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RE: crosspost: OEM: Carcinoid tumour of thymus / radioisotope exposure
Dosage could be estimated if the individual could provide information regarding the amount of time he was working with the radioisotopes and the relative geometry of the radioisotope to his body, i.e. the distance from his person and what type of shielding, if any was used. Was the radioisotope in a specific device for injecting into the well? Who was responsible for arranging for the radioisotopes and is there an available schedule of occurences? Was radiation dosimetry worn or even available?
I am not familiar with carcinoid tumors of the thymus being considered as being radiogenic! Have you searched the literature through medline and conducted a retrospective review of the literature?
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From: Louis H Iselin[SMTP:liselin@planetx.bloomu.edu]
Sent: Wednesday, September 04, 1996 3:05 PM
To: Multiple recipients of list
Subject: crosspost: OEM: Carcinoid tumour of thymus / radioisotope exposure
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