Stebbings J H
Midwest Epidemiology Associates, Naperville, IL 60540-3737, USA.
Health Phys. 1998 May;74(5):602-7. doi: 10.1097/00004032-199805000-00008.
A previous study of 25 radium workers reported radium osteonecrosis to be common down to that study's lower limit of detection of 226Ra. This paper reanalyzes those data using Poisson and linear regression to obtain quantitative dose-response estimates for radium osteonecrosis. A quadratic, supralinear response of the necrosis ratio to skeletal dose and preterminal 226Ra burden was observed at a high level of statistical significance. At low dose the response was linear. Clearly observable necrosis, that appearing in 4% of tissue blocks, was seen in femurs at approximately 0.8 Gy skeletal dose. Comparable effects from plutonium in spongy bone might therefore be expected in the 0.01-0.02 Gy dose range. Prediction equations are presented for preterminal 226Ra burden, for skeletal dose, and, at low doses where the response can be taken as linear, for dose from and uptakes of both 226Ra and 228Ra. Male New Jersey workers in the radium refinery were observed to have necrosis not explained by the 226Ra uptakes, but compatible with skeletal doses from other internal emitters, in the range 0.25-1.2 Gy lifetime dose acquired per year of employment. 210Po, inhaled directly or from inhaled 210Pb, is the most likely source of this dose.
先前一项针对25名镭作业工人的研究报告称，在该研究的镭-226检测下限之下，镭骨坏死很常见。本文使用泊松回归和线性回归重新分析了这些数据，以获得镭骨坏死的定量剂量反应估计值。在高度统计学显著性水平上，观察到坏死率对骨骼剂量和终末期前镭-226负荷呈二次超线性反应。在低剂量时，反应呈线性。在骨骼剂量约为0.8戈瑞时，在股骨中观察到明显可见的坏死，出现在4%的组织块中。因此，在0.01 - 0.02戈瑞剂量范围内，可能预期钚在松质骨中会产生类似的效应。给出了终末期前镭-226负荷、骨骼剂量的预测方程，以及在低剂量下（此时反应可视为线性）镭-226和镭-228的剂量及摄入量的预测方程。观察到新泽西州镭精炼厂的男性工人出现的坏死不能用镭-226的摄入量来解释，但与其他内照射源的骨骼剂量相符，每年就业获得的终身剂量范围为0.25 - 1.2戈瑞。直接吸入或从吸入的铅-210中吸入的钋-210是这种剂量最可能的来源。
