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It was shown on the basis of retrospective investigation of 500 workers at a nuclear enterprise (162 cases of lung cancer, 338 persons as matching control) that the interaction of external gamma-irradiation (> 2.0 Gy) and the body-burden of 239Pu (> 9.3 kBq) at lung cancer incidence in multiplicative. Combined influence of smoking and radiation factors was found dependent on smoking index (SI): it changed from additive up to multiplicative and than to antagonistic with the increase of the smoking effect. The received results could be explained on the basis of a two-mutation model of radiation carcinogenesis.

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The values of the natural urine excretion coefficient in 84 workers have been received. The observations were ranging from 1970 to 1984. To analyse this data the references about radiobiological, medical, anthropometrical and other factors which potentially influence osteotropic radionuclide excretion in man and animals have been studied. By means of linear regression (program KWAZAR) it was confirmed that 6 factors including liver and heart diseases were important. Mathematical description of this results is suggested.

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Adenocarcinoma frequency in Pu incorporation-related lung cancer patients among plutonium workers was found to be 74% versus 33% in control. Each histological pattern of lung cancer appeared to be related to several etiological factors but in varying degree. Incorporated Pu proved the strongest factor in adenocarcinoma development. Its odds ratio (OR) was 6.9, while that for smoking-4.3. However, smoking appeared to be the most significant factor in squamous cell carcinoma genesis (OR-6.8). Among other factors were chronic obstructive pathology of the lung (OR-3.9) and reduced body weight (OR-2.1). The OR for Pu incorporation was 3.9. Squamous cell carcinomas were traced to reduced body weight (OR-2.9), heavy smoking (smoking index more than 500) (OR-3.5). However, no significant relationship has been established between carcinogenesis and Pu incorporation.

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The "dose-response" mechanism has been studied for three main histological types of tumor in a cohort of 500 workers occupationally exposed to different doses of radiation (162 patients with lung cancer and 338 practically healthy persons) using the "case-control" method and multifactorial logic regression procedure. A non-linear threshold dependence was established for incorporated plutonium, with the threshold being at 8 kBq to correspond to 80 kGy. This relationship has been particularly distinct in cases of adenocarcinoma. No significant results have been obtained for the "dose-response" relationship in chronic external exposure to gamma irradiation. Said dependence for tobacco smoking appeared to be linear. Most pronounced variations were recorded for squamous cell carcinoma.

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A case-control study using logistic regression included 500 employees of the nuclear works (162 patients with lung carcinoma and 338 healthy controls). After examination of radiation and nonradiation causative factors 5 proved statistically significant. For them the following chance proportions were obtained: smoking 6.6, plutonium pneumosclerosis 4.6, plutonium incorporation 3.1, chronic nonspecific pulmonary diseases 2.1, external gamma-radiation 1.6. Attributive risk for the total of the radiation factors makes up 25% at the most while of the nonradiation factors at least 70%.

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Five hundred workers of a nuclear facility (162 cases of lung cancer and 338 healthy subjects) were examined on a case-control basis using the logical regression method and 10 radiation and non-radiation factors. Five significant factors were identified. The following rick values were obtained for them: tobacco smoking-6.6; plutonium-associated pneumosclerosis-4.6; plutonium incorporation-3.1; chronic non-specific diseases of the lung-2.1 and gamma ray exposure-1.6. Radiation-associated rick was under 25%, while that of non-radiation factors not less than 70%.

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Pulmonary cancer site was studied in 131 workers engaged into radioactive chemicals production and 178 examinees of control group. All examinees died in 1965-1989. Incorporation of plutonium-239 increased the number of lower lobe pulmonary cancers (upper-0.49; medium-0.06; lower-0.45) compared to 0.72; 0.03; 0.25 in control group. Ratio of cancer sites attributing to plutonium-239 was calculated for various levels of relative risk. Cancer site in the lower lobe appeared to show high probability attributing to plutonium-239 with relative risk over 1.39; in the case of upper lobe the relative risk was 3.67.

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Haptoglobin (Hp) phenotypes were determined by thin-layer polyacrylamide gel electrophoresis in 2071 normal Russians, Tatars, and Bashkirs. Hp phenotype distribution was found similar in these populations, making up 13.4% for Hp 1-1, 48% for Hp 1-2, 38.6% for Hp 2-2. Hp1 gene incidence (0.37) was characteristic of the European populations. Serum alkaline phosphatase and gamma-glutamyl transpeptidase activities were similar in all the three Hp phenotypes. Alanine and aspartate aminotransferases and acid phosphatase activities were higher in Hp 1-1 phenotype by 25, 15, and 15 percent, respectively.

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As a result of an accidental outburst of long-lived radionuclides at the nearest zone of the trace, a dose rate of gamma-radiation was several dozen CGy/h and in the open country at some populated areas it was 0.1 CGy/h. The evacuation of 10730 persons permitted a decrease of possible radiation doses 2-24-fold. A follow-up of persons who had been exposed to the highest effective equivalent doses of radiation before the evacuation revealed unstable indices of leukocytes and platelets (however they were within normal variations) in the first 2 years. Morbidity and mortality rates among the adults, the rates of congenital diseases and pediatric mortality did not differ from the control values. The rate of families having children born from persons aged 10 to 30 at the time of the accident did not differ from the similar rates for the USSR; this rate was lower by 5-10% than the control values for persons aged 0 to 9 at that time. Standardized birth rates in the study group (31 x 8,10(-3)) were much higher than in the control group (18 x 4,10(-3)).

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Alkaline phosphatase (AP) and lactate dehydrogenase (LDG) activities are stained in rat blood serum and osteogenic sarcomas of different histostructure, which developed following a combined exposure of 239Pu (92.5 kBq/kg of body mass) and gamma-irradiation (103.2 mC/kg), as well as following separate exposures to these factors at the same doses. Alkaline phosphatase activities in blood serum and neoplastic bone tissues were found to correlate with the histostructure of osteogenic sarcomas, the distribution and the localization of metastases. Shifts in an isoenzymic spectrum of lactate dehydrogenase in neoplastic bone tissues and blood serum are observed, with a tendency to an increase in the LDG3 and LDG4 and to a decrease in the LDG5 fractions.

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Levels of gamma-glutamyltranspeptidase and total, alpha 2 and alpha 1-alkaline phosphatase versus dissemination pattern and survival time were studied in patients with stage III and IV tumors of various sites. No significant changes in the activity of the said enzymes were registered in cases of single hepatic metastasis and metastasis-free liver. A slight increase in the enzymes' activity was observed in patients with pronounced liver involvement within months 10-4 before death. That was followed by a sharp and marked (3-4 times normal) rise in the levels during months 4-3. Changes in enzyme activity within the terminal 12 months were described with the aid of polynoms on the basis of regression analysis. A correlation between liver mass and degree of rise in serum enzymes levels was established.

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Serum creatine-kinase activity was above the upper normal limit in 40-80% of the 632 patients admitted to hospital for angina pectoris and deteriorating essential hypertension. The highest (4-6-fold) increase over the mean control values was associated with myocardial ischemia, paroxysmal tachycardia and hypertensive crises. Intramuscular injections were shown to be unrelated to increased incidence or magnitude of creatine-kinase activation in the examined patients. Creatine-kinase levels were particularly high in cases of cerebral stroke (a 7-fold increase above normal) and alcoholic cardiopathies (a 8-fold increase).

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An examination of 400 coronary patients demonstrated a relationship between increased serum CPK, AST, LDH and LDH-1, and the spread and severity of myocardial infarction (MI). In transmural and large-focal MI, CPK activity peak observed on Day 1-2 of the disease was increased 4-12-fold, and that of AST, 5-fold, as compared to the upper limit of the normal range. In small-focal and subendocardial MIs, the increase was 1.5-8-fold and 3-fold, respectively. In angina pectoris, serum CPK activity also showed an increase, although a less manifest one. A CPK activity level of 175 IU is proposed as a discriminative level to be used in the diagnosis of large-focal myocardial infarctions.

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