crosspost: OEM: Carcinoid tumour of thymus / radioisotope exposure

[liselin@planetx.bloomu.edu (Louis H Iselin)]

Cross posted to RadSafe from the Occupational & Environmental Medicine List:

In article <B9B561777F7@phs.med.ualberta.ca> CJMARTIN@PHS.Med.UAlberta.CA 
writes:>To: occ-env-med-l@list.mc.duke.edu
>Date:          Wed, 4 Sep 1996 13:16:47 MDT
>Subject: OEM: Carcinoid tumour of thymus and radioisotope exposure

>    Here is case that we would appreciate your comments on:
>     
>        We have just seen a 46 year old man who was employed from 
>1969 to 1978 as an oilfield cased-hole logging engineer.  Essentially 
>his work involved the underground injection of various radioactive 
>isotopes to obtain information on the best method to extract oil and 
>natural gas reserves.  He was exposed to the following agents:

>Iridium-192          10-20 mcuries       (seldom used)

>Cesium-137             3 curies          (used 4-5 times/year)

>Ammerisium-berylium    3-5 curies        (used everytime a well was 
>                                         logged, approximately 150-
>                                         200 times/yr)
>                                         
>Iodine-131             20 mcuries         (In liquid form, 100 
>                                          times/yr)

>    He describes the workers attitude towards radioactive hazards as 
>"cavalier".  They used no protection whatsoever.  Isotopes would 
>spill on clothing, blow into their faces etc.  They would store them 
>in the trucks to prevent freezing.  When the patient took a safety 
>course on radioisotopes, he recognized the danger and quit this line 
>of work!

>    He began to experience sharp retrosternal chest pain in 1981.  
>After being treated for everything you could possibly imagine, he 
>eventually had an open thoracotomy in 1989 at which time the tumour 
>was found and a tissue sample was taken.  He has had courses of 
>radiotherapy and chemotherapy, his lesion is apparently unresectable. 
>There has been impingement on his SVC and a stent has been inserted. 
>He is aware that the cancer is terminal but, understandably, no one 
>has given him a time frame. He is being followed with CT Scans every 
>6 months.

>    We have been asked to comment on causation.

>    He says numerous other co-workers have had various types of 
>malignancy - 2 cases of leukemia, plus bowel, prostate, bladder, 
>testicle.  Apparently several have had thyroid abnormalities but the 
>patient is unsure exactly what these are. 

>    We are in the process of:
>    - Alerting our Dept of Labour to the situation
>    - Obtaining all his records
>    - Searching the literature
>    
>    Any insight or help with this case the group could provide would 
>be most welcome.

>Christopher Martin
>Resident
>Occupational Health Program
>University of Alberta
>Edmonton, Alberta


_____________________________________________________________________
Louis H. Iselin, Ph.D.           * Go Gators! *                   <*>
Assistant Professor of Physics (Health Physics Program)
Bloomsburg University of Pennsylvania
Bloomsburg PA  17815-1399                          liselin@bloomu.edu