Exposure to actinides: report on Ca-DTPA injections in CEA-AREVA centres

Ca-DTPA was used for the medical treatment of plutonium and americium contaminations in the CEA and AREVA plants from 1970 to 2003. This report is a survey of the administered injections of Ca-DTPA as a chelating molecule. This report will be part of the registration process for Ca-DTPA by intravenous administration, submitted by the Pharmacie Centrale des Armees. Out of 1158 injections administered to 469 persons, 548 events of possible or confirmed contaminations were reported. These employees were followed by occupational physicians according to the current regulations. The first part of the report is a summary of the most recent findings. Due to its short biological period and its limited action in the blood, Ca-DTPA does not chelate with plutonium and americium as soon as these elements are deposited in the target organs. This justifies an early treatment, even in cases of suspected contamination, followed by additional injections, if necessary. The second part presents data concerning these 1158 injections (contamination routes, posology, adverse effects, ...). These incidents took place at work, were most often minor, and did not require follow-up treatment. A study concerning the efficacy of the product was conducted on a group of people having received 5 or more injections. These results were compared with the efficacy theoretically estimated. Posologies and therapeutic recommendations were proposed based on these observations. Additional studies are needed to confirm these findings. This document is the first summary in this field. It is the result of the collaboration of the occupational medical departments, the laboratories of the CEA and the AREVA and a working group CEA-AREVA-SPRA.