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Exposure to actinides: report on Ca-DTPA injections in CEA-AREVA centres

Published online by Cambridge University Press:  28 June 2007

L. Grappin
Affiliation:
CEA, Service du conseiller médical, route du Panorama, 92265 Fontenay-aux-Roses, France
Ph. Bérard
Affiliation:
CEA, Service du conseiller médical, route du Panorama, 92265 Fontenay-aux-Roses, France
F. Ménétrier
Affiliation:
CEA, DSV/CARMIN, route du Panorama, 92265 Fontenay-aux-Roses, France
L. Carbone
Affiliation:
CEA, Service du conseiller médical, route du Panorama, 92265 Fontenay-aux-Roses, France
C. Courtay
Affiliation:
AREVA, 50444 Beaumont Hague Cedex, France
X. Castagnet
Affiliation:
SPRA, 1 bis rue Raoul Batany, 92141 Clamart, France
J. P. Le Goff
Affiliation:
CEA, Service du conseiller médical, route du Panorama, 92265 Fontenay-aux-Roses, France
M. O. Néron
Affiliation:
CEA, Service du conseiller médical, route du Panorama, 92265 Fontenay-aux-Roses, France
P. Beau
Affiliation:
CEA, Service du conseiller médical, route du Panorama, 92265 Fontenay-aux-Roses, France
J. Piechowski
Affiliation:
CEA, HC, 91191 Gif-sur-Yvette Cedex, France
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Abstract

Ca-DTPA was used for the medical treatment of plutonium and americium contaminations in the CEA and AREVA plants from 1970 to 2003. This report is a survey of the administered injections of Ca-DTPA as a chelating molecule. This report will be part of the registration process for Ca-DTPA by intravenous administration, submitted by the Pharmacie Centrale des Armées. Out of 1158 injections administered to 469 persons, 548 events of possible or confirmed contaminations were reported. These employees were followed by occupational physicians according to the current regulations. The first part of the report is a summary of the most recent findings. Due to its short biological period and its limited action in the blood, Ca-DTPA does not chelate with plutonium and americium as soon as these elements are deposited in the target organs. This justifies an early treatment, even in cases of suspected contamination, followed by additional injections, if necessary. The second part presents data concerning these 1158 injections (contamination routes, posology, adverse effects, ...). These incidents took place at work, were most often minor, and did not require follow-up treatment. A study concerning the efficacy of the product was conducted on a group of people having received 5 or more injections. These results were compared with the efficacy theoretically estimated. Posologies and therapeutic recommendations were proposed based on these observations. Additional studies are needed to confirm these findings. This document is the first summary in this field. It is the result of the collaboration of the occupational medical departments, the laboratories of the CEA and the AREVA and a working group CEA-AREVA-SPRA.

Type
Research Article
Copyright
© EDP Sciences, 2007

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References

Blanchin, N., Desloires, S., Grappin, L., Guillermin, A.-M., Lafon, P., Miele, A. (2004) Protocoles de prise en charge des incidents d’expositions internes au plutonium dans un service médical d’installation nucléaire de base : élaboration – mise en place – évaluation-validation de 1996 à 2002, Radioprotection 39, 59-75. CrossRef
Breitenstein Jr B.D., Fry S.A., Lushbaugh C.C. (1990) DTPA therapy: The U.S. Experience 1958-1987, The Medical Basis of Radiation Accident Preparedness, 2nd edn., R. Ricks, S.A. Fry (Eds.) Elsevier Science Publishing Co., Inc., pp. 397-406.
Code du Travail (2003) livre 2, titre 3, chapitre 1, section 8, articles R231-73 à R231-116, relatif à la protection des travailleurs contre les dangers des rayonnements ionisants.
Durbin, P.W., Schmidt, C.T. (1989) Predicting the kinetics of chelating agents in man from animal data, Health Phys. 57, 165-174. CrossRef
Durbin P.W. (1972) Plutonium in Man: a New Look at the Old Data, Radiobiology of Plutonium, B.J. Stover, W.S.S. Jee (Eds.) The J.W. Press, Salt Lake City, pp. 469-530.
FDA (2004) Pentetate calcium trisodium injection, NDA 21-749, http://www.fda.gov/cder/foi/label/2004/021749lbl.pdf
Grappin L., Bérard Ph., Beau P., Carbone L., Castagnet X., Courtay C., Le Goff J.P., Ménétrier F., Néron M.O., Piechowski J. (2006) Exposition aux actinides : Bilan des injections de Ca-DTPA dans les centres CEA-AREVA, Rapport CEA-R-6097.
Gusev I.A., Guskova A.K., Mettler F.A. (2001) Assessment and treatment of internal contamination: general principles, in: Medical management of radiation accidents, 319-336.
IAEA (1981) Collection Sécurité n°47 IAEA Vienne, Manuel sur les premiers soins aux victimes d’accidents dus aux rayonnements.
IRSN (2002) Guide national d’intervention médicale en cas d’évènement nucléaire ou radiologique.
Jolly, L. Jr, McClearen, H.A., Poda, G.A., Walke, W.P. (1972) Treatment and evaluation of a plutonium-238 nitrate contaminated puncture wound. A two-year case history, Health Phys. 23, 333-341. CrossRef
Lafuma J. (1963) Diagnostic et traitement d’un cas d’intoxication par le plutonium, locale d’abord et généralisée ensuite, Diagnostic and Treatment of Radioactive Poisoning, IAEA Vienne, pp. 380-386.
Leggett, R.W. (2003) Reliability of ICRP's dose coeffectives for members of the public. III.: Plutonium as a case study of uncertainties in the systemic biokinetics of radionuclides, Rad. Prot. Dosim. 106, 103-120. CrossRef
Ménétrier, F., Grappin, L., Raynaud, P., Courtay, C., Wood, R., Joussineau, S., List, V., Stradling, G.N., Taylor, D., Bérard, Ph., Morcillo, M.A., Rencova, J. (2005) Treatment of accidental intakes of plutonium and americium: Guidance notes, Appl. Rad. Isotopes 62, 829-846. CrossRef
Piechowski J., Menoux B., Chaptinel Y. (1992) Evaluation de l’exposition systémique résultant d’une plaie contaminée par des produits radioactifs, Rapport CEA-R-5583, C.E. Saclay, Gif-sur-Yvette.
Piechowski, J., Menoux, B., Miele, A., Grappin, L., Guillermin, A.-M., Fottorino, R., Ruffin, M. (2003) Implications du médecin du travail et de l’expert dans la gestion et la dosimétrie d’un incident de contamination : exemple d’une plaie contaminée par le plutonium, Radioprotection 38, 29-50. CrossRef
REAC/TS Resources (2002) Ca-DTPA: informational material package insert http://www.orau.gov/reacts/calcium.htm
Schofield, G.B., Howells, H., Ward, F.A., Lynn, J.C., Dolphin, G.W. (1974) Assessment and management of a plutonium contaminated wound case, Health Phys. 26, 541-554. CrossRef
Stather, J., Smith, H., Bailey, M., Bulman, R., Crawley, F. (1983) The retention of 14C-DTPA in human volunteers after inhalation or intravenous injection, Health Phys. 44, 45-52. CrossRef
WHO (1984) Accidents radiologiques : Conduite à tenir en cas de surexposition, Collection 84.03 Institut Curie.