
I refer to the case of Prof. Shimizu. Immediately after the atomic bombing of Hiroshima the Japanese authorities mounted aconcerted and coordinated scientific and medical response to the disaster. Many surveys took place.
The descriptions discussed here are sourced from the article “Historical Sketch of the
Scientific Field Survey in Hiroshima Several Days after the Bombing” by Prof Sakae
Shimizu, 1982, published by Bulletin of the Institute for Chemical Research, Kyoto
University, Volume 60, (2), 1982.
It was on the 10 August 1945 that the Kyoto Imperial University Survey Team organised by Professor B. Arakatsu, and including K Kimura, Sakae Shimizu (Physics), S. Sugiyama, M. Shimamoto & M. Kimura (Medical School), with Army Technicians, a 10 man team, arrived in Hiroshima. This is the survey that Shimizu calls the “first survey” and about which he writes. It was not the first survey of Hiroshima undertaken by Japanese authorities and scientists.
We note that Shimizu arrived in Hiroshima on his first survey on 10 August 1945.
Shimizu reports traversing long distances throughout the ruined city, measuring the radioactivity of the surroundings and collecting samples. He measured neutron ray induced Phosphorous 32 in horse bone. He describes taking part in more than one visit, studying collected samples at Kyoto University in the interim.
For his second survey, Shimizu arrived at Kure, near Hiroshima, on 13 August 1845:
“Leaving Kyoto on the 12 August, this team, led by Shimizu, split up. Shimizu and Ueda
arrived at the Kure Naval Station on the 13th . There Shimizu presented a letter from Professor
Arakatsu detailing their special mission. Shimizu met the Kure medical staff : Naval Surgeon
Vice Admiral Dr. N. Fukui (Director, Kure Naval Hospital) and his staff and then Navy
Technical Captain Dr. M. Mitsui of the Kure Naval Arsenal, “to inform them that our finding of
strong induced radioactivity of the specimens from Hiroshima confirmed our opinion that
explosion of the bomb might be caused by nuclear reaction. I handed the letter over of Professor Arakatsu to Dr. Mitsui.” (ibid, pages 44 –45).
The rest of the team proceeded to Hiroshima led by Ishiwari. At 15:00 hours Shimizu and Ueda
rejoined the rest of the party in Hiroshima.
What was the nature of the radioactivity detected, identified and measured by Prof Shimizu and his colleagues? Was it the type which, predominately, was classed as “penetrating” and thus capable of causing Acute Radiation Syndrome? Given what Shimizu suffers later, this is a most important question.
Shimizu et al suspected the bomb which destroyed Hiroshima was uranium fuelled, and
could be expected to release fine uranium dust from the inefficient fission process. Thus
alpha radiation could reasonably be expected to be seen as a hazard by Shimizu and his
companions.
Shimizu reports only upon the measured beta radiation from the samples collected in the
attempt to find fallout and determine the extent of induced radiation in Hiroshima.

The radiometric results obtained from the samples obtained from Hiroshima are
presented in tabulated form on page 47 of the Bulletin.
The headings of the Table are:
Type of Sample, ID number of sample, Element, Beta activity in counts per minute, Half
life – Measured and Known, Measured max energy (MeV) (Millions of Electron Volts)
Location of sample, Distance from Hypocentre (m), Quantity of measured sample (g) .
13 samples are listed in this table. The bone of a horse taken from zero metres from
hypocentre gave a Beta emission reading of 529 cpm. An iron magnet taken 500 metres
from the hypocentre gave a Beta emission reading of 374 cpm.
Half lives ranged from hours to 18 days (horse bone).
Shimizu explains these results in detail. Of the horse bone Shimizu states it gave “an
extraordinarily strong activity of 637 cpm per gram (.89 of a gram being obtained and
measured). This is attributed to bone tissue reacting to the neutron bombardment from the bomb
by producing radio active Phosphorous and to a lesser extent radio calcium. This is significant
because experiments in nuclear medicine involving radio phosphorous, pre dating World War 2, were
censored from 1942 until 1953 (Brucer, Marshall, “A Chronology of Nuclear Medicine”.
Heritage Publishers, St. Louis, 1990. Esp: “Chronology from 1940 to 1953 – Vignettes on
Manhattan District Days and Atomic Medicine.” p 259, “The initial declassification of
MED reports (Manhattan Engineering District Declassified Documents)”.
“..the sand collected 1 m below the surface of the West Parade Ground showed activity 50
cpm smaller than that on the surface. …” (Bulletin, page 46). Shimizu discusses this reduction
in count rate (radioactivity) in the context of the slowing of fast neutrons (highly capable of
inducing radioactivity in many “ordinary” or stable substances) by the moderating effect
of depth of soil. This implies he considers the surface radioactivity to be solely the result of
neutron induction. However, fallout would not penetrate the surface of soil within the time
between the bombing and the survey. So the presence of fallout on the surface cannot be
discounted as a contributing factor in the count rate difference. Shimizu et al did not carry out
any radiochemical analysis (Ibid), and Shimizu does not mention alpha readings taken by a
suitable alpha sensitive instrument. Though Lauritsen electroscopes had been in wide use in Japanese
science since the 1930s. These devices being small, portable and sensitive to all forms of ionising radiation.

“It was also expected that very strong radioactive fallout, ie fission products, would be found in
some areas of the city.” (ibid page 48). In order to gather any such samples on 14 August a car
was obtained and many samples were taken from 50 locations at the periphery of the city. (ibid,
pages 48 and 49). An additional table, Table II is presented on page 48 which tabulates the
results of radiometric study of the samples. One sample, taken from the Asahi Bridge, 3.5 km
West from the hypocentre showed “intense” Beta radioactivity of 100 cpm. The 23 other
samples (out of the at least 50 samples) showed “weak” or “no” radioactivity. (ibid, page 48).
Shimizu states: “strong residual radioactivity found on the ground in the western and
northern areas as being due to the fission products fell down with a heavy shower of big
black drops which attacked these areas between 9:00am and 16:00pm of the 6 , (of August)
several hours after the explosion of the nuclear bomb. At that time we could not perform the
radiochemical analysis of the fallout. More than twenty years later, from these areas some longlife fission products were identified.” (ibid, page 49)
Shimizu describes in detail the radiation detector he used in the laboratory. His study of the Hiroshima samples shows marked beta radioactivity. His instrument appears to be a Beta-gamma detector. The type of radiation detected, measured and identified by Shimizu and considered most note worthy was not gamma or x, it was beta.
From the CDC definition of Acute Radiation Syndrome, we know ” The radiation dose must be large (i.e., greater than 0.7 Gray (Gy)1, 2 or 70 rads). Mild symptoms may be observed with doses as low as 0.3 Gy or 30 rads. The dose usually must be external ( i.e., the source of radiation is outside of the patient’s body).Radioactive materials deposited inside the body have produced some ARS effects only in extremely rare cases.The radiation must be penetrating (i.e., able to reach the internal organs).
High energy X-rays, gamma rays, and neutrons are penetrating radiations.The entire body (or a significant portion of it) must have received the dose).
Most radiation injuries are local, frequently involving the hands, and these local injuries seldom cause classical signs of ARS. The dose must have been delivered in a short time (usually a matter of minutes).
Shimizu first arrived in Hiroshima only on the 10th of August 1945, and so he did not suffer exposure to the atomic bomb, detonated on 6th August 1945.
Shimizu reported in 1982 regarding the effects of his visits to Hiroshima in August 1945:
“..in the night of the 19th I spat out much bloody sputa, and I was forced to lie on a bed for about 3 months,” ( Sketch of the Scientific Field Survey in Hiroshima Several Days after the Bombing” by Prof Sakae Shimizu, 1982, published by Bulletin of the Institute for Chemical Research, Kyoto University, Volume 60, (2), 1982, page 50).
EVEN IF SHIMIZU UNDER REPORTED THE GAMMA EXPOSURE, NO ONE CAN DENY THE IMPORTANCE OF THE INTERNAL BETA DOSE SUFFERED IN ALL PROBABILITY BY SHIMIZU.
It is in this situation that the solitary illness and its phases, Acute Radiation Syndrome, as relied upon for decades by Western nuclear authorities, is revealed to be totally inadequate as a descriptor of the phalanx of conditions and syndromes induced and caused in the human by exposures to ionizing radiations of all kinds.
Shimizu lived to a ripe old age. Many who entered Hiroshima at the same time as he did, and who also escaped exposure to the detonating atomic bomb, did not fair so well. They suffered and died, and some still suffer, and some of their children suffer still. As do those present for the Black Rain but who were out of range of the radiation pulse from the bomb. Their latest injustice has occurred within the last 2 years, as the Japanese government, relying on the inadequate admissions of Western Health Physics, refused to extend the area deemed to be “Black Rain” districts. The original US definition of 1945 still stands.
So, if Pecher’s patient, the cause of death of whom is described above, and Prof. Shimizu did not suffer from radiation sickness (common usage) or Acute Radiation Syndrome, what did they suffer from?
http://www.telegraph.co.uk/news/worldnews/asia/japan/10624946/US-Navy-sailors-seek-600m-damages-from-owners-of-Fukushima-nuclear-power-plant.html UK Daily Telegraph
By Danielle Demetriou in Tokyo and Peter Foster in Washington
5:28PM GMT 07 Feb 2014
….Nearly three years after the Fukushima disaster, more than 70 US Navy sailors who participated in rescue operations claim that radiation exposure has left them sickened for life…. Dozens of American sailors who assisted Japan during the 2011 nuclear disaster are suing the operators of Fukushima power plant for more than £612 million (US$1bn) in damages, claiming that they have become sick from radiation exposure.
The sailors were on board the USS Ronald Reagan super-carrier when it was diverted to northeast Japan following the devastation of the March 11, 2011 earthquake which triggered a tsunami and subsequent nuclear disaster.
As they helped rescue victims and evacuate disaster zones, the claimants allege that they drank, bathed and waded through water contaminated with radiation from the damaged nuclear power plant and were reportedly exposed to radioactive plumes.,,,,“These sailors were in radioactive plumes for more than five hours,” said Paul C Garner, a lawyer representing the sailors, who claims to have been contacted by more than 250 US navy personnel in relation to the case.,,,,The US government has vehemently denied that the sailors were exposed to levels of radiation that would negatively impact health during the Fukushima mission, and has published a full list of exposure details for each vessel involved…..Lt Steven Simmons, a 36-year-old administration officer, told The Telegraph that he had fallen ill within months of returning to the US in September 2011 from his deployment on the USS Reagan.
“I was perfectly healthy before that deployment. I was used to doing the P90-X extreme work out, I claimed the ’Stairway to Heaven’ in Hawaii but when I came back from the deployment my health started to decline.
“The Navy says they monitored everybody, but didn’t do internal or external monitoring of everyone, particularly not people below the flight deck,” he claimed, adding that at one point a message on the ship’s intercom said that ’contaminants’ had been sucked into the water system.
“There was an all-hands call on the intercom, but I was already up and had had breakfast and had drunk several glasses of water. I remember joking about it at the time. I never thought then I would get ill, even though some of my sailors were very worried and went to get checked out.”
Lt Simmons, who has three children, is now wheelchair bound despite doctors being unable to diagnose his condition despite carrying out a battery of tests for diseases including muscular dystrophy, Lou Gehrig’s disease and the tick-borne Lyme disease.
He is currently being treated and assessed by Navy doctors at the Walter Reed National Military Medical Centre in Maryland to decide whether to medically discharge him, although he admits that none have found any evidence of radiation-related illness.
“I’ve seen multiple doctors but they say that if it was radiation poisoning I would have been affected earlier; but you don’t have to be a nuclear engineer to know that radiation affects everyone in different ways.
“I don’t blame the Department of Defence or the Navy for what happened, but I believe that mistakes were made,” said the father of three.
“They [the Pentagon] have been sticking to this story for three years now, but we spent five hours sitting in a radioactive plume that came from the worst nuclear disaster since Chernobyl. How can they really expect there was no harm to human life?”
The specifications for Chronic Radiation Syndrome are poorly defined in the west and are not widely known. Even though US authorities have had an interest in patients who displayed aspects of the condition for decades. As follows:
April 6 1954 Letter to Dr L. Dunham from Dr Joseph Hamilton, Atomic Energy Commission Biology and Medicine Division, re medical use of radioisotopes: “Dear Chuck: Please find enclosed the available data from the University of California Hospital which was compiled by members of Stone’s staff who incidentally are quite unaware of the classified nature of this material. I discussed this matter with Dr. Stone and told him that it should not be discussed with anyone in the Division of Radiology with the exception of the two of us.”
” The picture is not too clear since a number of patients received stable strontium and
several others received some amounts of radio-strontium.” “Our own experimental
program is progressing very nicely using both rats and monkeys.”
“The use of radioactive strontium, (Sr89) in the treatment of patients…the rationale, based
on experimental animal studies with metastatic carcinoma to bone and in osteogenic
sarcoma was initiated in 1940 by Charles Pecher….Pecher’s experimental findings were
confirmed by Treadwell (Mrs. Anne de G. Low-Beer) , et al, who investigated uptake
of radio-strontium by bone tumours in six patients prior to biopsy or amputation.” Secret.
Dunham was in the process of tracking any surviving patients of the radio strontium injection trials undertaken by Pecher at Berkeley prior to 1942. Dunham was seeking data and outcomes in relation to the Atomic Energy Commissions study of radio strontium deposited in fallout from the atomic bomb tests it was overseeing. The strontium project was called Project Sunshine. Though Strontium 90 was the declared isotope of interest, in secret the strontium 89 data was given great importance. The now declassified 1954 document “Report on Project Gabriel” (the project which preceded Sunshine), the data created by Pecher in the pre war years is quoted both in the main body and in the Appendices. In fact the appendix quotes the actual patient data. If, as put to me by LBL, Strontium 89 was of no concern to fallout authorities, why go to the trouble of maintaining secrecy within the hospital at Berkeley (above, the “Dear Chuck” letter) and why cite the 1940s patient data if it were of no relevance?
And this actually brings us back to Hamilton 1942 – 1948, prior to his involvement with Sunshine.
Hamilton was instrumental in developing the Iodine 131 therapy for thyroid disease in the 1930s. It is still used today. (and this double edged sword aspect of radiation seems lost on modern commentators, though in previous era people such as Gofman (US) and Alexander (UK), understood it very well. Medicines are not beneficial when used inappropriately. Simply because I131 can extend the life of someone with a specific thyroid disease does not mean to say it does not cause illness in previously well test subjects. In fact, Clinton’s ACHRE committee found that throughout the cold war period US medicos subjected unwittingly populations to exposures such as the Green Run – deliberate I131 releases from the vent stacks at Hanford. See http://www.djc.com/special/enviro98/10043971.htm

By the 1940s Hamilton was working in close proximity to Pecher, and Pecher used the radiation counter (the “wall counter”) made by Wu for Hamilton and calibrated by her.
Hamilton knew of Pechers work.
It is not surprising that following Pecher’s death Hamilton was awarded the contract to describe the metabolism of the fission products. He had his own I131 data, Pecher’s Sr89 data and Lawrence’s P32 data. Brucer (“A Chronology of Nuclear Medicine”) describes the progress clearly, though it can be followed from the MED documents at DOE Opennet.
As Seaborg and others identified the fission products, Hamilton created them via cyclotron. It was coincidental that I131, Sr89 and P32 turned out to be fission products and an activation product. This coincidence gave the US a head start in the prediction of weapons effects. And predicting these effects was a primary aim of the Health Division of the MED, which was located within the Met Lab.
In the course of his study of the metabolism of the fission products Hamilton came to the conclusion that “The fission products can produce injury either as an external source of radiation or, if they gain entry into the body, by acting as an internal radioactive poison, quite analogous to radium poisoning. This latter consideration is a major concern, since the amounts required within the body to produce injurious effects are minute compared to the quantities necessary to induce damage by external beta and gamma irradiation.” (Source: The Metabolism of the Fission Products and the Heaviest Elements, Jos. G. Hamilton, M.D. Division of Medical Physics (Berkeley), Divisions of Medicine and Radiology (San Francisco) University of California This document is based on work performed under Contract No. W-7405-eng-48-A for the Manhattan Project and the Atomic Energy Commission. Lecture, Presented at the Thirty-second Annual Meeting of the Radiological Society of North America, Chicago, Ill., Dec. 1–6, 1946.)
The contents of this lecture show that Hamilton’s knowledge was in fact a development of the work and findings of Pecher and Aebersold as published in 1942.
The nuclear industry claims the Manhattan Project was safe, that bomb production was safe, its workers safe, yet the US Government declassified documents from 1994 on which compelled it in 2000 to admit for the first time that bomb production during and after World War 2 and later caused the sickness and premature deaths of many weapons plant workers. I will reproduce the press report in full:
“U.S. ACKNOWLEDGES RADIATION KILLED WEAPONS WORKERS , By MATTHEW L. WALD Published: January 29, 2000 WASHINGTON, Jan. 28— After decades of denials, the government is conceding that since the dawn of the atomic age, workers making nuclear weapons have been exposed to radiation and chemicals that have produced cancer and early death.
The new finding — that the exposure led to higher-than-normal rates of a wide range of cancers among workers at 14 nuclear weapons plants — raises the prospect of compensation to them. Although officials cautioned that any decision on that was a long way off, they said a package could amount to tens of millions of dollars for a group that might well include hundreds of families.
The new conclusion comes from the government’s most comprehensive review of studies of worker health and related raw health data. The review accepts the conclusion of many of those studies, some done under contract for the government, that workers were made sick by their exposure.
The finding goes far beyond an acknowledgment by the government last July that one substance handled by weapons workers, beryllium, a toxic metal, had caused some of them to become ill from breathing beryllium dust.
Of the new conclusion, Energy Secretary Bill Richardson said in an interview, ”This is the first time that the government is acknowledging that people got cancer from radiation exposure in the plants.”
The finding is detailed in a draft report prepared by officials of the Energy Department and the White House with the cooperation of a dozen government agencies.
President Clinton ordered the study in July, when the Energy Department concluded that some workers at plants that had supplied beryllium to the government for bomb-making had developed beryllium disease, an incurable lung ailment. The president asked then for a broad study that would look at the effects of radiation and chemical hazards from uranium, plutonium and other substances.
Mr. Clinton also asked the group to develop a policy on compensation, but that work has not been completed.
Legislation proposed by Representative Paul E. Kanjorski, a Pennsylvania Democrat whose constituents include some of the beryllium disease patients, calls for payments to an estimated 500 to 1,000 former workers who either have the illness or are at high risk of developing it. Under that bill, total payments in the beryllium cases could range from $15 million to $30 million a year, officials said.
One question that Congress would have to resolve in the beryllium compensation, and that would have to be addressed in any compensation plan developed as a result of the cancer finding, is whether to make payments to survivors.
In the 57 years since the Manhattan Project began processing radioactive material to produce bombs, the government has until now minimized the hazards of radiation and chemicals, criticized epidemiological research that raised questions related to them and spent tens of millions of dollars in defending itself against lawsuits charging that the bomb plants had made workers sick.
”In the past, the role of government was to take a hike,” Mr. Richardson said, ”and I think that was wrong.”
One expert on nuclear weapons manufacture, Robert Alvarez, a former Energy Department official, welcomed the government’s conclusion that many of its critics had been correct.
”A review of the studies by a body impaneled by the president is official recognition,” Mr. Alvarez said. ”That’s what makes this a big deal.”
Daniel J. Guttman, a lawyer for the Paper, Allied-Industrial Chemical and Energy Workers Union, which represents employees at 11 weapons factories, said of the draft conclusions, ”That’s stunning.”
”The prior story line is, ‘What’s the big deal, the risks were marginal,’ ” said Mr. Guttman, former executive director of a commission formed by the Clinton administration to look into improper radiation experiments using human subjects.
Richard D. Miller, a policy analyst with the union, said the change was remarkable because the Energy Department and its predecessor, the Atomic Energy Commission, had ”spared no resources in seeking to defeat claims” by employees who said they had been made sick by radiation or chemicals.
Secretary Richardson addressed a related issue last July, describing the problem of workers employed by private companies that had processed the beryllium for weapons use. They could rarely collect worker’s compensation, a program geared to injury rather than illness, and in any event their disease frequently did not emerge until years after their employment had ended. Further, Mr. Richardson said, the contractors who ran the beryllium factories for the government argued that the link to the workplace could not be demonstrated.
Mr. Richardson said then that the government should pay workers made sick by beryllium and that radiation and chemical exposure should be studied. That latter assessment led to Mr. Clinton’s call for the newly drafted report.
One plant that figures in the report is K-25, a now-shuttered Tennessee factory for enriching uranium. There, Mike Church, the president of the Energy Workers’ local, said, ”It would be a start in the right direction, trying to get help for these people, that the government is finally stepping forward.”
The industrial process used at the plant exposed workers to radiation and chemical hazards from uranium, plutonium and fluorine. The union says workers at the plant have higher-than-expected rates of leukemia, cancer of the lung and bladder, vision difficulties and chronic fatigue syndrome, among other health problems.
The report, though, says only that workers there show more lung cancer than the population at large. And it does not list another plant that used the same industrial process, at Paducah, Ky., where workers recently learned that elements to which they had been exposed included plutonium as well as uranium.
The government has the names of weapons workers and former workers who died of cancer. Researchers using government records have calculated the expected rates of various fatal cancers from such groups. In some cases, these rates are drawn from epidemiological studies of general populations; in others, they are drawn from studies of workers in the weapons complex who have been exposed to lower levels of radiation.
In the 14 plants with the elevated cancer rates, the report said, there were 22 categories of the disease that were more frequent than expected.
The cancers were found among nearly 600,000 people who have worked in nuclear weapons production since the start of World War II. They range from leukemia and Hodgkin’s lymphoma to cancer of the prostate, kidney, salivary gland and lung.
The draft does not sum up the instances of cancer resulting from the exposure, although a senior government official familiar with its contents and preparation said in an interview that ”my guess, we could be talking about hundreds of cases, in a population of hundreds of thousands.”
But Mr. Alvarez, the expert on nuclear weapons manufacture, said the number of victims would depend on how many diseases were linked to radiation. If, as some epidemiologists believe, radiation damages the human immune system and thus leaves people vulnerable to a wide variety of diseases beyond those cancers usually associated with radiation, then the number could rise to the thousands.
The draft report says that in addition to several other operations at Oak Ridge, Tenn., where K-25 was situated, elevated cancer levels were found at Savannah River in South Carolina and Hanford in eastern Washington State, where plutonium was manufactured; at Rocky Flats near Denver, where plutonium was shaped into weapons components; at the Fernald Feed Materials Center near Cincinnati, where uranium was processed, and at the Lawrence Livermore and Los Alamos national laboratories.
Some of the findings are drawn from epidemiological studies performed from the mid-1960′s onward, a number of them disavowed by the government when they were published. Others are from data gathered by the Energy Department, which now owns the plants, by the Atomic Energy Commission, or by their contractors. None of the research was done specifically for this study.” end of quote.
None of these people suffered Acute Radiation Sickness. Yet their sickness and premature death is predictable on the basis of Pecher, Aebersold and Hamilton. The sickness and deaths of the afflicted plutonium workers is acknowledged. And that acknowledgement contracts the current industry descriptions of those historic work practices.
Since the Clinton era, plutonium workers have had access to the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) Program. Today this program is administered by the US Department of Labor. Over the years this program has been watered weakened and watered down. Relatively few people have succeeded in accessing its benefits. I am advised by workers and their advocates. See http://www.dol.gov/owcp/owcpcomp.htm#.UIVTpoVy59Q
The following is taken from the US DoL brochure “How is my EEOICPA claim for RECA Section 5 processed?” :
“The Department of Labor’s Division of Energy Employees Occupational Illness Compensation
(DEEOIC) administers the Energy Employees Occupational Illness Compensation Program Act
(EEOICPA) which provides compensation and medical benefits to atomic weapons industry workers
and Radiation Exposure Compensation Act (RECA) Section 5 workers who became ill as a result of
working in the nuclear weapons industry. Survivors of qualified workers may also be entitled to benefits. The EEOICPA has two parts, Parts B and E. Both Parts B and E have unique criteria for establishing positive claims.
To adjudicate claims under the EEOICPA, DEEOIC staff must assemble a case file containing evidence that shows your eligibility for compensation and benefits. Our claims examiners (CEs) will work with you to obtain the necessary evidence and will also assist in obtaining certain evidence from other sources including the Department of Justice (DOJ). Once all the evidence is collected and analyzed, the CE will issue a Recommended Decision to accept or deny your claim. You have appeal rights if you disagree with the Recommended Decision.”
Since the days of Pecher and Aebersold and certainly since the time of Hamilton’s MED contract, the need for a precise definition of Chronic Radiation Syndrome has been needed.
While Pecher’s patients sickened and died over a period of weeks and months in the main, some lived longer. Some showed recovery and wellness only to relapse and die. These were patients suffering a terminal disease and so the picture is complicated. And this complication eventually led Hamliton to inject fission products and plutonium into healthy people and into some people who had been deliberately misdiagnosed as suffering terminal illness when they were not.
Among the chronic effects of radiation exposure suffered there are the diseases of the metabolic/endocrine system and of the immune system. And these are very frequently not recognized by nuclear authorities as being due to radiation exposure even though they may be well determined by dose and dose rate over time. It is these diseases and those of other systems which call into question the accuracy of the current characterization of what is a deterministic radiogenic disease.
Why is it that Lt Simmons (above) could state : “I’ve seen multiple doctors but they say that if it was radiation poisoning I would have been affected earlier”, when in fact the US Department of Labor, on the basis of the Clinton disclosures and de-classifications, knows full well chronic exposure outcomes DO NOT, BY DEFINITION conform to ACUTE RADIATION EXPOSURE OUTCOMES. That is, the chronic exposures are lower dose, lower dose rate, arise within different time frames and persist over time for periods which are in excess of the ARS exposure times of seconds, minutes and hours.
Victims are judged on derivatives of the ARS scenario. Regardless of what a Health Physics practitioner may think about that state of affairs, that is what happens. It has certainly happened down here to nuclear veterans and to Aboriginal people and to farmers and others. It has happened the the wives of the men who drove the supply trucks to Maralinga, bringing the hot dust down in their work clothes which the wives then had to handle, wash iron and fold. These were Department of Supply people.
Chronic – longer term – exposures are the hallmark of Downwinders everywhere.
The Soviet Union.

As noted above: “[Chronic Radiation Syndrome] is primarily known from the Kyshtym disaster, where 66 cases were diagnosed, and has received little mention in western literature. A future ICRP publication, currently in draft, may recognize the condition but with higher thresholds….”
Not withstanding Pecher, Aebersold and Hamilton presumably. Though one wonders where the Western descriptions of the syndrome got to between 1941 and the present time. Nice to know the ICRP is getting up to date, but, predictably, with a higher dose rate and dose.
The Wikipedia piece which opens this post cites Gusev, Igor A.; Gusʹkova, Angelina Konstantinovna; Mettler, Fred Albert (2001-03-28). Medical Management of Radiation Accidents. CRC Press. pp. 15–29. ISBN 978-0-8493-7004-5. A section of page 18 of this publication is reproduced below:

When one considers the large nature of the release of contaminants by the Kyshtym disaster of 1957 and the large land area and population affected by it, the finding that 66 cases of Chronic Radiation Syndrome resulted from it seems surprisingly low.

A description of the kyshtym nuclear disaster, 1957, by the Norwegian Radiation Protection Authority.

Source Link: http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=12&ved=0CGQQFjAL&url=http%3A%2F%2Fwww.nrpa.no%2Fdav%2F397736ba75.pdf&ei=wGj3UpOkM8ejkQW6wYDwDg&usg=AFQjCNGHNmatBM_SwcDTwn_S2-bkNLMGWw&bvm=bv.60983673,d.dGI&cad=rja

“The Kyshtym accident on the 29th of September 1957 resulted in the contamination of a large
area of land with radioactive materials and, along with the Windscale accident a short time
later, constitutes one of the first major accidents at a nuclear facility involving dispersal of radioactivity to the wider environment. Large areas with agriculture and rural settlements
were contaminated to a high degree necessitating the development and implementation of
various countermeasures to mitigate the consequences of the accident.”
“On the 29th September the cooling systems of one
of the waste storage tanks failed and the
temperature began to rise inside the tank.
Evaporation of the cooling liquid in the tank and
the rise in temperature of the 70 to 80 tonnes of
radioactive waste present resulted in a chemical
explosion within the tank at around 4:20 pm in the
afternoon, which later became known as the
Kyshtym accident. This explosion resulted in a
considerable loss of the tank’s integrity and the
ejection of radioactive material into the
surrounding environment. The resultant aerosol
plume attained an altitude of some 1000 m and
resulted in wide ranging dispersal of the ejected
material. Approximately 90% of the 740 PBq of
mixed fission products released (see Table 1)
were deposited as particulate material within 5 km
of the tank whilst the remaining 74 PBq of
radioactive material was deposited as dry fallout
over an area some 30-50 km in width and some
300 km in length stretching north-north east of the
Mayak facility (see Figure 2).”
“Some 15,000 to 20,000 km2 received
contamination levels higher than 3.7 kBq/m2 of
90Sr. A contamination density of 74 kBq/m2 of
90Sr was established as the intervention level for
evacuation of the population. This delineated an
area of approximately 1000 km2 that became
known as the East Urals Radioactive Trace
(EURT). The maximum contamination density
was found to be close to the site of the explosion
itself and attained levels of 150 MBq/m2 90Sr.
A quite rapid decline in levels of radioactivity
within the EURT occurred as short lived isotopes
decayed away. Within two years, isotopes such as
95Zr, 95Nb and 144Ce had ceased to constitute a
significant proportion of the contaminant load and
the main isotope of concern was 90Sr due to its
relatively long half-life of 28.8 years.”
“At the time of the accident, 63% of the area was
used for agricultural purposes, 20% was forested
and 23 rural communities existed in the area.
These populations were evacuated, amounting to
some 10,700 people in total over a 22 month
period after the accident. Further utilisation of the
area was temporarily banned but in 1961
reclamation of the area was initiated. As of today,
some 180 km2 near the site of the explosion are
still officially off-limits.”
“Immediately after the accident, activity levels in
various environmental compartments increased as
did levels in agricultural produce. The increases in
these products were of the order of 10-1000 in
peripheral regions of the EURT and by up to
100,000 near the explosion site itself. After 9-12
days, cases of acute radiation disease were
observed in farm animals with a subsequent lethal
outcome.”
“One year after the accident, surface contamination
levels had decreased due to radioactive decay but
resuspension of contaminated soil particles by
wind and rain was observed resulting in the
continued contamination of vegetation and
agricultural products.”
“In the early phase of the accident aftermath, the
external dose to humans from gamma radiation
was greater than the dose received internally from
ingested radioactivity. Some 270 days after the
accident, the external and internal doses had
equalised and thereafter the external dose began to
decrease relative to the internal. Internal dose was
delivered to the gastrointestinal tract via the
consumption of contaminated foodstuffs and
agricultural products. A radiation dose to bone
was also delivered via the incorporation of 90Sr
into bone tissue as strontium functions as a
chemical analogue to calcium within the body. In
the period immediately after the accident, the
main pathway for contamination to humans was
via bread made from fallout contaminated grain
harvested in the area. As time progressed, the soilplant
transfer system became more important and
contamination of humans with 90Sr was primarily
as a result of ingestion of the isotope in milk,
bread and from potable water from small
reservoirs.”
“For the first time in history, food intervention
limits were introduced concerning the content of
radionuclides (90Sr) in foodstuffs to protect the
public from radiation exposure at a dangerous
level.
Eight years after the accident, milk continued to
be a main pathway for contamination into the
human diet, constituting up to 50% of ingested
radioactivity. By 1987, the intake of 90Sr to
humans had decreased by a factor of 1300 relative
to the intake in the period immediately after the
accident and by a factor of 200 relative to one
year after the accident. Reduction of the levels of
contamination in the human diet was due to a
combination of
– radioactive decay of contaminants;
– natural environmental processes that
reduce the availability of contaminants;
and
– implementation of a wide range of
countermeasures designed to limit the
uptake of contaminants in the food chain
and humans.
By 1989-1990, the annual intake of 90Sr was 3%
of the maximum permissible level for a person
living in a zone that was contaminated with this
isotope to a density of 37 kBq/m2. Over a 30 year
residence period in an area contaminated to this
level, the committed effective dose amounted to
12 mSv, the equivalent doses to red bone marrow
and bone amounting to 25 and 80 mSv,
respectively. Doses would have been significantly
higher if no countermeasures had been introduced.”
……………………………………..
“The earliest impacts of radiation in pine forests of
the area were being observed in 1958 with
significant damage to the trees being evident
including yellowing of pine needles, defects in
tissue development and morphological changes in
tissue structures. In areas with contamination
greater than 18 MBq/m2, death of vegetation was
evident and such effects were sustained for up to
3-4 years after the accident.”
“Whilst the Kyshtym accident was a tragic event
on many levels with serious consequences for
both the population and the environment, the
accident served as an important impetus for a
number of initiatives and developments
fundamental to our understanding of
radioprotection today. The aftermath of the
accident witnessed concerted efforts to
decontaminate and remediate the affected area and
the methods developed to deal with the
consequences of the accident are still in use today.”

End Quote.

http://rpd.oxfordjournals.org/content/early/2012/08/22/rpd.ncs183

CHRONIC RADIATION SYNDROME AMONG RESIDENTS OF THE TECHA RIVERSIDE VILLAGES

A. V. Akleyev*

+ Author Affiliations

Urals Research Center for Radiation Medicine, Chelyabinsk, Russian Federation, 68-A, Vorovsky Street, Chelyabinsk 454076, Russia

↵*Corresponding author: akleyev@urcrm.ru

Abstract

Presented in the manuscript are the results of an analytic study on the chronic radiation syndrome (CRS) among 940 residents of the Techa riverside villages. The uniqueness of this pathology is associated with the fact that, so far, this clinical entity has mainly been observed among Mayak PA workers and residents of the Techa riverside villages. The analyses of CRS cases identified among a population characterised by significant heterogeneity in terms of age, baseline health status and other radiosensitivity modification factors presents a considerable scientific and practical interest. It has been shown that a long-term total exposure at doses in excess of the threshold organ dose in people causes primarily functional changes (neutropaenia, thrombocytopaenia, vegetative dysfunction and asthenia) which, if the exposure continues, are transformed into organic changes (bone marrow hypoplasia, organic damage to the nervous system). If the dose rate decreases below the threshold, a complete repair of the functional changes is observed, while organic alterations may persist for a long time.

© World Health Organization 2012. All rights reserved. The World Health Organization has granted the Publisher/Oxford University Press permission for the reproduction of this article.

CHRONIC RADIATION SYNDROME AMONG RESIDENTS OF THE TECHA RIVERSIDE VILLAGES
A. V. Akleyev*
+ Author Affiliations
Urals Research Center for Radiation Medicine, Chelyabinsk, Russian Federation, 68-A, Vorovsky Street, Chelyabinsk 454076, Russia
↵*Corresponding author: akleyev@urcrm.ru
Abstract
Presented in the manuscript are the results of an analytic study on the chronic radiation syndrome (CRS) among 940 residents of the Techa riverside villages. The uniqueness of this pathology is associated with the fact that, so far, this clinical entity has mainly been observed among Mayak PA workers and residents of the Techa riverside villages. The analyses of CRS cases identified among a population characterised by significant heterogeneity in terms of age, baseline health status and other radiosensitivity modification factors presents a considerable scientific and practical interest. It has been shown that a long-term total exposure at doses in excess of the threshold organ dose in people causes primarily functional changes (neutropaenia, (http://en.wikipedia.org/wiki/Neutropenia ) thrombocytopaenia (http://en.wikipedia.org/wiki/Thrombocytopenia), vegetative dysfunction and asthenia http://en.wikipedia.org/wiki/Weakness) which, if the exposure continues, are transformed into organic changes (bone marrow hypoplasia, organic damage to the nervous system). If the dose rate decreases below the threshold, a complete repair of the functional changes is observed, while organic alterations may persist for a long time.
© World Health Organization 2012. All rights reserved. The World Health Organization has granted the Publisher/Oxford University Press permission for the reproduction of this article.
I submit that the symptomatic crew of the USS Ronald Reagan are owed a far fuller explanation of their suffering than what they have received from authorities so far.

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