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Oral Histories
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Oral Histories

Health Physicist Constantine J. Maletskos, Ph.D.


Foreword

Short Biography

Early Education and Career (1920 to Mid '50s)

Early Dosimetry Research (1940s to 1960)

Radium Dial Painter Research (Early '50s–60s)

Fernald School Calcium Metabolism Studies (1948 to Early '50s)

Iodine-131 Thyroid Research (Early '50s); Additional Calcium Metabolism Studies on Elderly Subjects (Early '50s)

Iodine-131 Research and the Fernald School (Early to Mid '50s)

Robley Evans's Role in Experiment Oversight and Funding Information

Experiment Safety Protocols, Clarified (1950s)

Radium and Thorium Ingestion by Human Subjects (Late '50s to Early '60s)

Volunteer Inducements and Informed-Consent Procedures

Cesium-132 Research on Humans (Mid '60s)

Radium Burden Examination of Radium Dial Painters (Mid '50s to 1985)

Other Radionuclide Research

Personal Anecdotes

Research as a Private Consultant and Additional Publications (1972–95)

Comments on Human Radiation ExperimentsationControversy

First Knowledge of Plutonium Injections

Thoughts on the Use of "Disadvantaged" Populations in Human Radiation Experimentsation

Career Highlights

Work With Manomet Bird Observatory (1975–95)

Additional Comments on Human Radiation Experimentation Controversy and Closing Comments

Cesium-132 Research on Humans (Mid '60s)

FISHER: The high quality of scientist that you are, but I was certainly there.

In this same time period, we see some publications on the retention of cesium by humans after intravenous injections, and it's interesting that the isotope cesium-132 was used, and secondly, that it was administered intravenously. Can you remember some of the details of this experiment?
MALETSKOS: Yes, [but] I'm not remembering very much at all, and I'm surprised that I am [not,] because I was the honcho again on that one; I don't know why. I've almost got a total mental block; I cannot even remember the actual people who were involved or anything like that. I took a quick glance at the report and it still doesn't trigger anything. I may have mentioned to you that I thought the injections were done some place else. They were done at MIT by the physician that I talked to you about who was licensed to do this—
FISHER: By the name of?
MALETSKOS: [Martin] Lubin.86 He's not on the paper, [but] I think there is a footnote. Do you have a copy of the paper?
FISHER: I don't have a copy of the paper.
MALETSKOS: It was all done during this period, when I was developing this [absorption study] according to Hoyle. What I can't remember are the steps that we took. My thinking wasn't a step function [(a smooth progression)] from that experiment to the next, to the absorption experiment. My [moral] conscience was the same, as far as I know. So all the things I described [(all the precautions I followed during the radium experiments)] should have gone through that whole thing, but I don't remember a thing about it.
FISHER: I came across this by reading a report from Los Alamos and where your worked is referenced. (reading from the report) It says here, "Maletskos et al., report a two-exponential retention for five elderly subjects given cesium-132 intravenously."87
MALETSKOS: Yes, it probably came from the same place. I don't remember the routine of what I just described to you; I'm drawing a blank and I'm sorry, right at the moment. Keep in mind, you asked if it was intravenous instead of giving it orally, for example. Again, you're going to do an experiment, you want to extract as much information as you can; nobody had any information on the early retention. That's why we gave it intravenously: so we could use it not only as a calibrating device, but as a means of measuring fallout.88 In the early phases because you never were getting anybody immediately, except in an accident situation or from fallout.
FISHER: It also says that the BHL, which I assume was biological half-life, was 80 to 90 days.
MALETSKOS: Right, we could see that even in the short period of [measuring] that short-lived radionuclide.
FISHER: When only about two-tenths to three-tenths of a microcurie was administered.
MALETSKOS: That's low enough, isn't it? Again, remember, when you asked me the philosophy of "How much do you give," [well,] you give the least you could get away with, and do the experiment well.
FISHER: These subjects would have probably also come from the Age Center and they would have volunteered?
MALETSKOS: I'm sure that's where they would have come from. This is why I'm saying I'm drawing a blank. I'm sure we went through the same motions. Now whether we documented it as well as I described, I don't know, I cannot remember, I'm sorry. Matter of fact, I even missed starring it [(putting an asterisk by it)] when you asked to see my bibliography. That's how much of a blank it was for me; that's the first time I've gone through my bibliography in a half of century, practically.
FISHER: It was interesting to read of that first cited in the literature, and then secondly to come across it in your list of publications.
GOURLEY: I was looking through the materials and I guess we're up into the '60s now. I notice that you were chairman of the Ad Hoc Committee on intracomparison of human, I guess it was cesium-137 body burdens for the AEC Division of Biology and Medicine.
MALETSKOS: That's correct.
GOURLEY: How did that come about? How did you get to that position?
MALETSKOS: The AEC people were tracking to see what was in the body [with respect to] cesium, and they were getting all kinds of numbers; some of them didn't jive. It looked like it was a calibration problem. It turned out to be a calibration problem; I've forgotten what the test was. I didn't do the test; Ernie Anderson89 at Los Alamos did the test. As a matter of fact, he was the chairman first, but then he had to do something else, and got off sometime during the first year of this committee.

And so, when the committee was put together by the headquarters, and said "Look, we got to find out where we stand, because we're getting all these data on cesium body burden, and how fallout is going around the world, and everything else. We don't know that we're comparing apples and oranges between the different measurements." The questions were, "What is the problem, what do you do to correct it, and how to find out what the situation was?"

We decided that what we would do, is that we would literally—and it wasn't always clear that the people had correct [calibration] sources or good sources that they were using [as] standards. We determined what was going on by making a special set of radioactive sources that were under the jurisdiction of one person, so that they would be done right and correctly. They'd all be calibrated [and] each person involved in these measurements would get a set of three sources that would give a range of radioactivity, to see how well they could do with something that was close to background, something that was [higher than the background radiation and thus] easier to measure, and something that was intermediate. Then find out what was going on.

Eventually, the real test would be, two people would come around with cesium deliberately in them, and be tested by everybody. This is what the committee [planned], and I became the chairman, I oversaw the production [of these sources] up over here [by] what is called the New England Nuclear Company.
FISHER: Let's go to that just a little bit more.
MALETSKOS: I wanted to mention that we ended up here because, it turned out that they could make little beads containing not only radium, which is what I wanted—that's how I found out about it—but beads of cesium-137. There would be little baby BBs as a source, in a plastic rod, at a particular point in the rod. The rods had to be manufactured well; the cap after sealing had to be sealable, so that it could never pull apart after you sealed it. Even if the glue failed, and that sort of thing, because otherwise you would have [radioactive] beads [bouncing] all over the place.

This was done, these were sent around, and it took a little bit longer than we had intended, because people knew this was coming. They were working hard to get themselves up to snuff. So the pressure was on them to see if they could do a good job; they were building up to do a good job on their own. By the time we did the experiment, we found very few that could not do it well (it was a two-year period), and it was only from then on that you could say all the data were comparable.
FISHER: What you're saying is that there were some subjects, normal subjects, who ingested solution containing cesium-137 beads?
MALETSKOS: No, I'm not saying that at all. I'm saying these beads were used to make radioactive standards for calibrating, for measuring the device and calibrating the device and determining, by their methods, how much radioactivity was in each bead.
FISHER: Were they taken in vivo?90
MALETSKOS: No, no: these were in a plastic rod! Each of these laboratories was monitoring their own group of people because the AEC asked to follow this. We had at the Radioactivity Center six or seven people that we monitored on a monthly basis, and so did all the various laboratories. [The question was,] "Was everybody was on a common baseline or not?" The answer was that we [were] not.
FISHER: Cesium was from fallout?
MALETSKOS: This was the cesium-137 from fallout. And, so we went through this whole routine. Then two people at Los Alamos, put a little extra cesium-137 above and beyond what they had, so it would be a little bit higher [in radioactivity]. Then they went around to the laboratories to measure in actual human beings. I don't [know] whether it was two of them or it ended up as one; I know one person came around. That was the final test on the comparison, and then I put together a report of what the status was and the committee members reviewed it and submitted it to the Atomic Energy Commission.
GOURLEY: So there were one or two persons at Los Alamos?
MALETSKOS: Whatever they did down at Los Alamos, I don't know what the routine [was] for getting the radioactivity.
FISHER: Do you remember who the subjects were that went around to the different laboratories?
MALETSKOS: I remember one, Phil Dean,91 but I don't know anybody else. I think that there were going to be two, but I think they ended up as one, but I can't verify that right now.
FISHER: From Los Alamos?
MALETSKOS: Yes. He's no longer there; he left there and went some place else quite a while ago. I don't know where he is right now, if he's still alive, he should be my age.
FISHER: You published a paper in 1963 on cesium-137 measurements in normal human control subjects. These would be people from the general population and the cesium would be fallout cesium from normal ingestion of food and water.
MALETSKOS: That is correct. One or two people might have been from the laboratory at MIT, and the other would have been people at MIT or something like that.
FISHER: This was also at the height of the nuclear testing era, prior to the Test Ban [Treaty of 1963].92
MALETSKOS: That's why the AEC was interested in this information, and wanted to have it be on [a] good common basis. And why we were doing it. It was an extra measurement, as far as we were concerned. We did it and we followed them and watched it do whatever it did over the years.
FISHER: Was there any additional experimentation on human subjects where cesium was administered either orally or by injection?
MALETSKOS: No, the cesium-132 experiment that we talked about was done to make sure that we were calibrated correctly. We used cesium-132 because it's a short-lived nuclide [(6.2 days, vs. 30 years for cesium-137)] of the cesium nuclides.
FISHER: Where was the cesium-132 made?
MALETSKOS: I don't remember; I know the paper describes where it was done. It was done as a special radiation with some [bombarding] particle—it was done in an accelerator of some sort.
FISHER: But you don't know where?
MALETSKOS: No, I'm sure it says it in there, but I don't know what it is now. It's a radionuclide you come by easily.

Radium Burden Examination of Radium Dial Painters (Mid '50s to 1985)

FISHER: You were also involved, I think during this time, and maybe also before and afterwards, in the measurement of radium burdens in body tissues of former dial painters.
MALETSKOS: That's correct, and still have been, up to last measurement at MIT, which was about 1985 or something like that. I mentioned earlier [that] I started working by measuring people with radium out in an open room with a good old-fashion Geiger-Müller counter. Then we ended up building the whole-body counter with a huge sodium iodide crystal, which made life an awful easier.

We had a major set up for measuring their breath thoron [(radon-220)] and breath radon [(222Rn)] because we made gamma ray measurements, and we made breath measurements of both radon[-222], which comes from radon-226, and radon-220, which was called thoron in the old days, which comes from the thorium series. We always did that, so [that] we always knew what the ratio [of the exhaled to the retained radon] was. We could average out a ratio that we could use [as] an average ratio for those people we could only measure one way. However, [it] turned out to be [that] a lot of people were measured only by breath radon using flasks,93 for example.
FISHER: How was the work done in conjunction with the radiobiology center at Argonne?94 The human radiobiology study?
MALETSKOS: This work was being done at MIT long before Argonne ever got involved. The source of a lot of these subjects was New Jersey; that was where the bulk of the radium work was being done. The people who had been treated medically [with radium] were all over the country. Then there were people we called chemists and physicists, who happened to work with radium; they were eligible candidates to be in the [experiment] cohort [(sample)] because those people work with the open vials or material, [which] would allow [potential] ingestion or inhalation. [For] a physician who used a radium needle—for example, for therapy—[we] wouldn't bother with that person; there would be no access to them [of] the radium to the body.95

Argonne found some people that had been working with radium in Illinois, and so they decided to get into those measurements, [which] they did, and proceeded to follow their ideas and so forth. This was good, because it became a competition of how to do the job well. Eventually, we had to calibrate with each other, in terms of what we thought were the right [measurements to use].

Then we actually sent the same subjects to both places, so that we could see if we could get the same value for the[se] subjects, using somewhat different techniques, and so forth. This went on as two separate entities funded by the AEC, and as a matter of fact, there was a[n additional] small group in New Jersey that acted more as a source of finding new people, as opposed to making any measurements. The [people] came to MIT for measurements because they were closer to us, and this parallel study went on for quite a while. Then, when Robley Evans's time came to retire, he wanted to be sure that this whole study would continue, with the hope that you would catch every last person. You [wanted to] catch the last person, because it was possible to do that before the end of the century.

He set up the concept of the human research center at Argonne.96 Its main function would be to study the radium cases, and anything else that involved radioactivity in people. It would be something that would be directed by Argonne [because] Argonne was going to be a continuing organization [and] it would have a Congressional line item [for] its own budget. People couldn't interfere with it, and therefore, all the information would go over to Argonne, and all the data would be collected by them. We had started doing that anyway, because that was going to be a good way to handle [the data] in the first place. That's how the center started at Argonne. The work started at Argonne, and the Center came to life.
FISHER: So Robley Evans had a big part in this.
MALETSKOS: It was his idea, he [(Evans)] went and talked the AEC into doing this; he presented it to Congress, I believe, with the AEC, to make sure that everybody understood what the purpose of this was.

Here was a very select group of people of internal exposure to radiation that we had studied for quite a number of decades already. We had learned an awful lot: the standard [for internal radium] was set back in 1940 [by Evans], and there was no reason [to] change [the] need [for] all this information. We were learning new things; now we could do dose–response relationships, which we couldn't do before.

There was a chance to finish this in a decade with not too much of an expenditure to complete it. It was a great idea, [and] it went on for a while and then Congress decided they didn't want it in their line budget. [The] AEC or DOE eventually decided they didn't want to support it anymore, even though there was still less to do. I personally [am], and I'm sure Evans is, disappointed that it's not coming to its proper completion.

The reason for that is, when Robley Evans retired, we decided we wanted to do one last analysis, [but] before we would do the analysis we would review every piece of information on every subject, and see if we got it right. We would leave the data in as best shape as we could by the people who were involved—that was Robley Evans; Mary Margaret, his secretary and deputy director of the Radioactivity Center (eventually); and I. We did, we took two years to go through all those pieces of paper [and] we found errors, not only in our own reports, but in the reports of—presumably the same data [in]—the Argonne reports, for different subjects. This was peculiar; we found errors in different ways.
FISHER: Mary Margaret is Mary Margaret Evans.97
MALETSKOS: Yes, right, Evans. We had our set of data that we had to reanalyze in a new fashion. It shows a [safety] threshold of around 1,100 rads, which is big when you show a straight-line relationship to the abscissa [(the x-axis)]. I've given a talk on it [but] I haven't finished writing the paper, which I'm now making first priority.
FISHER: 1,100 rads dose to bone surfaces or bone volume—
MALETSKOS: —to average bone volume—
FISHER: —as a threshold for induction of late effects?
MALETSKOS: For sarcoma98 in the skeleton and for carcinoma99 in the sinuses. It's unusual that they both come out the same way. We can talk about that later. We've done that [reanalysis], but the whole operation at Argonne has now ceased, and the official data still are those [previous data of Argonne] rather than Argonne correcting their half as well, to get them all on a common new basis.

So I don't even know now how to handle the data; DOE has left us in a very bad situation. I don't know what could be done about it, because it took the three of us, with the help of two technicians, to do this on a semi–full-time basis because we were making measurements of radium subjects at the same time; this [reanalysis] was done on the side. It kept on going, and it would take you a long time. You wouldn't want to do [it] all the time, because it's nerve-racking to do. You have to go through every piece of paper and make sure the information you need is there in this great big table to make the dose calculations, and everything else, in some correct form.

A couple of years ago, we had a workshop at Argonne as to what the retention function [should be]. What do we know now that we should modify the retention function from the ICRP-20.100 We all agreed that lambda,101 which is [a] factor [in the] retention function, should be changed from 1.5 percent to 2.5 percent, as a function of radium content. You find that people with a higher radium content excrete more rapidly than those who have a lower radium content. The bone apparently is getting either some damage or whatever is happening; in effect, you have greater osteopetrosis102 is what it amounts to.

The [Argonne] dosimetry has been corrected, but our data [are] based on the old dosimetry. [The MIT cohort has] the best set of information on the data, but we have to convert our analyses to the new dosimetry. Argonne has the new dosimetry, but they haven't reviewed their data for the last time.

So what do we leave for posterity? I'm disturbed with this. Evans and I hoped that everything would be done well. We rechecked in the workshop what the dosimetry would be: we would make one new dose calculation and [so would] Argonne separately[; anyway, each of us] wanted our own data first. Then [the two sets] collectively, with everybody's data, would be available to anybody else to analyze anyway they wanted. [Neither of us] can do that now. I find that highly disturbing when we spent six decades on it already, and a few more years would do the trick [ to finish up the scientific analysis of the data]. I think that's really bad policy. The importance of it [(this data) is that the problem of radium ingestion] is chronic, it's not only internal, but it's chronic[, taken into the body a little at a time].
FISHER: We were talking about why the data should be analyzed to completion. I think we concluded that radium toxicity is still a concern, because we ingest, some more than others, radium in our drinking supplies, on a chronic basis, and some people drink more radium than others.
MALETSKOS: That's correct, it's one reason, but there [are] other, [even] more important reasons. One of the most important ones is that this is a long-term study of chronic irradiation over a long period time, because the radium stays in you for so long. Even though it's constantly excreted, but slowly, and this is the way you get exposed whether you are drinking the water like you just described. Whether you're getting radiation on a continuing basis from natural background or as a worker—if you're in a position to get any radiation at all as a worker, everything is done on a chronic basis. It's not done [on] an acute basis, except for an occasional accident or unusual situation. In the case of nuclear medicine, you get a single jolt of radioactivity for the test purpose, but you're not expecting any difficulty there, because presumably, the amount that is being administered to you is low enough to do the experiment, but not [high] enough to produce a health effect. Certainly it is not enough to produce health effects that compare with the seriousness of the health effects that are being checked for.

This is an important comparison. Something like the chronic irradiation of radium studies are the only thing we have that allows us to do a complete study of dose–response for people who have been studied very well. This is from the standpoint of the health status, including the x rays of their bones, and so forth, and from the standpoint of the fact that you can measure what is in them. The dosimetry is not based on the guess [of] what might have happened, like you do [for] the Atomic Bomb studies.103 There it's a calculated number and you hope you are in the right ballpark, never mind coming close to the right value. You don't know that you're going to be very high for one person, very low for another person, and hope that these things will cancel out and maybe make things come out right. But you don't know that [(the actual dose spread)], and you'll always be [suspicious of] that, and you'll always be [suspicious of] what the real dose was.

Here we have a situation where we may have a problem of deciding how to calculate the actual dose, but we were awful close to the right value. We are closer to the right value in these studies, where you can make the measurements of the content of radium in these people externally without taking them apart. That is a fundamental importance in the quality of the result.
GOURLEY: How did it come about, that—for some of the radium painters, exhumations were done?
MALETSKOS: That's correct.
GOURLEY: How did that come about?
MALETSKOS: Once you start getting your cohort and [it's] getting big now, you're maybe getting these people because they have a symptom, or you found them by some specific method. The two methods are different, and therefore you can prejudice your result. What you want to do is get as much of the cohort as you can so that you can say, "I can treat everybody equally" without saying, "These people are biased, and those people are biased in another way."

The next step, you work at finding people who are not alive, as well as those that are alive. Remember, the radium is in the bones; bones take a long time to disintegrate, if they are going to disintegrate at all. Measure those bones and know what that person has for a content of radium, and then you have all the diagnosis prior to that, if you can get it; you certainly have a death certificate and whatever else is available. You can also relate what the final findings on that person [were] from the health status to the amount of radioactivity found in that person. And that becomes a perfectly good subject in your study.

There were disinterments, [but] there's a lot of rigmarole finding people and getting the permission. There are major problems with handling dead bodies that are deteriorating. Especially at a place like MIT, where you don't even have a mortuary and [it was] rather gruesome sometimes, I might say.
FISHER: But in handling these tissues [obtained from graves] you went through some procedures to honor them, to pay due respect to the tissues, to watch over them, and to interact with the families?
MALETSKOS: Absolutely, everything was done in as nice a way as you can imagine. I mean that "nice" in all ways, and everything was returned after analysis.
FISHER: For proper internment?
MALETSKOS: For proper internment, this was all done ahead of time. Matter-of-fact, people could come in and look to see what we were going to do. I don't know if anybody actually did, but it was meticulously well-done. There would be an exception—for example, obviously you wanted to have a clean skeleton that you measure, because you couldn't afford to have decomposing tissues. In a laboratory where your doing the measurements, there would be occasions where you want to get rid of that decaying tissue; the permission was obtained that we would digest the skeleton in a caustic [solution, or] something like [that]. That material would have to be disposed-of correctly, but not go back to the original place.
GOURLEY: What percentage of [survivors] gave permission [to exhume the bones of their deceased family members]?
MALETSKOS: I don't remember. We've done I would guess we done on the order of a hundred bodies, but that's guessing, right now.
FISHER: Were most of these radium dial painters?
MALETSKOS: I'm sure there were [also] some people who had been medically treated. They would be harder to find, because they are scattered all over the place; so I'm sure that the bulk of them, if not all of them, are dial painters.

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