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Oral Histories

Biophysicist Robert E. Rowland, Ph.D.


Foreword

Short Biography

From College to Argonne National Laboratory

Initial Argonne Interest in Elgin State Hospital

Early Radium Injections at Elgin State Hospital

Radium Studies by Argonne National Laboratory

Medical Treatments Using Radium

Research Into How Radium Deposits in Bone

To University of Rochester for a Ph.D.

Wartime Plutonium Injection by Metallurgical Laboratory Staff

Director of the Radiological and Environmental Research Division

Establishment of the National Center for Human Radiobiology

Making Contact With Radium Cases for Follow-up

Tracing the Effects of Radium in Bone

Funding for Radium Study Ends

Recollections of Argonne Scientists Participating in Radium Studies

Radium-Induced Malignancies

Differing Perspectives on Radium Retention

Seeking a Threshold for Radium-Induced Malignancies

Radium in Ground Water

Obtaining Consent to Exhume Remains of Radium Cases

Human Use Committee at Argonne

Termination of the Radium Program

Potassium Studies in Cooperation with Loyola University

Arsenic-76 Study

Reassessment of Plutonium Injection Cases

Information Provided by Argonne to People in Radium Follow-up Program

Public and DOE Awareness of Plutonium Injections

Analyses of Thorium Workers

Making Contact With Radium Cases for Follow-up

ROWLAND: Anyhow, they did give us money to build a wing, and we built a morgue, and we built a records room, and we built the needed facilities to bring the [various studies] close together.

We added medical people to our staff. Austin Brues came over from Biology Division to be [our] medical director for a while. We were able to hire other physicians as the years went by.

We set up the Center for Human Radiobiology. We started it in '69.

Miller, Finkel, and Hasterlik caused a lot of problems when the decision was made, because they had been running the program at Argonne. I offered each of them positions, and they all turned [my offer] down. Hasterlik [left] the University of Chicago; Asher Finkel quit Argonne; Chuck Miller quit Argonne. So, we had a real nasty arrangement for a while there.

Asher Finkel — a wonderful guy — said very clearly and coldly that the medical records belonged to him, personally, and they would not be turned over to us, [of] some 400 radium cases.

This really appeared to [create] a real problem. I was in contact with the Chairman of the Joint Committee on Atomic Energy, [Representative] Chet Holifield, who kept writing to me, asking, "Are you getting these cases transferred?"

I kept writing back, "No, I'm not."

Asher agreed that when any case died, he would turn the records over, and if any case agreed to the turnover, he would be glad to turn the case over. But, unless he got a written instructions from the radium case, he would not turn them over.
FISHER: What was his basis for making the claim that the records were his?
ROWLAND: Medical privilege. He's a physician.
YUFFEE: Sure — because they were doing the medical exams of these people, so now he was their physician?
ROWLAND: That was it. I don't know how legally valid it is, but it was good enough. Nobody was going to fight it. And that seems to be the case in our legal system, that the physician has —
YUFFEE: It's a good argument.
FISHER: Who was his employer?
ROWLAND: His employer was the Argonne National Laboratory, which is run by the University of Chicago. You realize that the Argonne [employees] are not civil servants: we were all employees of the University of Chicago. The money was laundered, so to speak, and so we weren't Civil Service. We didn't have that rank. So, we did work for the University of Chicago.
FISHER: This strikes me as a very unusual position to take.
ROWLAND: I don't know how unusual it is, but it seemed to be an unbreakable logjam.

To make it even worse, we learned much later that Chuck Miller — my good friend, Chuck Miller — had written to all the patients, asking them not to work with us.

We didn't learn this, fortunately, [until] years later. But, finally, some of [the radium cases] turned in the letters they had received — that Chuck had written to them. I don't know if Asher knew about it, or Bob Hasterlik, but Chuck wrote and said, "We'll take care of you forever," and they didn't have any funds to do it.

But, anyhow, we lucked out. As often is the case, we lucked out. As we decided to build this center, we thought, one of the things we really need is a search-and-contact group, and we lucked — just pure lucked into a wonderful woman who had just decided it was no longer time to be a nun. She wanted to go into the real world.

She was about 40 years old, and she was looking for a job. We hired her, and she [formed] a group of women who took over the responsibilities we called "search and contact." Basically, it's to make the contacts and win the goodwill of the people who we depended upon, the dial painters, the other radium cases.
YUFFEE: All the people who were currently seeing Miller and Hasterlik.
ROWLAND: Right.
FISHER: What was her name?
ROWLAND: She married. After she married, it was Betty Patton.

Anyhow, these women tackled the job of contacting the patients that we knew that were in contact with Miller, Finkel, and Hasterlik, and winning over their goodwill. And she did it. In about three years, we had all the cases. They signed letters which we sent to Dr. Finkel; he would turn over their records.

At the end of about a three-year period, we had them all, and I give all the credit to this one woman, who really was a wonderful person. She had taught science, I think, in Catholic schools. Anyhow, it worked. We got the cases, and the whole thing was forgotten.

The fact of the matter, I wrote that up in this book that I referred to you this morning. Parts of that were edited out. [There is] a sensitivity about [such conflicts], so that part has been edited out of the book, the fact that there was this conflict, and there were some letters being written, and the like. But anyhow, we got the records.

One table I worked up one time showed the growth of the number of measured radium cases, in the files, starting with 1969, when we took over the MIT cases and the Argonne cases and combined them into one.

For the next 12 years, we got [about] 100 new cases a year. So, we found more radium cases in that 12-year period than had ever been found before, simply by going out and beating the bushes, trying to find [them], and having an organization funded to do the work.

We were funded to [locate] dial painters or anybody else exposed to radium, to ask them to come to Argonne, to pay their way up to Argonne, to pay the way of an escort if they needed such, put them up in a motel, and give them a two-day visit to the Laboratory in which their medical history was taken and physical measurements were made.
YUFFEE: Did you advertise in newspapers or things like that?
ROWLAND: No.
FISHER: So, it was either word of mouth—
ROWLAND: It was all done through our search-and-contact group. There were no advertisements, but there was publicity from time to time from newspapers.
YUFFEE: Sure.
ROWLAND: And sometimes this would aid in bringing people to our attention. But for the most part, it was done through word of mouth.
YUFFEE: These are small towns, anyway.
ROWLAND: Small towns. And "So-and-so visits with us and was treated royally and strongly suggests that their friends do the same thing," and it really worked. But, it's amazing to me the number we found over the years.
YUFFEE: I think it would be interesting to ask you about how you went about exhuming the remains of dial painters and others who had gotten radium administered, or were exposed to radium.

Tracing the Effects of Radium in Bone

ROWLAND: Right. The idea first came to me back when I was studying radium in bones. We were very interested in the deposition patterns of radium in the cases at Elgin State Hospital, because they were given radium once a week.

Now, radium is cleared very rapidly from the blood; dumped out of the body quickly. So it's unique, physiologically speaking. It's there for a while, and while it's there, it's available, and it looks to the body like calcium, remarkably like calcium. It goes everywhere calcium goes.

But it isn't there very long. So a single injection, for example, of radium, or a single ingestion, puts a spike of radium in the blood, which is visualized later in bone as a very sharp ring wherever new bone was growing at that time that the radium [was present] — a very sharp line, a ring, or an outline at the edge of a bone.

The Elgin cases, in contrast, had these weekly injection. And, the range of the alpha being what it is, they all blurred together and made a uniform growth pattern that had width to it.

Width is very useful for counting [alpha tracks] and determining how much radium per mass of bone is there. It's difficult to do from a sharp line, but if you get a broad area of so many microns thick, then you can, with some satisfaction you're doing it correctly, determine how much radium there is per gram of bone and per gram of calcium.

This is what I was trying to do when I was studying radium in bone, is quantitate 32 the deposition. And I learned very quickly from the samples we had been able to get earlier from the Elgin cases, that if I could get those broad bands, it was easy to do. Interestingly enough, this is what happened in the dial painters, because they ingested, but daily.
YUFFEE: Right.
ROWLAND: If they were tipping the brush in their mouth and ingesting the paint, they did it, five days, six days a week. And so, they had broad bands of radium laid down in new bone growth that took place at the time they were taking it.
YUFFEE: I don't remember: Did you say earlier that you could then reconstruct their total dose from this, or not? .
ROWLAND: I didn't say it, but we could.
YUFFEE: Oh, you could?
ROWLAND: It turns out that we were able to construct, within a factor — about a factor of two, which isn't bad — how much radium they had in their body, not from these bands of new growth, but — The interesting thing about radium is that it goes in all of bone slowly by an exchange process. It's laid down in growing regions [very rapidly, but also in non-growing regions, very slowly].

But bone is a living tissue, and there are cells that are embedded in bone and surrounded by bone, connected, apparently, by little tubules 33 called "canaliculi." I think these cells —osteocytes 34 — have little processes going into each one of these canaliculi.

I visualize these as a network that supplies all of bone with fluid and minerals and allows all of bone to take part in calcium exchange processes, make calcium available to the blood when the body needs it.

As you may know, calcium is an extremely well-regulated ion in the blood. It doesn't vary very widely, even when you're not eating any calcium. It's coming out of the bone. The bone is serving as that reservoir to keep that level constant.

Well, in order for that to go on, it has to have a continuing exchange process back and forth, and radium participates in this.

And so, after a person has had radium in their body for months or longer, when we make our autoradiograph, we see the bands of newly formed radium as intense — we call them "hot spots." But all of the bone is labeled, all of it, and it's labeled very uniformly.

We call this a diffuse distribution and, by counting the alpha tracks over an area of bone, we were able to determine the concentration per gram of bone in this diffuse, which was most of the bone. Most of the bone was labeled diffusely.

And it turned out this was about half the body burden.

So, we were able to take a bone from a person we had never been able to measure, look at the diffuse level, and make an estimate of the body content, which turned out to be very handy in a lot of cases. Within a factor of two, we were about right. We would measure this, double it, [and have an estimate] for the whole body, and it would work very nicely.

It's one of the fascinating things about bone that got me involved in the Gordon Research Conference on Bones and Teeth, because I began to learn a lot about how things worked in bone just from looking at this radium, which happened to be a long-lived tracer, whereas if you deal with something like calcium-45, even in human bone, it's a relatively short-lived tracer. Here I had something [that was] good for 50 years.
FISHER: As I have read the Argonne annual reports, I've been impressed with the quality of the scientists that you employed in that group. You had a number of outstanding scientists.
ROWLAND: I'm pleased to hear you say that. I thought it the case, too. I made one very serious mistake, but we had good people.

My associate division director and, actually, the day-to-day director of the Center for Human Radiobiology, [was] Dr. Andrew Stehney. Andy's a chemist.

In fact, he was the one who, I believe, discovered radium in the Midwest drinking-water supplies as part of a survey of the Argonne site. Before Argonne was moved to its rural site, he was doing, in those days, analysis of natural levels of radioactivity before Argonne got there to mess it up. He found that in the deep wells on the site, there was radium. And so, he started nosing around.

Pretty soon, it grew into a full-fledged study which indicated that [in] northern Illinois, eastern Iowa, and southern Wisconsin, if [people] drew their drinking water from an aquifer that was down about 1,000 feet, [they would encounter] a lot of radium in the drinking water. Not very many people realize that that was Andy Stehney's work.

Anyhow, Andy was my associate division director and head of the center and a good chemist. We had a man by the name of John Marshall. John —
FISHER: — John was a medical doctor, wasn't he?
ROWLAND: No; no. He wanted to be a theoretical physicist. He turned out to be a good experimentalist and not a bad theoretician.
FISHER: Hadn't he already worked at Los Alamos?
ROWLAND: No, you're thinking of somebody else.
FISHER: This is a different John Marshall.
ROWLAND: He was a student of Robley Evans. Robley suggested he come out and work with us, and he did. He did very good work, and, in later days, he was asked to chair [an] ICRP study group on behavior of the alkaline earths in humans and did a very outstanding job in a well-thought-of document that I referred to earlier as ICRP-20, which is Alkaline Earth Metabolism in Adult Man.

So, we had a number of good people. We were very fortunate. What we didn't have is a successor. I failed utterly to get someone who could take over the program. Andy was the same age I am, maybe even a year older.

We didn't have anybody who had that kind of mixture of science and administrative ability. It isn't always obvious where it is; I think it's hard to identify. But we didn't have such a person, and I've regretted this very, very much in later years.

Funding for Radium Study Ends

ROWLAND: I mentioned we had increased the number of radium cases from something like 700, 800, when we took over, to 2,400 measured cases by the time we ran out of funding.

Our funding ended, effectively, in 1983. We survived the demise of the AEC and were sort of supported by ERDA, 35 but, then, when DOE came on the scene, there were plans in the biological area to go in a different direction, [the] human genome. 36 All of the studies, to my knowledge, of radium in animals or isotopes in animals were cut and terminated.

In 1981, our Associate Laboratory Director for Biology and Medicine, who was Warren Sinclair, was offered a position to head up NCRP, 37 and he left, and I was asked to take over as Associate Laboratory Director for Biology and Medicine.

I did this under [my] condition[s], that I would not take the job on a permanent basis, so they gave me a title of "interim," and that I would not return to the RER division as division director. At that time, our Lab Director was Walter Massey, who was an excellent Lab Director. I liked him very much. He agreed to these terms, so I became ALD, Associate Laboratory Director at that point, and I took that job for two years and, finally, retired from that position.

That's when the funding started to go bad, and, I expect, part of that was my problem. One, I didn't have a good, [younger] successor for myself as division director, as head of the Center, and two, I wasn't in a position to fight for the Center anymore. I had to fight more for Argonne.

When I retired in '83, a decision was made to transfer the Radium Program to the Biology Division, because to Washington, to DOE, the study of radium is biology: It belongs in the Biology Division, and why not put it there where it belongs?

Well, there were lots of reasons, reasons that aren't immediately obvious. One of the reasons which was fairly obvious is, the Biology Division, because it ran a huge laboratory program of animal studies, had tremendous overhead.

The way these Laboratories are run, particularly the way Argonne is run, money comes to the research program. It doesn't come to the Laboratory. It doesn't fund snow cleaning; it doesn't fund maintenance; it doesn't fund janitorial; and it doesn't fund animal studies. It funds people.

Well, [the Center for Human Radiobiology] shared a building with Physics. And so, we had no very high external costs, running that building. So our overhead was low.

But, as soon as the Radium Program was transferred to Biology, they got hit with these mammoth overhead charges, which meant that people had to be laid off, even, to make the transfer.
FISHER: Some of the highest overhead charges at our Laboratory are in the Biology Department. Their charge-out rates are astronomical compared to the Health Physics Department.
ROWLAND: Yes, of course. It would be the same thing. And that's what, in part, killed the Radium Program.
FISHER: Now, I'm concerned about the change in direction at [DOE] Headquarters. This wasn't totally the fault of Argonne National Laboratory.
ROWLAND: No.
FISHER: There were changing priorities. Principally, would it have been the emphasis on the Human Genome [Project]?
ROWLAND: Yes, that's exactly what it was.
FISHER: And then, later, it would be increased emphasis on environmental management and restoration.
ROWLAND: Well, yes. It was at that time, too. That even came earlier than the Human Genome [Project].
FISHER: But, there had to be some declining interest in radiobiology at DOE Headquarters at the same time.
ROWLAND: I don't know how much of it was declining interest at the level of the agency that funded us, or [declining interest in] that part [of the agency], the Division of Biology and Medicine of the DOE, or whether it was on high, looking down, that dictated that you wouldn't get money for these kind of laboratory animal or human studies. Because you've had 20, 30 years to do it, you should be terminating these projects and going on to new areas, like environmental things, like Human Genome.
FISHER: But, these terminations also affected many other laboratories at the same time.
ROWLAND: Utah, the University of Utah, the dog studies; University of California at Davis, and others.
FISHER: Even Battelle-Northwest [Laboratory].
ROWLAND: Battelle-Northwest. They were all very severely hit by these.
FISHER: Los Alamos and ITRI. 38
ROWLAND: Yes. They all were hit, and it was a major watershed at that time.
FISHER: It was a traumatic experience for all these scientists who relied on these projects for their — not only their lifetime endeavors, but also their funding source was being dried up.

Recollections of Argonne Scientists Participating in Radium Studies

ROWLAND: That's right. We had a pretty uniform age group in the radium studies at Argonne, and that was a detriment. We didn't have as many young people coming along as we should have.
FISHER: While we're [on the topic], could you mention who your scientists were?
ROWLAND: Well, as well as the old memory survives. It goes back a long way, and they changed with time. People who played a key role. I've mentioned the name of Andy Stehney. I've mentioned the name of John Marshall.

Henry Lucas is a name that's of great importance. Henry did a lot of work on radium in water supplies, and Henry was very valuable, in that he was our computer lead person in the Radium Program. He was involved in setting up the radium databases that we used to store all this data we accumulated over the years, and he was responsible for that. That's a position that doesn't give you much glory but, boy, is it important. And so, in that sense, Henry Lucas is a key person. He's a chemist by training.

Other chemists included Dick Holtzman. Dick Holtzman is still at the Laboratory. So many of these people are. They've had to change endeavors, and he is in the Service Division. I believe it's what I would have called, in my day, health physics, but it now goes under a much longer name, and I don't recall what it is. But it's in that kind of an area.

Other names — who else did we have there? Bob Schlenker is still at the Laboratory. He was one of those who transferred to us from MIT, Robley Evans's group. Bob was one of our bright young stars in the Radium Program.
FISHER: And he still is, I think.
ROWLAND: Well, he's not in the Radium Program, but he's a bright young star at Argonne. He's associate director of whatever the Health Physics Division's name is now.
FISHER: Extremely knowledgeable in radiobiology and bone metabolism.
ROWLAND: Right. Right. Another one who transferred —
FISHER: — health effects of radioactive materials.
ROWLAND: Health effects, right. Another one who transferred is one of those terribly important people who not many people outside the Lab know, but those of us who knew him in the Lab were eternally indebted. His name was Al Keane.

Al Keane, like Henry Lucas, did not have a Ph.D. Al Keane came from MIT, and Al Keane has the unique ability to remember almost every radium case that ever came in, and he knew everything that went on at MIT and the like. He was a great resource.

Al Keane is a name that is extremely valuable to us in the Radium Program. He knows all of these things, and he can — if you can get him to get the free time, which he doesn't have now, in his new role, he can delve up and come up with a lot of great information that you'll wish you had a long time ago.
FISHER: I called on Al Keane on a number of occasions to help review manuscripts for health physics.
ROWLAND: Yeah, very good. Very good.
FISHER: You haven't mentioned John Rundo yet.
ROWLAND: No, I haven't mentioned, but John is a real star.

When Charles Miller left the Division, we were left without a person who was dedicated to whole-body counting, which Charlie Miller developed in our country. Charlie Miller was kind of the father of whole-body counting, at least at Argonne and for a great part of the United States. But, when he elected to move out of the Division, he took a whole-body counter with him. He didn't move it physically, but it became a Health Division whole-body counter. We still had a couple more left.

When the Center was in the process of being moved to Argonne, thanks to [the Division of Biology and Medicine of the AEC] and Robley Evans, I realized I desperately had to get some good, high-quality help.

I lucked out tremendously. On a trip to England, I dropped in to visit John Rundo, who I knew had done whole-body counting at Harwell, 39 and he was receptive to changing nationality and becoming an American citizen and moving his family, lock, stock, and barrel.

That was unbelievable luck, because John is a real scientist. He's a good guy. I think his training is primarily chemistry, and [he] was a marvelous guy to run our whole-body-counting system, and a good analyst and what have you. We couldn't have done it without him.
FISHER: Well, he has many different talents.
ROWLAND: Yes, he certainly does.
FISHER: Plus, you know, he's always very considerate to me, as a junior scientist, at least during the period of time when I was learning about this field.
ROWLAND: We had a young man come in as a postdoc, Dick Toohey. [He] worked with John and is now well-known in his own right as a man who does a lot with whole-body counters, and he's currently down in the Oak Ridge area, maybe with the university system or something.
FISHER: Well, he's with the Medical Science Division at ORISE. 40
ROWLAND: Yeah.
FISHER: He spent a short period of time with the Trans-Uranium Registry. 41
ROWLAND: Yeah, it was very short. But, he's out there. So, he's a key person in this field.

Others you might not have known as well, we had a woman from Dame Janet Vaughan's College at Oxford, [England,] by the name of Elizabeth Lloyd.
FISHER: Her name I've come across many times, because of her — I don't know. She's not still alive; she died.
ROWLAND: She died.
FISHER: But, she's recognized, at least from my perspective, for the bone studies, studies on bone cell growth.
ROWLAND: Cells, yes.
FISHER: And the radiobiology of alpha particle interactions with bone osteocytes.
ROWLAND: Exactly, exactly. She was doing very lovely work there.
FISHER: I've read all of Elizabeth Lloyd's papers and annual report contributions.
ROWLAND: When we started out in this game, a scientist from the University of Chicago had made some beautiful studies through a microscope of what happens when an alpha particle hits a living cell.

We were all pretty well brought up, in those days — I'm talking about the '50s — on, "One alpha particle, you're dead," to a cell. This didn't make sense when we got into the radium studies because, you know, we had a lot of alpha particles floating around there, and we didn't see that much cell death.

Then, Elizabeth Lloyd got into this business of trying to shoot alpha particles through cells, and she found that they weren't all that easy to kill, that they survived the particle passages we assumed that didn't directly clobber the nucleus.

She was doing great work at the time we lost her. She succumbed to esophageal 42 cancer, I think, which is a very quick, deadly killer. That was a great loss.
FISHER: One of the things I remember was that she showed that, at least for flattened osteocytes, it took about 15 alpha particle traversals to inactivate an osteocyte.
ROWLAND: And you see, this was terribly important for the Radium Program because, you know, we had this business of, "How do these cells survive?" Well, this began to make a little more sense when she was able to demonstrate that one passage did not terminate that cell.
FISHER: Now, osteosarcomas have always been very resistant to radiation therapy.
ROWLAND: That's my understanding.
FISHER: Can you explain this?
ROWLAND: No, I can't. I can't at all. But — no, we used to think for a while that the radium cases were very lucky, because when they got induced sarcomas, maybe the alphas there that induced it were turning around and killing it.
FISHER: Well, we've felt that that was the case in alpha-particle induced lung cancer, certainly.

Radium-Induced Malignancies

ROWLAND: Well, we weren't able to prove it or anything about it. But, you know, this brings up a point that I think we have to — that I would like to talk about while this tape is on, because I think it's one of the most important findings of our study, and it really hasn't been discussed very much, not at all today and not very much in the literature. That is the induction of these malignancies by radium deposited in people.
FISHER: I was hoping you would come to that.
ROWLAND: Well, it's important that we cover it, I think. I have done a number of papers on what I call "dose response," trying to find a suitable population of measured cases in looking at the incidence of these malignancies and trying to describe them mathematically.

I will preface it by saying that one of the first things that I have done is [to] decide that the bone sarcomas and the carcinomas that arise in bone cells are two different [malignancies] and should be considered separately.

I have elected to follow that, I guess, throughout all my career. So, I have talked about the induction of bone sarcomas, and I have talked about the induction of the carcinomas that arise in air spaces in bone. Previously, they were often lumped together as "radium-induced malignancies."

The first few papers that we wrote, after MIT and our studies were combined and brought together, had to do with how do you quantitate the induction of the bone sarcomas?

One of the things we did — and this is due to Andy Stehney's work — [was that] we decided to use as a measure of radium hazard or radium insult or radium "dose," we decided to use what we called the initial systemic intake of radium. By that we meant that quantity of radium that entered the blood of our case that we were studying.

Previous to that, what had been used was a skeletal dose in the sense of rads to the total skeleton. It turns out they're all related. What you do is, you measure a person with radium in their body. Now, [for] the characteristics of the study in which most big exposures took place in the 1910s and the 1920s and the early 1930s, the measurements were made, for the most part, in the 1950s, '60s, '70s. We're looking at a long time after the event.

So, what one does is [that] you measure body content of the day the person comes into the laboratory, and you can make a good measurement. Actually, what you need to do is to measure the gammas emitted from the bone and the radon exhaled and combine the two to get the total body content of radium.

But, what we learned was that the gamma-ray measurement of a skeleton was really all you needed, because it was pretty obvious that about 37 percent, plus or minus something, of the radon escaped from the body, so you could account for that without too big an error. So, we got a body content. To turn that into a skeleton dose, what one needed to do, whether it was obvious or not, was to go back to when they got [their radium] by means of a retention equation.

We always used the Norris Retention Function that came from the Elgin State Hospital patients, and we would walk back up to that to find out how much went in at day one [of their injections]. Now, a dial painter may have painted for a year, two years, three years, but that's a short period, 40 years later. It turned out the average dial painter was measured 40 years after their first exposure. So, it's a long time period.

Anyhow, mathematically, what you do is walk back to a midtime of exposure if it was a dial painter, or a midtime of injections if it was a medical case, and, basically, you calculated how much went into the circulating blood.

We didn't mention that, but then you turned around and went the other way and started calculating the dose that was delivered [each year], and it reduced every year as the body content went down. And then, you decide when to stop calculating dose, and you call [the sum] — the average skeletal dose.

All these steps are hidden, but we didn't even often publish the body content. All we did was publish dose. And so, this whole process was hidden in the process.

The problem with skeletal dose is it changed every year. It doesn't change much, but if you measured someone 10 years ago, and you're talking about them today, and they're still alive, it does make a big difference.

So, Andy Stehney suggested, why go through this whole process? Let's just [go back to] time zero or midtime of exposure, and take this initial intake of radium as our parameter. It's fixed. It doesn't matter how long they live, what have you; that's a fixed number.

And so, we started using that as what I call a measure of insult 43 of radium. I then was interested in getting an equation which would give me the probability of a sarcoma, for example, as a function of what went in during the exposure.

We were very surprised to find that when you did this for bone sarcomas, it was an equation best described as a square of the dose, a square of the systemic intake.

This is not very acceptable in radiobiological quarters, because everybody knows that the response is linear. There ought to be some sort of a linear relationship, extending back down to zero dose. Instead, we kept seeing that these sarcomas seemed to respond as a square.

Now, there isn't enough data to go back and see whether that changes to linear as you get to lower and lower dose.

The head carcinomas are not as abundant as the sarcomas, with only half as many for any given population. That reduction of a factor of two in number was such that we really couldn't tell the difference between linear, square, or what have you.

So, our earliest studies said, "Linear fits," meaning we tested by a chi-square 44 relationship. "Linear fits. Use linear for the head carcinomas. Use square for the sarcomas." This we did for some time.

The fact of the matter is, Mays and Rowland and Stehney have a paper about radium and uranium in drinking water, and —
FISHER: — I've read that one.
ROWLAND: There, we actually go and use linear relationships, which I regret very much, because I don't believe they're true at all. I do not think the relationships are linear.
FISHER: Well, I think Chuck [Miller] was trying to do some rationing between the risk of osteosarcoma from radium and the risk from plutonium, which was a bone surface [seeker].

Differing Perspectives on Radium Retention

ROWLAND: Right. Quite different. That's quite true.

Anyhow, more recently, Stehney and I were invited to go to Heidelberg[, Germany] last April [1994] to take part in another one of these periodic radium and thorium meetings.

One thing that has happened, in the meantime, is that I wrote a paper based on the ICRP-20 radium retention function, which is basically gospel for all agencies, and because I really began to wake up to the fact that that was based on the Elgin State Hospital patients from which Norris got his power function.

But, what I had discovered was that, after I retired and went down to live in Kentucky, Rundo and Keane and Schlenker were involved in looking at a number of radium cases that had been measured over and over again over four decades.

They demonstrated that low-level cases were losing radium much faster than the Norris Function predicted. So I went and looked at ICRP-20, and I found that John [Marshall] had used the Elgin cases as his model for radium loss.

John did say, however, in that volume of ICRP-20, that there is one characteristic of bones independent of the isotope that's strontium, calcium, radium, barium. It's a parameter that he called "the bone turnover rate of 2 percent per year." He says, "It's constant; it's independent [of the element used]."

But, when they wrote the equation for radium, they used 1 1/2 percent. Now, it makes a big difference 40 years and longer after [radium] uptake, no difference in the first 20 years.

So, when I looked at that, I redid the ICRP-20 document, and I used 2 1/2 percent, but I did everything else the same, and I published this in Health Physics a year or so ago.

And then it fits exactly what my Argonne colleagues found in the late '80s, that these low-level cases lost radium faster than an ICRP-20 retention function predicted, but the ICRP-20 retention function predicted it exactly if you use this 2 1/2 percent which Marshall and his committee said was the parameter they should be using.

So, I decided that we've learned something here. Low-level cases lose radium much faster than we thought. Then, up to this point, all of the calculations of this initial systemic intake for the cases in the radium studies have been calculated by the Norris Retention Function, which is contradicted by the ICRP-20 function to a certain extent, and it's contradicted even more with my modification.
FISHER: Does this imply the need to revise initial estimates of intake?
ROWLAND: We've done it.
FISHER: Okay.
ROWLAND: We have done it, and the only place they're calculated is in the newly published book by yours truly.
FISHER: That's good.
ROWLAND: Two subjects yet to be covered. One is Bob Thomas, whose name I haven't mentioned, and the other, I would like to continue on the induction of malignancies.

Two of the things that most people haven't realized on the induction of malignancies by radium deposited in a human [are], one, how few there are and, two, the fact that, whether we like it or not, they are the best definition of a threshold relationship that I've ever come across.
FISHER: Now, Robley Evans initially proposed a threshold for radium-induced osteosarcoma.
ROWLAND: Yes, and he called it a practical threshold. What he said was that, as you lower the dose or intake, as you lower the intake, the time to the induction takes longer. When it becomes longer than the human lifespan, you have a threshold.

He's wrong there, because we found that if radium — if there's enough radium in a person to cause a malignancy, it can take 50 years or five years for the same amount.
FISHER: That's very interesting.
ROWLAND: Well, that has been published, and no one has seen it. If there were a practical threshold, we would have a plot that would show an area of volume on the plot where no malignancies could occur, because there wasn't time enough. But, it doesn't work quite that way. Low-level malignancies have been induced 50 years or five years after intake.

Seeking a Threshold for Radium-Induced Malignancies

FISHER: Does the current reanalysis of radium in man support the practical threshold?
ROWLAND: Not the practical threshold as defined by Robley Evans, but it supports a threshold.
FISHER: A threshold.
ROWLAND: It does support a threshold, and what it shows is as follows: If you go through the mathematics involved mentally, you will find that low-level cases actually had higher intakes than we thought they did, because we're measuring, on the average, 40 years after uptake. And if the curve goes and bends down at long time, then you've got to go back further up. So, they had higher doses than we thought they did.

High-level cases apparently lose radium much slower than you would think and, therefore, the very highest-level cases had lower intakes than we thought. This squeezed the range of intakes together. It pushed down the high-level ones and it pushed up the low-level ones.

This accentuated to some extent the change in shape of those response relationships.
FISHER: Is that mechanism understood?
ROWLAND: Yes, because it has been demonstrated in the radium dogs at Utah and elsewhere — Davis, as well. They were the ones who were telling us about this years before, because they had the advantage.

They were giving their subjects known doses of isotopes and measuring them continually. We were looking at subjects and measuring them, essentially, once or twice in their lifetime, long after they got it. So we didn't have any idea of input.

They had idea of input, and, very early in the Utah studies they were telling us, high-level cases reduce — radium reduces the turnover of bone, and they retain radium better. Low-level cases lose their radium faster.
FISHER: We need to ask you about one more topic, and that's the irradiation of marrow 45 stem cells 46 and the incidence of leukemia 47 in radium dial painters, which, apparently, is not a major effect. Or is it?
ROWLAND: I think you have it quite right. The big dilemma in malignancies induced by radium is, "Why aren't there leukemias?"
FISHER: Because you have a gamma component, as well.
ROWLAND: Yes, you have a gamma, beta component, as well. But, these doses are low. When you start and calculate the gamma dose, it isn't all that big. Probably well, let me come back to this.

In the populations that we've examined, and the best work on this was done about 10 years ago by a visiting scientist from England who wrote a paper which appeared in our symposium in 1983, whatever it was, on the lack of leukemias in the radium cases —
FISHER: I'm trying to remember who that was.
ROWLAND: Yes, I am, too. It may come. Spiers.
FISHER: Bill Spiers?
ROWLAND: Bill Spiers, F.W. Spiers as written. He wrote what I think is the definitive paper in looking over all of the data, [and Spiers found that] there is no excess of leukemia in radium-exposed people.
FISHER: We still use his estimates of S factor for interaction of radiation and marrow.
ROWLAND: Yes, yes.
FISHER: His bone model for marrow.
ROWLAND: Yes. That hasn't changed, incidentally, although the radium studies didn't go on much longer after that paper appeared. To my knowledge, there's no change in the number of leukemias in radium-exposed people. So, leukemia is a non-event.

[We have, for radium-induced malignancies] bone sarcomas, a total of 85 in the whole population; carcinomas in the paranasal sinus and mastoid air cells, 37 in the whole population. [That population totals 6,675 measured and unmeasured radium-exposed individuals].

There's an excess of breast cancer in some populations, but not in others. In some populations, there's a tremendous deficiency of expected breast cancers. We don't know why.

I suspect that the breast cancers are in part, if not in toto, due to the placement of the radium on the desk in front of the dial painter. If someone placed the radium pot close to the front of their chest, they get a bigger dose than someone who placed it arm's length away.

That's the only thing I can [conclude], because there have been a number of papers on breast cancer in the U.S. cases, some finding a relationship, some not finding a relationship, most finding an excess, but not knowing why. It doesn't seem to fit much with anything.

I gave a paper sometime ago with [Henry] Lucas, in which I suggested it had to be the gamma rays to the breast for dial painters.

Multiple myeloma has been suggested as being in excess. Apparently it's not, if you look at the data very carefully. It's not in excess. Lung cancer doesn't seem to be in excess, but I want to look at that some more.

So, we're left, basically, with the two well-known malignancies. Another study that has now been repeated is that of Stehney's on life shortening among the dial painters.

The early dial painters died rapidly and quickly due to massive, massive doses of radiation. They died of all sorts of things, which the medical profession at that time called syphilis, gonorrhea, you name it.

Many of them had tremendous destruction of their bone cells, and aleukemic 48 leukemia has been suggested. But, anyhow, for those cases, radiation deaths occurred quickly after their painting experience.

Stehney examined the life expectancy of dial painters, and he found that if you looked at all the dial painters, there was something less than two years' life shortening.

If you then went back and took out all those cases that had radiation-induced malignancies — bone sarcomas and head carcinomas — took them out, there was no life shortening.

So it says if you didn't get one of those two malignancies, you didn't have any visible effect on, at least, life shortening, which implies indirectly that other cancers aren't causing problems, cancers induced by radium.

This was done about 15 years ago, and he brought it up-to-date at the conference in Heidelberg last April [1994]. That's a very nice paper, and it should be published sometime this summer [1995], I suppose.
FISHER: Is the incidence of osteosarcoma more related to cumulative dose or dose rate?
ROWLAND: Well, Otto Raabe thinks it's dose rate, and it depends a little bit upon how you handle the data. But, Otto and I have discussed this quite a little, and we've been exchanging diagrams and plots recently. I was showing Otto that initial systemic intake, if plotted against skeletal dose, made a nice, straight line. So, you know there's a relationship: they're all tied together, these parameters.
FISHER: You didn't mention what the threshold is for bone cancer.
ROWLAND: When I did this paper for Heidelberg, I went through the same process I had done before, but with the newly calculated initial systemic intakes or skeletal doses, any way you want to do it.

Now, the exponent has jumped up to 3, rather than 2. It gets very difficult to understand mechanistically.

So I have basically resolved those equations, and I've come to a conclusion that satisfies me that an initial systemic intake of less than about 75 microcuries of radium that's systemic intake, which is one-fifth of the total intake has never induced a malignancy, either bone sarcoma or carcinoma of the air cells.
YUFFEE: 75 microcuries.
ROWLAND: 75 microcuries, systemically, which is five times that in terms of oral ingestion, or 75 if you inject it with a needle in the vein. That seems good.
FISHER: The threshold seems to be about 75 microcuries systemic intake of radium-226.
ROWLAND: Correct. And that works for either of the two types of malignancies.
FISHER: But, that's a dose to the skeleton of about what?
ROWLAND: Oh, if you quote rem, 20,000. And, that's another reason why I don't like to use skeletal dose, either in rad, rem, grays or sieverts, because the number is meaningless: it's so high.

I mean, I [grew] up with the idea that 600 rad, to the whole body, was lethal. And then I go talking about, "But we've never seen a malignancy under 20,000 rem, or 1,000 rads, of radiation." You know, you don't even get a malignancy, yet you kill someone with 600 rads! It just didn't have meaning in the same sense.

And, the other thing that I came to a conclusion about many years ago, is that skeletal rads can't be compared with any other kind of rad, because — and it makes a lot of sense — a skeleton is primarily mineral, and you're dumping alpha energy into calcium phosphate types of crystals, and that doesn't do anything there.
FISHER: But, in a sense this is interesting, because in the dogs that have inhaled plutonium-239 oxide, I don't believe we've seen any lung cancers in dogs with less than about 150 rads to the lungs.
ROWLAND: To the lung?
FISHER: Uh-huh.
ROWLAND: So, are you suggesting that that's a sort of threshold type of relationship?
FISHER: It hasn't been published, but one thing we have observed is that in dogs with some plutonium, but less than 150 rads to lungs, there have been no lung cancers, and the incidence has been zero, whereas the incidence of lung cancers in the controls range between 3 and 16 percent.
ROWLAND: (laughs) That's a dilemma.
FISHER: And, that's statistically very powerful.
ROWLAND: That is interesting.
FISHER: So, in fact, there's not only a threshold, but perhaps —
ROWLAND: A preventive.
FISHER: A protective that, with no incidence of lung cancer in the very low-dose-plutonium dogs —
ROWLAND: — That's very interesting.
FISHER: — where plutonium is administered by inhalation.

Radium in Ground Water

ROWLAND: That's very interesting. One of the things I wanted to mention, to get into this interview, is another way of looking at the kind of data we have on the radium cases.

I mentioned that we have good measurements on 2,400 people who acquired radium, either dial painters or medical injections or drinking water. We haven't mentioned drinking water — spiked drinking water I am referring to — that you purchase over-the-counter or [from] chemists.

This population of people we've measured, if we line them up in order of initial systemic intake, how much radium got into the bloodstream, and put them in pecking order — of the 2,400, all of the malignancies occur in the highest 280 cases. The lower 2,100 cases, nothing. All of it occurs right there.

And so, another way of looking at the doses in a way, I think, that is striking to the layperson, that up to this level nothing happens, and all the experience and all the bad things you've heard about what radium can do — and it can do bad things — are all right here at the end, at the highest levels, which is another way of saying, "It sure looks like a threshold relationship."
FISHER: That has a lot of important implications for setting standards for radium in water.
ROWLAND: It certainly does.
FISHER: Normal drinking water.
ROWLAND: As you well know, several years ago, it was proposed that the radium levels in drinking water be changed significantly upward.

Now, upward changes don't take place easily, and this has still not been turned into law. By the time it's changed, it won't do any good, because — this is one area I get rabid about.

It's one of these mandates of our Congress that have insisted that a certain level was God-given, and we had better not have more than that in our water. And, depending upon the size of the community, it has cost millions of dollars to achieve this result.
FISHER: Particularly in Illinois.
ROWLAND: Particularly in Illinois, Wisconsin, and Iowa. And, it has caused tremendous other problems. We all know the story, nowadays, that you make a rule without looking at the endpoint.

And so these towns have to be very careful how they take the radium out of water, because once they take it out, it's liquid active waste, and then they can't get rid of it, so you're far better off leaving it in the water.

So, the safest way to do it is to dilute. If you can find a source of water that is lower in radium and dilute it, then you aren't stuck with the extraction process and the removal process and the burial process.

And, incidentally, you may not be aware, radium in water is causing a big problem, not in drinking, [but] in the oil industry, because when you —
YUFFEE: You flush out the oil.
ROWLAND: When you pump oil, water comes up. That comes from way down, and it's loaded with radium. And, if you live in an area where you have hard water, you know that hard water plugs your pipes up in your house. Ultimately, you call the plumber, and he replaces these pipes, because they're scaled up and you reduce the flow, and it's a calcium-strontium- what-have-you mess.
YUFFEE: A hard-water deposit.
ROWLAND: Hard-water deposit. If you own an oil well that has four miles of pipe going down, each one 30 feet long and 3 inches in diameter, when they scale up, 49 you don't throw them [away], you pull them and clean them out. This went on for years, until somebody discovered they contained radium in the scale. That's a real problem for the oil industry, and it's a real mecca for trial lawyers, because there's money to be made there. You can sue for everything under the sun. Anyhow —


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