Update on Oilfield Worker

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

The following is an update on the oilfied engineer that is provided out of 
professional courtesy.  Please accept it as such.

***************************************************************
>From: CJMARTIN@PHS.Med.UAlberta.CA
>Organization:  Public Health Sciences, U Alberta
>To: liselin@planetx.bloomu.edu (Louis H Iselin)
>Date:          Mon, 16 Sep 1996 11:45:33 MDT
>Subject:       Update on Oilfield Worker

>I finally spoke to the patient to clarify some of the outstanding 
>issues.  Could you please pass on to all interested parties?

>The patient states he wore a dosimeter "5 to 10% of the time".  His 
>accumulated dose was just over 3 milliSv.  I am in the process of 
>confirming this figure.  He did state that for some reason he never 
>wore the badge when working with the gamma source (the Am/Be).
> 
>In terms of sources:

>Americium/Beryllium was a sealed source which the workers carried by 
>hand.  When unloading it would have been near their neck, when 
>loading onto the rig, near their crotch.

>The AmBe Calibrator was sealed and also carried by hand.  It could 
>have been near various parts of the body.

>The same applies to the Radium Calibrator.

>Interestingly, these workers used Cesium in a novel way.  The patient 
>states that it was present in an unsealed form.  It was apparently 
>supplied as metal shavings in a tin.  The workers unscrewed the tin, 
>glued tiny pieces of the metal onto the top and bottom of a shot 
>which they would then load into a perforator gun.  After performing 
>well bore lithology, this gun would shoot the Cesium laterally at 
>various intervals along the well.  They would then do a gamma count.

>The Iodine 131 was unsealed.  This was the material which was 
>described as spilling etc.

>Iridium was very seldom used.

>The patient was not involved in other rig activities.

>There were no episodes of radiation burns.  He does not know if his 
>thyroid has been checked.  I am awaiting to hear from his oncologist 
>but will certainly order at least a thyroid function test if this has 
>not been done.  There is no family history of the rare syndrome which 
>can include this type of tumour (Multiple Endocrine Neoplasia, type 
>I).  The man smokes 1/2 pack per day for 30 years.

>A review of the literature by Medline not surprisingly reveals no 
>case reports suggesting any association of this tumour with radiation 
>of any type.  Interestingly, there is evidence that the thymus can 
>accumulate radioiodine (Jackson et al. Thymus accumulation of 
>radioactive iodine. Penn Med 11:37-38, 1979.)(Michigishi T et al. 
>Visualization of the thymus with therapeutic doses of radioiodine in 
>patients with thyroid cancer. Eur J Nucl Med 20:75-79, 1993.)  
>However, I don't think anyone would argue that it's uptake is as avid 
>as that of the thyroid.

>A review of my anatomy reveals that the thymus achieves it's peak 
>size at puberty.  This man did start this work at 19 and had a 
>2 inch growth spurt after beginning work.

>I am still in the process of obtaining supporting documents.  The 
>patient's request for compensation from the WCB has been denied.  He 
>would like to secure a lawyer but feels he doesn't have the financial 
>resources.

>Once again this is information for you to mull over only, no opinions! 
>Thanks again to each and all of the many responders from Australia, 
>New Zealand, across the States, Canada and the UK. Wow!  With your 
>comments and questions I was able to return to the patient and take 
>what I felt was a meaningful history.  Despite raising a few hackles, 
>I would do it all over again.

>A special thanks to Louis who has clearly taken a personal interest in 
>this case.  Since he signs all his email Go Gators! I assume he's a 
>football fan and I can testify that he is one great virtual 
>quarterback in the email world.  (Forgive my ignorance of football 
>but we're hockey mad here in Canada and are in a state of national 
>shock after losing the inaugural World Cup of Hockey to you folks 
>south of the border).

>I'll provide further updates through Louis.
>  
>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              liselin@bloomu.edu
Bloomsburg PA  17815-1399                             lhi@poboxes.com