Florence Kelley and the radium dial painters. External gamma ray exposure to the radioactive paint could also have been the cause of cancer in this population. In Great Britain, radium dial painters with higher total radium-226 intakes and who were younger than 30 years of age at the start of painting showed an excess of breast cancers (Baverstock and Papworth 1989). Similarly, Martland (1931) described the development of leukopenia in the radium dial painters. Autopsy revealed almost total absence of granular leukocytes, leukoblastic groups, and lymphoid tissue in the bone marrow. Evidence of radium s potential effects on the human immune system was presented by Reitter and Martland (1926) in the case study of a chemist who developed acute leukopenia after working with radium for 14 years. Anemia has also been reported in case studies of the radium dial painters (Martland 1931), but the disease patterns have not been clearly established (Sharpe 1974). Anemia, panmyelophthisis, and chronic myeloid leukemia were seen in excess of the control levels in these cases (compared with a higher incidence of acute leukemia in the control group) (Wick et al. Diseases of the hematopoietic tissues have been reported in patients given repeated injections of radium-224. Although no recognition of this fact has been located in the literature, it is noteworthy that no local effects on exposed skin have been described in the available case studies of these workers (eg., Martland 1931 Sharpe 1974). It is important to note, however, that the radium dial painters had chronic dermal exposure to radium on their lips and tongues. Of those dial painters for whom radium intakes have been estimated (a total of 1,907), 41 have developed bone sarcomas. These bone sarcomas and head carcinomas have been seen in many radium dial painters and have appeared from 5 to more than 50 years after first exposure to radium. The typical period of exposure was about two years. Causes of death were listed as anemia, necrosis of the jaw, and osteogenic sarcoma. Martland (1931) described the cases of 18 dial painters who died of cancer at ages 20 to 54 years old. Some of the radium dial painters ingested amounts of radium sufficient to cause death within a few years of their employment. A toxicity ratio has been developed for these isotopes it has been estimated that radium-228 is about 2.5 times as effective. The dial paint usually contained long-lived radium-226 and shorter-lived radium-228. (1978), female radium dial painters in the 1920s who "tipped" their paint brushes with their lips or tongues ingested radium in the process. Many deaths, especially from bone cancer, have occurred in humans following long-term oral exposure to radium-226 and radium-228. There is no information on the lethal effects of radium due to acute oral exposure. The long term follow up radium dial painters and thorium workers.
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