Plutonium Experiment Recalled (Science, VOL.191, March 12, 1976)

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Plutonium Experiment Recalled A generation-old cxpcrirnent involving the injection of plutonium, an extremcly potent carcinogen. into human subjects has finally gottcn a public airing aftsr years of obscurity. The project. initiated in the waning days of the Manhat:aii Project. seen:s appalling i n light of the ethics of tho 1970‘s. particularly m c c iofurrned consent apparenily \cas not obtained from the subjects. Yet. according to a scientist who tracked dour! 17 of the 18 subjects, the one-ofa-kind experinlent provcd to be of “incstimahle use” in jetting standards for plutonium wrkers. Therc i \ no evidence that an! of the people suffered i l l elfccts-in Tact, although a11 \rere supposed to be trrminally ill, three of them are 8 . .\I and women randomly assigned to Before long. according to Fishcr. bccomc the control group while uomcn in the experimental group *ill he given une of reviewed within a week or so. “We arc going about this in a very orderly mannrr.“ says Fisher. “First. we tested a drug versus nothing. then onc drug versus two. NUN. we’ll look at other combinations. The The experiment was conducted between 1945 and 1947. shortly acer the conley Laboratory, there was u n urgent need lor data on the raw at which the hupoint is to find the minimal treatment that We’re putting everything we kilo\c on the struction of the first plutonium bomb. by investigatorr for the Manhattan Engiman body excretes plutonium so that safe exposure levels could be set for bomb workers. Because ingested plutonium emits very weak radiation. the only way dogs h!i\. sa>s Durbin, because the two species excrete it at dinerent rates. they will do the job with ininirnal toxicit). line in breast chemotherapy now. The ne\t 10 years will be the ones that count in tellto mc:Isurc its retention is through measurement of alpha particles in the urine. While the NSABP study \\‘;is gcing on. Experiments had been conducted in w h i c h plutonium was injected into rats and NCI investigators were experimenting offercd no guidelines for humans. they developed, and thc Institute was an\- So 18 patients. a11 o f whom were thought to have fewer than IO years to live. were selected at four hospitals-those at the universities of California, Chicago, and Rochester, and the MED hospital in Oak Ridgc. Tennessee. They ranged in age from 4 to 69 and were afflicted with many things including cancer. heart disease, Cushing‘s syndrome, Addixon’s disease. and cirrhosis. Each was given a single intravenous plutonium injection that amounted, in most cascs, to about 5 % times uhat was considered an acceptable amount to be ingested by a plutonium worker over a 50-year span. Informed consent is known lo have been obtained in only one case, from a man who was injected in 1947, after the Atomic Energy Commission (AEC) had taken over from the MED. Durbin and her colleague. R. E. Row land of Argonne National Laboratory, have located information on all but I of the 18 ubjects. Eight of them survived at least 8 years following the injections. and 3: least 3 of the 18 were autopsied. None or the available evidence shows that the plu!onium injections influenced the course of the patients’ diseases. As of 1974. four of the subjects were still alive. One was still ill and has since died. tine had ulcers misdiagnosed , as stomach cancer. another was freed of cancer after his leg was amputated, and the disease of the fourth was not revealed by Durbin. That year the AEC contacted the doctors of the four and asked them to tell them about the injections; this was done except in the case of the woman who was ill. Durbin says the absence of contemporary written records indicates that everything was very secret and most communications were probably oral. She says that if there was any follow-up on the patients it did not last long-both the new AEC and the investigators involved felt embarrassed and ashamed about the study and wanted to put it behind them as quickly as possible. Another re3son for the lack of follow-up is that the sole purpose of the study was to find out how fast the body gets rid of plutonium. I t was discovered that hunian kidneys are at leust 50 times less efficient than animal kidneys at removing plutonium. “ I f animal data had been used,” says Durbin. “permissible levels would have been set much higher.” Mention has been made of the experiment in various scientific journals throughout the years and in 1972 Durbin wrote it up for a book called Rodiobidog). of Pfufonium(J. W. Press, University of Washington. 1972). The newsletter Science Trends gave the first news account of it 3ftcr Durbin and RowiouS to initiate a controlled clinical trial u b - ing it. Fishcr‘s group, which includes collaborators all over the country, was ai- ’ ready tied up in the L-P,\M study. NCI looked around the country for :I iarge institution that would be willin? to ccnduct t h s . ; one leading institution. for example. refused to cooperate because they still do not believe there is a role for drugs in breast cancer therapy. So. the NCl turned to Bonadonna and his group in Mi!an. There is a lot of breast canccr in Italy and the Milan cancer institute sees a large number of patients, which is important it able amount of time. And the group there was enthusiastic about doing the stud!. I t was begun late in 1973 and has, by nou. i n - cluded 386 women. each of whom had radical surgery for breast cancer with I ) m p h Bonadonna and his colleagues declare i n their article that “These results should bc considered with caution, since. at present. the effect of this therapy on survival 2nd one wants to get useful daia i n a rcasoc- .. . erations.” It is too early to tell whether - ’ rencc or actually lensthening survi\:I. There is evidence, the Ivalian team notes. land presented a paper last October at a workshop on plutonium and radium. They concluded. from their investigation of the study that “bone-tumor risk from plutonium is nogreater than that from radium. and might be less.” As far canctr of the liver, the other most likely site. the authors SJV the doses weren‘t RG high enough to make its occurrence 1ikcly:The experiiiicnta: group was too small and the survival times too short, given the long Idtency period for canct r, CO‘ for the project to have yielded a n y more detinite infarmation.-C.H. years after initial surgcry. Furthermore. :I