title: Treatment of actinide exposures: a review of Ca-DTPA injections inside CEA-COGEMA plants.
abstract: Calcium diethylenetriamine pentacetate (Ca-DTPA) has been used for medical treatment of plutonium and americium contaminations in the CEA and COGEMA plants from 1970 to 2003. This paper is a survey of the injections Ca-DTPA administered as a chelating molecule and it will be a part of the authorisation process for Ca-DTPA by intravenous administration. Out of 1158 injections administered to 469 persons, 548 events of possible or confirmed contamination were reported. These employees were followed by occupational physicians according to the current French regulations. These incidents took place at work, were most often minor, not requiring follow-up treatment. The authors present (1) a synthesis of the most recent findings. Due to its short biological half-time 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. It justifies an early treatment, even in cases of suspected contamination followed by additional injections if necessary (2) data concerning these 1158 injections (route of contamination, dosage, adverse effects, etc.) The authors also investigated a study on the efficacy of the product on a group of persons having received five or more injections. These results were compared with the efficacy estimated theoretically. Dosages and therapeutic schemes were proposed based on these observations. This synthesis is the result of a collective work having mobilised the occupational medicine departments, the medical laboratories inside a working group CEA-COGEMA-SPRA.
authors.affiliation: Commissariat à l'Energie Atomique (CEA) Service du Conseiller Médical, Route du Panorama, 92265 Fontenay-aux-Roses, France.
authors.forename: Louise
authors.initials: L
authors.lastname: Grappin
authors.forename: Philippe
authors.initials: P
authors.lastname: Berard
authors.forename: Florence
authors.initials: F
authors.lastname: Menetrier
authors.forename: Lise
authors.initials: L
authors.lastname: Carbone
authors.forename: Catherine
authors.initials: C
authors.lastname: Courtay
authors.forename: Xavier
authors.initials: X
authors.lastname: Castagnet
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Le Goff
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Neron
authors.forename: Jean
authors.initials: J
authors.lastname: Piechowski
mesh_terms: D008671:Actinoid Series Elements / Q000493:pharmacokinetics* / Q000633:toxicity*; D001822:Body Burden; D002614:Chelating Agents / Q000008:administration & dosage; D003198:Computer Simulation; D004305:Dose-Response Relationship, Drug; D004781:Environmental Exposure / Q000032:analysis; D006801:Humans; D008954:Models, Biological; D016273:Occupational Exposure / Q000032:analysis; D004369:Pentetic Acid / Q000008:administration & dosage*; D011210:Power Plants; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000378:metabolism* / Q000517:prevention & control*; D011837:Radiation-Protective Agents / Q000008:administration & dosage; D016896:Treatment Outcome; D014915:Whole-Body Counting
chemical_list: D008671:Actinoid Series Elements; D002614:Chelating Agents; D011837:Radiation-Protective Agents; D004369:Pentetic Acid