RE: Radium -Reply

["Frame, Paul" <FRAMEP@ORAU.GOV>]

Charlie Willis wrote in part:

> Her doctors said that she died of
> Pernicious Anemia (the inability of the intestines to absorb 
> vitamin B-12) which, I
> am told by the medical folk, would not have been confused 
> with leukemia. 
> Pernicious anemia, so far as we know today, is not radiogenic.
> 
> Thus, cause of death seems to shed little light on the 
> question of dose, except to
> suggest that she did not have a large body burden of radium.  

Since the above might be taken to suggest that Marie Curie died of what
we now call pernicious anemia and that her death was therefore not due
to radiation, permit me a few comments.

Although what we now call pernicious anemia has not been linked to
radiation exposure, other types of anemia have been (BEIR IV p 225-230)-
especially due to large uptakes of radium. While Charlie quotes Marie's
doctors as attributing her death to pernicious anemia, some authors
state that her death was due to aplastic anemia. What does this mean?
The following quote is that of Marie's doctor, Dr. Tobe,(see Eve Curie's
biography of her mother): "The disease was an aplastic pernicious anemia
of rapid, feverish development."  

How certain is this diagnosis? First of all it is not clear to me that
the doctor was describing what is considered today to be pernicious
anemia - after all they hadn't discovered vitamin B-12 at the time of
her death. Irrespective of this, Eve Curie notes "the abnormal symptoms,
the blood tests, differing from those in any known case of pernicious
anemia, accused the true criminal: radium". I other words it was not a
typical case of pernicious anemia. I also believe that the diagnosis was
based only on an evaluation of the blood and that no biopsy was employed
which make such a diagnosis even less certain.

The great difficulty in diagnosing the type of anemia (there are
several)experienced by individuals exposed to radium is discussed in
great detail by Harrison Martland, the first to unequivocally attribute
the deaths of radium dial painters to radium. See the discussion in his
two part paper in JAMA (92) 1929 "Occupational Poisoning in Manufacture
of Luminous Watch Dials" His other papers also address this issue.

In fact, Martland diagnosed (JAMA (85) 1925) the very first fatal case
of death in a radium dial painter as "Rapidly progressing anemia of the
pernicious type." And his second case (non fatal at the time) was
diagnosed as " chronic leukopenic anemia of the pernicious type." There
are plenty of other similar diagnoses. The point here is that radium
induced deaths were being diagnosed as pernicious anemia even though the
diagnosis today might be for a different anemia.

Interestingly, her body and that of her husband were moved a couple of
years ago to the Pantheon in Paris and an analysis was performed of
their radium burdens. Unfortunately I don't have the details, but
Pierre's remains were found to have a substantially higher amount of
radium than those of Marie.

There is some reason to believe that a major, if not the major, exposure
she received was from x-rays not radium. During W.W.I she was operating
unshielded x-ray units at the battle front.

best wishes

Paul Frame
Professional Training Programs
ORAU
framep@orau.gov
http://www.orau.gov/ptp/ptp.htm
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