Medical History on a Philco Corporation Employee

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Employed by: Phil co Corp. HISTORY: Exposure tox - radiation from an unshielded k lys tron at the Lockport Air Force Base on Tuesday, March 8 , 1960. Actual exposure was ata one t o two foot distance of approximately30 minutes between l O : 3 O ache, which did not hinder eating of lunch, had fair appetite.Following lunch he became aware o f mouth being extremely dry, and his face felt warm and flushed. He next noted an onset of moderately severe pain in jaws but no associated swell ing. He vomi ted several times during the afternoon until seen in the Air Force hospital at Niagara Falls where he was given an injection for nausea. That afternoon he became extremely face and conjunctiva e and noted temperature o f 100" a t 2:OO in the after - noon. Shortly after arriving home, he had a mild chill. He ate dinner and vomiting did not recur. day, facial redness began t o recede. Mild nausea still existed at the time of admission. Vomiting did not recur and he was able to eat all meals. Extreme fatigue has continued to persist. Mouth is dry but not sore. On Thursday, March 10, he awakened with nausea but without vomiting. He continued to be troubled by dryness o f mouth and increased thirst which persisted until the following day. There has been no abdominal pain or diarrhea.Definite improvement since the onset o f symptoms on Tuesday, On returning home, his wife commented on definite redness o f Jaw pain gradually subsided. On the following OCCUPATIONAL HISTORY: He started work as a radar technician six years ago and has worked with low energy apparatus since that time.

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SYSTEM REVIEW : Rare headache, occasional running ears in childhood. History of exposure to tuberculosis but no signs o r symptoms. FAMILY HISTORY: No familial illnesses in the family. PHYSICAL EXAMINATION: On examination, temperature 3 7 . 7 , pulse 84, respiration 16, blood pressure 118/72. A well-developed and nourished individual, whose dark complexion does not show specific erythema. There is no facial swelling. Eyes showed mild redness of conjunctivae but without edema or exudate. The oral mucous membranes are definitely dry and somewhat pale. Teeth are in good condition. Neck is negative. Chest is negative. Lungs are clear. Heart is negative. The abdomen shows no masses or tenderness. There is no hernia. The neurological examination shows slight fine tremor o f outstretched hands, but is otherwise negative. bands 0, lymphs 15.5, monos 6.5, eos 0.5, basos 1.0, platelets 175,000. Hematocrit on 3 / 1 3 of 41. Urine, 3 / 1 1 , clear and yellow, 1.024, trace of sugar, 2 RBC and 1 WBC/high-power field, rare granular cast, few epithelial cells. Stool, 3/25, formed brown and guaiac negative. BUN 17, blood sugar 56, total protein 6.6. Nose and throat culture negative for pathogens on 3/14. EKG, no diagnostic findings. On 4/18 hemolytic staph and parainfluenza. X-ray of chest negative. COURSE I N HOSPITAL: Dental and eye consults immediately obtained. On 3/16 patient is feeling well; morning nausea and dryness of mouth have disappeared. Lymphopenia was definitely marked by this date. On 3/19

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a small amount of blood was noted after blowing of the nose; dryness of mouth and nose continue. On 3/19 a second wave of erythema became definite. On 3 1 2 0 skin was red and dry with moderate around the eyes. Conjunctivae showed no injection. blister was noted on the soft palate, this disappear day. On 3 / 2 2 definite time hair loss was def occurring in loss of s from the oral cavity, ng by the following watering o f the left eye was observed. By this nite with epilation from the top of the head, zeable tufts. By 3/23 all lesions had disappeared By 3/26 the skin became brown rather than red, and n around left eye appeared somewhat leathery, non-tender and only y irritated. There was no sign of bleeding tendency. By 3 / 2 8 on became nearly complete; the skin during this interim, continuing to improve. A mild conjunctival redness and some excess tearing of the left eye were still present. Beard, which had been depressed in growth was now beginning to show activity, but at best, only sparsely over certain portions of the face. On 3/29 a sternal bone marrow aspiration was obtained, which was interpreted as hypocellular in type. Erythroid elements were relatively spared. Improvement has continued with gradual abating of the erythema. On 4/5 the iliac crest marrow was obtained, which was also hypocellular in type. The marrow essentially resembled that of the sternal aspiration. For the next week he continued to feel quite well, the beard growing slowly b u t with little or no evidence of hair growth on the head. On 4/19 an elevation of temperature occurred to 38.2, accompanied by frontal headache and dryness of the throat. An increase of fatigue was apparent. By this time the throat was slightly reddened with sane elevated lymphoid patches. A history of exposure to "flu" of

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family who had been visiting regularly was obtained. other signs or symptoms except for fatigue. The fever gradually abated without development of additional signs. The EKG taken on 4/27 showed no diagnostic findings. The course from here on was asymptomatic. P B I taken on 5/4 showed 6.2, 6.5 micrograms of iodine per 100 ml. of serum. Electroencephalograph taken on 5 1 6 was interpreted as abnormal with regular slow waves consistent with delirium or dementia. He was discharged on May 7 to be followed at weekly, bi-weekly and monthly intervals up to the present. Electroencephalographs taken on May 2 6 , June 2 and June 9 were normal. A semen analysis taken on 3/29, which had a reduced volume, showed no abnormality. P B I on 6/7 was 5 . 7 and 6 . 2 , on 6 / 2 3 was 5 . 2 and 5 . 3 . Hematology examinations showed a gradual, early development of an absolute lymphopenia with gradual reduction of total white cells to a maximum depression of approximately 2500 cells by 4/14. but definite increase in monocytosis occurred followed in turn by a gradual rise in circulating elements to safe levels by time of discharge on 5/7/60. By 4/23 he had On 4/24 temperature elevation recurred b u t without DIAGNOSIS: Acute radiation exposure, partial body. He is still being followed at the present time. FOLLOW-UP: He continued to report at regular intervals for opthal.mic examination, clinical examination, hematology, electroencephalograms and such clinical chemistry as thought necessary. There has been no return of clinical or laboratory findings in the interim. He was reassigned by the Philco Corporation to a facility at Caribou, Maine. Correspondence has indicated a continued good health in his new