CESIUM, RADIOACTIVE:  Nuclear Power Plant Emissions

Effluent Concentrations :
Radioactive isotopes of cesium (e.g., cesium-137 and cesium-134) have been released to the atmosphere from atmospheric weapons testing, accidents from nuclear reactors, and nuclear-powered satellites burning up in the atmosphere upon re-entry(1). The total amount of cesium-137 released from weapons testing through 1980 was estimated as 2.6X10+7 Ci, 76% of which was released in the northern hemisphere and 24% in the southern hemisphere(2). On April 26, 1986, a steam buildup caused an explosion and fire at a nuclear power generating plant in Chernobyl, Ukraine, releasing an estimated 5.4X10+5 Ci of cesium-134 and 1.1X10+6 Ci of cesium-137 into the atmosphere over Europe(3). Long-range transport spread the radionuclides through the Northern Hemisphere; no airborne activity from Chernobyl has been reported south of the equator(4). By early May 1986, these radionuclides were readily detectable in environmental samples collected in North America(5). More recent estimates have put the total activity of cesium-137 released from the Chernobyl power plant as 2.3X10+6 Ci and 1.2X10+6 Ci for cesium-134(6). On January 24, 1978, the Soviet nuclear-powered satellite Cosmos 954 re-entered earth's atmosphere over the Canadian Arctic, releasing an estimated 86 Ci of cesium-137(7). In October 1957, an accident at the Windscale nuclear weapons plant at Sellafield in the United Kingdom resulted in a release of 595 Ci of cesium-137(8). Routine activities at nuclear power plants and fuel-reprocessing stations also release cesium-137 and cesium-134 to the environment on a regular basis. Radiocesium released in airborne effluents from the normal operation of nuclear power plants is considered low in comparison to releases from atmospheric weapons testing and the major releases following accidents at nuclear power plants. In 1998, it was reported that 1.3X10-4 Ci of cesium-134 and 5.1X10-3 Ci of cesium-137 were released to the atmosphere from the Savannah River plutonium processing site in South Carolina(9). In 1993, the Nuclear Regulatory Commission estimated that 0.013 Ci of 134Ci and 0.023 Ci of cesium-137 were released in airborne effluents from 30 pressurize water reactor nuclear power plants operating in the United States(10). It was also estimated that 4.6X10-4 Ci of cesium-134 and 3.3X10-3 Ci of cesium-137 were released in airborne effluents from 28 boiling water reactors nuclear power plants(10).
[(1) ATSDR; Toxicological Profile for Cesium (Draft for Public Comment). Atlanta, GA: Agency for Toxic Substances and Disease Registry (2001) (2) WHO; Environmental Health Criteria 25. Geneva, Switzerland, WHO (1983) (3) Watson WS; pp. 232-236 in Trace Substances in Environmental Health-XXI: Proc Univ MO's 21st Ann Conf Trace Sub Environ Health. Columbia, MO: Univ Missouri (1987) (4) Eisler R; p. 15 in Handbook of Ecotoxicology. Hoffman DJ et al, eds. Tokyo, Japan: Lewis Pub (1995) (5) Huda M et al; J Can Assoc Radiol 39: 37-41 (1988) (6) Buzulukov YP, Dobrynin YL; pp. 3-21 in The Chernobyl Papers. Merwin SE, Balonov NI, eds. Richland, WA: Research Enterprises, Inc. Vol I (1993) (7) Barrie LA et al; Sci Total Environ 122: 1-74 (1992) (8) ATSDR; Toxicological Profile for Ionizing Radiation. Atlanta, GA: ATSDR (1999) (9) DOE; Savannah River Site Environmental Report for 1998. Aiken, SC: USDOE. WSRC-TR-98-00312. DE-ACO9-96SR18500 (1998) (10) NRC; Radioactive Materials Released from Nuclear Power Plants: Annual Report 1993. Washington, DC: US Nuclear Regulatory Committee. NUREG/CR-2907. BNL-NUREG-51581 (1993) ]**PEER REVIEWED**


Sediment/Soil Concentrations :
SEDIMENT: The concns of cesium-137 in eight sediment cores of the Danube River, Austria were about 540 pCi/kg in April 1985, but increased to approx 27,000-81,000 pCi/kg in October 1986, following the accident at the Chernobyl nuclear power plant(1). The deposition of cesium-137 attributed to the accident at the Chernobyl nuclear power plant in sediment at five different sites in Lake Constance, Germany ranged from 2.7X10-7 to 2.1X10-6 Ci/sq m, while the fallout from nuclear weapons testing since 1963 ranged from 1.4X10-7 to 5.4X10-7 Ci/sq m(2). It was estimated that 2,973 Ci of cesium-137 and 1,622 Ci of cesium-134 were released to the sediments in the cooling and surrounding the Chernobyl nuclear power plant following the accident in 1986(3). Surface sediment samples collected from the Spanish Mediterranean coast near the Vandellos nuclear power plant in 1989 contained cesium-137 and cesium-134 concentration ranges of 0.47-16.7 Bq/kg and <0.05-1.14 Bq/kg, respectively(4). Twenty-seven surface sediment samples (upper 3 cm) collected from the Pechora Sea in July 1994 had concentration values for cesium-137 ranging from below the detection limit to 10.4 Bq/kg, with a mean of 3.13 Bq/kg(5).
[(1) Rank D et al; Water Sci Technol 22: 211-8 (1990) (2) Richter T et al; Water Sci Technol 28: 117-21 (1993) (3) UNSCEAR; Sources and Effects of Ionizing Radiation: UNSCEAR 1996 Report to the General Assembly, with Scientific Annex. United Nations Scientific Committee on the Effects of Atomic Radiation. NY, NY: United Nations (1996) (4) Sanchez-Cabeza JA, Molero J; J Environ Radioact 51: 211-28 (2000) (5) Baskaran M et al; Mar Pollut Bull 40: 830-38 (2000) ]**PEER REVIEWED**


Effluent Concentrations :
The dumping of high and low level radioactive wastes into the Arctic waters by the former Soviet Union has also led to the release of cesium-137 and cesium-134 as well as other radioactive nuclides into these waters(1). In the past, the majority of radioactive cesium released to water surfaces in North America arose from deposition following atmospheric nuclear weapons testing conducted by the United States, primarily during the 1960s(1). Radioactive cesium can be introduced to water from nuclear power plants (during accidents and normal operation) and at facilities that produce weapons grade plutonium and uranium. During the period of 1961-1973, it was estimated that about 514 Ci of cesium-137 was emitted to the Savannah River, SC watershed due to activities at the Savannah River Plutonium Processing Plant(2). It was further noted that about 18% of this total (92 Ci) drained directly into the Savannah River(2). In 1998, it was reported that 1.0X10-4 Ci of cesium-134 and 0.19 Ci of cesium-137 were released in liquid effluents from the Savannah River plutonium processing site in South Carolina(3). In 1993, the NRC estimated that 1.88 Ci of cesium-134 and 2.85 Ci of cesium-137 were released in liquid effluents from 30 pressurized water reactor nuclear power plants operating in the United States(4). It was estimated that 0.12 Ci of cesium-134 and 0.58 Ci of cesium-137 were released in liquid effluents from 28 boiling water reactor nuclear power plants(4). EPA reported that the total on-site discharges of cesium-137 from containment ponds at the Nevada Test Site was 0.0017 Ci in 1997(5). It was estimated that 1,622 Ci of cesium-137 and 811 Ci of cesium-134 were released to the cooling pond surrounding the Chernobyl, Ukraine nuclear power plant following the accident in 1986(6).
[(1) Robbins JA et al; Can J Fish Aquat Sci 47: 572-87 (1990) (2) Olsen CR et al; Environ Sci Technol 23: 1475-81 (1989) (3) DOE; Savannah River Site Environmental Report for 1998. Aiken, SC: USDOE WSRC-TR-98-00312. DE-ACO9-96SR18500 (1998) (4) NRC; Radioactive Materials Released from Nuclear Power Plants: Annual Report 1993. Washington, DC: US NRC. NUREG/CR-2907. BNL-NUREG-51581 (1993) (5) USEPA; Offsite Environmental Monitoring Report: Radiation Monitoring Around United States Nuclear Test Areas, Calender Year 1997. Washington, DC: Off Rad Indoor Air. USEPA402/R-98-013 (1999) (6) UNSCEAR; Sources and Effects of Ionizing Radiation: UNSCEAR 1996 Report to the General Assembly, with Scientific Annex. United Nations Scientific Committee on the Effects of Atomic Radiation. NY, NY: United Nations (1996) ]**PEER REVIEWED**


Sediment/Soil Concentrations :
SOIL: Radioactive cesium has been released to soil surfaces by underground nuclear weapons testing, fallout from the accident at the Chernobyl power plant and fallout from atmospheric weapons testing. About 1,400 underground test have been performed worldwide, with a total explosive yield of about 90 megatons(1). Small amounts of cesium-137 and cesium-134 are also released to soil from the normal operation of nuclear power plants and the storage of spent fuel rods. Not including the 30-km exclusionary zone, an area of approximately 2.4X10+4 sq km near the Chernobyl nuclear power plant was contaminated with cesium-137 at a deposition density >5.4X10-5 Ci/sq m following the accident in 1986(2). Within the exclusionary zone, the contamination density may have been 2 orders of magnitude greater in limited areas(2). The mean deposition density of cesium-137 and cesium-134 in four different soils in Devoke, United Kingdom for May 1986 were reported as 3.7X10-5 to 5.4X10-7 Ci/sq m and 1.0X10-7 to 1.8X10-7 Ci/sq m, respectively(3). The deposition density of cesium-137 in 123 soil core collected at the Idaho National Engineering and Environmental Laboratory ranged from 1.6X10-8 to 3.4X10-7 Ci/sq m(6). The deposition density of cesium-137 in soils from Idaho, Montana, and Wyoming ranged from 3.0X10-9 to 1.1X10-7 Ci/sq m, and it was assumed that its origin was fallout from the Nevada Test Site(4). The mean deposition density of cesium-137 in the top layer (0-8 cm) of soils near the Chernobyl nuclear power plant in 1988 was 8.6X10-5 Ci/sq m and the mean deposition density of cesium-134 was 1.9X10-5 Ci/sq m(5).
[(1) ATSDR; Toxicological Profile for Ionizing Radiation. Atlanta, GA: Agency for Toxic Substances and Disease Registry (1999) (2) UNSCEAR; Sources and Effects of Ionizing Radiation: UNSCEAR 1996 Report to the General Assembly, with Scientific Annex. United Nations Scientific Committee on the Effects of Atomic Radiation. NY, NY: United Nations (1996) (3) Hilton J et al; Sci Total Environ 129: 253-66 (1993) (4) DOE; Heavy Element Radionuclides (Pu, Np, U) and 137Cs in Soils Collected from Idaho, Montana, and Wyoming. NY,NY: Environ, Meas Lab, USDOE EML-599 (1998) (5) Mikhaylovskaya LN et al; Euras Soil Sci 25: 103-7 (1993) ]**PEER REVIEWED**


Artificial Pollution Sources :
Radioactive cesium is released to the environment during the normal operation of nuclear power plants, explosion of nuclear weapons, and accidents involving nuclear power plants or nuclear powered satellites or submarines. High levels of cesium-134 and cesium-137 have been released to the environment, as a result of atmospheric nuclear weapons testing (which has been discontinued for many years) or underground weapons testing and the accident at the Chernobyl, Ukraine nuclear reactor site in 1986. There have only been two major reactor accidents at nuclear plants where radiocesium was released in significant amounts. The two accidents occurred in Windscale, England in 1957 and Chernobyl, Russia in 1986(1).
[(1) ATSDR; Toxicological Profile for Cesium. Atlanta, GA: Agency for Toxic Substances and Disease Registry, US Public Health Service (2004) ]**PEER REVIEWED**


Fish/Seafood Concentrations :
The concn of cesium-137 in bullhead catfish inhabiting an abandoned nuclear reservoir at the Savannah River site in South Carolina were as high as 1.54X10+5 pCi/kg(1), but concns in various freshwater species of fish in the Ottawa River ranged from 54 to 351 pCi/kg(2). After the accident at the Chernobyl nuclear power plant, the avg concns of cesium-137 in perch and pike obtained from 52 freshwater lakes in Finland were 55,811 and 66,297 pCi/kg, respectively, in 1988. By contrast, in 1992, the mean concns of cesium-137 in perch and pike had fallen to 14,324 and 18,567 pCi/kg, respectively(3). Mussels (Mytilus edulis (L.)) collected from 11 estuaries around the Irish coastline in August 1988 contained cesium-137 and cesium-134 concentration ranges of <0.5-9.8 and <0.4-<0.7 Bq/kg (dry weight), respectively(4). The mean activity concentrations of cesium-137 detected in the edible portion of 34 crabs and 37 lobsters caught commercially in the Sellafield coastal area offshore from the Sellafield nuclear fuel reprocessing plant in the northeast Irish Sea between May 25 and June 5, 1997 were 3.1 and 5.0 Bq/kg (wet), respectively(5).
[(1) McCreedy CD et al; Environ Toxicol Chem 16: 328-35 (1997) (2) Rowan DJ et al; J Environ Radioact 40: 15-36 (1998) (3) Sarkka J et al; Sci Total Environ 191: 125-36 (1996) (4) Crowley M et al; Ocean Shore Manag 13: 149-61 (1990) (5) Swift DJ, Nicholson MD; J Environ Radioact 54: 311-26 (2001) ]**PEER REVIEWED**


Sediment/Soil Concentrations :
SOIL: The concn of cesium-137 in soils of Thessaloniki, Greece ranged from 1,440 to 35,324 pCi/kg (avg 8,154 pCi/kg) and the concn of cesium-134 ranged from about 270 to 5,676 pCi/kg during the period of August 1986 to February 1989, with most of the fallout attributed to the accident at the Chernobyl nuclear power plant(1). The concn of cesium-137 in 10 uncultivated fields from southern England ranged from 0 to 946 pCi/kg, with the highest levels contained in the top 10 cm of the soil surface(2). The concn of cesium-137 in five cultivated fields ranged from 0 to 540 pCi/kg, and the concns were well distributed from the surface to the plough layer(2). The concn of cesium-137 in three soils in Hong Kong receiving a large amount of rainfall ranged from 32 to 201 pCi/kg(3). The avg concn of cesium-137 in uncultivated soils in northern Poland ranged between 616 and 4,170 pCi/kg from 1988-1991(4). The mean concn of cesium-137 in surface soils from the Los Alamos nuclear laboratory test site during the period of 1974-1996 was 611 pCi/kg(5). Concn of cesium-137 around the perimeter of the site and background concns off the site were 589 and 419 pCi/kg, respectively. The concn of cesium-137 and cesium-134 in soils and sediments at 18 US DOE facilities ranged from 20 to 4.69X10+7 pCi/kg(6). The mean concn of cesium-137 in soils taken from two high-elevation sites in northern Colorado ranged from 4,054 to 7,027 pCi/kg(7). Soil samples collected in 1994 and 1995 from the industrial area and residential area surrounding a plant for the utilization and repair of nuclear-powered submarines in the coastal area of Cut Bay in Olenjya Bay in the Kolsky Gulf, Russia contained cesium-137 in concentrations of 1-15 Bq/kg of air dry sample and 8-19 Bq/kg of air dry sample, respectively(8).
[(1) Papastefanou C et al; Sci Total Environ 84: 283-9 (1989) (2) Owens PN et al; J Environ Radioact 32: 169-91 (1996) (3) Ruse ME, Peart MR; Chemosphere 41: 45-51 (2000) (4) Pietrzak-Flis Z et al; Radiat Prot Dosim 25: 101-5 (1988) (5) Fresquez PR et al; Mutat Res 415: 151-8 (1998) (6) Olsen CR et al 1989; Environ Sci Technol 23: 1475-81 (1989) (7) Ulsh B et al; J Environ Radioact 47: 57-70 (2000) (8) Dovgusha VV et al; Chemosphere 42: 69-72 (2001) ]**PEER REVIEWED**


Methods of Manufacturing :
Radioactive isotopes of cesium such as cesium-134 and cesium-137 are produced by nuclear fission in fuel rods in nuclear power plants. Radiocesium can be recovered from fission products by digestion with nitric acid. After filtration to remove the waste, the radioactive cesium phosphotungstate is precipitated using phosphotungstic acid. Other processes for the removal of cesium-134 and cesium-137 from radioactive waste involve solvent extraction using macrocyclic polyethers, or crown ethers and coprecipitation with sodium tetraphenylboron.
[Kirk-Othmer Encyclopedia of Chemical Technology. 4th ed. Volumes 1: New York, NY. John Wiley and Sons, 1991-Present., p. V5: 762 (1993)]**PEER REVIEWED**


Environmental Fate/Exposure Summary :
Radioactive isotopes of cesium (cesium-134 and cesium-137) have been released to the environment by human activities such as the atmospheric testing of nuclear weapons (from 1945 to 1980) and accidents at nuclear power plants (e.g., at Chernobyl, Ukraine in 1986). There are no naturally-occurring radioactive forms of cesium. The environmental fate of the radioactive forms of cesium is expected to be similar to those of the stable (non-radioactive) form. Current exposure of the general population of the US to radioactive cesium-134 and cesium-137 is expected to be low since atmospheric testing of nuclear weapons has been discontinued for many years and Chernobyl-related fallout was low in the US. However, exposure is possible from contaminated ground/surface waters at US Dept of Energy (DOE) sites, resulting from past defense related efforts at these sites. (SRC)
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Toxicity Summary :
TOXICITY SUMMARY: The element cesium exists in several forms known as isotopes. In nature, cesium exists only as a non-radioactive (or stable) isotope known as cesium-133 (Cs-133); however, there exist several cesium isotopes that are radioactive. The radioactive isotopes of cesium are formed during nuclear fission, in commercial applications such as the generation of electricity at nuclear power plants. The most important cesium isotopes in terms of their potential effects on human health are cesium-134 (Cs-134) and cesium-137 (Cs-137). In this summary, the most pertinent information on the radiation toxicity of Cs-134 and Cs-137 are presented. Both Cs-137 and Cs-134 emit beta radiation and gamma radiation. Beta radiation travels short distances and can penetrate the skin and superficial body tissues while gamma radiation can travel great distances and penetrate the entire body. The radiation dose from these radionuclides can be classified as either external (if the radiation source is outside the body) or internal (if the radiation source is inside the body). Beta radiation emitted outside the body is normally of little health concern unless the radioactive material contacts the skin. Skin contact can allow the beta radiation to pass through the epidermis to live dermal tissue where it becomes a major contributor to the radiation dose to the skin. Beta and gamma radiation may induce tissue damage and disruption of cellular function. The half-lives of Cs-134 and Cs-137 are approximately 2 years and 30 years, respectively. Because of the continual emission of radiation, people could be exposed to radiation from Cs-137 or Cs-134 released to the environment. High levels of Cs-134 and Cs-137 have been released to the environment from nuclear weapons testing and incidents such as the 1986 accident at the Chernobyl nuclear reactor in Ukraine. In these cases, cesium was one of many radionuclides present in the release. It is, thus, not possible to ascribe any of the observed health effects to radioactive cesium specifically. There are, however, documented reports of health effects in humans exposed to radioactive cesium. These reports arise from the accidental exposure of civilians to Cs-137 sources in Goiania, Brazil, in 1987 and Tammiku, Estonia, in 1994 and from the exposure of military personnel to Cs-137 during 1996 and 1997 in Lilo, Republic of Georgia. External and internal exposures of humans to radiocesium have resulted in a spectrum of adverse health effects that range from nausea to death. In 1987, approximately 250 persons, including children, were exposed externally and internally to radiation from a scavenged medical source with an activity of 50.9 TBq (1,375 Ci) 137-CsCl. Some of the exposed individuals showed signs of acute radiation syndrome, such as nausea, vomiting, and diarrhea. A large number of the individuals with acute radiation syndrome developed bone marrow failure and 4 of these died. Dermal injuries observed among the exposed individuals ranged from radiation dermatitis to severe radiation injuries leading to an amputation. Ocular and reproductive effects were also reported. Two incidents of external exposure to radiation from Cs-137 have demonstrated that serious adverse effects may also be expected when individuals are exposed only externally to high levels of radiation from Cs-137. In 1997 it was discovered that military recruits had been accidentally exposed to several sealed Cs-137 radioactive sources at a training facility in Lilo, Republic of Georgia. Nausea, weakness, headaches, and loss of appetite were the most commonly reported symptoms among the exposed recruits. Vomiting was reported by three of the patients, two of whom received the highest estimated doses. The exposures of the recruits occurred over several months. Although accurate information on the duration of the exposure was not available, doses were estimated by scoring unstable chromosome aberrations in peripheral blood lymphocytes and by electron spin resonance dosimetry of teeth of the exposed individuals. The estimated mean doses ranged from 0.2 to 5.9 Gy (The radiological event at Lilo. International Atomic Energy Agency (2000). Vienna). In 1994, several individuals (aged 13 to 78) were exposed to a sealed Cs-137 source stolen from a waste repository in Tammiku, Estonia. The observed health effects in the exposed individuals ranged from a relatively mild case of radiation sickness to death. Solid state dosimetry techniques were applied for reconstruction of the doses of several individuals exposed in the house where the stolen Cs-137 source was kept. The estimated whole body radiation doses ranged from 0.1 Gy to 4 Gy. The individual with the highest estimated whole body dose also had an estimated localized radiation exposure to the thigh of 1,830 Gy. The latter individual died 12 days after the initial exposure event. The survivors showed dermal effects and effects in blood. A 13-year old male was the most exposed among the survivors (estimated whole-body dose of 1.5-5.5 Gy). He suffered severe and prolonged bone marrow aplasia and radiation burns. (The Radiological Accident in Tammiku (1998). The International Atomic Energy Agency, Vienna. 4 November 1998). (SRC)
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Artificial Pollution Sources :
The radioactive isotopes of cesium are formed during nuclear fission, in commercial applications such as the generation of electricity at nuclear power plants. The most abundant radioisotopes that are formed in this manner are cesium-137 and cesium-134(1).
[(1) ATSDR; Toxicological Profile for Cesium. Atlanta, GA: Agency for Toxic Substances and Disease Registry, US Public Health Service (2004) ]**PEER REVIEWED**


Environmental Bioconcentration :
Daphnids (250 individuals/L) placed in 0.45 um filtered river water (Vienne River, France; downstream from Civaux nuclear power plant) with a cesium-137 concentration of 6X10-2 ug/L (7X10+4 Bq/L) had an observed steady state concentration factor of 30 mL/g (wet weight) cesium-137(1). During the depuration phase, the half-life of cesium-137 from daphnids was very fast, 0.3 days, indicating that radionuclide absorption to the surface was the major process involved in the contamination of daphnids(1).
[(1) Adam C et al; Water Air Soil Pollut 125: 171-88 (2001) ]**PEER REVIEWED**


Environmental Water Concentrations :
GROUNDWATER: The concn of cesium-137 and cesium-134 in groundwater at 18 DOE facilities was reported in the range of 2.7X10-3 to 1.83X10+3 pCi/L(1). The concn of cesium-137 measured in groundwater wells at Carlsbad, NM (the site of project GNOME) ranged from 99 to 6.8X10+5 pCi/L in 1997(2). The concn of cesium-137 in groundwater at the Chernobyl nuclear power plant was in the range of 40.5 to 1,100 pCi/L in 1988 and 29.7 to 129.7 pCi/L in 1989(3).
[(1) DOE; Chemical Contaminants on DOE Lands and Selection of Contaminant Mixtures for Subsurface Science Research. Washington DC: USDOE. DE92-014826 (1992) (2) USEPA; Offsite Environmental Monitoring Report: Radiation Monitoring Around the United States Nuclear Test Areas, Calender Year 1997. Washington DC: Office of Radiation and Indoor Air USEPA. USEPA 402/R-98-013 (1998) (3) Prister BS et al; Sov Soil Sci 23: 76-86 (1990) ]**PEER REVIEWED**


Environmental Water Concentrations :
SURFACE WATER: High and low level radioactive wastes have been dumped by the former Soviet Union into remote Arctic waters, leading to the release of radioactive cesium into the Kara and Barents Seas(1). The level of cesium-137 in the surface water of the Barents Sea and Kara Sea was 0.14 and 0.16 pCi/L, respectively(1). Cesium-137 was also detected in deep water of the Barents Sea a concn of 0.15 pCi/L(1). The concn of cesium-137 in the Black Sea was in the range of 2.7 to 8.1 pCi/L for the period 1991-1996, with the exception of the spring of 1992, when concns as high as 43 pCi/L were observed(2). From 1988 to 1991, the mean concns of cesium-137 and cesium-134 along the Spanish coast of the Mediterranean Sea were 0.13 and 0.0072 pCi/L, respectively(3). Due to its shorter half-life, cesium-134 was detected in all 14 samples collected in 1988 and 1989, but only in 3 samples collected in 1990 and 1991, suggesting that the cesium-134 levels observed in the surface Mediterranean waters were due exclusively to Chernobyl-related deposition. The 137Cs concn incorporated into the Mediterranean Sea near the Spanish coast from the post-Chernobyl fallout was about 0.032 pCi/L, which was approx a 33% increase over previous levels(3). Max cesium-137 and cesium-134 levels in the immediate vicinity of nuclear power plants located on the southern Catalan shore of the Mediterranean were 0.57 and 0.059 pCi/L, respectively(3). The concn of cesium-137 in lakes and streams in Devoke, UK decreased exponentially from a max concn of about 8.1 pCi/L on May 6, 1986 to about 0.027 pCi/L, 1,200 days later(4). The mean concn of cesium-137 in six lakes located in central Finland ranged from 111 pCi/L in 1987 to 8.1 pCi/L in 1989(5).
[(1) Fisher NS et al; Environ Sci Technol 33: 1979-82 (1999) (2) Strezov A et al; Water Sci Technol 39: 21-6 (1999) (3) Molero J et al; J Environ Radioact 43: 357-70 (1999) (4) Hilton J et al; Sci Total Environ 129: 253-66 (1993) (5) Penttila S et al; Environ Pollut 82: 47-55 (1993) ]**PEER REVIEWED**


Atmospheric Concentrations :
URBAN/SUBURBAN: Radioactive cesium-134 and cesium-137 were detected at various concns in the atmosphere following the accident at the Chernobyl nuclear power plant on April 26, 1986(1). The avg concns of cesium-134 and cesium-137 in eastern Canada were reported as 0.024 and 0.046 pCi/cu m, respectively, during May 10-24, 1986 (2). The max atmospheric concn of cesium-137 measured in New York City in May 1986 was 0.26 pCi/cu m (3). In 1975, the max concn of cesium-137 in the atmosphere, in Poland, was 1.89 pCi/cu m (4). The concn of cesium-137 in the atmosphere of Thessaloniki, Greece ranged from 8.1X10-4 to 0.044 pCi/cu m from July 1987 to Dec 1988(5). The concn of cesium-137 in Tsukuba, Japan during May 1986 ranged from about 0.054 to 1.6 pCi/cu m(6).
[(1) ATSDR; Toxicological Profile for Cesium (Draft for Public Comment). Atlanta, GA: Agency for Toxic Substances and Disease Registry (2001) (2) Huda M et al; J Can Assoc Radiol 39: 37-41 (1988) (3) Feely HW et al; J Environ Radioact 7: 177-91 (1988) (4) Glowiak BJ et al; Environ Pollut 14: 101-11 (1977) (5) Papastefanou C et al; Sci Total Environ 84: 283-9 (1989) (6) Hirose K et al; J Atmos Chem 17: 61-71 (1993) ]**PEER REVIEWED**


Disposal Methods :
Low-level radioactive waste (LLW) is a general term for a wide range of wastes. Industries, hospitals and medical, educational, or research institutions; private or government laboratories; and nuclear fuel cycle facilities (e.g., nuclear power reactors and fuel fabrication plants) using radioactive materials generate low-level wastes as part of their normal operations. These wastes are generated in many physical and chemical forms and levels of contamination.
[Health Physics Society, Radiation Terms and Definitions: Low-level Radioactive Waste (2005). Available from http://hps.org/publicinformation/radterms/ as of November 28, 2005. ]**PEER REVIEWED**


General Manufacturing Information :
The materials cycle for cesium-137, a low-level radioactive material of interest from a security perspective ... as well as for its extensive industrial and medical uses, has been characterized for the United States for the year 2000. The focus is on products utilizing the isotope rather than on isotope production and subsequent disposal as a result of nuclear power generation. The results indicate that, during 2000, of the 1.5 PBq of cesium-137 that entered use, 94% was contained in sources in imported devices; the amounts in domestic source material recycling (4%) or as imported source materials (2%) were trivial by comparison. Losses from use were about 0.5 PBq; of this amount 86% was by radioactive decay, 11% was active source material that was recovered and recycled, and 3% was source material sent to low-level disposal sites. The current stock of cesium-137 in use is about 20 PBq; this stock is currently growing by more than 1 PBq per year (the difference between inputs to and losses from use).
[Okumura T, Graedel TE; Health Phys 90 (6): 521-32 (2006) ]**PEER REVIEWED** PubMed Abstract


Prior History of Accidents :
/Windscale, United Kingdom Radiation Incident/ In October 1957, the first substantially publicized release of radioactive material from a nuclear reactor accident occurred at the Windscale nuclear weapons plant at Sellafield in the United Kingdom. During a routine release of stored energy from the graphite core of a carbon dioxide-cooled, graphite-moderated reactor, operator error allowed the fuel to overheat. This led to uranium oxidation and a subsequent graphite fire. Attempts to extinguish the fire with carbon dioxide were ineffective. In the end, water was applied directly to the fuel channels but not before the fire had burned for 3 days, resulting in the release of iodine-131 (740 terrabecquerel; 20 kCi), cesium-137 (22 terrabecquerel; 0.6 kCi), polonium-210 (8.8 terrabecquerel; 0.2 kCi), ruthenium-106 (3 terrabecquerel; 0.08 kCi), and xenon-133 (1.2 petabecquerel; 32.4 kCi). The fire consumed much of the uranium fuel, and some of the resulting fallout was in the form of flake-like uranium oxide varying in size from 1 to 25 cm. The contamination of pastureland was widespread; for those in close proximity to the accident, the greatest threat of exposure was considered to be from iodine-131 via contaminated cow's milk. Those living farther from the accident were exposed to significant amounts of iodine-131 via milk consumption and air inhalation. The consumption of cow's milk was quickly banned; this lessened the exposure to iodine-131. The highest individual doses (approximately 100 milligray) were to the thyroids of children living near the accident site. The collective dose equivalent received in the United Kingdom and the rest of Europe was estimated to be 2,000 man-sieverts, of which 900 man-sieverts was from inhalation, 800 man-sieverts was from ingestion, and 300 man-sieverts was from external exposure. The main radionuclides contributing to the exposures were iodine-131 (37%), polonium-210 (37%), and cesium-137 (15%). There has been no detected impact on the health of the public from this accident.
[ATSDR; Toxicological Profile for Ionizing Radiation. Atlanta, GA: Agency for Toxic Substances and Disease Registry (1999) ]**PEER REVIEWED**


Ecotoxicity Excerpts :
/BIRDS and MAMMALS/ Liver and muscle tissue from dead seals and porpoises found stranded around the UK coast have been analysed for the following radionuclides: cesium-134, cesium-137, plutonium-238, plutonium 239+240. Multifactor analysis of variance indicated that, for radiocesium, there was no significant difference for harbour seals, grey seals or porpoises in terms of species or gender; however, the tissue activity concentration increased with body weight and decreased with distance from Sellafield, the major nuclear reprocessing plant in the UK. The levels of radiocesium in muscle were higher than those in liver, while there appeared to be a concentration factor of approximately 3-4 for muscle radiocesium when compared to radiocesium levels reported for fish, the main food source of the marine mammals under study. Approximate radiation dose calculations indicated that the average dose from radiocesium was less than 10% of the dose from the naturally occurring radioisotope of potassium, 40-K. ...The marine mammals concentrated radiocesium from their environment by a factor of 300 relative to the concentration in seawater indicating the value of using marine mammal tissue to measure radiocesium contamination in the marine environment. The maximum radiation dose to the marine mammals from radiocesium was higher than doses previously assessed for critical groups of humans living near Sellafield, while the maximum dose from plutonium was comparable to the doses for humans. /Cesium-134, cesium-137, plutonium-238, -239+240/
[Watson WS et al; Sci Total Environ 234 (1-3): 1-13 (1999) ]**PEER REVIEWED**


Plant Concentrations :
Lichens and mosses have been shown to trap and retain cesium-137 and cesium-134 more so than vascular plants, due to their relatively large surface area. Lichens and mosses from northern Greece contained cesium-137 levels of 6.6X10+4 to 5.1X10+5 pCi/kg during the period of 1989-1991(1) and moss samples from Finland collected in 1988-1989 contained 4.3X10+4 to 9.7X10+5 pCi/kg(2). The mean concn of cesium-137 in three species of lichens collected in August 1986 from Megalopolis, Greece were 2.6X10+4 to 3.3X10+4 pCi/kg, while the mean concns for the same three species of lichens collected in October 1996 had fallen to 3,324 to 7,892 pCi/kg(3). Mushrooms, lichens, and mosses obtained near Manitoba, Canada in August 1986 contained cesium-137 at mean concns of 6.4X10+5, 8.6X10+4, and 8.4X10+4 pCi/kg, respectively(4). Vegetation samples collected in 1994 and 1995 from the industrial area and residential area of a plant for the utilization and repair of nuclear-powered submarines in the coastal area of Cut Bay in Olenjya Bay in the Kolsky Gulf, Russia contained cesium-137 concentrations of 10 to 210 Bq/kg of air dry sample and 20 to 530 Bq/kg of air dry sample, respectively(5). Seaweeds collected from the water area of Cut Bay had a cesium-137 concentrations of 0.1 to 1.1 Bq/kg of moist sample(5).
[(1) Papastefanou C et al; Environ Int 18: 397-401 (1992) (2) Penttila S et al; Environ Pollut 82: 47-55 (1993) (3) Riga-Karandinos AN, Karandinos MG; Bryologist 101: 422-7 (1998) (4) Mihok S et al; Health Phys 57: 959-66 (1989) (5) Dovgusha VV et al; Chemosphere 42: 69-72 (2001) ]**PEER REVIEWED**


Soil Adsorption/Mobility :
The vertical migration patterns of cesium-137 produced from the atomic bomb that exploded in Nagasaki, Japan were studied over a 40-year period(1). Over this period, 95% of the cesium remained in the top 10 cm of the soil surface and no cesium was detected below a depth of 40 cm(1). The migration rate of cesim-137 was 0.10 cm/yr(1). Cesium-137 had the largest median distribution coefficient (Kd) of five radionuclides (manganese-54, cobalt-60, zinc-65, strontium-85, and cesium-137), and a positive correlation was observed between the adsorption coefficient and exchangeable potassium content in soil(2). In all 25 soil and sediment samples collected from a variety of contrasting locations in the Esk estuary on the Cumbrian coast in the United Kingdom (10 km south of the British Nuclear Fuels Ltd plant at Sellafield) in May 1990, >50% of cesium-137 appeared to be firmly bound within a residual phase(3). Four sediment samples (cesium-137 concentrations ranging from 1470 to 5680 kBq/kg)collected from Reservoir 10 in the Techa river near the Mayak Production Association in the Urals mountains were tested to determine the remobilization of cesium-137 using freshwater and seawater extractions(4). The total apparent distribution coefficient (Kd) values of cesium-137 in the four samples in a sediment-freshwater system ranged from 4,100 to 156,000 ml/g. In the seawater sediment system, the mean apparent Kd values decreased by 94% and remobilization in seawater was 5% of total activities (i.e. releases of 165 kBq/kg dry weight) for cesium-137(4).
[(1) Mahara Y; J Environ Qual 22: 722-30 (1993) (2) Yasuda H et al; Water Air Soil Pollut 83: 85-96 (1995) (3) Davies KS, Shaw G; Sci Total Environ 132: 71- 92 (1993) (4) Standring WJF et al; Environ Sci Technol 36: 2330-7 (2002) ]**PEER REVIEWED**


Environmental Water Concentrations :
SEAWATER: Seawater samples collected in 1994 and 1995 from the Cut Bay water area surrounding a plant for the utilization and repair of nuclear-powered submarines in Olenjya Bay in the Kolsky Gulf, Russia contained a cesium-137 concentration of 0.04 Bq/l(1). Cesium-137 concentrations in large volume water samples collected from the Catalan Sea in the Northwestern Mediterranean in 1991 at depths of 2-3 m (surface), 100 m, 500 m, and 1000 m were 4.4, 4.1, 3.2, and 1.80 Bq/cu m, respectively(2).
[(1) Dovgusha VV et al; Chemosphere 42: 69-72 (2001) (2) Molero J et al; J Environ Radioact 26: 205-16 (1995) ]**PEER REVIEWED**


Food Survey Values :
Levels of cesium-137 were below detection limits for all foods analyzed in the US FDA Total Diet Study in 1991-1996, with the exception of honey(1). The concn of cesium-137 in honey from the 1995 Market Basket Survey was 181.1 pCi/kg. The avg concn of total cesium-137 and cesium-134 in milk powder, infant milk powder, infant cereal, meat, lentil, wheat, and macaroni samples from Saudi Arabia were 514, 351, 486, 162, 270, 676, and 351 pCi/kg, respectively(2). For the month of June 1986, the avg concn of total cesium-137 and cesium-134 in milk, green vegetables, fruit, lamb, and beef were reported as 3,243, 2,703, 2,703, 8,108, and 1,622 pCi/kg in high deposition areas of the United Kingdom(3). It was also estimated that the concn of total cesium-137 and cesium-134 was <676 pCi/kg in each of these food sources in areas of low deposition during this time frame. The max concn of cesium-137 in pasteurized milk from 65 cities in the US was 14 pCi/L in May 1989(4). The concn of cesium-137 in fresh milk from Chester, NY and pasteurized milk samples from New York City in May 1986 ranged from about 5.4 to 18.9 pCi/L(5). Using radiological surveys from 1978 and 1985-1986, the concn of cesium-137 in 44 adult food groups from the Rongelap Island and Rongelap Atoll was in the range of 0.52-13,000 pCi/kg(6). The mean activity concentrations of cesium-137 detected in the edible portion of 34 crabs and 37 lobsters caught commercially in the Sellafield coastal area offshore from the Sellafield nuclear fuel reprocessing plant in the northeast Irish Sea between May 25 and June 5, 1997 were 3.1 and 5.0 Bq/kg (wet), respectively(7).
[(1) Capar SG, Cunningham WC; J AOAC Int 83: 157-77 (2000) (2) Abdul-Majid S et al; J Environ Sci Health A27: 1045-57 (1992) (3) Mondon KJ, Walters B; Food Addit Contam 7: 837-48 (1990) (4) USEPA; Environmental Radiation Data. Report 58. Montgomery, AL: Office of Radiation Programs. USEPA 520/5-89-034. (1989) (5) Feely HW et al; J Environ Radioact 7: 177-91 (1988) (6) Robinson WL, Phillips WA; Estimates of the Radiological Dose from Ingestion of 137cs and 90Sr to Infants, Children, and Adults in the Marshall Islands. Livermore, CA: Lawrence Livermore Natl Lab (1989) (7) Swift DJ, Nicholson MD; J Environ Radioact 54: 311-26 (2001) ]**PEER REVIEWED**


Prior History of Accidents :
The Chelyabinsk region of the southern Ural Mountains was one of the main military production centers of the former USSR and included the Mayak nuclear materials production complex in the closed city of Ozersk. Accidents, nuclear waste disposal and day-to-day operation of the Mayak reactor and radiochemical plant contaminated the nearby Techa River. The period of most releases of radioactive material was 1949-56, with a peak in 1950-51. During the first years of the releases, 39 settlements were located along the banks of the Techa River, and the total population was about 28,000. Technical flaws and lack of expertise in radioactive waste management led to contamination of vast areas, and the population was not informed about the releases. The protective measures that were implemented (evacuations, restrictions on the use of flood lands and river water in agricultural production and for domestic purposes) proved to be ineffective, since they were implemented too late. Approximately 7,500 people were evacuated from villages near the River between 1953 and 1960. ... During 1949-56, 7.6x10+7 cubic meters of liquid wastes with a total radioactivity of 100 PBq were released into the Techa-Isset-Tobol river system. ... Large populations were exposed over long periods to external gamma radiation, due largely to cesium-137 but also to other gamma-emitting radionuclides such as zirconium-95, niobium-95 and ruthenium-106 present in the water and on the banks of the Techa River. The internal radiation dose was from ingestion of strontium-90 and cesium-137 over long periods... . Systematic follow up of a cohort of almost 30,000 individuals who received significant exposure from the releases was begun in 1967. ... The preliminary results of follow-up from 1950 through 1989, which were analyzed in linear dose-response models for excess relative risk, indicate an increased rate of mortality from leukemia and solid tumors related to internal and external doses of ionizing radiation.
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. v75 p. 154-5 (2000)]**PEER REVIEWED**


Other Chemical/Physical Properties :
There are several radioactive isotopes of cesium ranging from cesium-114 to cesium-145. The radioactive isotopes have a wide range of half-lives ranging from about 0.57 seconds (cesium-114) to about 3X10+6 years (cesium-135). The radioactive isotopes cesium-137 and cesium-134 are significant fission products because of their high fission yield, their long half-lives, and their biochemical similarity to potassium. The fission yield of cesium-137 in nuclear reactions is relatively high, about 6 atoms of cesium-137 are produced per 100 fission events. Cesium-137 has a radioactive half-life of about 30 years and decays by beta decay either to stable barium-137 or a meta-stable form of barium (barium-137m). The metastable isotope (barium-137m) is rapidly converted to stable barium-137 (half-life of about 2 minutes) accompanied by gamma ray emission whose energy is 0.662 MeV. The first beta decay mode that forms barium-137m accounts for roughly 95% of the total intensity, while the second mode accounts for about 5%. Radioactive cesium-134 primarily decays to stable barium-134 by beta decay accompanied by gamma ray emissions or less frequently to stable xenon-134 by electron capture (EC) accompanied by a single gamma ray emission. The energy of the various gamma rays are in the range of 0.24-1.4 MeV.
[ATSDR; Toxicological Profile for Cesium. Atlanta, GA: Agency for Toxic Substances and Disease Registry. Available at http://www.atsdr.cdc.gov/toxprofiles/tp157.html as of March 15, 2004. ]**PEER REVIEWED**


Other Chemical/Physical Properties :
DECAY PATHWAY: Cesium-137, half-life 30.07 years, 5.6% decays via beta(-) emission (5.6%, 1176 keV maximum, 416.3 keV average energy) to barium-137, half-life stable; 94.4% decays via beta(-) emission (514 keV maximum, 174 keV average energy) to barium-137m, half-life 2.55 min, decays via isomeric transition (gamma emission, 661.6 keV) to barium-137, half-life stable
[Korea Atomic Energy Research Institute. Nuclear Data Evaluation Lab. 2000. Nuclide Table. Available from the database query page at http://atom.kaeri.re.kr/ton/ as of Nov 17, 2005. ]**PEER REVIEWED**


Radiation Limits & Potential :
DECAY PATHWAY: Cesium-137, half-life 30.07 years, 5.6% decays via beta(-) emission (5.6%, 1176 keV maximum, 416.3 keV average energy) to barium-137, half-life stable; 94.4% decays via beta(-) emission (514 keV maximum, 174 keV average energy) to barium-137m, half-life 2.55 min, decays via isomeric transition (gamma emission, 661.6 keV) to barium-137, half-life stable
[Korea Atomic Energy Research Institute. Nuclear Data Evaluation Lab. 2000. Nuclide Table. Available from the database query page at http://atom.kaeri.re.kr/ton/ as of Nov 17, 2005. ]**PEER REVIEWED**


Other Chemical/Physical Properties :
DECAY PATHWAY: Cesium-134, half-life 2.065 years, decays via beta(-) emission (27% ,88.6 keV maximum, 23.1 keV average energy; 70% ,668 keV maximum, 210 keV average energy) and gamma emission (abs intensities: 97.6% 605 keV; 85.5% 796 keV; 15.4% 569 keV) to barium-134, half-life stable
[Korea Atomic Energy Research Institute. Nuclear Data Evaluation Lab. 2000. Nuclide Table. Available from the database query page at http://atom.kaeri.re.kr/ton/ as of Nov 17, 2005. ]**PEER REVIEWED**


Radiation Limits & Potential :
DECAY PATHWAY: Cesium-134, half-life 2.065 years, decays via beta(-) emission (27% ,88.6 keV maximum, 23.1 keV average energy; 70% ,668 keV maximum, 210 keV average energy) and gamma emission (abs intensities: 97.6% 605 keV; 85.5% 796 keV; 15.4% 569 keV) to barium-134, half-life stable
[Korea Atomic Energy Research Institute. Nuclear Data Evaluation Lab. 2000. Nuclide Table. Available from the database query page at http://atom.kaeri.re.kr/ton/ as of Nov 17, 2005. ]**PEER REVIEWED**


Atmospheric Standards :
The following values may be used for determining if facilities are in compliance with the national emission standards for hazardous air pollutants for Cs-134 and Cs-137 in the gaseous form: 5.2X-05 and 2.3X-05 Ci/yr; in the liquid/powder form: 5.2X-02 and 2.3X-02 Ci/yr; and in the solid form: 5.2X+01 and 2.3X+01 Ci/yr, respectively. Radionuclides with a boiling point at 100 deg C or less, or exposed to a temperature of 100 deg C, must be considered a gas. Capsules containing radionuclides in liquid or powder form can be considered to be solids. Concentration levels for environmental compliance include dose levels to members of the general public from emissions of radionuclides to the atmosphere for Cs-134 and Cs-137 are 2.7X-14 and 1.9X-14 Ci/cu m, respectively(1).
[(1) EPA; Part 61 National emission standards for hazardous air pollutants; Appendix E to Part 61 Compliance procedures methods for determining compliance with Subpart I; 40CFR 61, Appendix E; Environmental Protection Agency; (2005) Available from: http://www.gpoaccess.gov/nara/index.html as of August 17, 2005. ]**PEER REVIEWED**


Soil Adsorption/Mobility :
In soil, cesium has low mobility and usually does not migrate below a depth of 40 cm. The majority of cesium ions are retained in the upper 20 cm of the soil surface(1-3). For example, vertical migration patterns of cesium-137 in four agricultural soils from southern Chile indicated that approx 90% of the applied cesium was retained in the top 40 cm of soil(4). In one soil, essentially 100% was bound in the upper 10 cm(4). Migration rates of radiocesium were derived from depth distribution profiles and were in the range of 0.11 to 0.29 cm/yr(4). No correlations were observed for other soil properties such as pH, water content, cation exchange capacity, and exchangeable calcium. Other studies report that clay and zeolite minerals strongly bind cesium cations and therefore reduce the bioavailability of cesium and the uptake in plants by irreversibly binding cesium in interlayer positions of the clay particles(5). Experiments conducted by growing plants in a peat soil showed that the introduction of zeolites into the soil-plant system decreased the uptake of cesium-134 in plants by a factor of eight(6). The low hydration energy of cesium cations is primarily responsible for their selective sorption and fixation by clays and zeolites(7). Soils rich in organic matter adsorb cesium(8). However, the cesium adsorbed in the organic fraction is readily exchangeable and highly available for plant uptake(8). Regions in Venezuela, Brazil, and Russia where the soils are peaty or podzolic, the mobility of cesium is considerably greater than in other soils(9,10).
[(1) Korobova E et al; Appl Geochem 13: 803-4 (1998) (2) Ruse ME, Peart MR; Chemosphere 41: 45-51 (2000) (3) Takenaka C et al; Sci Total Environ 222: 193-9 (1998) (4) Schuller P et al; Sci Total Environ 193: 197-205 (1997) (5) Paasikallio A; Plant Soil 206: 213-2 (1999) (6) Shenber MA, Johanson KJ; Sci Total Environ 113: 287-95 (1992) (7) Hakem N et al; pp. 652-7 in Conf. Proc. - Inter Containment Tech Conf Exhib, 9-12 Feb, 1997. St. Petersburg, FL. Springfield, VA: Natl Tech Info Srv NTIS DE98001967 (1997) (8) Sanchez Al et al; Environ Sci Technol 33: 2722-57 (1999) (9) LaBrecque JL, Rosales PA; J Trace Microprobe Tech 14: 213-21 (1996) (10) WHO; Selected radionuclides: Tritium, carbon-14, krypton-85, strontium-90, iodine, cesium-137, radon, plutonium. Environmental Health Criteria 25. Geneva, Switzerland: World Health Organization (1983) ]**PEER REVIEWED**


Ecotoxicity Excerpts :
/BIRDS AND MAMMALS/ Transfer of cesium-137 in the soil-plant/lichen-reindeer food chain was studied in central (Ostre Namdal) and southern Norway (Vaga) during 2000-2003. Reindeer from these areas have been continuously subjected to countermeasure application since the 1986 Chernobyl accident. In both areas no decline in cesium-137concentrations was detectable in reindeer slaughtered in autumn since 1995, or in reindeer slaughtered in winter since 1998-1999. Seasonal differences in cesium-137 concentrations in reindeer have been less pronounced in recent years, with cesium-137 concentrations occasionally higher in autumn than in winter. Soil-to-plant cesium-137 transfer was significantly higher in Ostre Namdal than in Vaga. Climatic influences on lichen growth and abundance, and on soil properties that influence the availability of cesium-137 for plant uptake, are hypothesized to have a larger impact on long-term transfer of radiocesium in the soil-plant/lichen-reindeer food chain than has been previously observed. /Cesium-137
[Skuterud L et al; Environ Radioact 83 (2): 231-52 (2005) . ]**PEER REVIEWED** PubMed Abstract


Other Chemical/Physical Properties :
DECAY PATHWAY: Cesium-131, half-life 9.69 days, decays via electron capture (352 keV) to xenon-131, half-life stable; 1.95% decays via electron capture to xenon-131m which decays via isomeric transition (16.4 keV, gamma emission) to xenon-131
[Korea Atomic Energy Research Institute. Nuclear Data Evaluation Lab. 2000. Nuclide Table. Available from the database query page at http://atom.kaeri.re.kr/ton/ as of Nov 17, 2005. ]**PEER REVIEWED**


Radiation Limits & Potential :
DECAY PATHWAY: Cesium-131, half-life 9.69 days, decays via electron capture (352 keV) to xenon-131, half-life stable; 1.95% decays via electron capture to xenon-131m which decays via isomeric transition (16.4 keV, gamma emission) to xenon-131
[Korea Atomic Energy Research Institute. Nuclear Data Evaluation Lab. 2000. Nuclide Table. Available from the database query page at http://atom.kaeri.re.kr/ton/ as of Nov 17, 2005. ]**PEER REVIEWED**


Prior History of Accidents :
/Chernobyl Radiation Incident/ The accident at the Chernobyl reactor happened during an experimental test of the electrical control system as the reactor was being shut down for routine maintenance. The operators, in violation of safety regulations, had switched off important control systems and allowed the reactor to reach unstable, low-power conditions. A sudden power surge caused a steam explosion that ruptured the reactor vessel, allowing further violent fuel-steam interactions that destroyed the reactor core and severely damaged the reactor building. The radioactive gases and particles released in the accident were initially carried by the wind in westerly and northerly directions. On subsequent days, the winds came from all directions. The deposition of radionuclides was governed primarily by precipitation occurring during the passage of the radioactive cloud, leading to a complex and variable exposure pattern throughout the affected region. The radionuclides released from the reactor that caused exposure of individual were mainly iodine-131, cesium-134 and cesium-137. Iodine-131 has a short radioactive half-life, but it can be transferred to humans relatively rapidly from the air and through milk and leafy vegetables. Iodine becomes localized in the thyroid gland. The isotopes of cesium have relatively longer half-lives. These radionuclides cause longer-term exposures through the ingestion pathway and through external exposure from their deposition on the ground. Average doses to those persons most affected by the accident were about 100 mSv for 240,000 recovery operation workers, 30 mSv for 116,000 evacuated persons and 10 mSv during the first decade after the accident to those who continued to reside in contaminated areas. Outside Belarus, the Russian Federation and Ukraine, other European countries were affected by the accident. Doses there were at most 1 mSv in the first year after the accident with the dose over a lifetime estimated to be 2-5 times the first year doses. The exposures were much higher for those involved in mitigating the effects of the accident and those who resided nearby. The Chernobyl accident caused many severe radiation effects almost immediately. Of 600 workers present on the site, 134 suffered from radiation sickness. Of these, 28 died in the first three months and another 2 soon afterwards. In addition, during 1986 and 1987, about 200,000 recovery operation workers received doses of between 0.01 Gy and 0.5 Gy. That cohort is at potential risk of late consequences such as cancer and other diseases. The Chernobyl accident also resulted in widespread radioactive contamination in areas of Belarus, the Russian Federation and Ukraine inhabited by several million people. In addition to causing radiation exposure, the accident caused long-term changes in the lives of the people living in the contaminated districts. For the last 14 years, attention has been focused on investigating the association between exposure caused by the radionuclides released in the Chernobyl accident and late effects, in particular thyroid cancer in children. The number of thyroid cancers (about 1,800) in individuals exposed in childhood is considerably greater than expected based on previous knowledge. Apart from the increase in thyroid cancer after childhood exposure, no increases in overall cancer incidence or mortality have been observed that could be attributed to ionizing radiation.
[UNSCEAR; Sources and Effects of Ionizing Radiation - Volume I: Sources: UNSCEAR 2000 Report to the General Assembly, with Scientific Annex. United Nations Scientific Committee on the Effects of Atomic Radiation. NY, NY: United Nations (2000) ]**PEER REVIEWED**


Ecotoxicity Excerpts :
/PLANTS/ The present study was designed to compare the effectiveness of three plant bioassays to assess DNA damage induced by low doses of cesium-137: Vicia-micronucleus test (Vicia-MCN), Tradescantia-micronucleus test (Trad-MCN) and Tradescantia-stamen-hair mutation test (Trad-SH) were used. Vicia faba (broad bean) and Tradescantia clone 4430 (spiderwort) were exposed to cesium-137 according to different scenarios: external and internal (contamination) irradiations. Experiments were conducted with various levels of radioactivity in solution or in soil, using solid or liquid cesium-137 sources. The three bioassays showed different sensitivities to the treatments. Trad-MCN appeared to be the most sensitive test (significant response from 1.5 kBq/200 mL after 30 hr of contamination). Moreover, at comparable doses, internal irradiations led to larger effects for the three bioassays. These bioassays are effective tests for assessing the genotoxic effects of radioactive cesium-137 pollution. /Cesium-137/
[Minouflet M et al; J Environ Radioact 81 (203): 143-53 (2005) ]**PEER REVIEWED**


Biological Half-Life :
Biological half-lives for radiocesium in specific organisms/environments were reported as follows: moss, 4-5 years; lichen, 5-8 years; grass, 14 days; plant surface, 14 days; hen, 1-5 days; cow, 3 days; fish, 70-300 days; child, 57 days; woman, 84 days; and man, 105 days. /Radiocesium/
[Avery SV; J Environ Radioact 30: 139-71 (1996) ]**PEER REVIEWED**


General Manufacturing Information :
Cesium isotopes of mass number 112 to 148 have been identified. Cesium-133 is the only stable isotope. Cesium-134, 136Cs and 137Cs are the only isotopes of significance from an environmental perspective. They are formed from the nuclear fission process. Their half-lives are 2.06 years, 13.2 days, and 30.17 years, respectively. Cesium-135 also is formed as a result of the fission process. However, it is not a significant isotope, because it is a low-energy (0.21 MeV) beta-only emitter with a long half-life (2.2ױ06 years). /Cesium isotopes/
[Multi-Agency Radiological Laboratory Analytical Protocols Manual Volume II: Chapters 10-17 and Appendix F. (July 2004) p 14-116 NUREG-1576, EPA 402-B-04-001B, NTIS PB2004-105421. Available at http://www.nrc.gov/reading-rm/doc-collections/nuregs/staff/sr1576/sr1576v2.pdf as of October 12, 2006 ]**PEER REVIEWED**


General Manufacturing Information :
Cesium-137 is produced in nuclear fission and occurs in atmospheric debris from weapons tests and accidents. It is a very important component of radioactive fallout; and because of its moderately long half-life and high solubility, it is a major source of long-lived external gamma radiation from fallout. It accounts for 30 percent of the gamma activity of fission products stored for one year, 70 percent in two years, and 100 percent after five years.
[Multi-Agency Radiological Laboratory Analytical Protocols Manual Volume II: Chapters 10-17 and Appendix F. (July 2004) p 14-116 NUREG-1576, EPA 402-B-04-001B, NTIS PB2004-105421. Available at http://www.nrc.gov/reading-rm/doc-collections/nuregs/staff/sr1576/sr1576v2.pdf as of October 12, 2006 ]**PEER REVIEWED**


Disposal Methods :
Nuclear Regulatory Commission regulations separate low-level waste into three classes: A, B and C. The classification of the waste depends on the concentration, half-life and types of the various radionuclides it contains. The NRC sets requirements for packaging and disposal of each class of waste. Class A low-level waste contains radionuclides with the lowest concentrations and the shortest half-lives. About 95% of all low-level waste is categorized as Class A.
[Nuclear Energy Institute: Disposal of Low level Radioactive Wastes Fact Sheet, NEI. Available from http://www.nei.org/doc.asp?docid=537 as of November 28, 2005. ]**PEER REVIEWED**


Disposal Methods :
Low-level waste disposal occurs at commercially operated low-level waste disposal facilities that must be licensed by either the Nuclear Regulatory Commission or Agreement States. The facilities must be designed, constructed, and operated to meet safety standards. The operator of the facility must also extensively characterize the site on which the facility is located and analyze how the facility will perform for thousands of years into the future. There are three existing low-level waste disposal facilities in the United States /Barnwell, SC, Richland, WA, Envirocare in Utah/ that accept... low-level waste. All are in Agreement States. The Low-level Radioactive Waste Policy Amendments Act of 1985 gave the states responsibility for the disposal of their low-level radioactive waste. The Act encouraged the states to enter into compacts that would allow them to dispose of waste at a common disposal facility. Most states have entered into compacts; however, no new disposal facilities have been built since the Act was passed.
[Nuclear Regulatory Commission; Low-Level Waste Disposal (page last revised: August 2003). Available from http://www.nrc.gov/waste/llw-disposal.html as of November 28, 2005. ]**PEER REVIEWED**


Human Toxicity Excerpts :
/EPIDEMIOLOGY STUDIES/ More than 25,000 residents were exposed to external gamma radiation as well as internally from fission products (primarily from cesium-137, strontium-90, ruthenium-106, and zirconium-95) released into the Techa river from the nearby Mayak plutonium production facility, predominately in the early 1950s. Studies have been conducted of cancer mortality in residents and their offspring, as well as pregnancy outcomes. Initial dose estimates were based on average doses reconstructed for settlements. Efforts are ongoing to estimate individual doses for members of this resident cohort. To date, there is no evidence of a decrease in birth rate or fertility in the exposed population and no increased incidence of spontaneous abortions or stillbirths. There is some evidence of a statistically significant increase in total cancer mortality. Current estimates of the excess absolute risk (EAR) of leukemia in this cohort is 0.85 per 10,000 person-year Gy (95% confidence interval 0.2, 1.5), and for solid tumors the relative risk estimate is 0.65 per Gy (95% confidence interval -0.3, 1.0). Median dose estimates for soft tissue in this cohort are 7 mSv (maximum 456 mSv), and for bone marrow are 253 mSv (maximum 2021 mSv). Estimates of the relative risk for cancer of the esophagus, stomach and lung are similar to those reported for atomic bomb survivors. There is no evidence of an increase in cancer mortality in the offspring of exposed residents. There has also been one study of persons living in the town of Ozyorsk exposed to fallout from the nearby Mayak nuclear facility. An excess of thyroid cancer 3-4 times expected relative to rates for all of Russia has been observed. The excess is somewhat lower (1.5-2-fold higher) based on a comparison with Chelyabinsk Oblast rates. No estimates of radiation dose were included in this study. /Cesium-137, strontium-90, ruthenium-106, and zirconium-95 contamination/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII- Phase 2. p. 380 (2005) ]**PEER REVIEWED**


Human Toxicity Excerpts :
/BIOMONITORING/ /GENOTOXICITY/ The results of... three post-Chernobyl studies (two in Belarus and one in Ukraine) and for the one conducted on the populations in the vicinity of the nuclear test site in Semipalatinsk (Kazakhstan) provide evidence that mutations at minisatellite loci can be induced by radiation in human germ cells. The dose-response relationships, however, remain uncertain because of considerable difficulties in the estimation of parental gonadal doses. For example, in the first Belarus study the level of surface contamination by cesium-137 was used as a broad dose measure, and the children of parents inhabiting heavily contaminate areas (>250 kBq/sq m) were found to have twice the frequency of mutations compared to those of parents from less contaminated areas (<250 kBq/sq m). In the second Belarus study (with more exposed families and more loci sampled), based on estimates of individual doses, two groups were defined <20 mSv and >20 mSv. The mutation frequency in the children from the latter group was 1.35 times that in the former and that from both groups was about 2-fold higher than in the unexposed U.K. controls. In the Ukraine study, a 1.6-fold increase in mutation rate in the exposed fathers but not in exposed mothers (both relative to unexposed controls) was found, but again, the dose-response relationship is uncertain. The authors noted that the dose from external chronic irradiation and internal exposures together were of the order of approx. 100 mSv (excluding short-lived isotopes). In the Semipalatinsk study, again, there was a 1.8-fold increase in the first generation progeny of parents receiving relatively high doses of radiation (cited as >1.0 Sv, but could have been lower or higher). In this study, through the use of three-generation families, the authors obtained evidence for a decline in mutation frequency as population doses decreased. /Cesium-137 fallout/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII-Phase 2. p. 200-1 (2005) ]**PEER REVIEWED**


Absorption, Distribution & Excretion :
Placental transfer: The concentrations of cesium-137 arising from exposure to fall-out from nuclear weapons were measured in nine newborn children within three days of birth and in their mothers. The concentrations were similar. After an accident in Brazil in which a woman in her fourth month of pregnancy was contaminated with cesium-137, both the mother and her newborn child were monitored one week after birth. The concentration of cesium-137 in the mother (0.91 kBq/kg bw) was similar to that in her newborn child (0.97 kBq/kg bw), and the concentration in the placenta was the same as that in the whole maternal body and the fetus./Cesium-137/
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. V78 343 (2001)]**PEER REVIEWED**


Biological Half-Life :
After the Chernobyl accident, increased cesium-137 body burdens were measured for 22 Japanese male adults. An average biological half-time of 101 days was estimated. In the 1960s, an average Cs biological half-time of 86 days was reported for 23 Japanese male adults under quasi-equilibrium conditions in regard to cesium-137 from atmospheric nuclear weapon tests. Comparing the present data with the 1960s results, the difference in the biological half-time of cesium at a confidence level of 90% was not significant but had an increasing tendency. When the two groups of data were combined, the biological half-time for cesium was 9327 days for the 45 individuals. Thus, the reference biological half-time should be 90 days for Japanese male adults. Four subjects were studied in both the 1960s and the 1980s. A clear relationship was observed between the increase in half-time and increase in age. /Cesium-137/
[Uchiyama M; J of Environ Radioactivity 41 (1): 83-94 (1998) ]**PEER REVIEWED**


Plant Concentrations :
Eight species of mushrooms collected in 1993 from the area around the Nuclear Center of Mexico (average cesium-137 soil concentration of 1.112 kBq/sq m) were determined to have the following cesium-137 activities (Bq/kg dry weight) and Aggregated Transfer Coefficients (sq m/kg): Agaricus campestre, 2 and 0.002; Clitocybe gibba, 14 and 0.018; Lactarius salmonicolor, 9 and 0.029; Psathyrella spadicea, 16 and 0.12; Russula delicata, 11 and 0.011; Clavariadelphus truncatus, 12 and 1; Gomphus flocosus, 16 and 0.28; and Helvella lacunosa, 7 and 0.016(1).
[(1) Gaso MI et al; Environ Interntl 22: 5365-68 (1996) ]**PEER REVIEWED**


Animal Concentrations :
In 1986, the concn of cesium-134 in animal muscle tissues taken from Ireland was as follows: woodcock (N=24; range, 3.9-206.4 Bq/kg), duck (N=5; range, 2.2-14.3 Bq/kg), and snipe (N=5; range, 1.0-5.4 Bq/kg); the concn of cesium-137 was as follows: woodcock (N=24; range, 6.2-565.5 Bq/kg), duck (N=5; range, 6.4-18.0 Bq/kg), and snipe (N=5; range, 3.6-16.9 Bq/kg)(1). The mean concn of cesium-137 in the reindeer muscle tissue was 900 Bq/kg between 1986-1987 in Northern Sweden(2). Between 1991-1998, the mean concn of cesium-137 in deer muscle and bone (N=11) from Los Alamos were 2,516 Bq/kg and 888 Bq/kg, respectively(3). The mean concn of cesium-137 in bone, liver, muscle, and kidney tissue from caribou (N=18) taken from Saskatchewan in 1995 were 58, 228, 367, and 553 Bq/kg, respectively(4). The concn of cesium-137 in neck, shoulder, and back tissue from caribou (N=36) taken from Alaska in 1987 ranged from 26-232, 28.4-204.1, and 30.2-166.5 Bq/kg, respectively(5). Cesium-137 was detected in four of eight reindeer bone samples collected from before 1989 to 1993 from Archipelago Novaya Zemlya, Russia, a nuclear testing site, in concentrations of <0.005, 0.08, 0.08, and 0.09 Bq/g(6).
[(1) Pearce J; Bull Environ Contam Toxicol 54: 805-11 (1995) (2) Ahman B, Ahman G; Health Phys 66: 503-12 (1994) (3) Fresquez PR et al; J Environ Sci Health B 34: 901-15 (1999) (4) Thomas PA, Gates TE; Environ Health Perspect 107: 527-37 (1999) (5) Allaye-Chan AC et al; Rangifer 3: 17-24 (1990) (6) Klevezal GA et al; Chemosphere 42: 61-7 (2001) ]**PEER REVIEWED**


Probable Routes of Human Exposure :
Exposure to radioactive cesium is more important from a health perspective than exposure to stable cesium(1). Current exposure of the general US population to cesium-134 and cesium-137 is expected to be low since atmospheric testing nuclear weapons has been discontinued for many years and Chernobyl-related fallout was low in the US(1).
[(1) ATSDR; Toxicological Profile for Cesium (Draft for Public Comment). Atlanta, GA; ATSDR (2001) ]**PEER REVIEWED**


Threshold Limit Values :
The Physical Agents TLV Committee accepts the occupational exposure guidance of the International Commission on Radiological Protection (ICRP). Ionizing radiation includes particulate radiation (e.g., alpha particles and beta particles emitted from radioactive materials, and neutrons from nuclear reactors and accelerators) and electromagnetic radiation (e.g., gamma rays emitted from radioactive materials and x-rays from electron accelerators and x-ray machines) with energy greater than 12.4 electron-volts (eV) ... The guiding principle of radiation protection is to avoid all unnecessary exposures. ICRP has established principles of radiological protection. There are (1) the justification of a work practice: No work practice involving exposure to ionizing radiation should be adopted unless it produces sufficient benefit to the exposed individuals or the society to offset the detriment it causes. (2) The optimization of a workpractice: All radiation exposures must be kept as low as reasonably achievable (ALARA), economic and social factors being taken into account. (3) The individual dose limits: The radiation dose from all relevant sources should not exceed the /ICRP/ prescribed dose limits.
[American Conference of Governmental Industrial Hygienists. Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices. Cincinnati, OH 2006, p. 140]**PEER REVIEWED**


Other Occupational Permissible Levels :
The recommendations in the American National Standards Institute standard, ANSI Z88.2-1992, "American National Standard For Respiratory Protection," are endorsed by the U.S. Nuclear Regulatory Commission and may be used by licensees in establishing a respiratory protection program with the /several/exceptions /including limitations that do not permit or greatly restrict the use of quarter-facepiece respirators and supplied air respirators and self-contained breathing apparatus (SCBA) that operate in the demand mode./
[U.S. Nuclear Regulatory Commission; Regulatory Guide 8.15 - Acceptable Programs for Respiratory Protection. October 1999. Available at http://www.nrc.gov/reading-rm/doc-collections/reg-guides/occupational-health/active/8-15/index.html as of October 2, 2006 ]**PEER REVIEWED**


Soil Standards :
Environmental radiation protection standards for management and disposal of spent nuclear fuel, high-level, and transuranic radioactive wastes include release limits for containment requirements (cumulative releases to the accessible soil environment for 10,000 years after disposal) per 1,000 metric tons of heavy metal or other unit of waste for Cs-137 is 1,000 curies(1).
[(1) USEPA; Part 191 Environmental radiation protection standards for management and disposal of spent nuclear fuel, high-level and transuranic radioactive wastes; 40CFR191, Appendix A, Table 1. Release Limits for Containment Requirements. Washington, DC, Environmental Protection Agency. (rev July 1, 2003). Available from: http://www.gpoaccess.gov/nara/index.html as of August 17, 2005.] ]**PEER REVIEWED**


Special Reports :
U.S. Nuclear Regulatory Commission; Regulatory Guide 8.34 - Monitoring Criteria and Methods to Calculate Occupational Radiation Doses. 1992/ Available at http://www.nrc.gov/reading-rm/doc-collections/reg-guides/occupational-health/active/8-34/index.html as of September 25, 2006


Prior History of Accidents :
In 1957, a nuclear waste storage facility in the Chelyabinsk region, near the town of Kyshtym, exploded (the Kyshtym accident) due to a chemical reaction, producing contamination referred to as the East Urals Radiation Trace (EURT). About 273, 000 people lived in the contaminated area. Ten years later, in 1967, after an exceptionally dry summer, the water of the Karachay Lake, an open depot of liquid radioactive waste, evaporated, and a storm transported radionuclides from the dry shores. Eleven thousand individuals were resettled as a result of the Kyshtym accident, of whom 1,500 had previously been resettled from the Techa River.
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. v75 p. 155 (2000)]**PEER REVIEWED**

MORE ABOUT HEALTH EFFECTS

CESIUM, RADIOACTIVE
CASRN: NO CAS RN


Toxicity Summary:
TOXICITY SUMMARY: The element cesium exists in several forms known as isotopes. In nature, cesium exists only as a non-radioactive (or stable) isotope known as cesium-133 (Cs-133); however, there exist several cesium isotopes that are radioactive. The radioactive isotopes of cesium are formed during nuclear fission, in commercial applications such as the generation of electricity at nuclear power plants. The most important cesium isotopes in terms of their potential effects on human health are cesium-134 (Cs-134) and cesium-137 (Cs-137). In this summary, the most pertinent information on the radiation toxicity of Cs-134 and Cs-137 are presented. Both Cs-137 and Cs-134 emit beta radiation and gamma radiation. Beta radiation travels short distances and can penetrate the skin and superficial body tissues while gamma radiation can travel great distances and penetrate the entire body. The radiation dose from these radionuclides can be classified as either external (if the radiation source is outside the body) or internal (if the radiation source is inside the body). Beta radiation emitted outside the body is normally of little health concern unless the radioactive material contacts the skin. Skin contact can allow the beta radiation to pass through the epidermis to live dermal tissue where it becomes a major contributor to the radiation dose to the skin. Beta and gamma radiation may induce tissue damage and disruption of cellular function. The half-lives of Cs-134 and Cs-137 are approximately 2 years and 30 years, respectively. Because of the continual emission of radiation, people could be exposed to radiation from Cs-137 or Cs-134 released to the environment. High levels of Cs-134 and Cs-137 have been released to the environment from nuclear weapons testing and incidents such as the 1986 accident at the Chernobyl nuclear reactor in Ukraine. In these cases, cesium was one of many radionuclides present in the release. It is, thus, not possible to ascribe any of the observed health effects to radioactive cesium specifically. There are, however, documented reports of health effects in humans exposed to radioactive cesium. These reports arise from the accidental exposure of civilians to Cs-137 sources in Goiania, Brazil, in 1987 and Tammiku, Estonia, in 1994 and from the exposure of military personnel to Cs-137 during 1996 and 1997 in Lilo, Republic of Georgia. External and internal exposures of humans to radiocesium have resulted in a spectrum of adverse health effects that range from nausea to death. In 1987, approximately 250 persons, including children, were exposed externally and internally to radiation from a scavenged medical source with an activity of 50.9 TBq (1,375 Ci) 137-CsCl. Some of the exposed individuals showed signs of acute radiation syndrome, such as nausea, vomiting, and diarrhea. A large number of the individuals with acute radiation syndrome developed bone marrow failure and 4 of these died. Dermal injuries observed among the exposed individuals ranged from radiation dermatitis to severe radiation injuries leading to an amputation. Ocular and reproductive effects were also reported. Two incidents of external exposure to radiation from Cs-137 have demonstrated that serious adverse effects may also be expected when individuals are exposed only externally to high levels of radiation from Cs-137. In 1997 it was discovered that military recruits had been accidentally exposed to several sealed Cs-137 radioactive sources at a training facility in Lilo, Republic of Georgia. Nausea, weakness, headaches, and loss of appetite were the most commonly reported symptoms among the exposed recruits. Vomiting was reported by three of the patients, two of whom received the highest estimated doses. The exposures of the recruits occurred over several months. Although accurate information on the duration of the exposure was not available, doses were estimated by scoring unstable chromosome aberrations in peripheral blood lymphocytes and by electron spin resonance dosimetry of teeth of the exposed individuals. The estimated mean doses ranged from 0.2 to 5.9 Gy (The radiological event at Lilo. International Atomic Energy Agency (2000). Vienna). In 1994, several individuals (aged 13 to 78) were exposed to a sealed Cs-137 source stolen from a waste repository in Tammiku, Estonia. The observed health effects in the exposed individuals ranged from a relatively mild case of radiation sickness to death. Solid state dosimetry techniques were applied for reconstruction of the doses of several individuals exposed in the house where the stolen Cs-137 source was kept. The estimated whole body radiation doses ranged from 0.1 Gy to 4 Gy. The individual with the highest estimated whole body dose also had an estimated localized radiation exposure to the thigh of 1,830 Gy. The latter individual died 12 days after the initial exposure event. The survivors showed dermal effects and effects in blood. A 13-year old male was the most exposed among the survivors (estimated whole-body dose of 1.5-5.5 Gy). He suffered severe and prolonged bone marrow aplasia and radiation burns. (The Radiological Accident in Tammiku (1998). The International Atomic Energy Agency, Vienna. 4 November 1998). (SRC)
[ ]**PEER REVIEWED**


Evidence for Carcinogenicity:
There is inadequate evidence in humans for the carcinogenicity of cesium-137. /Cesium/
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. V78 478 (2001)]**PEER REVIEWED**

There is sufficient evidence in experimental animals for the carcinogenicity of mixed beta-particle emitters (iodine-131, cesium-137, cerium-144 and radium-228). /Iodine, Cesium, Cerium, Radium/
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. V78 478 (2001)]**PEER REVIEWED**

Evaluation. There is sufficient evidence in humans for the carcinogenicity of X-radiation and gamma-radiation. There is sufficient evidence in experimental animals for the carcinogenicity of X-radiation and gamma-radiation. Overall evaluation. X-radiation and gamma-radiation are carcinogenic to humans (Group 1).
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. V75 304 (2000)]**PEER REVIEWED**


Human Toxicity Excerpts:
/SIGNS AND SYMPTOMS/ /ACUTE RADIATION SYNDROME/ Fifty persons involved in the cesium-137 accident in Goiania showed symptoms of whole-body and local acute irradiation and also external or internal contamination mainly due to ingestion or absorption of cesium-137. Fourteen of the 50 developed severe bone marrow depression characterized by neutropenia and thrombocytopenia. Eight of these 14 received GM-CSF intravenously. None were submitted to bone marrow transplantation. Four of the 14 died due to hemorrhage and infection. For those with significant internal contamination evaluated by in-vitro and in-vivo assays, Prussian Blue was administered with doses ranging from 1.5 to 10 g/day. Besides Prussian Blue, other measures were taken to increase decorporation of cesium-137, including administration of diuretics, water overload, and ergometric exercises. From 50 to 100 persons are being followed in a medical protocol. /Cesium-137/
[Brandao-Mello CE et al; Health Physics 60 (1): 31-9 (1991) ]**PEER REVIEWED**

/SIGNS AND SYMPTOMS/ /ACUTE RADIATION SYNDROME/ Approximately 250 individuals were exposed externally to an open 50.9 TBq (1,375 Ci) 137-cesium chloride radioactive source in Goiania, Brazil, in 1987. Many of these individuals also experienced oral and dermal exposure. The estimated absorbed doses ranged from 1 to 7 Gy (100 to 700 rad). The exposed individuals showed signs and symptoms of acute radiation syndrome including vomiting, diarrhea, and nausea, as well as skin lesions from radiation burns, orofacial lesions, ocular injury, hematological effects (bone marrow aplasia, leukopenia, thrombocytopenia, lymphopenia, neutropenia), mild elevations of some liver enzymes, and reduced sperm counts. Twenty individuals developed the acute radiation syndrome, 14 (70%) of whom developed bone marrow failure after having received whole-body radiation doses ranging from 1 to 7.0 Gy (100 to 700 rad). Four (29%) of these 14 individuals died. The adverse effects were the result of beta and gamma radiation, not cesium per se. /Cesium-137 chloride/
[ATSDR; Toxicological Profile for Cesium. Atlanta, GA: Agency for Toxic Substances and Disease Registry, US Public Health Service (2004) ]**PEER REVIEWED**

/CASE REPORTS/ /LIVER/ Mild elevations of aminotransferases (ALT/AST) were seen in a few patients hospitalized following radiation exposure to an opened cesium-137 chloride radioactive source in Goiania, Brazil, in 1987. /Cesium-137 chloride/
[DHHS/ATSDR; Toxicological Profile for Cesium p.38 (2004). Available from: www.atsdr.cdc.gov/toxprofiles/tp157.pdf as of November 30, 2005. ]**PEER REVIEWED**

/CASE REPORTS/ /ACUTE RADIATION SYNDROME/ On 13 September 1987, a radiation accident occurred in the city of Goiania in Central Brazil. Approximately 250 people were exposed to a cesium-137 source from an abandoned radiotherapy unit. At least 14 patients showed some degree of bone marrow depression, and eight developed the classical signs and symptoms of acute radiation syndrome (ARS). Twenty-eight people presented local radiation injuries ranging from first to third degree, and 104 individuals showed evidence of internal contamination. This paper describes the circumstances of the event, the first-aid measures taken, the criteria adopted for triage of the exposed population, and the radiation protection procedures used during the clinical management of the irradiated individuals. /Cesium-137/
[Oliveira AR et al; Health Physics 60 (1): 17-24 (1991) ]**PEER REVIEWED**

/CASE REPORTS/ /SKIN/ A case of child abuse involving industrial radiography sources has been reported ... . A petroleum engineer had possession of at least a 37GBq (1Ci) cesium-137 source used for oil and gas well logging. The dose rate at contact for such a source is approximately 5 Gy/min. One of the engineer's sons was subjected to various occasions in which "shiny silver pellets" were in the earpieces of headphones that he was told to wear, in a pillow he was told to use, and in a sock he found on his bed. It was also assumed that while under sedation, he was exposed at other times of which he was unaware. He was first seen by a family physician for what appeared to be bruises and reddish-brown blisters. These were assumed to be infections, but over succeeding weeks and months, new lesions appeared on the medial aspects of the thighs, right ankle, right hand, and left side of his forehead. ... Over the next 6 months, persistent, ulcerating lesions of the right thigh kept the child out of school. ... A plastic surgeon recognized the lesions as radiation necrosis. Both testes had been effectively destroyed, and the boy was functionally castrated. /Cesium-137/
[Gusev, I.A., Guskova, A.K., Mettler, F.A. (eds) Medical Management of Radiation Accidents. Second Edition. CRC Press. Boca Raton, FL. 2001, p. 224]**PEER REVIEWED**

/CASE REPORTS/ /ACUTE RADIATION SYNDROME/ In Tammiku, Estonia, in 1994, a cesium-137 source (a few terabecquerels) thought to have been part of an irradiator was disposed of as scrap metal. It was recovered and stored in a source store with limited security. The store was broken into and the source removed. Six people, exposed to varying degrees up to 4 Gy whole body, developed a variety of lesions. One localized exposure was up to 1,800 Gy and the person died. /Cesium-137/
[UNSCEAR; Sources and Effects of Ionizing Radiation - Volume I: Sources: UNSCEAR 2000 Report to the General Assembly, with Scientific Annex. United Nations Scientific Committee on the Effects of Atomic Radiation. NY, NY: United Nations (2000) ]**PEER REVIEWED**

/CASE REPORTS/ /SKIN/ Eleven frontier guards were exposed to one or more sources of cesium-137 with activities up to 150 GBq at the Lilo Training Center near Tbilisi, Georgia. The incident occurred over a period spanning 1996 and 1997. The sources were intended for training civil defense specialists or for calibration. Some of the sources had been removed from their containers, either still fixed in the source holder or separate from it. Information on the irradiation is incomplete, but it appears that at least one source was kept in the pocket of a coat. Each of the guards suffered from one or more acute localized irradiation lesions of varying seriousness; several suffered from nausea and vomiting. /Cesium-137/
[UNSCEAR; Sources and Effects of Ionizing Radiation - Volume I: Sources: UNSCEAR 2000 Report to the General Assembly, with Scientific Annex. United Nations Scientific Committee on the Effects of Atomic Radiation. NY, NY: United Nations (2000) ]**PEER REVIEWED**

/CASE REPORTS/ /ACUTE RADIATION SYNDROME/ In an accident involving the stealing and breaching of a radiotherapy source in Goiania, Brazil, 39 individuals had a high level of cesium-137 internal contamination. Prussian Blue was used, in doses that varied from 3-10 g/day for adults, to enhance the elimination of cesium-137 from the body. The total internal committed doses and the effect of Prussian Blue treatment for 15 contaminated adults involved in this accident have been evaluated in this paper. Prussian Blue caused dose reductions in the range of 51-84%, with an average of 71%. This reduction was shown to be independent of the dosage of Prussian Blue. ...
[Melo DR et al; Health Physics 66 (3): 245-52 (1994) ]**PEER REVIEWED**

/CASE REPORTS/ /ACUTE RADIATION SYNDROME/ In September 1987, the Goiania radiological accident involving a source of cesium-137 culminated in about 140 victims who presented internal and/or external contamination and/or external exposure to radiation and/or radiation burns. Internal contamination was verified through analysis of urine and fecal samples. Internal contamination was also evaluated by measurements performed at the whole-body counter installed in Goiania in November 1987. To enhance the decorporation of cesium-137, patients were treated with the following: 1) Prussian Blue, oral administration, in 46 patients; 2) diuretics, oral administration, in 17 patients; 3) induced perspiration, increasing cesium-137 elimination. These procedures were done under rigorous clinical evaluation and considering the data from assay of excreta and data obtained from the whole-body counter. The doses of Prussian Blue exceeded about 6.5 times the dose previously indicated in the literature. It was the first time diuretics were used in humans to treat cesium-137 internal contamination. The results of these procedures are discussed. /Cesium-137/
[Farina R et al; Health Physics 60 (1): 63-6 (1991) ]**PEER REVIEWED**

/CASE REPORTS/ /REPRODUCTIVE SYSTEM/ Spermatozoa were reduced or absent in the semen of nine males examined approximately 1 month following presumed acute radiation doses on the order of several hundred rad from an opened cesium-137 chloride radioactive source in Goiania, Brazil, in 1987. These individuals may have experienced mixed external, dermal, and oral exposure. /Cesium-137 chloride/
[DHHS/ATSDR; Toxicological Profile for Cesium p.40 (2004). Available from: www.atsdr.cdc.gov/toxprofiles/tp157.pdf as of November 30, 2005. ]**PEER REVIEWED**

/CASE REPORTS/ /EYE/ Among 20 patients hospitalized following mixed external and internal exposure to an opened cesium-137 chloride radioactive source in Goiania, Brazil, in 1987, a few patients complained of lacrimation, hyperemia and edema of the conjunctiva, and ocular pain. A few cases of protracted reduction in visual capacity were also reported, among which retinal injury was documented. In these cases, there was no change in lens transparency. These effects were due to the radiation, not to cesium per se. /Cesium-137 chloride /
[ATSDR; Toxicological Profile for Cesium. Atlanta, GA: Agency for Toxic Substances and Disease Registry, US Public Health Service (2004) ]**PEER REVIEWED**

/EPIDEMIOLOGY STUDIES/ More than 25,000 residents were exposed to external gamma radiation as well as internally from fission products (primarily from cesium-137, strontium-90, ruthenium-106, and zirconium-95) released into the Techa river from the nearby Mayak plutonium production facility, predominately in the early 1950s. Studies have been conducted of cancer mortality in residents and their offspring, as well as pregnancy outcomes. Initial dose estimates were based on average doses reconstructed for settlements. Efforts are ongoing to estimate individual doses for members of this resident cohort. To date, there is no evidence of a decrease in birth rate or fertility in the exposed population and no increased incidence of spontaneous abortions or stillbirths. There is some evidence of a statistically significant increase in total cancer mortality. Current estimates of the excess absolute risk (EAR) of leukemia in this cohort is 0.85 per 10,000 person-year Gy (95% confidence interval 0.2, 1.5), and for solid tumors the relative risk estimate is 0.65 per Gy (95% confidence interval -0.3, 1.0). Median dose estimates for soft tissue in this cohort are 7 mSv (maximum 456 mSv), and for bone marrow are 253 mSv (maximum 2021 mSv). Estimates of the relative risk for cancer of the esophagus, stomach and lung are similar to those reported for atomic bomb survivors. There is no evidence of an increase in cancer mortality in the offspring of exposed residents. There has also been one study of persons living in the town of Ozyorsk exposed to fallout from the nearby Mayak nuclear facility. An excess of thyroid cancer 3-4 times expected relative to rates for all of Russia has been observed. The excess is somewhat lower (1.5-2-fold higher) based on a comparison with Chelyabinsk Oblast rates. No estimates of radiation dose were included in this study. /Cesium-137, strontium-90, ruthenium-106, and zirconium-95 contamination/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII- Phase 2. p. 380 (2005) ]**PEER REVIEWED**

/EPIDEMIOLOGY STUDIES/ A few studies have investigated adult resident populations living in highly contaminated areas. ...The incidence of leukemia and lymphoma in the general population of the Bryansk region of Russia for the period 1979-1993 /was investigated/ using an ad hoc registry of hematological diseases established after the Chernobyl accident. The incidence rates in the 6 most contaminated districts (more than 37 kBq/sq m of cesium-137 deposition density) did not exceed the rates in the rest of the region or in Bryansk city, where the highest rates were observed. Comparisons of crude incidence rates before and after the accident (1979-1985 and 1986-1993) showed a significant increase in the incidence of all leukemia and non-Hodgkin lymphoma, but this was mainly due to increases in the older age groups in rural areas. The incidence of childhood leukemia and non-Hodgkin lymphoma was not significantly different in the 6 most contaminated areas from the incidence in the rest of the region. Similarly, ... no evidence of an increase in leukemia rates in the most contaminated areas of the Kaluga district of the Russian Federation /was found/ after the Chernobyl accident. In Ukraine, ...incidence rates for leukemia and lymphoma in the most highly contaminated areas of the Zhytomir and Kiev districts /were examined/ before and after the Chernobyl accident. Total incidence in adults increased from 5.1 per 100,000 during 1980-1985 to 11 per 100,000 person-years during 1992-1996 but there was no excess in contaminated areas of the regions. Similarly, ...the incidence of leukemia and lymphoma /was investigated/ in the three most contaminated regions of Ukraine. There was a steady increase in leukemia and lymphoma rates for both men and women between 1980 and 1993, but there was no evidence of a more pronounced increase after the accident. /Cesium-137 fallout/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII-Phase 2. p. 398 (2005) ]**PEER REVIEWED**

/EPIDEMIOLOGY STUDIES/ ...Reports have focused on changes in childhood leukemia rates before and after the accident in individual European countries and elsewhere. Overall, there was little evidence for an increase in rates of childhood leukemia in Ukraine, Belarus, Russia, Finland, Sweden, Greece, or a number of other countries from Central, Eastern and Southern Europe after the Chernobyl accident. Furthermore, there was no association between the extent of contamination /(primarily cesium-137)/ and the increase in risk in these countries. However, one Swedish study, reported a nonstatistically significant increase of /acute lymphoblastic leukemia/ (ALL) after the accident in children younger than five years old (OR=1.5, 95% confidence interval 0.8, 2.6). A small study in northern Turkey showed that in one pediatric cancer treatment center, more patients with ALL were seen after the accident than before, but no incidence rates were reported. There has been only one analytic (case-control) study of childhood leukemia reported based on cases identified among residents of the Rivno and Zhytomir oblasts in Ukraine. Cases were under age 20 at the time of the accident and were diagnosed between 1987 and 1997. Data were collected on 272 cases, however, the analysis was based on only 98 cases that were independently verified and interviewed. Controls were randomly selected fro the same oblasts, excluding the raion of residence of the case, and matched according to age at the time of the accident, sex, and type of settlement. The mean estimated dose to the bone marrow among study subjects was 4.5 mSv and the maximum was 101 mSv. the study found a statistically significant increased risk of acute leukemia among males with cumulative doses above 10 mSv and diagnosed form 1993-1997. A similar association was found for acute myeloid leukemia diagnosed in the period 1987-1992. Theses results should be interpreted cautiously, however, as they are based on approximately only one-third of the cases and a lesser proportion of controls, and it is not clear whether cases and controls were selected for dose estimation in an unbiased manner. /Cesium-137 fallout/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII-Phase 2. p. 397 (2005) ]**PEER REVIEWED**

/EPIDEMIOLOGY STUDIES/ Several studies have investigated the risk of leukemia in children exposed to Chernobyl fallout /(primarily cesium-137)/ while in utero. All are ecologic in design, and results are inconsistent. The initial study compared rates for temporal cohorts born during "exposed" and "unexposed" periods in Greece and found a 2.6-fold increase in leukemia risk and elevated rates for those born in regions with higher levels of radioactive fallout. However, the numbers of cases in each exposure group were small and the results could not be duplicated when a similar approach comparing areas with the same categories of contamination (<6 kBq/sq m, 6-10 kBq/sq m, >10 kBq/sq m) was applied to the analysis of data from the German Childhood Cancer Registry. In a study in Belarus, where levels of contamination are higher by a factor of ten or more, the results were similar to the Greed study but the trend was weaker. Nevertheless, although the findings are based on small number and are not statistically significant, the highest annual incidence rate was in 1987, the year after the accident, and the largest rate ratio (RR=1.51, 95% confidence interval 0.63, 3.61) was in the two most contaminated regions: Gomel and Mogilev. A more recent small study ... compared leukemia incidence during 1986 to 1996 among children born in 1986 and thus exposed in utero in Zhitomir, a contaminated region with children born in Poltava, a relatively uncontaminated region. The reported risk ratios based on cumulative incidence show significant increases for all leukemia (relative risk (RR)=2.7, 95% confidence interval 1.9, 3.8) and for the subtype of acute lymphoblastic leukemia (RR=3.4, 95% confidence interval 1.1, 10.4). The ongoing European Childhood Leukemia-Lymphoma Incidence Study (ECLIS) has evaluated the risk of leukemia by age using data from population-based cancer registries in Europe (including Belarus and Ukraine). Focusing on the risk of leukemia by age of diagnosis in 6 month intervals in relation to the estimated doses from the Chernobyl fallout received in utero, preliminary results suggest a small increase in risk in infant leukemia and leukemia diagnosed between 24-29 months. /Cesium-137 fallout/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII-Phase 2. p. 396-7 (2005) ]**PEER REVIEWED**

/EPIDEMIOLOGY STUDIES/ Fall-out from weapons testing in the 1950s and from the Chernobyl accident resulted in the ingestion of cesium-137 by Lapps who breed reindeer in the northern parts of the Nordic countries and the Russian Federation. In addition, small amounts of americium and plutonium were ingested by Lapps from contaminated reindeer. A cohort of 2034 Lapps who bred reindeer in Sweden or who were members of the households of breeders was assembled in 1960 and followed through mortality registries from 1961 through 1985. The rate of mortality from all causes was similar to that of the entire Swedish population: 428 deaths occurred, and the SMR was 0.95. A significantly lower mortality rate than expected was observed for all cancers (SMR, 0.70), and significantly decreased risks were found for cancers of the colon, respiratory organs, female breast, male genital organs and kidneys and for malignant lymphomas. The stomach was the only site for which a significantly increased risk for cancer was found (SIR, 2.25; 95% CI, 1.46-3.32) when compared with national rates. /Cesium-137 fallout/
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. V78 249 (2001)]**PEER REVIEWED**

/BIOMONITORING/ /GENOTOXICITY/ The results of... three post-Chernobyl studies (two in Belarus and one in Ukraine) and for the one conducted on the populations in the vicinity of the nuclear test site in Semipalatinsk (Kazakhstan) provide evidence that mutations at minisatellite loci can be induced by radiation in human germ cells. The dose-response relationships, however, remain uncertain because of considerable difficulties in the estimation of parental gonadal doses. For example, in the first Belarus study the level of surface contamination by cesium-137 was used as a broad dose measure, and the children of parents inhabiting heavily contaminate areas (>250 kBq/sq m) were found to have twice the frequency of mutations compared to those of parents from less contaminated areas (<250 kBq/sq m). In the second Belarus study (with more exposed families and more loci sampled), based on estimates of individual doses, two groups were defined <20 mSv and >20 mSv. The mutation frequency in the children from the latter group was 1.35 times that in the former and that from both groups was about 2-fold higher than in the unexposed U.K. controls. In the Ukraine study, a 1.6-fold increase in mutation rate in the exposed fathers but not in exposed mothers (both relative to unexposed controls) was found, but again, the dose-response relationship is uncertain. The authors noted that the dose from external chronic irradiation and internal exposures together were of the order of approx. 100 mSv (excluding short-lived isotopes). In the Semipalatinsk study, again, there was a 1.8-fold increase in the first generation progeny of parents receiving relatively high doses of radiation (cited as >1.0 Sv, but could have been lower or higher). In this study, through the use of three-generation families, the authors obtained evidence for a decline in mutation frequency as population doses decreased. /Cesium-137 fallout/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII-Phase 2. p. 200-1 (2005) ]**PEER REVIEWED**

/BIOMONITORING/ /GENOTOXICITY/ Following the Goiania radiation accident, lymphocytes from 110 exposed or potentially exposed individuals were analyzed for the frequencies of chromosomal aberrations (dicentrics and centric rings) to estimate absorbed radiation dose. Dose estimates for 21 subjects exceeded 1.0 Gy, and for eight subjects they exceeded 4.0 Gy. Four of the subjects died. After the emergency period, a cytogenetic follow-up of 10 of the highest exposed patients was started. The results suggest that the average disappearance half-time of lymphocytes containing dicentric and centric rings was 130 days, which is shorter than the usually accepted value of 3 yr reported in the literature. /Cesium-137 chloride/
[Ramalho AT, Nascimento ACH; Health Physics 60 (1): 67-70 (1991) ]**PEER REVIEWED**

/BIOMONITORING/ /GENOTOXICITY/ The current study comprises the analysis of mutations in 10 individuals accidentally exposed to cesium-137 during the 1987 radiological accident in Goiania, Brazil. Their exposures were among the highest experienced, ranging from 1 to 7 Gy. Peripheral T-lymphocyte samples were obtained 3.3 years after the original exposure and mutation was studied at the hprt locus using the 6-thioguanine-resistance selection assay. The mutational spectrum for the exposed population is comprised of 90 independent mutants. Based on T-cell receptor analysis, only 5% (5/95) were clonally related. Mutants were initially studied using RT-PCR and directly sequenced using an automated laser fluorescent DNA sequencer. Mutants that repeatedly failed to produce cDNAs were studied using a multiplex PCR assay with genomic DNA. Missense mutations were the most frequent event recovered, comprising 40% (23/57) of the spectral sample. An excess of events involving A:T base pairs was observed, exhibiting a significant difference (chi square = 12.7, P = 0.0004) when compared to the spontaneous spectrum. This finding may reflect the effect of ionizing radiation-induced damage, suggesting a potential similarity to radiation effects in prokaryotes. At the genomic level, 36.7% (33/90) of the mutants exhibited gross structural alterations, as detected by multiplex PCR. Deletion events were over-represented in our spectral sample, displaying a twofold increase when compared to the frequency observed in the spontaneous mutation database. /Cesium-137 chloride/
[da Cruz AD, Glickman BW; Environ Mol Mutagen 30 (4): 385-95 (1997) ]**PEER REVIEWED**

/BIOMONITORING/ /GENOTOXICITY/ Five years after the initial exposure to radioactive fallout from the Chernobyl accident of 1986, slightly greater frequencies of chromosomal aberrations were observed in peripheral blood lymphocytes of three groups of Byelorussian children (41 total) living in areas with ground contamination from cesium-137 fallout than in those of an Italian control group of 10 children. /Cesium-137 fallout/
[ATSDR; Toxicological Profile for Cesium. Atlanta, GA: Agency for Toxic Substances and Disease Registry, US Public Health Service (2004) ]**PEER REVIEWED**

/BIOMONITORING/ /GENOTOXICITY/ Results of multiyear cytogenetic study of children and teenagers living in areas, radioactive by contaminated after Chernobyl accident, were adduced. Mean density of cesium-137 contamination in two compared living areas were 111 and 200 kBq/sq m and mean external doses accumulated for 1986-2001 were 6.7 and 11.4 mGy correspondingly. Averaged thyroid doses received by subjects of all age groups in the second area were approximately 1.5 times higher than in the first area; in the youngest group (0-1 year) the doses were 114.3 and 174.3 mGy. During 17 years cytogenetic investigation approximately from 30% to 60% of examined persons were observed the increased level of chromosome aberrations in lymphocytes of peripheral blood. Average frequency of unstable aberrations (acentrics, dicentrics and centric rings) constituted about 0.4 per 100 cells (0.22 per 100 cells in controls) during all period of observation. Level of marker aberrations (dicentrics and centric rings) was increased almost all times of study and varied within 0.04-0.19 per 100 cell (0.03 in control group). The parallel investigation of frequency of stable aberrations by FISH method showed up their level about 3 times exceeding observed dicentrics level. Comparably higher indexes of cytogenetic disturbances were revealed in group exposed in utero during period of accident. /Cesium-137 fallout/
[Sevan'kaev AV et al; Radiats Biol Radioecol 45 (1): 5-15 (2005) ]**PEER REVIEWED** PubMed Abstract

/BIOMONITORING/ /GENOTOXICITY/ Chromosome analysis of peripheral lymphocytes from two Norwegian populations (44 reindeer herding South samis from Roros and Snasa, 12 sheep farmers from Valdres) exposed to fallout from the Chernobyl accident were made. The doses from cesium through the years 1987-1991 were calculated based on whole-body measurements of cesium-134 and cesium-137 giving a total cumulative mean internal dose of 5.54 mSv for the total group of 56 persons. Chromosome aberrations were within the normal range when compared with historical controls with the exception of dicentrics (0.3% per cell, which is a 10-fold increase) and rings (0.07% per cell). A dose-dependent increase in dicentrics and rings based on cesium exposure was not observed.
[Brogger A et al; Mutat Res 361 (2-3): 73-9 (1996) ]**PEER REVIEWED**

/BIOMONITORING/ /GENOTOXICITY/ Fluorescence in situ hybridization (FISH) is a powerful method largely used for detecting chromosomal rearrangements, translocations in particular, which are important biomarkers for dose assessment in case of human exposure to ionizing radiation. To test the possibility of using the translocation analysis by FISH-painting method in retrospective dose assessment, /the authors/ carried out in vitro experiments in irradiated human lymphocytes, in parallel with the analysis of translocations in lymphocytes from 10 individuals, who were exposed to cesium-137 in the Goiania (Brazil) accident (samples collected 10 years after exposure). The in vitro dose-response curve for the genomic translocation frequencies (FGs) fits a linear quadratic model, according to the equation: Y=0.0243X(2)+0.0556X. The FG values were also calculated for the individuals exposed to cesium-137, ranging from 0.58 to 5.91 per 100 cells, and the doses were estimated and compared with the results obtained by dicentric analysis soon after the accident, taking the opportunity to test the validity of translocation analysis in retrospective biodosimetry. A tentative of retrospective dosimetry was performed, indicating that the method is feasible only for low level exposure (below 0.5 Gy), while for higher doses there is a need to apply appropriate correction factors, which take into consideration mainly the persistence of chromosomal translocations along with time, and the influence of endogenous and exogenous factors determining the inter-individual variability in the cellular responses to radiation.
[Camparoto ML et al; Mutat Res 530 (1-2): 1-7 (2003) ]**PEER REVIEWED**

/OTHER TOXICITY INFORMATION/ /SKIN/ The external dose from cesium radionuclides arises primarily from the penetrating gamma rays that travel great distances in air. Beta radiation emitted outside the body is normally of little health concern unless the radioactive material contacts the skin. Skin contact can allow the beta radiation to pass through the epidermis to live dermal tissue where it becomes a major contributor to a radiocesium-generated radiation dose to the skin. At very high doses, the beta and gamma radiation can cause such adverse effects as erythema, ulceration, or even tissue necrosis. /Cesium radionuclides/
[DHHS/ATSDR; Toxicological Profile for Cesium p.20 (2004). Available from: www.atsdr.cdc.gov/toxprofiles/tp157.pdf as of November 30, 2005. ]**PEER REVIEWED**

/OTHER TOXICITY INFORMATION/ /ENDOCRINE SYSTEM/ ...Relatively little has been published regarding thyroid outcomes other than thyroid cancer, although one study has reported an elevated risk of benign thyroid tumors. There have been reports of increases in autoimmune disease and antithyroid antibodies following childhood exposure to Chernobyl. However, a study by the Sasakawa Foundation which screened 114,000 children found no association between a surrogate for thyroid dose (cesium-137) and thyroid antibodies, hypothyroidism, hyperthyroidism, or goiter. /Cesium-137/
[NAS/BRER; Health Risks from Exposure to Low Levels of Ionizing Radiation BEIR VII-Phase 2. p. 396 (2005) ]**PEER REVIEWED**


Populations at Special Risk:
Dose rate, i.e., the time over which a radiation dose is delivered, may influence risk in a variety of ways. In experimental animals, the risk per unit dose is usually greater at higher dose rates, for the same cumulative dose of low-LET radiation.
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. V75 226 (2000)]**PEER REVIEWED**


Probable Routes of Human Exposure:
Exposure to radioactive cesium is more important from a health perspective than exposure to stable cesium(1). Current exposure of the general US population to cesium-134 and cesium-137 is expected to be low since atmospheric testing nuclear weapons has been discontinued for many years and Chernobyl-related fallout was low in the US(1).
[(1) ATSDR; Toxicological Profile for Cesium (Draft for Public Comment). Atlanta, GA; ATSDR (2001) ]**PEER REVIEWED**


Toxicity Summary:
TOXICITY SUMMARY: The element cesium exists in several forms known as isotopes. In nature, cesium exists only as a non-radioactive (or stable) isotope known as cesium-133 (Cs-133); however, there exist several cesium isotopes that are radioactive. The radioactive isotopes of cesium are formed during nuclear fission, in commercial applications such as the generation of electricity at nuclear power plants. The most important cesium isotopes in terms of their potential effects on human health are cesium-134 (Cs-134) and cesium-137 (Cs-137). In this summary, the most pertinent information on the radiation toxicity of Cs-134 and Cs-137 are presented. Both Cs-137 and Cs-134 emit beta radiation and gamma radiation. Beta radiation travels short distances and can penetrate the skin and superficial body tissues while gamma radiation can travel great distances and penetrate the entire body. The radiation dose from these radionuclides can be classified as either external (if the radiation source is outside the body) or internal (if the radiation source is inside the body). Beta radiation emitted outside the body is normally of little health concern unless the radioactive material contacts the skin. Skin contact can allow the beta radiation to pass through the epidermis to live dermal tissue where it becomes a major contributor to the radiation dose to the skin. Beta and gamma radiation may induce tissue damage and disruption of cellular function. The half-lives of Cs-134 and Cs-137 are approximately 2 years and 30 years, respectively. Because of the continual emission of radiation, people could be exposed to radiation from Cs-137 or Cs-134 released to the environment. High levels of Cs-134 and Cs-137 have been released to the environment from nuclear weapons testing and incidents such as the 1986 accident at the Chernobyl nuclear reactor in Ukraine. In these cases, cesium was one of many radionuclides present in the release. It is, thus, not possible to ascribe any of the observed health effects to radioactive cesium specifically. There are, however, documented reports of health effects in humans exposed to radioactive cesium. These reports arise from the accidental exposure of civilians to Cs-137 sources in Goiania, Brazil, in 1987 and Tammiku, Estonia, in 1994 and from the exposure of military personnel to Cs-137 during 1996 and 1997 in Lilo, Republic of Georgia. External and internal exposures of humans to radiocesium have resulted in a spectrum of adverse health effects that range from nausea to death. In 1987, approximately 250 persons, including children, were exposed externally and internally to radiation from a scavenged medical source with an activity of 50.9 TBq (1,375 Ci) 137-CsCl. Some of the exposed individuals showed signs of acute radiation syndrome, such as nausea, vomiting, and diarrhea. A large number of the individuals with acute radiation syndrome developed bone marrow failure and 4 of these died. Dermal injuries observed among the exposed individuals ranged from radiation dermatitis to severe radiation injuries leading to an amputation. Ocular and reproductive effects were also reported. Two incidents of external exposure to radiation from Cs-137 have demonstrated that serious adverse effects may also be expected when individuals are exposed only externally to high levels of radiation from Cs-137. In 1997 it was discovered that military recruits had been accidentally exposed to several sealed Cs-137 radioactive sources at a training facility in Lilo, Republic of Georgia. Nausea, weakness, headaches, and loss of appetite were the most commonly reported symptoms among the exposed recruits. Vomiting was reported by three of the patients, two of whom received the highest estimated doses. The exposures of the recruits occurred over several months. Although accurate information on the duration of the exposure was not available, doses were estimated by scoring unstable chromosome aberrations in peripheral blood lymphocytes and by electron spin resonance dosimetry of teeth of the exposed individuals. The estimated mean doses ranged from 0.2 to 5.9 Gy (The radiological event at Lilo. International Atomic Energy Agency (2000). Vienna). In 1994, several individuals (aged 13 to 78) were exposed to a sealed Cs-137 source stolen from a waste repository in Tammiku, Estonia. The observed health effects in the exposed individuals ranged from a relatively mild case of radiation sickness to death. Solid state dosimetry techniques were applied for reconstruction of the doses of several individuals exposed in the house where the stolen Cs-137 source was kept. The estimated whole body radiation doses ranged from 0.1 Gy to 4 Gy. The individual with the highest estimated whole body dose also had an estimated localized radiation exposure to the thigh of 1,830 Gy. The latter individual died 12 days after the initial exposure event. The survivors showed dermal effects and effects in blood. A 13-year old male was the most exposed among the survivors (estimated whole-body dose of 1.5-5.5 Gy). He suffered severe and prolonged bone marrow aplasia and radiation burns. (The Radiological Accident in Tammiku (1998). The International Atomic Energy Agency, Vienna. 4 November 1998). (SRC)
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Evidence for Carcinogenicity:
There is inadequate evidence in humans for the carcinogenicity of cesium-137. /Cesium/
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work)., p. V78 478 (2001)]**PEER REVIEWED**

There is sufficient evidence in experimental animals for the carcinogenicity of mixed beta-particle emitters (iodine-131, cesium-137, cerium-144 and radium-228). /Iodine, Cesium, Cerium, Radium/
[IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man. Geneva: World Health Or