Some Effects of Ionizing Radiation on Human Beings - US AEC

121 Pages·1956·7.285 MB·English

SOME EFFECTS OF
Ionizing
RaLiation
‘\
ON HUMAN BEINGS
A Report otzthe
from the
Naval Medical Research Institute
Mdrsld)ese ad American
Bethesda 14, Maryland
U. S. Naval Radiological Defense
Exposed to Radi~tzon
Laboratory
SanFrancisco, California
and a Dzwwszon of
Medical Department
Brookhaven National Laboratory kzditi~iotz Injury in the
Upton, New York
Edited by Hwviwv Being
E. P. Cronkite
V. P. Bond
and C. L. Dunham
UNITEDSTATES
ATOMICENERGYCOMMISSION
REPOSITORY t3NL REcoRDS JULY 1956
IY4J?S”H4LLIILANLK
COLLECTION
TID 5358
For saleby the SuperintendentofDocuments, U.S.GovernmentPrinting Office,
Washington25, D. C.
Introduction
ON 31AROH1, 1954, an experimental thermo- Interim care and study had been capably
nuclear device was exploded at the U. S. Atomic handled by the small medical department of the
Energy Commission% Eniwetok Proving U. S. Naval Station, Kwajalein, Marshall Is-
Grounds in the Marshall Islands. Following lands The commander of the naval station had
the detonation, unexpected changes in the wind arranged living facilities for the exposed Mar-
structure deposited radioactive materials on shallese, and installed laboratory and clinical
inhabited atolls and on ships of Joint Task facilities as requested immediately upon arrival
Force #7, which was conducting the tests. of the medical team.
Radiation surveys of the areas revealed injuri- Full cooperation and support from all agen-
ous radiation levels; therefore, evacuation was cies in the field enabled the medical team to
ordered, and was carried out as quickly as pos- operate at maximum efficiency, so that the de-
sible with the facilities available to the Task gree of radiation injury could be assessed
Force. quickly, and appropriate care and study of the
Although the calculated accumulated doses to injured could be instituted without delay. All
the exposed human beings were believed to be of the exposed individuals have recovered from
well below levels that would produce serious the immediate effects without serious sequelae.
injury or any mortality, the Commander of the Nevertheless it is planned to evaluate the
Task Force requested the Department of De- medical and genetic status of the group at ap-
fense and the U. S. .4tomic Energy Commis- propriate intervals with a view to learning
sion to organize a medical team to provide the what if any of the known late effects of radia-
best possible care of the exposed persons and to tion exposure may be observed. Obviously and
make a medical study of the exposures. indeed fortunately the number of persons re-
Responsibility for organization of the medi- ceiving 75 roentgens exposure and greater is
cal team was shared by the Armed Forces Spe- too small to make it possible to determine with
cial Weapons Project, Department of Defense, any degree of accuracy the effect on life span.
and the Division of Biology and Medicine, U. S.
In addition to providing medical care for
Atomic Energy Commission. Experienced
these persons, the team accumulated a large
professional and technical personnel were im-
body of scientific observations on radiation in-
mediately available from the Naval Medical Re-
jury in human beings. The initial data have
search Institute and the U. S. Naval Radiologi-
been supplemented by field resurveys 6, and 24
cal Defense Laboratory. Since speed was es-
months after the original investigation.
sential in the organization and transport of the
The results of this work are summarized in
medical team to the mid-Pacific area, the as-
the present volume. The data which were ob-
sistance of the Medical Department of the Navy
was requested, and w-aspromptly received from tained substantial y increase the fundamental
the Surgeon General. knowledge of radiation injury and the medical
A team was organized from personnel of the capability of caring for persons exposed to
two Navy laboratories and representatives of the large doses of radiation.
.4EC Division of Biology and Medicine and the
.4rmed Forces Special Weapons Project. The CHARLESL. D~TNHAM,M. D., Dimctcw,
team was air lifted to the Marshall Islands, Division of Biology and Medicine,
arriving on the eighth day after the explosion. U. S. Atomic Energy Commission.
III
Preface and Acknowledgments
THE 1.’NDERTAKINGof the care ancl study of the HM l/C; and J. S. Hamby, HM, 2/C were
human beings accidentally exposed to fallout provided. From the United States Naval Ra-
radiation following the March 1, 1954, nuclear diological Defense Laboratory, one civilian
test detonation in the Pacific represented the physician, Doctor V. P. Bond; one medical
first instance in which study of a large group service corps officer, Lt. Corn. L, J. Smith; and
of irraciiated human beings was possible soon four enlisted men, W. H. Gibbs, HMC, USN;
after exposure. Although the physical esti- J. C. Hendrie, HM, l/C; W. S. Argonza, HM,
mates of dose received by the individuals ex- 2/C; and J. Flannagan, HM, were supplied.
posed to fallout radiation were thought to be The Division of Biology and Medicine, .Itomic
sublethal. precise knowledge of the relative Energy Commission, sent two civilian physi-
sensitivity of human beings to penetrating ion- cians, Dr. C. L. Dunham then Chief of the
izing radiation was lacking. Accordingly, in Medical 13ranch and Dr. G. V. LeRoy, Con-
addition to the initial medical team, provisions sultant and Special Representative of the Di-
were made for a second echelon of specialized rector of the Division. The Armed Forces Spe-
personnel in case they were needed. A pre- cial Weapons Project supplied one .41my medi-
ventative medicine unit of the Commander-in- cal officer, Lt. Col. L. E. Browning, MC, USA.
Chief, Pacific fleet, was alerted for possible bac- All personnel were experienced in the study
teriological studies; blood bank personnel, and of radiation injury:
additional clinicians and nurses were notified The preliminary studies performed by the
in case conditions justified their services in the Medical Department of the Naval Station at
Kwajalein area. Rear Admiral Bartholomew Kwajalein were under the direction of Com-
Hogan, MC, USN, Pacific Fleet Medical Offi- mander W. S. Hall, MC, ~“SN, the station
cer,” promised full support of all the medical medical officer and his small staff who are to
facilities of the Pacific Fleet were they deemed be commended for an excellent job.
necessary. With the preceding planning it Upon arrival of the medical team, it became
was felt that any medical problem, regardless quite evident that, because of tihelarge numbers
of the severity, could be promptly and ade- of radiation casualties and the huge amount of
quately handled in the field. work involved in collecting data, that primary
The personnel for the team were obtained responsibilities for various phases of the study
within the continental limits of the United would have to be delegated in order to obtain
States from the Naval Medical Research In- the necessary information for biological assay
stitute and the L“nited States Naval Radiologi- of the degree of injury. In the initial phase,
cal Defense Laboratory. From the former, four hematological surveys and establishment of
medical officers, E. P. Cronkite, R. A. Conard, clinical records on each individual were empha-
N. R. Shulman, and R. S. Farr were obtained. sized. Dr. V. P. Bond organized and ana-
Two Medical Service Corps officers, W. H. lyzed the results of tihedaily blood studies. Lt.
Chapman and Robert Sharp, were also ob- N. R. Shulman, MC, USN, with the capable
tained from the same institution. In addition, assistance of Mr. John Tobin, anthropologist of
six enlisted men, (1. R. Sipe, HMC, LTShT;P. the Trust Territory, and Kathleen Emil, Mar-
K. Schork, HMC, USN; C. P. A. Strome, HMC,
shallese nurse, as interpreters, undertook the
~Ts~; ~1’. (J. clutter, HM, l/~; R. E. Hansen,
establishment of medical histories and initial
lNOWSurgeonGeneral,LT.S.Navy. physical examinations. As the clinical pkture
IV
PREFACE AND ACKNOWLEDGMENTS v
unfolded, daily sick ctll and cme of the radia- lished and operating within M hours after ar-
tion lesions were carried out by Doctor Shul- rival of the medical team.
mnn along lines clecidecl in general conference In ilddition, we wish to acknowledge the out-
of the entire grollp. l~hen epilation and skin standing contributions of Col. C. S. Maupin,
lesions appeared, Commander R. .\. (’onard, MC, ITSA, Field Commaml .lrmecl Forces Spe-
MC, 1“SS. was assigned primary responsibility cial Weapons Project; Captain H. H. Haight,
for [loc~lnlentfition of the onset, incidence, anfl MC, USN, Division of Military Application,
detailed description of the skin lesions. During .itomic Energy Commission; Dr. Gordon Dun-
the field phase, Lt. Robert Sharp, MSC, I-SN, ning, Division of Biology and Medicine. .~tomic
was given the responsibility for clecontmnina- Energy Commission; and Dr. H. Scoville of
tion and collection of clata from all so(lrces on .!rmed Forces Special Weapons Project who in
the radiation intensities of tile contaminated addition to their primary duties, collected ex-
atolls and tl~ecalculation of probable doses of tensive di~t:~in the field on the radiation intensi-
radiation received. Piltll K. Scl~ork. H31C. ties of the ntolls i~l~(l kindly furnished this ma-
lTS3”, was in clmrge of the IZematology Labora- terial to the project personnel. Drs. T. L. Sliip-
tory. The services of Doctor S. H. Cohn were man, Thomas White,* and Payne Harris of the
requested, and made available by USNRDIJ to Ims .ilamos Scientific I.aboratory kindly fur-
undertake a field study of the clegiee of internal nishe(l very valuable data on urinary excretion
contamination, in addition to the studies that of rndionuclides. The early studies of the I,os
were to be performed on urine samples returned .~lamos group in particular contributed sig-
to the Los Alamos Scientific Laboratory, N’ew nificantly to the information on the degree and
York operations (Mice of the Atomic Energy nature of internal deposition of short lived
Commission, and the USNRDL. radionuclides. Dr. G. V. IRRoy, .ksociate
The authors wish to express their gratitude Denn, school of Biological Sciences, ITniversity
and indebtedness in particular to Doctor John of (’hicago. participated in the early phase of
(’. Bugher, tl]en Director of the Division of the study as a consultant to the Jledical Group.
Biolo~~ and Medicine, .Itomic Energy Com- The authors of Chapter I are particularly in-
mission, who came to tile forward Ilrea ~llldlvas debted to Dr. C. S. Cook and the hTuclear Radia-
always available for counsel. In addition Cap- tion 13ranch at the Navy Radiological Defense
tain ~ranTipton, MC, [~SN, Director of .itonlic I,aboratory for information on energy distri-
Defense Division of the Bureau of Medicine bution of the gamma radiation. Di~titon radio-
iIncl Surgery? Department of the Savy; Com- chemical and radioactive decay rates were sup-
mander Harry Etter. MC, UShT; Captain W. E. plied by Dr. C. F. 31iller and the Chemical
Kellum, MC, 17SN-: and (’aptain T. 1,.Willmon, Technology Division of USNRDL and Dr. R.
(Xommancling and Ilxecutive officers respec- IV. Spense of I.os .~lamos Scientific Laboratory.
tively of tile Naval Medical Research Insti- In collecting data on the skin lesions, the
tute: (Jptain R. -i. Hinners, USS, Director help of Billiet Edmond, Marshallese school
~TSXRDL. ancl Captain .L R. 13elmke, MC, teacher for the Rongelap group in interpreta-
T~SA-, .ksociate Director NRDL; gave unlin~- tion was invaluable. Miss Patricia Ronn of
ited support anc~ reduced administrative pro- USNRDL prepared the histologic prepara-
cedures to a hare minin~uu~>thus making it pos- tions of the skin biopsies and Mr. William Mur-
sible for the unit to be assembled and mlderway ray and George Needum of USNRDL and
in a matter of hours. C. P. A. Strome, HMC, IJSN, Naval lfedical
1‘pen il~rival at Kwa jalein, Rear Admiral Research Institute performed the excellent
R. S. Clarke. lJSX’, Commanding officer [-nited color photography.
States Si~~i~l Stntion, Kwajalein, supported the In preparation of the material and writing of
l)roject with all of the facilities at his disposal. C%apter V, the authors are indebted to }Iiss C.
.\s a result. a laboratory and clinic was estab- *Deceased.
VI PREFACE AND ACKNOWLEDGMENTS
Jones of USNRDL, who prepared the autora- It is quite impossible to acknowledge the
diographs of the tissues. In addition, Dr. W. P. assistance of the numerous individuals in vari-
~Torris of .Irgonne National Laboratory made ous agencies who assisted in collection of data
autographs of specific tissues. Dr. Rachael and editing of the various chapters. The Pro-
Reed of UShTRDL performed the microscopic ject Officer wishes to commend all of the pro-
pathological studies of the tissues from the ani- fessional nnd technical members of the group
mals in whom radioisotopes were deposited in- for their excellent motivation, initiative, and
ternally. Lt. Col. R. ,J. Veenstra, V(2, U. S. voluntary long hours of extrz work that were
Army, was in charge of the cm-e of all the ex- essential for the accomplishment of the clinical
perimental animals collected in the field and re- and research objectives and the rapid collection
turned to the United States NLIwd Radiological of the preliminary data in the field. It is
I)efense Laboratory. Dr. E. R. Thornpkins quite evident that the entire study of the ex-
made the facilities of the chemical technology posed individuals was a cooperative endeavor
division of the USNRDL available and pro- involving numerous activities, and that it would
vided technical advice on the radiochemical have been impossible except for the splenclid
aspects of the project. spirit of unselfish cooperation by all concerned.
The continuous help and cooperation of the The fine team work of the group itself made
Trust Territory representatives in particular, it possible for realistic daily reports on all of
Mr. Maynard Neass, District Administrator of the above phases to be forwarded daily to re-
Majuro Atoll and their aid in obtaining the sponsible agencies and thlls keep authorities
necessary control data on Marshallese inhabi- informed of the course and severity of events
tants was indispensable to the success of this following this untownrd and unavoidable acci-
study. Particular help was obtained from Mr. dent.
John Tobin, the district anthropologist, whose Upon completion of the initial phase of the
knowledge of the Marshallese language and study, primary responsibility for writing re-
habits, in addition to services as an interpreter, ports on the variouse phases was delegated as
were invaluable. follows: C. A. Sondhaus, dosimetry; N. R.
The initial measurements on skin and cloth- Shulman, clinical course and care; R. .L Con-
ing contamination were made by Lt. J. S. ard, skin lesions; V. P. Bond, hematology: S.
Thompson, MC, USN, of V. P. 29 Squadron. H. Cohn, internal deposition.
J\Teare indebted to him for furnishing his rec- The final publication of this monograph on
ords on the contaminated individuals and the human radiation injury represents the comple-
initial decontamination that was performed by tion of the finest in cooperation and team work
his group. of a diverse group who willingly sacrificed
The care and the study of these human beings personal ambitions and desires for the good
would not have been successful unless the of the project at large. It was a distinct privi-
Marshallese had accepted the importance of lege to be chosen to direct the medical team,
their being under careful medical observation a real pleasure to edit and integrate the sepa-
and of gathering medical data. At all times rate reports and finally realize their fruitiou
these people were most pleasant, cooperative as a homogeneous monograph.
and actively participated in the project. In
particular the project officer wishes to express E. P. CRONKITE,M. D.,
thanks to the Magistrates of the groups, to the Medical Department,
Marshallese health aids, school teachers, and Brookhaven National Laboratory,
nurses. Upton, New York.
Table of Couteuts
Poge
I1~tro(iuctioll ---------------------------------------- III
Preface and Ackno~vledgcnlcnts ___________ _____________ KV
Chapter]: Radiation Characteristics of the Fallout Ma-
terial and Determination of the Doseof Radia-
tion _____________________ ________________ 1
Chapter2: Clinical Observations and General .Manage-
merit ----------------- -------- ----------- 13
Chapter3: Skin Lesions and Epilation--- -------------- 25
Chapter4: Hematologic Observations___ _______________ 43
Chapter5: InternalDepositionof Radionuclides. -------- 65
Chapter6: General Discussionof Radiation Injury From
Atomic Weapons .. ..._._.-_ _______________ 93
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ISODOSELINES OF
ESTIMATED PATTERN OF RADIOACTIVE FALLOUT
PACIFIC PROVING GROUNDS
MARCH 1,1954
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Chapter I
Radiation Characteristics of the Fallout Material and the
Determination of the Dose of Radiation
C. A. SONDEUUS
ROBERTSHARP,It. (jg) MSC USN
V. P. BOND,M. D., Ph. D.
E. P. CRONKITR,Cdr. (MC) USN
1.1 Nature of the Event and Description of the
Exposed Groups.
1.2 Whole-Body Gamma Doses.
1.21 Characteristics of the Radiation.
1.22 Duration of the Exposures.
1.23 Geometry of the Exposures.
1.3 Estimation of the Doses From Beta and
Soft Gamma Radiation.
1.4 Summary.