3.2.3
Dermal Exposure...................................................................................................................65
3.2.3.1
Death..............................................................................................................................65
3.2.3.2
Systemic Effects.............................................................................................................65
3.2.3.3
Immunological and Lymphoreticular Effects ................................................................65
3.2.3.4
Neurological Effects ......................................................................................................65
3.2.3.5
Reproductive Effects......................................................................................................65
3.2.3.6
Developmental Effects...................................................................................................65
3.2.3.7
Cancer ............................................................................................................................65
3.2.4
Other Routes of Exposure .....................................................................................................65
3.3 GENOTOXICITY ........................................................................................................................66
3.4 TOXICOKINETICS.....................................................................................................................72
3.4.1
Absorption.............................................................................................................................72
3.4.1.1
Inhalation Exposure .......................................................................................................72
3.4.1.2
Oral Exposure ................................................................................................................75
3.4.1.3
Dermal Exposure ...........................................................................................................77
3.4.2
Distribution ...........................................................................................................................78
3.4.2.1
Inhalation Exposure .......................................................................................................78
3.4.2.2
Oral Exposure ................................................................................................................83
3.4.2.3
Dermal Exposure ...........................................................................................................83
3.4.2.4
Other Routes of Exposure..............................................................................................83
3.4.3
Metabolism............................................................................................................................84
3.4.4
Elimination and Excretion.....................................................................................................84
3.4.4.1
Inhalation Exposure .......................................................................................................85
3.4.4.2
Oral Exposure ................................................................................................................87
3.4.4.3
Dermal Exposure ...........................................................................................................87
3.4.4.4
Other Routes of Exposure..............................................................................................87
3.4.5
Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models .............88
3.5 MECHANISMS OF ACTION ...................................................................................................118
3.5.1
Pharmacokinetic Mechanisms.............................................................................................118
3.5.2
Mechanisms of Toxicity......................................................................................................122
3.5.3
Animal-to-Human Extrapolations.......................................................................................123
3.6 TOXICITIES MEDIATED THROUGH THE NEUROENDOCRINE AXIS...........................124
3.7 CHILDREN’S SUSCEPTIBILITY............................................................................................125
3.8 BIOMARKERS OF EXPOSURE AND EFFECT .....................................................................127
3.8.1
Biomarkers Used to Identify or Quantify Exposure to Plutonium......................................128
3.8.2
Biomarkers Used to Characterize Effects Caused by Plutonium........................................128
3.9 INTERACTIONS WITH OTHER CHEMICALS .....................................................................129
3.10
POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE ............................................132
3.11
METHODS FOR REDUCING TOXIC EFFECTS................................................................133
3.11.1
Reducing Peak Absorption Following Exposure.............................................................134
3.11.2
Reducing Body Burden ...................................................................................................134
3.11.3
Interfering with the Mechanism of Action for Toxic Effects ..........................................135
3.12
ADEQUACY OF THE DATABASE.....................................................................................135
3.12.1
Existing Information on Health Effects of Plutonium.....................................................136
3.12.2
Identification of Data Needs............................................................................................138
3.12.3
Ongoing Studies ..............................................................................................................144
4.
CHEMICAL, PHYSICAL, AND RADIOLOGICAL INFORMATION.............................................145
4.1 CHEMICAL IDENTITY............................................................................................................ 145
4.2 PHYSICAL, CHEMICAL, AND RADIOLOGICAL PROPERTIES .......................................145
xvi
PLUTONIUM