Chronic radium intoxication: radium osteonecrosis and cancer in relation to 226Ra burdens

Histologic examination of 35 femora from 25 New Jersey radium workers with measured preterminal 226Ra burdens between background levels (less than or equal to 0.0042) and 1.78 muCi demonstrated that 10 of the 11 whose burdens exceeded background had radium osteonecrosis, including 6 of 7 whose burdens were above background levels but below 0.1 muCi. Ten of 16 cases with radium osteonecrosis had cancer as did 5 of 9 who did not have radium osteonecrosis. The number of cases is too small to be confident of any association between bone necrosis and cancer, but the presence of changes consistent with radium osteonecrosis in 6 of 14 radium workers whose 226Ra burdens could not be measured above background levels is disturbing.