The U. S. Uranium Registry Tissue Program*

INTRODUCTION The United States Uranium Registry (USUR) tissue program was funded in 1978 by the United States Department of Energy (DOE) through its Human Health and Assessments Division, and registrant enrollment began in 1980. It is operated by Hanford Environmental Health Foundation (HERF), Richland, Washington, with support provided by Pacific Northwest Laboratory (PNL).** The USUR tissue program is the first systematic effort to contact and gain assistance of workers occupationally exposed to uranium and to seek and study uranium deposition in human tissue. This paper describes the program objectives, populations selected for study, procedures for enrolling workers in the program, types of tissue to be studied, and analytical procedures to be used. PROGRAM OBJECTIVES The objectives of the USUR tissue program are to: 1) Determine the distribution and concentration of uranium, if any, in the tissues of occupationally exposed workers. 2) Compare bioassay measurements of exposed individuals with the results of analyses of tissues obtained at autopsy. 3) Seek evidence of histopathologic changes related to any uranium deposition that may be present. 4) Conduct analyses of whole bodies, when available, to obtain more precise data on the uranium burdens, if any, in the body and organs, and especially the distribution in parts of the body, such as the skeleton, that are not usually accessible for sampling. 5) Develop data that will assist in evaluating a) the accuracy of current in-vivo measurement techniques, b) the propriety of existing regulations, and c) the adequacy of current protection programs. SELECTION OF POPULATIONS FOR STUDY Selection of the populations for the USUR tissue program was based on studies of the United States Uranium Registry described elsewhere (0c81). Potential populations for study were quite varied because of occupational exposure to different chemical forms of uranium, different levels and eras of exposure, varying ability to identify populations exposed in the past, and the general interest and cooperativeness of the populations. Nevertheless, certain identifiable populations emerged that were both willing to participate in the study and likely to provide useful information. Among the targeted populations are individuals who were exposed to uranium prior to the existence of modern exposure standards. These individuals are presently being enrolled by the USUR. The reliability of concentration and distribution data and the demonstration of effects are more likely in such individuals than in those who have received less exposure. However, the targeted groups also include individuals who Have been exposed to permissible levels of uranium, and reference employees in uranium plants who have not worked with uranium. The lesser exposures are of immediate interest because of the rarity of heavy exposures under current standards. The sampling of potentially exposed individuals with negative in-vivo measurement results may serve to check the adequacy of in-vivo measurements in the detection of deposition. [ENROLLMENT PROCEDURE] The enrollment of participants follows three patterns. 1) Presently employed workers are enrolled by the cooperative efforts of USUR staff with the medical, industrial relations, and/or health physics personnel of the uranium facility. Volunteers may be enrolled by medical personnel at the time of their physical examination or by health physics personnel at the time of a bioassay or lung counting procedure. Follow-up after initial contacts with currently employed uranium workers is carried out by on-site personnel, but subsequent follow-up is the responsibility of the Registry. 2) Retired workers are contacted by mail, with a covering letter from their former employer supporting the principles of the study but leaving participation in the program on an entirely voluntary basis. 3) An alternate method of enrollment is to obtain a USUR autopsy consent after death from the next of kin. As part of enrollment in the program, permission is requested for access to the individual's medical and exposure data, and a short occupational history is filled out. The autopsy permission agreement signed by the individual is for an initial period of 5 years; the USUR ordinarily seeks renewal of the agreement upon its expiration. While this agreement provides