Plutonium, that horrendously potent cancer-causing substance, is viewed more benignly in some governmental and industrial circles. The Nuclear Regulatory Commission is proposing to license wide-scale use of plutonium-powered heart pacemakers.
There are more than 100,000 conventional or non-nuclear pacemakers implanted in Americans, and the market is growing rapidly. Companies wanting to manufacture the plutonium pacemaker are pressing the NRC for approval.
They claim their pacemaker will operate longer than conventional types and that any radiation risk to the patient or progeny is acceptable.
SCIENTIFIC and medical critics filing comments with the NRC disagree. They are especially critical of the NRC’s environmental impact statement as overly optimistic as to the superiority of this pacemaker and too neglectful of the hazards. Any use of plutonium, a tiny 0.2 micrograms of which has given lung cancer to animals, must be viewed with utmost caution.
It was only two years ago that an independent panel of specialists advised the National Heart and Lung Institute against even the experimental use of an artificial heart with an implantable plutonium-powered pump.
Containing SO grams of plutonium, such an artificial heart would pose risks to bystanders as well as patients. One scientist commented that he would not want to sit between two people with such plutonium pumps for any length of time.
The proposed pacemaker contains less of the toxic plutonium —about 5OO milligrams of plutonium of the 238 variety, which is not weapons-grade.
BUT CRITICS, such as as Dr. Dean Abrahamson of the University of Minnesota, say the latest non-nuclear pacemakers will do just as good a job without such hazardous shortcomings. Dr. Abrahamson cites several studies of patients with conventional pacemakers to rebut the NRC position that a plutonium design will save lives on the operating table.
Prof. Donald Geesaman, a leading authority on plutonium, believes that the radiation dose to patients (particularly younger, more susceptible patients), is a cumulative exposure that is unacceptable even if the device operates without any disintegration.
The NRC’s environmental impact statement did not consider the effects of production and disposal of the pacer. The Oil, Chemical and Atomic Workers Union wants to know why the statements ignored the potential effects to the people who would fabricate these units.
In the commission’s benefit-risk comparison, advanced conventional pacers with comparable durability and much greater clinical testing than the plutonium pacemaker were not adequately discussed as alternatives. Moreover, all pacers have a common limitation in their electrodes and wires.
PROF. Karl Z. Morgan, a prominent health physicist now at the Georgia Institute of Technology, advises stronger safeguards for any future user of plutonium pacemakers than those proposed by the NRC.
For example, he recommends that patients with radioactive pacers be tattooed for any emergency identification. An ID card or bracelet, he feels, would be inadequate. Dr. Abrahamson thinks younger patients of child-bearing age would be well-advised not to become parents.
Should the NRC go ahead and license these pacemakers, licensing requests for other similarly powered products like plutonium-heated diving suits, plutonium-powered coffee-makers or wristwatches may not be far behind.
SEVERAL YEARS ago I heard a pro-nuclear power scientist say that citizens must be given a stake in nuclear power if that technology were to flourish. Plutonium-powered consumer products as well as plutonium recycling for electric generating plants makes this indeed a macabre vision.
For more information on these pacemakers, send a self-addressed, stamped envelope to Health Research Group, P.O. Box 19404, Washington, D.C. 20036.