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The skeleton is one of the major retention sites for internally deposited actinides. Thus, an accurate estimation of the total skeleton content of these elements is important for biokinetic modeling and internal radiation dose assessment. Data from 18 whole-body donations to the US Transuranium and Uranium Registries with known plutonium intakes were used to develop a simple and reliable method for estimation of plutonium and Am activity in the total skeleton from single-bone analysis. A coefficient of deposition Kdep, defined as the ratio of actinide content in the patella to that in the skeleton, was calculated for Pu, Pu, and Am. No statistical difference was found in Kdep values among these radionuclides. Variability in Kdep values was investigated with relation to skeleton pathology (osteoporosis). The average Kdep of 0.0051 ± 0.0009 for the osteoporotic group was statistically different from Kdep of 0.0032 ± 0.0010 for nonosteoporotic individuals. The use of Kdep allows for rapid estimation of the total skeletal content of plutonium and Am with up to 35% uncertainty. To improve accuracy and precision of total skeleton activity estimates, regression analysis with power function was applied to the data. Strong correlation (r > 0.9) was found between Pu, Pu, and Am activities measured in the patella bone and total skeleton activity. The results of this study are specifically important for the optimization of bone sample collection for US Transuranium and Uranium Registries partial-body donations.

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Decorporation therapy with salts of diethylenetriamine-pentaacetic acid binds actinides, thereby limiting uptake to organs and enhancing the rate at which actinides are excreted in urine. International Commission on Radiological Protection reference biokinetic models cannot be used to fit this enhanced exertion simultaneously with the baseline actinide excretion rate that is observed prior to the start of therapy and/or after the effects of therapy have ceased. In this study, the Coordinated Network on Radiation Dosimetry approach, which was initially developed for modeling decorporation of plutonium, was applied to model decorporation of americium using data from a former radiation worker who agreed to donate his body to the US Transuranium and Uranium Registries for research. This individual was exposed to airborne Am, resulting in a total-body activity of 66.6 kBq. He was treated with calcium-diethylenetriamine-pentaacetic acid for 7 y. The time and duration of intakes are unknown as no incident reports are available. Modeling of different assumptions showed that an acute intake of 5-µm activity median aerodynamic diameter type M aerosols provides the most reasonable description of the available pretherapeutic data; however, the observed Am activity in the lungs at the time of death was higher than the one predicted for type M material. The Coordinated Network on Radiation Dosimetry approach for decorporation modeling was used to model the in vivo chelation process directly. It was found that the Coordinated Network on Radiation Dosimetry approach, which only considered chelation in blood and extracellular fluids, underestimated the urinary excretion of Am during diethylenetriamine-pentaacetic acid treatment; therefore, the approach was extended to include chelation in the liver. Both urinary excretion and whole-body retention could be described when it was assumed that 25% of chelation occurred in the liver, 75% occurred in the blood and ST0 compartment, and the chelation rate constant was 1 × 10 pmol d. It was observed that enhancement of urinary excretion of Am after injection of diethylenetriamine-pentaacetic acid exponentially decreased to the baseline level with an average half-time of 2.2 ± 0.7 d.

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The accidental or intentional release of plutonium or americium can cause acute and long term adverse health effects if they enter the human body by ingestion, inhalation, or injection. These effects can be prevented by rapid removal of these radionuclides by chelators such as calcium or zinc diethylenetriaminepentaacetate (calcium or zinc DTPA). These compounds have been shown to be efficacious in enhancing the elimination of members of the actinide family particularly plutonium and americium when administered intravenously or by nebulizer. The efficacy and adverse effects profile depend on several factors that include the route of internalization of the actinide, the type, and route time of administration of the chelator, and whether the calcium or zinc salt of DTPA is used. Current and future research efforts should be directed at overcoming limitations associated with the use of these complex drugs by using innovative methods that can enhance their structural and therapeutic properties.

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Accidental or deliberate dispersion of plutonium (Pu) and americium (Am) into the public environment could contaminate large numbers of people by inhalation. If measures to reduce the internal dose are considered appropriate, oral administration of either calcium (Ca) or zinc (Zn) diethylenetriaminepenta-acetic acid (DTPA) would be the simplest treatment. Published experimental data from rats on the effects of oral DTPA on the retention of inhaled Pu and Am show that: (1) orally administered Zn-DTPA is as effective as repeated intravenous injection for the decorporation of Pu and Am inhaled as nitrates, although higher dosages are required; (2) oral Zn-DTPA appears to be an effective treatment for Am dioxide but not Pu dioxide; (3) maximum decorporation of Pu, by oral or intravenous administration, requires a large molar excess of Zn-DTPA over Pu (>1 x 10(6)); (4) neither oral nor injected Zn-DTPA are likely to be effective for Pu oxides, nor when Pu and Am nitrates are mixed with other dusts. It is concluded that oral administration of a simple aqueous solution of Zn-DTPA could be an important treatment in accident or emergency scenarios after intake of pure chemical forms of Pu and Am, which are highly or moderately soluble in biological fluids. However, more research is needed on the efficacy of treatment when these forms are mixed with other materials. Importantly, studies designed to increase the efficiency of uptake of DTPA from the gastrointestinal tract could appreciably reduce the dosage.

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The authors represent data on studies of tolerance and efficiency of Cinkocin administered to 18 patients who had occupational exposure to plutonium and americium.

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The scientific basis for the treatment of the contamination of the human body by plutonium, americium and other actinides is reviewed. Guidance Notes are presented for the assistance of physicians and others who may be called upon to treat workers or members of the public who may become contaminated internally with inhaled plutonium nitrate, plutonium tributyl phosphate, americium nitrate or americium oxide.

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The metabolism of americium-241 has been studied during an 8-year period in an adult male and his son who, at the ages of 50 and 4 years, respectively, were accidentally and unknowingly contaminated within their home by means of inhalation. Chelation therapy with calcium trisodium pentetate was more effective in enhancing the removal of americium-241 from the child than from the father.

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