TOXICOLOGICAL PROFILE FOR 

CESIUM 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Public Health Service 

Agency for Toxic Substances and Disease Registry
 

April 2004 
CESIUM ii 

DISCLAIMER 

The use of company or product name(s) is for identification only and does not imply endorsement by the 

Agency for Toxic Substances and Disease Registry. 
CESIUM iii 

UPDATE STATEMENT 

A Toxicological Profile for Cesium, Draft for Public Comment was released in July 2001. This edition 

supersedes any previously released draft or final profile. 

Toxicological profiles are revised and republished as necessary. For information regarding the update 

status of previously released profiles, contact ATSDR at: 

Agency for Toxic Substances and Disease Registry
 

Division of Toxicology/Toxicology Information Branch 

1600 Clifton Road NE, 

Mailstop E-32 

Atlanta, Georgia 30333 


vi 

Background Information 

The toxicological profiles are developed by ATSDR pursuant to Section 104(i) (3) and (5) of the 

Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA or 

Superfund) for hazardous substances found at Department of Energy (DOE) waste sites. CERCLA 

directs ATSDR to prepare toxicological profiles for hazardous substances most commonly found at 

facilities on the CERCLA National Priorities List (NPL) and that pose the most significant potential threat 

to human health, as determined by ATSDR and the EPA. ATSDR and DOE entered into a Memorandum 

of Understanding on November 4, 1992 which provided that ATSDR would prepare toxicological profiles 

for hazardous substances based upon ATSDR=s or DOE=s identification of need. The current ATSDR 

priority list of hazardous substances at DOE NPL sites was announced in the Federal Register on July 24, 

1996 (61 FR 38451). 
CESIUM vii 

QUICK REFERENCE FOR HEALTH CARE PROVIDERS 

Toxicological Profiles are a unique compilation of toxicological information on a given hazardous 

substance. Each profile reflects a comprehensive and extensive evaluation, summary, and interpretation 

of available toxicologic and epidemiologic information on a substance. Health care providers treating 

patients potentially exposed to hazardous substances will find the following information helpful for fast 

answers to often-asked questions. 

Primary Chapters/Sections of Interest 

Chapter 1: Public Health Statement: The Public Health Statement can be a useful tool for educating 

patients about possible exposure to a hazardous substance. It explains a substance’s relevant toxicologic 

properties in a nontechnical, question-and-answer format, and it includes a review of the general health 

effects observed following exposure. 

Chapter 2: Relevance to Public Health: The Relevance to Public Health Section evaluates, interprets, 

and assesses the significance of toxicity data to human health. 

Chapter 3: Health Effects: Specific health effects of a given hazardous compound are reported by type 

of health effect (death, systemic, immunologic, reproductive), by route of exposure, and by length of 

exposure (acute, intermediate, and chronic). In addition, both human and animal studies are reported in 

this section. 

NOTE: Not all health effects reported in this section are necessarily observed in the clinical setting. 

Please refer to the Public Health Statement to identify general health effects observed following exposure. 

Pediatrics: Four new sections have been added to each Toxicological Profile to address child health 

issues: 

Section 1.6 How Can (Chemical X) Affect Children? 

Section 1.7 How Can Families Reduce the Risk of Exposure to (Chemical X)? 

Section 3.8 Children’s Susceptibility 

Section 6.6 Exposures of Children 

Other Sections of Interest: 

Section 3.9 Biomarkers of Exposure and Effect 

Section 3.12 Methods for Reducing Toxic Effects 

ATSDR Information Center 

Phone: 1-888-42-ATSDR or (404) 498-0110 Fax: (770) 488-4178 

E-mail: atsdric@cdc.gov Internet: http://www.atsdr.cdc.gov 

The following additional material can be ordered through the ATSDR Information Center: 

Case Studies in Environmental Medicine: Taking an Exposure History—The importance of taking an 

exposure history and how to conduct one are described, and an example of a thorough exposure 

history is provided. Other case studies of interest include Reproductive and Developmental 

Hazards; Skin Lesions and Environmental Exposures; Cholinesterase-Inhibiting Pesticide 

Toxicity; and numerous chemical-specific case studies. 
CESIUM viii 

Managing Hazardous Materials Incidents is a three-volume set of recommendations for on-scene 

(prehospital) and hospital medical management of patients exposed during a hazardous materials 

incident. Volumes I and II are planning guides to assist first responders and hospital emergency 

department personnel in planning for incidents that involve hazardous materials. Volume III— 

Medical Management Guidelines for Acute Chemical Exposures—is a guide for health care 

professionals treating patients exposed to hazardous materials. 

Fact Sheets (ToxFAQs) provide answers to frequently asked questions about toxic substances. 

Other Agencies and Organizations 

The National Center for Environmental Health (NCEH) focuses on preventing or controlling disease, 

injury, and disability related to the interactions between people and their environment outside the 

workplace. Contact: NCEH, Mailstop F-29, 4770 Buford Highway, NE, Atlanta, GA 30341­

3724 • Phone: 770-488-7000 • FAX: 770-488-7015. 

The National Institute for Occupational Safety and Health (NIOSH) conducts research on occupational 

diseases and injuries, responds to requests for assistance by investigating problems of health and 

safety in the workplace, recommends standards to the Occupational Safety and Health 

Administration (OSHA) and the Mine Safety and Health Administration (MSHA), and trains 

professionals in occupational safety and health. Contact: NIOSH, 200 Independence Avenue, 

SW, Washington, DC 20201 • Phone: 800-356-4674 or NIOSH Technical Information Branch, 

Robert A. Taft Laboratory, Mailstop C-19, 4676 Columbia Parkway, Cincinnati, OH 45226-1998 

• Phone: 800-35-NIOSH. 

The National Institute of Environmental Health Sciences (NIEHS) is the principal federal agency for 

biomedical research on the effects of chemical, physical, and biologic environmental agents on 

human health and well-being. Contact: NIEHS, PO Box 12233, 104 T.W. Alexander Drive, 

Research Triangle Park, NC 27709 • Phone: 919-541-3212. 

Radiation Emergency Assistance Center/Training Site (REAC/TS) provides support to the U.S. 

Department of Energy, the World Health Organization, and the International Atomic Energy 

Agency in the medical management of radiation accidents. A 24-hour emergency response 

program at the Oak Ridge Institute for Science and Education (ORISE), REAC/TS trains, 

consults, or assists in the response to all kinds of radiation accidents. Contact: Oak Ridge 

Institute for Science and Education, REAC/TS, PO Box 117, MS 39, Oak Ridge, TN 37831-0117 

• Phone 865-576-3131 • FAX 865-576-9522 • 24-Hour Emergency Phone 865-576-1005 (ask for 

REAC/TS) • e-mail: cooleyp@orau.gov • website (including emergency medical guidance): 

http://www.orau.gov/reacts/default.htm 

Referrals 

The Association of Occupational and Environmental Clinics (AOEC) has developed a network of clinics 

in the United States to provide expertise in occupational and environmental issues. Contact: 

AOEC, 1010 Vermont Avenue, NW, #513, Washington, DC 20005 • Phone: 202-347-4976 • 

FAX: 202-347-4950 • e-mail: AOEC@AOEC.ORG • Web Page: http://www.aoec.org/. 
CESIUM ix 

The American College of Occupational and Environmental Medicine (ACOEM) is an association of 

physicians and other health care providers specializing in the field of occupational and 

environmental medicine. Contact: ACOEM, 55 West Seegers Road, Arlington Heights, IL 

60005 • Phone: 847-818-1800 • FAX: 847-818-9266. 

CESIUM xi 

CONTRIBUTORS 

CHEMICAL MANAGER(S)/AUTHOR(S): 

Malcolm Williams, Ph.D. 

ATSDR, Division of Toxicology, Atlanta, GA 

David W. Wohlers, Ph.D. 

Mario Citra, Ph.D. 

Gary L. Diamond, Ph.D. 

Stephen G. Swarts, Ph.D. 

Syracuse Research Corporation, North Syracuse, NY 

THE PROFILE HAS UNDERGONE THE FOLLOWING ATSDR INTERNAL REVIEWS: 

1. Health Effects Review. The Health Effects Review Committee examines the health effects chapter 

of each profile for consistency and accuracy in interpreting health effects and classifying end points. 

2.	 Minimal Risk Level Review. The Minimal Risk Level Workgroup considers issues relevant to 

substance-specific Minimal Risk Levels (MRLs), reviews the health effects database of each profile, 

and makes recommendations for derivation of MRLs. 

3. Data Needs Review. The Research Implementation Branch reviews data needs sections to assure 

consistency across profiles and adherence to instructions in the Guidance. 

CESIUM	 xiii 

PEER REVIEW 

A peer review panel was assembled for cesium. The panel consisted of the following members: 

1. Ranjan Bose, M.B.B.S., M.D., New Substances Assessment and Controls Bureau, Health Canada, 

Ottawa, Ontario, Canada; 

2. Darrell Fisher, Ph.D., Senior Scientist, Pacific Northwest National Laboratory, Richland, 

Washington; 

3.	 Richard Leggett, Ph.D., Life Sciences Division, Oak Ridge National Laboratory, Oak Ridge, 

Tennessee; 

4.	 Bruce Muggenburg, D.V.M., Ph.D., Senior Scientist and Veterinary Physiologist, Toxicology 

Division, Lovelace Respiratory Research Institute, Albuquerque, New Mexico; 

5. Herman Cember, C.H.P., Ph.D., P.E., Adjunct Professor, School of Health Sciences, Purdue 

University, Lafayette, Indiana; and 

6. Marvin Goldman, Ph.D., Professor Emeritus of Radiation Biology, Department of Surgical and 

Radiological Sciences, University of California, Davis, California. 

These experts collectively have knowledge of cesium's physical and chemical properties, toxicokinetics, 

key health end points, mechanisms of action, human and animal exposure, and quantification of risk to 

humans. All reviewers were selected in conformity with the conditions for peer review specified in 

Section 104(I)(13) of the Comprehensive Environmental Response, Compensation, and Liability Act, as 

amended. 

Scientists from the Agency for Toxic Substances and Disease Registry (ATSDR) have reviewed the peer 

reviewers' comments and determined which comments will be included in the profile. A listing of the 

peer reviewers' comments not incorporated in the profile, with a brief explanation of the rationale for their 

exclusion, exists as part of the administrative record for this compound. A list of databases reviewed and 

a list of unpublished documents cited are also included in the administrative record. 

The citation of the peer review panel should not be understood to imply its approval of the profile's final 

content. The responsibility for the content of this profile lies with the ATSDR. 

CESIUM	 xv 

CONTENTS 

DISCLAIMER ..............................................................................................................................................ii 

UPDATE STATEMENT .............................................................................................................................iii 

FOREWORD ................................................................................................................................................v 

QUICK REFERENCE FOR HEALTH CARE PROVIDERS....................................................................vii 

CONTRIBUTORS.......................................................................................................................................xi 

PEER REVIEW .........................................................................................................................................xiii 

CONTENTS................................................................................................................................................xv 

LIST OF FIGURES ...................................................................................................................................xix 

LIST OF TABLES.....................................................................................................................................xxi 

1. PUBLIC HEALTH STATEMENT..........................................................................................................1 

1.1 WHAT IS CESIUM?...................................................................................................................2 

1.2 WHAT HAPPENS TO CESIUM WHEN IT ENTERS THE ENVIRONMENT? .....................3 

1.3 HOW MIGHT I BE EXPOSED TO CESIUM? ..........................................................................4 

1.4 HOW CAN CESIUM ENTER AND LEAVE MY BODY? .......................................................5 

1.5 HOW CAN CESIUM AFFECT MY HEALTH? ........................................................................5 

1.6 HOW CAN CESIUM AFFECT CHILDREN? ...........................................................................6 

1.7 HOW CAN FAMILIES REDUCE THE RISK OF EXPOSURE TO CESIUM? .......................7 

1.8 IS THERE A MEDICAL TEST TO DETERMINE WHETHER I HAVE BEEN EXPOSED 

 TO CESIUM?..............................................................................................................................7 

1.9 WHAT RECOMMENDATIONS HAS THE FEDERAL GOVERNMENT MADE TO 

PROTECT HUMAN HEALTH?.................................................................................................7 

1.10 WHERE CAN I GET MORE INFORMATION?...................................................................9 

2. RELEVANCE TO PUBLIC HEALTH .................................................................................................11 

2.1 BACKGROUND AND ENVIRONMENTAL EXPOSURES TO CESIUM IN THE UNITED 

STATES ....................................................................................................................................11 

2.2 SUMMARY OF HEALTH EFFECTS......................................................................................12 

2.3 MINIMAL RISK LEVELS .......................................................................................................16 

3. HEALTH EFFECTS..............................................................................................................................19 

3.1 INTRODUCTION.....................................................................................................................19 

3.2 DISCUSSION OF HEALTH EFFECTS OF STABLE CESIUM BY ROUTE OF 

EXPOSURE ..............................................................................................................................24 

3.2.1 Inhalation Exposure ..........................................................................................................25 

3.2.1.1 Death............................................................................................................................25 

3.2.1.2 Systemic Effects...........................................................................................................25 

3.2.1.3 Immunological and Lymphoreticular Effects ..............................................................25 

3.2.1.4 Neurological Effects ....................................................................................................25 

3.2.1.5 Reproductive Effects....................................................................................................25 

3.2.1.6 Developmental Effects.................................................................................................26 

3.2.1.7 Cancer ..........................................................................................................................26 

3.2.2 Oral Exposure ................................................................................................................... 26 

3.2.2.1 Death............................................................................................................................26 

3.2.2.2 Systemic Effects...........................................................................................................26 

3.2.2.3 Immunological and Lymphoreticular Effects ..............................................................28 

3.2.2.4 Neurological Effects ....................................................................................................29 
CESIUM	 xvi 

3.2.2.5 Reproductive Effects....................................................................................................29 

3.2.2.6 Developmental Effects.................................................................................................29 

3.2.2.7 Cancer ..........................................................................................................................30 

3.2.3 Dermal Exposure ..............................................................................................................30 

3.2.3.1 Death............................................................................................................................30 

3.2.3.2 Systemic Effects...........................................................................................................30 

3.2.3.3 Immunological and Lymphoreticular Effects ..............................................................31 

3.2.3.4 Neurological Effects ....................................................................................................31 

3.2.3.5 Reproductive Effects....................................................................................................31 

3.2.3.6 Developmental Effects.................................................................................................31 

3.2.3.7 Cancer ..........................................................................................................................31 

3.2.4 Other Routes of Exposure.................................................................................................31 

3.2.4.1 Death............................................................................................................................31 

3.2.4.2 Systemic Effects...........................................................................................................32 

3.2.4.3 Immunological and Lymphoreticular Effects ..............................................................32 

3.2.4.4 Neurological Effects ....................................................................................................32 

3.2.4.5 Reproductive Effects....................................................................................................32 

3.2.4.6 Developmental Effects.................................................................................................32 

3.2.4.7 Cancer ..........................................................................................................................32 

3.3 DISCUSSION OF HEALTH EFFECTS OF RADIOACTIVE CESIUM BY ROUTE OF 

EXPOSURE ..............................................................................................................................32 

3.3.1 Inhalation Exposure ..........................................................................................................33 

3.3.1.1 Death............................................................................................................................33 

3.3.1.2 Systemic Effects...........................................................................................................34 

3.3.1.3 Immunological and Lymphoreticular Effects ..............................................................34 

3.3.1.4 Neurological Effects ....................................................................................................35 

3.3.1.5 Reproductive Effects....................................................................................................35 

3.3.1.6 Developmental Effects.................................................................................................35 

3.3.1.7 Cancer ..........................................................................................................................35 

3.3.2 Oral Exposure ...................................................................................................................36 

3.3.2.1 Death............................................................................................................................36 

3.3.2.2 Systemic Effects...........................................................................................................37 

3.3.2.3 Immunological and Lymphoreticular Effects ..............................................................39 

3.3.2.4 Neurological Effects ....................................................................................................39 

3.3.2.5 Reproductive Effects....................................................................................................40 

3.3.2.6 Developmental Effects.................................................................................................43 

3.3.2.7 Cancer ..........................................................................................................................43 

3.3.3 External Exposure.............................................................................................................43 

3.3.3.1 Death............................................................................................................................44 

3.3.3.2 Systemic Effects...........................................................................................................44 

3.3.3.3 Immunological and Lymphoreticular Effects ..............................................................45 

3.3.3.4 Neurological Effects ....................................................................................................45 

3.3.3.5 Reproductive Effects....................................................................................................45 

3.3.3.6 Developmental Effects.................................................................................................46 

3.3.3.7 Cancer ..........................................................................................................................51 

3.3.4 Other Routes of Exposure.................................................................................................51 

3.3.4.1 Death............................................................................................................................52 

3.3.4.2 Systemic Effects...........................................................................................................52 

3.3.4.3 Immunological and Lymphoreticular Effects ..............................................................53 

3.3.4.4 Neurological Effects ....................................................................................................53 

3.3.4.5 Reproductive Effects....................................................................................................53 
CESIUM xvii 

3.3.4.6 Developmental Effects.................................................................................................53 

3.3.4.7 Cancer ..........................................................................................................................54 

3.4 GENOTOXICITY .....................................................................................................................54 

3.5 TOXICOKINETICS..................................................................................................................58 

3.5.1 Absorption ........................................................................................................................59 

3.5.1.1 Inhalation Exposure .....................................................................................................59 

3.5.1.2 Oral Exposure ..............................................................................................................60 

3.5.1.3 Dermal Exposure .........................................................................................................60 

3.5.2 Distribution .......................................................................................................................61 

3.5.2.1 Inhalation Exposure .....................................................................................................61 

3.5.2.2 Oral Exposure ..............................................................................................................61 

3.5.2.3 Dermal Exposure .........................................................................................................62 

3.5.2.4 Other Routes of Exposure............................................................................................62 

3.5.3 Metabolism .......................................................................................................................63 

3.5.4 Elimination and Excretion ................................................................................................63 

3.5.4.1 Inhalation Exposure .....................................................................................................63 

3.5.4.2 Oral Exposure ..............................................................................................................64 

3.5.4.3 Dermal Exposure .........................................................................................................66 

3.5.4.4 Other Routes of Exposure............................................................................................66 

3.5.5 Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models.........67 

3.6 MECHANISMS OF ACTION ..................................................................................................86 

3.6.1 Pharmacokinetic Mechanisms ..........................................................................................86 

3.6.2 Mechanisms of Toxicity ...................................................................................................88 

3.6.3 Animal-to-Human Extrapolations.....................................................................................89 

3.7 TOXICITIES MEDIATED THROUGH THE NEUROENDOCRINE AXIS ..........................89 

3.8 CHILDREN’S SUSCEPTIBILITY...........................................................................................90 

3.9 BIOMARKERS OF EXPOSURE AND EFFECT ....................................................................93 

3.9.1 Biomarkers Used to Identify or Quantify Exposure to Cesium........................................94 

3.9.2 Biomarkers Used to Characterize Effects Caused by Cesium ..........................................94 

3.10 INTERACTIONS WITH OTHER CHEMICALS................................................................95 

3.11 POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE...........................................95 

3.12 METHODS FOR REDUCING TOXIC EFFECTS ..............................................................96 

3.12.1 Reducing Peak Absorption Following Exposure..........................................................96 

3.12.2 Reducing Body Burden ................................................................................................96
 

3.12.3 Interfering with the Mechanism of Action for Toxic Effects.......................................97 

3.13 ADEQUACY OF THE DATABASE ...................................................................................97 

3.13.1 Existing Information on Health Effects of Cesium ......................................................97 

3.13.2 Identification of Data Needs.......................................................................................100
 

3.13.3 Ongoing Studies .........................................................................................................109 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION ...............................................111 

4.1 CHEMICAL IDENTITY.........................................................................................................111 

4.2 PHYSICAL, CHEMICAL, AND RADIOLOGICAL PROPERTIES.....................................111 

5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL..........................................................119 

5.1 PRODUCTION .......................................................................................................................119 

5.2 IMPORT/EXPORT .................................................................................................................120 

5.3 USE..........................................................................................................................................120 

5.4 DISPOSAL..............................................................................................................................121 

6. POTENTIAL FOR HUMAN EXPOSURE .........................................................................................125 
CESIUM xviii 

6.1 OVERVIEW............................................................................................................................125 

6.2 RELEASES TO THE ENVIRONMENT................................................................................130 

6.2.1 Air...................................................................................................................................134 

6.2.2 Water...............................................................................................................................135 

6.2.3 Soil..................................................................................................................................136 

6.3 ENVIRONMENTAL FATE....................................................................................................137
 

6.3.1 Transport and Partitioning ..............................................................................................137 

6.3.2 Transformation and Degradation ....................................................................................140 

6.3.2.1 Air..............................................................................................................................140 

6.3.2.2 Water..........................................................................................................................140 

6.3.2.3 Sediment and Soil ......................................................................................................140 

6.4 LEVELS MONITORED OR ESTIMATED IN THE ENVIRONMENT...............................140 

6.4.1 Air...................................................................................................................................141 

6.4.2 Water...............................................................................................................................142 

6.4.3 Sediment and Soil ...........................................................................................................143 

6.4.4 Other Environmental Media ...........................................................................................145
 

6.5 GENERAL POPULATION AND OCCUPATIONAL EXPOSURE .....................................148 

6.6 EXPOSURES OF CHILDREN...............................................................................................150 

6.7 POPULATIONS WITH POTENTIALLY HIGH EXPOSURES ...........................................153 

6.8 ADEQUACY OF THE DATABASE......................................................................................154 

6.8.1 Identification of Data Needs ...........................................................................................155 

6.8.2 Ongoing Studies..............................................................................................................158 

7. ANALYTICAL METHODS ...............................................................................................................159 

7.1 BIOLOGICAL MATERIALS.................................................................................................159 

7.1.1 In Vivo Cesium Measurements .......................................................................................159 

7.1.2 In Vitro Cesium Measurements ......................................................................................163 

7.2 ENVIRONMENTAL SAMPLES............................................................................................164 

7.2.1 Field Measurements of Cesium ......................................................................................164 

7.2.2 Laboratory Analysis of Environmental Samples............................................................165 

7.3 ADEQUACY OF THE DATABASE......................................................................................170 

7.3.1 Identification of Data Needs ...........................................................................................171 

7.3.2 Ongoing Studies..............................................................................................................171 

8. REGULATIONS AND ADVISORIES ...............................................................................................173 

9. REFERENCES ....................................................................................................................................177 

10. GLOSSARY ......................................................................................................................................225 

APPENDIX A. ATSDR MINIMAL RISK LEVELS AND WORKSHEETS.........................................A-1 

APPENDIX B. USER'S GUIDE..............................................................................................................B-1 

APPENDIX C. ACRONYMS, ABBREVIATIONS, AND SYMBOLS.................................................C-1 

APPENDIX D. OVERVIEW OF BASIC RADIATION PHYSICS, CHEMISTRY, AND 

BIOLOGY..........................................................................................................................................D-1 

APPENDIX E. INDEX............................................................................................................................ E-1 
CESIUM xix 

LIST OF FIGURES 

3-1. Levels of Significant Exposure to Cesium–Radiation Toxicity–Oral ................................................ 42 

3-2. Levels of Significant Exposure to Cesium–Radiation Toxicity–External Radiation ......................... 49 

3-3. Conceptual Representation of a Physiologically Based Pharmacokinetic (PBPK) Model for 

a Hypothetical Chemical Substance.................................................................................................... 69 

3-4. Compartment Model to Represent Particle Deposition and Time-Dependent Particle 

Transport in the Respiratory Tract ...................................................................................................... 72 

3-5. Reaction of Gases or Vapors at Various Levels of the Gas-Blood Interface...................................... 76 

3-6. The Human Respiratory Tract Model: Absorption into Blood........................................................... 79 

3-7. Directions of Flow of Cesium............................................................................................................. 85 

3-8. Existing Information on Health Effects of Stable Cesium ................................................................. 98 

3-9. Existing Information on Health Effects of Radioactive Cesium ........................................................ 99 

4-1. The Decay Scheme of 137Cs.............................................................................................................. 114 

4-2. The Decay Scheme of 134Cs.............................................................................................................. 117 

6-1. Frequency of NPL Sites with Cesium Contamination...................................................................... 126
 

6-2. Frequency of NPL Sites with 134Cs Contamination.......................................................................... 127 

6-3. Frequency of NPL Sites with 137Cs Contamination.......................................................................... 128 

CESIUM xxi 

LIST OF TABLES 

3-1. Levels of Significant Exposure to Cesium—Radiation Toxicity—Oral ............................................ 41 

3-2. Levels of Significant Exposure to Cesium—Radiation Toxicity—External Radiation ..................... 47 

3-3. Genotoxicity of Cesium In Vitro ........................................................................................................ 55
 

3-4. Genotoxicity of Cesium In Vivo ......................................................................................................... 56
 

3-5. Reference Respiratory Values for a General Caucasian Population at Different Levels of 

Activity................................................................................................................................................ 71
 

3-6. Reference Values of Parameters for the Compartment Model to Represent Time-dependent 

Particle Transport from the Human Respiratory Tract........................................................................ 74
 

3-7. Transfer Coefficients (d-1) for a Reference Adult Male...................................................................... 81
 

3-8. Tissue-specific Extraction Fractions Assumed for Cesium................................................................ 83
 

3-9. Tissue Masses, Cesium Equilibrium Distribution, and Tissue Blood Flow for a Reference Adult 

Male ..................................................................................................................................................... 84
 

4-1. Chemical Identity of Cesium and Compounds................................................................................. 112
 

4-2. Physical and Chemical Properties of Cesium and Compounds........................................................ 113
 

4-3. Decay Properties of the Radioactive Isotopes of Cesium................................................................. 116
 

6-1. Radiocesium Releases from Nuclear Power Plants for 1993 ........................................................... 131
 

6-2. Concentration of 133Cs, 134Cs, and 137Cs in Animals......................................................................... 146
 

6-3. The Mean Body Burdens of 137Cs for Adults in Finland from 1987 to 1994 ................................... 151
 

7-1. Analytical Methods for Determining Cesium in Biological Samples .............................................. 160
 

7-2. Analytical Methods for Determining Radiocesium in Biological Samples...................................... 161
 

7-3. Analytical Methods for Determining Cesium in Environmental Samples ....................................... 166
 

7-4. Analytical Methods for Determining Radiocesium in Environmental Samples............................... 168
 

8-1. Regulations and Guidelines Applicable to Cesium .......................................................................... 174 

8-2. Regulations and Guidelines Applicable to Radioactive Cesium ...................................................... 175 

CESIUM 1 

1. PUBLIC HEALTH STATEMENT 

This public health statement tells you about cesium and the effects of exposure. 

The Environmental Protection Agency (EPA) identifies the most serious hazardous waste sites in 

the nation. These sites make up the National Priorities List (NPL) and are the sites targeted for 

long-term federal cleanup activities. Stable (not radioactive) cesium (133Cs) has been identified 

in at least 8 of the 1,636 hazardous waste sites that have been proposed for inclusion on the EPA 

National Priorities List (NPL) (HazDat 2003). It was reported that 134Cs (radioactive) has been 

found in at least 3 of the 1,636 current or former NPL sites and 137Cs (radioactive) has been 

detected in at least 23 of the 1,636 current or former NPL sites. However, the number of sites 

evaluated for cesium is not known. As more sites are evaluated, the sites at which cesium is 

found may increase. This information is important because exposure to this substance may harm 

you and because these sites may be sources of exposure. 

When a substance is released from a large area, such as an industrial plant, or from a container, 

such as a drum or bottle, it enters the environment. This release does not always lead to 

exposure. You are exposed to a substance when you come in contact with it. You may be 

exposed by breathing, eating, or drinking the substance, or by skin contact. If the substance is 

radioactive, you may also be exposed to radiation if you are near it. 

External exposure to radiation may occur from natural or man-made sources. Naturally 

occurring sources of radiation are cosmic radiation from space or radioactive materials in soil or 

building materials. Man-made sources of radioactive materials are found in consumer products, 

industrial equipment, atom bomb fallout, and to a smaller extent from hospital waste, medical 

devices, and nuclear reactors. 

If you are exposed to cesium, many factors determine whether you’ll be harmed. These factors 

include the dose (how much), the duration (how long), and how you come in contact with it. 

You must also consider the other chemicals you’re exposed to and your age, sex, diet, family 

traits, lifestyle, and state of health. 
CESIUM 2 

1. PUBLIC HEALTH STATEMENT 

1.1 WHAT IS CESIUM? 

Cesium is a naturally-occurring element found in rocks, soil, and dust at low concentrations. 

Granites contain an average cesium concentration of about 1 part of cesium in a million parts of 

granite (ppm) and sedimentary rocks contain about 4 ppm. Natural cesium is present in the 

environment in only one stable form, as the isotope 133Cs. Pure cesium metal is silvery white in 

color and very soft, but pure cesium is not expected to be found in the environment. Pure cesium 

metal reacts violently with air and water, resulting in an explosion-like reaction. Cesium 

compounds do not react violently with air or water and are generally very soluble in water. The 

most important source of commercial cesium is a mineral known as pollucite, which usually 

contains about 5–32% cesium oxide (Cs2O). No known taste or odor is associated with cesium 

compounds. Cesium is not mined or produced in the United States and very little is imported 

from other countries. There are relatively few commercial uses for cesium metal and its 

compounds. Sometimes cesium is used as a getter for residual gas impurities in vacuum tubes 

and as a coating in tungsten filaments or cathodes of the tubes. Crystalline cesium iodide and 

cesium fluoride are used in scintillation counters, which convert energy from ionizing radiation 

into pulses of visible light for radiation detection and spectroscopy. Cesium is also used in 

highly accurate atomic clocks. For more information on the physical and chemical properties 

and on the production and use of cesium, see Chapters 4 and 5. 

Radioactive forms of cesium are produced by the fission of uranium in fuel elements (fuel rods) 

during the normal operation of nuclear power plants, or when nuclear weapons are exploded. 

Radioactive forms of cesium are unstable and eventually change into other more stable elements 

through the process of radioactive decay. The two most important radioactive isotopes of cesium 

are 134Cs and 137Cs. Radioactive isotopes are constantly decaying or changing into different 

isotopes by giving off radiation. Each atom of 134Cs changes into either xenon 134 (134Xe) or 

barium 134 (134Ba), neither of which is radioactive, while each atom of 137Cs decays to barium 

137 (137Ba), which is also not radioactive. As 134Cs and 137Cs decay, beta particles and gamma 

radiation are given off. The half-life is the time it takes for half of that cesium isotope to give off 
CESIUM 3 

1. PUBLIC HEALTH STATEMENT 

its radiation and change into a different element. The half-life of 134Cs is about 2 years and the 

half-life of 137Cs is about 30 years. 

Quantities of radioactive cesium, as well as other radioactive elements, are measured in units of 

mass (grams) or radioactivity (curies or becquerels). Both the curie (Ci) and the becquerel (Bq) 

describe the rate of decay and tell us how much a radioactive material decays every second. The 

becquerel is a new international unit known as the SI unit, and the curie is an older, traditional 

unit; both are currently used. A becquerel is the amount of radioactive material in which 1 atom 

transforms every second. One curie is the amount of radioactive material in which 37 billion 

atoms transform every second; this is approximately equivalent to the radioactivity of 1 gram of 

radium. 

1.2 WHAT HAPPENS TO CESIUM WHEN IT ENTERS THE ENVIRONMENT? 

Naturally-occurring cesium occurs in the environment mostly from the erosion and weathering of 

rocks and minerals. The mining and milling of certain ores can also release cesium to the air, 

water, and soil. 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. 

Nonradioactive (stable) cesium can be neither created nor destroyed under typical environmental 

conditions, but can react with other compounds found in the environment and change into 

different cesium compounds. Radioactive decay decreases the concentration of 134Cs and 137Cs. 

Both stable and radioactive cesium are the same element and behave in a similar manner 

chemically and in the body. Cesium compounds can travel long distances in the air before being 

brought back to the earth by rainfall and gravitational settling. In water and moist soils, most 

cesium compounds are very soluble. Cesium binds strongly to most soils and does not travel far 

below the surface of the soil. Consequently, cesium is not readily available for uptake by 

vegetation through roots. However, radiocesium can enter plants upon falling onto the surface of 

leaves. 
CESIUM 4 

1. PUBLIC HEALTH STATEMENT 

1.3 HOW MIGHT I BE EXPOSED TO CESIUM? 

You can be exposed to stable or radioactive cesium by breathing air, drinking water, or eating 

food containing cesium. The level of cesium in air and water is generally very low. The 

concentration of natural cesium in air is generally less than 1 nanogram (1 nanogram equals 

1/1,000,000,000 of a gram) per cubic meter of air (ng/m3

). The amount of cesium in drinking 

water is ordinarily about 1 microgram (1 microgram equals 1/1,000,000 of a gram) per liter of 

water (μg/L). On average, a person swallows about 10 μg of stable cesium per day in food and 

water, and breathes about 0.025 μg per day. Plants and animals contain cesium at concentrations 

of about 1–300 ng/g. 

Radioactive cesium has been detected in surface water and in many types of food. This includes 

breast milk and pasteurized milk. The amount of radioactive cesium in food and milk is highly 

dependent upon several factors. The most important factor is whether or not there has been 

recent fallout from a nuclear explosion such as a weapons test or an accident that has occurred at 

a nuclear power plant. However, atmospheric testing of nuclear weapons was halted many years 

ago, and 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. You should understand that cesium only contributed a small 

fraction of the total radioactivity released following these events. The radiological impacts in 

Europe from 137Cs and 134Cs released from the Chernobyl accident, however, were great. These 

included environmental dispersion of radiocesium and uptake in reindeer, caribou, and livestock. 

Furthermore, the consequences of external exposure to gamma radiation and beta particles are 

not unique to 137Cs and 134Cs, but are very similar for all gamma and beta emitting radionuclides. 

People who work in industries that process or use natural cesium or cesium compounds can be 

exposed to higher-than-normal levels of cesium. An estimated 16,461 workers (4,276 of these 

are female) are potentially exposed to natural cesium and cesium compounds in the United 

States. If you work in the nuclear power industry, you may also be exposed to higher-thannormal levels of radioactive cesium, but there are many precautionary measures taken at these 

facilities to minimize this exposure. 
CESIUM 5 

1. PUBLIC HEALTH STATEMENT 

1.4 HOW CAN CESIUM ENTER AND LEAVE MY BODY? 

Stable and radioactive cesium can enter your body from the food you eat or the water you drink, 

from the air you breathe, or from contact with your skin. When you eat, drink, breathe, or touch 

things containing cesium compounds that can easily be dissolved in water, cesium enters your 

blood and is carried to all parts of your body. Cesium is like potassium; it enters cells and helps 

to maintain a balance of electrical charges between the inside and the outside of cells so that cells 

can perform tasks that depend on those electrical charges. Cells like muscle cells and nerve cells 

require changing electrical charges in order to function properly and allow you to think and 

move. 

Once cesium enters your body, your kidneys begin to remove it from the blood; some cesium is 

quickly released from your body in the urine. A small portion is also released in the feces. 

Some of the cesium that your body absorbs can remain in your body for weeks or months, but is 

slowly eliminated from your body through the urine and feces. 

1.5 HOW CAN CESIUM AFFECT MY HEALTH? 

To protect the public from the harmful effects of toxic chemicals and to find ways to treat people 

who have been harmed, scientists use many tests. 

One way to see if a chemical will hurt people is to learn how the chemical is absorbed, used, and 

released by the body. In the case of a radioactive chemical, it is also important to gather 

information concerning the radiation dose and dose rate to the body. For some chemicals, 

animal testing may be necessary. Animal testing may also be used to identify health effects such 

as cancer or birth defects. Without laboratory animals, scientists would lose a basic method to 

get information needed to make wise decisions to protect public health. Scientists have the 

responsibility to treat research animals with care and compassion. Laws today protect the 

welfare of research animals, and scientists must comply with strict animal care guidelines. 
CESIUM 6 

1. PUBLIC HEALTH STATEMENT 

You are not likely to experience any health effects that could be related to stable cesium itself. 

Animals given very large doses of cesium compounds have shown changes in behavior, such as 

increased activity or decreased activity, but it is highly unlikely that you would breathe, eat, or 

drink amounts of stable cesium large enough to cause similar effects. If you were to breathe, eat, 

drink, touch, or come close to large amounts of radioactive cesium, cells in your body could 

become damaged from the radiation that might penetrate your entire body, much like x-rays, 

even if you did not touch the radioactive cesium. You would probably experience similar effects 

if you were exposed to any other substance with similar radioactivity. You might also 

experience acute radiation syndrome, which includes such effects as nausea, vomiting, diarrhea, 

bleeding, coma, and even death. A number of people in Brazil, who handled radioactive cesium 

that was scavenged from a medical machine used for radiation therapy, became sick from 

exposure to the radiation; a few of them died. But people exposed to radioactive cesium that has 

been widely dispersed in air, water, soil, or foods following nuclear bombings or accidents have 

not been exposed to amounts large enough to cause the same effects. 

1.6 HOW CAN CESIUM AFFECT CHILDREN? 

This section discusses potential health effects from exposures during the period from conception 

to maturity at 18 years of age in humans. 

Children can be affected by cesium in the same ways as adults. Stable cesium is not likely to 

affect the health of children, but large amounts of gamma radiation, from sources such as 

radioactive cesium, could damage cells and might also cause cancer. Short exposure to 

extremely large amounts of radiation might cause nausea, vomiting, diarrhea, bleeding, coma, 

and even death. In addition, if babies were to be exposed to enough radiation while in their 

mother’s womb during the time when their nervous system is rapidly developing, they could 

experience changes in their brains that could result in changes in behavior or decreased mental 

abilities. However, it is unlikely that children or babies would be exposed to enough gamma 

radiation from a radioactive cesium source to do such damage to their bodies. 
CESIUM 7 

1. PUBLIC HEALTH STATEMENT 

1.7 HOW CAN FAMILIES REDUCE THE RISK OF EXPOSURE TO CESIUM? 

If your doctor finds that you have been exposed to significant amounts of cesium, ask whether 

your children might also be exposed. Your doctor might need to ask your state health 

department to investigate. 

Since cesium is naturally found in the environment, we cannot avoid being exposed to it. 

However, the relatively low concentrations of stable cesium do not warrant any immediate steps 

to reduce exposure. You are unlikely to be exposed to high levels of radioactive cesium unless 

there is a fuel meltdown and accidental release at a nuclear power plant or a nuclear weapon has 

been detonated. In such cases, follow the advice of public health officials who will publish 

guidelines for reducing exposure to radioactive material when necessary. 

1.8 IS THERE A MEDICAL TEST TO DETERMINE WHETHER I HAVE BEEN 

EXPOSED TO CESIUM? 

Everyone has small amounts of cesium in their body. Laboratories use special techniques to 

measure the amount of cesium in body fluids such as blood and urine, as well as in feces or other 

human samples. This can give an indication of whether a person has been exposed to levels of 

cesium that are higher than those normally found in food, water, or air. Special radiation 

detectors can be used to detect if a person has absorbed radioactive cesium. It is difficult to 

determine if a person has been exposed only to external radiation from radioactive cesium. 

Health professionals examining people who have health problems similar to those resulting from 

radiation exposure would need to rely on additional information, such as the testing of blood 

samples for cell counts and chromosomal damage, in order to establish if such people had been 

affected by being near a source of radioactivity. 

1.9 WHAT RECOMMENDATIONS HAS THE FEDERAL GOVERNMENT MADE 

TO PROTECT HUMAN HEALTH? 

The federal government develops regulations and recommendations to protect public health. 

Regulations can be enforced by law. Federal agencies that develop regulations for toxic 
CESIUM 8 

1. PUBLIC HEALTH STATEMENT 

substances include the Environmental Protection Agency (EPA), the Occupational Safety and 

Health Administration (OSHA), the Food and Drug Administration (FDA), and the U.S. Nuclear 

Regulatory Commission (USNRC). 

Recommendations provide valuable guidelines to protect public health but cannot be enforced by 

law. Federal organizations that develop recommendations for toxic substances include the 

Agency for Toxic Substances and Disease Registry (ATSDR), the National Institute for 

Occupational Safety and Health (NIOSH), and the FDA. 

Regulations and recommendations can be expressed in not-to-exceed levels in air, water, soil, or 

food that are usually based on levels that affect animals; they are then adjusted to help protect 

people. Sometimes these not-to-exceed levels differ among federal organizations because of 

different exposure times (an 8-hour workday or a 24-hour day), the use of different animal 

studies, or other factors. 

Recommendations and regulations are also periodically updated as more information becomes 

available. For the most current information, check with the federal agency or organization that 

provides it. Some regulations and recommendations for cesium include the following: 

There are few guidelines for compounds of stable cesium. Based on eye irritation, the NIOSH 

has established a recommended exposure limit (REL) for cesium hydroxide of 2 mg/m3

 as a 

time-weighted average (TWA) for up to a 10-hour workday and a 40-hour workweek. The 

American Conference of Governmental Industrial Hygienists (ACGIH) has assigned cesium 

hydroxide a threshold limit value (TLV) of 2 mg/m3

 as a TWA for a normal 8-hour workday and 

a 40-hour workweek, based on respiratory and eye irritation. 

The NRC established guidelines for radioactive cesium that include occupational inhalation 

exposure Derived Air Concentrations (DACs) of 0.00000004 μCi/mL (4x10-8 μCi/mL) for 134Cs 

and 0.00000006 μCi/mL (6x10-8 μCi/mL) for 137Cs. Annual Limits on Intake (ALIs) for on-thejob exposure are 100 μCi (1x102

 μCi) for 134Cs and 200 μCi (2x102 μCi) for 137Cs. 

More information on regulations and guidelines is available in Chapter 8. 
CESIUM 9 

1. PUBLIC HEALTH STATEMENT 

1.10 WHERE CAN I GET MORE INFORMATION? 

If you have any more questions or concerns, please contact your community or state health or 

environmental quality department, your regional Nuclear Regulatory Commission office, or 

contact ATSDR at the address and phone number below. 

ATSDR can also tell you the location of occupational and environmental health clinics. These 

clinics specialize in recognizing, evaluating, and treating illnesses resulting from exposure to 

hazardous substances. 

Toxicological profiles are also available on-line at www.atsdr.cdc.gov and on CD-ROM. You 

may request a copy of the ATSDR ToxProfiles CD-ROM by calling the information and 

technical assistance toll-free number at 1-888-42ATSDR (1-888-422-8737), by email at 

atsdric@cdc.gov, or by writing to: 

Agency for Toxic Substances and Disease Registry 

Division of Toxicology 

1600 Clifton Road NE 

Mailstop E-32 

Atlanta, GA 30333 

Fax: 1-770-488-4178 

For-profit organizations may request a copy of final profiles from the following: 

National Technical Information Service (NTIS) 

5285 Port Royal Road 

Springfield, VA 22161 

Phone: 1-800-553-6847 or 1-703-605-6000 

Web site: http://www.ntis.gov/ 

CESIUM	 11 

2. RELEVANCE TO PUBLIC HEALTH 

2.1	 BACKGROUND AND ENVIRONMENTAL EXPOSURES TO CESIUM IN THE 

UNITED STATES 

Naturally-occurring cesium exists as the stable isotope (133Cs) in the earth’s crust at an average 

concentration of about 1 ppm in granites and 4 ppm in sedimentary rocks. The most important source of 

commercial cesium is the mineral pollucite, which usually contains about 5–32% Cs2O by weight. The 

largest deposits of pollucite are located in Manitoba, Canada and account for about two-thirds of the 

world’s known supply. Cesium has very low mobility in soil surfaces. Clay minerals and soils rich in 

exchangeable potassium adsorb cesium by binding the cations to interlayer positions of the clay particles. 

The low hydration energy of cesium cations is primarily responsible for their selective sorption and 

fixation by clays, which can result in limited uptake of cesium by grass and plant material. Continental 

dust and soil erosion are the main emission sources of naturally-occurring cesium that is present in the 

environment. As a result of human activities, however, cesium is released into the environment globally 

in small amounts. Cesium has also been detected in the fly ash of hazardous waste incinerators and coal 

burning power plants. Cesium is deposited on plants and trees by wet and dry deposition and can be 

absorbed into the flora through its foliage. The deposited cesium can make its way to soil through litter 

decomposition. Due to its low relative abundance, limited use in industry, and relatively low level of 

toxicity observed in animal studies, exposure to stable cesium is not considered to be a significant public 

health concern. 

Radioactive isotopes of cesium (134Cs and 137Cs) are formed during nuclear fission, in commercial 

applications such as the generation of electricity at nuclear power plants. However, high levels of 134Cs 

and 137Cs 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. Once released, these radioactive cesium isotopes persist 

in the environment, with the potential for adverse health effects. Following release to the atmosphere, 

radioactive cesium can travel thousands of miles before settling to earth, and is removed by wet and dry 

deposition. Radioactive cesium can also be released to soil or water in liquid effluents from spent fuel 

and fuel reprocessing plants. 
CESIUM 12 

2. RELEVANCE TO PUBLIC HEALTH 

The total amount of 137Cs released from weapons testing through 1980 was estimated as 2.6x107 Ci 

(9.6x1017 Bq), 76% of which was released in the northern hemisphere and 24% in the southern 

hemisphere. 

The accident at the Chernobyl nuclear power plant resulted in the release of an estimated 5.4x105

 Ci 

(2.0x1016 Bq) of 134Cs and 1.1x106

 Ci (4.0x1016 Bq) of 137Cs into the atmosphere over Europe (see 

Agency for Toxic Substances and Disease Registry 1999 for details of other accidental releases). Routine 

activities at nuclear power plants and fuel-reprocessing stations also release 137Cs and 134Cs to the 

environment on a regular basis, but these are at such levels as to be considered insignificant. 

Since the half-life for some radioactive isotopes of cesium is long (the half-life of 137Cs is about 30 years 

and the half-life of 134Cs is about 2 years), the general population is exposed to 137Cs and 134Cs for long 

periods of time after it is released from a nuclear accident or weapons test, with the greatest exposure 

occurring near the source. Although inhalation and dermal exposure is possible, oral ingestion of 

contaminated food items is the greatest source of internal exposure for both naturally-occurring and 

radioactive cesium. Workers employed in the mining and milling of pollucite ores and the production of 

cesium compounds are exposed to cesium through oral, dermal, and inhalation routes. Similar routes of 

exposure to 137Cs and 134Cs are experienced by workers employed in the nuclear industry. External 

exposure to beta and gamma radiation can also occur for workers employed in the nuclear industry as 

well as for the general population following an accidental release or weapons test. 

As discussed in Appendix A, the average annual effective dose of ionizing radiation (including 134Cs and 

137Cs) from anthropogenic sources to the U.S. population is very small in comparison to natural sources. 

2.2 SUMMARY OF HEALTH EFFECTS 

Information regarding health effects in humans that can be associated with exposure to higher-thannormal levels of stable cesium is restricted to an account of decreased appetite, nausea, and diarrhea in a 

man who repeatedly ingested experimental amounts of cesium chloride and reports of prolonged QT 

syndrome and associated cardiac arrhythmias in patients who ingested cesium chloride as a component of 

homeopathic remedies. 

Exposure to radioisotopes of cesium is of much greater human health concern. Energy released by 

radioactive isotopes can result in significant damage to living cells. Both 134Cs and 137Cs emit beta 
CESIUM 13 

2. RELEVANCE TO PUBLIC HEALTH 

particles and gamma rays, which may ionize molecules within cells penetrated by these emissions and 

result in tissue damage and disruption of cellular function. The most important exposure routes for 

radioisotopes of cesium are external exposure to the radiation released by the radioisotopes and ingestion 

of radioactive cesium-contaminated food sources. Inhalation and dermal exposure routes may also 

present a health hazard. The hazards of external exposure to 134Cs and 137Cs are similar to those of other 

gamma- and beta-emitting radionuclides. 

Radiation absorbed doses are expressed in terms of the amount of energy absorbed per unit mass, in units 

called rad or gray (Gy) (see Appendix D and Agency for Toxic Substances and Disease Registry 1999 for 

a complete description of principles of ionizing radiation). Generally, acute radiation doses below 15 rad 

(0.15 Gy) do not result in observable adverse health effects. At doses in the range of 15–50 rad (0.15– 

0.5 Gy), subclinical responses such as chromosomal breaks and transient changes in formed elements of 

the blood may be seen in sensitive individuals. Symptoms of acute radiation syndrome are observed at 

radiation doses above 50 rad (0.5 Gy), characterized by transient hematopoietic manifestations, nausea 

and vomiting, and moderate leukopenia at doses near 100 rad (1 Gy), progressing through more serious 

hematopoietic symptoms, clinical signs, and gastrointestinal symptoms with increasing dose (100–800 rad 

or 1–8 Gy), and usually death in persons receiving total doses ≥1,000 rad (10 Gy). Other health effects 

from acute or continued exposure to ionizing radiation may include reproductive, developmental, and 

latent cancer effects. 

Signs and symptoms of acute toxicity from external and internal exposure to high levels of radiation from 

134Cs or 137Cs are typical of those observed in cases of high exposure to ionizing radiation in general. 

Depending on the radiation dose, symptoms may include those typical of acute radiation syndrome 

(vomiting, nausea, and diarrhea), skin and ocular lesions, neurological signs, chromosomal abnormalities, 

compromised immune function, and death. 

Acute or repeated exposure of humans or animals to ionizing radiation (from radioisotopes of cesium or 

other radioactive elements) may result in reduced male fertility, abnormal neurological development 

following exposure during critical stages of fetal development, and genotoxic effects such as increased 

frequencies of chromosomal aberrations, T-lymphocyte point mutations, dominant lethal mutations, and 

reciprocal translocations. 

Due to the ionizing properties of radionuclides such as 134Cs and 137Cs, increased cancer risk would be 

expected among exposed individuals. However, studies of increased cancer risk specifically associated 
CESIUM 14 

2. RELEVANCE TO PUBLIC HEALTH 

with exposure of humans to radioactive cesium isotopes were not located. The only documented reports 

of health effects in humans exposed to cesium as the source of radiation are derived from accidental 

exposure to a 137Cs source in 1987 in Goiânia, Brazil, and during 1996 and 1997 in Russia. Long-term 

cancer studies on exposed individuals have not been completed to date. 

Animal studies indicate increased risk of cancer following external or internal exposure to relatively high 

doses of radiation from 137Cs sources. Increased lifetime risk of mammary tumors was noted in female 

rats acutely exposed to whole-body radiation. Intravenous injection of 137Cs (as cesium chloride) in dogs 

resulted in long-term increased risk of all cancers combined in males, and all cancers combined 

(excluding mammary cancer) in females. 

Immunological and Lymphoreticular Effects. Humans who were accidentally exposed externally 

and internally to 137Cs that resulted in estimated radiation absorbed doses of 100–700 rad (1–7 Gy), 

exhibited severe bone marrow depression. Similar effects were seen in dogs exposed to 137Cs by 

intravenous injection, resulting in estimated bone marrow doses of 700–2,400 rad (7–24 Gy). 

Reproductive Effects. Exposure to radioisotopes of cesium may result in reduced fertility in males, 

as evidenced by reduced concentrations of spermatozoa in men who had been exposed externally and 

internally to 137CsCl approximately 1 month prior to testing. Reduced fertility, including sterility, was 

reported in male mice exposed to gamma radiation from 137Cs either by total-body external radiation, 

which resulted in a total radiation dose of 300 rad (3 Gy) over a 19.5-day exposure period, or by single or 

repeated oral dosing, which resulted in estimated total testicular radiation doses of 300–385 rad (3– 

3.85 Gy), measured at 5 weeks post-treatment. No significant reduction in male fertility was seen from 

total testicular radiation doses in the range of 10–100 rad (0.1–1 Gy). Persistent germinal epithelium 

damage and azoospermia were reported in all long-term surviving dogs that had been administered 137Cs 

(as cesium chloride) by intravenous injection at activity levels resulting in long-term total whole-body 

doses ranging from 742 to 1,640 rad (7.42–16.40 Gy). 

Developmental Effects. Developmental effects such as reduced post-natal body weight, impaired 

motor activity, morphological changes in the brain, reduced head size, and retarded odontogenesis and 

palatal closure have been reported in rats that had been exposed to radioactive cesium sources (137Cs) 

in utero via whole-body external exposure of dams; effects were of largest magnitude when exposure 

occurred around gestational day 15. Reported developmental effects in similarly-exposed mice included 

significantly decreased brain weight and increased aggressive behavior. Atomic bomb survivors of 
CESIUM 15 

2. RELEVANCE TO PUBLIC HEALTH 

Hiroshima and Nagasaki, exposed to high levels of ionizing radiation in utero during weeks 8–15 or 16– 

25 post-ovulation, exhibited later signs of impaired cognitive function. Radiation-induced developmental 

effects would be expected in humans or animals exposed to similar levels of ionizing radiation from any 

ionizing radiation source, including a radiocesium source. Resulting adverse health effects would be due 

to the external, penetrating gamma radiation, not cesium per se. 

Neurological Effects. Excess exposure to stable cesium appears to result in central nervous system 

effects. A man who voluntarily ingested cesium chloride daily for 36 days reported neurological signs 

that included feelings of euphoria, heightened sense perception, and tingling sensations within 15 minutes 

of dosing, in the absence of apparent adverse mental or motor skills. In animal studies, administration of 

cesium chloride has been reported to trigger stimulant and depressant central nervous system responses. 

Since radioisotopes of cesium such as 134Cs and 137Cs emit beta particles and gamma rays capable of 

ionizing cells, acute radiation doses >3,000 rad (30 Gy) in humans would be expected to result in 

symptoms indicative of central nervous system syndrome that include immediate onset of violent nausea 

and vomiting, diarrhea, irrational behavior, circulatory system collapse, and neuromuscular 

incoordination, followed by convulsions, coma, and death within 48 hours (see Agency for Toxic 

Substances and Disease Registry 1999 for more detailed information on health effects from exposure to 

ionizing radiation). 

Cancer. Studies that assess the risk of cesium-induced cancer are restricted to radioactive isotopes, not 

stable cesium. No human studies were located in which cancer incidence was specifically associated with 

exposure to radioisotopes of cesium. Due to the nature of ionizing radiation in general, carcinogenic 

effects similar to those observed in Japanese survivors of the 1945 atomic bombing incidents might be 

expected among individuals acutely exposed to high levels of radiation from a radioactive cesium source 

(see Agency for Toxic Substances and Disease Registry 1999 for a detailed discussion of the carcinogenic 

effects of ionizing radiation). However, it is unlikely that levels of ionizing radiation as high as those 

experienced by the survivors of the atomic bombing incidents would be experienced by individuals who 

might be exposed to a radiocesium source. Exceptions are reports of accidental human exposures to 

radioactive cesium sources in Goiânia, Brazil, in 1987 and Lilo, Georgia (Russia) in 1996 and 1997. 

However, the incidents are too recent for meaningful carcinogenicity data. The EPA Office of Radiation 

and Indoor Air (ORIA) has classified all radionuclides, including radioisotopes of cesium, as known 

human carcinogens. 
CESIUM 16 

2. RELEVANCE TO PUBLIC HEALTH 

Animal studies indicate increased risk of cancer following external or internal exposure to relatively high 

doses of radiation from 137Cs sources. Increased lifetime risk of mammary tumors was noted in female 

rats acutely exposed to whole-body radiation. There were no significant differences between age groups 

irradiated at 8, 12, 16, 22, or 36 weeks of age, but irradiation at 64 weeks yielded fewer carcinomas than 

unirradiated controls. In lifetime studies of dogs administered single intravenous doses of 137CsCl, which 

resulted in average initial body burdens ranging from 36.4 to 147 MBq/kg (1 to 4 mCi/kg), benign and 

malignant neoplasms were found in a variety of tissues and organs, with no apparent single target organ 

of toxicity. 

2.3 MINIMAL RISK LEVELS 

Inhalation MRLs 

No acute-, intermediate-, or chronic-duration inhalation MRLs were derived for cesium due to the lack of 

suitable human or animal data regarding health effects following inhalation exposure to stable or 

radioactive cesium. Available information, considered relevant to inhalation exposure, is limited to two 

studies of dogs intravenously administered 137CsCl (Nikula et al. 1995, 1996; Redman et al. 1972). 

Adverse health effects included depressed blood factors, severe bone marrow depression, germinal cell 

damage, early death, and increased incidences of benign and malignant neoplasms in a variety of tissues 

and organs. Striking similarities in the biokinetics, observed in laboratory animals exposed to 137CsCl via 

either parenteral injection or inhalation or oral routes, indicate that adverse health effects might be 

common to all three routes of exposure (Boecker et al. 1969a; Melo et al. 1996, 1997; Nikula et al. 1995, 

1996). However, extrapolation of data across exposure routes was not considered to be a valid basis for 

the derivation of inhalation MRLs. 

Oral MRLs 

No acute-, intermediate-, or chronic-duration oral MRLs were derived for stable cesium due to the lack of 

suitable human or animal data regarding health effects following oral exposure to stable or radioactive 

cesium. Reports of health effects following oral exposure to stable cesium are limited. Daily ingestion of 

approximately 68 mg Cs/kg (as cesium chloride) for up to 36 days resulted in decreased appetite, nausea, 

and diarrhea, as well as neurological signs within 15 minutes following ingestion (Neulieb 1984). 

Prolonged QT syndrome and associated cardiac arrhythmias were reported in patients who ingested 

cesium chloride as a component of homeopathic remedies (Bangh et al. 2001; Harik et al. 2002; Saliba et 

al. 2001). Animal studies regarding oral exposure to stable cesium are limited to LD50 studies that 
CESIUM	 17 

2. RELEVANCE TO PUBLIC HEALTH 

indicate relatively low toxicity for stable cesium compounds (Ghosh et al. 1990; Johnson et al. 1975; 

Khosid 1967). Information regarding human exposure to radioactive cesium is inadequate because no 

human data were available on health effects from oral exposure to radioactive cesium. Oral data 

regarding health effects in animals exposed to radioactive cesium are restricted to a single study in which 

only reproductive and genotoxic end points were reported (Ramaiya et al. 1994). 

Due to striking similarities in the biokinetics, observed in laboratory animals exposed to 137CsCl via either 

parenteral injection or inhalation or oral routes, it has been suggested that adverse health effects might be 

common to all three routes of exposure (Boecker et al. 1969a; Melo et al. 1996, 1997; Nikula et al. 1995, 

1996). Depressed blood factors, severe bone marrow depression, germinal cell damage, early death, and 

increased incidences of benign and malignant neoplasms in a variety of tissues and organs were observed 

in dogs intravenously administered 137CsCl (Nikula et al. 1995, 1996; Redman et al. 1972). However, 

extrapolation of data across exposure routes was not considered to be a valid basis for the derivation of 

oral MRLs. 

MRLs for External Exposure to Cesium Isotopes 

Two MRLs have been derived for ionizing radiation (Agency for Toxic Substances and Disease Registry 

1999) and are applicable to external exposure to radioisotopes of cesium: 

•	 An MRL of 400 mrem (4.0 mSv) has been derived for acute-duration external exposure to 

ionizing radiation (14 days or less). 

The acute MRL is based on results of a study by Schull et al. (1988) in which neurological effects of 

radiation, measured by intelligence test scores, were evaluated in children 10–11 years of age who had 

been exposed at critical stages of fetal development (gestation weeks 8–15) during the atomic bombing of 

Hiroshima and Nagasaki. When IQ scores were regressed on radiation dose estimates, IQ diminished 

linearly with increasing dose, resulting in an estimated decrease in IQ score of approximately 25 points 

per 100 rad (100 rem in dose equivalent) or 0.25 points/rem (25 points/Sv). To derive the MRL of 

400 mrem (4.0 mSv), the Agency for Toxic Substances and Disease Registry (1999) divided the dose 

associated with a predicted change of 0.25 IQ points (1 rem) by an uncertainty factor of 3 (for human 

variability/sensitive population). The Agency for Toxic Substances and Disease Registry (1999) noted 

that a change in IQ points of 0.25 is less than the reported difference of 0.3 IQ points between separated 

and unseparated identical twins (Burt 1966). 
CESIUM	 18 

2. RELEVANCE TO PUBLIC HEALTH 

The NRC set a radiation exposure limit of 500 mrem (5 mSv) for pregnant working women over the full 

gestational period (USNRC 1991). For the critical gestational period of 8–15 weeks, ATSDR believes 

that the acute MRL of 400 mrem (4 mSv) is consistent with the NRC limit and could be applied to either 

acute (0–14-day) or intermediate (15–365-day) exposure periods. 

•	 An MRL of 100 mrem/year (1.0 mSv/year) above background has been derived for chronicduration external exposure to ionizing radiation (365 days or more). 

The MRL is based on the BEIR V (1990) report that the average annual effective ionizing radiation dose 

to the U.S. population is 360 mrem/year (3.6 mSv/year) from all background sources of radiation (earth, 

cosmic rays, building materials, etc.), a dose not expected to produce adverse health effects. This dose is 

obtained mainly by naturally-occurring radiation from external sources, medical uses of radiation, and 

radiation from consumer products. An uncertainty factor of 3 (for human variability) was applied to the 

NOAEL. 
CESIUM 19 

3. HEALTH EFFECTS 

3.1 INTRODUCTION 

The primary purpose of this chapter is to provide public health officials, physicians, toxicologists, and 

other interested individuals and groups with an overall perspective on the toxicology of cesium, existing 

naturally as the stable (nonradioactive) isotope 133Cs and in the form of radioactive isotopes produced 

during nuclear fission, the most abundant of which are 137Cs and 134Cs. This chapter contains descriptions 

and evaluations of toxicological studies and epidemiological investigations and provides conclusions, 

where possible, on the relevance of toxicity and toxicokinetic data to public health. Section 3.2 contains a 

discussion of the chemical toxicity of stable cesium; radiation toxicity associated with exposure to 

radiocesium (primarily 137Cs and 134Cs) is discussed in Section 3.3. The chemical properties of stable and 

radioactive cesium isotopes are identical and are described in Chapter 4. 

A glossary and list of acronyms, abbreviations, and symbols can be found at the end of this profile. 

Since the average concentration of stable cesium in the earth’s crust is low (on average about 1 ppm) and 

stable cesium is used only in small quantities in electronic and energy production industries, the risk of 

significant exposure to stable cesium via inhalation, oral, or dermal routes is expected to be small. 

Limited information is available on monitoring (or detection) of stable cesium in the environment and on 

health effects from exposure to stable cesium. 

Decreased appetite, nausea, and diarrhea were reported in a man who ingested about 34 mg Cs/kg (as 

cesium chloride) after morning and evening meals for 36 days; this man also experienced apparent 

neurological changes within 15 minutes of dosing (Neulieb 1984). Prolonged QT syndrome and 

associated cardiac arrhythmias have been described in patients who have ingested cesium chloride as a 

component of homeopathic remedies (Bangh et al. 2001; Harik et al. 2002; Saliba et al. 2001). 

Animal studies indicate that cesium is of relatively low toxicity. Acute oral LD50 values for rats and mice 

range from 800 to 2,000 mg Cs/kg, cesium hydroxide being more toxic than cesium iodide or cesium 

chloride. Single oral doses of cesium chloride, administered to female mice at dose levels ranging from 

125 to 500 mg/kg, have been shown to result in significant increases in chromosomal breaks in bone 

marrow cells (Ghosh et al. 1990, 1991). 
CESIUM 20 

3. HEALTH EFFECTS 

No reports were located regarding adverse effects in humans or animals following acute-, intermediate-, 

or chronic-duration inhalation or dermal exposure to stable cesium. 

Radioactive isotopes of cesium are a greater health concern than stable cesium. The most important 

exposure routes are external exposure to the radiation emitted by the radioisotope and ingestion of 

radioactive cesium-contaminated food sources. Vascular plants do not accumulate large levels of cesium 

through root uptake because cesium is strongly adsorbed to soils. However, the deposition of radioactive 

debris on flora with large surface areas such as lichens or moss is significant. Animals that feed on this 

vegetation, such as reindeer and caribou, may ingest large quantities of radiocesium (and other radionuclides found in fallout). Human consumption of meat from such animals results in the internalization 

of these radionuclides (see Section 6.7 for more detailed information on the lichen-caribou-human food 

chain). Radioactive cesium particles may be found in the air following the release of nuclear fission 

products; however, no reports were located in which adverse health effects from inhalation of radioactive 

cesium were discussed. Dermal absorption has been observed in rats, as evidenced by traces of 137Cs in 

the blood a few minutes following dermal application of 137CsCl (Pendic and Milivojevic 1966), but no 

data were located on relative amounts and absorption rates. 

Limited human data are available regarding health effects that can be exclusively associated with 

exposure to radioactive cesium sources such as 137Cs and 134Cs. These radionuclides are products of 

either neutron activation or nuclear fission and may, therefore, be released from sites where nuclear 

fission occurs, from radioactive material removed from such sites, or from leakage of radioactive cesium 

sources. Both 137Cs and 134Cs emit beta radiation (that travels short distances and can penetrate the skin 

and superficial body tissues) and gamma radiation (that penetrates the entire body). The radiation dose 

from these radionuclides can be classified as either external (if the source is outside the body) or internal 

(if the source is inside the body). 

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 21 

3. HEALTH EFFECTS 

Once radioactive cesium is internalized, it is absorbed, distributed, and excreted in the same manner as 

stable cesium. The internal radiation dose from cesium is a measure of the amount of energy that the beta 

and gamma emissions deposit in tissue. The short-range beta radiation produces a localized dose while 

the more penetrating gamma radiation contributes to a whole body dose. Molecular damage results from 

the direct ionization of atoms that are encountered by beta and gamma radiation and by interactions of 

resulting free radicals with nearby atoms. Tissue damage results when the molecular damage is extensive 

and not sufficiently repaired in a timely manner. 

In radiation biology, the term absorbed dose is the amount of energy deposited by radiation per unit mass 

of tissue, expressed in units of rad or gray (Gy) (see Appendix D for a detailed description of principles of 

ionizing radiation. The term dose equivalent refers to the biologically significant dose, which is 

determined by multiplying the absorbed dose by radiation weighting factors for the type and energy of the 

radiations involved. Dose equivalent is expressed in units of rem or sievert (Sv). The radiation weighting 

factors are considered to be unity for the beta and gamma radiation emitted from 134Cs and 137Cs, so for 

these radionuclides, the absorbed dose (in rad or Gray) is equal to the dose equivalent (in rem or sievert). 

The dose equivalent from internalized cesium radionuclides is estimated using the quantity of material 

entering the body (via ingestion or inhalation), the biokinetic parameters for cesium (retention, 

distribution, and excretion), the energies and intensities of the beta and gamma radiation emitted, and 

parameters describing the profile of absorbed radiation energy within the body. If, for example, a person 

ingests a given activity of radiocesium (measured in curies [Ci] or becquerels [Bq]), the tissues of the 

body will absorb some of the energy of the emitted beta and gamma radiation in a pattern reflecting the 

kinetics of distribution and elimination of the ingested radiocesium, the rate at which the radioactive 

isotope decays to a stable form, and the age of the person at the time of ingestion, which affects both the 

biokinetics of the radiocesium as well as the potential length of time over which the tissues can be 

exposed to the radiation. The biodistribution of cesium will vary somewhat for uptake in muscle, fat, 

various organs, and the skeleton. Therefore, each tissue may receive a different dose equivalent. The 

total dose equivalent for the body will reflect the integration of the dose equivalents for the various tissues 

using a weighting scheme for the relative sensitivities of tissues and organs to short- and long-term 

effects. 

The EPA has published a set of internal dose conversion factors for standard persons of various ages 

(newborn; 1, 5, 10, or 15 years of age; and adult) in its Federal Guidance Report No. 13 supplemental CD 

(EPA 2000). For example, the EPA has estimated that the dose equivalent following ingestion of 1 Bq of 

137Cs is 1.30x10-8 Sv (assuming an integration time of 50 years for an adult following the initial 
CESIUM 22 

3. HEALTH EFFECTS 

exposure). Age-specific dose coefficients for inhalation and ingestion of any of the radioactive isotopes 

of cesium by the general public can be found in ICRP publications 71 (ICRP 1995) and 72 (ICRP 1996), 

respectively. Dose coefficients for inhalation, ingestion, and submersion in a cloud of cesium radionuclides can be found in U.S. EPA Federal Guidance Report No. 11 (EPA, 1993a). Dose coefficients for 

external exposure to radioisotopes of cesium in air, surface water, or soil contaminated to various depths 

can be found in U.S. EPA Federal Guidance Report No. 12 (EPA, 1993b). 

Adverse health effects resulting from external exposure to beta or gamma emissions from radioisotopes of 

cesium would be the same as those from other radioactive elements that release beta or gamma radiation, 

and would not be the result of exposure to cesium per se (refer to Section 2.2 for a discussion of doserelated symptoms of acute radiation exposure). Developmental and carcinogenic effects have been 

reported in Japanese survivors of acute high-dose external radiation from the atomic bombs detonated 

over Hiroshima and Nagasaki (see Agency for Toxic Substances and Disease Registry 1999 for a detailed 

description of the health effects related to ionizing radiation in general). Exposure to lower levels of 

radiation would be expected to result in decreased health risk. Although developmental and carcinogenic 

effects would be expected in individuals subjected to high radiation doses from any source of gamma 

radiation, non-accidental exposure to a level of significant health risk via a radiocesium source is not 

likely to occur. 

Symptoms typical of cutaneous radiation syndrome (initial dermal erythema and subsequent ulceration) 

occurred among Russian military recruits who were accidentally exposed to a sealed source of 137Cs 

(Gottlöber et al. 2000). Some of the exposed men also described symptoms of nausea, vomiting, and 

headache, which occurred at the onset of the dermal effects. 

A number of individuals in Goiânia, Brazil, who experienced mixed external, dermal, and oral exposure 

to an opened 137CsCl source, exhibited classic 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, reduced sperm counts, and death (in four cases, attributed to 

infections resulting from reduced resistance) (Brandão-Mello et al. 1991; Gomes et al. 1990). External 

exposure was estimated based on frequencies of chromosomal aberrations in lymphocytes of exposed 

individuals at various times following exposure, while internal doses were estimated based on wholebody radiation counting and excretory levels of 137Cs. The adverse effects were the result of beta and 

gamma radiation, not cesium per se. 
CESIUM 23 

3. HEALTH EFFECTS 

Information regarding adverse effects in animals exposed to radioactive isotopes of cesium via natural 

routes (inhalation, oral, or dermal) is limited to observations of significantly reduced fertility and 

temporary sterility in male mice following single or repeated oral administration of radioactive cesium 

nitrate (Ramaiya et al. 1994). Postmating embryo mortality was associated with increased frequency of 

dominant lethal mutations. Studies of animals exposed to radiocesium via natural routes are not usually 

performed because levels great enough to cause significant adverse health effects would also pose a 

severe health risk to investigators. However, it has been shown that distribution patterns of 137Cs are 

similar in animals exposed to relatively nontoxic levels of 137CsCl by parenteral injection, inhalation 

exposure, or oral administration (Boecker et al. 1969a; Stara 1965). Therefore, the occurrence of 

depressed blood factors, severe bone marrow depression, germinal cell damage, early death, and 

increased incidences of benign and malignant neoplasms in a variety of tissues in dogs exposed to 137CsCl 

via intravenous injection provide the most reasonable indication of health effects that would be expected 

in animals exposed to 137CsCl by inhalation or oral exposure (Nikula et al. 1995, 1996). 

Adverse neurological, developmental, reproductive, genotoxic, and cancer effects have been observed in 

animal studies employing external exposure to sealed radioactive cesium sources, and are the result of the 

external gamma radiation, not the cesium per se. Impaired motor activity, decreased thickness of cortical 

layers of the brain, and increased aggressive behavior were observed after the birth of rats that had been 

briefly exposed in utero to relatively high levels of external radiation from a 137Cs source (Minamisawa et 

al. 1992; Norton and Kimler 1987, 1988). The most vulnerable developmental period was around 

gestational days 14–15. In another study, adverse developmental effects in fetal rats irradiated on 

gestational day 12 included reduced litter size, smaller head size, retarded odontogenesis, and cleft palate 

when examined on gestational day 18 (Saad et al. 1991, 1994). Significant increases in the formation rate 

of micronuclei were seen in blood cells of other fetal rats following irradiation of pregnant dams via a 

sealed 137Cs source on gestational day 14 (Koshimoto et al. 1994). Significantly reduced fertility 

(including temporary sterility) was reported in male mice exposed to an external 137Cs source for almost 

20 days; an increased frequency of dominant lethal mutations was also indicated by increased postmating 

embryo mortality (Ramaiya et al. 1994). Increased lifetime risk of mammary tumors was noted in female 

rats that were exposed, between the ages of 8 and 36 weeks, to single whole-body doses of radiation from 

a 137Cs source (Bartstra et al. 1998). Irradiation at 64 weeks, however, yielded fewer carcinomas than 

unirradiated controls. 
CESIUM	 24 

3. HEALTH EFFECTS 

3.2	 DISCUSSION OF HEALTH EFFECTS OF STABLE CESIUM BY ROUTE OF 

EXPOSURE 

Section 3.2 discusses the chemical toxicity of cesium. Radiation toxicity resulting from exposure to 

radiocesium is discussed in Section 3.3. 

To help public health professionals and others address the needs of persons living or working near 

hazardous waste sites, the information in this section is organized first by route of exposure (inhalation, 

oral, and dermal) and then by health effect (death, systemic, immunological, neurological, reproductive, 

developmental, genotoxic, and carcinogenic effects). These data are discussed in terms of three exposure 

periods: acute (14 days or less), intermediate (15–364 days), and chronic (365 days or more). 

Levels of significant exposure for each route and duration are presented in tables and illustrated in 

figures. The points in the figures showing no-observed-adverse-effect levels (NOAELs) or lowestobserved-adverse-effect levels (LOAELs) reflect the actual doses (levels of exposure) used in the studies. 

LOAELs have been classified into "less serious" or "serious" effects. "Serious" effects are those that 

evoke failure in a biological system and can lead to morbidity or mortality (e.g., acute respiratory distress 

or death). "Less serious" effects are those that are not expected to cause significant dysfunction or death, 

or those whose significance to the organism is not entirely clear. ATSDR acknowledges that a 

considerable amount of judgment may be required in establishing whether an end point should be 

classified as a NOAEL, "less serious" LOAEL, or "serious" LOAEL, and that in some cases, there will be 

insufficient data to decide whether the effect is indicative of significant dysfunction. However, the 

Agency has established guidelines and policies that are used to classify these end points. ATSDR 

believes that there is sufficient merit in this approach to warrant an attempt at distinguishing between 

"less serious" and "serious" effects. The distinction between "less serious" effects and "serious" effects is 

considered to be important because it helps the users of the profiles to identify levels of exposure at which 

major health effects start to appear. LOAELs or NOAELs should also help in determining whether or not 

the effects vary with dose and/or duration, and place into perspective the possible significance of these 

effects to human health. 

The significance of the exposure levels shown in the Levels of Significant Exposure (LSE) tables and 

figures may differ depending on the user's perspective. Public health officials and others concerned with 

appropriate actions to take at hazardous waste sites may want information on levels of exposure 

associated with more subtle effects in humans or animals (LOAELs) or exposure levels below which no 
CESIUM 25 

3. HEALTH EFFECTS 

adverse effects (NOAELs) have been observed. Estimates of levels posing minimal risk to humans 

(Minimal Risk Levels or MRLs) may be of interest to health professionals and citizens alike. 

Estimates of exposure levels posing minimal risk to humans (Minimal Risk Levels or MRLs) have been 

made for cesium. An MRL is defined as an estimate of daily human exposure to a substance that is likely 

to be without an appreciable risk of adverse effects (noncarcinogenic) over a specified duration of 

exposure. MRLs are derived when reliable and sufficient data exist to identify the target organ(s) of 

effect or the most sensitive health effect(s) for a specific duration within a given route of exposure. 

MRLs are based on noncancerous health effects only and do not consider carcinogenic effects. MRLs can 

be derived for acute, intermediate, and chronic duration exposures for inhalation and oral routes. 

Appropriate methodology does not exist to develop MRLs for dermal exposure. 

Although methods have been established to derive these levels (Barnes and Dourson 1988; EPA 1990b), 

uncertainties are associated with these techniques. Furthermore, ATSDR acknowledges additional 

uncertainties inherent in the application of the procedures to derive less than lifetime MRLs. As an 

example, acute inhalation MRLs may not be protective for health effects that are delayed in development 

or are acquired following repeated acute insults, such as hypersensitivity reactions, asthma, or chronic 

bronchitis. As these kinds of health effects data become available and methods to assess levels of 

significant human exposure improve, these MRLs will be revised. 

A User's Guide has been provided at the end of this profile (see Appendix B). This guide should aid in 

the interpretation of the tables and figures for Levels of Significant Exposure and the MRLs. 

3.2.1 Inhalation Exposure 

No reports were located regarding the following health effects in humans or animals following inhalation 

exposure to stable cesium: 

3.2.1.1 Death 

3.2.1.2 Systemic Effects 

3.2.1.3 Immunological and Lymphoreticular Effects 

3.2.1.4 Neurological Effects 

3.2.1.5 Reproductive Effects 
CESIUM 26 

3. HEALTH EFFECTS 

3.2.1.6 Developmental Effects 

3.2.1.7 Cancer 

3.2.2 Oral Exposure 

Limited information is available regarding health effects following oral exposure of humans to stable 

cesium compounds. Symptoms of decreased appetite, nausea, diarrhea, and cardiac arrhythmia have been 

associated with consumption of cesium chloride (Bangh et al. 2001; Harik et al. 2002; Neulieb 1984; 

Saliba et al. 2001). Death was reported laboratory animals following oral administration of large doses of 

cesium compounds (Ghosh et al. 1990; Johnson et al. 1975; Khosid 1967). 

3.2.2.1 Death 

No reports were located regarding death in humans following acute-, intermediate-, or chronic-duration 

oral exposure to stable cesium. 

No studies were located regarding death in animals following intermediate- or chronic-duration oral 

exposure to stable cesium. However, acute oral administration of cesium at high dose levels has resulted 

in observed mortality in rats and mice. In female mice administered cesium chloride, reported oral LD50 

values range from 2,300 to 2,500 mg/kg (Ghosh et al. 1990; Khosid 1967). An acute oral LD50 value for 

cesium iodide is 2,386 mg/kg in rats (Johnson et al. 1975). Cesium hydroxide appears to be more highly 

toxic to rats than cesium chloride and cesium iodide, as evidenced by a lower LD50 value of 1,026 mg/kg 

(Johnson et al. 1975). Some of the toxic effects can be attributed to the strong alkaline nature of cesium 

hydroxide. Khosid (1967) estimated an acute oral LD50 value of 800 mg/kg for mice that were 

administered cesium hydroxide. No information was located regarding mortality in animals following 

oral administration of other compounds of stable cesium. 

3.2.2.2 Systemic Effects 

Decreased appetite, nausea, and diarrhea were reported in a man who ingested about 34 mg Cs/kg (as 

stable cesium chloride) after morning and evening meals for 36 days; this man also experienced apparent 

neurological changes within 15 minutes of dosing (Neulieb 1984). Prolonged QT syndrome and 

associated cardiac arrhythmias have been described in patients who have ingested cesium chloride as a 
CESIUM 27 

3. HEALTH EFFECTS 

component of homeopathic remedies (Bangh et al. 2001; Harik et al. 2002; Saliba et al. 2001). No 

additional information was located regarding systemic effects in humans following oral exposure to stable 

cesium. 

No animal studies were located in which the systemic effects that were observed following oral 

administration of compounds of stable cesium could be attributed to the presence of cesium. 

Gastrointestinal and respiratory effects noted in rats administered acute oral doses of cesium hydroxide 

may have been due to the alkaline properties of the compound rather than the biochemical behavior of 

cesium. 

No data were located regarding, hematological, musculoskeletal, endocrine, dermal, ocular, or metabolic 

effects in humans or animals following oral exposure to stable cesium. 

Respiratory Effects. No reports were located regarding respiratory effects in humans following 

acute-, intermediate-, or chronic-duration oral exposure to stable cesium. 

No reports were located regarding respiratory effects in animals following intermediate- or chronicduration exposure to stable cesium. Congested, cyanotic lungs with petechial hemorrhages were observed 

in rats following oral treatment with single cesium iodide doses large enough to cause death. A bloody 

nasal exudate was seen in some relatively high-dose rats (Johnson et al. 1975). 

Cardiovascular Effects. Individual case reports describe prolonged QT syndrome and associated 

cardiac arrhythmia in patients who consumed cesium chloride as a component of homeopathic remedies 

for cancer prevention (Saliba et al. 2001), tumor reduction (Harik et al. 2002), and cyst reduction (Bangh 

et al. 2001. No reports were located regarding cardiovascular effects in animals following acute-, 

intermediate-, or chronic-duration oral exposure to stable cesium. 

Gastrointestinal Effects. No reports were located regarding gastrointestinal effects in humans 

following acute- or chronic-duration oral exposure to stable cesium, and only one report of intermediateduration exposure was located. An investigator who voluntarily ingested about 34 mg Cs/kg (as cesium 

chloride, assuming 70 kg body weight) after each morning and evening meal (68 mg Cs/kg/day) for 

36 days reported gradually decreased appetite, prenausea feelings, and diarrhea. The observations were 

self-described and effects were correlated to dietary habits during the course of the study (Neulieb 1984). 
CESIUM 28 

3. HEALTH EFFECTS 

No reports were located regarding gastrointestinal effects in animals following intermediate- or chronicduration oral exposure to stable cesium. In an acute lethality study of rats, administration of cesium 

hydroxide or cesium iodide at dose levels up to 910 or 1,217 mg Cs/kg, respectively, resulted in stomach 

and intestinal hemorrhage, bloody fluid exudate within the peritoneal cavity, and adhesions of abdominal 

organs. Rats receiving lethal doses of cesium iodide exhibited fluid-filled stomach (Johnson et al. 1975). 

Hepatic Effects. No reports were located regarding hepatic effects in humans following acute-, 

intermediate-, or chronic-duration oral exposure to stable cesium. 

No reports were located regarding hepatic effects in animals following acute- or chronic-duration oral 

exposure to stable cesium. No significant effect on maternal liver weight was noted in rats consuming 

115 mg Cs/kg/day (as cesium chloride in the drinking water) during gestation and 40 mg Cs/kg/day 

during lactation (Messiha 1988b). 

Renal Effects. No reports were located regarding renal effects in humans following acute-, 

intermediate-, or chronic-duration oral exposure to stable cesium. 

No reports were located regarding renal effects in animals following acute- or chronic-duration oral intake 

of stable cesium, and one report was located regarding intermediate-duration intake. In that study, no 

significant effect on maternal kidney weight was noted in mice consuming 115 mg Cs/kg/day (as cesium 

chloride in the drinking water) during gestation and 40 mg Cs/kg/day during lactation (Messiha 1988b). 

Body Weight Effects. No reports were located regarding body weight effects in humans following 

acute-, intermediate-, or chronic-duration oral exposure to stable cesium. 

No reports were located regarding body weight effects in animals following acute- or chronic-duration 

oral exposure to stable cesium. One intermediate-duration study found no significant effect on maternal 

body weight in mice consuming 115 mg Cs/kg/day (as cesium chloride in the drinking water) during 

gestation and 40 mg Cs/kg/day during lactation (Messiha 1988b). 

3.2.2.3 Immunological and Lymphoreticular Effects 

No reports were located regarding immunological or lymphoreticular effects in humans following acute-, 

intermediate-, or chronic-duration oral exposure to stable cesium. 
CESIUM 29 

3. HEALTH EFFECTS 

No reports were located regarding immunological or lymphoreticular effects in animals following acuteor chronic-duration oral exposure to stable cesium. In one study of intermediate-duration, no significant 

effect on maternal spleen weight was noted in mice consuming 115 mg Cs/kg/day (as cesium chloride in 

the drinking water) during gestation and 40 mg Cs/kg/day during lactation (Messiha 1988b). 

3.2.2.4 Neurological Effects 

No reports were located regarding neurological effects in humans following acute- or chronic-duration 

oral exposure to stable cesium. In one study of intermediate-duration exposure, an investigator, who 

voluntarily ingested about 34 mg Cs/kg/day (as stable cesium chloride) after morning and evening meals 

for 36 days, experienced general feelings of well-being, heightened sense perception, and tingling 

sensations in lips, cheeks, hands, and feet within 15 minutes of intake (Neulieb 1984). No self-reported 

adverse effects were noted in performance of mathematical tasks or in automobile driving skill. 

No reports were located regarding neurological effects in animals following intermediate- or chronicduration oral exposure to stable cesium. Rats administered unspecified acute gavage doses of cesium 

hydroxide exhibited initial signs of hyperexcitability followed by apathy and weakness during the course 

of 14 days of observation after dosing (Johnson et al. 1975). 

3.2.2.5 Reproductive Effects 

No reports were located regarding reproductive effects in humans or animals following acute-, 

intermediate-, or chronic-duration oral exposure to stable cesium. 

3.2.2.6 Developmental Effects 

No reports were located regarding developmental effects in humans following acute-, intermediate-, or 

chronic-duration oral exposure to stable cesium. 

No reports were located regarding developmental effects in animals following acute- or chronic-duration 

oral exposure to stable cesium. In intermediate-duration studies, one investigator reported reduced body 

weight in offspring of mouse dams consuming approximately 115 mg Cs/kg/day during gestation and 
CESIUM 30 

3. HEALTH EFFECTS 

40 mg Cs/kg/day during lactation (Messiha 1988b). Other observations included slight, but significant, 

changes in some organ weights and slight differences in activity of some hepatic enzymes among 

offspring of treated dams, relative to controls. Similar results were reported in the offspring of female 

mice consuming approximately 40 mg Cs/kg/day only during lactation (Messiha 1989b). However, gross 

and histopathologic examinations of the offspring, typical of well-designed developmental toxicity 

studies, were not performed in either of these studies, making them of little value for assessment of the 

developmental toxicity potential of cesium. 

3.2.2.7 Cancer 

No reports were located in which cancer in humans or animals could be associated with acute-, 

intermediate-, or chronic-duration oral exposure to stable cesium. 

3.2.3 Dermal Exposure 

3.2.3.1 Death 

No reports were located regarding death in humans or animals following acute-, intermediate-, or chronicduration dermal exposure to stable cesium. 

3.2.3.2 Systemic Effects 

No reports were located in which respiratory, cardiovascular, gastrointestinal, hematological, musculoskeletal, hepatic, renal, endocrine, body weight, or metabolic effects in humans or animals could be 

associated with dermal exposure to stable cesium. 

Dermal Effects. No reports were located regarding dermal effects in humans following acute-, 

intermediate-, or chronic-duration dermal exposure to stable cesium. 

No reports were located regarding dermal effects in animals following intermediate- or chronic-duration 

dermal exposure to stable cesium. Cesium hydroxide was considered a nonirritant on intact skin and a 

mild irritant on abraded skin of rabbits 24 and 48 hours, respectively, following closed-patch application 

of a 5% solution; similar application of cesium iodide resulted in no observed irritation (Johnson et al. 

1975). 
CESIUM 31 

3. HEALTH EFFECTS 

Ocular Effects. No reports were located regarding eye irritation in humans resulting from ocular 

contact with stable cesium. 

A 5% solution of cesium hydroxide was extremely irritating and caustic to the rabbit eye (Johnson et al. 

1975). It is likely that this effect was the result of the caustic nature of the hydroxide rather than an effect 

due to cesium per se. Similar treatment with cesium iodide resulted in no evidence of ocular irritation. 

3.2.3.3 Immunological and Lymphoreticular Effects 

No reports were located regarding immunological or lymphoreticular effects in humans following acute-, 

intermediate-, or chronic-duration dermal exposure to stable cesium. 

No reports were located regarding immunological or lymphoreticular effects in animals following acuteor chronic-duration dermal exposure to stable cesium. There was no indication of a sensitization response 

in guinea pigs following repeated intracutaneous injections of 0.1% solutions of cesium hydroxide or 

cesium iodide (Johnson et al. 1975). 

No reports were located regarding the following health effects in humans or animals following dermal 

exposure to stable cesium: 

3.2.3.4 Neurological Effects 

3.2.3.5 Reproductive Effects 

3.2.3.6 Developmental Effects 

3.2.3.7 Cancer 

3.2.4 Other Routes of Exposure 

3.2.4.1 Death 

No data were located regarding death in humans or animals following exposure to stable cesium via 

routes other than inhalation, oral, or dermal exposure. 
CESIUM	 32 

3. HEALTH EFFECTS 

3.2.4.2 Systemic Effects 

No data were located regarding respiratory, gastrointestinal, hematological, musculoskeletal, hepatic, 

renal, endocrine, dermal, ocular, body weight, or metabolic effects in humans or animals following 

exposure to stable cesium via routes other than inhalation, oral, or dermal exposure. 

Cardiovascular Effects. Cardiac arrhythmias were elicited in experimental animals following the 

injection of stable cesium chloride directly into the circulatory system (Brachmann et al. 1983; Levine et 

al. 1985; Murakawa et al. 1997; Patterson et al. 1990; Senges et al. 2000). 

No reports were located in which the following health effects in humans or animals could be associated 

with exposure to stable cesium via routes other than inhalation, oral, or dermal exposure: 

3.2.4.3	 Immunological and Lymphoreticular Effects 

3.2.4.4 Neurological Effects 

3.2.4.5 Reproductive Effects 

3.2.4.6 Developmental Effects 

3.2.4.7 Cancer 

3.3	 DISCUSSION OF HEALTH EFFECTS OF RADIOACTIVE CESIUM BY ROUTE OF 

EXPOSURE 

Section 3.3 discusses radiation toxicity associated with exposure to radionuclides of cesium and is 

organized in the same manner as that of Section 3.2, first by route of exposure (inhalation, oral, and 

external) and then by health effect (death, systemic, immunological, neurological, reproductive, 

developmental, and carcinogenic effects). These data are discussed in terms of three exposure periods: 

acute (14 days or less), intermediate (15–364 days), and chronic (365 days or more). 

Levels of significant exposure for each route and duration are presented in tables and illustrated in 

figures. The points in the figures showing NOAELs or LOAELs reflect the actual dose (levels of 

exposure) used in the studies. Refer to Section 3.2 for detailed discussion of the classification of 

endpoints as a NOAEL, less serious LOAEL, or serious LOAEL. 
CESIUM 33 

3. HEALTH EFFECTS 

Refer to Appendix B for a User's Guide, which should aid in the interpretation of the tables and figures 

for Levels of Significant Exposure. 

3.3.1 Inhalation Exposure 

During and after nuclear accidents, such as the steam explosion that occurred at the Chernobyl nuclear 

power plant in 1986, significant amounts of 137Cs (and to a lesser extent 134Cs) may be released to the 

atmosphere in suspended particles and be widely dispersed through the air. Although radioactive cesium, 

suspended in the air following such accidents or re-suspended later from ground-deposited fallout 

(USNRC 1998), may be internalized via inhalation, there was no indication that inhalation was a 

significant route of exposure to radioactive cesium among individuals exposed externally by either being 

in the vicinity of a release or in areas receiving substantial ground-deposited fallout, or those exposed by 

ingestion of radioactive cesium-contaminated food following the Chernobyl accident (Balonov 1993). 

No reports were located regarding health effects in humans or animals following inhalation exposure to 

radioactive cesium. Available human case reports and animal studies involving inhaled radioisotopes of 

cesium deal exclusively with biokinetics. Parenteral injection of 137CsCl in laboratory animals has 

resulted in distribution patterns and tissue doses of 137Cs that are similar to those resulting from inhalation 

or oral exposure (Boecker et al. 1969a; Stara 1965). For these reasons, it has been proposed that adverse 

health effects, related to a soluble and readily absorbed compound such as 137CsCl, should be similar 

across the three routes of exposure (Melo et al. 1996, 1997; Nikula et al. 1995, 1996). Therefore, 

depressed blood factors, severe bone marrow depression, germinal cell damage, early death, and 

increased incidences of benign and malignant neoplasms in a variety of tissues and organs, effects that 

have been observed in dogs following intravenous administration of 137CsCl (Nikula et al. 1995, 1996; 

Redman et al. 1972), would be expected to occur following inhalation exposure to air concentrations of 

137CsCl that would result in comparable 137Cs blood concentrations (see Section 3.3.4 for additional 

information regarding exposure other than inhalation, oral, dermal, or external exposure). 

3.3.1.1 Death 

Although no studies were located regarding death in humans or animals following acute-, intermediate-, 

or chronic-duration inhalation exposure to radioactive cesium, dose-related decreased survival was 

observed in beagle dogs that had received single intravenous injections of 137CsCl in amounts resulting in 

average initial body burdens of 64–147 MBq/kg (1.7–4.0 mCi/kg) (Nikula et al. 1995, 1996). Similar 
CESIUM 34 

3. HEALTH EFFECTS 

effects would be expected in animals exposed to air concentrations of 137CsCl that would result in similar 

body burdens (see Section 3.3.4 for more detailed information regarding health effects in animals exposed 

to radioactive cesium via routes other than inhalation, oral, dermal, or external exposure). 

3.3.1.2 Systemic Effects 

No data were located regarding systemic effects in humans or animals following acute-, intermediate-, or 

chronic-duration inhalation exposure to radioactive cesium. However, hematological effects similar to 

those observed in dogs that had received single intravenous injections of 137CsCl (Nikula et al. 1995, 

1996; Redman et al. 1972) would be expected in animals exposed to air concentrations of 137CsCl that 

would result in body burdens similar to those attained via intravenous injection. 

Hematological Effects. Depressed blood cell counts and platelet levels, reduced packed-cell volume, 

and bone marrow aplasia were observed in dogs that had been administered single intravenous injections 

of 137CsCl, which resulted in average initial body burdens ranging from 36.4 to 141.0 MBq/kg (1.0 to 

3.8 mCi/kg) (Nikula et al. 1995; Redman et al. 1972). Severely depressed blood cell counts were 

observed in 23 dogs that died within 52 days following single intravenous administration of 137CsCl at 

levels resulting in average initial body burdens in the range of 64–147 MBq/kg (1.7–4.0 mCi/kg) (Nikula 

et al. 1996). Similar effects would be expected in dogs exposed to air concentrations of 137CsCl that 

would result in body burdens similar to those attained via intravenous injection (see Section 3.3.4 for 

more detailed information regarding health effects in animals exposed to radioactive cesium via routes 

other than inhalation, oral, dermal, or external exposure). 

3.3.1.3 Immunological and Lymphoreticular Effects 

No data were located regarding immunological or lymphoreticular effects in humans or animals following 

acute-, intermediate-, or chronic-duration inhalation exposure to radioactive cesium. However, severe 

bone marrow depression was observed in dogs exposed to 137CsCl by intravenous injection at activity 

levels resulting in estimated total bone marrow doses of 7–24 Gy (700–2,400 rad) (Nikula et al. 1995). 

Similar effects would be expected in dogs exposed to air concentrations of 137CsCl that would result in 

body burdens similar to those attained via intravenous injection (see Section 3.3.4 for more detailed 

information regarding health effects in animals exposed to radioactive cesium via routes other than 

inhalation, oral, dermal, or external exposure). 
CESIUM 35 

3. HEALTH EFFECTS 

3.3.1.4 Neurological Effects 

No data were located regarding neurological effects in humans or animals following acute-, intermediate-, 

or chronic-duration inhalation exposure to radioactive cesium. 

3.3.1.5 Reproductive Effects 

No data were located regarding reproductive effects in humans or animals following acute-, intermediate-, 

or chronic-duration inhalation exposure to radioactive cesium. However, germinal epithelium damage 

and azoospermia were reported in dogs that had been administered 137CsCl by intravenous injection at 

activity levels resulting in long-term total whole-body doses ranging from 7.42 to 16.40 Gy (742 to 

1,640 rad) (Nikula et al. 1995, 1996). Similar effects would be expected in dogs exposed to air 

concentrations of 137CsCl that would result in body burdens similar to those attained via intravenous 

injection (see Section 3.3.4 for more detailed information regarding health effects in animals exposed to 

radioactive cesium via routes other than inhalation, oral, dermal, or external exposure). 

3.3.1.6 Developmental Effects 

No data were located regarding developmental effects in humans or animals following acute-, 

intermediate-, or chronic-duration inhalation exposure to radioactive cesium. 

3.3.1.7 Cancer 

No data were located in which cancer in humans or animals could be associated with acute-, 

intermediate-, or chronic-duration inhalation exposure to radioactive cesium. However, benign and 

malignant neoplasms were found in a variety of tissues and organs of dogs administered single 

intravenous doses of 137CsCl, which resulted in average initial body burdens ranging from 37 to 

147 MBq/kg (1.0 to 4.0 mCi/kg) (Nikula et al. 1995, 1996). Similar effects would be expected in dogs 

exposed to air concentrations of 137CsCl that would result in body burdens similar to those attained via 

intravenous injection (see Section 3.3.4 for more detailed information regarding health effects in animals 

exposed to radioactive cesium via routes other than inhalation, oral, dermal, or external exposure). 
CESIUM 36 

3. HEALTH EFFECTS 

3.3.2 Oral Exposure 

No reports were located regarding health effects in humans or animals that could be exclusively 

associated with oral exposure to radioisotopes of cesium. Available human case reports and animal 

studies involving ingested radioisotopes of cesium deal with biokinetics. Parenteral injection of 137CsCl 

in laboratory animals has resulted in distribution patterns and tissue doses of 137Cs that are similar to those 

resulting from inhalation or oral exposure (Boecker et al. 1969a; Stara 1965). For these reasons, it has 

been proposed that adverse health effects, related to a soluble and readily absorbed compound such as 

137CsCl, should be similar across the three routes of exposure (Melo et al. 1996, 1997; Nikula et al. 1995, 

1996). Therefore, depressed blood factors, severe bone marrow depression, germinal cell damage, early 

death, and increased incidences of benign and malignant neoplasms in a variety of tissues and organs, 

effects that have been observed in dogs following intravenous administration of 137CsCl (Nikula et al. 

1995, 1996; Redman et al. 1972), would be expected to occur following oral administration of 137CsCl in 

amounts that would result in comparable 137Cs blood concentrations (see Section 3.3.4 for additional 

information regarding exposure other than inhalation, oral, dermal, or external exposure). 

3.3.2.1 Death 

No reports were located regarding death in humans that could be exclusively associated with acute-, 

intermediate-, or chronic-duration oral exposure to radioactive cesium. In an event involving mixed 

external, dermal, and oral exposure of adults and children to an opened 137CsCl source, significant shortterm morbidity was followed in 50 patients and 4 deaths were reported within a few weeks among 

individuals with estimated radiation doses ranging from 4.5 to 6 Gy (450 to 600 rad) (Brandão-Mello et 

al. 1991). 

Although no studies were located regarding death in humans or animals following acute-, intermediate-, 

or chronic-duration oral exposure to radioactive cesium, decreased survival was observed in young adult 

beagle dogs that had received single intravenous injections of 137CsCl in amounts resulting in average 

initial body burdens of 64–147 MBq/kg (1.7–4.0 mCi/kg) (Nikula et al. 1995, 1996). Similar results 

would be expected in animals following oral exposure to 137CsCl levels that would result in similar body 

burdens (see Section 3.3.4 for more detailed information regarding health effects in animals exposed to 

radioactive cesium via routes other than inhalation, oral, dermal, or external exposure). 
CESIUM 37 

3. HEALTH EFFECTS 

3.3.2.2 Systemic Effects 

Acute radiation syndrome, characterized by nausea, vomiting, and diarrhea was reported in a number of 

individuals following mixed external, dermal, and oral exposure to an opened 50.9 TBq (1,375 Ci) 

137CsCl source in Goiânia, Brazil. Other adverse effects included skin lesions, ocular lesions, severe bone 

marrow depression, and mild elevations in the activities of some liver enzymes (Brandão-Mello et al. 

1991; Gomes et al. 1990; Rosenthal et al. 1991). Hematological effects similar to those observed in dogs 

that had received single intravenous injections of 137CsCl (Nikula et al. 1995, 1996; Redman et al. 1972) 

would be expected in animals following oral administration of 137CsCl at levels that would result in body 

burdens similar to those attained via intravenous injection. 

No data were located regarding, respiratory, cardiovascular, musculoskeletal, renal, endocrine, body 

weight, or metabolic effects in humans or animals following oral exposure to radioactive cesium. 

Gastrointestinal Effects. Vomiting, diarrhea, and nausea were observed among eight patients 

treated for acute radiation exposure to an opened 137CsCl source, both via external exposure and internal 

exposure (Brandão-Mello et al. 1991). These and other symptoms were classic symptoms of acute 

radiation syndrome. No reports were located regarding gastrointestinal effects in humans following 

intermediate- or chronic-duration oral exposure to radioactive cesium 

No reports were located for animals regarding gastrointestinal effects following acute-, intermediate-, or 

chronic-duration oral exposure to radioactive cesium. 

Hematological Effects. No reports were located for humans regarding hematological effects 

following intermediate- or chronic-duration oral exposure to radioactive cesium. In the 1987 incident of 

overexposure to a scavenged medical radiation source containing 50.9 TBq (1,375 Ci) 137CsCl, 

approximately 250 persons were contaminated externally, many of whom also were contaminated 

internally. Twenty individuals developed the acute radiation syndrome, 14 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 of these 14 heavily contaminated individuals died. These effects are typical signs and 

symptoms of the hemopoietic (blood forming) syndrome in which the blood forming cells in the bone 

marrow are killed. This results in sharp decreases of all the blood cells and consequent impairment of the 

immune system and anemia (Brandão-Mello et al. 1991; Gomes et al. 1990). 
CESIUM 38 

3. HEALTH EFFECTS 

No reports were located for animals regarding hematological effects following acute-, intermediate-, or 

chronic-duration oral exposure to radioactive cesium. However, depressed blood cell counts and platelet 

levels, reduced packed-cell volume, and bone marrow aplasia were observed in dogs that had been 

administered single intravenous injections of 137CsCl, which resulted in average initial body burdens 

ranging from 36.4 to 141.0 MBq/kg (1.0 to 3.8 mCi) (Nikula et al. 1995; Redman et al. 1972). Severely 

depressed blood cell counts were observed in 23 dogs that died from 20 to 52 days following single 

intravenous administration of 137CsCl at levels resulting in initial body burdens in the range of 122– 

164 MBq/kg (3.3–4.4 mCi/kg) (Nikula et al. 1996) and in 11 other dogs (Nikula et al. 1995) that died 

from 19 to 81 days following intravenous administration of 137CsCl at levels resulting in initial body 

burdens in the range of 72–141 MBq/kg (1.9–3.8 mCi/kg). Similar effects would be expected in dogs 

following oral administration of 137CsCl at levels that would result in body burdens similar to those 

attained via intravenous injection (see Section 3.3.4 for more detailed information regarding health effects 

in animals exposed to radioactive cesium via routes other than inhalation, oral, dermal, or external 

exposure). 

Hepatic Effects. No reports were located that associate acute-duration oral exposure to radioactive 

cesium with hepatic effects. Mild elevations of aminotransferases (ALT/AST) were seen in a few patients 

hospitalized following radiation exposure to an opened 137CsCl source (Brandão-Mello et al. 1991). 

Exposures were both external and internal. No reports were located for humans regarding hepatic effects 

following intermediate- or chronic-duration oral exposure to radioactive cesium. 

No reports were located for animals regarding hepatic effects following acute-, intermediate-, or chronicduration oral exposure to radioactive cesium. 

Dermal Effects. Reports of dermal effects are restricted to the accidental mixed external, dermal, and 

oral exposure of a number of individuals to an opened 137CsCl source in which orofacial lesions, including 

oral bleeding and associated oral rash, mouth ulcers, acute oral candidiasis, and radiation dermatitis and 

depigmentation, were observed in 21 patients who had been acutely exposed at estimated radiation doses 

ranging from 1 to 7 Gy (100 to 700 rad) (Gomes et al. 1990). Some individuals exposed in the same 

incident exhibited typical radiation-induced skin lesions; the forearm was amputated in one individual 

with severe radiation injury (Brandão-Mello et al. 1991; Gomes et al. 1990). 

No reports were located regarding dermal effects in animals following acute-, intermediate-, or chronicduration oral exposure to radioactive cesium. 
CESIUM 39 

3. HEALTH EFFECTS 

Ocular Effects. No reports were located regarding ocular effects in humans following intermediateor chronic-duration oral exposure to radioactive cesium. Among 20 patients hospitalized following mixed 

external, dermal, and oral exposure to an opened 137CsCl source, a few patients complained of 

lacrimation, hyperemia and edema of the conjunctiva, and ocular pain (Brandão-Mello et al. 1991). 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. 

No reports were located regarding ocular effects in animals following acute-, intermediate-, or chronicduration oral exposure to radioactive cesium. 

3.3.2.3 Immunological and Lymphoreticular Effects 

No reports were located that associate immunological or lymphoreticular effects in humans with 

intermediate- or chronic-duration oral exposure to radioactive cesium. Severe bone marrow depression, 

characterized by a low white blood cell count and consequent immunodeficiency, developed in 

14 patients hospitalized following mixed external, dermal, and oral exposure to an opened 137CsCl source 

resulting in estimated absorbed doses ranging from 1 to 7 Gy (100 to 700 rad) (Brandão-Mello et al. 

1991). 

No reports were located regarding immunological or lymphoreticular effects in animals following acute-, 

intermediate-, or chronic-duration oral exposure to radioactive cesium. However, severe bone marrow 

depression was observed in dogs exposed to 137CsCl by intravenous injection at activity levels resulting in 

estimated total bone marrow doses of 7–24 Gy (700–2,400 rad) (Nikula et al. 1995). Similar effects 

would be expected in dogs following oral exposure to 137CsCl levels that would result in body burdens 

similar to those attained via intravenous injection (see Section 3.3.4 for more detailed information 

regarding health effects in animals exposed to radioactive cesium via routes other than inhalation, oral, 

dermal, or external exposure). 

3.3.2.4 Neurological Effects 

No reports were located for humans or animals that associate neurological effects with acute-, 

intermediate-, or chronic-duration oral exposure to radioactive cesium. 
CESIUM 40 

3. HEALTH EFFECTS 

3.3.2.5 Reproductive Effects 

No reports were located that associate reproductive effects in humans with intermediate- or chronicduration oral exposure to radioactive cesium. 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 137CsCl source (Brandão-Mello et al. 1991). These individuals may have 

experienced mixed external, dermal, and oral exposure. 

No reports were located regarding reproductive effects in animals following intermediate- or chronicduration oral exposure to radioactive cesium. Significantly reduced fertility, expressed as the percentage 

of matings resulting in pregnancy (percent effective matings), was noted in male mice following a single 

oral administration of 137Cs (as cesium nitrate) at activity levels that resulted in a total dose to the testis of 

approximately 3 Gy (300 rad) (Ramaiya et al. 1994). Complete, though temporary, sterility was evident 

at week 6 after dosing. By week 17, there were no significant differences in fertility between treatment 

and control groups. No significant reduction in male fertility was observed at activity levels resulting in 

cumulative doses to the testes ranging from 0.1 to 1 Gy (10 to 100 rad). Significantly reduced fertility 

was also evident in male mice administered daily oral doses of 137Cs (as cesium nitrate) for 2 weeks that 

resulted in total testicular radiation doses of about 3.85 Gy (385 rad), measured at 5 weeks after treatment 

(Ramaiya et al. 1994). 

Germinal epithelium damage and azoospermia were reported in dogs that had been administered 137Cs (as 

cesium chloride) by intravenous injection at activity levels resulting in long-term total whole-body doses 

ranging from 7.42 to 16.40 Gy (742 to 1,640 rad) (Nikula et al. 1995, 1996). Similar effects would be 

expected in dogs following oral exposure to 137CsCl levels that would result in body burdens similar to 

those attained via intravenous injection (see Section 3.3.4 for more detailed information regarding health 

effects in animals exposed to radioactive cesium via routes other than inhalation, oral, dermal, or external 

exposure). 

The highest NOAEL values and all reliable LOAEL values for reproductive effects from oral exposure to 

radioactive cesium are presented in Table 3-1 and plotted in Figure 3-1. 
Table 3-1 Levels of Significant Exposure to Cesium - Radiation Toxicity - Oral 

Exposure/ LOAEL
 

Duration/ a

Key to Species Frequency NOAEL Less Serious Serious 

(Specific Route) figure (Strain) System (rad) (rad) (rad) 

ACUTE EXPOSURE Reproductive 

1 Mouse Once 

200 M 300 M (temporary sterility)
 (Hybrid) (G) 

2 Mouse 2 wk 1x/d 

154 M 385 M (reduced fertility)
 (Hybrid) (G) 

a The number corresponds to entries in Figure 3-1. d=day(s); (G) = gavage; LOAEL = lowest-observed-adverse-effect level; M = male; NOAEL = no-observed-adverse-effect level; wk = week(s) 
1000 

Reproductive 

Figure 3-1. Levels of Significant Exposure to Cesium - Radiation Toxicity - Oral
 

Acute (≤14 day)
 

rad 

2m 1m 1m 2m 

c-Cat -Humans f-Ferret n-Mink Cancer Effect Level-Animals Cancer Effect Level-Humans 

d-Dog k-Monkey j-Pigeon o-Other LOAEL, More Serious-Animals LOAEL, More Serious-Humans 

r-Rat m-Mouse e-Gerbil LOAEL, Less Serious-Animals LOAEL, Less Serious-Humans 

p-Pig h-Rabbit s-Hamster NOAEL - Animals NOAEL - Humans 

q-Cow a-Sheep g-Guinea Pig 

100 
CESIUM 43 

3. HEALTH EFFECTS 

3.3.2.6 Developmental Effects 

No reports were located that associate developmental effects in humans or animals with acute-, 

intermediate-, or chronic-duration oral exposure to radioactive cesium. 

3.3.2.7 Cancer 

No reports were located in which cancer in humans or animals could be associated with acute-, 

intermediate-, or chronic-duration oral exposure to radioactive cesium. However, benign and malignant 

neoplasms were found in a variety of tissues and organs of dogs administered single intravenous doses of 

137CsCl, which resulted in initial body burdens ranging from 37 to 147 MBq/kg (1.0 to 4.0 mCi/kg) 

(Nikula et al. 1995, 1996). Similar effects would be expected in dogs following oral exposure to 137CsCl 

levels that would result in body burdens similar to those attained via intravenous injection (see 

Section 3.3.4 for more detailed information regarding health effects in animals exposed to radioactive 

cesium via routes other than inhalation, oral, dermal, or external exposure). 

3.3.3 External Exposure 

This section contains information regarding health effects related to external exposure to radioactive 

cesium sources. Radionuclides of cesium, such as 137Cs and 134Cs, emit both beta particles and gamma 

rays, which are a health hazard in living organisms because they are capable of ionizing atoms that they 

encounter. Beta particles can travel appreciable distances in air, but travel only a few millimeters in 

tissues. External exposure to beta particles may result in damage to skin and superficial body tissues, but 

is not a threat to internal organs unless the radiation source is internalized. Gamma radiation, on the other 

hand, can easily pass completely through the human body and cause ionization of atoms in its path. 

Several feet of concrete or a few inches of lead or other high-density shielding are required for protection 

from gamma rays. Because it is so highly penetrating, external gamma radiation emitted by radionuclides 

such as cesium is a radiation hazard to internal organs (Agency for Toxic Substances and Disease 

Registry 1999; EPA 1998). 

The purpose of this section is to provide information regarding health effects associated with external 

exposure to a radioactive cesium source. External exposure to radioactive cesium is simply exposure to 

beta and gamma radiation; there is nothing unique to cesium per se. The same hazards exist from 
CESIUM 44 

3. HEALTH EFFECTS 

external exposure to any source of beta and gamma radiation. Refer to Agency for Toxic Substances and 

Disease Registry (1999) for a detailed description of health effects from external exposure to ionizing 

radiation in general. 

3.3.3.1 Death 

There are no reports of deaths in humans that could be exclusively associated with acute-, intermediate-, 

or chronic-duration external exposure to radioactive cesium. Death was noted within a few weeks 

following mixed external, dermal, and oral exposure to an opened 137CsCl source that resulted in 

estimated radiation doses ranging from 4 to 6 Gy (400 to 600 rad) (Brandão-Mello et al. 1991). See 

Section 3.3.2.1 for more detailed information. 

Significantly reduced survival was noted in rat fetuses following whole-body irradiation (via a 137Cs 

source) of pregnant dams on gestational day 14 at acute radiation doses ≤4 Gy (400 rad); an LD50 value 

was about 5 Gy (500 rad ) (Koshimoto et al. 1994). No reports were located regarding death in animals 

following intermediate- or chronic-duration external exposure to radioactive cesium. 

3.3.3.2 Systemic Effects 

Symptoms typical of cutaneous radiation syndrome (initial dermal erythema and subsequent ulceration) 

occurred among Russian military recruits who were accidentally exposed to a sealed source of 137Cs 

during training in 1996 and 1997 (Gottlöber et al. (2000). Some of the exposed men also described 

symptoms of acute radiation syndrome (nausea, vomiting, and headache), which occurred at the onset of 

the dermal effects. Nausea, vomiting, and diarrhea, were reported in a number of individuals following 

mixed external, dermal, and oral exposure to an opened 137CsCl source in Goiânia, Brazil; other adverse 

effects included skin lesions, ocular lesions, severe bone marrow depression, and mild elevations in the 

activities of some liver enzymes (Brandão-Mello et al. 1991; Gomes et al. 1990; Rosenthal et al. 1991). 

See Section 3.3.2.2 for a more detailed description of systemic effects following mixed exposure to 

radioactive cesium. 

No reports were located regarding respiratory, cardiovascular, gastrointestinal, hematological, 

musculoskeletal, hepatic, renal, endocrine, ocular, body weight, metabolic, or other systemic effects in 

humans or animals that could be exclusively associated with external exposure to radioactive cesium. 
CESIUM 45 

3. HEALTH EFFECTS 

Dermal Effects. Initial dermal erythema progressed to ulceration within a few weeks following initial 

accidental exposure of Russian military recruits to a sealed external source of 137Cs gamma radiation 

(Gottlöber et al. 2000). However, there was no information regarding radiation doses to these individuals. 

3.3.3.3 Immunological and Lymphoreticular Effects 

No reports were located that associate immunological or lymphoreticular effects in humans with 

intermediate- or chronic-duration external exposure to radioactive cesium. Severe bone marrow 

depression, characterized by neutropenia and thrombocytopenia, developed in 14 patients hospitalized 

following mixed external, dermal, and oral exposure to an opened 137CsCl source resulting in estimated 

absorbed doses ranging from 1 to 7 Gy (100 to 700 rad) (Brandão-Mello et al. 1991). This effect was the 

result of the radiation, not the presence of cesium per se. 

No reports were located regarding immunological or lymphoreticular effects in animals following acute-, 

intermediate-, or chronic-duration external exposure to radioactive cesium. 

3.3.3.4 Neurological Effects 

No reports were located that associate neurological effects in humans or animals with postnatal acute-, 

intermediate-, or chronic-duration external exposure to radioactive cesium. Neurological effects 

associated with in utero exposure are discussed in Section 3.3.3.6, Developmental Effects. 

3.3.3.5 Reproductive Effects 

No reports were located that associate reproductive effects in humans with intermediate- or chronicduration external exposure to radioactive cesium. Spermatozoa were reduced or absent in the semen of 

nine males examined approximately 1 month following presumed acute exposure to an opened 137CsCl 

source (Brandão-Mello et al. 1991). These individuals may have experienced mixed external, dermal, and 

oral exposure. 

No reports were located regarding reproductive effects in animals following acute- or chronic-duration 

external exposure to radioactive cesium. Significantly reduced fertility, expressed as the percentage of 

matings resulting in pregnancy (% effective matings), was noted in male mice following external 
CESIUM 46 

3. HEALTH EFFECTS 

exposure to a 137Cs source 23 hours a day for 19.5 days at a dose rate of 0.675 mGy/hour 

(6.75 mrad/hour), resulting in a total dose of 3Gy (300 rad) (Ramaiya et al. 1994). Complete sterility was 

evident in males by the third week following exposure termination. During weeks 1 and 2 after the 

cessation of treatment, significantly increased total and postimplantation embryo mortality was noted. 

These effects were the result of the radiation, not the presence of cesium per se. 

All reliable LOAEL values for reproductive effects from external exposure to radioactive cesium are 

presented in Table 3-2 and plotted in Figure 3-2. 

3.3.3.6 Developmental Effects 

No reports were located that associate developmental effects in humans with acute-, intermediate-, or 

chronic-duration external exposure to radioactive cesium. Cells of the developing central nervous system 

are among the most sensitive to the effects of ionizing radiation in the developing fetus (Agency for Toxic 

Substances and Disease Registry 1999). Schull and Otake (1999) cite numerous reports in which 

impaired cognitive function was observed in atomic bomb survivors of Hiroshima and Nagasaki 

prenatally exposed (during weeks 8–15 or 16–25 after ovulation) to ionizing radiation from the bombs. 

The small number (38) of mentally-impaired survivors makes it difficult to generalize a dose-response 

relationship. However, the data are compatible with either a threshold dose of 20–40 rad (0.2–0.4 Gy) or 

zero threshold linear response. Although such effects would be expected in individuals exposed to similar 

levels of external radiation from any source of gamma radiation, it is unlikely that such high levels would 

be achieved from any radiocesium source under situations of normal use. 

No reports were located regarding developmental effects in animals following intermediate- or chronicduration external exposure to radioactive cesium. Significantly reduced postnatal body weight, impaired 

motor activity, and decreased thickness within cortical layers of the brain were observed in young rats (7– 

21 days postpartum) exposed during gestation by whole-body radiation of pregnant dams via a sealed 

137Cs gamma radiation source at a rate of approximately 0.5 Gy/minute (50 rad/minute) for a total 

radiation dose of 0.75 or 1 Gy (75 or 100 rad) (Norton and Kimler 1987, 1988). The effects were of 

larger magnitude when the fetal rats were exposed on gestation day 15 rather than earlier (gestation 

days 11 or 13) or later (gestation day 17). Significantly smaller litter size, smaller head size, and retarded 

odontogenesis were observed in fetuses of pregnant mice exposed on gestation day 12 to whole-body 

irradiation from a sealed 137Cs gamma radiation source for 4.9 minutes (resulting in a total radiation dose 
Table 3-2 Levels of Significant Exposure to Cesium - Radiation Toxicity - External Radiation 

Exposure/ LOAEL
 

Duration/ a

Key to Species Frequency NOAEL Less Serious Serious 

(Specific Route) figure (Strain) System (rad) (rad)	 (rad) 

ACUTE EXPOSURE Developmental 

1 Rat Once 

Gd 13, 14, or 15 50 (increased micronuclei in 400 (31.5% fetal mortality) (Wistar) 

hematocytes) 

2 Rat	 Once 

Gd 11 or 17 100 (altered motor function, (Sprague- decreased cortical thickness) 

Dawley)
 

3 Rat	 Once 

Gd 13, 15, or 17 75 (altered motor function, (Sprague- decreased cortical thickness, 

Dawley) most prominent when exposed
 

on Gd 15)
 

4 Mouse Once 

Gd 14 100 M (6% lower body weight, 9% (C57BL/6)	 

lower brain weight, reduced brain size) 

5 Mouse	 Once 

Gd 14 100 M (16% lower body weight, (C57BL/6)	 

increased aggressive behavior) 

6 Mouse	 Once 

Gd 12 400 (retarded odontogenesis) Swiss albino	 
7 

Table 3-2 Levels of Significant Exposure to Cesium - Radiation Toxicity 

Exposure/
 

Duration/

a

Key to Species Frequency NOAEL Less Serious 

figure (Strain) (Specific Route) System (rad) (rad) 

Mouse Once 

- External Radiation (continued) 

LOAEL 

Gd 12 400 (smaller litter size, smaller head Swiss albino size, delayed palatogenesis) 

Cancer 

8 Rat Once 

at 8, 12, WAG/Rij 16, 22, 36,
 

or 64 wk of age
 

INTERMEDIATE EXPOSURE Reproductive 

9 Mouse 19.5 d 

23 hr/d (Hybrid) 

(rad) 

Serious 

100 F (mammary carcinoma in 57/200 

rats) 

300 M (reduced fertility) 

a The number corresponds to entries in Figure 3-2.
 

d=day(s); F = Female; Gd = gestational day; hr = hour(s); LOAEL = lowest-observed-adverse-effect level; M = male; NOAEL = no-observed-adverse-effect lev
1000 

Developmental Cancer * Reproductive 

Figure 3-2. Levels of Significant Exposure to Cesium - Radiation Toxicity - External Rad

Acute (≤14 days) Intermediate (15-364 

rad 

6m 7m 1r 

9m 

100 4m 5m 2r 8r 

3r 

1r 

*Doses represent the lowest dose tested per study that produced a tumorigenic 

10 response and do not imply the existence of a threshold for the cancer endpoint.

c-Cat -Humans f-Ferret n-Mink Cancer Effect Level-Animals Cancer Effect Level-Humans 

d-Dog k-Monkey j-Pigeon o-Other LOAEL, More Serious-Animals LOAEL, More Serious-Humans 

r-Rat m-Mouse e-Gerbil LOAEL, Less Serious-Animals LOAEL, Less Serious-Humans 

p-Pig h-Rabbit s-Hamster NOAEL - Animals NOAEL - Humans 

q-Cow a-Sheep g-Guinea Pig 
CESIUM 50 

3. HEALTH EFFECTS 

of 4 Gy or 400 rad) and examined on gestation day 18. Additionally, all exposed fetuses exhibited cleft 

palate on examination while normal closure was observed in all unexposed control fetuses (Saad et al. 

1991, 1994). Significantly reduced survival was observed in rat fetuses following whole-body irradiation 

(via a sealed 137Cs gamma radiation source) of pregnant dams on gestation day 14 at acute radiation doses 

of 4 Gy (400 rad) or greater. An LD50 value for fetuses was about 5 Gy (500 rad) (Koshimoto et al. 

1994). Aggressive behavior was studied in male mice (100–135 days of age) exposed in utero on 

gestation day 14 through whole-body irradiation of pregnant dams via an external sealed 137Cs gamma 

radiation source at total radiation doses of 1 or 2 Gy (100 or 200 rad) (Minamisawa et al. 1992). 

Incidences of aggressive behavior were significantly higher among irradiated groups, relative to untreated 

controls. The intensity of aggressive behavior was significantly higher only in the 2 Gy (200 rad) 

exposure group. Minamisawa et al. (1990) found dose-related significantly decreased brain weight in 

6-month-old mice that had been irradiated on gestation day 14 at doses of 1–3 Gy (100–300 rad). In each 

of these studies (Koshimoto et al. 1994; Minamisawa et al. 1990, 1992; Norton and Kimler 1987, 1988), 

the observed developmental effects were the result of radiation exposure, not the presence of cesium per 

se. 

Kusama and Hasegawa (1993) designed a study to examine the relationship between fetal developmental 

stage at the time of external exposure to a sealed 137Cs gamma radiation source and the occurrence of 

external malformations and growth retardation. Groups of pregnant ICR mice were irradiated once with 

1.5 Gy (150 rad) at a dose rate of 0.2 Gy/minute (20 rad/minute) on 6-hour intervals during the period of 

organogenesis (gestation days 6.5–14). Fetuses were examined on gestation day 18. The authors reported 

peaks in the occurrence of exencephaly among fetuses irradiated during gestation days 6.5–8.75 and 

10.25–10.75, and the highest peak occurred at gestation day 7.5. Peaks in the occurrence of cleft palate 

were seen in fetuses irradiated at gestation days 8.75 and 10.75. The most apparent reduction in body 

weight of irradiated fetuses, relative to controls, occurred in groups irradiated between gestation days 9.75 

and 11. The observed developmental effects were the result of radiation exposure, not the presence of 

cesium per se. 

All reliable LOAEL values for developmental effects from external exposure to radioactive cesium are 

presented in Table 3-2 and plotted in Figure 3-2. 
CESIUM 51 

3. HEALTH EFFECTS 

3.3.3.7 Cancer 

No reports were located regarding cancer in humans following acute-, intermediate-, or chronic-duration 

external exposure to radioactive cesium in particular. Due to the nature of ionizing radiation in general, 

carcinogenic effects similar to those observed in Japanese survivors of the 1945 atomic bombing incidents 

might be expected among individuals acutely exposed to high levels of radiation from a radioactive 

cesium source. In the only available reports of adverse health effects in humans following exposure to 

radioactive cesium (137Cs, the accidental human exposures in Goiânia, Brazil in 1987 and Russia in 1996 

and 1997), the incidents are too recent for meaningful data on the potential for carcinogenicity. No 

reports were located in which increased cancer risk could be associated with long-term exposure to low 

levels of ionizing radiation. 

No reports were located regarding cancer in animals following intermediate- or chronic-duration external 

exposure to radioactive cesium. Increased lifetime risk of mammary tumors was observed in female 

WRG/Rij rats exposed to single whole-body doses of 1 or 2 Gy (100 or 200 rad) of 137Cs gamma radiation 

at a dose rate of 75 rad/minute (0.75 Gy/minute) between the ages of 8 and 36 weeks (Bartstra et al. 

1998). The excess normalized risk values for carcinoma were 0.9 and 2.2 for 1 and 2 Gy (100 and 

200 rad) doses, respectively, with no significant differences between the age groups of 8, 12, 16, 22, or 

36 weeks. Irradiation at 64 weeks, however, yielded fewer carcinomas than unirradiated controls. The 

excess normalized risk values were found to be -0.7 and -0.3 for 1 and 2 Gy (100 and 200 rad) doses, 

respectively. These effects were the result of the gamma radiation, not the presence of cesium per se. 

3.3.4 Other Routes of Exposure 

Although parenteral injection is not considered to be an exposure route of concern for the general 

population, it has been considered to be a good indicator of adverse health effects that would be expected 

in laboratory animals following the absorption of 137CsCl into the blood if such animals were to be 

exposed via inhalation or oral routes (Boecker et al. 1969a; Melo et al. 1996, 1997; Nikula et al. 1995, 

1996). This argument is based on the results of biokinetic studies in dogs (Boecker et al. 1969a) in which 

intravenous injections of 137CsCl resulted in temporal and tissue distribution patterns and tissue doses of 

137Cs that were similar to those resulting from inhalation exposure (Boecker et al. 1969a). Similar tissue 

distribution and retention kinetics were also shown in guinea pigs whether exposure to 137CsCl had been 

via intraperitoneal, inhalation, or oral routes (Stara 1965). 
CESIUM 52 

3. HEALTH EFFECTS 

In dogs, intravenous administration of soluble 137CsCl has resulted in depression of a number of blood 

factors, severe bone marrow depression, germinal cell damage (males), and early death (Nikula et al. 

1995, 1996; Redman et al. 1972). Long-term surviving dogs exhibited increased incidences of benign and 

malignant neoplasms in a variety of tissues and organs, with no apparent single target organ of toxicity. 

3.3.4.1 Death 

Dose-related decreased survival was observed in young adult beagle dogs that had received single 

intravenous injections of 137CsCl in amounts resulting in average initial body burdens of 71.7– 

141 MBq/kg (1.9–3.8 mCi/kg) (Nikula et al. 1995). All six dogs in the highest exposure group died 

between 19 and 33 days following injection. The total whole body radiation dose to death in this group of 

dogs averaged 11.8 Gy (1,180 rad). Deaths were attributed to severe pancytopenia resulting from 

hematopoietic cell damage. In a study of 63 other beagle dogs, intravenous injection of 137CsCl resulted 

in initial body burdens of approximately 64–147 MBq/kg (1.7–4.0 mCi/kg) (Nikula et al. 1996). These 

dogs, grouped according to age, were juveniles (142–151 days old), young adults (388–427 days old), or 

middle-aged adults (1,387–2,060 days old) at the time of injection. Early mortality, within 52 days 

following injection, was noted in 10/10 middle-aged dogs, 10/38 young adults, and 3/15 juveniles. 

Average initial 137Cs body burdens among the early deaths were in the range of 133–147 MBq/kg (3.6– 

4.0 mCi/kg). The middle-aged dogs died significantly earlier (p=0.002) than the juvenile or young adult 

dogs, and middle-aged female dogs died significantly earlier (p=0.002) than middle-aged male dogs. 

3.3.4.2 Systemic Effects 

No data were located regarding respiratory, cardiovascular, gastrointestinal, musculoskeletal, hepatic, 

renal, endocrine, dermal, ocular, body weight, or metabolic effects in humans or animals following 

exposure to radioactive cesium via routes other than inhalation, oral, dermal, or external exposure. 

Hematological Effects. Hematological dyscrasia, characterized by severe thrombocytopenia and 

leukopenia, and death within 81 days were observed in 11 of 54 dogs that had been administered single 

intravenous injections of 137CsCl (Nikula et al. 1995; Redman et al. 1972). The early deaths occurred in 

groups with average initial body burdens ranging from 71.7 to 141 MBq/kg (1.9 to 3.8 mCi) and 

cumulative doses to death in the range of 11.8–14.0 Gy (1,180–1,400 rad). Moderately to severely 

depressed blood cell counts were observed among 25 surviving dogs, some of which had been injected 

with lower levels of 137CsCl that resulted in average initial body burdens of 36.4 or 51.7 MBq/kg (1.0 or 
CESIUM 53 

3. HEALTH EFFECTS 

1.4 mCi/kg). Other treatment-related hematological effects included bone marrow aplasia, decreased 

platelet levels, and reduced packed-cell volume. In long-term surviving dogs, depressed blood values 

returned toward normal within during the first year after radiocesium injection. Severely depressed blood 

cell counts were observed in 23 dogs that died within 52 days following single intravenous administration 

of 137CsCl at levels resulting in average initial body burdens in the range of 64–162 MBq/kg (1.7– 

4.4 mCi/kg) (Nikula et al. 1996). 

3.3.4.3 Immunological and Lymphoreticular Effects 

Severe bone marrow depression was observed in dogs administered 137CsCl by intravenous injection at 

activity levels resulting in estimated total bone marrow doses of 7–24 Gy (700–2,400 rad) (Nikula et al. 

1995). 

3.3.4.4 Neurological Effects 

No data were located regarding neurological effects in humans or animals following exposure to 

radioactive cesium via routes other than inhalation, oral, dermal, or external exposure. 

3.3.4.5 Reproductive Effects 

Persistent germinal epithelium damage and azoospermia were reported in all long-term surviving dogs 

that had been administered 137CsCl by intravenous injection at activity levels resulting in long-term total 

whole-body doses ranging from 7.42 to 16.40 Gy (742 to 1,640 rad) (Nikula et al. 1995, 1996). 

3.3.4.6 Developmental Effects 

No data were located regarding developmental effects in humans or animals following exposure to 

radioactive cesium via routes other than inhalation, oral, dermal, or external exposure. 
CESIUM 54 

3. HEALTH EFFECTS 

3.3.4.7 Cancer 

Benign and malignant neoplasms were found in a variety of tissues and organs of beagle dogs that had 

been administered single intravenous injections of 137CsCl (Nikula et al. 1995, 1996). Fifty-four young 

adult dogs at the Inhalation Toxicology Research Institute (ITRI) received amounts of 137CsCl that 

resulted in average initial body burdens ranging from 37 to 141 MBq/kg (1.0 to 3.8 mCi/kg) (Nikula et al. 

1995). In a study initiated at the Argonne National Laboratory (ANL), 63 beagle dogs, grouped 

according to age at study initiation (juveniles, 142–151 days old; young adults, 388–427 days old; and 

middle-aged adults, 1,387–2,060 days old), were administered single intravenous injections of 137CsCl 

that resulted in initial body burdens of approximately 64–147 MBq/kg (1.7–4.0 mCi/kg) (Nikula et al. 

1996). In both studies, dose-related increased incidences were observed for malignant neoplasms, 

malignant neoplasms excluding mammary neoplasms, all sarcomas considered as a group, all 

nonmammary carcinomas considered as a group, and malignant liver neoplasms. An increased risk for 

malignant thyroid neoplasms was seen in the ANL male dogs, but not in the ITRI males or females. In 

the ITRI (but not ANL) dogs, an increased relative risk for benign neoplasms excluding mammary 

neoplasms was observed. The occurrence of neoplasms in a diversity of tissues and organs results from 

the widespread distribution of cesium in the body. 

3.4 GENOTOXICITY 

Genotoxicity data for stable and radioactive cesium are summarized in Tables 3-3 and 3-4, respectively. 

Evidence for genotoxic effects of stable cesium is limited to studies in which cesium chloride induced 

significantly increased incidences of chromosomal aberrations in human lymphocytes in vitro (Ghosh et 

al. 1993) (see Table 3-3) and mouse bone marrow in vivo (Ghosh et al. 1990, 1991; Santos-Mello et al. 

2001) (see Table 3-4). Cesium sulfate was not mutagenic in Escherichia coli (E. coli) tester strains PQ37 

and PQ35 either with or without metabolic activation in the SOS Chromotest (a bacterial colorimetric 

assay) at doses up to those resulting in significant toxicity (Olivier and Marzin 1987). 

Increased frequency of point mutations in T-lymphocytes was observed in individuals in Goiânia, Brazil 

who had been exposed to an opened 137CsCl source approximately 2.5 years prior to testing (Skandalis et 

al. 1997). The estimated dose from external radiation was 1.7 Gy (170 rad). The authors estimated 

internal doses based on whole-body counts and measured activity in urine and feces; however, realistic 

estimates were not reported. Among individuals exposed in the same incident, frequencies of 
CESIUM 55 

3. HEALTH EFFECTS 

Table 3-3. Genotoxicity of Cesium In Vitro 

Result 

With Without 

Species (test system) End point activation activation Reference 

Stable Cesium

 Mammalian cells: 

Human lymphocytes
 

 Human lymphocytes
 

 Prokaryotic organisms: 

Escherichia coli (PQ 37 

and PQ 35) 

Radioactive Cesium

 Mammalian cells: 

 Human peripheral blood 

lymphocytes 

 Human peripheral blood 

lymphocytes 

 Human peripheral blood 

lymphocytes 

 Human peripheral blood 

lymphocytes 

 Human peripheral blood 

lymphocytes 

Human spermatozoa 

 Human spermatozoa and 

zona-free hamster oocytes 

fertilization system 

 Mouse (BALB/c, SC3T3/W, 

Scid/St cells) 

 Chinese hamster ovary 

cells 

Chromosomal aberrations No data + 

Micronuclei No data – 

Mutations – – 

Micronuclei No data + 

Chromosomal aberrations No data + 

Chromosomal aberrations No data + 

Chromosomal aberrations No data + 

Sister chromatid No data – 

exchange 

Chromosomal aberrations No data + 

Micronuclei No data + 

DNA double-strand No data + 

breaks 

Chromosomal aber- No data + 

rations, sister chromatid 

exchange 

Ghosh et al. 1993 

Santos-Mello et al. 

1999 

Olivier and Marzin 

1987 

Balasem and Ali 1991

Doggett and 

McKenzie 1983

Hintenlang 1993 

lijima and Morimoto 

1991 

lijima and Morimoto 

1991 

Mikamo et al. 1990, 

1991 

Kamiguchi et al. 1991

Biedermann et al. 

1991 

Arslan et al. 1986 

DNA = deoxyribonucleic acid; – = negative results; + = positive results 
CESIUM 56 

3. HEALTH EFFECTS 

Table 3-4. Genotoxicity of Cesium In Vivo 

Species (test system) End point Results Reference 

Stable Cesium

 Mammalian cells: 

Mouse bone marrow Chromosomal aberrations + Ghosh et al. 1990, 1991 

Mouse bone marrow Micronuclei + Santos-Mello et al. 2001 

Mouse bone marrow Micronuclei – Santos-Mello et al. 1999 

Radioactive Cesium

 Mammalian cells: 

Human peripheral blood Chromosomal aberrations + Natarajan et al. 1998 

lymphocytes 

Human peripheral blood Chromosomal aberrations + Padovani et al. 1993 

lymphocytes 

Monkey germ cells (male) Reciprocal translocations + Tobari et al. 1988 

Monkey germ cells (male) Reciprocal translocations + Ramaiya et al. 1994 

Mouse germ cells (male) Reciprocal translocations + Ramaiya et al. 1994 

Mouse germ cells (male) Dominant lethal mutations + Ramaiya et al. 1994 

+ = positive results; – = negative results 
CESIUM 57 

3. HEALTH EFFECTS 

chromosomal aberrations were used to estimate external radiation doses (Natarajan et al. 1998). No 

human reports were located in which genotoxic effects could be associated with specific radiation 

exposure levels, nor was there any information regarding potential for route-specific differences in 

observed genotoxic effects related to radioactive cesium exposure. 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 137Cs fallout than in those of an Italian control 

group of 10 children (Padovani et al. 1993). Whole-body counts found an internally deposited 137Cs 

activity range of 0.46–2.8 kBq (12-75 nCi) in children from Navrovl’a, an area (70 km from Chernobyl) 

exhibiting 137Cs contamination of 550-1,500 GBq/km2

 (15–40 Ci/km2). Internally deposited 137Cs activity 

ranges of 0.044–0.4 kBq (1.2-10.8 nCi) and 7.7–32.3 kBq (208–872 nCi) were reported for children 

evacuated from the Chernobyl area soon after the accident to areas 200–300 km from Chernobyl with 

137Cs ground contamination of 40-400 GBq/km2

 (1–10 Ci/km2), and children living in the Stolin area 

(250 km from Chernobyl) with 137Cs ground contamination of 40–550 GBq/km2

 (1–5 Ci/km2), 

respectively. Internalized activity was presumably from the consumption of 137Cs-contaminated food. 

Although a small increase in the frequency of chromosomal aberrations in lymphocytes was observed, no 

pathology was apparent. These genotoxic effects were the result of the radiation, not the presence of 

cesium per se. 

A dose-related increased frequency of micronuclei was observed in human peripheral blood lymphocytes 

exposed in vitro to gamma radiation from a sealed 137Cs source at doses ranging from 0.05 to 6.00 Gy 

(5 to 600 rad) (Balasem and Ali 1991). This effect was the result of the radiation, not the presence of 

cesium per se. 

In mice, genotoxic effects resulting from repeated oral exposure (daily administration for 2 weeks) to 

137Cs (as cesium nitrate) were compared with those elicited from external whole-body irradiation 

(23 hours/day for 19.5 days) using a 137Cs source (Ramaiya et al. 1994). At comparable total radiation 

doses (approximately 3–4 Gy or 300–400 rad), both exposure scenarios resulted in similar increases in 

dominant lethal mutations among exposed male mice. Significant increases in the frequency of reciprocal 

translocations have been reported in spermatogonia of mice orally administered single doses of 137Cs (as 

cesium chloride) that resulted in absorbed total body doses of approximately 3 Gy (300 rad) (Ramaiya et 

al. 1994). 
CESIUM 58 

3. HEALTH EFFECTS 

Significant (dose-related) increases in the formation rate of micronuclei were seen in blood cells of fetal 

rats following irradiation of pregnant dams to total radiation doses of 0.5–4 Gy (50–400 rad), from a 

sealed 137Cs gamma source, on gestation day 14 (Koshimoto et al. 1994). In crab-eating monkeys 

exposed to gamma radiation from an external 137Cs source, increases in reciprocal translocations in 

spermatogonia were dose-related through the total absorbed dose range of 0.3–1.5 Gy (30–150 rad); it 

was also noted that the induction rate of translocations after acute high-dose-rate (0.25 Gy/minute or 

25 rad/minute) exposure was about 10 times higher than that resulting from longer-term low-dose-rate 

(1.8x10-7 Gy/minute or 1.8x10-5 rad/minute) exposure (Tobari et al. 1988). These effects were the result 

of the radiation, not the presence of cesium per se. 

Additional assays, performed in vitro, have also indicated that radioisotopes of cesium are genotoxic; 

specific end points include chromosomal aberrations and breaks, sister chromatid exchanges, and 

micronuclei (Arslan et al. 1986; Biedermann et al. 1991; Doggett and McKenzie 1983; Hintenlang 1993; 

Iijima and Morimoto 1991; Kamiguchi et al. 1991; Mikamo et al. 1990, 1991). Refer to Agency for 

Toxic Substances and Disease Registry (1999) for more information on the genotoxic effects of ionizing 

radiation. 

3.5 TOXICOKINETICS 

Numerous biokinetic studies have been performed in animals exposed internally to small amounts of the 

radioisotope 137Cs. The biokinetic behavior of cesium has also been studied in humans either given tracer 

amounts of radiocesium or accidentally exposed to larger amounts. 

Fractional absorption of inhaled or ingested cesium to the blood decreases with decreasing solubility of 

the carrier. Cesium taken into the body in soluble form is almost completely absorbed to blood. Cesium 

entering the respiratory or gastrointestinal tract as relatively insoluble particulates is mostly excreted in 

the feces. Cesium that comes into contact with the skin may be absorbed to some extent through the skin. 

Following uptake by the blood, widespread distribution of cesium to all major soft tissues is observed in 

humans and animals. Cesium levels are slightly higher in skeletal muscle than other tissues. Distribution 

patterns in animals have been shown to be similar following exposure to soluble cesium compounds by 

inhalation, oral, and parenteral routes of exposure. Cesium crosses the placenta to the fetus. Cesium is 

also found in breast milk of a mother with an internal deposition. 
CESIUM 59 

3. HEALTH EFFECTS 

Cesium is a close chemical analogue of potassium. Cesium has been shown to compete with potassium 

for transport through potassium channels and can also substitute for potassium in activation of the sodium 

pump and subsequent transport into the cell. 

Excretion rates for 137Cs have been studied in numerous populations exposed to nuclear fallout following 

incidents such as the Chernobyl accident. Biologically based pharmacokinetic models have been 

developed to describe relationships between intake and elimination. Experimental human studies have 

also been performed using tracer amounts of 134Cs and 137Cs. Urinary excretion is the primary route of 

elimination of cesium, and is independent of the route of exposure. Urinary to fecal ratios for cesium in 

humans have been found to range from 2.5:1 to 10:1. Radiocesium excretion rates were higher in males 

with muscular dystrophy than in normal, age-matched controls, and higher in pregnant women than in 

others who were not pregnant. 

The elimination of cesium in humans appears to be age and sex related; long-term retention is principally 

a function of muscle mass. Elimination half-times are shorter in children than in adults, and shorter in 

women than in men. 

3.5.1 Absorption 

3.5.1.1 Inhalation Exposure 

Inhalation exposure to relatively soluble cesium compounds will result in absorption of cesium in 

humans, although no reports were located that measured absorption of cesium following inhalation 

exposure. Evidence for absorption was presented by Miller (1964) via whole-body counts of 137Cs (taken 

periodically for up to 285 days) in two men following occupational exposure to 137Cs (as cesium sulfate) 

that was presumed to have been by inhalation. Distribution of 137Cs was relatively uniform throughout 

the body, and steadily decreasing whole-body counts indicated that 137Cs was eliminated from the body 

with a biological half-time of approximately 73–84 days. Additional indirect evidence of absorption was 

reported for an adult male who had been accidentally exposed to airborne 137Cs twice in a 13-month 

period (Hölgye and Malý 2002). In this case, biological half-times for elimination of 137Cs were 72 and 

73 days. 

Inhaled soluble cesium compounds are readily absorbed and distributed systemically in animals. 

Approximately 80% cesium absorption was observed in dogs acutely exposed to small amounts of 

aerosolized 137Cs (as cesium chloride) (Boecker 1969a, 1969b). Deposition and distribution of cesium 
CESIUM 60 

3. HEALTH EFFECTS 

following inhalation exposure to radiolabeled cesium chloride was also observed in rats (Lie 1964; Stara 

and Thomas 1963) and guinea pigs (Stara 1965). Absorption was rapid following inhalation exposure. 

3.5.1.2 Oral Exposure 

It is generally accepted that cesium ingested as soluble cesium compounds is well absorbed by the 

gastrointestinal tract of humans and animals. Observations indicating that soluble cesium compounds 

were absorbed after ingestion by humans include: (1) low fecal excretory rates, (2) urinary excretory rates 

4–10 times higher than those of fecal excretion, and (3) elimination half-times ranging from 45 to 

147 days (Henrichs et al. 1989; Iinuma et al. 1965; Richmond et al. 1962; Rosoff et al. 1963). Henrichs et 

al. (1989) estimated an average cesium absorption of 78% in a group of 10 adult (5 male, 5 female) 

volunteers ingesting a meal of venison that was highly contaminated with 137Cs and 134Cs. Results from 

other controlled studies on human subjects indicate that absorption represented >90% of the cesium 

ingested in soluble form (Rosoff et al. 1963; Rundo 1964; Yamataga et al. 1966). 

Absorption of 137Cs from ingestion of radioactive fallout particles was found to be in the range of only 

3%, indicating that such particles are relatively insoluble in biological fluids (LeRoy et al. 1966). 

Measurable amounts of 137Cs were found in breast milk of women living in areas contaminated with 

radioactive fallout from the Chernobyl nuclear accident (Johansson et al. 1998). Based on whole body 

measurements of radioactivity in mothers and nursing infants and measured radioactivity in breast milk 

samples, it was estimated that 15% of the mothers’ daily 137Cs intake from contaminated food was 

transferred to the infant. 

Animal studies support the findings in humans. Rapid absorption and widespread distribution of cesium 

was reported in guinea pigs administered single oral doses of soluble 137Cs (as cesium chloride); fractional 

absorption data were not reported (Stara 1965). In rats orally administered single doses of highly 

insoluble irradiated fuel particles (mean diameter of 0.93 μm) containing 137Cs and other radioactive 

elements, absorption of 137Cs was found to be <10% (Talbot et al. 1993). 

3.5.1.3 Dermal Exposure 

Dermal absorption has been demonstrated in rats (Pendic and Milivojevic 1966). Traces of 137Cs were 

observed in the blood of rats within a few minutes following the dermal application of 137CsCl in aqueous 
CESIUM 61 

3. HEALTH EFFECTS 

solution. Approximately 3% of 137CsCl applied to a surface area of several cm2 was absorbed within 

6 hours. 

3.5.2 Distribution 

3.5.2.1 Inhalation Exposure 

Once absorbed, cesium is rapidly distributed throughout the body. Separate measurements of radioactivity from head, chest, upper abdomen, lower abdomen, thighs, legs, and feet indicated that 137Cs was 

widely distributed throughout the bodies of two men who were occupationally exposed to 137Cs (Miller 

1964). Proportions of radioactivity in these body segments remained relatively constant from days 9 

to 285 after exposure, indicating that 137Cs was not likely to have been selectively accumulating in a 

particular region. 

Animal studies also indicate a relatively uniform distribution of cesium following inhalation exposure to 

soluble cesium compounds (Boecker 1969a, 1969b; Stara 1965). Within 2 hours following exposure to 

aerosols of 137Cs (as cesium chloride), up to 60% of the total body burden of 137Cs was found in tissues 

other than respiratory or gastrointestinal tracts of dogs (Boecker 1969a). At 32 days post exposure, 

concentrations of 137Cs in skeletal muscles, diaphragm, kidneys, and mandibular salivary gland were 

slightly higher than the whole-body average; concentrations in lung, skin, bone (femur, ribs), fat, and 

blood were somewhat lower (Boecker 1969b). Other tissues exhibited concentrations approximating the 

whole-body average. A relatively uniform distribution of 137Cs in numerous body tissues, with the 

highest concentrations in skeletal muscle, was also observed in guinea pigs and rats exposed by inhalation 

(Lie 1964; Stara 1965; Stara and Thomas 1963). 

3.5.2.2 Oral Exposure 

Widespread distribution of cesium was observed in humans following oral exposure to soluble cesium 

compounds. In two human subjects orally administered 137Cs (as cesium chloride), whole blood levels of 

137Cs within the first hour after administration amounted to approximately 2–3% of the amount 

administered, indicating that 137Cs was rapidly absorbed and well distributed via the circulation (Rosoff et 

al. 1963). 
CESIUM 62 

3. HEALTH EFFECTS 

Animal studies also showed relatively uniform distribution following oral exposure to soluble cesium 

compounds. Guinea pigs exhibited 137Cs in numerous body tissues after receiving single oral doses of 

137Cs (as cesium chloride). The highest concentrations were found in skeletal muscle (Stara 1965). After 

the first day post administration, no significant differences in 137Cs distribution patterns were observed 

between groups of guinea pigs exposed by inhalation, oral administration, or intraperitoneal injection of 

137Cs (as cesium chloride) (Stara 1965). Dogs and mice exhibited relatively uniform distribution of 

cesium throughout body tissues following chronic oral administration of 137Cs (as cesium chloride) 

(Furchner et al. 1964). Cesium also crossed the placenta of animals and was found in breast milk. 

Newborn lambs exhibited lower tissue levels of 134Cs than their mothers following oral administration of 

radiolabeled cesium chloride during pregnancy (Vandecasteele et al. 1989). The concentrations of 134Cs 

in nursing lambs eventually exceeded the levels in their mothers. 

3.5.2.3 Dermal Exposure 

One report was located regarding distribution of cesium in animals following dermal exposure (Pendic 

and Milivojevic 1966). The investigators found widespread distribution of 137Cs in rats within a few 

minutes following application of 137CsCl solution to the skin. Although cesium was distributed 

throughout the body, it was deposited mainly in the kidneys, muscular tissues (particularly cardiac 

muscle), and liver. 

3.5.2.4 Other Routes of Exposure 

Comparative human and animal studies have shown that parenteral exposure to cesium compounds results 

in cesium distribution patterns similar to those observed following inhalation or oral exposure (Rosoff et 

al. 1963; Stara 1965). By 3 days following administration, 137Cs was found to be distributed relatively 

uniformly among the body tissues of five cancer patients who died at various times following intravenous 

injection of a single tracer dose of 137Cs (as cesium chloride). Time-related decreases were observed in 

137Cs retention by all tissues surveyed (Rosoff et al. 1963). Transfer of 137Cs from pregnant dam to fetus 

has been shown in rats following intraperitoneal injection of radiolabeled cesium chloride (Mahlum and 

Sikov 1969). 
CESIUM 63 

3. HEALTH EFFECTS 

3.5.3 Metabolism 

Absorbed cesium behaves in a manner similar to that of potassium (Rundo 1964; Rundo et al. 1963). 

Both potassium and cesium are alkali metals that distribute throughout the body as cations, and are 

incorporated into intracellular fluids by active transport mechanisms. Cesium has been shown to compete 

with potassium for transport through potassium channels and can also substitute for potassium in 

activation of the sodium pump and subsequent transport into the cell (Cecchi et al. 1987; Edwards 1982; 

Hodgkin 1947; Latorre and Miller 1983; Sjodin and Beauge 1967). In both types of transport, movement 

of cesium is sluggish compared with that of potassium (Blatz and Magleby 1984; Coronado et al. 1980; 

Cukierman et al. 1985; Edwards 1982; Gay and Stanfield 1978; Gorman et al. 1982; Hille 1973; Reuter 

and Stevens 1980); that is, transport mechanisms generally favor potassium over cesium. Discrimination 

between potassium and cesium generally is greater for passive transport out of cells (selectivity ratios of 

Cs:K for a variety of tissues ranging from <0.02 to approximately 0.2) than for active transport into cells 

(selective Cs:K ratio approximating 0.25) (Leggett et al. 2003). This results in a greater residence time of 

cesium than potassium in muscle cells and hence in the whole body, since skeletal muscle contains most 

of the body’s potassium or cesium at equilibrium. However, cesium appears to compete somewhat more 

favorably with potassium during transport out of red blood cells (Forth et al. 1963) or across or between 

epithelial cells (Cereijido et al. 1981; Greger 1981; Wright 1972). 

3.5.4 Elimination and Excretion 

3.5.4.1 Inhalation Exposure 

Urinary excretion is the major route of elimination of cesium taken into the body in soluble form. In dogs 

exposed to 137Cs (as cesium chloride) by inhalation, rates of excretion of 137Cs in the urine and feces were 

highest in the first 3 days after exposure, accounting for approximately 12 and 3% of the initial body 

burden, respectively. Urinary and fecal excretion of 137Cs continued at lower rates through 130 days of 

analysis. Rates of elimination were determined by measuring the cesium remaining in the organs of rats 

sacrificed at 9 time points during 120 days following treatment. The elimination rates for specific tissues 

(muscle, kidney, liver, and lung) were similar to the whole-body rates, indicating that cesium did not 

selectively accumulate in any particular tissues (Boecker 1969b). Within 2.5 days following inhalation 

exposure to 137Cs (as cesium chloride), guinea pigs had eliminated approximately 50% of the initial 137Cs 

body burden in the urine and feces (Stara 1965). The urinary to fecal ratio for excretion was 

approximately 3:1 throughout 60 days of post-exposure measurements, by which time, virtually all of the 

initial 137Cs body burden had been eliminated. The urinary to fecal ratio for elimination of cesium in rats 
CESIUM 64 

3. HEALTH EFFECTS 

was about 3.5:1, with a biological half-time of elimination of approximately 4 days; 99% had been 

eliminated within 65 days following exposure (Stara and Thomas 1963). 

No reports were located regarding routes of elimination and excretion of cesium in humans following 

inhalation exposure. However, kinetics of 137Cs elimination in two adult males, accidentally exposed to 

137Cs (as cesium sulfate), were studied by whole-body measurements of gamma emission. The measured 

biological half-times were 73 and 84 days (Miller 1964). In the case of another adult male, accidentally 

exposed to airborne 137Cs twice in a 13-month period, biological half-times for elimination were 72 and 

73 days (Hölgye and Malý 2002). 

In dogs exposed by inhalation, elimination rates of 137Cs from specific tissues were similar to the rate of 

whole-body elimination, indicating that 137Cs did not selectively accumulate in certain tissues, but was 

relatively uniformly eliminated from the body with a half-time of approximately 36–42 days (Boecker 

1969b). Elimination rates of 137Cs in guinea pigs and rats exposed by inhalation also did not vary 

significantly according to tissue type, although much shorter half-times of 137Cs elimination (2.5 and 

4 days) were observed for guinea pigs and rats, respectively (Stara 1965; Stara and Thomas 1963). 

Relatively insoluble inhaled particles containing cesium were not absorbed in significant amounts and 

were more slowly eliminated from the lungs. 

3.5.4.2 Oral Exposure 

Urinary excretion is the primary route of elimination for cesium in humans. Among seven cancer or 

pulmonary patients who were administered single oral doses of 137Cs (as cesium chloride), 7-day 

cumulative excretion of 137Cs ranged from 7.0 to 17.3% of the administered activity. The urinary to fecal 

excretion ratio ranged from 2.5:1 to 10:1 (Rosoff et al. 1963). In a study of four Japanese volunteers 

orally administered single doses of 137Cs (as cesium chloride), urinary to fecal excretion ratios ranging 

from 4.57:1 to 8.75:1 were calculated for excretory data collected after day 4 post administration. During 

the first 4 days after administration, excretory rates were consistently higher and the urinary:fecal 

excretory ratio was also somewhat higher (Iinuma et al. 1965). Based on the results of numerous reports 

of urinary and fecal excretion of Cs in human subjects, Leggett et al. (2003) reported an average urinary 

fraction (i.e., the ratio of cumulative urinary Cs to cumulative Cs in urine plus feces) of 0.86. Other 

sources of information on excretion rates of 137Cs include numerous studies of populations exposed via 

fallout following atmospheric testing of nuclear weapons and from the Chernobyl accident, and 
CESIUM 65 

3. HEALTH EFFECTS 

mathematical models, such as those described in Section 3.5.5, have been developed to describe the 

relationships among intake, retention, and elimination of cesium. 

Animal data support the findings in humans of urinary excretion as the major route of elimination of 

cesium following oral administration of soluble cesium compounds. Guinea pigs had eliminated 

approximately 50% of the initial 137Cs body burden in the urine and feces within 2.5 days following 

administration (Stara 1965). The urinary to fecal ratio was within the range of 2–3:1 throughout 60 days 

of post exposure measurements, by which time, virtually all of the initial 137Cs body burden had been 

eliminated. 

Elimination half-times for cesium in the whole body, sometimes expressed in terms of whole-body 

radioactivity retention, have been reported by some investigators (Henrichs et al. 1989; Iinuma et al. 

1967; Lloyd et al. 1973; Melo et al. 1997; Richmond et al. 1962; Rundo 1964). For example, among 

10 volunteers who consumed 134Cs- and 137Cs-contaminated food, approximately 6% of the initial body 

burden was rapidly eliminated (average half-time of elimination of 0.3 days); the remaining 94% was 

eliminated more slowly (average half-time of elimination of 90 days) (Henrichs et al. 1989). In another 

oral study of four adult males, a mean elimination half-time was 135 days for 134Cs and 137Cs (Richmond 

et al. 1962). 

Elimination rates for 137Cs appear to be age- and sex-dependent, decreasing with age and lower in adult 

males than adult females. Results of studies of populations that consumed food containing 137Cs from 

weapons testing fallout showed elimination half-times that varied from 15±5 days in infants to 

100±50 days in adults (McCraw 1965). Similar studies after the Chernobyl accident found similar 

elimination half-times, which ranged from about 8 days for 1-year-old infants to about 110 days for adults 

(IAEA 1991). A 4-year study of 110 persons comprising a cross-section within an unspecified population 

indicated that children, 5–14 years of age, had the shortest elimination half-times (20 days, with no 

significant difference between males and females) (Boni 1969b). The elimination half-times in older 

groups were significantly longer (47 days for adolescent and adult females, 67 days in 15-year-old males, 

and 93 days in males 30–50 years of age). Melo et al. (1994) also reported age- and sex-related 

differences in elimination rates among individuals internally contaminated by 137CsCl in the Goiânia, 

Brazil accident (see Agency for Toxic Substances and Disease Registry 1999 for a complete description 

of the incident). Elimination half-times for girls 1–4 years of age averaged 24 days. For 7–10-year-old 

girls and boys, the average elimination half-time was 37 days. Elimination half-times of 58 and 83 days 

were estimated for adolescent and adult males, respectively; compared with 46 and 66 days for adolescent 
CESIUM 66 

3. HEALTH EFFECTS 

and adult females, respectively. In the study of Melo et al. (1994), a high correlation was found between 

biological half-time for 137Cs and weight for all age groups and sexes, except adult females. 

Elimination rates of cesium may be altered by potassium intake. Following the intraperitoneal injection 

of 137Cs in rats, a basal diet supplemented with 8–11% potassium resulted in cesium clearance of 60 days 

compared to about 120 days for rats receiving the unsupplemented basal diet that contained 1% potassium 

(Richmond and Furchner 1961). After 20 days on the diets, rats receiving supplemental potassium had 

body burdens of 137Cs that were one-half those of the rats not receiving supplemental potassium. This 

finding shows that supplemental potassium reduces the uptake and increases the elimination of ingested 

137Cs. 

Retention of cesium was lower in males suffering from muscular dystrophy than in age-matched controls. 

Older males with advanced signs of muscular dystrophy had lower retention than younger males 

exhibiting earlier stages of the disease (Lloyd et al. 1973). 

Cesium crosses the placenta from mother to fetus. Measurable amounts of 137Cs have been detected in 

human placenta and fetal tissue (Toader et al. 1996; Yoshioka et al. 1976). Cesium concentrations are 

higher in older fetuses than in younger ones (Toader et al. 1996). Pregnancy may increase the removal of 

cesium from the mother, as indicated by shorter elimination half-times during pregnancy relative to 

measurements taken before or after pregnancy or among nonpregnant controls (Bengtsson et al. 1964; 

Rundo and Turner 1966; Thornberg and Mattsson 2000; Zundel et al. 1969). Cesium has also been 

detected in human breast milk (Thornberg and Mattsson 2000). 

3.5.4.3 Dermal Exposure 

No reports were located regarding elimination and excretion of cesium in humans or animals following 

dermal exposure. 

3.5.4.4 Other Routes of Exposure 

Evidence for age-related differences in cesium elimination rates was observed in rats injected with 134Cs 

or 137Cs (as cesium chloride) at various ages. Retention of radiocesium from a single intraperitoneal 

injection of 0.5 μCi of carrier-free 134CsCl increased with increasing age of rats at the time of dosing 

(Lengemann 1970). For example, the amount of radiocesium retained at 49 days after dosing was 
CESIUM 67 

3. HEALTH EFFECTS 

>14 times greater in rats dosed at 4 months of age than in rats dosed at 1 month of age. Retention in rats 

injected at 21 months of age was approximately 1.9 times greater than that of the rats dosed at 4 months 

of age. Long-term retention also appears to be age related in dogs injected intravenously with 137CsCl; 

puppies 3–5 months of age exhibited elimination half-times that were shorter than those of adult dogs 

(Melo et al. 1997). Age-related increases in cesium retention rates were also observed in other young 

dogs from 61 to approximately 300 days old, after which cesium retention reached a plateau; the increases 

in cesium retention were similar to growth curves (Tyler et al. 1969). There is some indication, however, 

that retention of cesium is higher in neonatal rats than in weanling or adult rats (Lengemann 1969, 1970; 

Mahlum and Sikov 1969). 

3.5.5 Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models 

Physiologically based pharmacokinetic (PBPK) models use mathematical descriptions of the uptake and 

disposition of chemical substances to quantitatively describe the relationships among critical biological 

processes (Krishnan et al. 1994). PBPK models are also called biologically based tissue dosimetry 

models. PBPK models are increasingly used in risk assessments, primarily to predict the concentration of 

potentially toxic moieties of a chemical that will be delivered to any given target tissue following various 

combinations of route, dose level, and test species (Clewell and Andersen 1985). Physiologically based 

pharmacodynamic (PBPD) models use mathematical descriptions of the dose-response function to 

quantitatively describe the relationship between target tissue dose and toxic end points. 

PBPK/PD models refine our understanding of complex quantitative dose behaviors by helping to 

delineate and characterize the relationships between: (1) the external/exposure concentration and target 

tissue dose of the toxic moiety, and (2) the target tissue dose and observed responses (Andersen and 

Krishnan 1994; Andersen et al. 1987). These models are biologically and mechanistically based and can 

be used to extrapolate the pharmacokinetic behavior of chemical substances from high to low dose, from 

route to route, between species, and between subpopulations within a species. The biological basis of 

PBPK models results in more meaningful extrapolations than those generated with the more conventional 

use of uncertainty factors. 

The PBPK model for a chemical substance is developed in four interconnected steps: (1) model 

representation, (2) model parameterization, (3) model simulation, and (4) model validation (Krishnan and 

Andersen 1994). In the early 1990s, validated PBPK models were developed for a number of 

toxicologically important chemical substances, both volatile and nonvolatile (Krishnan and Andersen 
CESIUM 68 

3. HEALTH EFFECTS 

1994; Leung 1993). PBPK models for a particular substance require estimates of the chemical substancespecific physicochemical parameters, and species-specific physiological and biological parameters. The 

numerical estimates of these model parameters are incorporated within a set of differential and algebraic 

equations that describe the pharmacokinetic processes. Solving these differential and algebraic equations 

provides the predictions of tissue dose. Computers then provide process simulations based on these 

solutions. 

The structure and mathematical expressions used in PBPK models significantly simplify the true 

complexities of biological systems. If the uptake and disposition of the chemical substance(s) is 

adequately described, however, this simplification is desirable because data are often unavailable for 

many biological processes. A simplified scheme reduces the magnitude of cumulative uncertainty. The 

adequacy of the model is, therefore, of great importance, and model validation is essential to the use of 

PBPK models in risk assessment. 

PBPK models improve the pharmacokinetic extrapolations used in risk assessments that identify the 

maximal (i.e., the safe) levels for human exposure to chemical substances (Andersen and Krishnan 1994). 

Similar models have been developed for radionuclides. These PBPK models provide a scientifically 

sound means to predict the target tissue dose of chemicals and radiation in humans who are exposed to 

environmental levels (for example, levels that might occur at hazardous waste sites) based on the results 

of studies where doses were higher or were administered in different species. Figure 3-3 shows a 

conceptualized representation of a PBPK model. Figures 3-4 through 3-7 show models for radionuclides 

in general or specifically for cesium. 

The International Commission on Radiological Protection (ICRP 1994, 1995) developed a Human 

Respiratory Tract Model for Radiological Protection, which contains respiratory tract deposition and 

clearance compartmental models for inhalation exposure that may be applied to particulate aerosols of 

cesium compounds. The ICRP (1979, 1989, 1993) also developed a 2-compartment biokinetic model for 

human oral exposure that applies to cesium. EPA (1998) adopted the ICRP (1993, 1994, 1995) models 

for assessment of radiologic risks from cesium exposures. The National Council on Radiation Protection 

and Measurements (NCRP) also developed a respiratory tract model for inhaled radionuclides (NCRP 

1997). At this time, the NCRP recommends the use of the ICRP model for calculating radiation doses for 

workers and the general public. Readers interested in this topic are referred to NCRP Report No. 125; 

Deposition, Retention and Dosimetry of Inhaled Radioactive Substances (NCRP 1997). In the appendix 
Inhaled chem ical E xhaled chem ical 

Lungs 

Liver 

Fat 

S low ly 

perfused 

tissues 

Richly 

perfused 

tissues 

Kidney 

Skin 

V 

E 

N 

O 

U 

S 

B 

L 

O 

O 

D 

A 

R 

T 

E 

R 

I 

A 

L 

B 

L 

O 

O 

D 

V ma x K m 

Ingestion 

GI 

Tract 

Feces 

Urine

 C hem icals in air 

CESIUM 69 

3. HEALTH EFFECTS 

Figure 3-3. Conceptual Representation of a Physiologically Based 

Pharmacokinetic (PBPK) Model for a Hypothetical 

Chemical Substance 

contacting skin 

Source: adapted from Krishnan et al. 1994 

Note: This is a conceptual representation of a physiologically based pharmacokinetic (PBPK) model for a hypothetical 

chemical substance. The chemical substance is shown to be absorbed via the skin, by inhalation, or by ingestion, 

metabolized in the liver, and excreted in the urine or by exhalation. 
CESIUM 70 

3. HEALTH EFFECTS 

to the report, NCRP provides the animal testing clearance data and equations fitting the data that 

supported the development of the human model for cesium. 

Human Respiratory Tract Model for Radiological Protection (ICRP 1994) 

Deposition. The ICRP (1994) developed a deposition model to describe the behavior of inhaled aerosols 

and vapors in the respiratory tract. This model was developed to estimate the fractions of radioactivity in 

breathing air that deposit in each anatomical region of the respiratory tract. ICRP (1994) provides 

inhalation dose coefficients, which can be used to estimate the committed equivalent and effective doses 

to organs and tissues throughout the body based on a unit intake of radioactive material. The model 

applies to three levels of particle solubility, a wide range of particle sizes (approximately 0.0005–100 μm 

in diameter), and parameter values. The model may be adjusted for various segments of the population 

(e.g., sex, age, level of physical exertion). This model also allows the evaluation of the bounds of 

uncertainty in deposition estimates. Uncertainties arise from natural biological variability among 

individuals. The ICRP model is applicable to particulate aerosols containing cesium, but was developed 

for a wide variety of radionuclides and their chemical forms. 

The ICRP deposition model may be used to estimate the amount of inhaled material that initially enters 

each compartment (see Figure 3-4). The model was developed with 5 compartments: (1) the anterior 

nasal passages (ET1); (2) all other extrathoracic airways (ET2) (posterior nasal passages, the naso- and 

oropharynx, and the larynx); (3) the bronchi (BB); (4) the bronchioles (bb); and (5) the alveolar 

interstitium (AI). Particles deposited in the ET1 region may be cleared either by dissolution and 

absorption into the blood or by nose-blowing. Particles deposited in each of the other regions may then 

be removed from each region and redistributed either upward into the respiratory tree by mucociliary 

clearance mechanisms, or to the lymphatic system and blood by different particle removal mechanisms. 

For extrathoracic deposition of particles, the model is based on experimental data, where deposition is 

related to particle size and airflow parameters. The model scales deposition for women and children from 

adult male data. Similarly to the extrathoracic region, experimental data served as the basis for lung 

(bronchi, bronchioles, and alveoli) aerosol transport and deposition. A theoretical model of gas transport 

and particle deposition was used to interpret data and to predict deposition for compartments and 

subpopulations other than adult males. Table 3-5 provides reference respiratory values for the general 

Caucasian population and for several levels of physical activity. 
CESIUM 71 

3. HEALTH EFFECTS 

Table 3-5. Reference Respiratory Values for a General Caucasian Population at 

Different Levels of Activitya
 

Activity: Resting (sleeping) Sitting awake Light exercise Heavy exercise 

Maximal 8 12 32 64 

workload (%): 

Breathing VT B fR VT B fR VT B fR VT B fR 

parameters:b (L) (m3h-1) (min-1) (L) (m3h-1) (min-1) (L) (m3h-1) (min-1) (L) (m3h-1) (min-1) 

Age Sex 

3 months 0.04 0.09 38 N/A N/A N/A 0.07 0.19 48 N/A N/A N/A 

1 year 0.07 0.15 34 0.1 0.22 36 0.13 0.35 46 N/A N/A N/A 

5 years 0.17 0.24 23 0.21 0.32 25 0.24 0.57 39 N/A N/A N/A 

10 years Both: 0.3 0.31 17 0.33 0.38 19 0.58 1.12 32 

Male: 0.841 2.22 44 

Female: 0.667 1.84 46 

15 years Male: 0.500 0.42 14 0.533 0.48 15 1.0 1.38 23 1.352 2.92 36 

 Female: 0.417 0.35 14 0.417 0.40 16 0.903 1.30 24 1.127 2.57 38 

Adult Male: 0.625 0.45 12 0.750 0.54 12 1.25 1.5 20 1.923 3.0 26 

 Female: 0.444 0.32 12 0.464 0.39 14 0.992 1.25 21 1.364 2.7 33 

a

See Annex B (ICRP 1994) for data from which these reference values were derived. b

B = ventilation rate; fR = respiration frequency; VT = tidal volume 

H = hour; L = liter; m = meter; min = minute; N/A = not applicable 
Sequestered i Sequestered i T ssu S r sport n T issu e S urface Trurface T ansp ort

AnteriorAnterior

ET1 

14 

ET1

14

1 Nasa l

ExtrathorExtr acicathoracic Environment 

16 

Environment

16

Naso-o ro­-

pharyn x

Larynx

0.001 

ETSEQ

12 

LNET 

13 

Bronchi 

bb2 

BB2 

LNTH 

bbSEQ

0.03 2 

0.01 

0.01 

8 

BBSEQ 

9 

Thoracic 

6 5

10 

Al3 

0.0001 

BB1 

bb1 

7 

4 

Al Al2 1

0.001 0.02 

3 2 1

ET GI Tract 2 

11 15 

100 

Bronchioles 

Alveolar 

Interstitium 

0.03 10 

0.00002 

0.001

ETSEQ

12

LNET

13

Bronchi

bb2

BB2

LNTH

bbSEQ

0.03 2

0.01

0.01

8

BBSEQ

9

Thoracic

6 5

10

Al3

0.0001

BB1

bb1

7

4

Al Al2 1

0.001 0.02

3 2 1

ET GI Tract 2

11 15

100

Bronchioles

Alveolar 

Interstitium

0.03 10

0.00002

CESIUM 72 

3. HEALTH EFFECTS 

Figure 3-4. Compartment Model to Represent Particle Deposition and TimeDependent Particle Transport in the Respiratory Tract* 

*Compartment numbers shown in lower right corners are used to define clearance pathways. The clearance rates, 

half-lives, and fractions by compartment, as well as the compartment abbreviations are presented in Table 3-6. 

Source: ICRP 1994 
CESIUM	 73 

3. HEALTH EFFECTS 

Deposition of inhaled gases and vapors is modeled as a partitioning process that depends on the 

physiological parameters noted above as well as the solubility and reactivity of compounds in the 

respiratory tract (see Figure 3-5). The ICRP (1994) model defines three categories of solubility and 

reactivity: SR-0, SR-1, and SR-2: 

•	 Type SR-0 compounds include insoluble and nonreactive gases (e.g., inert gases such as H2, He). 

These compounds do not significantly interact with the respiratory tract tissues and essentially all 

the inhaled gas is exhaled. Radiation doses from inhalation of SR-0 compounds are assumed to 

result from the irradiation of the respiratory tract from the air spaces. 

•	 Type SR-1 compounds include soluble or reactive gases and vapors that are expected to be taken 

up by the respiratory tract tissues and may deposit in any or all of the regions of the respiratory 

tract, depending on the dynamics of the airways and properties of the surface mucous and airway 

tissues, as well as the solubility and reactivity of the compound. 

•	 Type SR-2 compounds include soluble and reactive gases and vapors that are completely retained 

in the extrathoracic regions of the respiratory tract. SR-2 compounds include sulfur dioxide 

(SO2) and hydrogen fluoride (HF). 

Respiratory Tract Mechanical (Particle) Clearance. The clearance portion of the model identifies the 

principal clearance pathways within the respiratory tract. The model was developed to predict the 

retention and clearance of various radioactive materials. The compartmental model is linked to the 

deposition model (see Figure 3-4) and to reference values presented in Table 3-6. Table 3-6 provides 

clearance rates by biological processes only, not by radioactive decay, and deposition fractions for each 

compartment for insoluble particles. The table provides rates of insoluble particle transport for each of 

the compartments, expressed as a fraction per day and also as half-time. ICRP (1994) also developed 

modifying factors for some of the parameters, such as age, smoking, and disease status. Parameters of the 

clearance model are based on human data, although particle retention in airway walls is based on 

experimental data from animal experiments. 

The clearance of particles from the respiratory tract is a dynamic process. The rate of clearance generally 

changes with time from each region and by each route. Following deposition of large numbers of 

particles over a short time period (acute exposure), transport rates change as particles are cleared from the 

various regions. Physical and chemical properties of deposited material determine the rate of dissolution. 

As particles dissolve, absorption rates also tend to change over time. By creating a model with 

compartments of different clearance rates within each region (e.g., BB1, BB2, BBseq), the ICRP model 
CESIUM 74 

3. HEALTH EFFECTS 

Table 3-6. Reference Values of Parameters for the Compartment Model to 

Represent Time-dependent Particle Transport from the Human 

Respiratory Tract 

Part A: Clearance rates for insoluble particles 

Pathway From To Rate (d-1) Half-timea

 m1,4 AI1 bb1 0.02 35 days 

m2,4 AI2 bb1 0.001 700 days 

m3,4 AI3 bb1 0.0001 7,000 days 

m3,10 AI3 LNTH 0.00002 — 

m4,7 bb1 BB1 2 8 hours 

m5,7 bb2 BB1 0.03 23 days 

m6,10 bbseq LNTH 0.01 70 days 

m7,11 BB1 ET2 10 100 minutes

 m8,11 BB2 ET2 0.03 23 days 

m9,10 BBseq LNTH 0.01 70 days 

m11,15 ET2 GI tract 100 10 minutes

 m12,13 ETseq LNET 0.001 700 days 

m14,16 ET1 Environment 1 17 hours 

See next page for Part B 
CESIUM	 75 

3. HEALTH EFFECTS 

Table 3-6. Reference Values of Parameters for the Compartment Model to 

Represent Time-dependent Particle Transport from the Human 

Respiratory Tract 

Part B: Partition of deposit in each region between compartmentsb 

Fraction of deposit in region assigned to 

Region or deposition site Compartment compartmentc

 ET2 ET2 0.9995 

ETseq 0.0005 

BB BB1 0.993-fs 

BB2 fs 

BBseq 0.007 

bb bb1 0.993-fs 

bb2 fs 

bbseq 0.007 

AI AI1 0.3 

AI2 0.6 

AI3 0.1 

a

The half-times are approximate since the reference values are specified for the particle transport rates and are 

rounded in units of d-1. A half-time is not given for the transport rate from Al3 to LNTH, since this rate was chosen to 

direct the required amount of material to the lymph nodes. The clearance half-time of compartment Al3 is determined 

by the sum of the clearance rates from it. 

b

See paragraph 181, Chapter 5 (ICRP 1994) for default values used for relating fs to dae. c

It is assumed that fs is size-dependent. For modeling purposes, fs is taken to be: 

fs = 0 5. for dae ≤ 2 5. ρ χμ / m and

0 63 .( d ρ χ/ − 25 .) ae fs = 0 5. e for dae > 25 . ρ χμ / m

where: 

fs = fraction subject to slow clearance 

dae = aerodynamic particle diameter/(μm) 

ρ = particle density (g/cm3

) 

χ = particle shape factor 

AI = alveolar-interstitial region; BB = bronchial region; bb = bronchiolar region; BBseq = compartment representing 

prolonged retention in airway walls of small fraction of particles deposited in the bronchial region; 

bbseq = compartment representing prolonged retention in airway walls of small fraction of particles deposited in the 

bronchiolar region; d = day(s); ET = extrathoracic region; ETseq = compartment representing prolonged retention in 

airway tissue of small fraction of particles deposited in the nasal passages; GI tract = gastrointestinal tract; LNET = 

lymphatics and lymph nodes that drain the extrathoracic region; LNTH = lymphatics and lymph nodes that drain the 

thoracic region 

Source: ICRP 1994 
Airway Uptake Gas or Vapor 

Lumen 

Airway 

Fluid 

Tissue 

Blood Blood 

Sb 

Reaction 

Product 

Reaction 

Product 

Bound 

Product 

Material 

Gas/Vapor 

Gas/Vapor 

Reaction Gas/Vapor 

Source: ICRP 1994 

Convection 

Diffusion 

CESIUM 76 

3. HEALTH EFFECTS 

Figure 3-5. Reaction of Gases or Vapors at Various Levels of the Gas-Blood 

Interface 
CESIUM 77 

3. HEALTH EFFECTS 

overcomes problems associated with time-dependent functions. Each compartment clears to other 

compartments by constant rates for each pathway. 

Particle transport from all regions is toward both the lymph nodes and the pharynx. A majority of 

deposited particles are eventually swallowed. In the front part of the nasal passages (ET1), nose blowing, 

sneezing, and wiping remove most of the deposited particles. Particles remain in the nasal passages for 

about a day. For particles with AMADs of a few micrometers or greater, the ET1 compartment is 

probably the largest deposition site. A majority of particles deposited at the back of the nasal passages 

and in the larynx (ET2) are removed quickly by the mucous fluids that cover the airways. In this region, 

particle clearance is completed within 15 minutes. 

Ciliary action removes deposited particles from the bronchi and bronchioles. Though mucociliary action 

rapidly transports most particles deposited here toward the pharynx, a fraction of these particles is cleared 

more slowly. Evidence for this clearance is found in human studies. For humans, retention of particles 

deposited in the lungs (BB and bb) is apparently biphasic. The “slow” action of the cilia may remove as 

many as half of the bronchi- and bronchiole-deposited particles. In human bronchi and bronchiole 

regions, mucus movement is influenced by location. Movement is slower in areas closer to alveoli. It 

takes about 2 days for particles to travel from the bronchioles to the bronchi and 10 days from the bronchi 

to the pharynx. The second (slower) compartment is assumed to have approximately equal fractions 

deposited between BB2 and bb2 and both with clearance half-times estimated at 20 days. Particle size is a 

primary determinant of the fraction deposited in this slow thoracic compartment. A small fraction of 

particles deposited in the BB and bb regions may be retained in the airway wall for even longer periods 

(BBseq and bbseq). 

If particles reach and become deposited in the alveoli, they tend to stay imbedded in the fluid on the 

alveolar surface or move into the lymph nodes. The mechanism by which particles are physically 

resuspended and removed from the AI region is coughing. For modeling purposes, the AI region is 

divided into three subcompartments representing different slow clearance rates, all of which are slow. 

Particle clearance from the alveolar-interstitial region has been measured in human subjects. The ICRP 

model uses 2 half-times to represent clearance. About 30% of the particles have a 30-day half-time, and 

the remaining 70% are given a half-time of several hundred days. Over time, AI particle transport 

diminishes and some insoluble particles may remain in lungs 10–50 years after exposure. 
CESIUM	 78 

3. HEALTH EFFECTS 

Absorption into Blood. The ICRP model assumes that absorption into blood occurs at equivalent rates in 

all parts of the respiratory tract, except in the anterior nasal passages (ET1), where no absorption occurs. 

Absorption is essentially a 2-stage process, as shown in Figure 3-6. First, there is dissociation 

(dissolution) of particles. The dissolved molecules or ions then diffuse across capillary walls and are 

taken up by the blood. Immediately following dissolution, rapid absorption takes place. For some 

elements, rapid absorption does not occur because of binding to respiratory-tract components. In the 

absence of specific data for specific compounds, the model uses the following default absorption rate 

values for those specific compounds that are classified as Types F (fast), M (medium), S (slow), and V 

(instantaneous): 

•	 For Type F, there is rapid 100% absorption within 10 minutes of the material deposited in the BB, 

bb, and AI regions, and 50% of material deposited in ET2. Thus, for nose breathing, there is 

rapid absorption of approximately 25% of the deposit in ET and 50% for mouth breathing. 

•	 For Type M, about 70% of the deposit in AI reaches the blood eventually. There is rapid 

absorption of about 10% of the deposit in BB and bb, and 5% of material deposited in ET2. 

Thus, there is rapid absorption of approximately 2.5% of the deposit in ET for nose breathing, 

and 5% for mouth breathing. 

•	 For Type S, 0.1% is absorbed within 10 minutes and 99.9% is absorbed within 7,000 days, so 

there is little absorption from ET, BB, or bb, and about 10% of the deposit in AI reaches the 

blood eventually. 

•	 For Type V, complete absorption (100%) is considered to occur instantaneously. 

ICRP (1995) considers the experimental and human data to support the following classifications: cesium 

chloride and nitrate, Type F; cesium in irradiated fuel fragments, Type F or M; and cesium in fused 

aluminosilicate particles, M or S. ICRP (1995) recommends assigning all cesium aerosols to Type F in 

the absence of specific information supporting an alternative classification. 

ICRP (1993) Cesium Biokinetic Model 

Description of the Model. ICRP (1979, 1989, 1993) developed a 2-compartment model of the kinetics of 

ingested cesium in humans (Figure 3-6) that is applicable to infants, children, adolescents, and adults. 

The model is based on an age- and gender-specific model of Leggett (1986) in which compartment sizes 

and retention half-times were expressed as a function of the mass of potassium in the body. Ingested 

cesium is assumed to be completely absorbed into blood. Absorbed cesium is then assumed to distribute 
Figure 3-6. The Human Respiratory Tract Model: Absorption into Blood 

Particulate Material 

Dissociated Material 

Bound Material 

Blood 

Dissolution 

Uptake 

Source: ICRP 1994 

CESIUM 79 

3. HEALTH EFFECTS 
CESIUM 80 

3. HEALTH EFFECTS 

uniformly in the body and to be eliminated from fast and slow elimination pools. The fraction of the total 

body cesium associated with the fast and slow pools, as well as the elimination half-times from each pool, 

are assumed to vary with age. The elimination half-times vary for ages 3 months, 1, 5, 10, 15 years, and 

adult (>15 years). The contribution of the fast pool decreases from 45% at age 5 years to 10% in adults. 

The elimination half-times of the fast pool decrease from 9.1 days at age 5 years to 2 days in adults, 

whereas the elimination half-times of the slow pool increase from 13–16 days in infants to 110 days in 

adults. 

Validation of the Model. The extent to which the ICRP model has been validated is not described in 

ICRP (1993). 

Risk Assessment. The ICRP biokinetic model has been used to establish radiation dose equivalents 

(Sv/Bq) of ingested 134Cs, 136Cs, and 137Cs for ages 3 months to 70 years (ICRP 1993). 

Target Tissues. The ICRP model is designed to calculate radiocesium intake limits based on radiation 

dose to all major organs. 

Species Extrapolation. The ICRP model is designed for applications to human dosimetry and cannot be 

applied to other species without modification. 

Interroute Extrapolation. The ICRP model is designed to simulate oral exposure assuming 100% 

absorption of ingested cesium. The model is applicable to other routes of exposure if the extent of 

absorption for a particular exposure route is known. 

Leggett et al. (2003) Cesium Biokinetics Model 

Description of the Model. Leggett et al. (2003) developed a PBPK model of the kinetics of ingested or 

injected cesium in humans (Figure 3-7). The model includes compartments representing blood (plasma 

and red blood cells), brain, gastrointestinal tract, heart, kidney, liver, lung, pancreas, skin, and spleen. 

Transfers between plasma and tissues are simulated as first-order, flow-limited, rate constants (Table 3-7). 

Flow limitation is imposed by deriving the plasma-to-tissue rate constants in terms of tissue blood flows 

and empirically-derived arterial-venous extraction fractions (Table 3-8). Rate constants for transfers from 

tissues to plasma are derived from the product of the plasma-to-tissue rate constants and empiricallyderived equilibrium ratios for cesium (fraction of body burden) in plasma and tissue (Table 3-9). 
CESIUM 81 

3. HEALTH EFFECTS 

Table 3-7. Transfer Coefficients (d-1) for a Reference Adult Male 

Plasma to heart 14.128 

Plasma to liver 19.515 

Plasma to kidneys 67.108 

Plasma to muscle 30.022 

Plasma to gastrointestinal tract tissue 52.98 

Plasma to stomach contents 4.516 

Plasma to small intestine contents 1.0480 

Plasma to large intestine contents 0.02 

Plasma to spleen 5.298 

Plasma to pancreas 1.766 

Plasma to brain 0.424 

Plasma to red marrow 5.298 

Plasma to other skeleton 3.532 

Plasma to skin 4.415 

Plasma to lungs 4.415 

Plasma to adipose tissue 8.83 

Plasma to other 1a

 8.826 

Plasma to other 2b

 0.00353 

Plasma to red blood cells 1.8 

Heart to plasma 8.073 

Liver to plasma 2.204 

Liver to small intestine 0.116 

Kidneys to urinary bladder contents 1.678 

Kidneys to plasma 31.876 

Muscle to plasma 0.0751 

Gastrointestinal tract tissue to plasma 8.191 

Gastrointestinal tract tissue to liver 0.431 

Gastrointestinal tract tissue to stomach contents 0.0333 

Gastrointestinal tract tissue to small intestine contents 0.108 

Gastrointestinal tract tissue to large intestine contents 0.0667 

Spleen to plasma 5.033 

Spleen to liver 0.265 

Pancreas to plasma 1.678 

Pancreas to liver 0.0883 

Skin to plasma 0.867 

Skin to excreta 0.0159 

Brain to plasma 0.0848 

Red marrow to plasma 0.706 

Other skeleton to plasma 0.128 

Lungs to plasma 1.472 

Adipose tissue to plasma 1.766 

Other 1a

 to plasma 0.692 
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3. HEALTH EFFECTS 

Table 3-7. Transfer Coefficients (d-1) for a Reference Adult Male 

Other 2b to plasma 0.00141 

Red blood cells to plasma 0.257 

Urinary bladder contents to urine 12.0 

Stomach to small intestine (contents) 40.0 

Small intestine contents to plasma 28.215 

Small intestine to large intestine (contents) 0.3 

Small intestine contents to liver 1.485 

Large intestine contents to feces 0.5 

a

Remaining tissues and fluids in the body with a relatively short turnover time. 

b

Small component of the remaining tissues and fluids in the body with a tenacious retention of Cs apparent in some 

long-term studies. 

Source: Leggett et al. 2003 
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3. HEALTH EFFECTS 

Table 3-8. Tissue-specific Extraction Fractions Assumed for Cesium 

Tissues Extraction fraction 

Kidneys, gastrointestinal tract, heart 0.2 

Liver, skin 0.05 

Brain 0.002 

All other tissues 0.1 

Source: Leggett et al. 2003 
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3. HEALTH EFFECTS 

Table 3-9. Tissue Masses, Cesium Equilibrium Distribution, and 

Tissue Blood Flow for a Reference Adult Male 

Equilibrium cesium contenta
 

Compartment Massa (g) (fraction of total-body cesium) Blood flow (FCO) 

Adipose tissueb 12,000 0.01 0.05 

Brain 1,450 0.01 0.12 

Gastrointestinal contents 900 0.004 – 

Gastrointestinal tract tissue 1,170 0.015 0.15 

Heart 330 0.0035 0.04 

Kidneys 310 0.004 0.19 

Liver 1,800 0.02 0.065 (arterial) 

(0.19) (portal) 

Lungs 500 0.006 0.025 

Skeletal muscle 29,000 0.8 0.17 

Plasma 3,100 0.002 – 

Red blood cells 2,500 0.014 – 

Skeleton 10,500 0.07 0.05 

 Red marrow (0.015) (0.03) 

Bone and other tissue (0.055) (0.02) 

Skin 3,300 0.01 0.05 

Spleen 150 0.002 0.03 

Pancreas 140 0.002 0.01 

Otherc

 5,850 0.0305 0.05 

Totals 73,000 1.00 1.00 

a

Without blood. 

b

Separable adipose tissue excluding yellow bone marrow.
 c

Remaining tissues and fluids in the body. 

FCO = fraction of cardiac output 

Source: Leggett et al. 2003 
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3. HEALTH EFFECTS 

Figure 3-7. Directions of Flow of Cesium 

Brain

Heart 

tissue

Adipose 

tissue 

Adipose

tissue

Muscle

Other 

Skeleton Skeleton

Red 

marrow 

Red

marrow

Skin

Red blood 

cells

Lung 

tissue

Liver

Kidneys

2 

1 

Other 

2

Other

PancreasPancreas

Spleen

Gastrointestinal tract tissue 

Stomach 

contents 

Small 

intestine 

contents 

Large 

intestine 

contents 

Sweat (0.02) Urine (0.85) Feces (0.13)

15% 

1% 

3% (19%) 

6.5% 

19% 

5% 

4.998% 

0.002% 

4% 

Cardiac output 

2.5% 

5% 

17% 

2% 

3% 

Solid arrows represent plasma flow and broken arrows represent flow not involving plasma. Percentages indicate 

distribution of carbon monoxide. Numbers besides sweat, urine, and feces are fractions of cumulative excretion. 

Source: Leggett et al. (2003). 
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3. HEALTH EFFECTS 

Excretory pathways represented in the model include feces, sweat, and urine. Transfers between the 

central plasma flow and the gastrointestinal tract include secretion into the gastrointestinal tract and 

absorption to plasma. 

Validation of the Model. The model has been evaluated for predicting observed blood and plasma 

cesium concentrations, whole-body retention of cesium, and urinary clearance of cesium in adults, 

following injections or ingestion of cesium (Leggett et al. 2003). Additional evaluations are reported, 

based on evaluations in rats and dogs. Model predictions corresponded reasonably well with 

observations. 

Risk Assessment. The model is intended for predicting internal tissue doses to radiation following 

exposures to cesium for use in radiation risk assessment. 

Target Tissues. The model is designed to calculate cesium concentrations in tissues, and includes major 

sites of accumulation (e.g., kidney, liver, and muscle). 

Species Extrapolation. The model is designed for applications to human dosimetry and can be applied to 

other species (e.g., dog and rat) with modification of physiological parameters. 

Interroute Extrapolation. The model is designed to simulate the intravenous or oral exposures to cesium 

and can be applied to other routes of exposure with the addition of simulations or estimates of the uptake 

of cesium into the central blood compartment. 

3.6 MECHANISMS OF ACTION 

3.6.1 Pharmacokinetic Mechanisms 

Cesium is rapidly absorbed into blood following inhalation or oral exposure to soluble cesium 

compounds, as demonstrated by the rapid distribution of cesium activity after inhalation or ingestion. 

Approximately 80% absorption of 137Cs was observed in dogs exposed to aerosols containing 137Cs (as 

cesium chloride) (Boecker 1969a, 1969b). Oral ingestion of 134Cs- and 137Cs-contaminated food by 

volunteers resulted in approximately 78% absorption. Animal studies indicate that absorption rates from 

orally administered soluble cesium compounds are highest in the duodenum, followed in order by the 

jejunum, ileum, and colon. Very little absorption occurs in the stomach or caecum (Moore and Comar 

1962, 1963). Absorption rates are higher in fasted rats than in fed rats, indicating that stomach contents 
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3. HEALTH EFFECTS 

may influence the rate of cesium absorption. Relatively insoluble forms of cesium compounds, which 

may sometimes be associated with irradiated fuel particles, are poorly absorbed by inhalation and oral 

exposure routes (Boecker et al. 1974, 1977; LeRoy et al. 1966; Talbot et al. 1993). Dermal retention, but 

not transdermal absorption, has been qualitatively demonstrated in humans (Rundo 1964). Dermal 

absorption was observed following application of 137CsCl in aqueous solution to the skin of rats (Pendic 

and Milivojevic 1966). Traces of 137Cs were observed in the blood of rats within a few minutes following 

application. 

Once absorbed, cesium is rapidly distributed throughout the body, becoming incorporated into the 

intracellular fluid of numerous tissues. Animal studies indicate that distribution patterns are similar 

following absorption from inhalation or oral exposure and that concentrations of cesium within muscle 

tissue are somewhat higher than the whole-body average (Stara 1965). Comparative human and animal 

studies have shown that parenteral exposure to cesium compounds results in cesium distribution patterns 

similar to those following inhalation or oral exposure (Rosoff et al. 1963; Stara 1965). 

Absorbed cesium behaves in a manner similar to that of potassium. Both potassium and cesium are alkali 

metals that are distributed throughout the body as cations, becoming incorporated into intracellular fluids. 

Cesium has been shown to compete with potassium for transport through potassium channels and can also 

substitute for potassium in activation of the sodium pump and subsequent transport into the cell (Cecchi 

et al. 1987; Edwards 1982; Hodgkin 1947; Latorre and Miller 1983; Sjodin and Beauge 1967). In both 

types of transport, movement of cesium is sluggish compared with that of potassium (Blatz and Magleby 

1984; Coronado et al. 1980; Cukierman et al. 1985; Edwards 1982; Gay and Stanfield 1978; Gorman et 

al. 1982; Hille 1973; Reuter and Stevens 1980). Discrimination between potassium and cesium generally 

is greater for passive transport out of cells than for active transport into cells (Leggett et al. 2003). This 

results in a greater residence time of cesium than potassium in muscle cells and hence in the whole body, 

since skeletal muscle contains most of the body’s potassium or cesium at equilibrium. Although the 

biokinetics of potassium and cesium may vary somewhat in such characteristics as relative affinity for 

various cell types and differing retention rates, the similarities allow elimination rates for potassium to be 

used as an index of elimination rates for cesium (USNRC 1983). Urinary excretion is the major route of 

elimination of cesium. 
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3. HEALTH EFFECTS 

3.6.2 Mechanisms of Toxicity 

Earth contains relatively small amounts of stable (nonradioactive) cesium. Cesium has few industrial 

applications. At environmental levels, stable cesium is not chemically toxic in animals. Cesium is not 

likely to be of toxic concern to humans exposed to cesium by inhalation, oral, or dermal contact. 

Although a number of investigators have reported cesium-induced alterations in behavior or cardiac 

activity in animals systems exposed to cesium chloride by parenteral injection, underlying mechanisms 

are not yet fully understood. 

Cesium may have both depressant and antidepressant properties in rodents, as it was shown to decrease 

the conditioned avoidance response of pole-climbing (Bose and Pinsky 1983b) and to reduce vertical and 

horizontal motor activity (Bose and Pinsky 1981, 1984; Bose et al. 1981; Pinsky et al. 1980), while 

enhancing amphetamine-induced hyperactivity and reducing the locomotor depressive action of reserpine 

(Messiha 1978). 

Increased vertical activity (rearing), but not horizontal activity, was observed in mice given repeated 

injections of cesium chloride (Johnson 1972). Rastogi et al. (1980) found no increase in behavioral 

activity in rats repeatedly injected with cesium chloride, but noted a number of biochemical changes in 

the brain that included a statistically significant rise in tyrosine hydroxylase activity that resulted in a 

slight but statistically significant increase in tyrosine levels, markedly enhanced levels of the 

neurotransmitters norepinephrine and dopamine, and increased levels of a norepinephrine metabolite 

(4-hydroxy-3-methoxyphenylglycol). Cesium appeared to block the uptake of norepinephrine by 

synaptosomes. 

Cesium was shown to alter normal cardiac rhythm, triggering short-lived early after depolarizations 

(EADs) and polymorphic ventricular tachyarrhythmias (VTs) in canine myocardial muscle fibers and 

Purkinje cells (Brachmann et al. 1983; Levine et al. 1985; Murakawa et al. 1997; Patterson et al. 1990), 

effects that are similar to those observed in humans with congenital and acquired long QT syndrome 

(Bonatti et al. 1983). Prolonged QT syndrome and associated cardiac arrhythmia have been observed in 

patients who consumed cesium chloride as a component of homeopathic remedies (Bangh et al. 2001; 

Harik et al. 2002; Saliba et al. 2001). Available animal data suggest that cesium-induced EADs and VTs 

were most likely the result of ionic imbalance due to reduced potassium permeability (Isenberg 1976) and 

imbalances of intra- and extracellular concentrations of calcium and sodium (Szabo et al. 1987). 
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3. HEALTH EFFECTS 

Both 134Cs and 137Cs emit gamma radiation, and therefore, radioactive cesium is a health hazard. Highly 

penetrating gamma rays are the major cause of damage to tissues and internal organs following external 

overexposure to radioactive cesium. Once radioactive cesium is taken internally, cells of nearby tissues 

are at highest risk for damage due to the emission of beta particles. Radiation-induced damage in cells 

may be repaired quickly. Misrepaired damage may lead to permanent DNA changes and the potential for 

carcinogenesis. Very large acute radiation doses can damage or kill enough cells to cause the disruption 

of organ systems (acute radiation syndrome), harm to developing fetuses, and even death. Human and 

animal data indicate that radioactive cesium overexposure can result in adverse effects such as reduced 

fertility, abnormal neurological development, genotoxicity, and damage to blood-forming organs (Bartstra 

et al. 1998; Matsuda et al. 1985; Nikula et al. 1995, 1996; Padovani et al. 1993; Ramaiya et al. 1994; 

Skandalis et al. 1997; Tobari et al. 1988). For a more complete discussion of the mechanisms associated 

with the toxic effects of ionizing radiation, refer to Chapter 5 of the Toxicological Profile for Ionizing 

Radiation (Agency for Toxic Substances and Disease Registry 1999). 

3.6.3 Animal-to-Human Extrapolations 

No data were located to indicate significant interspecies differences in pharmacokinetics or health effects 

associated with exposure to stable or radioactive cesium. 

3.7 TOXICITIES MEDIATED THROUGH THE NEUROENDOCRINE AXIS 

Recently, attention has focused on the potential hazardous effects of certain chemicals on the endocrine 

system because of the ability of these chemicals to mimic or block endogenous hormones. Chemicals 

with this type of activity are most commonly referred to as endocrine disruptors. However, appropriate 

terminology to describe such effects remains controversial. The terminology endocrine disruptors, 

initially used by Colborn and Clement (1992), was also used in 1996 when Congress mandated the 

Environmental Protection Agency (EPA) to develop a screening program for “...certain substances 

[which] may have an effect produced by a naturally occurring estrogen, or other such endocrine 

effect[s]...”. To meet this mandate, EPA convened a panel called the Endocrine Disruptors Screening and 

Testing Advisory Committee (EDSTAC), which in 1998 completed its deliberations and made 

recommendations to EPA concerning endocrine disruptors. In 1999, the National Academy of Sciences 

released a report that referred to these same types of chemicals as hormonally active agents. The 

terminology endocrine modulators has also been used to convey the fact that effects caused by such 

chemicals may not necessarily be adverse. Many scientists agree that chemicals with the ability to disrupt 
CESIUM 90 

3. HEALTH EFFECTS 

or modulate the endocrine system are a potential threat to the health of humans, aquatic animals, and 

wildlife. However, others think that endocrine-active chemicals do not pose a significant health risk, 

particularly in view of the fact that hormone mimics exist in the natural environment. Examples of 

natural hormone mimics are the isoflavinoid phytoestrogens (Adlercreutz 1995; Livingston 1978; Mayr et 

al. 1992). These chemicals are derived from plants and are similar in structure and action to endogenous 

estrogen. Although the public health significance and descriptive terminology of substances capable of 

affecting the endocrine system remains controversial, scientists agree that these chemicals may affect the 

synthesis, secretion, transport, binding, action, or elimination of natural hormones in the body responsible 

for maintaining homeostasis, reproduction, development, and/or behavior (EPA 1997). Stated differently, 

such compounds may cause toxicities that are mediated through the neuroendocrine axis. As a result, 

these chemicals may play a role in altering, for example, metabolic, sexual, immune, and neurobehavioral 

function. Such chemicals are also thought to be involved in inducing breast, testicular, and prostate 

cancers, as well as endometriosis (Berger 1994; Giwercman et al. 1993; Hoel et al. 1992). 

No studies were located regarding endocrine disruptive effects resulting from exposure to stable or 

radioactive cesium. 

3.8 CHILDREN’S SUSCEPTIBILITY 

This section discusses potential health effects from exposures during the period from conception to 

maturity at 18 years of age in humans, when all biological systems will have fully developed. Potential 

effects on offspring resulting from exposures of parental germ cells are considered, as well as any indirect 

effects on the fetus and neonate resulting from maternal exposure during gestation and lactation. 

Relevant animal and in vitro models are also discussed. 

Children are not small adults. They differ from adults in their exposures and may differ in their 

susceptibility to hazardous chemicals. Children’s unique physiology and behavior can influence the 

extent of their exposure. Exposures of children are discussed in Section 6.6, Exposures of Children. 

Children sometimes differ from adults in their susceptibility to hazardous chemicals, but whether there is 

a difference depends on the chemical (Guzelian et al. 1992; NRC 1993). Children may be more or less 

susceptible than adults to health effects, and the relationship may change with developmental age 

(Guzelian et al. 1992; NRC 1993). Vulnerability often depends on developmental stage. There are 

critical periods of structural and functional development during both prenatal and postnatal life and a 
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3. HEALTH EFFECTS 

particular structure or function will be most sensitive to disruption during its critical period(s). Damage 

may not be evident until a later stage of development. There are often differences in pharmacokinetics 

and metabolism between children and adults. For example, absorption may be different in neonates 

because of the immaturity of their gastrointestinal tract and their larger skin surface area in proportion to 

body weight (Morselli et al. 1980; NRC 1993); the gastrointestinal absorption of lead is greatest in infants 

and young children (Ziegler et al. 1978). Distribution of xenobiotics may be different; for example, 

infants have a larger proportion of their bodies as extracellular water and their brains and livers are 

proportionately larger (Altman and Dittmer 1974; Fomon 1966; Fomon et al. 1982; Owen and Brozek 

1966; Widdowson and Dickerson 1964). The infant also has an immature blood-brain barrier (Adinolfi 

1985; Johanson 1980) and probably an immature blood-testis barrier (Setchell and Waites 1975). Many 

xenobiotic metabolizing enzymes have distinctive developmental patterns. At various stages of growth 

and development, levels of particular enzymes may be higher or lower than those of adults, and 

sometimes unique enzymes may exist at particular developmental stages (Komori et al. 1990; Leeder and 

Kearns 1997; NRC 1993; Vieira et al. 1996). Whether differences in xenobiotic metabolism make the 

child more or less susceptible also depends on whether the relevant enzymes are involved in activation of 

the parent compound to its toxic form or in detoxification. There may also be differences in excretion, 

particularly in newborns who all have a low glomerular filtration rate and have not developed efficient 

tubular secretion and resorption capacities (Altman and Dittmer 1974; NRC 1993; West et al. 1948). 

Children and adults may differ in their capacity to repair damage from chemical insults. Children also 

have a longer remaining lifetime in which to express damage from chemicals; this potential is particularly 

relevant to cancer. 

Certain characteristics of the developing human may increase exposure or susceptibility, whereas others 

may decrease susceptibility to the same chemical. For example, although infants breathe more air per 

kilogram of body weight than adults breathe, this difference might be somewhat counterbalanced by their 

alveoli being less developed, which results in a disproportionately smaller surface area for alveolar 

absorption (NRC 1993). 

Soluble cesium compounds are readily absorbed into body fluids and bloodstream and are widely 

distributed throughout the body (see Section 3.5 for detailed information). PBPK models are used to 

simulate potential age-related differences in deposition of inhaled cesium, as well as differences in 

elimination rates for absorbed cesium (see Section 3.5.5 for more information on PBPK models). 

Although inhalation exposure to environmental levels of stable or radioactive cesium is not considered to 

be a major health concern, age-related differences in physical properties of the respiratory system and 
CESIUM 92 

3. HEALTH EFFECTS 

ventilation patterns could result in differences in absorption rates of inhaled soluble or insoluble cesium 

compounds. Soluble cesium compounds are assumed to be completely absorbed in the gastrointestinal 

tract, with no adjustments for age. Available human and animal data do not indicate that age-related 

differences might exist for absorption and distribution of cesium following oral exposure. Since cesium 

is principally absorbed and distributed in ionic form (as Cs+

), any age-related differences in absorption 

following oral exposure would likely be the result of differences in diffusion rates and active transport 

mechanisms involved in the movement of cesium through extra- and intracellular fluids. Elimination 

rates for cesium appear to be age-related and may be most closely related to body mass. As described in 

detail in Section 3.5.4.2, young children exhibit whole-body biological elimination half-times that are 

much shorter than those of older children and adults (Boni 1969b; Melo et al. 1994). It is not known 

whether or not these age-related differences may be due to higher retention of cesium in adult tissues and 

lower rates of excretion. 

Measurable amounts of 137Cs have been found in the breast milk of women living in areas contaminated 

with radioactive fallout. Transfers to newborns and 1-year-old children were estimated to be 

approximately 40 and 50%, respectively (Johansson et al. 1998). Animal studies have shown that cesium 

crosses the placental barrier, but cesium is found in lower concentrations in the fetus than in maternal or 

placental tissues (Mahlum and Sikov 1969; Vandecasteele et al. 1989). 

Although no information was located regarding age-related health effects in humans exposed to stable 

cesium, age-related differences in the pharmacokinetics of stable cesium could conceivably result in agerelated differences in health effects. No studies were located regarding age-related differences in toxicity 

in animals exposed to stable cesium. 

Most of the available information regarding age-related health effects from overexposure to cesium 

concern developmental effects related to in utero irradiation of human or animal fetuses from an external 

source of radiation. Impaired cognitive function was observed in atomic bomb survivors overexposed to 

ionizing radiation in utero during critical stages of neurological development (Schull and Otake 1999). 

Developmental toxicity studies employing external gamma radiation from a radioactive cesium source (or 

from any other gamma ray source) indicate that rats and mice are most sensitive to the effects of external 

radiation around gestation day 14. Effects observed following irradiation during this period include 

reduced survival, decreased brain size, smaller head size, and retarded odontogenesis (Koshimoto et al. 

1994; Minamisawa et al. 1990; Norton and Kimler 1987, 1988; Saad et al. 1991, 1994). When tested as 

adults, animals irradiated during this developmental period exhibit increased aggressive behavior 
CESIUM 93 

3. HEALTH EFFECTS 

(Minamisawa et al. 1992; Norton and Kimler 1987, 1988). Although comparative studies of neurological 

effects in animals first irradiated as juveniles or adults were not located, it is apparent that there are 

critical stages of fetal developmental during which there is increased susceptibility to the effects of 

radiation. In these studies, although cesium was used as the gamma source, the effects were not unique to 

cesium. Similar results would be elicited by any gamma source. 

3.9 BIOMARKERS OF EXPOSURE AND EFFECT 

Biomarkers are broadly defined as indicators signaling events in biologic systems or samples. They have 

been classified as markers of exposure, markers of effect, and markers of susceptibility (NAS/NRC 

1989). 

Due to a nascent understanding of the use and interpretation of biomarkers, implementation of biomarkers 

as tools of exposure in the general population is very limited. A biomarker of exposure is a xenobiotic 

substance or its metabolite(s) or the product of an interaction between a xenobiotic agent and some target 

molecule(s) or cell(s) that is measured within a compartment of an organism (NAS/NRC 1989). The 

preferred biomarkers of exposure are generally the substance itself or substance-specific metabolites in 

readily obtainable body fluid(s), or excreta. However, several factors can confound the use and 

interpretation of biomarkers of exposure. The body burden of a substance may be the result of exposures 

from more than one source. The substance being measured may be a metabolite of another xenobiotic 

substance (e.g., high urinary levels of phenol can result from exposure to several different aromatic 

compounds). Depending on the properties of the substance (e.g., biologic half-life) and environmental 

conditions (e.g., duration and route of exposure), the substance and all of its metabolites may have left the 

body by the time samples can be taken. It may be difficult to identify individuals exposed to hazardous 

substances that are commonly found in body tissues and fluids (e.g., essential mineral nutrients such as 

copper, zinc, and selenium). Biomarkers of exposure to cesium are discussed in Section 3.9.1. 

Biomarkers of effect are defined as any measurable biochemical, physiologic, or other alteration within an 

organism that, depending on magnitude, can be recognized as an established or potential health 

impairment or disease (NAS/NRC 1989). This definition encompasses biochemical or cellular signals of 

tissue dysfunction (e.g., increased liver enzyme activity or pathologic changes in female genital epithelial 

cells), as well as physiologic signs of dysfunction such as increased blood pressure or decreased lung 

capacity. Note that these markers are not often substance specific. They also may not be directly 
CESIUM 94 

3. HEALTH EFFECTS 

adverse, but can indicate potential health impairment (e.g., DNA adducts). Biomarkers of effects caused 

by cesium are discussed in Section 3.9.2. 

A biomarker of susceptibility is an indicator of an inherent or acquired limitation of an organism's ability 

to respond to the challenge of exposure to a specific xenobiotic substance. It can be an intrinsic genetic or 

other characteristic or a preexisting disease that results in an increase in absorbed dose, a decrease in the 

biologically effective dose, or a target tissue response. If biomarkers of susceptibility exist, they are 

discussed in Section 3.11, Populations that are Unusually Susceptible. 

3.9.1 Biomarkers Used to Identify or Quantify Exposure to Cesium 

Stable or radioactive isotopes of cesium may be measured in samples of urine, blood, feces, or body 

tissues by a number of methods outlined in Section 7.1. Stable cesium is of little toxicological concern. 

However, overexposure to radioactive isotopes of cesium may pose a significant health risk. Internal 

exposure may be quantified by direct counting (in vivo measurements) of radioactive emission from the 

body using whole-body counters capable of distinguishing the gamma emissions that are unique to 

radioactive isotopes of cesium. Radioactivity can be accurately measured in blood, excrement, and tissue 

samples using scintillation counting. The biomarkers that may help quantify exposure to stable or 

radioactive cesium are similar in children and adults. 

3.9.2 Biomarkers Used to Characterize Effects Caused by Cesium 

There are no known biomarkers of effect for exposure to stable cesium. High-level external or internal 

exposure to radioactive cesium can result in bone marrow aplasia, reduced white blood cell counts, 

decreased hemoglobin and platelet levels, and increased frequencies of chromosomal aberrations in 

lymphocytes. Frequencies of chromosomal aberrations were used to estimate external radiation doses 

among individuals in Goiânia, Brazil who had been exposed to an opened 137CsCl source (Natarajan et al. 

1998). These results are not unique to radioactive cesium. Similar results would be expected following 

overexposure to any source of ionizing radiation. 
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3. HEALTH EFFECTS 

3.10 INTERACTIONS WITH OTHER CHEMICALS 

No data were located regarding interactions of cesium with other chemicals that might influence the 

toxicity of cesium. 

3.11 POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE 

A susceptible population will exhibit a different or enhanced response to cesium than will most persons 

exposed to the same level of cesium in the environment. Reasons may include genetic makeup, age, 

health and nutritional status, and exposure to other toxic substances (e.g., cigarette smoke). These 

parameters result in reduced detoxification or excretion of cesium, or compromised function of organs 

affected by cesium. Populations who are at greater risk due to their unusually high exposure to cesium 

are discussed in Section 6.7, Populations with Potentially High Exposures. 

Increased susceptibility to the toxic effects resulting from exposure to high levels of stable or radioactive 

cesium might be indicated among individuals with abnormally low potassium intake, those with 

compromised kidney function, and patients taking stimulant or depressant drugs for the treatment of 

mental disorders (see Sections 3.5 and 3.6 for detailed information on the toxicokinetics and mechanisms 

of action of cesium). Individuals with compromised immune function might be more susceptible to the 

adverse effects of radiation overexposure from a radioactive cesium source (or from any other gamma 

emitting radioactive source). 

Evidence for potential age-related differences in susceptibility to stable or radioactive cesium toxicity is 

provided by studies of elimination rates for 137Cs in humans (Boni 1969b; Melo et al. 1994; Toader et al. 

1996). Elimination rates are higher in young children than adults, and higher in adult females than adult 

males, indicating that lower elimination rates could result in greater retention and, therefore, increased 

toxicity for a given intake. Animal studies support these findings (Lengemann 1970; Mahlum and Sikov 

1969; Melo et al. 1996, 1997; Tyler et al. 1969). There is some indication, however, that retention of 

cesium is higher in neonatal rats than in weanling or young adult rats (Lengemann 1969, 1970; Mahlum 

and Sikov 1969) (see Sections 3.5.4.2 and 3.5.4.4 for more detailed information. 

Pregnant women (Zundel et al. 1969) and individuals suffering from muscular dystrophy (Lloyd et al. 

1973) exhibited decreased cesium retention, which may decrease susceptibility to stable or radioactive 

cesium-induced toxicity. 
CESIUM 96 

3. HEALTH EFFECTS 

3.12 METHODS FOR REDUCING TOXIC EFFECTS 

This section will describe clinical practice and research concerning methods for reducing toxic effects of 

exposure to cesium. However, because some of the treatments discussed may be experimental and 

unproven, this section should not be used as a guide for treatment of exposures to cesium. When specific 

exposures have occurred, poison control centers and medical toxicologists should be consulted for 

medical advice. The following texts provide specific information about treatment following exposures to 

cesium: 

Ellenhorn MJ, Schonwald S, Ordog G, et al., eds. 1997. Medical toxicology: Diagnosis and treatment of 

human poisoning. 2nd edition. Baltimore, MD: Williams & Wilkins, 1682-1723. 

Haddad LM, Shannon MW, Winchester JF, eds. 1998. Clinical management of poisoning and drug 

overdose. 3rd edition. Philadelphia, PA: WB Saunders, 413-425. 

NCRP Report No. 65. 1980. Management of persons accidentally contaminated with radionuclides. 

Bethesda MD: National Council on Radiation Protection and Measurements. 

3.12.1 Reducing Peak Absorption Following Exposure 

Because soluble cesium compounds are rapidly absorbed into blood following inhalation, oral, and 

dermal exposure, there are no prescribed methods for reducing peak absorption following exposure. 

Early counter measures that may aid in reducing peak absorption following oral exposure to stable or 

radioactive cesium include oral administration of insoluble Prussian blue (ferric hexacyanoferrate) that 

exchanges potassium for cesium, forming an insoluble complex that is eliminated through the feces (Oak 

Ridge Associated Universities 2003). Animal studies indicate that absorption of cesium may also be 

reduced by the administration of excess potassium (Richmond and Furchner 1961). Cathartics such as 

magnesium sulfate, as well as gastric lavage, will shorten the transit time of ingested cesium in the 

gastrointestinal tract (Ellenhorn et al. 1997; Gerber et al. 1992; Haddad et al. 1998). Countermeasures 

attempt to reduce the body burden of cesium following inadvertent exposure (see Section 3.12.2). 

3.12.2 Reducing Body Burden 

Oral administration of Prussian blue (potassium ferricyanoferrate) may enhance the fecal excretion of 

absorbed cesium (Ducousso et al. 1975; Ellenhorn et al. 1997; Gerber et al. 1992; Haddad et al. 1998; 
CESIUM 97 

3. HEALTH EFFECTS 

Melo et al. 1996). Animal studies indicate that excretion of cesium may also be enhanced by the 

administration of excess potassium (Richmond and Furchner 1961). Higher plasma concentrations of 

potassium may increase the mobilization of cesium from tissues, and thus increase excretion. 

3.12.3 Interfering with the Mechanism of Action for Toxic Effects 

No data were located regarding reduction of the toxic effects of cesium through interfering with 

mechanisms of action. 

3.13 ADEQUACY OF THE DATABASE 

Section 104(i)(5) of CERCLA, as amended, directs the Administrator of ATSDR (in consultation with the 

Administrator of EPA and agencies and programs of the Public Health Service) to assess whether 

adequate information on the health effects of cesium is available. Where adequate information is not 

available, ATSDR, in conjunction with the National Toxicology Program (NTP), is required to assure the 

initiation of a program of research designed to determine the health effects (and techniques for developing 

methods to determine such health effects) of cesium. 

The following categories of possible data needs have been identified by a joint team of scientists from 

ATSDR, NTP, and EPA. They are defined as substance-specific informational needs that if met would 

reduce the uncertainties of human health assessment. This definition should not be interpreted to mean 

that all data needs discussed in this section must be filled. In the future, the identified data needs will be 

evaluated and prioritized, and a substance-specific research agenda will be proposed. 

3.13.1 Existing Information on Health Effects of Cesium 

The existing data on health effects of inhalation, oral, and dermal exposure of humans and animals to 

stable and radioactive cesium are summarized in Figure 3-8 and 3-9, respectively. The purpose of these 

figures is to illustrate the existing information concerning the health effects of cesium. Each dot in the 

figure indicates that one or more studies provide information associated with that particular effect. The 

dot does not necessarily imply anything about the quality of the study or studies, nor should missing 

information in this figure be interpreted as a “data need.” A data need, as defined in ATSDR’s Decision 

Guide for Identifying Substance-Specific Data Needs Related to Toxicological Profiles (Agency for Toxic 
CESIUM 98 

3. HEALTH EFFECTS 

Figure 3-8. Existing Information on Health Effects of Stable Cesium 

Death

Acute 

Intermediate 

Chronic 

Immunologic/Lymphoretic 

Neurologic 

Reproductive 

Developmental 

Genotoxic 

Cancer 

Systemic 

Human 

Inhalation 

Oral 

Dermal 

Death

Acute 

Intermediate 

Chronic 

Immunologic/Lymphoretic 

Neurologic 

Reproductive 

Developmental 

Genotoxic 

Cancer 

Systemic 

Animal 

Inhalation 

Oral 

Dermal 

Existing Studies 
CESIUM 99 

3. HEALTH EFFECTS 

Figure 3-9. Existing Information on Health Effects of Radioactive Cesium 

Inhalation 

Oral 

Dermal 

Death

Acute 

Intermediate 

Chronic 

Immunologic/Lymphoretic 

Neurologic 

Reproductive 

Developmental 

Genotoxic 

Cancer 

Systemic 

External 

Human 

Inhalation 

Oral 

Dermal 

External 

Existing Studies 

Death

Acute 

Intermedi te 

Chronic 

Immunolo

ic/Lymphoreti

r

l

t

a

g

c 

Neu ologic 

Reproductive 

Deve opmental 

Geno oxic 

Cancer 

Systemic 

Animal 
CESIUM 100 

3. HEALTH EFFECTS 

Substances and Disease Registry 1989), is substance-specific information necessary to conduct 

comprehensive public health assessments. Generally, ATSDR defines a data gap more broadly as any 

substance-specific information missing from the scientific literature. 

As shown in Figure 3-8, limited information is available regarding health effects in humans following 

intermediate-duration oral exposure to stable cesium. No information is available regarding health effects 

in humans following inhalation or dermal exposure to stable cesium. Information is available on the 

health effects in animals exposed to stable cesium. However, the available information is mostly from 

acute oral LD50 studies, a single intermediate-duration oral study, and a study of male reproductive 

toxicity. 

As shown in Figure 3-9, limited information is available regarding oral and dermal exposure to 

radioactive cesium. An accidental exposure of a number of individuals in Goiânia, Brazil resulted in 

adverse health effects that could be attributed to external and internal (oral and dermal) exposure to 

radiation from a radioactive cesium source. Information is also available for humans externally exposed 

to a radiocesium source that resulted in adverse dermal effects. Numerous reports are available regarding 

other cases of external and internal environmental exposure to radioactive isotopes of cesium in humans, 

especially from areas with significant amounts of radioactive fallout. However, at present, associations 

between exposure to environmental levels of radioactive cesium and adverse health effects have not been 

confirmed. Present environmental levels of radiocesium, therefore, might not represent overexposure to 

radiation. 

Reduced sperm counts in mice were found following oral administration of radioactive cesium. Studies 

of dogs, intravenously administered 137CsCl, resulted in hematologic dyscrasia as early effects and tumors 

of various organs as late effects. Given by this route, the tissue distribution of 137Cs is similar to that 

resulting from oral or inhalation exposure. 

3.13.2 Identification of Data Needs 

Acute-Duration Exposure. Results from human and animal studies indicate that stable cesium is of 

little acute oral toxicity concern. Toxicokinetic data regarding the widespread distribution of cesium 

absorbed following oral exposure indicate that dermal and inhalation exposure to stable cesium would not 

present a greater health concern than that posed by oral exposure. Acute-duration inhalation and oral 

MRLs were not derived for stable cesium due to a lack of human or animal data. To generate appropriate 
CESIUM 101 

3. HEALTH EFFECTS 

data for deriving acute-duration inhalation and oral MRLs for stable cesium, at least one comprehensive 

acute inhalation and one acute oral toxicity study would be needed of at least one animal species exposed 

to several dose levels. 

Reports of adverse effects in humans that can be specifically attributed to acute exposure to radioactive 

cesium are restricted to the accounts of accidental external exposure (Gottlöber et al. 2000) and both 

external and internal (dermal and oral) exposure (Brandão-Mello et al. 1991) to an opened 137CsCl source. 

Observed health effects were representative of those resulting from overexposure to other beta- and 

gamma-emitting sources of ionizing radiation. Animal data regarding acute oral exposure to radioactive 

cesium are limited to reports of dominant lethal mutations and reduced fertility in mice (Ramaiya et al. 

1994). Acute-duration inhalation and oral MRLs were not derived for radioactive cesium due to a lack of 

human or animal data. To generate appropriate data for deriving acute-duration inhalation and oral MRLs 

for radioactive cesium, at least one comprehensive acute inhalation study and one acute oral toxicity study 

of at least one animal species exposed to several dose levels would be needed. Such studies could be 

designed to also generate data regarding potential age-related differences in toxicity. However, great 

danger would be posed to investigators considering the exposure of laboratory animals to radioactive 

cesium at levels great enough to cause significant adverse health effects. Distribution patterns of 137Cs are 

similar in animals exposed to relatively nontoxic levels of 137CsCl by parenteral injection, inhalation 

exposure, or oral administration (Boecker et al. 1969a; Stara 1965). Therefore, the results of the 

intravenous injection studies in dogs (Nikula et al. 1995, 1996) provide the most reasonable indication of 

health effects that would be expected in animals exposed by inhalation or oral administration. An acuteduration MRL that was derived by Agency for Toxic Substances and Disease Registry (1999) for acute 

external exposure to ionizing radiation was considered to be appropriate as an acute-duration MRL for 

external exposure to ionizing radiation from a radioactive cesium source. 

Intermediate-Duration Exposure. Limited information regarding intermediate-duration oral 

exposure in humans indicates that the nervous and cardiovascular systems are the most likely targets of 

toxicity for high-dose stable cesium (Bangh et al. 2001; Harik et al. 2002; Neulieb 1984; Saliba et al. 

2001). Limited data indicate that intermediate-duration oral exposure of pregnant mice to stable cesium 

may adversely affect developing fetuses (Messiha 1988b, 1989b). Orally administered stable cesium has 

also been shown to be genotoxic to female mice (Ghosh et al. 1990, 1991). Intermediate-duration 

inhalation and oral MRLs were not derived for stable cesium due to the paucity of human or animal data. 

To generate appropriate data for deriving intermediate-duration inhalation and oral MRLs for stable 

cesium, at least one comprehensive intermediate-duration inhalation and one intermediate-duration oral 
CESIUM 102 

3. HEALTH EFFECTS 

toxicity study of at least one animal species exposed to several dose levels would be needed. Such studies 

could be designed to also generate data regarding potential age-related differences in toxicity. 

No human or animal data are available in which intermediate-duration inhalation or oral exposure to 

radioactive cesium can be associated with adverse human health effects. When humans are exposed to 

high levels of radioactivity from a radiocesium source, as were the cases of acute exposure in Goiânia, 

Brazil (Brandão-Mello et al. 1991) and Russia (Gottlöber et al. 2000), such exposures should be of value 

in assessing potential health hazards. Animal studies could be designed to assess the health effects 

associated with intermediate-duration exposure to radioactive cesium. Such studies could be designed to 

also generate data regarding potential age-related differences in toxicity. 

Chronic-Duration Exposure and Cancer. Since there are no studies pertaining to noncancer or 

cancer health effects in humans or animals following chronic-duration inhalation or oral exposure to 

stable cesium, no chronic-duration inhalation or oral MRLs were derived for stable cesium. Additional 

data from acute- and intermediate-duration animal studies might be helpful in determining the need for 

longer-term studies. 

There are no data regarding noncancer or cancer health effects in humans following chronic-duration 

inhalation or dermal exposure to radioactive cesium. Low levels of radioactive cesium are found in the 

diets of individuals living in areas that have been contaminated with radioactive fallout; however, there is 

a lack of information regarding dose-response following chronic-duration oral exposure. No chronicduration inhalation or oral MRLs were derived for radioactive cesium. A chronic-duration MRL that was 

derived by Agency for Toxic Substances and Disease Registry (1999) for chronic external exposure to 

ionizing radiation was appropriate as a chronic-duration MRL for external exposure to ionizing radiation 

from a radioactive cesium source. Long-term research into health effects associated with chronic 

exposure to radioactive cesium following incidents such as the Chernobyl nuclear accident may help to 

elucidate long-term noncancer and cancer health risks from chronic exposure to radionuclides of cesium. 

Genotoxicity. No genotoxicity studies of in vivo exposure of humans to stable cesium compounds 

were located. Stable cesium (as cesium chloride) induced chromosomal aberrations in human 

lymphocytes in vitro (Ghosh et al. 1993) and chromosomal aberrations and micronuclei in mouse bone 

marrow in vivo (Ghosh et al. 1990, 1991; Santos-Mello et al. 2001). Cesium sulfate was not mutagenic in 

E. coli either with or without metabolic activation (Olivier and Marzin 1987). Studies in mammalian 
CESIUM 103 

3. HEALTH EFFECTS 

systems would be useful. Studies of workers exposed to known levels of stable cesium would be useful 

in establishing whether or not cesium is of genotoxicity concern in humans. 

In vivo human data are limited to the findings of increased point mutations in T-lymphocytes and 

chromosomal aberrations among individuals who had been exposed to beta and gamma radiation from an 

opened 137CsCl source (Natarajan et al. 1998; Skandalis et al. 1997) and apparently increased frequencies 

of chromosomal aberrations in lymphocytes of children living in areas contaminated by 137Cs fallout 

following the Chernobyl nuclear accident (Padovani et al. 1993). In vitro exposure of human 

lymphocytes to a sealed 137Cs gamma source resulted in an increased frequency of micronuclei (Balasem 

and Ali 1991). In vivo oral and external exposure of male mice to a 137Cs gamma source resulted in 

increases in dominant lethal mutations (Ramaiya et al. 1994). Increases in the frequency of reciprocal 

translocations in spermatogonia were observed following oral exposure to 137Cs in mice (Ramaiya et al. 

1994) and external exposure to a 137Cs source in crab-eating monkeys (Tobari et al. 1988). A number of 

in vitro genotoxicity assays have indicated chromosomal aberrations and breaks, sister chromatid 

exchanges, and micronuclei in animal cells (Arslan et al. 1986; Biedermann et al. 1991; Doggett and 

McKenzie 1983; Hintenlang 1993; Iijima and Morimoto 1991; Kamiguchi et al. 1991; Mikamo et al. 

1990, 1991). 

Human and animal studies show that external and internal exposure to radioactive cesium is a 

genotoxicity concern. External exposure to any gamma source would be expected to result in genotoxic 

effects similar to those observed following external exposure to radioisotopes of cesium (see Agency for 

Toxic Substances and Disease Registry 1999 for more information on ionizing radiation). Whenever 

possible, additional human studies should focus on exposure levels to establish dose-response 

relationships. 

Reproductive Toxicity. There are no reports of reproductive effects in humans or animals exposed 

to stable cesium. Although stable cesium appears to be of relatively low toxicity concern, animal studies 

could be designed to assess the potential for adverse health effects (including reproductive effects) 

associated with repeated exposure. Human data could be collected from individuals occupationally 

exposed to significant levels of stable cesium. 

Reports of human reproductive effects following exposure to radioactive cesium are limited to the 

findings of reduced sperm counts following external and internal exposure to an opened 137CsCl source 

(Brandão-Mello et al. 1991). Mice, exposed to 137Cs either orally or externally, exhibited reduced fertility 
CESIUM 104 

3. HEALTH EFFECTS 

(including complete sterility) (Ramaiya et al. 1994). Persistent germinal epithelium damage and 

azoospermia were observed in all long-term surviving dogs that had been administered intravenous 

injections of 137Cs (Nikula et al. 1995, 1996). In cases of known human exposure to radioactive cesium, 

exposure-response relationships should be established when possible. Although reduced fertility has been 

shown in males, additional animal studies could be designed to assess the potential for reproductive 

toxicity in females. 

Developmental Toxicity. There are no reports of developmental effects in humans exposed to stable 

cesium. One investigator reported reduced body weight and certain organ weights among offspring, as 

well as indications of altered activity of some hepatic enzymes among offspring of pregnant mouse dams 

repeatedly exposed (orally) to stable cesium (Messiha 1988b). The same investigator reported similar 

results in pups exposed (via their nursing mothers) only during lactation (Messiha 1989b). These studies 

did not include gross and histopathologic examination of the offspring. Well-designed animal studies 

could more completely assess the potential for developmental toxicity of stable cesium. 

Although there are no reports of developmental effects in humans exposed specifically to radioisotopes of 

cesium, impaired cognitive function was observed in atomic bomb survivors of Hiroshima and Nagasaki 

prenatally exposed to high levels of ionizing radiation during critical stages of neural development (Schull 

and Otake 1999; Schull et al. 1988). External exposure to sufficiently high doses of radiation from a 

radioactive cesium source would be expected to result in similar effects. In utero exposure of rat and 

mouse fetuses via whole body exposure of dams resulted in developmental effects such as reduced 

postnatal body weight, impaired motor activity, morphological changes in the brain, increased aggressive 

behavior, reduced brain and head size, and retarded odontogenesis and palatal closure (Minamisawa et al. 

1990, 1992; Norton and Kimler 1987, 1988; Saad et al. 1991, 1994). Continued monitoring of 

populations known to have been exposed to ionizing radiation (including radioactive cesium sources) 

should help to refine estimates of dose-response and the relationship to adverse health effects, including 

developmental toxicity. 

Immunotoxicity. There are no reports regarding the immunotoxicity of stable cesium in humans or 

animals. Animal studies could be designed to assess these parameters, but such studies do not presently 

seem necessary. 

Severe bone marrow depression was observed in individuals exposed externally and internally to a 137Cs 

source. This effect is typical of individuals exposed to ionizing radiation (see Agency for Toxic 
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3. HEALTH EFFECTS 

Substances and Disease Registry 1999 for additional information on the effects of ionizing radiation). A 

similar effect was observed in dogs given an intravenous injection of 137CsCl (Nikula et al. 1995). Data 

should be collected from individuals known to have been exposed to ionizing radiation (including that 

from radioactive cesium sources). Additional animal studies could be designed to establish dose-response 

relationships. 

Neurotoxicity. Data regarding neurological effects of stable cesium in humans are restricted to a 

single case of an investigator reporting feelings of euphoria, heightened sense perception, and tingling 

sensations within 15 minutes of ingesting oral doses of cesium chloride during a 36-day exposure period. 

No apparent adverse effects on mental or motor skills were observed (Neulieb 1984). Administration of 

cesium chloride to animals has triggered stimulant (Johnson 1972; Messiha 1978) and depressant (Bose 

and Pinsky 1981, 1983b, 1984; Bose et al. 1981; Pinsky et al. 1980) central nervous system responses. 

Additional animal studies could be designed to elucidate mechanisms responsible for the observed 

neurological effects. 

Although there are no reports of neurotoxicity in humans exposed specifically to radioisotopes of cesium, 

impaired cognitive function was observed in atomic bomb survivors of Hiroshima and Nagasaki 

prenatally exposed to high levels of external ionizing radiation during critical stages of neural 

development (Schull and Otake 1999; Schull et al. 1988). External exposure to sufficiently high doses of 

radiation from a sealed radioactive cesium gamma source would result in similar effects. In utero 

exposure of rat and mouse fetuses via whole-body exposure of dams resulted in impaired motor activity, 

morphological changes in the brain, increased aggressive behavior, and reduced brain and head size 

(Minamisawa et al. 1990, 1992; Norton and Kimler 1987, 1988; Saad et al. 1991, 1994), effects that have 

been shown to be related to critical developmental stages. Neurotoxic effects, noted in humans suffering 

from acute radiation syndrome due to ionizing radiation exposure, are well-characterized (see Agency for 

Toxic Substances and Disease Registry 1999 for more detailed information on the effects of ionizing 

radiation). Such effects would be expected in humans exposed to sufficiently high doses of radiation 

from a radioactive cesium source. Additional well-designed animal studies might elucidate mechanisms 

of neurotoxicity, but do not presently appear to be needed. 

Epidemiological and Human Dosimetry Studies. Stable cesium is ubiquitous in the earth’s 

crust, but is found at such low environmental levels that the probability of human intake of toxic amounts 

of stable cesium is negligible. Although there is no apparent need for specifically designed 

epidemiological or human dosimetry studies regarding stable cesium, such data, collected from 
CESIUM 106 

3. HEALTH EFFECTS 

individuals occupationally exposed to significant amounts of cesium or persons living near toxic waste 

sites with significant levels of cesium, might be useful. 

Due to accidental or intentional releases during nuclear fission, 134Cs and 137Cs can be found in air, soil, 

water, and food. There is concern for the health of humans living in close proximity to release or storage 

sites or in areas receiving significant amounts of radioactive fallout. Epidemiological studies of radiation 

doses typically involve estimates of exposure that are based on whole-body measurements of internallydeposited 134Cs or 137Cs or genotoxic effects such as chromosomal aberrations in peripheral blood 

lymphocytes. A need remains for epidemiological data that can provide quantitative human doseresponse information while supplying additional information on the health effects of exposure to ionizing 

radiation and radioisotopes of cesium; in particular, for cases of known internal exposure. 

Biomarkers of Exposure and Effect. 

Exposure. Both stable and radioactive isotopes of cesium may be detected in samples of urine, blood, 

feces, or body tissues. Due to the relatively long biological half-time of cesium (several months in 

humans), short-term exposures cannot be readily distinguished from longer-term ones. No new 

biomarkers of exposure are needed at this time. 

Effect. No known biomarkers of effect exist for exposure to stable cesium. Although high radiation 

doses from internally deposited radioactive cesium can cause bone marrow aplasia, altered blood values, 

and increased chromosomal aberrations in lymphocytes (Brandão-Mello et al. 1991; Natarajan et al. 

1998), these effects are not specific to radioactive cesium. 

Absorption, Distribution, Metabolism, and Excretion. Human and animal data show that 

inhaled or ingested cesium (in soluble compounds) is rapidly absorbed into the blood (Boecker 1969a, 

1969b; Henrichs et al. 1989; Lie 1964; Miller 1964; Stara 1965; Stara and Thomas 1963), whereas 

relatively insoluble forms of cesium are not readily absorbed into blood following inhalation or oral 

exposure (Boecker et al. 1974, 1977; Leroy et al. 1966; Talbot et al. 1993). Dermal absorption has been 

qualitatively (but not quantitatively) demonstrated in rats (Pendic and Milivojevic 1966). Additional 

studies could measure relative absorption rates for a variety of soluble and insoluble cesium compounds. 

Furthermore, studies could be designed to measure dermal absorption rates. Other studies could further 

assess the fate of relatively insoluble inhaled particles containing radioisotopes of cesium that may be 

retained in lung tissue for long periods of time. 
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3. HEALTH EFFECTS 

Cesium absorbed via inhalation or ingestion has been shown to be rapidly distributed throughout the body 

in humans and animals (Boecker 1969a, 1969b; Furchner et al. 1964; Lie 1964; Miller 1964; Rosoff et al. 

1963; Stara 1965; Stara and Thomas 1963). Once absorbed by pregnant women, cesium can pass the 

placental barrier and be absorbed by the conceptus. Absorbed cesium can also be found in the milk of 

lactating women (Thornberg and Mattsson 2000). Once cesium is absorbed into body fluids, distribution 

patterns in soft tissue are expected to be similar for any route of exposure since cesium is distributed 

throughout the body as the cation (Cs+

), much like potassium (K+). Available studies appear to 

adequately describe the distribution of absorbed cesium. Additional studies could be designed to 

elucidate mechanisms whereby cesium ions may influence central nervous system activity. 

Human and animal studies adequately describe elimination of absorbed cesium, primarily via the urine 

(Boecker 1969b; Hölgye and Malý 2002; Iinuma et al. 1965; Rosoff et al. 1963; Stara 1965; Stara and 

Thomas 1963). Age-related differences in elimination rates have been described in humans (Boni 1969b; 

Melo et al. 1994) and dogs (Melo et al. 1996). In cases of known human exposure to cesium, additional 

information may help to further assess age-related differences in the toxicokinetics of cesium. 

Comparative Toxicokinetics. Available cesium toxicokinetic data in humans and various animal 

species indicate similar patterns of absorption, distribution, and elimination. The central nervous system 

appears to be a target for effects in humans (Neulieb 1984) and animals (Bose and Pinsky 1981, 1983b, 

1984; Bose et al. 1981; Johnson 1972; Messiha 1978; Pinsky et al. 1980). Additional studies could be 

designed to elucidate and compare mechanisms responsible for central nervous system effects. 

Methods for Reducing Toxic Effects. Oral administration of Prussian blue that exchanges 

potassium for cesium, cathartics that shorten the transit time of ingested cesium within the gastrointestinal 

tract, and gastric lavage may aid in reducing peak absorption of ingested cesium, but due to the rapid 

absorption of cesium from soluble cesium compounds, these measures would only be of potential benefit 

within a short time following initial exposure. Most countermeasures focus on reducing the body burden 

of absorbed cesium. The intestinal reabsorption of cesium that is excreted into the small intestine via the 

bile can be blocked by oral administration of Prussian blue, forming an insoluble cesium complex that is 

excreted in the feces. Animal studies also indicate that increased plasma concentrations of potassium may 

increase the mobilization of cesium from tissues, increasing its excretion (Richmond and Furchner 1961). 

There are no prescribed methods for interfering with mechanisms of action for toxic effects of cesium, 

since such mechanisms have not been elucidated. 
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3. HEALTH EFFECTS 

Children’s Susceptibility. Available information on age-related differences in health effects comes 

from in utero exposure to radiation from external ionizing radiation sources (including radioisotopes of 

cesium). Studies have shown neurological effects in humans and animals exposed during critical periods 

of central nervous system development (Koshimoto et al. 1994; Minamisawa et al. 1990; Norton and 

Kimler 1987, 1988; Schull and Otake 1999). Comparative studies of neurological effects in animals first 

irradiated as juveniles or adults are lacking. No information was located regarding age-related health 

effects in humans or animals exposed to stable cesium. 

PBPK models account for potential age-related differences in deposition of inhaled cesium, as well as 

differences in elimination rates for absorbed cesium (see Section 3.5.5 for more information on PBPK 

models). Potential differences in absorption rates of inhaled cesium compounds could be due to agerelated differences in physical properties of the respiratory system and/or ventilation patterns. PBPK 

models also could adjust for potential age-related differences in gastrointestinal absorption. If such 

differences exist, they would likely be the result of differences in diffusion rates and active transport 

mechanisms. Young children exhibit biological half-times for absorbed cesium that are shorter than those 

of older children and adults (Boni 1969b; Melo et al. 1994); these age-related differences are associated 

with body mass and could be the result of age-related differences in tissue retention and excretory rates. 

Cesium is found in the breast milk of mothers with an internal cesium burden (Johansson et al. 1998; 

Thornberg and Mattsson 2000), and can be transferred to nursing infants (Johansson et al. 1998). Cesium 

has been shown to cross the placental barrier of animals, but concentrations of cesium in the fetal tissues 

are less than those in corresponding tissues of the mother (Mahlum and Sikov 1969; Vandecasteele et al. 

1989). Data collected from areas containing elevated concentrations of radioactive cesium fallout might 

be of value in further assessing age-related transfer rates. 

Biomarkers of exposure or effect are the same in adults and children (see Section 3.9 for detailed 

information on biomarkers of exposure and effect). There are no data on interactions of cesium with 

other chemicals in children. No pediatric-specific methods have been found to reduce peak absorption, or 

body burden, of cesium following exposure, although methods employed to reduce the body burden of 

cesium in adults are also effective in children. 

Child health data needs relating to exposure are discussed in Section 6.8.1, Identification of Data Needs: 

Exposures of Children. 
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3. HEALTH EFFECTS 

3.13.3 Ongoing Studies 

A single relevant ongoing study was identified in the Federal Research In Progress database (FEDRIP 

2002). Dr. R. Albertini, from the University of Vermont, Burlington, Vermont, is quantitatively 

examining radiation-induced mutation at the hprt gene in human T-lymphocytes. Gamma radiation 

sources used in the study include 137Cs. 

CESIUM 111 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION 

4.1 CHEMICAL IDENTITY 

Information regarding the chemical identity of cesium is located in Table 4-1. 

4.2 PHYSICAL, CHEMICAL, AND RADIOLOGICAL PROPERTIES 

Information regarding the physical and chemical properties of cesium is located in Table 4-2. 

Cesium is a silvery white, soft, ductile metal with only one oxidation state (+1). At slightly above room 

temperature, cesium exists in the liquid state. Compared to the other stable alkali metals, cesium has the 

lowest boiling point and melting point, highest vapor pressure, highest density, and lowest ionization 

potential. These properties make cesium far more reactive than the other members of the alkali metal 

group. When exposed to air, cesium metal ignites, producing a reddish violet flame, and forms a mixture 

of cesium oxides. Pure cesium reacts violently with water to form cesium hydroxide, the strongest base 

known, as well as hydrogen gas. The burning cesium can ignite the liberated hydrogen gas and produce 

an explosion. Cesium salts and most cesium compounds are generally very water soluble, with the 

exception of cesium alkyl and aryl compounds, which have low water solubility. 

There are several radioactive isotopes of cesium ranging from 114Cs to 145Cs (Helmers 1996). The 

radioactive isotopes have a wide range of half-lives ranging from about 0.57 seconds (114Cs) to about 

3x106

 years (135Cs) (Helmers 1996). The radioactive isotopes 137Cs and 134Cs are significant fission 

products because of their high fission yield, and their relatively long half-lives. The fission yield of 137Cs 

in nuclear reactions is relatively high; about 6 atoms of 137Cs are produced per 100 fission events (WHO 

1983). 137Cs has a radioactive half-life of about 30 years and decays by beta decay either to stable 137Ba 

or a meta-stable form of barium (137mBa). The meta-stable isotope (137mBa) is rapidly converted to stable 

137Ba (half-life of about 2 minutes) accompanied by gamma ray emission whose energy is 0.662 MeV 

(ICRP 1983). Figure 4-1 illustrates this decay scheme. The first beta decay mode that forms 137mBa 

accounts for roughly 95% of the total intensity, while the second mode accounts for about 5% (WHO 

1983). Radioactive 134Cs primarily decays to stable 134Ba by beta decay accompanied by gamma ray 

emissions or less frequently to stable 134Xe by electron capture (EC) accompanied by a single gamma ray 
CESIUM 112 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION 

Table 4-1. Chemical Identity of Cesium and Compounds 

Characteristic 

Cesium 

(metal) 

Cesium 

chloride 

Cesium 

carbonate 

Cesium 

hydroxide 

Cesium 

oxide 

Cesium 

nitrate 

Synonym(s) Caesium 

Registered trade No data 

name(s) 

Chemical formula Cs 

Chemical Cs 

structure 

Identification 

numbers: 

 CAS registry 7440-46-2 

NIOSH RTECS FK9225000 

 EPA hazardous No data 

waste 

OHM/TADS No data 

 DOT/UN/NA/ No data 

IMCO shipping 

HSDB No data 

NCI No data 

Cesium 

monochloride 

No data 

CsCl 

Cs Cl 

7647-17-8 

FK9625000 

No data 

No data 

No data 

No data 

No data 

Dicesium salt Cesium 

hydrate 

No data No data 

Cs2CO3 CsOH 

+ Cs OH Cs

O 

O 

O 

+ Cs

534-17-8 21351-79-1 

FK9400000 FK9800000 

No data No data 

No data No data 

No data No data 

No data No data 

No data No data 

No data 

Cs2O 

O 

Cs Cs 

20281-00-9 

No data 

No data 

No data 

No data 

No data 

No data 

No data 

CsNO3 

-O

Cs+ 

N+ 

-O

7789-18-6 

No data 

No data 

No data 

No data 

No data 

O

CAS = Chemical Abstracts Services; DOT/UN/NA/IMCO = Department of Transportation/United Nations/North 

America/International Maritime Dangerous Goods Code; EPA = Environmental Protection Agency; 

HSDB = Hazardous Substances Data Bank; NCI = National Cancer Institute; NIOSH = National Institute for 

Occupational Safety and Health; OHM/TADS = Oil and Hazardous Materials/Technical Assistance Data System; 

RTECS = Registry of Toxic Effects of Chemical Substances 
CESIUM 113 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION 

Table 4-2. Physical and Chemical Properties of Cesium and Compounds 

Cesium Cesium Cesium Cesium Cesium 

Property (metal) chloride carbonate hydroxide Cesium oxide nitrate 

Molecular 132.906 168.36 325.82 149.91 281.81 194.91b 

weight 

Color Silvery-white White White Colorless Golden-yellow Whiteb 

Physical state Solid (liquid Solid Solid Solid Solid Solidb 

slightly above 

room 

temperature) 

Melting point 29 °C 646 °C 610 °C 272 °C 490 °C 414 °Cb 

Boiling point 685 °C 1290 °C No data No data No data No Data 

Density, g/cm3

 1.93 (20 °C)b 3.988 (20 °C)b 4.24 (20 °C)b 3.68 (20 °C)b 4.65 (20 °C)b 3.66 (20 °C)b 

Odor No data No data No data No data No data No data 

Odor threshold: 

Water No data No data No data No data No data No data 

Air No data No data No data No data No data No data 

Solubility: 

 Water Reacts 

violently with 

1.87 kg/L 

(20 °C) 

2.1 kg/L 4 kg/L 

(15 °C) 

Very soluble in 

waterb 

Solubleb

water 

 Organicsolvent(s)  Soluble in 

ethanolb 

Soluble in 

ethanol and 

etherb 

Soluble in 

ethanolb 

Partition 

coefficients: 

 Log Kow N/A N/A N/A N/A N/A N/A

 Log Koc N/A N/A N/A N/A N/A N/A 

Vapor pressure 0.0075 mmHg No data No data No data No data No data 

at 144.5 °C 

Henry’s Law N/A N/A N/A N/A N/A N/A 

constant 

Autoignition No data No data No data No data No data 

temperature 

Flashpoint No data No data No data No data No data No data 

Flammability No data No data No data No data No data No data 

limits 

Conversion No data No data No data No data No data No data 

factors 

Explosive limits No data No data No data No data No data No data 

a

Data from Burt 1993 unless otherwise specified. 

b

Lide 1998 

N/A = not applicable 
137Cs 

β1 

-

β2 

-

γ

137Ba (Stable) 

CESIUM 114 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION 

Figure 4-1. The Decay Scheme of 137Cs 

β = beta decay; γ= γ -ray emission 
CESIUM 115 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION 

emission as depicted in Figure 4-2. The energy of the various gamma rays are in the range of 0.24– 

1.4 MeV. The half-life average energy of the beta transitions and intensity of the transitions for both 

134Cs and 137Cs are summarized in Table 4-3. 
CESIUM	 116 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION 

Table 4-3. Decay Properties of the Radioactive Isotopes of Cesium 

Isotope Half-life (years) Decay mode Intensity percent Beta particle energy (MeV) 

134Cs 2.062 β1

- 27 0.02309 

β2

- 2.5 0.1234 

β3

- 70 0.2101 

137Cs 30 β1

- 94.6 0.1734 

β2

- 5.4 0.4246 

a

ICRP 1983 

b

The 134Xe daughter yield from the electron capture decay of 134Cs is approximately 3x10-6. 
134Cs - EC β1 

- γ11 γ7 

γ8 γ2 

γ6 

γ4 γ1 β2

134Xe (Stable) β3

-

γ10 γ3 

γ5 

134Ba (Stable) 

CESIUM 117 

4. CHEMICAL, PHYSICAL, and RADIOLOGICAL INFORMATION 

Figure 4-2. The Decay Scheme of 134Cs 

EC = electron capture; β = beta decay; γ = gamma-ray emission 

CESIUM 119 

5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL 

5.1 PRODUCTION 

Cesium is the rarest of the naturally occurring alkali metals, ranking 40th in elemental abundance. 

Although it is widely distributed in the earth’s crust, cesium is found at relatively low concentrations. 

Granites contain cesium at about 1 ppm of cesium and sedimentary rocks contain approximately 4 ppm of 

cesium. Cesium is found in muscovite, beryl, spodumene, potassium feldspars, leucite, petalite, and other 

related minerals. The most common commercial source of cesium is pollucite, which contains between 

5 and 32% Cs2O (Burt 1993). There are three basic methods of converting pollucite ore to cesium metal 

or related compounds: direct reduction with metals; decomposition with bases; and acid digestion. In 

each method, grinding of the mined ore to approximately 75 μm sized particles precedes chemical 

conversion. 

Direct Reduction With Metals. Pollucite is directly reduced by heating the ore in the presence of 

calcium to 950 °C in vacuum, or in the presence of either sodium or potassium to 750 °C in an inert 

atmosphere (Burt 1993). Excessive amounts of reducing metal are required, and the resultant cesium 

metal is impure, requiring further distillation and purification. 

Decomposition With Bases. Alkaline decomposition is carried out by roasting the pollucite ore with 

either a calcium carbonate-calcium chloride mix at 800–900 °C or with a sodium carbonate-sodium 

chloride mix at 600–800 °C followed by a water leach of the roasted mass. The resultant cesium chloride 

solution is separated from the gangue by filtration (Burt 1993). 

Acid Digestion. Acid digestion of pollucite is the preferred commercial process for producing pure 

cesium. Hydrofluoric, hydrobromic, hydrochloric, and sulfuric acid may be employed in this method. 

Hydrofluoric and hydrobromic acid digestion yield the greatest cesium recovery, but the inherent 

difficulties of safely handling these acids limit their use. Digestion with hydrochloric acid takes place at 

elevated temperatures and produces a solution of mixed cesium chlorides, aluminum, and other alkali 

metals separated from the siliceous residue by filtration. The impure cesium chloride can be purified as 

cesium chloride double salts that are then recrystallized. The purified double salts are decomposed to 

cesium chloride by hydrolysis or precipitated with hydrogen sulfide (Burt 1993). 
CESIUM 120 

5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL 

Sulfuric acid digestion is performed at 110 °C with a 35–40% solution of sulfuric acid, followed by a hot 

water wash and vacuum filtration. Cesium alum is crystallized from the leach filtrate by stage cooling to 

50 °C and then to 20 °C and roasted in the presence of 4% carbon. The residue is leached to produce 

cesium sulfate solution, which can be converted to cesium chloride (Burt 1993). 

Radioactive isotopes of cesium such as 134Cs and 137Cs are produced by nuclear fission in fuel rods in 

nuclear power plants and in fallout from nuclear weapons. 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 (Burt 1993). Other processes for the removal 

of 134Cs and 137Cs from radioactive waste involve solvent extraction using macrocyclic polyethers, or 

crown ethers and coprecipitation with sodium tetraphenylboron (Burt 1993). 

5.2 IMPORT/EXPORT 

The United States is 100% import-reliant for elemental cesium. No economic data, such as production 

volume, consumption, or import/export volumes of cesium, are available. Although there is no 

information regarding the countries shipping cesium or cesium compounds to the United States, it is 

believed that Canada is the major foreign source of cesium (USGS 1999). Other possible sources of 

cesium-bearing material include Germany and the United Kingdom. 

5.3 USE 

There are relatively few commercial uses for cesium metal and its compounds. Cesium is used as a getter 

(combines chemically with residual gas in partial vacuum to increase the vacuum) for residual gas 

impurities in vacuum tubes and as a coating to reduce the work function of the tungsten filaments or 

cathodes of the tubes. Crystalline cesium iodide and cesium fluoride are used in scintillation counters, 

which convert energy from ionizing radiation into pulses of visible light (Burt 1993). Cesium is also used 

in magnetohydrodynamic power generators as a plasma seeding agent (Lewis 1997). Recently, cesium 

compounds have been employed as catalysts in organic synthesis, replacing sodium or potassium salts. 

One of the most interesting uses of cesium is in the production of highly accurate atomic clocks. When 

exposed to microwave radiation, the natural vibration of cesium atoms occurs at a frequency of 

9,192,631,770 Hz, and 1 second in time is defined as the duration of 9,192,631,770 periods of radiation 

absorbed or emitted by the transition of 133Cs atoms in two hyperfine levels of their ground state. 

Radioactive 137Cs has been approved as the gamma ray source for the sterilization of wheat, flour, 
CESIUM 121 

5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL 

potatoes, surgical equipment and other medical supplies, and sewage sludge, and is also used as a 

calibration source in gamma ray spectroscopy (Lewis 1997). 137Cs is also used in industrial radiography 

and for imaging of transport containers at border crossings. 131Cs was recently approved by the U.S. FDA 

as an active source in radioactive seeds used to treat prostate cancer (FDA 2003). 

5.4 DISPOSAL 

Because of its high reactivity, special precautions are required for the handling and disposal of pure 

cesium metal. Cesium metal is usually stored and transported in stainless steel containers, which are 

contained in outer packing, to ensure that the metal remains in a dry, oxygen-free environment. 

Most nonradioactive cesium minerals, compounds, and materials do not require special disposal and 

handling requirements. However, some chemical forms may be classified as hazardous materials if the 

compound is chemically reactive, flammable, or toxic. Care should be taken to read and understand all of 

the hazards, precautions, and safety procedures for each specific chemical form. In addition, all federal, 

state, and local laws and regulations should be investigated and subsequently followed with regard to 

disposal and handling of the specific chemical form of the cesium mineral, compound, or material. 

Radioactive cesium requires special disposal and handling requirements. Radioactive waste containing 

134Cs and 137Cs is usually grouped into four categories: low-level waste (LLW), high-level waste (HLW), 

mixed waste, and spent nuclear fuel. 

Low-level waste is all radioactive waste that cannot be classified as either HLW, spent fuel, or mixed 

waste. Low-level does not necessarily mean low radioactivity or low environmental hazard. Low-level 

waste types that may be contaminated with 134Cs and 137Cs include both wet and dry wastes. Examples of 

the physical form of LLW are: spent ion exchange resins, filter sludges, filter cartridges, evaporator 

bottoms, compactible trash, noncompactible trash, irradiated components, ashes produced from the 

incineration of combustible material, contaminated detergents or solvents, organic liquids, and discarded 

contaminated equipment or tools. Of the LLW generated today, approximately 64% of the volume and 

70% of the radioactivity is generated as a result of nuclear power plant activities or supporting fuel cycle 

operations. Other sources of LLW are commercial, academic, and government research laboratories and 

medical facilities. Radiocesium contamination accounts for only a small fraction of the activity of LLW. 

Nearly all of the 134Cs and 137Cs produced as a result of fission events remains trapped within the spent 

nuclear fuel rods (DOE 1996b). Low-level waste from Department of Energy (DOE) sources is currently 
CESIUM 122 

5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL 

disposed of at several DOE facilities across the United States. Only two sites accept non-DOE LLW: 

Barnwell, South Carolina and Richland, Washington (DOE 1996a). As required by the Federal Low 

Level Radioactive Waste (LLRW) Policy Act in 1980 and the 1985 amendments, states are required to 

build facilities to contain LLW generated from sources within its boundaries. The law encourages states 

to cooperate together in coordinating LLW disposal facilities. Many states have formed “compacts” to 

collaborate on construction of these LLW facilities. However, other than Barnwell, South Carolina and 

Richland, Washington, no other facility in the United States is accepting LLW from non-DOE sources 

(Eisenbud 1987). Over half of the LLW in the eastern United States is disposed of at the Barnwell site 

(Eisenbud 1987). The method of disposal for LLW has been to package the material in drums or boxes 

and bury the material in shallow pits and trenches. Approximately 3 million cubic meters of LLW 

generated has been disposed of in this way (DOE 1996a). 

As defined by the Nuclear Waste Policy Act, HLW is “the highly radioactive material resulting from the 

reprocessing of spent nuclear fuel, including liquid waste produced directly in reprocessing and any solid 

material derived from such liquid waste that contains fission products in sufficient concentration...” 

(42 USC 100). Most HLW has been generated from the production of plutonium. A smaller fraction is 

related to the recovery of enriched uranium from naval reactor fuel. This waste typically contains highly 

concentrated solutions of relatively long-lived fission by-products such as 90Sr and 137Cs, hazardous 

chemicals, and toxic heavy metals. Liquid HLW is typically stored in large underground tanks of either 

stainless steel or carbon steel depending on whether they are acid or alkaline solutions. Approximately 

100 million gallons of liquid HLW is stored in underground tanks in Washington, South Carolina, Idaho, 

and New York. These tanks contain a variety of radioactive liquids, solids, and sludges. Some of the 

liquid waste has been solidified into glass, ceramic slag, salt cake, and sludge. High-level waste in solid 

form is stored in underground bins (DOE 1996a). 

Mixed waste contains both radioactive and chemically hazardous materials. All HLW is managed as 

mixed waste and some LLW is classified as mixed waste. Certain hazardous mixed wastes that contain 

radioactive isotopes have been incinerated in Oak Ridge, Tennessee (DOE 1996a). Spent nuclear fuel, 

such as fuel elements and irradiated targets used in nuclear reactors, are currently stored at the 

commercial nuclear power plants and DOE facilities where they were produced. Spent fuel is highly 

radioactive, due to the large concentration of fission products, and must be stored in special water-cooled 

pools that shield and cool the material. Nearly all of the DOE spent fuel, about 3,000 metric tons, is 

stored at four sites: Hanford, Savannah River, Idaho National Environmental and Engineering 
CESIUM 123 

5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL 

Laboratory, and West Valley. Commercial reactors have generated >30,000 metric tons of spent fuel. 

The spent fuel from these facilities is located at >100 commercial nuclear reactor sites around the country. 

The establishment of a HLW and spent fuel repository for both DOE and commercial waste is currently 

under evaluation at Yucca Flats, Nevada. This commercial waste storage facility will not be ready to 

accept spent fuel before 2010. 

CESIUM 125 

6. POTENTIAL FOR HUMAN EXPOSURE 

6.1 OVERVIEW 

Cesium has been identified in at least 8 of the 1,636 hazardous waste sites that have been proposed for 

inclusion on the EPA National Priorities List (NPL) (HazDat 2003). It was reported that 134Cs has been 

found in at least 3 of the 1,636 current or former NPL sites and 137Cs has been detected in at least 23 of 

the 1,636 current or former NPL sites. However, the number of sites evaluated for cesium is not known. 

The frequency of these sites can be seen in Figures 6-1, 6-2, and 6-3. Of these sites, none are located in 

the Commonwealth of Puerto Rico. 

Naturally-occurring cesium and cesium minerals consist of only one stable isotope, 133Cs. Cesium occurs 

in the earth's crust at low concentrations. Granites contain an average cesium concentration of about 

1 ppm and sedimentary rocks contain about 4 ppm (Burt 1993). Higher concentrations are found in 

lepidolite, carnallite, muscovite, beryl, spodumene, potassium feldspars, leucite, petalite, and related 

minerals. The most important source of commercial cesium is the mineral pollucite, which usually 

contains about 5–32% Cs2O (Burt 1993). The largest deposits of pollucite are located in Manitoba, 

Canada and account for about two-thirds of the world’s known supply. Smaller deposits are located in 

Zimbabwe, Namibia, Brazil, Scandinavia, Czechoslovakia, and the United States. Continental dust and 

soil erosion are the main emission sources of naturally occurring cesium present in the environment. 

Cesium is also released to the environment as a result of human activities. The mining of pollucite ores 

and the production and use of cesium compounds in the electronic and energy production industries 

contribute to its direct release to the environment. Cesium has also been detected in the fly ash of 

hazardous waste incinerators and coal burning power plants (Fernandez et al. 1992; Mumma et al. 1990). 

Since the production and use of cesium compounds are limited, and since the natural concentration of 

cesium in the earth's crust is low, stable 133Cs is not often monitored or detected in the environment. 

Of much greater concern is the release of radioactive forms of cesium to the environment, such as 137Cs 

and 134Cs. These and other radioactive isotopes were released to the environment as a result of 

atmospheric testing of nuclear weapons (carried out from 1945 to 1980) and accidents that occurred at 

nuclear power plants such as the incident at the Chernobyl nuclear power plant in 1986 and the accident at 

the Windscale nuclear weapons facility in the United Kingdom in 1957. Small amounts of 137Cs and 134Cs 
CESIUM 126 

6. POTENTIAL FOR HUMAN EXPOSURE 

Figure 6-1. Frequency of NPL Sites with Cesium Contamination 

Frequency of 

NPL Sites 

1 

2 

Derived from HazDat 2003 
CESIUM 127 

6. POTENTIAL FOR HUMAN EXPOSURE 

Figure 6-2. Frequency of NPL Sites with 134Cs Contamination 

Frequency of 

NPL Sites

1 

Derived from HazDat 2003 
CESIUM 128 

6. POTENTIAL FOR HUMAN EXPOSURE 

Figure 6-3. Frequency of NPL Sites with 137Cs Contamination 

Frequency of 

NPL Sites 

1
 

2
 

3
 

5
 

Derived from HazDat 2003
 
CESIUM 129 

6. POTENTIAL FOR HUMAN EXPOSURE 

are also released in the airborne and liquid effluents during the normal operation of nuclear power plants. 

These levels are very low in comparison to the amounts released from weapons tests and accidents at 

nuclear power plants and are not expected to have a major impact upon human health. For the most part, 

testing of nuclear weapons has been discontinued by most nations for many years now. However, India 

and Pakistan have recently (May of 1998) conducted limited underground tests of nuclear weapons (UN 

1998). 

Radioactive materials are commonly referred to by activity rather than mass. The activity is the number 

of transformations (disintegrations) that the material undergoes in a given period of time. The most 

common units of activity are the curie (Ci) or the becquerel (Bq). One curie is equal to 3.7x1010 transformations per second (tps) and 1 becquerel is equal to 1 tps. For convenience, picocuries (pCi) are often 

reported for lower activities; 1pCi=1x10-12 Ci=0.037 Bq. 

Radioactive cesium is removed from the air by wet and dry deposition and can travel thousands of miles 

before settling to earth. Wet deposition is considered the most important pathway for the removal of 

radioactive cesium from the atmosphere. It is a complex process that depends upon meteorological 

conditions such as temperature, the microphysical structure of the clouds, and the rainfall rate, as well as 

the physical and chemical properties of the airborne cesium. 

Cesium has very low mobility in soil. In general, it has been reported that cesium usually does not 

migrate below depths of about 40 cm, with the majority of cesium being retained in the upper 20 cm of 

the soil surface (Korobova et al. 1998; Takenaka et al. 1998). Clay minerals and soils rich in 

exchangeable potassium adsorb cesium by binding the cations to interlayer positions of the clay particles 

(Paasikallio 1999). The low hydration energy of cesium cations is primarily responsible for their 

selective sorption and fixation by clays. These factors can limit the uptake of cesium in grass and plant 

material. There are exceptional areas, however, where cesium fixation in soil is much less, resulting in 

greater transport in the soil and uptake in plants. Regions in Venezuela, Brazil, and Russia have been 

identified where the mobility of cesium is considerably greater than in other soils (LaBrecque and Rosales 

1996; WHO 1983). Cesium is also deposited on plants and trees by wet and dry deposition and is 

absorbed into the flora through its foliage (Sawidis et al. 1990). The deposited cesium can make its way 

to soil through decomposition of the contaminated foliage. 

Since the half-life for some radioactive isotopes of cesium is long (the half-life of 137Cs is about 30 years 

and the half-life of 134Cs is about 2 years), the general population is exposed to 137Cs and 134Cs for long 
CESIUM 130 

6. POTENTIAL FOR HUMAN EXPOSURE 

periods of time after it is released from a nuclear accident or weapons test, with the greatest exposure 

occurring near the source. Although inhalation and dermal exposure is possible, oral ingestion of 

contaminated food items is the greatest source of internal exposure for both naturally occurring and 

radioactive cesium. Cesium is uniformly distributed throughout the whole body similar to potassium, and 

it does not accumulate in any one particular part of the body like iodine (thyroid) or strontium (bones). 

For this reason, radioactive cesium only poses significant health risks if a large amount has been ingested. 

Workers employed in the mining and milling of pollucite ores and the production of cesium compounds 

are exposed to cesium through oral, dermal, and inhalation routes. Similar routes of exposure to 137Cs and 

134Cs occurs for workers employed in the nuclear industry. External exposure to gamma radiation can 

also occur for workers employed in the nuclear industry as well as for the general population. The health 

consequences of external exposure to gamma radiation are not unique to 137Cs and 134Cs, but are similar 

for all gamma emitting radionuclides. 

6.2 RELEASES TO THE ENVIRONMENT 

Throughout this chapter, the units used to express concentration or intakes of cesium are the same units 

reported by the authors. In most cases, values are expressed in mass units when referring to 133Cs, while 

radioactive cesium isotopes are expressed in units of activity. 

According to the Toxics Release Inventory (TRI), in 2000, there were no reportable releases of 133Cs, or 

its compounds into the environment by commercial sources (TRI00 2002). The TRI data should be used 

with caution since only certain types of facilities are required to report. Therefore, it is not an exhaustive 

list. Facilities are required to report to TRI if they have 10 or more full-time employees, or if the facility 

is classified under Standard Industrial Classification (SIC) codes 20–39, if the facility manufactures or 

processes over 25,000 pounds of the chemical, or otherwise uses >10,000 pounds of the chemical in a 

calendar year. 

In the United States, commercial nuclear power plant operators are required to report any detectable 

quantities of radioactive materials released to the environment (10 CFR 50.36a). Table 6-1 summarizes 

releases of 137Cs and 134Cs to the atmosphere and water for 1993 from pressurized water reactor (PWR) 

and boiling water reactor (BWR) nuclear power plants. Nearly all of the radioactive material reported as 

being released in effluents are from planned releases. Planned releases result from normal plant operation 

or from anticipated operational occurrences. The latter include unplanned releases of radioactive 
CESIUM 131 

6. POTENTIAL FOR HUMAN EXPOSURE 

Table 6-1. Radiocesium Releases from Nuclear Power Plants for 1993 

Annual total site environmental releases for 1993 

Water Air 

Installation Locationa 134Cs, Ci 137Cs, Ci 134Cs, Ci 137Cs, Ci 

Boiling water reactors 

Browns Ferryb Decatur, AL 0.033 0.18 3.5x10-4 8.9x10-4 

Brunswickb Wilmington, NC 2.9x10-4 1.7x10-3 No data 7.0x10-4 

Clinton Clinton, IL No data No data No data No data 

Cooper Omaha, NE 9.3x10-3 0.052 No data No data 

Dresdenb Joliet, IL 1.2x10-6 0.025 No data 1.9x10-4 

Duane Arnold Cedar Rapids, IA No data No data No data 1.4x10-6 

Edwin I. Hatch Baxley, GA 6.3x10-3 0.044 No data 6.2x10-5 

Fermi Laguna Beach, MI No data 8.3x10-6 No data No data 

Grand Gulf Vicksburg, MS 3.5x10-4 6.0x10-4 2.1x10-6 2.3x10-6 

Hope Creek Wilmington, DE No data 4.8x10-5 No data No data 

Humbolt Bayb Eureka, CA No data 8.8x10-3 No data 3.2x10-5 

James A. Fitzpatrick Syracuse, NY No data 4.1x10-5 No data 6.6x10-6 

LaCrosseb LaCrosse, WI 3.2x10-4 0.010 No data 1.0x10-4 

LaSalle Ottawa, IL No data No data No data No data 

Limerick Philadelphia, PA 2.0x10-3 6.0x10-3 No data No data 

Millstone New London, CT 0.066 0.224 6.9x10-6 8.9x10-5 

Monticello St. Cloud, MN No data No data No data 4.8x10-4 

Nine Mile Point Oswego, NY No data No data No data 1.9x10-5 

Oyster Creek Toms River, NJ No data No data No data 6.5x10-5 

Peach Bottom Lancaster, PA 5.2x10-4 1.4x10-3 6.1x10-5 3.0x10-4 

Perry Painesville, OH 8.8x10-5 1.6x10-4 No data No data 

Pilgram Boston, MA No data 9.8x10-4 2.4x10-5 7.3x10-5 

Quad-Cites Moline, IL No data 3.6x10-3 No data 1.8x10-4 

River Bend Baton Rouge, LA 2.6x10-4 2.2x10-3 No data No data 

Shoreham Brookhaven, NY No data No data No data No data 

Susquehanna Berwick, PA No data 2.9x10-5 No data No data 

Vermont Yankee Brattleboro, VT No data No data No data 9.9x10-5 

WNP-2 Richland, WA 6.3x10-3 0.019 6.7x10-6 7.2x10-6 

Total 0.12 0.58 4.5x10-4 3.3x10-3 

Pressurized water reactors

 Arkansas One Russellville, AR 0.054 0.11 No data 3.5x10-8 

Beaver Valley Shippingport, PA 1.2x10-3 2.3x10-3 No data No data 

Big Rock Point Charlevoix, MI 9.5x10-4 0.012 1.1x10-5 1.5x10-4 

Braidwood Joliet, IL 6.5x10-4 1.7x10-3 No data No data 

Byron Byron, IL 5.6x10-3 1.5x10-3 No data No data 

Callaway Fulton, MO 5.3x10-4 7.8x10-4 No data No data 

Calvert Cliffs Washington, DC 0.14 0.21 3.4x10-3 4.2x10-3 
CESIUM 132 

6. POTENTIAL FOR HUMAN EXPOSURE 

Table 6-1. Radiocesium Releases from Nuclear Power Plants for 1993 

Annual total site environmental releases for 1993
 

Water Air
 

Installation Locationa 134Cs, Ci 137Cs, Ci 134Cs, Ci 137Cs, Ci 

Catawba Rock Hill, SC 1.6x10-3 3.9x10-3 No data No data 

Comanche Peak Glen Rose, TX 8.7x10-3 8.7x10-3 No data No data 

Crystal River Tampa, FL 2.7x10-3 9.3x10-3 No data 3.1x10-6 

Davis-Besse Toledo, OH 1.4x10-3 6.2x10-3 No data No data 

Diablo Canyon San Luis Obispo, CA 0.036 0.064 3.3x10-5 2.4x10-4 

Donald C. Cook St. Joseph, MI 1.3x10-3 6.3x10-3 No data 7.3x10-7 

Fort Calhoun Omaha, NE 1.3x10-3 0.012 No data 1.7x10-6 

H.B. Robinson Hartsville, SC 3.6x10-4 4.1x10-4 5.8x10-6 1.8x10-5 

Haddam Neck Middletown, CT 0.013 0.023 8.0x10-4 8.8x10-3 

Harris Raleigh, NC 2.9x10-4 3.9x10-4 No data No data 

Indian Pointb Peekskill, NY 3.0x10-3 0.10 No data 7.0x10-4 

Joseph M. Farley Dothan, AL 1.5x10-3 3.6x10-3 No data No data 

Kewaunee Green Bay, WI No data 2.6x10-6 No data 2.0x10-6 

Maine Yankee Wicassett, ME 1.4x10-3 8.2x10-3 No data 4.2x10-5 

McGuire Charlotte, NC 1.6x10-3 4.6x10-3 No data 1.3x10-6 

North Anna NW Richmond, VA 6.2x10-3 9.2x10-3 3.4x10-6 8.2x10-5 

Oconee Greenville, SC 2.7x10-3 0.010 No data 3.9x10-4 

Palisades South Haven, MI 2.4x10-4 4.3x10-3 No data 1.1x10-5 

Palo Verde Phoenix, AZ No data No data 2.0x10-3 1.7x10-3 

Point Beach Manitowoc, WI 0.019 0.027 6.9x10-3 6.9x10-3 

Prairie Island Minneapolis, MN 2.8x10-3 3.8x10-3 1.5x10-5 1.8x10-5 

R.E. Ginna Rochester, NY 0.042 0.041 No data 5.2x10-6 

Rancho Secob Sacramento, CA 1.9x10-5 3.6x10-4 No data No data 

Salem Wilmington, DE 0.81 1.0 No data 7.0x10-7 

San Onofreb San Clemente, CA 0.49 0.57 2.5x10-5 4.0x10-5 

Seabrook Portsmouth, NH No data 3.3x10-5 No data No data 

Sequoyah Daisy, TN 0.086 0.14 No data No data 

South Texas Bay City, TX 3.4x10-3 5.4x10-3 No data No data 

St. Lucie Ft. Pierce, FL 0.055 0.083 9.2x10-6 2.1x10-5 

Summer Columbia, SC 1.6x10-3 3.3x10-3 2.2x10-5 2.9x10-5 

Surry Newport News, VA 7.6x10-5 0.011 No data 7.2x10-5 

Three Mile Islandb Harrisburg, PA 0.026 0.030 1.2x10-7 4.7x10-6 

Trojanb Portland, OR 1.0x10-3 4.0x10-3 No data No data 

Turkey Point Florida City, FL 9.4x10-4 5.5x10-3 No data 9.4x10-7 

Vogtle Augusta, GA 5.6x10-3 7.3x10-3 No data No data 

Waterford New Orleans, LA 0.013 0.016 No data No data 

Wolf Creek Burlington, KS 0.022 0.024 No data No data 
CESIUM 133 

6. POTENTIAL FOR HUMAN EXPOSURE 

Table 6-1. Radiocesium Releases from Nuclear Power Plants for 1993 

Annual total site environmental releases for 1993
 

Water Air
 

Installation Locationa 134Cs, Ci 137Cs, Ci 134Cs, Ci 137Cs, Ci 

Yankee Roweb Greenfield, MA 4.3x10-6 6.0x10-5 No data 1.0x10-7 

Zion Waukegan, IL 0.014 0.029 2.4x10-4 2.9x10-4 

Total 1.88 2.85 0.013 0.023 

a

Post office state abbreviations used.
 b

Facilities that are permanently or indefinitely shut down. 
CESIUM 134 

6. POTENTIAL FOR HUMAN EXPOSURE 

materials from miscellaneous actions such as equipment failure, operator error, or procedure error; these 

releases are not of such consequence as to be considered an accident. 

The TRI data should be used with caution because only certain types of facilities are required to report. 

This is not an exhaustive list. 

6.2.1 Air 

Stable cesium is introduced into the atmosphere by resuspension of soil, accidental release from mining 

and milling pollucite, and emissions from hazardous waste incinerators or coal burning plants. These 

emissions are expected to be low since cesium occurs naturally in the earth's crust at low concentrations 

and only small amounts of pollucite are mined annually. Cesium was detected at concentrations of 

10.8 and 6.11 mg/m3

 in the effluent of a coal-burning power plant in the western United States (Ondov et 

al. 1989) and has been identified in the fly ash from municipal incinerators (Mumma et al. 1990, 1991). 

Fly ash from five municipal waste incinerators in the United States contained cesium at concentrations of 

2,100–12,000 ppm (EPA 1990a). Stable cesium has been identified in air at one of the eight NPL 

hazardous waste sites where it was detected in some environmental media (HazDat 2003). 

Radioactive isotopes of cesium such as 137Cs and 134Cs have been released to the atmosphere from 

atmospheric nuclear weapons testing, accidents at nuclear reactors, and nuclear-powered satellites 

burning up in the atmosphere upon re-entry. The total amount of 137Cs released from weapons testing 

through 1980 was estimated as 2.6x107

 Ci (9.6x1017 Bq), 76% of which was released in the northern 

hemisphere and 24% in the southern hemisphere (WHO 1983). On April 26, 1986, a steam buildup 

caused an explosion and fire at a nuclear power generating plant in Chernobyl, Russia, releasing an 

estimated 5.4x105

 Ci (2.0x1016 Bq) of 134Cs and 1.1x106 Ci (4.0x1016 Bq) of 137Cs into the atmosphere 

over Europe (Watson 1987). Long-range atmospheric transport spread the radionuclides throughout the 

Northern Hemisphere. No airborne activity from Chernobyl has been reported south of the equator 

(Eisler 1995). By early May 1986, these radionuclides were readily detectable in environmental samples 

collected in North America (Huda et al. 1988). More recent estimates have put the total activity of 137Cs 

released from the Chernobyl power plant as 2.3x106

 Ci (8.5x1016 Bq) and 1.2x106 Ci (4.4x1016 Bq) for 

134Cs (Buzulukov and Dobrynin 1993). 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 137Cs 

(Barrie et al. 1992). In October 1957, an accident at the Windscale nuclear weapons plant at Sellafield in 

the United Kingdom resulted in the release of 595 Ci of 137Cs (Agency for Toxic Substances and Disease 
CESIUM 135 

6. POTENTIAL FOR HUMAN EXPOSURE 

Registry 1999). Routine activities at nuclear power plants and fuel-reprocessing stations also release 

137Cs and 134Cs 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 past 

atmospheric weapons tests and the major releases following accidents at nuclear power plants. In 1998, it 

was reported that 1.3x10-4 Ci of 134Cs and 5.1x10-3 Ci of 137Cs were released to the atmosphere from the 

Savannah River plutonium processing site in South Carolina (DOE 1998b). In 1993, the Nuclear 

Regulatory Commission (NRC) estimated that 0.013 Ci of 134Cs and 0.023 Ci of 137Cs were released in 

airborne effluents from 30 PWR nuclear power plants operating in the United States (USNRC 1993). It 

was also estimated that 4.6x10-4 Ci of 134Cs and 3.3x10-3 Ci of 137Cs were released in airborne effluents 

from 28 BWR nuclear power plants (USNRC 1993). The total airborne and liquid releases of 134Cs and 

137Cs from the individual nuclear power plants are summarized in Table 6-1. 

Radioactive 134Cs was not identified in air at the 3 NPL hazardous waste sites where it was detected in 

some environmental media, but 137Cs was identified in air at 5 of the 23 NPL hazardous waste sites where 

it was detected in some environmental media (HazDat 2003). 

6.2.2 Water 

Cesium can be released to water surfaces during the mining, milling, and production process of pollucite 

ore. The natural erosion and weathering of rocks will also lead to cesium's introduction into ground and 

surface water. Stable cesium was identified in groundwater and surface water at four and one of the eight 

NPL hazardous waste sites, respectively, where it was detected in some environmental media (HazDat 

2003). 

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 137Cs and 134Cs as well as other radioactive nuclides into these waters. 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 (Robbins et al. 1990). Radioactive cesium can be introduced to water from nuclear 

power plants (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 137Cs was emitted to the 

Savannah River watershed due to the activities at the Savannah River plutonium processing plant (Olsen 

et al. 1989). It was further noted that about 18% of this total (92 Ci) drained directly into the Savannah 

River (Olsen et al. 1989). In 1998, it was reported that 1.0x10-4 Ci of 134Cs and 0.19 Ci of 137Cs were 
CESIUM 136 

6. POTENTIAL FOR HUMAN EXPOSURE 

released in liquid effluents from the Savannah River plutonium processing site in South Carolina (DOE 

1998b). In 1993, the NRC estimated that 1.88 Ci of 134Cs and 2.85 Ci of 137Cs were released in liquid 

effluents from 30 PWR nuclear power plants operating in the United States (NRC 1993a). It was also 

estimated that 0.12 Ci of 134Cs and 0.58 Ci of 137Cs were released in liquid effluents from 28 BWR 

nuclear power plants (NRC 1993a). The EPA reported that the total on-site liquid discharge of 137Cs from 

containment ponds at the Nevada Test Site was 0.0017 Ci in 1997 (EPA 1999c). It was estimated that 

1,622 Ci of 137Cs and 811 Ci of 134Cs were released to the cooling pond surrounding the Chernobyl 

nuclear power plant following the accident in 1986 (UNSCEAR 1996). 

Radioactive 134Cs was not identified in water at the three NPL hazardous waste sites where it was detected 

in some environmental media (HazDat 2003). However, 137Cs was identified in groundwater and surface 

water at 5 and 3 of the 23 NPL hazardous waste sites, respectively, where it was detected in some 

environmental media (HazDat 2003). 

6.2.3 Soil 

Anthropogenic sources of stable 133Cs releases to soils include the mining, milling, and processing of 

pollucite ore. It is also found in the ash of coal burning power plants and municipal waste incinerators. 

Stable cesium was detected at concentrations of 0.44–2.01 ppm in the bottom ash of municipal solid 

waste incinerators operating in the United States (Mumma et al. 1990) and at concentrations of 3–23 ppm 

from a municipal waste incinerator operating in Barcelona, Spain (Fernandez et al. 1992). Stable cesium 

was identified in soil at one of the eight NPL hazardous waste sites and in sediment at one of the eight 

NPL hazardous waste sites where it was detected in some environmental media (HazDat 2003). 

Radioactive cesium has been released to soil surfaces by underground nuclear weapons testing, fallout 

from the accident at the Chernobyl nuclear power plant, and fallout from atmospheric weapons testing. 

About 1,400 underground tests have been performed worldwide, with a total explosive yield of about 

90 megatons (Agency for Toxic Substances and Disease Registry 1999). Small amounts of 137Cs and 

134Cs 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 2.4x104

 km2 near the 

Chernobyl nuclear power plant was contaminated with 137Cs at a deposition density >5.4x10-5 Ci/m2 

following the accident in 1986 (UNSCEAR 1996). Within the exclusionary zone the contamination 

density may have been 2 orders of magnitude greater in limited areas (UNSCEAR 1996). The mean 

deposition density of 137Cs and 134Cs in four different soils in Devoke, United Kingdom for May 1986 
CESIUM 137 

6. POTENTIAL FOR HUMAN EXPOSURE 

were reported as 3.7x10-7–5.4x10-7 Ci/m2 and 1.0x10-7–1.8x10-7 Ci/m2, respectively (Hilton et al. 1993). 

The concentrations of 137Cs in eight sediment cores of the Danube River, Austria were about 540 pCi/kg 

in April 1985, but increased to approximately 27,000–81,000 pCi/kg in October 1986, following the 

accident at the Chernobyl nuclear power plant (Rank et al. 1990). The deposition of 137Cs 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/m2

, while the concentration attributed to fallout from 

nuclear weapons testing since 1963 ranged from 1.4x10-7 to 5.4x10-7 Ci/m2

 (Richter et al. 1993). It was 

estimated that 2,973 Ci of 137Cs and 1,622 Ci of 134Cs were released to the sediments in the cooling pond 

surrounding the Chernobyl nuclear power plant following the accident in 1986 (UNSCEAR 1996). The 

deposition density of 137Cs in 123 soil cores collected at the Idaho National Engineering and Environmental Laboratory (INEEL), a site for stored transuranic waste in the United States, ranged from 

1.6x10-8 to 3.4x10-7 Ci/m2

 (DOE 1998a). The deposition density of 137Cs in soils from Idaho, Montana, 

and Wyoming ranged from 3.0x10-9 to 1.1x10-7 Ci/m2

, and it was assumed that its origin was fallout from 

the Nevada Test Site (DOE 1998a). The mean deposition density of 137Cs in the top layer (0–8 cm) of 

soils near the Chernobyl nuclear power plant in 1988 was 8.6x10-5 Ci/m2

 and the mean deposition density 

of 134Cs was 1.9x10-5 Ci/m2

 (Mikhaylovskaya et al. 1993). 

It was reported that 134Cs was identified in soil at one site, but was not detected in sediment at the three 

NPL hazardous waste sites where it was detected in some environmental media (HazDat 2003). It was 

also reported that 137Cs was identified in soil and sediment at 14 and 5 of the 23 NPL hazardous waste 

sites, respectively, where it was detected in some environmental media (HazDat 2003). 

6.3 ENVIRONMENTAL FATE 

6.3.1 Transport and Partitioning 

The transport and partitioning of particulate matter in the atmosphere is largely dependent upon the 

physical properties of the matter such as size and density as well as the meteorological conditions such as 

temperature, the microphysical structure of the clouds, and rainfall rate. The particle size of 137Cs 

released to the atmosphere following the Chernobyl nuclear accident was in the range of 0.1–10 μm, 

(Hirose et al. 1993). Particles <5 μm in diameter usually have low deposition velocities and are 

transported long distances before being removed from the atmosphere. Atmospheric cesium is deposited 

on land and water via wet and dry deposition and the deposited cesium may be re-suspended to the 

atmosphere by disturbances that occur on the ground such as vehicular traffic and construction activity. 
CESIUM 138 

6. POTENTIAL FOR HUMAN EXPOSURE 

The wet deposition velocity of 137Cs at Tsukauba, Japan from May 5 to May 30, 1986 ranged from 

0.0026 to 0.110 m/second, and the largest value recorded was during a period of heavy rainfall (Hirose et 

al. 1993). The mean deposition velocity (wet and dry) of 137Cs measured in Prague, Czechoslovakia was 

reported as 0.08 m/second from 1989–1992 and the mean flux rate was 1,108 pCi/m2

-year (Rybacek et al. 

1994). 

Since cesium does not volatilize from water, transport of cesium from water to the atmosphere is not 

considered likely, except by windblown sea sprays. Most of the cesium released to water will adsorb to 

suspended solids in the water column and ultimately be deposited in the sediment core. Cesium can also 

bioconcentrate and has been shown to bioaccumulate in both terrestrial and aquatic food chains. Mean 

bioconcentration factors (BCF) for 137Cs of 146, 124, and 63 were reported for fish, brown macroalgae, 

and molluscs, respectively (Fisher et al. 1999). Mean BCF values of 92, 58, 39, and 150 were reported 

for 137Cs in cod, haddock, plaice, and whiting, respectively (Steele 1990). In a study of aquatic organisms 

inhabiting the Ottawa River, a 4-fold increase of 137Cs levels was observed with each trophic level 

(Rowan et al. 1998). The levels of 137Cs in lake trout from Great Slave Lake, Canada were consistently 

higher than levels found in food sources and a biomagnification factor of 1.9 was calculated for lake trout, 

relative to their food sources. The biomagnification factor was 3.5 for large mature trout populating the 

lake (Rowan et al. 1998). It was shown that the bioconcentration and bioaccumulation of 137Cs by aquatic 

organisms is significantly reduced in waters with a large humic content and high levels of potassium 

cations (Penttila et al. 1993). Because of the high potassium concentration in oceans, the transfer of 137Cs 

and 134Cs to fish is much greater in freshwater and the activity of freshwater fish may be 100 times that of 

ocean fish, given the same cesium concentration in the water (WHO 1983). 

In soil surfaces, cesium has low mobility in comparison to other metals and usually does not migrate 

below a depth of 40 cm. The major portion of cesium is retained in the upper 20 cm of the soil surface 

(Korobova et al. 1998; Ruse and Peart 2000; Takenaka et al. 1998). Vertical migration patterns of 137Cs 

in four agricultural soils from southern Chile indicated that approximately 90% of the applied cesium was 

retained in the top 40 cm of soil, and that in one soil, essentially 100% was bound in the upper 10 cm 

(Schuller et al. 1997). Migration rates of radiocesium were derived from the depth distribution profiles 

and were in the range of 0.11 to 0.29 cm/year (Schuller et al. 1997). The vertical migration patterns of 

90Sr and 137Cs produced from the atomic bomb exploded in Nagasaki, Japan were studied over a 40-year 

period (Mahara 1993). 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. In contrast, only 70% of 90Sr was located within a 

depth of 10 cm and a small percentage was detectable below a depth of 200 cm. The in situ vertical 
CESIUM 139 

6. POTENTIAL FOR HUMAN EXPOSURE 

migration rate of 90Sr was calculated as 0.42 cm/year and the migration rate of 137Cs was 0.10 cm/year 

(Mahara 1993). The distribution of 137Cs deposited in eastern France due to the Chernobyl accident was 

studied recently in four soil types with differing land use. The soils were all high in clay content, organic 

matter content never exceeded 10% in any of the soils, and none of the soils had been ploughed or tilled 

since the Chernobyl accident in 1986. In all cases, the majority of 137Cs was detected in the upper 10 cm 

of soil, with only 1–2% migrating to depths of 40 cm or more (Renaud et al. 2003). Soil adsorption 

coefficients (Kd) of five radionuclides (54Mn, 60Co, 65Zn, 85Sr, and 137Cs) were measured for 

36 agricultural soils collected in Japan. It was determined that 137Cs had the largest median Kd of all five 

radionuclides, and that a positive correlation was observed between the adsorption coefficient and 

exchangeable potassium content in the soil (Yasuda et al. 1995). No correlations were observed for other 

soil properties such as pH, water content, cation exchange capacity, and exchangeable calcium. Other 

studies have reported that clay and zeolite minerals strongly bind cesium cations and can therefore reduce 

the bioavailability of cesium and the uptake in plants by irreversibly binding cesium in interlayer 

positions of the clay particles (Paasikallio 1999). Experiments conducted by growing plants in a peat soil 

showed that the introduction of zeolites into the soil-plant system decreased the uptake of 134Cs in plants 

by a factor of 8 (Shenber and Johanson 1992). The low hydration energy of cesium cations is primarily 

responsible for their selective sorption and fixation by clays and zeolites (Hakem et al. 1997). Soils rich 

in organic matter adsorb cesium, but the cesium adsorbed in the organic fraction is readily exchangeable 

and highly available for plant uptake (Sanchez et al. 1999). Regions in Venezuela, Brazil, and Russia 

have been identified where a great deal of rain is encountered, the soil is peaty or podzolic (a type of 

forest soil characterized by high leachability), and the mobility of cesium is considerably greater than in 

other soils (LaBrecque and Rosales 1996; WHO 1983). 

The plant/soil concentration ratio (activity/kg of plant/activity/kg of soil) of 137Cs for field crops in 

southern Finland ranged from 0.01 to 0.26. In northern Finland, this ratio ranged from 0.01 to 2.29, with 

the lowest values occurring in clay and silt soils and the highest values observed in fine sands (Paasikallio 

et al. 1994). The plant/soil concentration ratios for a series of vegetables and grains decreased in the 

following order: lettuce, cabbage>carrot, potato>cereals, onion; for fruits, the order was: blackcurrant>strawberry>apple (Paasikallio et al. 1994). The mean plant/soil concentration ratios of 137Cs for 

trees at the Hanford Waste Site in the United States were 0.03 (roots), 0.06 (cores), and 0.02 (leaf/twig) 

(Landeen and Mitchell 1986). 
CESIUM 140 

6. POTENTIAL FOR HUMAN EXPOSURE 

6.3.2 Transformation and Degradation 

6.3.2.1 Air 

When pure cesium metal is exposed to air, an explosion-like oxidation occurs, forming a mixture of 

cesium oxides (Cs2O, Cs2O2, and Cs2O3). Cesium compounds released to the atmosphere will eventually 

settle to earth by wet and dry deposition. Radioactive forms of cesium such as 137Cs and 134Cs are 

continuously transformed to stable isotopes of barium or xenon by the natural process of radioactive 

decay. The pathways and mechanisms of these reactions have been described in Chapter 4. 

6.3.2.2 Water 

When pure cesium metal is released to water, a vigorous reaction occurs yielding cesium hydroxide 

(CsOH), the strongest base known, and hydrogen gas, which may ignite spontaneously. In general, 

cesium compounds are very water soluble, in which cesium is present in the ionic form as the Cs+

 cation. 

Under normal environmental conditions, Cs+

 cations are neither degraded nor transformed, but may 

adsorb to suspended solids and sediment in the water column, forming insoluble complexes. 

6.3.2.3 Sediment and Soil 

Cesium salts and most cesium compounds are generally very water soluble, with the exception of cesium 

alkyl and aryl compounds, which have low water solubility. Cesium cations have low hydration energy 

and can react with clay minerals, zeolites, or soils with a high percentage of exchangeable potassium, 

forming insoluble, immobile complexes. 

6.4 LEVELS MONITORED OR ESTIMATED IN THE ENVIRONMENT 

Reliable evaluation of the potential for human exposure to cesium depends in part on the reliability of 

supporting analytical data from environmental samples and biological specimens. Radioactive cesium is 

measured in units of activity, not mass. A great deal of monitoring data for radioactive cesium in 

environmental samples prior to, and shortly following, the accident at the Chernobyl nuclear power plant 

on April 26, 1986 has been included in this chapter. 
CESIUM 141 

6. POTENTIAL FOR HUMAN EXPOSURE 

6.4.1 Air 

Data reporting the background levels of 133Cs in the atmosphere are limited. Since the amount of cesium 

mined and milled is small, it is expected that background concentrations in the atmosphere will be low. 

The concentration of 133Cs measured in the South Pole during 1974–1975 was reported in the range of 

0.072–0.14 pg/m3

, with a mean of 0.10 pg/m3 (Maenhaut et al. 1979). The maximum airborne 

concentrations of 133Cs at the Tera Nova Bay Station in the Arctic were reported as 20–90 pg/m3

 during 

the 1989–1990 Italian expedition and 10–60 pg/m3

 for the 1990–1991 expedition (Chiavarini et al. 1994). 

The average concentration of 133Cs in precipitation collected in Lennox, Massachusetts during the 

summer of 1984 was reported as 0.0075 μg/L, with a range from 0.0050 to 0.024 μg/L (Dasch and Wolff 

1989). 

Radioactive 134Cs and 137Cs have been detected at various concentrations (activities) in the atmosphere 

following the accident at the Chernobyl nuclear power plant on April 26, 1986. The greatest 

concentrations were observed in locations throughout Russia and Europe, but detectable levels were 

measured globally, including in North America. The air concentrations of 134Cs above the destroyed 

reactor were 1,756.8 pCi/m3

 on May 8 and 54.0 pCi/m3 on May 18 (Buzulukov and Dobrynin 1993). The 

concentrations of 137Cs in the air above the destroyed reactor were 8,918.9 pCi/m3

 on May 8 and 

135.1 pCi/m3

 on May 18 (Buzulukov and Dobrynin 1993). Atmospheric concentrations of 134Cs in 

Belgrade, Yugoslavia were 5.4x10-4 (May 1, 1986), 160.5 (May 2, 1986), 145.0 (May 3, 1986), and 

25.4 (May 4, 1986) pCi/m3

, while atmospheric concentrations of 137Cs were 0.001 (May 1, 1986), 

324 (May 2, 1986), 276 (May 3, 1986), and 49 (May 4, 1986) pCi/m3

 (Ajdacic and Martic 1990). Cesium 

concentrations decreased significantly over time as advection, wet deposition, and dry deposition lowered 

the atmospheric concentrations. The average monthly atmospheric concentrations of 137Cs in Belgrade 

that were measured during 1991–1996 ranged from 1.3x10-4 to 2.0x10-3 pCi/m3

, with a pronounced 

maximum during the winter months (Todorovic et al. 1999). Monitoring data from Prague, 

Czechoslovakia indicated that there was a gradual decrease in the atmospheric concentration of 137Cs 

from May 1986 to February 1992. Maximum concentrations were observed immediately following the 

accident at the Chernobyl nuclear power plant (approximately 0.05 pCi/m3

) and gradually decreased over 

a 6-year period (Rybacek et al. 1994). The atmospheric concentration of 134Cs decreased more rapidly, 

presumably due to the shorter half-life of 134Cs. The concentration of 137Cs in the atmosphere of 

Thessaloniki, Greece ranged from 8.1x10-4 to 0.044 pCi/m3

 from July 1987 to December 1988, and the 

concentration of 137Cs in rainfall ranged from 0.27 to 34 pCi/L from November 1986 to February 1989 

(Papastefanou et al. 1989). During a heavy rainfall event occurring on May 6, 1986, 137Cs was detected at 

a concentration of 46,000 pCi/L (Papastefanou et al. 1989). The concentration of 137Cs in Tsukuba, Japan 
CESIUM 142 

6. POTENTIAL FOR HUMAN EXPOSURE 

during May 1986 ranged from about 0.054 to 1.6 pCi/m3 (Hirose et al. 1993). The average atmospheric 

concentrations of 134Cs and 137Cs in eastern Canada were reported as 0.024 and 0.046 pCi/m3

, 

respectively, during May 10–24, 1986 (Huda et al. 1988). The maximum atmospheric concentration of 

137Cs measured in New York City in May 1986 was reported as 0.26 pCi/m3

 (Feely et al. 1988). The 

average concentrations of 137Cs and 134Cs in Barrow, Alaska were reported as 0.027 and 0.019 pCi/m3

, 

respectively, for the month of May 1986 (DOE 1986). 

6.4.2 Water 

The background concentration of 133Cs in fresh water lakes and rivers is ordinarily in the range of 0.01 to 

1.2 μg/L, and the concentration in seawater is about 0.5 μg/L (WHO 1983). Stable cesium was detected 

in streams that feed into the Tamagawa River, Japan at concentrations of 9x10-4 to 0.093 μg/L (Tanizaki 

et al. 1992). Studies from five distinct geochemical areas of the semi-arid endorheic region of the 

Famatina Range (La Rioja, Argentina) have shown some areas contain high levels of 133Cs in natural 

waters and sediment (Fernandez-Turiel et al. 1995). The cesium concentration in fresh water systems of 

this region ranged from 0.58 to 3.69 μg/L (Fernandez-Turiel et al. 1995). The concentrations of 19 trace 

metals were studied in drinking water and groundwater supplies in southern Nigeria. Stable cesium was 

detected in groundwater and drinking water at mean concentrations of 0.61 μg/L (range 0.09–3.72 μg/L) 

and 0.35 μg/L (range 0.05–4.32 μg/L), respectively (Asubiojo et al. 1997). The mean concentration of 

cesium in drinking water was lower than the mean concentration of any of the other trace elements 

analyzed. 

High and low level radioactive wastes were dumped by the former Soviet Union into remote Arctic 

waters, leading to the release of radioactive cesium into the Kara and Barents Seas. The level of 137Cs in 

surface water of the Barents Sea and Kara Sea was 0.14 and 0.16 pCi/L, respectively, and 137Cs was also 

detected in deep water of the Barents Sea at a concentration of 0.15 pCi/L (Fisher et al. 1999). The 

concentration of 137Cs in the Black Sea ranged from 2.7 to 8.1 pCi/L for the period of 1991–1996, with 

the exception of the spring of 1992, when concentrations as high as 43 pCi/L were observed (Strezov et 

al. 1999). Preliminary measurements taken in the vicinity of the nuclear submarine, the Kursk, which 

accidentally sank in the Barents Sea in August 2000, indicate that that no leakage of radionuclides from 

the reactor has occurred and only background levels of radioactive cesium (and other radionuclides) have 

been observed in water and sediment near the submarine (Amundsen et al. 2002). From 1988 to 1991, the 

mean concentrations of 137Cs and 134Cs along the Spanish coast of the Mediterranean Sea were 0.13 and 

0.0072 pCi/L, respectively (Molero et al. 1999). Due to its shorter half-life, 134Cs was detected in all 
CESIUM 143 

6. POTENTIAL FOR HUMAN EXPOSURE 

14 samples collected in 1988 and 1989, but only in 3 samples collected in 1990 and 1991, suggesting that 

the 134Cs levels observed in surface Mediterranean waters during this period were due mainly to 

Chernobyl-related deposition. The 137Cs concentration incorporated into the Mediterranean Sea near the 

Spanish coast from the post-Chernobyl fallout was about 0.032 pCi/L, which was approximately a 33% 

increase over previous levels (Molero et al. 1999). Maximum 137Cs and 134Cs 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 (Molero et al. 1999). Concentrations of 137Cs in lakes and streams in Devoke, United 

Kingdom decreased exponentially from a maximum concentration of about 8.1 pCi/L on May 6, 1986 to 

about 0.027 pCi/L 1,200 days later (Hilton et al. 1993). The mean concentration of 137Cs in six lakes 

located in central Finland ranged from 111 pCi/L in 1987 to 8.1 pCi/L in 1989 (Penttila et al. 1993). 

The concentration of 137Cs and 134Cs in groundwater at 18 U.S. Department of Energy (DOE) facilities 

was reported in the range of 2.7x10-3 to 1.83x103 pCi/L (DOE 1992). The concentration of 137Cs 

measured in groundwater wells at Carlsbad, New Mexico (the site of Project GNOME) ranged from 99 to 

6.8x105

 pCi/L in 1997 (EPA 1999c). The concentration of 137Cs in groundwater at the Chernobyl nuclear 

power plant was in the range of 40.5–1,100 pCi/L in 1988 and 29.7–129.7 pCi/L in 1989 (Prister et al. 

1990). The mean concentration of 137Cs in drinking water in Poland in 1974 was reported as 0.2 pCi/L 

(Glowiak et al. 1977b). These concentrations in water may be compared to the federal radiation safety 

standards. For continuous ingestion over a lifetime, the maximum concentrations of 134Cs and 137Cs in 

drinking water are limited to 900 and 1,000 pCi/L respectively; these limits assume no other intake of 

radioactivity. If other radioisotopes are ingested, then the intake limits for each must be adjusted 

proportionately (USNRC 1999a). 

6.4.3 Sediment and Soil 

Stable cesium occurs naturally in the earth's crust at low concentrations. Granites contain an average 

cesium concentration of about 1 ppm and sedimentary rocks contain about 4 ppm (Burt 1993). Others 

have estimated cesium concentration of granites as high as 5 ppm (WHO 1983). Stable cesium was 

detected in dust samples from roadside and pedestrian traffic in Nagpur, India at concentrations of 1.53– 

3.63 μg/g, with the largest value obtained in the vicinity of a metals factory (Chutke et al. 1995). 133Cs 

was detected at concentrations ranging from 0.9 to 2.2 μg/g in alluvial sediments in the Sava River, 

Croatia (Vertacnik et al. 1997). The concentration of 133Cs in river sediment from five distinct 

geochemical areas of the semi-arid endorheic region of the Famatina Range (La Rioja, Argentina) was 

2.28–6.20 μg/g (Fernandez-Turiel et al. 1995). 
CESIUM 144 

6. POTENTIAL FOR HUMAN EXPOSURE 

The concentration of 137Cs in soils of Thessaloniki, Greece ranged from 1,440 to 35,324 pCi/kg 

(average 8,154 pCi/kg) and the concentration of 134Cs 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 (Papastefanou et al. 1989). The concentration of 137Cs 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 (Owens et al. 1996). The concentration of 137Cs in five cultivated fields ranged 

from 0 to 540 pCi/kg, and the concentrations were well distributed from the surface to the plough layer 

(Owens et al. 1996). The concentration of 137Cs in three soils in Hong Kong receiving a large amount of 

rainfall ranged from 32 to 201 pCi/kg (Ruse and Peart 2000). The concentration of 137Cs in sediment 

from the Ribble Estuary, England near the British Nuclear Fuels Laboratory ranged from 270 to 

1,351 pCi/kg (Brown et al. 1999). The average concentration of 137Cs in sediment from Lake Ontario was 

reported as 8,108 pCi/kg, and suspended solids from the Niagara River contained 324 pCi/kg, measured 

during the 1983–1986 sampling period (Platford and Joshi 1989). The average concentrations of 137Cs in 

uncultivated soils in northern Poland were reported as 616–4,170 pCi/kg from 1988 to 1991 (Pietrzak-Flis 

et al. 1994). The mean concentration of 137Cs in surface soil samples from the Los Alamos nuclear 

laboratory test site during the period of 1974–1996 was reported as 611 pCi/kg (Fresquez et al. 1998). 

Concentrations of 137Cs around the perimeter of the site and background concentrations off the site were 

reported as 589 and 419 pCi/kg , respectively. The concentration of 137Cs and 134Cs in soils and sediments 

at 18 U.S. DOE facilities was reported to range from 20 to 4.69x107 pCi/kg (DOE 1992). The 

concentration of 137Cs in sediment from the Savannah River ranged from 5 to 100 pCi/kg in 1986, while 

the concentration in suspended solids and particulate matter ranged from 240 to 4.324x106

 pCi/kg (Olsen 

et al. 1989). The mean concentration of 137Cs in soil at the Hanford Site in the United States was 

4,540 pCi/kg (Landeen and Mitchell 1986). The mean concentration of 137Cs in soils taken from two 

high-elevation sites in northern Colorado ranged from 4,054 to 7,027 pCi/kg (Ulsh et al. 2000). 

The concentration of 137Cs in sediment near the nuclear submarine, the Kursk, which accidentally sank in 

the Barents Sea in August 2000, ranged from about 18.9 to 40.5 pCi/kg (Amundesen et al. 2002). These 

levels are considered typical background levels in the Barents Sea and are attributed to releases from the 

Sellafield reprocessing facility in the United Kingdom, Chernobyl related fallout, and deposition from 

past nuclear weapons tests. 
CESIUM 145 

6. POTENTIAL FOR HUMAN EXPOSURE 

6.4.4 Other Environmental Media 

Information on the concentrations of 137Cs, 134Cs, and 133Cs in various animals is shown in Table 6-2. 

Concentrations are dependent on the location, date, and level of exposure. For example, the 

concentrations of 137Cs in bullhead catfish inhabiting an abandoned nuclear reactor reservoir at the 

Savannah River site in South Carolina were as high as 1.54x105 pCi/kg (McCreedy et al. 1997), but 

concentrations in various freshwater species of fish in the Ottawa River were in the range of 54 to 

351 pCi/kg (Rowan et al. 1998). After the accident at the Chernobyl nuclear power plant, the average 

concentrations of 137Cs in perch, pike, and roach obtained from 52 freshwater lakes in Finland were 

55,811, 66,297, and 15,270 pCi/kg, respectively, in 1988. By contrast, the mean concentrations in 1992 

had fallen to 14,324, 18,567, and 5,892 pCi/kg, respectively (Sarkka et al. 1996). The concentration of 

total 137Cs and 134Cs measured in body tissue from sheep in Ireland from 1989 to 1991 ranged from about 

2,700 to 10,811 pCi/kg, with highest levels observed during November of 1989 (McGee et al. 1993). 

The concentrations of 133Cs in plants from Britain were studied over a 1-year period. Concentrations of 

50–300 ng/g were measured, with the highest levels observed during the summer and fall months. The 

median concentration of 133Cs in poplar leaves collected in Bulgaria was reported as 75 ng/g, while 

concentrations in land plants ranged from 30 to 440 ng/g (Djingova et al. 1995). In contrast to the 

radioactive isotopes of cesium, concentrations of stable 133Cs depend primarily on the root uptake from 

soil and not on atmospheric deposition. Lichens and mosses have been shown to trap and retain 137Cs and 

134Cs more than vascular plants due to their relatively large surface area. Lichens and mosses from 

northern Greece contained 137Cs levels of 6.6x104

–5.1x105 pCi/kg during the period of 1989–1991 

(Papastefanou et al. 1992) and moss samples from Finland collected in 1988–1989 contained 4.3x104

– 

9.7x105

 pCi/kg (Penttila et al. 1993). The mean concentration of 137Cs in three species of lichens 

collected in August 1986 from Megalopolis, Greece were 2.6x104

–3.3x104 pCi/kg, while the mean 

concentrations for the same three species of lichens collected in October 1996 had fallen to 3,324– 

7,892 pCi/kg (Riga-Karandinos and Karandinos 1998). Mushrooms, lichens, and mosses obtained near 

Manitoba, Canada in August 1986 contained 137Cs at mean concentrations of 6.4x105

, 8.6x104, and 

8.4x104

 pCi/kg, respectively (Mihok et al. 1989). Since caribou and reindeer consume large amounts of 

this vegetation during the winter months, elevated levels of 137Cs and 134Cs have been detected in these 

animals. 

Stable cesium has been detected infrequently in food products at low concentrations. The average 

concentration of stable 133Cs in 110 onion samples collected in Denmark was 0.21 μg/kg, with a range of 
CESIUM 146 

6. POTENTIAL FOR HUMAN EXPOSURE 

Table 6-2. Concentration of 133Cs, 134Cs, and 137Cs in Animals 

Species Location and date 133Cs (μg/g) 134Cs (Bq/kg) 137Cs (Bq/kg) Source 

Royal albatross Indian Ocean (1994) 0.009–0.025 No data No data Kim et al. 

(N=3) (0.014 mean); liver 1998 

Black-footed North Pacific (1985) 0.007–0.049 No data No data Kim et al. 

albatross (0.022 mean); liver 1998 

(N=18) 

Black-browed Indian Ocean (1994) 0.013–0.042 No data No data Kim et al. 

albatross (N=9) (0.022 mean); liver 1998 

White-capped Indian Ocean (1994) 0.011–0.039 No data No data Kim et al. 

albatross (N=3) (0.029 mean); liver 1998 

Yellow-nosed Indian Ocean (1994) 0.0029–0.079 No data No data Kim et al. 

albatross (N=4) (0.022 mean); liver 1998 

Grey-headed Indian Ocean (1994) 0.011–0.031 No data No data Kim et al. 

albatross (0.016 mean); liver 1998 

(N=10) 

Northern giant Indian Ocean (1994) 0.005–0.034 No data No data Kim et al. 

petrel (N=6) (0.015 mean); liver 1998 

Northern fulmar North Pacific (1985) 0.008–0.036 No data No data Kim et al. 

(N=17) (0.016 mean); liver 1998 

Bluefin tuna Newfoundland (1990) 0.08–0.24 No data No data Hellou et al. 

(N=14) (0.13 mean); 1992a 

muscle 

Cod (N=12) Newfoundland (1990) 0.16–0.24 No data No data Hellou et al. 

(0.19 mean); 1992b 

muscle 

Cod (N=10) Newfoundland (1990) 0.14–0.36 No data No data Hellou et al. 

(0.23 mean); 1992b 

muscle 

Pilot whale North Atlantic (1987– 0–0.010 No data No data Becker et al. 

(N=9) 1996) (0.006 mean); liver 1997 

White-sided North Atlantic (1987– 0.027–0.042 No data No data Becker et al. 

dolphin (N=4) 1996) (0.032 mean); liver 1997 

Beluga whale Arctic (1987–1996) 0.021–0.046 No data No data Becker et al. 

(N=15) (0.031 mean); liver 1997 

Ringed seal Arctic (1987–1996) 0.0045–0.048 No data No data Becker et al. 

(N=13) (0.020 mean); liver 1997 

Woodcock Ireland (1986) No data 3.9–206.4; 6.2–565.5; Pearce 1995 

(N=24) muscle muscle 

Duck (N=5) Ireland (1986) No data 2.2–14.3; 6.4–18.0; Pearce 1995 

muscle muscle 

Snipe (N=5) Ireland (1986–1987) No data 1.0–5.4; 3.6–16.9; Pearce 1995 

muscle muscle 

Reindeer (N=8) Northern Sweden No data No data 900 (mean); Ahman and 

(1986–1987) muscle Ahman 1994 

Deer (N=11) Los Alamos (1991– No data No data 2,516 (mean); Fresquez et 

1998) muscle al. 1999a 
CESIUM 147 

6. POTENTIAL FOR HUMAN EXPOSURE 

Table 6-2. Concentration of 133Cs, 134Cs, and 137Cs in Animals 

Species Location and date 133Cs (μg/g) 134Cs (Bq/kg) 137Cs (Bq/kg) Source 

Deer (N=11) Los Alamos (1991– 

1998) 

No data No data 888 (mean); 

bone 

Fresquez et 

al. 1999a 

Caribou (N=18) Saskatchewan 

(1995) 

No data No data 58 (mean); 

bone 

Thomas and 

Gates 1999 

Caribou (N=18) Saskatchewan 

(1995) 

No data No data 228 (mean); 

liver 

Thomas and 

Gates 1999 

Caribou (N=18) Saskatchewan 

(1995) 

No data No data 367 (mean); 

muscle 

Thomas and 

Gates 1999 

Caribou (N=18) Saskatchewan 

(1995) 

No data No data 553 (mean); 

kidney 

Thomas and 

Gates 1999 

Caribou (N=36) Alaska (1987) No data No data 26–232; neck Allaye-Chan 

et al. 1990 

Caribou (N=36) Alaska (1987) No data No data 28.4–201.1; 

shoulder 

Allaye-Chan 

et al. 1990 

Caribou (N=36) Alaska (1987) No data No data 30.2–166.5; 

back 

Allaye-Chan 

et al. 1990 
CESIUM 148 

6. POTENTIAL FOR HUMAN EXPOSURE 

not detected to 0.98 μg/kg (Bibak et al. 1998). By comparison, other elements such as calcium and 

potassium had mean concentrations of 2x105

 and 1.6x106 μg/kg, respectively. The concentration range of 

133Cs in wheat flour samples collected in Pakistan was 6.7–11.2 ppb, but 133Cs was not detected from 

wheat flour samples from America (Ahman et al. 1994). 

Levels of 137Cs were below detection limits for all foods analyzed for in the U.S. Food and Drug 

Administration (FDA) Total Diet Study in 1991–1996 with the exception of honey (Capar and 

Cunningham 2000). The concentration of 137Cs in honey from the 1995 Market Basket Survey was 

6.7 Bq/kg (181.1 pCi/kg), which is almost 200 times lower than the regulatory level of 137Cs in foods. 

The average concentrations of total 137Cs and 134Cs 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 (Abdul-Majid et al. 1992). For the month of June 1986, the average 

concentrations of total 137Cs and 134Cs 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 (Cumbria, 

north Wales, Scotland, northern Ireland, and the Isle of Man) (Mondon and Walters 1990). The 

concentration of total 137Cs and 134Cs was <676 pCi/kg in each of these food sources in areas of low 

deposition during this time frame. The maximum concentration of 137Cs in pasteurized milk from 

65 cities in the United States was 14 pCi/L in May 1989 (EPA 1989). The concentration of 137Cs in fresh 

milk from Chester, New York and pasteurized milk samples from New York City in May 1986 ranged 

from about 5.4 to 18.9 pCi/L (Feely et al. 1988). Using radiological surveys from 1978 and 1985–1986, 

the concentration of 137Cs in 44 adult food groups from the Rongelap Island and Rongelap Atoll was in 

the range of 0.52–13,000 pCi/kg (Robinson and Phillips 1989). 

6.5 GENERAL POPULATION AND OCCUPATIONAL EXPOSURE 

General population exposure to cesium occurs by ingestion of food and drinking water, by inhalation of 

ambient air, and dermal contact with cesium in soil. Since stable 133Cs is found in low concentrations in 

the environment, the exposure to the general population is also low. The National Health And Nutritional 

Examination Survey (NHANES), conducted by the Centers for Disease Control and Prevention (CDC), 

reported that the geometric mean concentration of 133Cs in the urine of 2,464 U.S. residents in various 

population groups was as follows: children aged 6–11 years, 4.87 μg/L; adolescents aged 12–19 years, 

4.54 μg/L; adults aged 20 or older, 4.26 μg/L (CDC 2003). Based upon gender, males had a higher 

geometric mean concentration (4.83 μg/L), as compared to females (3.94 μg/L). Occupational exposure 

to 133Cs occurs primarily through inhalation and dermal contact at workplaces where pollucite is mined or 
CESIUM 149 

6. POTENTIAL FOR HUMAN EXPOSURE 

cesium compounds are manufactured or used. The National Occupational Exposure Survey (NOES) 

conducted by the National Institute for Occupational Safety and Health (NIOSH) from 1981 to 1983 has 

estimated that 16,461 workers (4,276 of these were female) were potentially exposed to cesium and 

cesium compounds in the United States (NOES 1989). The NOES database does not contain information 

on the frequency, level, or duration of the exposure of workers to any of the chemicals listed therein. 

They are surveys that only provide estimates of workers potentially exposed to the chemicals. The 

median concentration of 133Cs in the lungs of metal workers in northern Sweden was 0.016 μg/g and was 

lower than the median concentration of 0.021 μg/g for a control group that was not occupationally 

exposed (Hewitt 1988). The range of 133Cs concentrations in lung tissue of coal miners from the United 

Kingdom was 0.07–0.91 μg/g (Hewitt 1988). 

Exposure to radioactive cesium is of greater concern from a health perspective than exposure to stable 

cesium. The primary source of radioactive cesium in the environment is due to fallout from past 

atmospheric nuclear weapons tests and the Chernobyl accident. Additional contributions from the normal 

operation of nuclear power plants and other nuclear facilities are small by comparison. Current exposure 

of the general U.S. population to 134Cs and 137Cs is expected to be low since atmospheric testing of 

nuclear weapons was discontinued in 1963 and Chernobyl-related fallout was low in the United States. 

As discussed in Appendix A, the average annual effective dose of ionizing radiation (including 134Cs and 

137Cs) to the U.S. population from anthropogenic sources is negligible in comparison to natural sources, 

especially radon and its decay products. 

The average daily intake (AVDI) of 137Cs and 134Cs was estimated for adult males residing in the Ukraine 

in 1994, based upon total diet samples. The mean intake of 137Cs was estimated as 109 pCi/day and the 

mean intake of 134Cs was estimated as 8.1 pCi/day (Shiraishi et al. 1997). Based on dietary patterns and 

the concentration of radiocesium in food sources, the total dietary intakes of 134Cs and 137Cs for typical 

adults residing in Croatia for the month of May 1986 were estimated as 2.8x104

 and 5.9x104 pCi, 

respectively (Lokobauer et al. 1988). The mean monthly levels of 137Cs in human muscle tissue in Graz, 

Austria were reported as 1,519 (July 1986 to June 1987), 1,049 (July 1987 to June 1988), 340.5 (July 

1988 to June 1989), and 202.7 pCi/kg (July 1989 to June 1990), with a maximum value of 9,584 pCi/kg 

observed in an individual during September 1986 (Rabitsch et al. 1991). The monthly averages for 134Cs 

were about half of those reported for 137Cs. By comparison, the maximum concentration of 137Cs in 

muscle tissue from Harwell, England in 1959 was reported as 224 pCi/kg, the mean concentration in 

muscle tissue from Massachusetts during January 1961 to June 1962 was 100 pCi/kg, and the mean 

concentration in human muscle tissue obtained from Japan during April to December 1963 was reported 
CESIUM 150 

6. POTENTIAL FOR HUMAN EXPOSURE 

as 119 pCi/kg (Rabitsch et al. 1991). The mean concentrations of 137Cs in the urinary excretion of Italians 

in northern Italy were 7.3 and 6.2 pCi/day in 1995 and 1996, respectively (Ropolo and Cesana 1997). 

These values were about two orders of magnitude less than values reported for measurements taken in 

1987. The mean concentration of 137Cs in brain, heart, liver, gonads, muscle, bone, and teeth were 0.440, 

1.860, 0.490, 2.440, 0.017, 0.106, and 0.23 pCi/g, respectively, for adult cadavers over 34 years of age in 

Poland during 1975 (Glowiak et al. 1977a). The mean body burdens of 137Cs for adults in Helsinki, 

Viitasaari, and Ammans, Finland from 1987 to 1994 are given in Table 6-3 (Rahola and Suomela 1998). 

Persons employed at nuclear power facilities and waste disposal sites are potentially exposed to higher 

levels of 137Cs and 134Cs than the is general population. The NOES conducted by NIOSH from 1981 to 

1983 estimated that 13,148 workers (1,294 of these were female) were potentially exposed to 134Cs and 

137Cs in the United States (NOES 1989). 

6.6 EXPOSURES OF CHILDREN 

This section focuses on exposures from conception to maturity at 18 years in humans. Differences from 

adults in susceptibility to hazardous substances are discussed in Section 3.7, Children’s Susceptibility. 

Children are not small adults. A child’s exposure may differ from an adult’s exposure in many ways. 

Children drink more fluids, eat more food, breathe more air per kilogram of body weight, and have a 

larger skin surface in proportion to their body volume. A child’s diet often differs from that of adults. 

The developing human’s source of nutrition changes with age: from placental nourishment to breast milk 

or formula to the diet of older children who eat more of certain types of foods than adults. A child’s 

behavior and lifestyle also influence exposure. Children crawl on the floor, put things in their mouths, 

sometimes eat inappropriate things (such as dirt or paint chips), and spend more time outdoors. Children 

also are closer to the ground, and they do not use the judgment of adults to avoid hazards (NRC 1993a). 

As for adults in the general population, exposures of children to cesium occur from normal ingestion of 

food and drinking water, inhaling air, and dermal contact with cesium in soil. No information on cesium 

levels in amniotic fluid, meconium, cord blood, or neonatal blood was available. 

Radioactive cesium was detected in several pasteurized milk and breast milk samples worldwide, and 

since children tend to consume large amounts of milk, this represents an important source of childhood 
CESIUM 151 

6. POTENTIAL FOR HUMAN EXPOSURE 

Table 6-3. The Mean Body Burdens of 137Cs for Adults in Finland 

from 1987 to 1994a 

Location Date Concentration (pCi/kg) 

Helsinki, Finland 1987 649 

1988 568 

1989 405 

1990 297 

1991 246 

1992 214 

1993 195 

1994 181 

Viitasaari, Finland 1987 3,514 

1988 1,946 

1989 1,595 

1990 1,081 

1991 838 

1992 676 

1993 649 

1994 514 

Ammans, Finland 1987 2,892 

1988 3,108 

1989 2,243 

1990 2,486 

1991 1,568 

1992 1,405 

1993 865 

1994 811 

a

Rahola and Suomela 1998 
CESIUM 152 

6. POTENTIAL FOR HUMAN EXPOSURE 

exposure. The maximum concentration of 137Cs in pasteurized milk from 65 cities in the United States 

was 14 pCi/L in May 1989 (EPA 1989). Concentrations of 137Cs in human milk samples from several 

U.S. cities from 1956 to 1961 were <20 pCi/L (Eaman 1986). The overall 137Cs concentrations in milk 

taken 7 days postpartum from 37 mothers in two Italian hospitals were 5.8–115 pCi/L (Eaman 1986). In 

a study of females from northern Sweden, 137Cs was detected in breast milk from 8 out of 12 mothers at 

concentrations of 7.3–178.4 pCi/kg (Johansson et al. 1998). The infants of these mothers who were 

breast-fed had whole-body levels of 137Cs in the range of 45.9–675.7 pCi/kg (Johansson et al. 1998). 

Based on dietary patterns and the concentration of radiocesium in food sources, the total dietary intakes of 

134Cs and 137Cs for children (10 years old) residing in Croatia for May–June 1986 were estimated as 

43,000 and 190,000 pCi, respectively (Lokobauer et al. 1988). For infants (1 year of age), it was 

estimated that the total intakes of 134Cs and 137Cs were 46,000 and 170,000 pCi, respectively (Lokobauer 

et al. 1988). The total intakes of 134Cs and 137Cs for adults during this same time period were estimated as 

40,000 and 84,000 pCi, respectively (Lokobauer et al. 1988). The higher intakes of 134Cs and 137Cs for 

infants and children were linked to a greater consumption of contaminated milk. 

The tendency of young children to ingest soil, either intentionally through pica or unintentionally through 

hand-to-mouth activity, is well documented. These behavioral traits can result in ingestion of cesium 

present in soil and dust. Soil ingestion may be a potentially important exposure pathway in areas that 

have historically had a great deal of 134Cs and 137Cs deposited onto soil surfaces from the accident at the 

Chernobyl nuclear power plant or fallout from weapons testing. Playing in contaminated soil could also 

lead to dermal and external exposure. Ingested cesium is adsorbed strongly to soils and may not be in 

bioavailable form. In a study in which 102 healthy volunteers were fed 134Cs-contaminated soil pellets, 

only about 1% of the original amount was absorbed and on average, about 60% of the intake was excreted 

within 48 hours (LeRoy et al. 1966). 

It is unlikely that children whose parents are employed at nuclear power generating plants and facilities 

that store or handle radioactive waste are exposed to 134Cs and 137Cs from parents’ clothing or items 

removed from the workplace because workers pass through exit monitors at nuclear power plants, and the 

extensive use of outerware that remains in the plant prevents these types of incidents. It is also unlikely 

that children are exposed to 133Cs from parents’ clothing or items that have been removed from the 

workplace if the parents are employed in the mining, milling, or processing of pollucite ore. Other home 

exposures are unlikely since household items or products used in crafts, hobbies, or cottage industries do 

not contain significant amounts of cesium. 
CESIUM 153 

6. POTENTIAL FOR HUMAN EXPOSURE 

6.7 POPULATIONS WITH POTENTIALLY HIGH EXPOSURES 

Few populations are likely to be exposed to high levels of 133Cs. Persons residing in the vicinity of 

pollucite mines and workers employed in the mining, milling, and production of cesium may be exposed 

to higher levels than the general population. 

Human exposure to 134Cs and 137Cs can be external, due to exposure from a radioactive cloud and 

contaminated environmental media after deposition, or internal, via inhalation and ingestion of 

contaminated food or drinking water. In both cases, populations residing near the source are exposed to 

potentially higher doses than populations far removed from the source. Humans residing near areas 

where nuclear weapon testing was previously conducted may have been exposed to higher doses of 

radiation from 134Cs and 137Cs, both internally and externally, than the general population. Populations 

residing in southern Utah and Nevada were exposed to radioactive cesium (and many other radionuclides) 

due to testing conducted at the Nevada Test Site (NTS). A total of 100 surface or near-surface tests with 

a total explosive yield of about 1 megaton were performed at the Nevada test site between 1951 and 1962. 

The dust from these tests also drifted over the continental United States, producing varying degrees of 

exposure for remote populations depending upon the meteorological conditions. For example, the 

greatest non-local fallout from one of the tests was received in New York State in 1953, some 2,000 miles 

away from the source, due to wet deposition (Agency for Toxic Substances Disease Registry 1999). 

About 500 underground tests were also performed at the NTS, but underground testing rarely leads to 

significant off-site contamination (Agency for Toxic Substances Disease Registry 1999). The EPA Office 

of Radiation and Indoor Air conducts off-site environmental monitoring around former U.S. nuclear test 

areas. The 1997 report concluded that the current exposure to populations around the NTS from 

radionuclides, including 137Cs and 134Cs, was negligible in comparison to background levels (EPA 1999c). 

Populations residing in the vicinity of nuclear power plants may also be exposed to higher levels of 134Cs 

and 137Cs than the general population due to airborne and liquid effluents from these plants. Persons 

employed in these facilities are also likely to be exposed to greater levels than the general population, 

particularly those employees who must handle radioactive waste material. However, despite the potential 

for exposure, increased body burdens of radioactive cesium have not been observed among the population 

of workers in nuclear facilities or among members of the off-site general public. 

Human populations that received a large amount of fallout from the Chernobyl nuclear accident were 

potentially exposed to high levels of radiocesium. These populations were primarily located in the 

Ukraine and northern Europe that received a great deal of rainfall in the weeks following the Chernobyl 
CESIUM 154 

6. POTENTIAL FOR HUMAN EXPOSURE 

accident. Not including the 30-km exclusionary zone, an area of approximately 2.4x104 km2 near the 

plant was contaminated with 137Cs at a deposition density >5.4x10-5 Ci/m2

 (UNSCEAR 1996). Within the 

exclusionary zone, the contamination density may have been a factor of about 100 greater in limited areas 

(UNSCEAR 1996). The Bryansk-Belarus region about 200 km northeast of the reactor had deposition 

densities as high as 1.3x10-4 Ci/m2

, and the Kaluga-Tula-Orel location approximately 500 km northeast of 

the reactor had deposition densities of about 1.6x10-5 Ci/m2

 (Agency for Toxic Substances Disease 

Registry 1999). While cesium is not considerably taken up by the roots of vascular plants, the deposition 

of radioactive debris on flora with large surface areas such as lichens or moss is significant (see 

Section 6.4.4). As a result, animals that feed on this vegetation such as caribou or reindeer may ingest 

large quantities of radiocesium. Nordic or Eskimo populations that use these animals as an important 

source for food are exposed to larger quantities of 137Cs and 134Cs than the general population (AllayeChan et al. 1990; WHO 1983). The average concentration of 137Cs in the skeletal muscle of a herd of 

caribou from Alaska was in the range of 76–133 Bq/kg in 1987 (Allaye-Chan et al. 1990). According to 

the National Council on Radiation Protection and Measurements, the maximum nonoccupational 

radiocesium intake is 300,666 Bq/year (8.1x106 pCi/year) for adults (NCRP 1977). At the maximum 

average skeletal muscle concentration (133 Bq/kg), an annual consumption of over 2,260 kg of caribou 

meat would be required to reach this limit (assuming no other intake sources). Using the mean 137Cs level 

of 900 Bq/kg in the muscle of reindeer obtained from northern Sweden in 1986–1987 (Ahman and 

Ahman 1994), over 330 kg of contaminated meat would have to be consumed to reach the maximum 

intake level. Populations residing in the Marshall Islands were exposed to higher levels of 137Cs than the 

general population due to nuclear weapons testing conducted by the United States from 1946 to 1958. 

Using radiological surveys from 1978 and 1985–1986, the AVDI of 137Cs due to food ingestion was 

estimated for seven age groups residing in the Rongelap Atoll (Robinson and Phillips 1989). The intakes 

in pCi/day were as follows: 0–3 months of age, 424; 4–8 months of age, 556; 9 months to 1.4 years of 

age 773; 1.5–3 years of age, 517; 4–11 years of age, 594; 12–17 years of age, 761; over 18 years of age, 

1,085 (Robinson and Phillips 1989). This corresponds to an annual intake of 3.96x105 pCi/year for adults 

over 18 years of age. 

6.8 ADEQUACY OF THE DATABASE 

Section 104(i)(5) of CERCLA, as amended, directs the Administrator of ATSDR (in consultation with the 

Administrator of EPA and agencies and programs of the Public Health Service) to assess whether 

adequate information on the health effects of cesium is available. Where adequate information is not 

available, ATSDR, in conjunction with the National Toxicology Program (NTP), is required to assure the 
CESIUM 155 

6. POTENTIAL FOR HUMAN EXPOSURE 

initiation of a program of research designed to determine the health effects (and techniques for developing 

methods to determine such health effects) of cesium. 

The following categories of possible data needs have been identified by a joint team of scientists from 

ATSDR, NTP, and EPA. They are defined as substance-specific informational needs that if met would 

reduce the uncertainties of human health assessment. This definition should not be interpreted to mean 

that all data needs discussed in this section must be filled. In the future, the identified data needs will be 

evaluated and prioritized, and a substance-specific research agenda will be proposed. 

6.8.1 Identification of Data Needs 

Physical and Chemical Properties. As shown in Table 4-2, the relevant physical and chemical 

properties of cesium and its compounds are known (Burt 1993; Lide 1998). In general, cesium 

compounds are very water soluble and primarily exist in ionic form in aqueous environments. Cesium 

adsorbs strongly to soils and is not very mobile (Korobova et al. 1998; Paasikallio 1999; Ruse and Peart 

2000; Takenaka et al. 1998). The radioactive decay modes of the two most important cesium isotopes, 

134Cs and 137Cs, are also well known (ICRP 1983), and no additional physical or chemical data are 

required to predict the environmental fate of cesium. 

Production, Import/Export, Use, Release, and Disposal. Knowledge of a chemical's 

production volume is important because it may indicate possible environmental contamination and human 

exposure. If a chemical's production volume is high, there is an increased probability of general 

population exposure via consumer products and environmental sources such as air, drinking water, and 

food. Data concerning production volumes, import, and use of commercially significant cesium 

compounds are not available. No information was found for cesium in the TRI. According to the 

Emergency Planning and Community Right-to-Know Act of 1986, 42 U.S.C. Section 11023, industries 

are required to submit chemical release and off-site transfer information to the EPA. This database will 

be updated yearly and should provide a list of industrial production facilities and emissions. The United 

States is 100% import reliant for stable 133Cs. No data are available on production volume, consumption, 

or import/export volumes of cesium. Although there is no information regarding the countries shipping 

cesium or cesium compounds to the United States, it is believed that Canada is the major source of 

cesium (USGS 1999). Data regarding the U.S. production (if any) of cesium and its compounds as well 

as import/export statistics would be useful. The amount of 134Cs and 137Cs released in airborne and liquid 

effluents from nuclear power plants in the United States is known (USNRC 1993). 
CESIUM 156 

6. POTENTIAL FOR HUMAN EXPOSURE 

Environmental Fate. Information is available to permit the assessment of the environmental fate and 

transport of cesium in air (Hirose et al. 1993; Rybacek et al. 1994), water (Burt 1993; WHO 1983), and 

sediment and soil (Korobova et al. 1998; Paasikallio 1999; Ruse and Peart 2000; Takenaka et al. 1998). 

Cesium compounds are water soluble, and only one oxidation state (+1) is observed under environmental 

conditions (Burt 1993). Cesium released to the atmosphere may be carried long distances before being 

deposited onto soil and water surfaces by wet and dry deposition (Hirose et al. 1993). Most of the cesium 

released to water will adsorb to suspended solids in the water column and ultimately be deposited in the 

sediment core. In soil surfaces, cesium is strongly adsorbed in the upper layers and generally has very 

low mobility (Korobova et al. 1998; Paasikallio 1999; Ruse and Peart 2000; Takenaka et al. 1998). This 

is particularly true for soils with high potassium content or soils rich in clay. The radioactive decay 

modes of the two most important cesium isotopes, 134Cs and 137Cs, have been described in Chapter 4 

(ICRP 1983). 

Bioavailability from Environmental Media. The bioavailability of cesium in environmental media 

is well understood and no data needs are identified at this time. For the most part, cesium is adsorbed 

strongly in the surface of most soils and is not readily bioavailable (Paasikallio 1999). In a study in 

which 102 healthy volunteers were fed 134Cs-contaminated soil pellets, only about 1% of the original 

intake was absorbed, and on average, about 60% of the original amount was excreted within 48 hours 

(LeRoy et al. 1966). In peaty or podzolic soils with low clay content, cesium is reversibly adsorbed to the 

organic fraction and is expected to be in bioavailable form (Sanchez et al. 1999). Cesium uptake in 

vascular plants has been demonstrated (Djingova et al. 1995; Willey and Martin 1995). Increasing the 

clay or potassium content results in lower uptake by plants (Shenber and Johanson 1992). It has also been 

shown that fish residing in waters with high concentrations of humic material and potassium, such as 

oceans, have lower whole-body cesium concentrations than fish in freshwater where the concentration of 

dissolved potassium is lower for the same cesium concentration in the water (WHO 1983). 

Food Chain Bioaccumulation. Cesium bioaccumulates in both aquatic and terrestrial food chains 

(Rowan et al. 1998; WHO 1983). Mean BCFs for 137Cs of 146, 124, and 63 were reported for fish, brown 

macroalgae, and molluscs, respectively (Fisher et al. 1999). Cesium accumulates in aquatic organisms 

from both food sources and from cesium dissolved in the water column or adsorbed to suspended solids 

and sediments. The lichen-caribou-human food chain is an important route of human exposure and has 

been well studied (Allaye-Chan et al. 1990; WHO 1983). No additional data are required to assess the 

potential for human exposure to cesium through food chain bioaccumulation. 
CESIUM 157 

6. POTENTIAL FOR HUMAN EXPOSURE 

Exposure Levels in Environmental Media. Stable cesium and radioactive cesium have been 

detected in air (Ajdacic and Martic 1990; Chiavarini et al. 1994; Dasch and Wolff 1989; Rybacek et al. 

1994; Todorovic et al. 1999), water (Asubiojo et al. 1997; DOE 1992; Fisher et al. 1999; Prister et al. 

1990; Strezov et al. 1999; WHO 1983), soil/sediment (Burt 1993; DOE 1992, 1998a; Ruse and Peart 

2000; WHO 1983), and food (Ahman et al. 1994; Bibak et al. 1998; Mondon and Walters 1990). Due to 

the large surface area of lichens and moss, they can collect a great deal of atmospheric nuclear fallout and 

often have high concentrations of 134Cs and 137Cs (Papastefanou et al. 1992; Penttila et al. 1993). Grazing 

animals such as reindeer and caribou that feed on large quantities of lichens or moss may potentially 

ingest large amounts of radioactive cesium, and this cesium may be transferred to humans who consume 

these animals as a meat source (Allaye-Chan et al. 1990; WHO 1983). Continued monitoring data on 

134Cs and 137Cs in environmental media are needed to increase knowledge of human exposure to 134Cs and 

137Cs. 

Exposure Levels in Humans. Monitoring data are available for the levels of 134Cs and 137Cs in 

human populations (Glowiak et al. 1977b; Lokobauer et al. 1988; Rabitsch et al. 1991; Rahola and 

Suomela 1998; Ropolo and Cesana 1997). Most of the current data are for areas of eastern Europe and 

Russia. Limited data are available regarding the levels of 133Cs in humans (Hewitt 1988). Stable cesium 

was detected in the urine of U.S. residents at geometric mean concentrations of about 4–5 μg/L depending 

upon age and gender (CDC 2003). More information regarding the background concentration of 133Cs in 

human populations would be useful, but given the ubiquitous distribution of cesium at low levels in the 

environment, background levels are unlikely to approach levels that would reflect cesium toxicity. Since 

the levels of radioactivity change over time, continued monitoring data on the levels of 134Cs and 137Cs in 

humans are needed to evaluate potential risks to human health at current exposure levels. 

Exposures of Children. Children, like adults, are not expected to be over exposed to 133Cs. Existing 

data show that children are exposed to 134Cs and 137Cs after major releases. These exposures are primarily 

related to dietary intake and the intake of contaminated milk (Lokobauer et al. 1988). Dietary 

consumption patterns suggest that the weight-adjusted intake of radioactive cesium for children may be 

greater than for adults following a nuclear release (Lokobauer et al. 1988). In a study of females from 

northern Sweden, 137Cs was detected in breast milk from 8 out of 12 mothers at concentrations of 7.3– 

178.4 pCi/kg (Johansson et al. 1998). The infants of these mothers who were being breast-fed had wholebody levels of 137Cs in the range of 45.9–675.7 pCi/kg (Johansson et al. 1998). Additional data regarding 

the transfer of 134Cs and 137Cs from breast milk and contaminated pasteurized milk samples to children, as 
CESIUM 158 

6. POTENTIAL FOR HUMAN EXPOSURE 

well as body burden studies on children, would be useful in assessing the potential risk that these 

radionuclides would pose following a major release. 

Child health data needs relating to susceptibility are discussed in Section 3.13.2, Identification of Data 

Needs: Children’s Susceptibility. 

Exposure Registries. Cesium is currently one of the chemicals for which a subregistry has been 

established in the National Exposure Registry. The information that is amassed in the National Exposure 

Registry facilitates the epidemiological research needed to assess adverse health outcomes that may be 

related to cesium exposure. 

6.8.2 Ongoing Studies 

The database of federal research programs in progress (FEDRIP 2002) indicates several current projects 

that may fill some existing data gaps and add to the current database of knowledge. Studies are in 

progress to identify methods for more effective removal of radioactive cesium from contaminated soils 

and wastes. Researchers at the Universitaet des Saarlandes, Saarbruecken (Germany) are seeking costeffective methods to remove gamma-emitting radionuclides, such as 137Cs and 134Cs, from radioactive 

waste commonly produced at nuclear power plants. Researchers at the Oak Ridge National Laboratory, 

Environmental Sciences Division are studying the environmental fate and behavior of selected 

radionuclides in terrestrial and aquatic environments. Dr. Michael Blaylock of Phytotech Incorporated is 

investigating the use of metal-accumulating plant species to extract and remove the radionuclides cesium 

and strontium from contaminated soils ("phytoextraction"). Rufus L. Chaney from the Beltsville 

Agricultural Research Center in Beltsville, Maryland is researching the feasibility of developing plants, 

soil, and plant management practices that can cost-effectively phytoextract radionuclides and heavy 

metals from contaminated soils. Dr. Heit from the U.S. DOE is conducting measurements regarding the 

fallout of nuclear debris from both atmospheric weapons tests and accidental atmospheric releases to 

determine the mechanisms of transport and deposition and to verify and correct fallout models. Work is 

being performed by Dr. Kinkead at the Los Alamos National Laboratory regarding the separation of 

cesium and strontium from high-level radioactive waste. Dr. Leon Kochian from the Agricultural 

Research Center in Ithaca, New York is investigating the bioaccumulation of 137Cs in plants grown in 

contaminated soils. 
CESIUM 159 

7. ANALYTICAL METHODS 

The purpose of this chapter is to describe the analytical methods that are available for detecting, 

measuring, and/or monitoring cesium, its metabolites, and other biomarkers of exposure and effect to 

cesium. The intent is not to provide an exhaustive list of analytical methods. Rather, the intention is to 

identify well-established methods that are used as the standard methods of analysis. Many of the 

analytical methods used for environmental samples are the methods approved by federal agencies and 

organizations such as EPA and the National Institute for Occupational Safety and Health (NIOSH). Other 

methods presented in this chapter are those that are approved by groups such as the Association of 

Official Analytical Chemists (AOAC) and the American Public Health Association (APHA). 

Additionally, analytical methods are included that modify previously used methods to obtain lower 

detection limits and/or to improve accuracy and precision. 

7.1 BIOLOGICAL MATERIALS 

Entry of cesium and its radioisotopes into the human body occurs by ingestion, inhalation, or penetration 

through skin (IAEA 1988; NCRP 1977, 1985). The amounts of cesium in the body can be assessed by 

bioassay (in vivo and in vitro) measurements. In vivo measurements are made with whole-body counters. 

In vivo measurement techniques are commonly used to measure body burdens of cesium radioisotopes, 

but can not be used to measure the body content of the stable isotope of cesium. In vitro measurements 

provide an indirect estimate of internally deposited cesium (both the stable and radioactive isotopes), by 

techniques that measure cesium in body fluids, feces, or other human samples (Gautier 1983). Examples 

of these analytical techniques are given in NCRP Report No. 87 (1987) and are also listed in Table 7-1 for 

stable cesium and Table 7-2 for radioactive cesium. 

7.1.1 In Vivo Cesium Measurements 

In vivo measurement techniques are the most direct and widely used approach for assessing the burden of 

cesium radioisotopes in the body. The in vivo measurement of these radioisotopes within the body is 

performed with various radiation detectors and associated electronic devices that are collectively known 

as whole-body counters. These radiation detectors usually employ sodium iodide (NaI), hyperpure 

germanium, or organic liquid scintillation detectors to measure the 605 (98%) and 796 keV (85%) gamma 
CESIUM 160 

7. ANALYTICAL METHODS 

Table 7-1. Analytical Methods for Determining Cesium in Biological Samples 

Sample Analytical Sample Percent 

matrix Preparation method method detection limit recovery Reference 

Urine Sample dried, ashed, and INAA 1x10-5 μg/g No data Oughton and Day 

irradiated 1993 

Soft tissue Sample ashed and then Flame 0.005 μg/g 96–99% Feldman and 

concentrated by precipitation photometry Rains 1964 

with AMP, extracted with 

sodium phenylboron 

Feces Sample dried, ashed, and INAA 1x10-5 μg/g No data Oughton and Day 

irradiated 1993 

AMP = ammonium molybdophosphate; INAA = instrument neutron activated analysis 
CESIUM 161 

7. ANALYTICAL METHODS 

Table 7-2. Analytical Methods for Determining Radiocesium in Biological 

Samples 

Sample Analytical Sample Percent 

matrix Preparation method method detection limit recovery Reference 

Urine Sample is acidified and γ-spectrometry 6 pCi/L 98% Boni 1966 

concentrated on a KCFC with Nal detector 

column 

Urine Sample transferred to γ-spectrometry 100 pCi/L 98% Gautier 1983 

Marinelli beaker and counted with Nal detector 

Urine Sample transferred to γ-spectrometry 2 pCi/L No data Cahill and 

Marinelli beaker and counted with Nal(Tl) Wheeler 1968 

detector 

Soft Sample wet-ashed γ-spectrometry No data No data Baratta et al. 

tissue 1969 

Soft Sample directly counted in γ-spectrometry 5 pCi/g No data Rabon and 

tissue detector Johnson 1973 

Soft Sample digested in acid, β-counter 0.1 pCi/g 40–85% Nevissi 1992 

tissue oxidized with HClO4, 

concentrated by precipitated 

with AMP, purified by resin 

column, precipitated with 

hexachloroplatinic acid 

Feces Sample directly counted in γ-spectrometry 0.14 nCi/L No data Lipsztein et al. 

detector with Nal detector 1991 

Human Sample directly counted in γ-spectrometry 0.001 pCi/L No data Risica et al. 

milk detector with Nal detector 1994 

KCFC = potassium cobalt ferrocyanide 
CESIUM 162 

7. ANALYTICAL METHODS 

rays from the decay of 134Cs, and 662 keV (89.9%) gamma rays that are emitted from the decay of 137Cs 

(Palmer et al. 1976). 134Cs and 137Cs distribute uniformly in muscle and soft tissue of the body. The 

photons emitted by 134Cs and 137Cs are easily detected and quantitated using whole-body counting 

techniques (NCRP 1987; Palmer et al. 1976; Sun et al. 1997). Many configurations of the whole-body 

counter and scanning methods have been utilized, ranging from unshielded single-crystal field detectors 

to shielded, multi-detector scanning detectors (IAEA 1962, 1970, 1972, 1976, 1985; NCRP 1987; Palmer 

et al. 1976). Where appropriate, shielding of the room that houses the whole-body counter and/or the 

detector is often used to increase the detection sensitivity of the equipment by minimizing background 

radiation. Additionally, care must be exercised to ensure that external contamination with radioactive 

cesium or other gamma-emitting radioisotopes are not present on the clothing or skin of the individual to 

be scanned. In vitro measurements of cesium (see Section 7.1.2) are used in conjunction with wholebody counting when monitoring individuals working with cesium, especially in conjunction with the 

assessment of individuals who have experienced accidental exposures to cesium (Bhat et al. 1973). 

Whole-body counters are calibrated using tissue-equivalent phantoms. These phantoms are constructed to 

mimic the shape and density of the anatomical structure using tissue-equivalent materials such as waterfilled canisters or masonite (Barnaby and Smith 1971; Bhat et al. 1973; Sun et al. 1997). For example, 

the bottle mannequin absorber (BOMAB) consists of a series of water-filled polyethylene canisters 

constructed into seated or reclined human forms (Sun et al. 1997). Cesium standards are measured either 

as point sources along the phantom or dissolved within the water-filled canisters. Comparisons of the 

actual counts obtained from the phantom to the known activity of the cesium standards are used to 

determine the efficiency of the counting technique and, thus, to provide the basis for calibrating the 

counting system. 

Assessment of short- and long-term retention of cesium radioisotopes takes into account the turnover rate 

for cesium within the human body. Although the physical half-life of 137Cs is 30 years, the biological and 

effective half-life of cesium inside the body is approximately 110 days (NCRP 1987; Rundo and Newton 

1964). This relatively high turnover rate for cesium in the body is due to the high solubility of cesium in 

body fluids that allows for the rapid uptake (e.g., absorption of ingested cesium through the gut) and 

elimination of cesium into and from the body (e.g., excreted through urine) (NCRP 1987). For acute and 

chronic exposures to cesium, the estimates of cesium retention are determined from direct, whole-body 

measurements. Models for cesium in the human body have been developed for estimating the short- and 

long-term retention of cesium based on whole-body measurement techniques (ICRP 1979, 1989, 1993; 

NCRP 1987; Sun et al. 1997). 
CESIUM 163 

7. ANALYTICAL METHODS 

7.1.2 In Vitro Cesium Measurements 

In vitro analyses of cesium are routinely performed in support of an in vivo monitoring program or in 

situations where direct in vivo measurements can not be obtained. Urinalysis is the preferred sample for 

in vitro analyses of cesium, although other sample types, such as feces, tissue, bone, or blood, can also be 

analyzed. Urinalysis is an optimum method for assessing the clearance of soluble cesium. Fecal analysis 

is used to assess the clearance of ingested, insoluble cesium (Baratta et al. 1969; Gautier 1983; Ide and 

McInroy 1975; NCRP 1987). 

The in vitro analysis of the stable isotope of cesium, 133Cs, in human samples (e.g., urine, tissue, feces) is 

performed by a number of methods that have the selectivity and sensitivity to measure cesium in 

biological matrices. These methods include spectrophotometry, instrumental neutron activation analysis 

(INAA), and inductively coupled plasma mass spectrometry (ICP-MS) (Dreizen et al. 1970; Iyengar and 

Woittiez 1988; Paschal et al. 1996). Of these methods, the INAA and ICP-MS methods offer the greatest 

detection sensitivity and are the preferred method of analysis for cesium in human samples (Iyengar and 

Woittiez 1988). 

For the in vitro analysis of the cesium radioisotopes 134Cs and 137Cs in human samples, a number of 

analytical methods can be used to measure the cesium radioisotopes directly in the samples without 

requiring an extensive sample preparation procedure. In the radiochemical analysis of cesium in urine, a 

24-hour urine collection (approximately 2 L) is obtained, followed by the transfer of a 1 L aliquot to a 

Marinelli beaker for counting in a gamma-ray spectrometer (Gautier 1983). This simple procedure offers 

high recoveries of cesium (98%) and the minimum detection sensitivity (100 pCi/L) that is required to 

evaluate individuals for exposures to radioactive cesium (Gautier 1983). Similar methods are also used 

for the analysis of cesium radioisotopes in tissues, feces, and blood (Table 7-1). Mass spectrometry 

techniques have also been employed to measure cesium radioisotopes in human samples. 

Accuracy of in vivo and in vitro measurements of cesium is determined through the use of standard, 

certified solutions or radioactive sources with known concentrations or activities of cesium. National 

Institute of Standards and Technology (NIST) traceable standards for 133Cs can be obtained through a 

number of commercial sources. The primary source of certified cesium radioisotope standards is the 

NIST. Gamma-ray point sources for 137Cs (standard reference material [SRM] 4200, 60,000 Bq [1.6 μCi] 
CESIUM 164 

7. ANALYTICAL METHODS 

and SRM 4207, 300,000 Bq [8 μCi]) and standard solutions of 137Cs (SRM 4233, 600,000 Bq/g 

[16 μCi/g]) are available from NIST. 

7.2 ENVIRONMENTAL SAMPLES 

Two common approaches are available for measuring cesium radioisotopes in the environment. Cesium 

radioisotopes can either be measured directly in the field (in situ) using portable survey instruments, or 

samples can be procured from the field and returned to the laboratory for quantitation of cesium. 

However, quantitation of the stable cesium isotope in environmental samples is generally conducted in 

the laboratory. 

7.2.1 Field Measurements of Cesium 

In situ measurement techniques are useful for the rapid characterization of radionuclide contamination in 

the environment, such as soils, sediments, and vegetation, and for monitoring personnel for exposure to 

radionuclides. The measurement of gamma ray-emitting radionuclides such as 134Cs and 137Cs in the 

environment is conducted with portable survey instruments such as Gieger-Mueller detectors, sodium 

iodide scintillation detectors, and gamma-ray spectrometers. The use of gamma-spectrometers in field 

survey equipment is preferred for measuring cesium in the field because of its energy selectivity and 

detection sensitivity. The relatively high energy and penetrance of the gamma ray that is emitted during 

the decay of 134Cs and 137Cs provide an advantage for assessing the level of cesium. These gamma-ray 

spectrometers are equipped with a high purity germanium detector that is able to separate the 602, 662, 

and 796 keV gamma rays emitted from 134Cs and 137Cs from the gamma rays emitted from other radionuclides; for example, 40K (USNRC 1997). Minimum detectable activities (MDAs) of 0.005 Bq/g for 

137Cs are routinely achieved using p-type germanium gamma spectrometers with 10-minute counting 

times (USNRC 1997). Computational methods have been derived to aid in determining the 

concentrations and distributions of 134Cs and 137Cs in different soil types and depths (Fülöp and Ragan 

1997; Hillmann et al. 1996; USNRC 1997). The concentrations and distributions of 134Cs and 137Cs that 

have been derived from the computational analysis of the survey data are often verified by laboratorybased analyses of soil samples procured from the survey area. 
CESIUM 165 

7. ANALYTICAL METHODS 

7.2.2 Laboratory Analysis of Environmental Samples 

Analytical methods for measuring cesium and cesium radioisotopes in environmental samples (e.g. air, 

water, soil, and biota) are summarized in Tables 7-3 (133Cs) and 7-4 (134Cs, 137Cs). The methods that are 

commonly used in the analysis of 133Cs are based on instrumental analytical techniques such as spectrophotometry, instrumental neutron activation analysis, and mass spectrometry. The analysis of 134Cs and 

137Cs can be determined either as total mass or total activity, depending on the analytical technique that is 

used. Typically, radiochemical methods of analysis employing gamma spectrometry techniques are used 

to quantitate 134Cs and 137Cs in environmental samples. However, spectrophotometric and mass spectrometry techniques have been used to determine the total mass of 134Cs and 137Cs in samples. Using the 

specific activity of 137Cs (89 μCi/μg), it can be deduced that a sample with activity of 1 μCi of 137Cs 

contains roughly 0.011 μg of 137Cs. 

The analysis of cesium in air is based on the measurement of cesium in aerosols or particles that become 

trapped on cellulose or glass fiber filters after a measured amount of air is pulled through the filters. For 

the analysis for 133Cs, the filter is solvent extracted and the extracted metals are analyzed by INAA (Gone 

et al. 2000). Analysis of 134Cs and 137Cs can be performed directly from the filter, or by following some 

sample preparation (e.g., ashing or solvent extraction), using gamma spectrometry (Kanapilly et al. 1983; 

Kolb 1971; Krieger et al. 1976). 

For the analysis of cesium in water, a broad array of sample preparation and detection methodologies are 

available (see Tables 7-3 and 7-4). Different standardized methods that can directly measure cesium or 

its radioactive isotopes within a water sample using INAA or radiochemical techniques with minimal 

sample preparation and good detection sensitivities (10–20 pCi/L), precision (4–9%), and bias (-5–1%) 

(ASTM 1999; EPA 1980). Other methods are available that preconcentrate cesium from natural or 

potable waters when interfering impurities are present or the activity of the cesium radioisotopes are too 

low (<30 pCi/L) for quantitation by gamma spectrometry (APHA 1998; Frigieri et al. 1980). This 

preconcentration of cesium can be achieved either through precipitation with molybdate compounds, for 

example, or through chromatographic techniques using columns packed with resins that specifically bind 

cesium (EPA 1980; Frigieri et al. 1980; Gaur 1996; Petrow and Levine 1967). 

The quantity of cesium and its radioisotopes in soil, sediments, vegetation, and biota is determined using 

detection methods similar to those described above (Tables 7-3 and 7-4). Analysis of the stable cesium 

isotope by INAA and ICP-MS requires either digesting the sample in acid or ashing the sample before 
CESIUM 166 

7. ANALYTICAL METHODS 

Table 7-3. Analytical Methods for Determining Cesium in Environmental Samples 

Sample Analytical Sample Percent 

matrix Preparation method method detection limit recovery Reference 

Water 

River water 

River water 

Lake water 

Sea water 

Sea water 

Mineral and 

thermal 

waters 

Groundwater 

Groundwater 

Soil 

Soil 

Soil 

Sediment 

Silicate rock 

Sample is purified by 

passage through 

Dowex 50-X8 resin, 

concentrated with 

NCFC column 

Sample concentrated 

by precipitation with 

AMP, purified by 

extraction with sodium 

tetraphenylboron 

Sample is purified by 

passage through 

Dowex 50-X8 resin, 

concentrated with 

NCFC column 

Filtered samples were 

irradiated 

Sample was 

precipitated with 

sodium tetraphenylborate, and the 

precipitate was 

neutron irradiated 

Sample precipitated 

with AMP, purified by 

extraction with sodium 

tetraphenyl-boron 

Direct aspiration of 

sample into graphite 

furnace 

Sample purified by 

ultracentrifugation 

Sample purified by 

ultracentrifugation 

Sample was preashed, digested with 

acid 

Sample was dried, 

ground, and irradiated 

Sample digested with 

acid 

Sample was dried and 

irradiated 

Sample digested in 

HF/H2SO4 

Electrothermal-AA 1 μg/L 

Flame photometry 0.010 μg/L 

Electrothermal-AA 1 μg/L 

INAA 0.010 μg/L 

INAA 0.008 μg/L 

Flame photometry 0.010 μg/L 

Graphite furnace- 0.00185 μg/L 

AA 

ICP-MS 0.010 μg/L 

ICP-AES 0.010 μg/L 

Electrothermal-AA 0.09 mg/g 

INAA 0.003 ng/g 

ICP-MS 0.011 μg/g 

INAA 0.010 μg/g 

Graphite furnace- 0.05 μg/L 

AA 

99% at 10– 

100 μg/L 

94.5% 

99% at 10– 

100 μg/L 

90% 

92% 

94.5% 

92.3– 

100.9% 

No data 

No data 

80–85% 

No data 

95% 

90% 

76% 

Frigieri et al. 

1980 

Feldman and 

Rains 1964 

Frigieri et al. 

1980 

Hakonson and 

Whicker 1975 

Taskaev 1987 

Feldman and 

Rains 1964 

Bermejo-Barrera 

et al. 1989 

Probst et al. 

1995 

Probst et al. 

1995 

Anderson et al. 

1996 

Oughton and 

Day 1993 

Robb et al. 1995 

Hakonson and 

Whicker 1975 

Grobenski et al. 

1983 
CESIUM 167 

7. ANALYTICAL METHODS 

Table 7-3. Analytical Methods for Determining Cesium in Environmental Samples 

Sample Analytical Sample Percent 

matrix Preparation method method detection limit recovery Reference 

Vegetation Sample ashed and INAA 1x10-5 μg/g No data Oughton and 

irradiated Day 1993 

Vegetation Sample prepared by ICP-MS 2x10-5 μg/g 95–105% Dombovári et al. 

microwave digestion 2000 

AA = atomic absorption; AMP = ammonium molybdophosphate; ICP-AES = inductively coupled plasma-atomic 

emission spectrometry; ICP-MS = inductively coupled plasma-mass spectrometry; INAA = instrumental neutron 

activation analysis; NCFC = ammonium hexacyanocobalt ferrate 
CESIUM 168 

7. ANALYTICAL METHODS 

Table 7-4. Analytical Methods for Determining Radiocesium in Environmental 

Samples 

Sample Sample Percent 

matrix Preparation method Analytical method detection limit recovery Reference 

Air (occup- Sample filter was Scintillation counter No data 95% Kanapilly et al. 

ational) solvent extracted with NaI detector 1983 

Air Sample filter digested in γ-spectrometry with 0.01 fCi/m3 80% Krieger et al. 

(ambient) acid, cesium precipitated Ge/Li detector 1976 

with chloroplatinate 

Drinking Direct count of sample γ-spectrometry with 10 pCi/L No data EPA 1980 

water Ge/Li detector 

Drinking Direct count of sample γ-spectrometry with <2 pCi/L 92–100% APHA 1998 

water Ge detector 

Fresh water Sample concentrated γ-spectrometry with 3 pCi/L 99% Boni 1966 

with Dowex 1x8/KCFC NaI detector 

mixed ion exchange 

column 

River water Sample precipitated with Scintillation counter <7 fCi/L 99% Kahn et al. 1957 

AMP, concentrated with with NaI detector 

Dowex-50 cation 

exchange column 

River water Sample concentrated on γ-spectrometry with 2 pCi/L (50 L 97% Luetzelschwab 

Dowex 50W-X8 column Ge(Li) detector sample) 1976 

Lake water Sample concentrated on γ-spectrometry with No data 97% Eyman and 

ACFC column NaI(Tl) detector Kevern 1975 

Water and Direct count of sample γ-spectrometry with <2 pCi/L 92–100% ASTM 1999 

waste water Ge/Li detector at 2– 

94 pCi/L 

Sea water Sample purified by γ-spectrometry with 0.07 pCi/L 98% Boni 1966 

passage through NaI detector 

chelating resin, 

concentrated with KCFC 

ion exchange column 

Soil Sample dried and γ-spectrometry with 0.05 pCi/g No data Arnalds et al. 

crushed Ge(Li) detector 1989 

Soil Sample mixed with 5% GDMS 0.2 pg/g No data Betti et al. 1996 

Ag and compressed into 

disc 

Sediment Sample extracted with γ-spectrometry with No data 96% Eyman and 

acid, concentrated by Ge(Li) detector Kevern 1975 

precipitation with AMP, 

solvent extracted with 

sodium tetraphenylboron 
CESIUM 169 

7. ANALYTICAL METHODS 

Table 7-4. Analytical Methods for Determining Radiocesium in Environmental 

Samples 

Sample Sample Percent 

matrix Preparation method Analytical method detection limit recovery Reference 

Biota Sample ashed, oxidized β-counter 0.1 pCi/g No data Nevissi 1992 

with HClO4, 

concentrated by 

precipitation with AMP, 

puriifed by resin column, 

precipitated with hexachloroplatinic acid 

ACFC = ammonium hexacyanocobalt ferrate; AMP=ammonium molybdophosphate; ICP-MS = inductively coupled 

plasma-mass spectrometry; KCFC = potassium cobalt ferrocyanide; GDMS = glow discharge mass spectrometry 
CESIUM 170 

7. ANALYTICAL METHODS 

analysis. In some cases where interfering compounds or materials may be present, additional sample 

concentration or purification may be required. For the radioisotopes of cesium, direct detection of 134Cs 

and 137Cs within the neat sample can be performed using gamma spectrometry detection methods. 

The detection limits, accuracy, and precision of any analytical methodology are important parameters in 

determining the appropriateness of a method to quantitate a specific analyte at the desired level of 

sensitivity within a particular matrix. The MDA refers to the intrinsic detection capability of a 

measurement procedure (sampling through data reduction and reporting) (USNRC 1984). Several factors 

influence the MDA, including background count rates, size or concentration of sample, detector 

sensitivity, recovery of desired analyte during sample isolation and purification, level of interfering 

contaminants, and particularly, counting time. Because of these variables, the MDAs may vary between 

laboratories using the same or similar measurement procedures. 

The accuracy of a measurement technique in determining the quantity of a particular analyte in 

environmental samples is dependent on the reliability of the calibrating technique. Thus, the availability 

of standard, certified radiation sources with known concentrations of cesium and its radioisotopes is 

required in order to insure the reliability of the calibration methods and accuracy of cesium measurements 

in environmental samples. NIST traceable standards for 133Cs can be obtained through a number of 

commercial sources. The primary source of certified cesium radioisotope standards is the NIST. 

Gamma-ray point sources for 137Cs (SRM 4200, 60,000 Bq [1.6 μCi] and SRM 4207, 300,000 Bq [8 μCi]) 

and standard solutions of 137Cs (SRM 4233, 600,000 Bq/g [16 μCi/g]) are available from NIST. SRMs 

are also available containing the stable (SRM 1944 [sediment], SRM 2710 and 2711 [soil]) and 

radioactive isotopes of cesium (SRM 4350 [sediment] and SRM 4357 [sediment]). 

7.3 ADEQUACY OF THE DATABASE 

Section 104(i)(5) of CERCLA, as amended, directs the Administrator of ATSDR (in consultation with the 

Administrator of EPA and agencies and programs of the Public Health Service) to assess whether 

adequate information on the health effects of cesium is available. Where adequate information is not 

available, ATSDR, in conjunction with the National Toxicology Program (NTP), is required to assure the 

initiation of a program of research designed to determine the health effects (and techniques for developing 

methods to determine such health effects) of cesium. 
CESIUM 171 

7. ANALYTICAL METHODS 

The following categories of possible data needs have been identified by a joint team of scientists from 

ATSDR, NTP, and EPA. They are defined as substance-specific informational needs that if met would 

reduce the uncertainties of human health assessment. This definition should not be interpreted to mean 

that all data needs discussed in this section must be filled. In the future, the identified data needs will be 

evaluated and prioritized, and a substance-specific research agenda will be proposed. 

7.3.1 Identification of Data Needs 

Methods for Determining Biomarkers of Exposure and Effect. Analytical methods with 

satisfactory sensitivity and precision are available to determine the levels of cesium and its radioisotopes 

in human tissues and body fluids. 

Methods for Determining Parent Compounds and Degradation Products in Environmental 

Media. Analytical methods with the required sensitivity and accuracy are available for measuring 

cesium, both total and isotopic, in environmental matrices (Tables 7-2 and 7-4). Knowledge of the levels 

of cesium in various environmental media, along with appropriate modeling (see Chapters 4 and 6), can 

be used to evaluate potential human exposures through inhalation and ingestion pathways. 

Whether in the environment or in the human body, cesium radioisotopes will undergo radioactive decay 

to nonradioactive isotopes (see Chapter 4). Current analytical methods, such as mass spectrometry, have 

the necessary resolution and sensitivity to detect and quantitate these decay products. 

7.3.2 Ongoing Studies 

Current research trends in the quantitation of cesium and its radioisotopes are focused on improving the 

selectivity and detection sensitivity of cesium in biological and environmental samples. Mass spectrometry approaches, such as double focusing sector field inductively coupled mass spectrometry or time-offlight selected ion monitoring systems, are being developed further to provide the required selectivity and 

sensitivity to rapidly measure cesium in the presence of other trace metals in complex environmental 

samples. Cesium-selective electrodes are being developed into a highly-selective, rapid detection 

technique for measuring cesium in environmental samples and waste streams. Current efforts are focused 

on the development of electrode membranes that contain cesium binding agents, such as crown ether 

derivatives. New cesium-selective resins, for example lanthanum-based resins or montmorillonite clays, 

are being developed and tested for selectivity and recovery of cesium. 
CESIUM 172 

7. ANALYTICAL METHODS 

The database of federal research programs in progress (FEDRIP 2002) indicates several current projects 

that may fill some existing data gaps and add to the current database of knowledge. W.H. Aberth from 

Antek Incorporated, located in Palo Alto, California is attempting to increase the sensitivity to which 

cesium can be analyzed in human tissue through the use of a cluster ion gun in liquid dynamic secondary 

ion mass spectrometry (SIMS). 
CESIUM 173 

8. REGULATIONS AND ADVISORIES 

The international, national, and state regulations and guidelines regarding stable cesium in air, water, and 

other media are summarized in Table 8-1. The regulations regarding radioactive cesium are summarized 

in Table 8-2. 

No MRLs were derived for inhalation or oral exposure to stable or radioactive cesium. Two MRLs, 

derived by the Agency for Toxic Substances and Disease Registry (1999) for external exposure to 

ionizing radiation, are applicable to external exposure to radioisotopes of cesium. An MRL of 400 mrem 

(4.0 mSv) was derived for acute-duration external exposure (14 days or less), based on cognitive learning 

deficit in children who had been exposed to ionizing radiation at critical stages of fetal development 

(gestation weeks 8–15) during the atomic bombing of Hiroshima and Nagasaki (Schull et al. 1988). An 

MRL of 100 mrem/year (1.0 mSv/year) above background was derived for chronic-duration external 

exposure (365 days or more), based on the BEIR V (1990) report that the average annual effective 

ionizing radiation dose to the U.S. population is 360 mrem/year (3.6 mSv/year), a dose not expected to 

produce adverse health effects. 

The EPA has not derived reference concentrations (RfCs) or reference doses (RfDs) for stable or 

radioactive cesium (IRIS 2002). The IRIS database does not provide cancer assessments for radioisotopes of cesium. This function is the responsibility of the EPA Office of Radiation and Indoor Air 

(ORIA). All radionuclides, including radioisotopes of cesium, are classified as known human (Group A) 

carcinogens. This classification is based on results of epidemiological studies of Japanese atomic bomb 

survivors, underground uranium miners, radium dial painters, and patients subjected to a variety of 

radiation treatments, as well as results of laboratory animal research and mammalian tissue culture 

studies. ORIA has published cancer slope factors (mortality and morbidity cancer risk estimates) for all 

known radionuclides, by various exposure routes (inhalation, drinking water ingestion, food ingestion, 

soil ingestion, immersion in a cloud, and external exposure from contaminated soil) for five age groups 

and 14 radiogenic cancer sites (EPA 2000). Slope factors for 137Cs and 134Cs are listed in Table 8-2. 
CESIUM	 174 

8. REGULATIONS AND ADVISORIES 

Table 8-1. Regulations and Guidelines Applicable to Cesium 

Agency Description Information Reference 

INTERNATIONAL 

Guidelines: 

IARC No data IARC 2000 

NATIONAL 

Regulations and 

Guidelines: 

a. Air 

ACGIH TLV (8-hour TWA for a 40-hour ACGIH 2000, 2001 

workweek) 

Cesium hydroxide (based on upper 2 mg/m3 

respiratory tract, skin, and eye 

irritation) 

EPA No data 

NIOSH REL (10-hour TWA for a 40-hour NIOSH 1992, 2000 

workweek

Cesium hydroxide (based on skin, 2 mg/m3 

eye, and respiratory irritation) 

OSHA No data 

b. Water No data 

c. Food No data 

d. Other No data 

STATE No data 

ACGIH = American Conference of Governmental Industrial Hygienists; EPA = Environmental Protection Agency; 

IARC = International Agency for Research on Cancer; NIOSH = National Institute for Occupational Safety and 

Health; OSHA = Occupational Safety and Health Administration; REL = recommended exposure limit;
 

TLV = threshold limit value; TWA = time weighted average
 
CESIUM	 175 

8. REGULATIONS AND ADVISORIES 

Table 8-2. Regulations and Guidelines Applicable to Radioactive Cesium 

Agency Description Information Reference 

INTERNATIONAL 

Guidelines: 

IARC No data IARC 2000 

NATIONAL 

Regulations and Guidelines: 

a. Air 

ACGIH No data ACGIH 2000 

EPA Detection limits for man-made beta particle and 10 pCi/L EPA 1999a 

photon emitters 40 CFR 141.25 

NIOSH No data NIOSH 2000 

 NRC Effluent concentrations–air NRC 1999a 

134Cs 2x10-10 μCi/mL 10 CFR 20 App B 

137Cs 2x10-10 μCi/mL 

b. Water NRC 1999a 

10 CFR 20 App B NRC Effluent concentrations–water 

134Cs 9x10-7 μCi/ml 

137Cs 1x10-6 μCi/ml 

c. Food FDA 1998 

FDA Derived intervention levela

 (DIL; Bq/kg food) in 

accidentally-contaminated human food
 134Cs 930 

137Cs 1360 

d. Other 

EPA Concentration levels for environmental EPA 1999a 

compliance 40 CFR 61 App E 

134Cs 0.7x10-14 Ci/m3

137Cs 1.9x10-14 Ci/m3 

Carcinogenicity–slope factorsb EPA 2002 

Lifetime risk per pCi–ingestion 

Water 

134Cs 4.22x10-11 

137Cs 3.04x10-11 

Food 

134Cs 5.14x10-11 

137Cs 3.74x10-11 

Soil 

134Cs 5.81x10-11 

137Cs 4.33x10-11 

Lifetime risk per pCi–inhalation 

134Cs 1.65x10-11 

137Cs 1.19x10-11 
CESIUM	 176 

8. REGULATIONS AND ADVISORIES 

Table 8-2. Regulations and Guidelines Applicable to Radioactive Cesium 

Agency Description Information Reference 

NATIONAL (cont.) 

External exposure–risk/year per pCi/g soil EPA 2002 

134Cs 7.10x10-6 

137Cs 5.32x10-10 

137Cs (plus disintegration products) 2.55x10-6 

 NRC Occupational inhalation exposure NRC 1999a 

ALIs 10 CFR 20 App B 

134Cs 100 μCi 

137Cs 200 μCi 

 DACs 

134Cs 4x10-8 μCi/mL 

137Cs 6x10-8 μCi/mL 

Quantities of licensed material requiring labeling NRC 1999b 

134Cs 10 μCi 10 CFR App C 

137Cs 10 μCi 

STATE 

a. Air 

 Michigan Gross beta particle activity MI Dept Environ 

134Cs Quality 2000 15 pCi/L 

b. Water No data 

c. Food No data 

d. Other 

 Louisiana Quantity required for consideration of need for Release Quantity LA Dept Environ 

emergency plan for responding to a release fraction Quality 2000 

134Cs 0.01 2,000 Ci

137Cs 0.01 3,000 Ci 

a

The FDA-recommended Derived Intervention Level (DIL) for radionuclides of cesium, is defined as the DIL for the most 

sensitive age group (adults) that was calculated from the most limiting Protective Action Goal (PAG; 5 mSv committed 

effective whole body dose equivalent).

b

EPA classifies all radionuclides as Group A (known human) carcinogens. Radionuclide risk coefficients, or slope 

factors, are calculated by EPA’s Office of Radiation and Indoor Air (ORIA) to assist HEAST users with risk-related 

evaluations and decision-making at various stages of the remediation process. Ingestion and inhalation slope factors 

are central estimates in a linear model of the age-averaged, lifetime attributable radiation cancer incidence (fatal and 

nonfatal cancer) risk per unit of activity inhaled or ingested, expressed as risk/picocurie (pCi). Ingestion values are 

tabulated separately for ingestion of tap water, dietary intakes (food), and incidental soil ingestion. External exposure 

slope factors are central estimates of the lifetime attributable radiation cancer incidence risk for each year of exposure to 

external radiation from photon-emitting radionuclides distributed uniformly in a thick layer of soil, and are expressed as 

risk/year per pCi/gram of soil. 

ACGIH = American Conference of Governmental Industrial Hygienists; ALI = annual limitations on intake; CFR = Code 

of Federal Regulations; DAC = derived air concentrations; EPA = Environmental Protection Agency; FDA = Food and 

Drug Administration; IARC = International Agency for Research on Cancer; NIOSH = National Institute for Occupational 

Safety and Health; NRC = Nuclear Regulatory Commission; OSHA = Occupational Safety and Health Administration 
CESIUM 177 

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CESIUM 225 

10. GLOSSARY 

Some terms in this glossary are generic and may not be used in this profile. 

Absorbed Dose, Chemical—The amount of a substance that is either absorbed into the body or placed in 

contact with the skin. For oral or inhalation routes, this is normally the product of the intake quantity and 

the uptake fraction divided by the body weight and, if appropriate, the time, expressed as mg/kg for a 

single intake or mg/kg/day for multiple intakes. For dermal exposure, this is the amount of material 

applied to the skin, and is normally divided by the body mass and expressed as mg/kg. 

Absorbed Dose, Radiation—The mean energy imparted to the irradiated medium, per unit mass, by 

ionizing radiation. Units: rad (rad), gray (Gy). 

Absorbed Fraction—A term used in internal dosimetry. It is that fraction of the photon energy (emitted 

within a specified volume of material) which is absorbed by the volume. The absorbed fraction depends 

on the source distribution, the photon energy, and the size, shape and composition of the volume. 

Absorption—The process by which a chemical penetrates the exchange boundaries of an organism after 

contact, or the process by which radiation imparts some or all of its energy to any material through which 

it passes. 

Absorption Coefficient—Fractional absorption of the energy of an unscattered beam of x- or gammaradiation per unit thickness (linear absorption coefficient), per unit mass (mass absorption coefficient), or 

per atom (atomic absorption coefficient) of absorber, due to transfer of energy to the absorber. The total 

absorption coefficient is the sum of individual energy absorption processes (see Compton Effect, 

Photoelectric Effect, and Pair Production). 

Absorption Coefficient, Linear—A factor expressing the fraction of a beam of x- or gamma radiation 

absorbed in a unit thickness of material. In the expression I=Ioe

-μx, Io is the initial intensity, I the intensity 

of the beam after passage through a thickness of the material x, and μ is the linear absorption coefficient. 

Absorption Coefficient, Mass—The linear absorption coefficient per cm divided by the density of the 

absorber in grams per cubic centimeter. It is frequently expressed as μ/ρ, where μ is the linear absorption 

coefficient and ρ the absorber density. 

Absorption Ratio, Differential—Ratio of concentration of a nuclide in a given organ or tissue to the 

concentration that would be obtained if the same administered quantity of this nuclide were uniformly 

distributed throughout the body. 

Activation—The process of making a material radioactive by bombardment with neutrons or protons. 

Activity—The number of radioactive nuclear transformations occurring in a material per unit time (see 

Curie, Becquerel). The term for activity per unit mass is specific activity. 

Activity Median Aerodynamic Diameter (AMAD)—The diameter of a unit-density sphere with the 

same terminal settling velocity in air as that of the aerosol particle whose activity is the median for the 

entire size distribution of the aerosol. 

Acute Exposure, Chemical—Exposure to a chemical for a duration of 14 days or less, as specified in the 

Toxicological Profiles. 
CESIUM 226 

10. GLOSSARY 

Acute Exposure, Radiation—The absorption of a relatively large amount of radiation (or intake of a 

radioactive material) over a short period of time. 

Acute Radiation Syndrome—The symptoms which taken together characterize a person suffering from 

the effects of intense radiation. The effects occur within hours or days. 

Ad libitum—Available in excess and freely accessible. 

Adsorption Coefficient (Koc)—The ratio of the amount of a chemical adsorbed per unit surface area or 

per unit weight of organic carbon of a specific particle size in the soil or sediment to the concentration of 

the chemical in solution at equilibrium. 

Adsorption Ratio (Kd)—See Distribution Coefficient 

Alpha Particle—A positively charged particle ejected spontaneously from the nuclei of some radioactive 

elements. It is identical to a helium nucleus, i.e., 2 neutrons and two protons, with a mass number of 4 

and an electrostatic charge of +2. 

Alpha Track—The track of ionized atoms (pattern of ionization) left in a medium by an alpha particle 

that has traveled through the medium. 

Annihilation (Positron-Electron)—An interaction between a positive and a negative electron in which 

they both disappear; their rest mass, being converted into electromagnetic radiation (called annihilation 

radiation) with two 0.51 MeV gamma photons emitted at an angle of 180E to each other. 

Annual Limit on Intake (ALI)—The derived limit for the amount of radioactive material taken into the 

body of an adult worker by inhalation or ingestion in a year. It is the smaller value of intake of a given 

radionuclide in a year by the reference man that would result in a committed effective dose equivalent of 

5 rem or a committed dose equivalent of 50 rem to any organ or tissue. 

Atom—The smallest particle of an element that cannot be divided or broken up by chemical means. It 

consists of a central core called the nucleus, which contains protons and neutrons and an outer shell of 

electrons. 

Atomic Mass (u)—The mass of a neutral atom of a nuclide, usually expressed in terms of "atomic mass 

units." The "atomic mass unit" is one-twelfth the mass of one neutral atom of carbon-12; equivalent to 

1.6604x10-24 g. 

Atomic Mass Number—See Mass Number. 

Atomic Number—The number of protons in the nucleus of an atom. The "effective atomic number" is 

calculated from the composition and atomic numbers of a compound or mixture. An element of this 

atomic number would interact with photons in the same way as the compound or mixture. (Symbol: Z). 

Atomic Weight—The weighted mean of the masses of the neutral isotopes of an element expressed in 

atomic mass units. 

Attenuation—A process by which a beam from a source of radiation is reduced in intensity by 

absorption and scattering when passing through some material. 
CESIUM 227 

10. GLOSSARY 

Attenuation Coefficient—The fractional reduction in the intensity of a beam of radiation as it passes 

through an absorbing medium. It may be expressed as reduction per unit distance, per unit mass 

thickness, or per atom, and is called the linear, mass, or atomic attenuation coefficient, respectively. 

Auger Effect—The emission of an electron from the extranuclear portion of an excited atom when the 

atom undergoes a transition to a less excited state. 

Background Radiation—The amount of radiation to which a member of the general population is 

exposed from natural sources, such as terrestrial radiation from naturally occurring radionuclides in the 

soil, cosmic radiation originating from outer space, and naturally occurring radionuclides deposited in the 

human body. 

Becquerel (Bq)—International System of Units unit of activity and equals that quantity of radioactive 

material in which one transformation (disintegration) occurs per second (see Units). 

 Terabecquerel (TBq)—One trillion becquerel. 

 Gigabecquerel (GBq)—One billion becquerel. 

 Megabecquerel (MBq)—One million becquerel. 

 Kilobecquerel (kBq))—One thousand becquerel.

 Millibecquerel (mBq)—One-thousandth of a becquerel. 

 Microbecquerel (μBq)—One-millionth of a becquerel. 

Beta Particle—An electron that is emitted from the nucleus of an atom during one type of radioactive 

transformation. A beta particle has a mass and charge equal in magnitude to that of the electron. The 

charge may be either +1 or -1. Beta particles with +1 charges are called positrons (symbolized β+

), and 

beta particles with -1 charges are called negatrons (symbolized β-

). 

Bioconcentration Factor (BCF)—The quotient of the concentration of a chemical in aquatic organisms 

at a specific time or during a discrete time period of exposure divided by the concentration in the 

surrounding water at the same time or during the same period. 

Biologic Effectiveness of Radiation—See Relative Biological Effectiveness. 

Biological Half-time—The time required for a biological system, such as that of a human, to eliminate by 

natural process half of the amount of a substance (such as a chemical substance, either stable or 

radioactive) that has entered it. 

Biomarkers—Broadly defined as indicators signaling events in biologic systems or samples. They have 

been classified as markers of exposure, markers of effect, and markers of susceptibility. 

Body Burden, Chemical—The total amount of a chemical found in an animal or human body. 

Body Burden, Radioactivity—The amount of radioactive material found in an animal or human body. 

Bone Seeker—Any compound or ion which migrates in the body and preferentially deposits into bone. 

Branching—The occurrence of two or more modes by which a radionuclide can undergo radioactive 

decay. For example, 214Bi can undergo alpha or beta minus decay, 64Cu can undergo beta minus, beta 

plus, or electron capture decay. An individual atom of a nuclide exhibiting branching disintegrates by one 

mode only. The fraction disintegrating by a particular mode is the "branching fraction" for that mode. 

The "branching ratio" is the ratio of two specified branching fractions (also called multiple 

disintegration). 
CESIUM 228 

10. GLOSSARY 

Bremsstrahlung—X rays that are produced when a charged particle accelerates (speeds up, slows down, 

or changes direction) in the strong field of a nucleus. 

Buildup Factor—The ratio of the radiation intensity, including both primary and scattered radiation, to 

the intensity of the primary (unscattered) radiation. 

Cancer Effect Level (CEL)—The lowest dose of chemical or radiation in a study, or group of studies, 

that produces significant increases in the incidence of cancer (or tumors) between the exposed population 

and its appropriate control. 

Capture, Electron—A mode of radioactive decay involving the capture of an orbital electron by its 

nucleus. Capture from a particular electron shell, e.g., K or L shells, is designated as "K-electron capture" 

or "L-electron capture." 

Capture, K-Electron—Electron capture from the K shell by the nucleus of the atom. Also loosely used 

to designate any orbital electron capture process. 

Carcinogen—A chemical or radiation that is capable of inducing cancer. 

Carcinoma—Malignant neoplasm composed of epithelial cells, regardless of their derivation. 

Case-Control Study—A type of epidemiological study which examines the relationship between a 

particular outcome (disease or condition) and a variety of potential causative agents (such as toxic 

chemicals). In a case-controlled study, a group of people with a specified and well-defined outcome is 

identified and compared to a similar group of people without outcome. 

Case Report—Describes a single individual with a particular disease or exposure. These may suggest 

some potential topics for scientific research but are not actual research studies. 

Cataract—A clouding of the crystalline lens of the eye which obstructs the passage of light. 

Ceiling Value—A concentration of a substance that should not be exceeded, even temporarily. 

Charged Particle—A nuclear particle, atom, or molecule carrying a positive or negative charge. 

Chronic Exposure—A long-term, continuous exposure to a chemical or radioactive material. For 

example, exposure to a chemical for 365 days or more, as specified in the Toxicological Profiles. 

Cohort Study—A type of epidemiological study of a specific group or groups of people who have had a 

common insult (e.g., exposure to an agent suspected of causing disease or a common disease) and are 

followed forward from exposure to outcome. At least one exposed group is compared to one unexposed 

group. 

Collective Dose—The sum of the individual doses received in a given period of time by a specified 

population from exposure to a specified source of radiation. Collective dose is expressed in units such as 

man-rem and person-sievert. 

Compton Effect—An attenuation process observed for x- or gamma radiation in which an incident 

photon interacts with an orbital electron of an atom to produce a recoil electron and a scattered photon 

whose energy is less than the incident photon. 
CESIUM 229 

10. GLOSSARY 

Containment—The confinement of a chemical or radioactive substance in such a way that it is prevented 

from being dispersed from its container or into the environment, or is released only at a specified rate. 

Contamination—Deposition of a stable or radioactive substance in any place where it is not desired. 

Cosmic Rays—High-energy particulate and electromagnetic radiations that originate outside the earth's 

atmosphere and interact with the atmosphere to produce a shower of secondary cosmic rays. 

Count (Radiation Measurements)—The external indication of a radiation-measuring device designed to 

enumerate ionizing events. It refers to a single detected event. The term “count rate” refers to the total 

number registered in a given period of time. The term is sometimes erroneously used to designate a 

disintegration, ionizing event, or voltage pulse. 

Counter, Gas-flow Proportional (GPC)—An instrument for detecting beta particle radiation. Beta 

particles are detected by ionization of the counter gas which results in an electrical impulse at an anode 

wire. 

Counter, Geiger-Mueller (GM counter)— Highly sensitive, gas-filled radiation-measuring device that 

detects (counts) individual photons or particulate radiation. 

Counter, Scintillation—The combination of a crystal or phosphor, photomultiplier tube, and associated 

circuits for counting light emissions produced in the phosphors by ionizing radiation. Scintillation 

counters generally are more sensitive than GM counters for gamma radiation. 

Counting, Cerenkov—Relatively energetic β-particles pass through a transparent medium of high 

refractive index and a highly-directional, bluish-white light ("Cerenkov" light) is emitted. This light is 

detected using liquid scintillation counting equipment. 

Cross-sectional Study—A type of epidemiological study of a group or groups which examines the 

relationship between exposure and outcome to a chemical or to chemicals at one point in time. 

Curie (Ci)—A unit of radioactivity. One curie equals that quantity of radioactive material in which there 

are 3.7x1010 nuclear transformations per second. The activity of 1 gram of radium is approximately 1 Ci. 

Attocurie (aCi)—One-thousandth of a femtocurie (3.7x10-8 disintegrations per second). 

 Femtocurie (fCi)—One-billionth of a microcurie (3.7x10-5 disintegrations per second).

 Megacurie (MCi)—One million curies (3.7x1016 disintegrations per sec). 

 Microcurie (μCi)—One-millionth of a curie (3.7x104

 disintegrations per sec). 

 Millicurie (mCi)—One-thousandth of a curie (3.7x107 disintegrations per sec). 

 Nanocurie (nCi)—One-billionth of a curie (3.7x101 disintegrations per sec). 

 Picocurie (pCi)—One-millionth of a microcurie (3.7x10-2 disintegrations per second. 

Daughter Products—See Progeny and Decay Product 

Decay Chain or Decay Series—A sequence of radioactive decays (transformations) beginning with one 

nucleus. The initial nucleus, the parent, decays into a daughter or progeny nucleus that differs from the 

first by whatever particles were emitted during the decay. If further decays take place, the subsequent 

nuclei are also usually called daughters or progeny. Sometimes, to distinguish the sequence, the daughter 

of the first daughter is called the granddaughter, etc. 
CESIUM 230 

10. GLOSSARY 

Decay Constant (λ)—The fraction of the number of atoms of a radioactive nuclide which decay in unit 

time (see Disintegration Constant). 

Decay Product, Daughter Product, Progeny—A new nuclide formed as a result of radioactive decay. 

A nuclide resulting from the radioactive transformation of a radionuclide, formed either directly or as the 

result of successive transformations in a radioactive series. A decay product (daughter product or 

progeny) may be either radioactive or stable. 

Decay, Radioactive—Transformation of the nucleus of an unstable nuclide by spontaneous emission of 

radiation, such as charged particles and/or photons (see Disintegration). 

Delta Ray—An electron removed from an atom of a medium that is irradiated, or through which 

radiation passes, during the process of ionization (also called secondary electron). Delta rays cause a 

track of ionizations along their path. 

Derived Air Concentration (DAC)—The concentration of radioactive material in air that, if breathed by 

the reference man for a working year of 2000 hours under conditions of light work (at a rate of 1.2 liters 

of air per hour), would result in an intake of one ALI (see Annual Limit on Intake). 

Deterministic Effect—A health effect, the severity of which varies with the dose and for which a 

threshold is believed to exist (also called a non-stochastic effect). 

Developmental Toxicity—The occurrence of adverse effects on the developing organism that may result 

from exposure to a chemical or radiation prior to conception (either parent), during prenatal development, 

or postnatally to the time of sexual maturation. Adverse developmental effects may be detected at any 

point in the life span of the organism. 

Disintegration Constant—Synonymous with decay constant. The fraction of the number of atoms of a 

radioactive material that decays per unit time (see Decay Constant.) 

Disintegration, Nuclear—A spontaneous nuclear transformation (radioactivity) characterized by the 

emission of energy and mass from the nucleus. When large numbers of nuclei are involved, the process is 

characterized by a definite half-life (see Transformation, Nuclear). 

Distribution Coefficient (Kd)—Describes the distribution of a chemical between the solid and aqueous 

phase at thermodynamic equilibrium, is given as follows: 

[C]s Kd = [C]w , Units = (L solution)/(kg solid), 

where [C]s is the concentration of the chemical associated with the solid phase in units of (mg)/(kg solid), 

and [C]w is the concentration of the chemical in the aqueous phase in units of (mg)/(L solution). As the 

magnitude of Kd decreases, the potential mobility of the chemical to groundwater systems increases and 

vice versa. 

Dose—A general term denoting the quantity of a substance, radiation, or energy absorbed. For special 

purposes it must be appropriately qualified. If unqualified, it refers to radiation absorbed dose. 

Absorbed Dose—The energy imparted to matter by ionizing radiation per unit mass of irradiated 

material at the place of interest. The unit of absorbed dose is the rad. One rad equals 100 ergs 

per gram. In SI units, the absorbed dose is the gray which is 1 J/kg (see Rad). 
CESIUM 231 

10. GLOSSARY 

Cumulative Dose (Radiation)—The total dose resulting from repeated or continuous exposures 

to radiation. 

Dose Assessment—An estimate of the radiation dose to an individual or a population group usually by 

means of predictive modeling techniques, sometimes supplemented by the results of measurement. 

Dose Equivalent (DE)—A quantity used in radiation safety practice to account for the relative biological 

effectiveness of the several types of radiation. It expresses all radiations on a common scale for 

calculating the effective absorbed dose. The NRC defines it as the product of the absorbed dose, the 

quality factor, and all other modifying factors at the location of interest. ICRP has changed its definition 

to be the product of the absorbed dose and the radiation weighting factor. (The unit of dose equivalent is 

the rem. In SI units, the dose equivalent is the sievert, which equals 100 rem.) 

Dose, Fractionation—A method of administering therapeutic radiation in which relatively small doses 

are given daily or at longer intervals. 

Dose, Protraction—A method of administering therapeutic radiation by delivering it continuously over a 

relatively long period at a low dose rate. 

Dose, Radiation—The amount of energy imparted to matter by ionizing radiation per unit mass of the 

matter, usually expressed as the unit rad, or in SI units, the gray. 100 rad'1 gray (Gy) (see Absorbed 

Dose). 

Committed Dose Equivalent (HT,50)—The dose equivalent to organs or tissues of reference (T) 

that will be received from an intake of radioactive material by an individual during the 50 years 

following the intake. 

Committed Effective Dose Equivalent (HE,50)—The sum of the products of the weighting 

factors applicable to each of the body organs or tissues that are irradiated and the committed dose 

equivalent to those organs or tissues. 

Effective Dose—A dose value that attempts to normalize the detriment to the body (for cancer 

mortality and morbidity, hereditary effects, and years of life lost) from a non-uniform exposure to 

that of a uniform whole body exposure. Effective dose is calculated as the sum of products of the 

equivalent dose and the tissue weighting factor (wT) for each tissue exposed. (E = ∑DT,R wR wT)). 

Effective Dose Equivalent (HE)—This dose type is limited to internal exposures and is the sum 

of the products of the dose equivalent to the organ or tissue (HT) and the weighting factors (wT) 

applicable to each of the body organs or tissues that are irradiated. (HE = ∑wT HT). 

Equivalent Dose—A dose quantity that places the biological effect of all radiation types on a 

common scale for calculating tissue damage. Alpha particles, for example, are considered to 

cause 20 times more damage than gamma rays. Equivalent dose is calculated as the sum of 

products of the average absorbed dose (in gray) in an organ or tissue (DT,R) from each type of 

radiation and the radiation weighting factor (wR) for that radiation (∑DT,R wR). 

External Dose—That portion of the dose equivalent received from radiation sources outside the 

body. 

Internal Dose—That portion of the dose equivalent received from radioactive material taken into 

the body. 
CESIUM 232 

10. GLOSSARY 

Limit—A permissible upper bound on the radiation dose. 

Maximum Permissible Dose (MPD)—The greatest dose equivalent that a person or specified 

part thereof shall be allowed to receive in a given period of time. 

Median Lethal Dose (MLD)—Dose of radiation required to kill, within a specified period 

(usually 30 days), 50% of the individuals in a large group of animals or organisms. Also called 

the LD50, or LD50/30 if for 30 days.. 

Threshold Dose—The minimum absorbed dose that will produce a detectable degree of any 

given effect. 

Tissue Dose—Absorbed dose received by tissue in the region of interest, expressed in rad (see 

Dose, Gray, and Rad). 

Dose Rate—The amount of radiation dose delivered per unit time. Generically, the rate at which 

radiation dose is delivered to any material or tissue. 

Dose-Response Relationship—The quantitative relationship between the amount of exposure to a 

toxicant and the incidence of the adverse effects. 

Dosimetry—Quantification of radiation doses to cells, tissues, organs, individuals or populations 

resulting from radiation exposures. 

Early Effects (of radiation exposure)—Effects that appear within 60 days of an acute exposure. 

Electron—A stable elementary particle having an electric charge equal to ±1.60210x10-19 C (Coulombs) 

and a rest mass equal to 9.1091x10-31 kg. A positron is a positively charged "electron" (see Positron). 

Electron Volt—A unit of energy equivalent to the energy gained by an electron in passing through a 

potential difference of one volt. Larger multiple units of the electron volt are frequently used: keV for 

thousand or kilo electron volts; MeV for million or mega electron volts (eV). 1 eV=1.6x10-12 erg. 

Embryotoxicity and Fetotoxicity—Any toxic effect on the conceptus as a result of prenatal exposure to 

a chemical; the distinguishing feature between the two terms is the stage of development during which the 

insult occurred. The terms, as used here, include malformations and variations, altered growth, and in 

utero death. 

Energy—Capacity for doing work. Gravitationally, "potential energy" is the energy inherent in a mass 

because of its spatial relation to other masses. Chemically or radiologically, “potential energy” is the 

energy released when a chemical reaction or radiological transformation goes to completion. "Kinetic 

energy" is the energy possessed by a mass because of its motion (SI unit: joules): 

Binding Energy (Electron)—The amount of energy that must be expended to remove an 

electron from an atom. 

Binding Energy (Nuclear)—The energy represented by the difference in mass between the sum 

of the component parts and the actual mass of the nucleus. It represents the amount of energy 

that must be expended to break a nucleus into its component neutrons and protons. 
CESIUM 233 

10. GLOSSARY 

Excitation Energy—The energy required to change a system from its ground state to an excited 

state. Each different excited state has a different excitation energy. 

Ionizing Energy—The energy required to knock an electron out of an atom. The average energy 

lost by electrons or beta particles in producing an ion pair in air or in soft tissue is about 34 eV. 

Radiant Energy—The energy of electromagnetic radiation, such as radio waves, visible light, x 

and gamma rays. 

Enrichment, Isotopic—An isotopic separation process by which the relative abundances of the isotopes 

of a given element are altered, thus producing a form of the element that has been enriched in one or more 

isotopes and depleted in others. In uranium enrichment, the percentage of uranium-235 in natural 

uranium can be increased from 0.7% to >90% in a gaseous diffusion process based on the different 

thermal velocities of the constituents of natural uranium (234U, 235U, 238U) in the molecular form UF6. 

EPA Health Advisory—An estimate of acceptable drinking water levels for a chemical substance based 

on health effects information. A health advisory is not a legally enforceable federal standard, but serves 

as technical guidance to assist federal, state, and local officials. 

Epidemiology—Refers to the investigation of factors that determine the frequency and distribution of 

disease or other health-related conditions within a defined human population during a specified period. 

Equilibrium, Radioactive—In a radioactive series, the state which prevails when the ratios between the 

activities of two or more successive members of the series remains constant. 

Secular Equilibrium—If a parent element has a very much longer half-life than the daughters 

(so there is not appreciable change in its amount in the time interval required for later products to 

attain equilibrium) then, after equilibrium is reached, equal numbers of atoms of all members of 

the series disintegrate in unit time. This condition is never exactly attained, but is essentially 

established in such a case as 226Ra and its transformation series to stable 206Pb. The half-life of 

226Ra is about 1,600 years; of 222Rn, approximately 3.82 days, and of each of the subsequent 

members, a few minutes. After about a month, essentially the equilibrium amount of radon is 

present; then (and for a long time) all members of the series disintegrate the same number of 

atoms per unit time. At this time, the activity of the daughter is equal to the activity of the parent. 

Transient Equilibrium—If the half-life of the parent is short enough so the quantity present 

decreases appreciably during the period under consideration, but is still longer than that of 

successive members of the series, a stage of equilibrium will be reached after which all members 

of the series decrease in activity exponentially with the period of the parent. At this time, the 

ratio of the parent activity to the daughter activity is constant. 

Equilibrium, Electron—The condition in a radiation field where the energy of the electrons entering a 

volume equals the energy of the electrons leaving that volume. 

Excitation—The addition of energy to a system, thereby transferring it from its ground state to an excited 

state. Excitation of a nucleus, an atom, or a molecule can result from absorption of photons or from 

inelastic collisions with other particles. The excited state of an atom is an unstable or metastable state and 

will return to ground state by radiation of the excess energy. 
CESIUM 234 

10. GLOSSARY 

Exposure (Chemical)—Contact of an organism with a chemical or physical agent. Exposure is 

quantified as the amount of the agent available at the exchange boundaries of the organism (e.g., skin, 

lungs, gut) and available for absorption. 

Exposure (Radiation)—Subjection to ionizing radiation or to a radioactive material. For example, 

exposure in air is a measure of the ionization produced in air by x or gamma radiation; the sum of the 

electric charges on all ions of one sign produced in air when all electrons liberated by photons in a 

volume of air are completely stopped in air (dQ), divided by the mass of the air in the volume (dm). The 

unit of exposure in air is the roentgen, or coulomb per kilogram (SI units). One roentgen is equal to 

2.58x10-4 coulomb per kilogram (C/kg). 

Fission, Nuclear—A nuclear transformation characterized by the splitting of a nucleus into at least two 

other nuclei with emission of several neutrons, accompanied by the release of a relatively large amount of 

energy. 

Gamma Ray, Penetrating—Short wavelength electromagnetic radiation of nuclear origin. 

Genetic Effect of Radiation—Inheritable change, chiefly mutations, produced by the absorption of 

ionizing radiation by germ cells. Genetic effects have not been observed in any human population 

exposed at any dose level. 

Genotoxicity—A specific adverse effect on the genome of living cells that, upon the duplication of 

affected cells, can be expressed as a mutagenic, clastogenic or carcinogenic event because of specific 

alteration of the molecular structure of the genome. 

Gray (Gy)—SI unit of absorbed dose, 1 J/kg. One gray equals 100 rad (see Units). 

Half-life, Effective—See Half-Time, Effective. 

Half-life, Radioactive—Time required for a radioactive substance to lose 50% of its activity by decay. 

Each radio-nuclide has a unique physical half-life. Known also as physical half-time and symbolized as 

Tr or Trad. 

Half-time, Biological—Time required for an organ, tissue, or the whole body to eliminate one-half of any 

absorbed substance by regular processes of elimination. This is the same for both stable and radioactive 

isotopes of a particular element, and is sometimes referred to as half-time, symbolized as tbiol or Tb. 

Half-time, Effective—Time required for a radioactive element in an organ, tissue, or the whole body to 

be diminished 50% as a result of the combined action of radioactive decay and biological elimination, 

symbolized as Te or Teff. 

Biological half-time × Radioactive half-life Effective half-time = Biological half-time + Radioactive half-life 

Immediately Dangerous to Life or Health (IDLH)—The maximum environmental concentration of a 

contaminant from which one could escape within 30 minutes without any escape-impairing symptoms or 

irreversible health effects. 

Immunologic Toxicity—The occurrence of adverse effects on the immune system that may result from 

exposure to environmental agents such as chemicals. 
CESIUM 235 

10. GLOSSARY 

Immunological Effects—Functional changes in the immune response. 

In Vitro—Isolated from the living organism and artificially maintained, as in a test tube. Literally, “in 

glass.” 

In Vivo—Occurring within the living organism. Literally, “in life.” 

Intensity—Amount of energy per unit time passing through a unit area perpendicular to the line of 

propagation at the point in question. 

Intermediate Exposure—Exposure to a chemical for a duration of 15–364 days, as specified in the 

Toxicological Profiles. 

Internal Conversion—Process in which a gamma ray knocks an electron out of the same atom from 

which the gamma ray was emitted. The ratio of the number of internal conversion electrons to the 

number of gamma quanta emitted in the de-excitation of the nucleus is called the "conversion ratio." 

Ion—Atomic particle, atom or chemical radical bearing a net electrical charge, either negative or positive. 

Ion Pair—Two particles of opposite charge, usually referring to the electron and positive atomic or 

molecular residue resulting after the interaction of ionizing radiation with the orbital electrons of atoms. 

Ionization—The process by which a neutral atom or molecule acquires a positive or negative charge. 

Primary Ionization—(1) In collision theory: the ionization produced by the primary particles as 

contrasted to the "total ionization" which includes the "secondary ionization" produced by delta 

rays. (2) In counter tubes: the total ionization produced by incident radiation without gas 

amplification. 

Specific Ionization—Number of ion pairs per unit length of path of ionizing radiation in a 

medium; e.g., per centimeter of air or per micrometer of tissue. 

Total Ionization—The total electric charge of one sign on the ions produced by radiation in the 

process of losing its kinetic energy. For a given gas, the total ionization is closely proportional to 

the initial ionization and is nearly independent of the nature of the ionizing radiation. It is 

frequently used as a measure of absorption of radiation energy. 

Ionization Density—Number of ion pairs per unit volume. 

Ionization Path (Track)—The trail of ion pairs produced by an ionizing particle in its passage through 

matter. 

Ionizing Radiation—Any radiation capable of knocking electrons out of atoms and producing ions. 

Examples: alpha, beta, gamma and x rays, and neutrons. 

Isobars—Nuclides having the same mass number but different atomic numbers. 

Isomers—Nuclides having the same number of neutrons and protons but capable of existing, for a 

measurable time, in different quantum states with different energies and radioactive properties. 

Commonly the isomer of higher energy decays to one with lower energy by the process of isomeric 

transition. 
CESIUM 236 

10. GLOSSARY 

Isotopes—Nuclides having the same number of protons in their nuclei, and hence the same atomic 

number, but differing in the number of neutrons, and therefore in the mass number. Identical chemical 

properties exist in isotopes of a particular element. The term should not be used as a synonym for nuclide 

because isotopes refer specifically to different nuclei of the same element. 

 Stable Isotope—A nonradioactive isotope of an element. 

Joule—The S.I. unit for work and energy. It is equal to the work done by raising a mass of one newton 

through a distance of one meter (J = Nm), which corresponds to about 0.7 ft-pound. 

Kerma (k)—A measure of the kinetic energy transferred from gamma rays or neutrons to a unit mass of 

absorbing medium in the initial collision between the radiation and the absorber atoms. The SI unit is 

J/kg. The special name of this unit is the rad (traditional system of units) or Gray (SI). 

Labeled Compound—A compound containing one or more radioactive atoms intentionally added to its 

structure. By observations of radioactivity or isotopic composition, this compound or its fragments may 

be followed through physical, chemical, or biological processes. 

Late Effects (of radiation exposure)—Effects which appear 60 days or more following an acute 

exposure. 

LD50/30—The dose of a chemical or radiation expected to cause 50% mortality in those exposed within 

30 days. For radiation, this is about 350 rad (3.5 gray) received by humans over a short period of time. 

Lethal Concentration(Lo) (LCLo)—The lowest concentration of a chemical in air that has been reported 

to have caused death in humans or animals. 

Lethal Concentration(50) (LC50)—A calculated concentration of a chemical in air to which exposure for 

a specific length of time is expected to cause death in 50% of a defined experimental animal population 

within a specified time, usually 30 days. 

Lethal Dose(Lo) (LDLo)—The lowest dose of a chemical introduced by a route other than inhalation that is 

expected to have caused death in humans or animals within a specified time, usually 30 days. 

Lethal Dose(50) (LD50)—The dose of a chemical which has been calculated to cause death in 50% of a 

defined experimental animal population. 

Lethal Time(50) (LT50)—A calculated period of time within which a specific concentration of a chemical 

is expected to cause death in 50% of a defined experimental animal population. 

Linear Energy Transfer (LET)—A measure of the energy that a charged particle transfers to a material 

per unit path length. 

Average LET—The energy of a charged particle divided by the length of the path over which it 

deposits all its energy in a material. This is averaged over a number of particles. 

High-LET—Energy transfer characteristic of heavy charged particles such as protons and alpha 

particles where the distance between ionizing events is small on the scale of a cellular nucleus. 
CESIUM 237 

10. GLOSSARY 

Low-LET—Energy transfer characteristic of light charged particles such as electrons produced 

by x and gamma rays where the distance between ionizing events is large on the scale of a 

cellular nucleus. 

Lowest-Observed-Adverse-Effect Level (LOAEL)—The lowest dose of chemical in a study, or group 

of studies, that produces statistically or biologically significant increases in frequency or severity of 

adverse effects between the exposed population and its appropriate control. 

Lung Clearance Class (fast, F; medium, M; slow, S)—A classification scheme for inhaled material 

according to its rate of clearance from the pulmonary region of the lungs to the blood and the 

gastrointestinal tract. 

Lymphoreticular Effects—Represent morphological effects involving lymphatic tissues such as the 

lymph nodes, spleen, and thymus. 

Malformations—Permanent structural changes that may adversely affect survival, development, or 

function. 

Mass Numbers (A)—The number of nucleons (protons and neutrons) in the nucleus of an atom. 

Minimal Risk Level—An estimate of daily human exposure to a substance that is likely to be without an 

appreciable risk of adverse noncancerous effects over a specified duration of exposure. 

Morbidity—State of being diseased; morbidity rate is the incidence or prevalence of disease in a specific 

population. 

Mutagen—A substance that causes changes (mutations) in the genetic material in a cell. Mutations can 

lead to birth defects, miscarriages, or cancer. 

Necropsy—The gross examination of the organs and tissues of a dead body to determine the cause of 

death or pathological conditions. 

Neurotoxicity—The occurrence of adverse effects on the nervous system following exposure to a 

substance. 

Neutrino (ν)—A neutral particle of infinitesimally small rest mass emitted during beta plus or beta minus 

decay. This particle accounts for conservation of energy in beta plus and beta minus decays. It plays no 

role in damage from radiation. 

No-Observed-Adverse-Effect Level (NOAEL)—The dose of a substance at which there were no 

statistically or biologically significant increases in frequency or severity of adverse effects seen between 

the exposed population and its appropriate control. Effects may be produced at this dose, but they are not 

considered to be adverse. 

Nuclear Reactor—A power plant that heats the medium (typically water) by using the energy released 

from the nuclear fission of uranium or plutonium isotopes instead of burning coal, oil, or natural gas. All 

of these sources of energy simply heat water and use the steam which is produced to turn turbines that 

make electricity or propel a ship. 

Nucleon—Common name for a constituent particle of the nucleus. Applied to a proton or neutron. 
CESIUM 238 

10. GLOSSARY 

Nuclide—A species of atom characterized by the constitution of its nucleus. The nuclear constitution is 

specified by the number of protons (Z), number of neutrons (N), and energy content; or, alternatively, by 

the atomic number (Z), mass number A(N+Z), and atomic mass. To be regarded as a distinct nuclide, the 

atom must be capable of existing for a measurable time. Thus, nuclear isomers are separate nuclides, 

whereas promptly decaying excited nuclear states and unstable intermediates in nuclear reactions are not 

so considered. 

Octanol-Water Partition Coefficient (Kow)—The equilibrium ratio of the concentrations of a chemical 

in n-octanol and water, in dilute solution. 

Odds Ratio (OR)—A means of measuring the association between an exposure (such as toxic substances 

and a disease or condition) which represents the best estimate of relative risk (risk as a ratio of the 

incidence among subjects exposed to a particular risk factor divided by the incidence among subjects who 

were not exposed to the risk factor). An odds ratio of greater than 1 is considered to indicate greater risk 

of disease in the exposed group compared to the unexposed. 

Pair Production—An absorption process for x- and gamma radiation in which the incident photon is 

absorbed in the vicinity of the nucleus of the absorbing atom, with subsequent production of an electron 

and positron pair (see annihilation). This reaction can only occur for incident photon energies exceeding 

1.02 MeV. 

Parent—Any radionuclide nuclide which, upon disintegration, yields a new nuclide (termed the progeny 

or daughter), either directly or as a later member of a radioactive series. 

Permissible Exposure Limit (PEL)—A maximum allowable atmospheric level of a substance in 

workplace air averaged over an 8-hour shift. 

Pharmacokinetic Model—A set of equations that can be used to describe the time course of a parent 

chemical or metabolite in an animal system. There are two types of pharmacokinetic models: data-based 

and physiologically-based. A data-based model divides the animal system into a series of compartments 

which, in general, do not represent real, identifiable anatomic regions of the body whereas the 

physiologically-based model compartments represent real anatomic regions of the body. 

Pharmacokinetics—The dynamic behavior of a material in the body, used to predict the fate 

(disposition) of an exogenous substance in an organism. Utilizing computational techniques, it provides 

the means of studying the absorption, distribution, metabolism and excretion of chemicals by the body. 

Physiologically Based Pharmacodynamic (PBPD) Model—A type of physiologically-based doseresponse model which quantitatively describes the relationship between target tissue dose and toxic end 

points. These models advance the importance of physiologically based models in that they clearly 

describe the biological effect (response) produced by the system following exposure to an exogenous 

substance. 

Physiologically Based Pharmacokinetic (PBPK) Model—A model comprising a series of 

compartments representing organs or tissue groups with realistic weights and blood flows. These models 

require a variety of physiological information: tissue volumes, blood flow rates to tissues, cardiac output, 

alveolar ventilation rates and, possibly membrane permeabilities. The models also utilize biochemical 

information such as air/blood partition coefficients, and metabolic parameters. PBPK models are also 

called biologically based tissue dosimetry models. 
CESIUM 239 

10. GLOSSARY 

Photoelectric Effect—An attenuation process observed for x and gamma radiation in which an incident 

photon interacts with a tightly bound inner orbital electron of an atom delivering all of its energy to knock 

the electron out of the atom. The incident photon disappears in the process. 

Photon—A quantum of electromagnetic energy (E) whose value is the product of its frequency (ν) in 

hertz and Planck's constant (h). The equation is: E = hν. 

Population dose—See Collective dose. 

Positron—A positively charged electron. 

Potential, Ionization—The energy expressed as electron volts (eV) necessary to separate one electron 

from an atom, resulting in the formation of an ion pair. 

Power, Stopping—A measure of the ability of a material to absorb energy from an ionizing particle 

passing through it; the greater the stopping power, the greater the energy absorbing ability (see Linear 

Energy Transfer). 

Progeny—The decay product or daughter products resulting after a radioactive decay or a series of 

radioactive decays. The progeny can also be radioactive, and the chain continues until a stable nuclide is 

formed. 

Proton—Elementary nuclear particle with a positive electric charge equal numerically to the charge of 

the electron and a rest mass of 1.007 mass units. 

Quality—A term describing the distribution of the energy deposited by a particle along its track; 

radiations that produce different densities of ionization per unit intensity are said to have different 

"qualities." 

Quality Factor (Q)—The linear-energy-transfer-dependent factor by which absorbed doses are 

multiplied to obtain (for radiation protection purposes) a quantity that expresses - on a common scale for 

all ionizing radiation - the approximate biological effectiveness of the absorbed dose. 

Type of radiation Quality Factor 

X, gamma, or beta 1 

Alpha particles 20 

Neutrons of unknown energy 10 

High energy protons 10 

Rad—The traditional unit of absorbed dose equal to 100 ergs per gram, or 0.01 joule per kilogram (0.01 

Gy) in any medium (see Absorbed Dose). 

Radiation—The emission and propagation of energy through space or through a material medium in the 

form of waves (e.g., the emission and propagation of electromagnetic waves, or of sound and elastic 

waves). The term radiation or radiant energy, when unqualified, usually refers to electromagnetic 

radiation. Such radiation commonly is classified according to frequency, as microwaves, infrared, visible 

(light), ultraviolet, and x and gamma rays (see Photon.) and, by extension, corpuscular emission, such as 

alpha and beta radiation, neutrons, or rays of mixed or unknown type, as cosmic radiation. 

Radiation, Annihilation—Photons produced when an electron and a positron unite and cease to 

exist. The annihilation of a positron-electron pair results in the production of two photons, each 

of 0.51 MeV energy. 
CESIUM 240 

10. GLOSSARY 

Radiation, Background—See Background Radiation. 

Radiation, Characteristic (Discrete)—Radiation originating from an excited atom after removal 

of an electron from an atom. The wavelength of the emitted radiation is specific, depending only 

on the element and particular energy levels involved. 

Radiation, External—Radiation from a source outside the body. 

Radiation, Internal—Radiation from a source within the body (as a result of deposition of 

radionuclides in body tissues). 

Radiation, Ionizing—Any electromagnetic or particulate radiation capable of producing ions, 

directly or indirectly, in its passage through matter (see Radiation). 

Radiation, Monoenergetic—Radiation of a given type in which all particles or photons originate 

with and have the same energy. 

Radiation, Scattered—Radiation which during its passage through a substance, has been 

deviated in direction. It may also have been modified by a decrease in energy. 

Radiation, Secondary—A particle or ray that is produced when the primary radiation interacts 

with a material, and which has sufficient energy to produce its own ionization, such as 

bremsstrahlung or electrons knocked from atomic orbitals with enough energy to then produce 

ionization (see Delta Rays). 

Radiation Weighting Factor (also called Quality Factor)—In radiation protection, a factor (1 for xrays, gamma rays, beta particles; 20 for alpha particles) weighting the absorbed dose of radiation of a 

specific type and energy for its effect on tissue. 

Radioactive Material—Material containing radioactive atoms. 

Radioactivity—Spontaneous nuclear transformations that result in the formation of new elements. These 

transformations are accomplished by emission of alpha or beta particles from the nucleus or by the 

capture of an orbital electron. Each of these reactions may or may not be accompanied by a gamma 

photon. 

Radioactivity, Artificial—Man-made radioactivity produced by particle bombardment or 

nuclear fission, as opposed to naturally occurring radioactivity. 

Radioactivity, Induced—Radioactivity produced in a substance after bombardment with 

neutrons or other particles. The resulting activity is "natural radioactivity" if formed by nuclear 

reactions occurring in nature and "artificial radioactivity" if the reactions are caused by man. 

Radioactivity, Natural—The property of radioactivity exhibited by more than 50 naturally 

occurring radionuclides. 

Radioisotope—An unstable or radioactive isotope of an element that decays or disintegrates 

spontaneously, emitting radiation. 
CESIUM 241 

10. GLOSSARY 

Radionuclide—Any radioactive isotope of any element. Approximately 5,000 natural and artificial 

radioisotopes have been identified. 

Radiosensitivity—Relative susceptibility of cells, tissues, organs, organisms, or any living substance to 

the injurious action of radiation. Radiosensitivity and its antonym, radioresistance, are used 

comparatively, rather than absolutely. 

Reference Dose (RfD)—An estimate of the daily exposure of the human population to a potential hazard 

that is likely to be without risk of deleterious effects during a lifetime. The RfD is operationally derived 

from the NOAEL (from animal and human studies) by a consistent application of uncertainty factors that 

reflect various types of data used to estimate RfDs and an additional modifying factor, which is based on 

a professional judgment of the entire database on the chemical. The RfDs are not applicable to nonthreshold effects such as cancer. 

Relative Biological Effectiveness (RBE)—The RBE is a factor used to compare the biological 

effectiveness of absorbed radiation doses (i.e., rad) due to different types of ionizing radiation. More 

specifically, it is the experimentally determined ratio of an absorbed dose of a radiation in question to the 

absorbed dose of a reference radiation (typically 60Co gamma rays or 200 kVp x rays) required to produce 

an identical biological effect in a particular experimental organism or tissue (see Quality Factor). 

Rem—The traditional unit of dose equivalent that is used in the regulatory, administrative, and 

engineering design aspects of radiation safety practice. The dose equivalent in rem is numerically equal 

to the absorbed dose in rad multiplied by the quality factor (1 rem is equal to 0.01 sievert). 

Reportable Quantity (RQ)—The quantity of a hazardous substance that is considered reportable under 

CERCLA. Reportable quantities are (1) 1 pound or greater or (2) for selected substances, an amount 

established by regulation either under CERCLA or under Sect. 311 of the Clean Water Act. Quantities 

are measured over a 24-hour period. 

Reproductive Toxicity—The occurrence of adverse effects on the reproductive system that may result 

from exposure to a chemical. The toxicity may be directed to the reproductive organs and/or the related 

endocrine system. The manifestation of such toxicity may be noted as alterations in sexual behavior, 

fertility, pregnancy outcomes, or modifications in other functions that are dependent on the integrity of 

this system. 

Roentgen (R)—A unit of exposure (in air) to ionizing radiation. It is the amount of x or gamma rays 

required to produce ions carrying 1 electrostatic unit of electrical charge in 1 cubic centimeter of dry air 

under standard conditions. Named after William Roentgen, a German scientist who discovered x rays in 

1895. 

Retrospective Study—A type of cohort study based on a group of persons known to have been exposed 

at some time in the past. Data are collected from routinely recorded events, up to the time the study is 

undertaken. Retrospective studies are limited to causal factors that can be ascertained from existing 

records and/or examining survivors of the cohort. 

Self-Absorption—Absorption of radiation (emitted by radioactive atoms) by the material in which the 

atoms are located; in particular, the absorption of radiation within a sample being assayed. 

Short-Term Exposure Limit (STEL)—The maximum concentration to which workers can be exposed 

for up to 15 minutes continually. No more than four excursions are allowed per day, and there must be at 

least 60 minutes between exposure periods. The daily TLV-TWA may not be exceeded. 
CESIUM 242 

10. GLOSSARY 

SI Units—The International System of Units as defined by the General Conference of Weights and 

Measures in 1960. These units are generally based on the meter/kilogram/second units, with special 

quantities for radiation including the becquerel, gray, and sievert. 

Sickness, Acute Radiation (Syndrome)—The complex symptoms and signs characterizing the condition 

resulting from excessive exposure of the whole body (or large part) to ionizing radiation. The earliest of 

these symptoms are nausea, fatigue, vomiting, and diarrhea, and may be followed by loss of hair 

(epilation), hemorrhage, inflammation of the mouth and throat, and general loss of energy. In severe 

cases, where the radiation dose is relatively high (over several hundred rad or several gray), death may 

occur within two to four weeks. Those who survive six weeks after exposure of a single high dose of 

radiation may generally be expected to recover. 

Sievert (Sv)—The SI unit of any of the quantities expressed as dose equivalent. The dose equivalent in 

sieverts is equal to the absorbed dose, in gray, multiplied by the quality factor (1 sievert equals 100 rem). 

The sievert is also the SI unit for effective dose equivalent, which is the sum of the products of the dose 

equivalent to each organ or tissue and its corresponding tissue weighting factor. 

Specific-Activity—Radioactivity per unit mass of a radionuclide, expressed, for example, as Ci/gram or 

Bq/kilogram. 

Specific Energy—The actual energy per unit mass deposited per unit volume in a small target, such as 

the cell or cell nucleus, as the result of one or more energy-depositing events. This is a stochastic 

quantity as opposed to the average value over a large number of instance (i.e., the absorbed dose). 

Standardized Mortality Ratio (SMR)—A ratio of the observed number of deaths and the expected 

number of deaths in a specific standard population. 

Stochastic Effect—A health effect that occurs randomly and for which the probability of the effect 

occurring, rather than its severity, is assumed to be a linear function of dose without a threshold (also 

called a nondeterministic effect). 

Stopping Power—The average rate of energy loss of a charged particle per unit thickness of a material or 

per unit mass of material traversed. 

Surface-seeking Radionuclide—A bone-seeking internal emitter that deposits and remains on the bone 

surface for a long period of time, although it may eventually diffuse into the bone mineral. This contrasts 

with a volume seeker, which deposits more uniformly throughout the bone volume. 

Target Organ Toxicity—This term covers a broad range of adverse effects on target organs or 

physiological systems (e.g., renal, cardiovascular) extending from those arising through a single limited 

exposure to those assumed over a lifetime of exposure to a chemical. 

Target Theory (Hit Theory)—A theory explaining some biological effects of radiation on the basis that 

ionization, occurring in a discrete volume (the target) within the cell, directly causes a lesion which 

subsequently results in a physiological response to the damage at that location. One, two, or more "hits" 

(ionizing events within the target) may be necessary to elicit the response. 

Teratogen—A chemical that causes birth defects. 
CESIUM 243 

10. GLOSSARY 

Threshold Limit Value (TLV)—The maximum concentration of a substance to which most workers can 

be exposed without adverse effect. TLV is a term used exclusively by the ACGIH. Other terms used to 

express similar concepts are the MAC (Maximum Allowable Concentration) and PEL (Permissible 

Exposure Limits). 

Time-Weighted Average (TWA)—An allowable exposure concentration averaged over a normal 8-hour 

workday or 40-hour workweek. 

Tissue Weighting Factor (Wt)—Organ- or tissue-specific factor by which the equivalent dose is 

multiplied to give the portion of the effective dose for that organ or tissue. Recommended values of 

tissue weighting factors are: 

Tissue/Organ Tissue Weighting Factor 

Gonads 0.70 

Bone marrow (red) 0.12 

Colon 0.12 

Lung 0.12 

Stomach 0.12 

Bladder 0.05 

Breast 0.05 

Liver 0.05 

Esophagus 0.05 

Thyroid 0.05 

Skin 0.01 

Bone surface 0.01 

Remainder (adrenals, brain, upper large 0.05 

intestine, small intestine, pancreas, spleen, 

thymus, and uterus) 

Toxic Dose (TD50)—A calculated dose of a chemical, introduced by a route other than inhalation, which 

is expected to cause a specific toxic effect in 50% of a defined experimental animal population. 

Toxicokinetic—The absorption, distribution and elimination of toxic compounds in the living organism. 

Toxicosis —A diseased condition resulting from poisoning. 

Transformation, Nuclear—The process of radioactive decay by which a nuclide is transformed into a 

different nuclide by absorbing or emitting particulate or electromagnetic radiation. 

Transition, Isomeric—The process by which a nuclide decays to an isomeric nuclide (i.e., one of the 

same mass number and atomic number) of lower quantum energy. Isomeric transitions (often abbreviated 

I.T.) proceed by gamma ray and internal conversion electron emission. 

Tritium—The hydrogen isotope with one proton and two neutrons in the nucleus (Symbol: 3

H). It is 

radioactive and has a physical half-life of 12.3 years. 

Unattached Fraction—That fraction of the radon daughters, usually 218Po and 214Po, which has not yet 

attached to a dust particle or to water vapor. As a free atom, it has a high probability of being exhaled and 

not retained within the lung. It is the attached fraction which is primarily retained. 
CESIUM 244 

10. GLOSSARY 

Uncertainty Factor (UF)—A factor used in operationally deriving the RfD from experimental data. UFs 

are intended to account for (1) the variation in sensitivity among the members of the human population, 

(2) the uncertainty in extrapolating animal data to the case of human, (3) the uncertainty in extrapolating 

from data obtained in a study that is of less than lifetime exposure, and (4) the uncertainty in using 

LOAEL data rather than NOAEL data. Usually each of these factors is set equal to 10. 

Units, Prefixes—Many units of measure are expressed as submultiples or multiples of the primary unit 

(e.g., 10-3 curie is 1 mCi and 103

 becquerel is 1 kBq). 

Factor Prefix Symbol Factor Prefix Symbol 

10-18 atto A 103

 kilo k 

10-15 femto F 106

 mega M 

10-12 pico p 109

 giga G 

10-9 nano N 1012 tera T 

10-6 micro Μ 1015 peta P 

10-3 milli M 1018 exa E 

10-2 centi C 

Units, Radiological— 

Units Equivalents 

Becquerel* (Bq) 1 disintegration per second = 2.7x10-11 Ci 

Curie (Ci) 3.7x1010 disintegrations per second = 3.7x1010 Bq 

Gray* (Gy) 1 J/kg = 100 rad 

Rad (rad) 100 erg/g = 0.01 Gy 

Rem (rem) 0.01 sievert 

Sievert* (Sv) 100 rem 

*International Units, designated (SI) 

Working Level (WL)—Any combination of short-lived radon daughters in 1 liter of air that will result in 

the ultimate emission of 1.3x105

 MeV of potential alpha energy. 

Working Level Month (WLM)—A unit of exposure to radon daughters corresponding to the product of 

the radon daughter concentration in Working Level (WL) and the exposure time in nominal months 

(1 nominal month = 170 hours). Inhalation of air with a concentration of 1 WL of radon daughters for 

170 working hours results in an exposure of 1 WLM. 

X rays—Penetrating electromagnetic radiations whose wave lengths are very much shorter than those of 

visible light. They are usually produced by bombarding a metallic target with fast electrons in a high 

vacuum. X rays (called characteristic x rays) are also produced when an orbital electron falls from a high 

energy level to a low energy level. 

Zero-Threshold Linear Hypothesis (or No-Threshold Linear Hypothesis)—The assumption that a 

dose-response curve derived from data in the high dose and high dose-rate ranges may be extrapolated 

through the low dose and low dose range to zero, implying that, theoretically, any amount of radiation 

will cause some damage. 
CESIUM A-1 

APPENDIX A. ATSDR MINIMAL RISK LEVELS AND WORKSHEETS 

The Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) [42 U.S.C. 

9601 et seq.], as amended by the Superfund Amendments and Reauthorization Act (SARA) [Pub. L. 99– 

499], requires that the Agency for Toxic Substances and Disease Registry (ATSDR) develop jointly with 

the U.S. Environmental Protection Agency (EPA), in order of priority, a list of hazardous substances most 

commonly found at facilities on the CERCLA National Priorities List (NPL); prepare toxicological 

profiles for each substance included on the priority list of hazardous substances; and assure the initiation 

of a research program to fill identified data needs associated with the substances. 

The toxicological profiles include an examination, summary, and interpretation of available toxicological 

information and epidemiologic evaluations of a hazardous substance. During the development of 

toxicological profiles, Minimal Risk Levels (MRLs) are derived when reliable and sufficient data exist to 

identify the target organ(s) of effect or the most sensitive health effect(s) for a specific duration for a 

given route of exposure. An MRL is an estimate of the daily human exposure to a hazardous substance 

that is likely to be without appreciable risk of adverse noncancer health effects over a specified duration 

of exposure. MRLs are based on noncancer health effects only and are not based on a consideration of 

cancer effects. These substance-specific estimates, which are intended to serve as screening levels, are 

used by ATSDR health assessors to identify contaminants and potential health effects that may be of 

concern at hazardous waste sites. It is important to note that MRLs are not intended to define clean-up or 

action levels. 

MRLs are derived for hazardous substances using the no-observed-adverse-effect level/uncertainty factor 

approach. They are below levels that might cause adverse health effects in the people most sensitive to 

such chemical-induced effects. MRLs are derived for acute (1–14 days), intermediate (15–364 days), and 

chronic (365 days and longer) durations and for the oral and inhalation routes of exposure. Currently, 

MRLs for the dermal route of exposure are not derived because ATSDR has not yet identified a method 

suitable for this route of exposure. MRLs are generally based on the most sensitive chemical-induced end 

point considered to be of relevance to humans. Serious health effects (such as irreparable damage to the 

liver or kidneys, or birth defects) are not used as a basis for establishing MRLs. Exposure to a level 

above the MRL does not mean that adverse health effects will occur. 

MRLs are intended only to serve as a screening tool to help public health professionals decide where to 

look more closely. They may also be viewed as a mechanism to identify those hazardous waste sites that 
CESIUM A-2 

APPENDIX A 

are not expected to cause adverse health effects. Most MRLs contain a degree of uncertainty because of 

the lack of precise toxicological information on the people who might be most sensitive (e.g., infants, 

elderly, nutritionally or immunologically compromised) to the effects of hazardous substances. ATSDR 

uses a conservative (i.e., protective) approach to address this uncertainty consistent with the public health 

principle of prevention. Although human data are preferred, MRLs often must be based on animal studies 

because relevant human studies are lacking. In the absence of evidence to the contrary, ATSDR assumes 

that humans are more sensitive to the effects of hazardous substance than animals and that certain persons 

may be particularly sensitive. Thus, the resulting MRL may be as much as a hundredfold below levels 

that have been shown to be nontoxic in laboratory animals. 

Proposed MRLs undergo a rigorous review process: Health Effects/MRL Workgroup reviews within the 

Division of Toxicology, expert panel peer reviews, and agency wide MRL Workgroup reviews, with 

participation from other federal agencies and comments from the public. They are subject to change as 

new information becomes available concomitant with updating the toxicological profiles. Thus, MRLs in 

the most recent toxicological profiles supersede previously published levels. For additional information 

regarding MRLs, please contact the Division of Toxicology, Agency for Toxic Substances and Disease 

Registry, 1600 Clifton Road, Mailstop E-32, Atlanta, Georgia 30333. 
CESIUM A-3 

APPENDIX A 

MINIMAL RISK LEVEL (MRL) WORKSHEET 

Chemical Name: Radioactive Cesium 

CAS Number: Multiple 

Date: March 11, 2004 

Profile Status: Draft 3, Post-Public 

Route: [ ] Inhalation [ ] Oral [X] External 

Duration: [X] Acute [ ] Intermediate [ ] Chronic 

Species: Human 

Minimal Risk Level: 4 [ ] mg/kg/day [ ] ppm [ ] mg/m3

 [X] mSv (400 mrem) 

Reference: 

Schull WJ, Otake M, Yoshimaru H. 1988. Effect on intelligence test score of prenatal exposure to 

ionizing radiation in Hiroshima and Nagasaki: A comparison of the T65DR and DS86 dosimetry 

systems. Radiation Effects Research Foundation. RERF TR 3-88. Research project 24-62. 

Burt C. 1966. The genetic determination of differences in intelligence: A study of monozygotic twins 

reared together and apart. Brit J Psychol 57(1 & 2):137-153. 

Experimental design: 

Schull et al. (1988) study: Schull et al. (1988) evaluated the quantitative effect of exposure to ionizing 

radiation on the developing fetal and embryonic human brain. The end point measured was changes in 

intelligence test scores. The effects on individuals exposed in utero to the atomic bombing of Hiroshima 

and Nagasaki were based on the original PE86 samples (n=1,759; data on available intelligence testing) 

and a clinical sample (n=1,598). The original PE86 sample included virtually all prenatally exposed 

individuals who received tissue-absorbed doses of 0.50 Gy or more. There were many more individuals 

in the dose range of 0–0.49 Gy in the PE86 sample than in the clinical sample. The clinical sample does 

not include children prenatally exposed at distances between 2,000 and 2,999 m in Hiroshima and 

Nagasaki. Children exposed at greater distances or not present in the city were selected as controls. In 

1955–1956, Tanaka-B (emphasis on word-sense, arithmetic abilities, and the like, which were associated 

with the more subtle processing of visual clues than their simple recognition and depended more on 

connectedness) and the Koga (emphasis on perception of spatial relationships) intelligence tests were 

conducted in Nagasaki and the Koga test in Hiroshima. 

Burt (1966) study: This study determined differences in intelligence in monozygotic twins reared 

together (n=95) and apart (n=53). All tests conducted in school consisted of (1) a group test of 

intelligence containing both nonverbal and verbal items, (2) an individual test (the London Revision of 

the Terman-Binet Scale) used primarily for standardization and for doubtful cases, and (3) a set of 

performance tests, based on the Pitner-Paterson tests and standardization. The methods and standard 

remained much the same throughout the study. Some of the reasons for separation of the twins were 

given as follows: death of the mother (n=9), unable to bring them up properly, mother's poor health 

(n=12), unmarried (n=6), and economic difficulties. The children were brought up by parents or foster 

parents (occupation ranged from unskilled to professional). IQ scores in the study group ranged from 

66 to 137. The standard deviation of the group of separated monozygotic twins was reported at 15.3 as 

compared to 15.0 of ordinary siblings. Twins brought up in different environments were compared with 

those brought up in similar circumstances. 
CESIUM A-4 

APPENDIX A 

Effects noted in study and corresponding doses: 

Schull et al. (1986) study: No evidence of radiation-related effect on intelligence was observed among 

individuals exposed within 0–7 weeks after fertilization or in the 26th or subsequent weeks. The highest 

risk of radiation damage to the embryonic and fetal brain occurs 8–15 weeks after fertilization under both 

dosimetric systems. The regression of intelligence score on estimated DS86 uterine absorbed dose is 

linear with dose, and the diminution in intelligence score is 21–29 points per Gy for the 8–15-week group 

and 10–26 points per Gy for the 16–25-week group. The results for 8–15 weeks applies regardless 

whether or not the mentally retarded individuals were included. The cumulative distribution of test scores 

suggested a progressive shift downwards in individual scores with increasing exposure. The mean IQ 

scores decrease significantly and systematically with uterine or fetal tissue dose within the 8–15- and 16– 

25-week groups. 

In summary, analysis of intelligence test scores at 10–11 years of age of individuals exposed prenatally 

showed that: 

There is no evidence of a radiation-related effect on intelligence scores among those individuals exposed 

within 0–7 weeks of fertilization or in the 26th week of gestation and beyond. 

The cumulative distribution of test scores suggests a progressive shift downwards in intelligence scores 

with increasing exposure to ionizing radiation (dose-response relationship). 

The most sensitive group was the 8–15 weeks exposure group. The regression in intelligence scores was 

found to be linear, with 1 Gy dose resulting in a 21–29 point decline in intelligence scores. 

There was no indication of groups of individuals with differing sensitivities to radiation. 

Burt (1966) study: The average intelligence of the twins measured on a conventional IQ scale (SD=15) 

was 97.8 for the separated monozygotes, 98.1 for monozygotes brought up together, 99.3 for the 

dizygotes as compared with 100.2 for the siblings, and 100.0 for the population as a whole. The 

difference of 0.3 IQ point between the separated and unseparated identical twins is considered a NOAEL 

for this study. 

Dose and end point used for MRL derivation: 

[X] NOAEL [ ] LOAEL 0.3 IQ point reduction in twins, between those raised together and those 

raised apart. 

Uncertainty Factors used in MRL derivation: 

[X] 1 [ ] 3 [ ] 10 (for use of a NOAEL) 

[X] 1 [ ] 3 [ ] 10 (for extrapolation from animals to humans) 

[ ] 1 [X] 3 [ ] 10 (for human variability/sensitive population) 

Was a conversion used from ppm in food or water to a mg/body weight dose? No. 

If an inhalation study in animals, list the conversion factors used in determining human equivalent dose: 

Not applicable 

Was a conversion used from intermittent to continuous exposure? No. 
CESIUM A-5 

APPENDIX A 

Other additional studies or pertinent information which lend support to this MRL: Husen (1959) reported 

a study involving 269 pairs of Swedish monozygotic (identical) twins where the intrapair IQ difference 

was 4 IQ points for a combination of twins raised together and apart. This is somewhat lower than the 

value of 7 IQ points for identical twins raised apart, and just larger than the range of IQ scores for 

Washington, DC children repetitively tested (Jacobi and Glauberman 1995). 

Supporting evidence for the acute MRL is provided by Jacobi and Glauberman (1995). Children in the 

1st, 3rd, and 5th grades born in Washington, DC were tested, and average IQ levels of 94.2, 97.6, and 

94.6 were reported. The range of 3.4 IQ points is considered to be a LOAEL for this study, which, if used 

for MRL derivation, would yield an MRL of 0.004 Sv (3.4 IQ points x 1 Sv/25 IQ points ÷ 30 [10 for use 

of a LOAEL and 3 for a sensitive population]). 

Additional supporting evidence for the acute MRL is provided by Berger et al. 1997, in a case study of 

accidental radiation injury to the hand. A Mexican engineer suffered an accidental injury to the hand 

while repairing an x-ray spectrometer. The day after the accident, his symptoms included a tingling 

sensation and itching in the index and middle fingers. On days 4 and 7, a "pinching" sensation, swelling, 

and slight erythema were observed. By day 7, the tip of his index fingers was erythematous and a large 

blister developed with swelling on other fingers. On day 10, examination by a physician showed that the 

lesions had worsened and the fingers and palms were discolored. On day 10, he was admitted to the 

hospital where hyperbaric oxygen therapy was administered without success. One month after the 

accident, the patient entered the hospital again with pain, discoloration, and desquamation of his hand. 

Clinical examination showed decreased circulation in the entire hand, most notably in the index and 

middle finger. Total white blood count decreased to 3,000/μL (normal range 4,300–10,800/μL). 

Cytogenic studies of peripheral blood lymphocytes revealed four dicentrics, two rings, and eight 

chromosomal fragments in the 300 metaphases studied. The estimated whole body dose was reported to 

be 0.382 Gy (38.2 rad). This dose is a potential LOAEL for acute ionizing radiation and would yield an 

MRL of 0.004 Sv (0.38 Sv ÷100 [10 for use of LOAEL and 10 for sensitive human population]). 

The NRC set a radiation exposure limit of 0.5 rem (50 mSv) for pregnant working women over the full 

gestational period (USNRC 1991). For the critical gestational period of 8–15 weeks ATSDR believes 

that the conservative acute MRL of 4 mSv is consistent with the NRC limit and could be applied to either 

acute (0–14-day) or intermediate (15–365-day) exposure periods. 

Calculations: 

Given: 0.3 IQ point is a NOAEL. A 1 Sv dose results in a 25 IQ point reduction (range=21–29 points; 

mean=25) and provides a conversion factor from IQ prediction to radiation dose. Assume that the 

radiation dose and the subsequent reduction in IQ is a linear relationship. 

MRL = NOAEL x CF ÷ UF 

MRL = 0.3 x 1/25 ÷ 3 

MRL = 0.004 Sv =4 mSv (400 mrem) 

Agency Contact (Chemical Manager): Malcolm Williams, Ph.D. 
CESIUM A-6 

APPENDIX A 

MINIMAL RISK LEVEL (MRL) WORKSHEET 

Chemical Name: Radioactive Cesium 

CAS Number: Multiple 

Date: March 11, 2004 

Profile Status: Draft 3, Post-Public 

Route: [ ] Inhalation [ ] Oral [X] External 

Duration: [ ] Acute [ ] Intermediate [X] Chronic 

Species: Human 

Minimal Risk Level: 1 [ ] mg/kg/day [ ] ppm [ ] mg/m3

 [X] mSv/year (100 mrem/year) 

Reference: BEIR V. 1990. Health effects of exposure to low levels of ionizing radiation. Committee on 

the Biological Effects of Ionizing Radiations, National Research Council. National Academy Press. 

Washington, DC. 

Experimental design: Not applicable 

Effects noted in study and corresponding doses: No individual studies were identified that could be used 

to base a chronic-duration external exposure MRL that did not result in a cancer-producing end point. 

However, two sources of information were identified that did provide doses of ionizing radiation that 

have not been reported to be associated with detrimental effects (NOAELs). These sources provide 

estimates of background levels of primarily natural sources of ionizing radiation that have not been 

implicated in producing cancerous or noncancerous toxicological endpoints. BEIR V states that the 

average annual effective dose to the U.S. population is 3.6 mSv/year. A total annual effective dose 

equivalent of 3.6 mSv (360 mrem)/year to members of the U.S. population is obtained mainly by 

naturally occurring radiation from external sources, medical uses of radiation, and radiation from 

consumer products. The largest contribution (82%) is from natural sources, two-thirds of which is from 

naturally occurring radon and its decay products. Specific sources of this radiation are demonstrated in 

Table A-1. 

The annual dose of 3.6 mSv per year has not been associated with adverse health effects or increases in 

the incidences of any type of cancers in humans or other animals. 

Dose and end point used for MRL derivation: 3.6 mSv/year 

[X] NOAEL [ ] LOAEL 3.6 mSv/year 

Uncertainty Factors used in MRL derivation: 

[X] 1 [ ] 3 [ ] 10 (for use of a NOAEL) 

[X] 1 [ ] 3 [ ] 10 (for extrapolation from animals to humans) 

[ ] 1 [X] 3 [ ] 10 (for human variability) 

Was a conversion used from ppm in food or water to a mg/body weight dose? No. 
CESIUM A-7 

APPENDIX A 

Table A-1. Average Annual Effective Dose Equivalent from Ionizing Radiation to a 

Member of the U.S. Populationa
 

Effective dose equivalent 

Percent of total 

Source mSv dose 

Natural 

 Radonb

 2.0 55 

 Cosmic 0.27 8.0 

 Terrestrial 0.28 8.0 

Internal 0.39 11 

 Total natural 3.0 82 

Artificial 

Medical 

X-ray 0.39 11 

Nuclear 0.14 4.0 

Consumer 0.10 3.0 

products 

Other 

Occupational <0.01 <0.3 

Nuclear fuel <0.01 <0.03 

cycle 

Fallout <0.01 <0.03 

Miscellaneousc

 <0.01 <0.03 

Total artificial 0.63 18 

Total natural 3.6 100 

and artificial 

Nuclear Medicine 

4% 

Radon 

55% 

X Rays 

11% 

Consumer 

Products 3% 

Other 

<1% 

Terrestrial 

8% 

Cosmic 

8% 

Natural Internal 

11% 

a

Adapted from BEIR V, Table 1-3 , page 18.

b

Dose equivalent to bronchi from radon daughter products 

c

DOE facilities, smelter, transportation, etc. 
CESIUM A-8 

APPENDIX A 

If an inhalation study in animals, list the conversion factors used in determining human equivalent dose: 

Not applicable. 

Was a conversion used from intermittent to continuous exposure? No. 

Other additional studies or pertinent information which lend support to this MRL: ICRP has developed 

recommended dose limits for occupational and public exposure to ionizing radiation sources. The ICRP 

recommends limiting public exposure to 1 mSv/year (100 mrem/year), but does note that values at high 

altitudes above sea level and in some geological areas can sometimes be twice that value (≥2 mSv). In 

Annex C of ICRP 60, the commission provides data that suggests increasing the dose from 1 mSv to 

5 mSv results in a very small, but detectable, increase in age-specific human mortality rate. ICRP states 

that the value of 1 mSv/year was chosen over the 5 mSv value because 5 mSv/year (500 mrem/year) 

causes this increase in age specific mortality rate, and 1 mSv/year (100 mrem/year) is typical of the 

annual effective dose from background, less radon (ICRP 1991). The 1 mSv estimate may underestimate 

the annual exposure to external sources of ionizing radiation to the U.S. population, as it does not include 

radiation from radon. Conversely, the 5 mSv estimate may be high, in that increases in mortality rate 

been reported. The most useful estimate appears to be the BEIR V estimate of 3.6 mSv, in that it 

accounts for an annual exposure to radon, is specific to the U.S. population, has not been associated with 

increases mortality, and it falls short of the 5 mSv value associated with small increases in human 

mortality. 

Calculations: 

MRL = NOAEL(ADJ) ÷ UF 

MRL = 3.6 mSv/year ÷ 3 

MRL = 1.20 mSv/year 

MRL = 1.0 mSv/year =100 mrem/year above background 

Agency Contact (Chemical Manager): Malcolm Williams, Ph.D. 
CESIUM	 B-1 

APPENDIX B. USER'S GUIDE 

Chapter 1 

Public Health Statement 

This chapter of the profile is a health effects summary written in nontechnical language. Its intended 

audience is the general public, especially people living in the vicinity of a hazardous waste site or 

chemical release. If the Public Health Statement were removed from the rest of the document, it would 

still communicate to the lay public essential information about the chemical. 

The major headings in the Public Health Statement are useful to find specific topics of concern. The 

topics are written in a question and answer format. The answer to each question includes a sentence that 

will direct the reader to chapters in the profile that will provide more information on the given topic. 

Chapter 2 

Relevance to Public Health 

This chapter provides a health effects summary based on evaluations of existing toxicologic, 

epidemiologic, and toxicokinetic information. This summary is designed to present interpretive, weightof-evidence discussions for human health end points by addressing the following questions. 

1. What effects are known to occur in humans? 

2. What effects observed in animals are likely to be of concern to humans? 

3. What exposure conditions are likely to be of concern to humans, especially around hazardous 

waste sites? 

The chapter covers end points in the same order that they appear within the Discussion of Health Effects 

by Route of Exposure section, by route (inhalation, oral, and dermal) and within route by effect. Human 

data are presented first, then animal data. Both are organized by duration (acute, intermediate, chronic). 

In vitro data and data from parenteral routes (intramuscular, intravenous, subcutaneous, etc.) are also 

considered in this chapter. 

The carcinogenic potential of the profiled substance is qualitatively evaluated, when appropriate, using 

existing toxicokinetic, genotoxic, and carcinogenic data. ATSDR does not currently assess cancer 

potency or perform cancer risk assessments. Minimal Risk Levels (MRLs) for noncancer end points (if 

derived) and the end points from which they were derived are indicated and discussed. 

Limitations to existing scientific literature that prevent a satisfactory evaluation of the relevance to public 

health are identified in the Chapter 3 Data Needs section. 

Interpretation of Minimal Risk Levels 

Where sufficient toxicologic information is available, ATSDR has derived MRLs for inhalation and oral 

routes of entry at each duration of exposure (acute, intermediate, and chronic). These MRLs are not 
CESIUM B-2 

APPENDIX B 

meant to support regulatory action, but to acquaint health professionals with exposure levels at which 

adverse health effects are not expected to occur in humans. 

MRLs should help physicians and public health officials determine the safety of a community living near 

a chemical emission, given the concentration of a contaminant in air or the estimated daily dose in water. 

MRLs are based largely on toxicological studies in animals and on reports of human occupational 

exposure. 

MRL users should be familiar with the toxicologic information on which the number is based. Chapter 2, 

"Relevance to Public Health," contains basic information known about the substance. Other sections such 

as Chapter 3 Section 3.10, Interactions with Other Substances, and Section 3.11, Populations that are 

Unusually Susceptible provide important supplemental information. 

MRL users should also understand the MRL derivation methodology. MRLs are derived using a 

modified version of the risk assessment methodology that the Environmental Protection Agency (EPA) 

provides (Barnes and Dourson 1988) to determine reference doses (RfDs) for lifetime exposure. 

To derive an MRL, ATSDR generally selects the most sensitive end point which, in its best judgment, 

represents the most sensitive human health effect for a given exposure route and duration. ATSDR 

cannot make this judgment or derive an MRL unless information (quantitative or qualitative) is available 

for all potential systemic, neurological, and developmental effects. If this information and reliable 

quantitative data on the chosen end point are available, ATSDR derives an MRL using the most sensitive 

species (when information from multiple species is available) with the highest no-observed-adverse-effect 

level (NOAEL) that does not exceed any adverse effect levels. When a NOAEL is not available, a 

lowest-observed-adverse-effect level (LOAEL) can be used to derive an MRL, and an uncertainty factor 

(UF) of 10 must be employed. Additional uncertainty factors of 10 must be used both for human 

variability to protect sensitive subpopulations (people who are most susceptible to the health effects 

caused by the substance) and for interspecies variability (extrapolation from animals to humans). In 

deriving an MRL, these individual uncertainty factors are multiplied together. The product is then 

divided into the inhalation concentration or oral dosage selected from the study. Uncertainty factors used 

in developing a substance-specific MRL are provided in the footnotes of the levels of significant exposure 

(LSE) Tables. 

Chapter 3 

Health Effects 

Tables and Figures for Levels of Significant Exposure (LSE) 

Tables and figures are used to summarize health effects and illustrate graphically levels of exposure 

associated with those effects. These levels cover health effects observed at increasing dose 

concentrations and durations, differences in response by species, MRLs to humans for noncancer end 

points, and EPA's estimated range associated with an upper- bound individual lifetime cancer risk of 1 in 

10,000 to 1 in 10,000,000. Use the LSE tables and figures for a quick review of the health effects and to 

locate data for a specific exposure scenario. The LSE tables and figures should always be used in 

conjunction with the text. All entries in these tables and figures represent studies that provide reliable, 

quantitative estimates of NOAELs, LOAELs, or Cancer Effect Levels (CELs). 

The legends presented below demonstrate the application of these tables and figures. Representative 

examples of LSE Table 3-1 and Figure 3-1 are shown. The numbers in the left column of the legends 

correspond to the numbers in the example table and figure. 
CESIUM	 B-3 

APPENDIX B 

LEGEND 

See Sample LSE Table 3-1 (page B-6) 

(1) Route of Exposure. One of the first considerations when reviewing the toxicity of a substance 

using these tables and figures should be the relevant and appropriate route of exposure. 

Typically when sufficient data exist, three LSE tables and two LSE figures are presented in the 

document. The three LSE tables present data on the three principal routes of exposure, i.e., 

inhalation, oral, and dermal (LSE Table 3-1, 3-2, and 3-3, respectively). LSE figures are 

limited to the inhalation (LSE Figure 3-1) and oral (LSE Figure 3-2) routes. Not all substances 

will have data on each route of exposure and will not, therefore, have all five of the tables and 

figures. 

(2) Exposure Period. Three exposure periods—acute (<15 days), intermediate (15–364 days), and 

chronic (365 days or more)—are presented within each relevant route of exposure. In this 

example, an inhalation study of intermediate exposure duration is reported. For quick reference 

to health effects occurring from a known length of exposure, locate the applicable exposure 

period within the LSE table and figure. 

(3) Health Effect. The major categories of health effects included in LSE tables and figures are 

death, systemic, immunological, neurological, developmental, reproductive, and cancer. 

NOAELs and LOAELs can be reported in the tables and figures for all effects but cancer. 

Systemic effects are further defined in the "System" column of the LSE table (see key number 

18). 

(4) Key to Figure. Each key number in the LSE table links study information to one or more data 

points using the same key number in the corresponding LSE figure. In this example, the study 

represented by key number 18 has been used to derive a NOAEL and a Less Serious LOAEL 

(also see the two "18r" data points in sample Figure 3-1). 

(5) Species. The test species, whether animal or human, are identified in this column. Chapter 2, 

"Relevance to Public Health," covers the relevance of animal data to human toxicity and 

Section 3.5, Toxicokinetics, contains any available information on comparative toxicokinetics. 

Although NOAELs and LOAELs are species specific, the levels are extrapolated to equivalent 

human doses to derive an MRL. 

(6) Exposure Frequency/Duration. The duration of the study and the weekly and daily exposure 

regimen are provided in this column. This permits comparison of NOAELs and LOAELs from 

different studies. In this case (key number 18), rats were exposed to “Chemical X” via 

inhalation for 6 hours per day, 5 days per week, for 13 weeks. For a more complete review of 

the dosing regimen refer to the appropriate sections of the text or the original reference paper, 

i.e., Nitschke et al. 1981. 

(7) System. This column further defines the systemic effects. These systems include respiratory, 

cardiovascular, gastrointestinal, hematological, musculoskeletal, hepatic, renal, and 

dermal/ocular. "Other" refers to any systemic effect (e.g., a decrease in body weight) not 

covered in these systems. In the example of key number 18, one systemic effect (respiratory) 

was investigated. 

(8) NOAEL. A NOAEL is the highest exposure level at which no harmful effects were seen in the 

organ system studied. Key number 18 reports a NOAEL of 3 ppm for the respiratory system, 
CESIUM	 B-4 

APPENDIX B 

which was used to derive an intermediate exposure, inhalation MRL of 0.005 ppm (see 

footnote "b"). 

(9) LOAEL. A LOAEL is the lowest dose used in the study that caused a harmful health effect. 

LOAELs have been classified into "Less Serious" and "Serious" effects. These distinctions 

help readers identify the levels of exposure at which adverse health effects first appear and the 

gradation of effects with increasing dose. A brief description of the specific end point used to 

quantify the adverse effect accompanies the LOAEL. The respiratory effect reported in key 

number 18 (hyperplasia) is a Less Serious LOAEL of 10 ppm. MRLs are not derived from 

Serious LOAELs. 

(10) Reference. The complete reference citation is given in Chapter 9 of the profile. 

(11) CEL. A CEL is the lowest exposure level associated with the onset of carcinogenesis in 

experimental or epidemiologic studies. CELs are always considered serious effects. The LSE 

tables and figures do not contain NOAELs for cancer, but the text may report doses not causing 

measurable cancer increases. 

(12) Footnotes. Explanations of abbreviations or reference notes for data in the LSE tables are found 

in the footnotes. Footnote "b" indicates that the NOAEL of 3 ppm in key number 18 was used 

to derive an MRL of 0.005 ppm. 

LEGEND 

See Sample Figure 3-1 (page B-7) 

LSE figures graphically illustrate the data presented in the corresponding LSE tables. Figures help the 

reader quickly compare health effects according to exposure concentrations for particular 

exposure periods. 

(13) Exposure Period. The same exposure periods appear as in the LSE table. In this example, 

health effects observed within the acute and intermediate exposure periods are illustrated. 

(14) Health Effect. These are the categories of health effects for which reliable quantitative data 

exists. The same health effects appear in the LSE table. 

(15)	 Levels of Exposure. Concentrations or doses for each health effect in the LSE tables are 

graphically displayed in the LSE figures. Exposure concentration or dose is measured on the 

log scale "y" axis. Inhalation exposure is reported in mg/m3

 or ppm and oral exposure is 

reported in mg/kg/day. 

(16) NOAEL. In this example, the open circle designated 18r identifies a NOAEL critical end point 

in the rat upon which an intermediate inhalation exposure MRL is based. The key number 18 

corresponds to the entry in the LSE table. The dashed descending arrow indicates the 

extrapolation from the exposure level of 3 ppm (see entry 18 in the Table) to the MRL of 

0.005 ppm (see footnote "b" in the LSE table). 

(17) CEL. Key number 38r is one of three studies for which CELs were derived. The diamond 

symbol refers to a CEL for the test species-mouse. The number 38 corresponds to the entry in 

the LSE table. 
CESIUM	 B-5 

APPENDIX B 

(18)	 Estimated Upper-Bound Human Cancer Risk Levels. This is the range associated with the 

upper-bound for lifetime cancer risk of 1 in 10,000 to 1 in 10,000,000. These risk levels are 

derived from the EPA's Human Health Assessment Group's upper-bound estimates of the slope 

of the cancer dose response curve at low dose levels (q1*). 

(19)	 Key to LSE Figure. The Key explains the abbreviations and symbols used in the figure. 
Serious (ppm) (CEL, multiple organs) (CEL, lung tumors, nasal tumors) (CEL, lung tumors, hemangiosarcomas) 

11 ↓20 10 10 

LOAEL (effect) Less serious (ppm) 

9 

↓

10 (hyperplasia) 

SAMPLE 

NOAEL (ppm) 8 ↓3b 

System 7 ↓Resp 

Exposure frequency/ duration 6 ↓13 wk 5 d/wk 6 hr/d 18 mo 5 d/wk 7 hr/d 89-104 wk 5 d/wk 6 hr/d 79-103 wk 5 d/wk 6 hr/d 

Species 5 

↓

Rat Rat Rat Mouse 

TABLE 3-1. Levels of Significant Exposure to [Chemical x] – Inhalation 

Key to figurea 

INTERMEDIATE EXPOSURE Systemic 18 CHRONIC EXPOSURE Cancer 38 39 40 

a The number corresponds to entries in Figure 3-1. b Used to derive an intermediate inhalation Minimal Risk Level (MRL) of 5x10-3 ppm; dose adjusted for intermittenby an uncertainty factor of 100 (10 for extrapolation from animal to humans, 10 for human variability). 

→→→→→

1 2 3 4 12 


CESIUM C-1 

APPENDIX C. ACRONYMS, ABBREVIATIONS, AND SYMBOLS 

Some terms are generic and may not be used in this profile. 

ACGIH American Conference of Governmental Industrial Hygienists 

ACOEM American College of Occupational and Environmental Medicine 

ADI acceptable daily intake 

ADME absorption, distribution, metabolism, and excretion 

AED atomic emission detection 

AFID alkali flame ionization detector 

AFOSH Air Force Office of Safety and Health 

ALI annual limit on intake 

ALT alanine aminotransferase 

AML acute myeloid leukemia 

AOAC Association of Official Analytical Chemists 

AOEC Association of Occupational and Environmental Clinics 

AP alkaline phosphatase 

APHA American Public Health Association 

AST aspartate aminotransferase 

atm atmosphere 

ATSDR Agency for Toxic Substances and Disease Registry 

AWQC Ambient Water Quality Criteria 

BAT best available technology 

BCF bioconcentration factor 

BEI Biological Exposure Index 

BMD benchmark dose 

BMR benchmark response 

BSC Board of Scientific Counselors 

C centigrade 

CAA Clean Air Act 

CAG Cancer Assessment Group of the U.S. Environmental Protection Agency 

CAS Chemical Abstract Services 

CDC Centers for Disease Control and Prevention 

CEL cancer effect level 

CELDS Computer-Environmental Legislative Data System 

CERCLA Comprehensive Environmental Response, Compensation, and Liability Act 

CFR Code of Federal Regulations 

Ci curie 

CI confidence interval 

CL ceiling limit value 

CLP Contract Laboratory Program 

cm centimeter 

CML chronic myeloid leukemia 

CPSC Consumer Products Safety Commission 

CWA Clean Water Act 

DAC derived air concentration 

DHEW Department of Health, Education, and Welfare 

DHHS Department of Health and Human Services 

DNA deoxyribonucleic acid 

DOD Department of Defense 
CESIUM C-2 

APPENDIX C 

DOE Department of Energy 

DOL Department of Labor 

DOT Department of Transportation 

DOT/UN/ Department of Transportation/United Nations/ 

NA/IMCO North America/International Maritime Dangerous Goods Code 

DWEL drinking water exposure level 

ECD electron capture detection 

ECG/EKG electrocardiogram 

EEG electroencephalogram 

EEGL Emergency Exposure Guidance Level 

EPA Environmental Protection Agency 

F Fahrenheit 

F1 first-filial generation 

FAO Food and Agricultural Organization of the United Nations 

FDA Food and Drug Administration 

FEMA Federal Emergency Management Agency 

FIFRA Federal Insecticide, Fungicide, and Rodenticide Act 

FPD flame photometric detection 

fpm feet per minute 

FR Federal Register 

FSH follicle stimulating hormone 

g gram 

GC gas chromatography 

gd gestational day 

GLC gas liquid chromatography 

GPC gel permeation chromatography 

HPLC high-performance liquid chromatography 

HRGC high resolution gas chromatography 

HSDB Hazardous Substance Data Bank 

IARC International Agency for Research on Cancer 

IDLH immediately dangerous to life and health 

ILO International Labor Organization 

IRIS Integrated Risk Information System 

Kd adsorption ratio 

kg kilogram 

kkg metric ton 

Koc organic carbon partition coefficient 

Kow octanol-water partition coefficient 

L liter 

LC liquid chromatography 

LC50 lethal concentration, 50% kill 

LCLo lethal concentration, low 

LD50 lethal dose, 50% kill 

LDLo lethal dose, low 

LDH lactic dehydrogenase 

LH luteinizing hormone 

LOAEL lowest-observed-adverse-effect level 

LSE Levels of Significant Exposure 

LT50 lethal time, 50% kill 

m meter 

MA trans,trans-muconic acid 
CESIUM C-3 

APPENDIX C 

MAL maximum allowable level 

mCi millicurie 

MCL maximum contaminant level 

MCLG maximum contaminant level goal 

MF modifying factor 

MFO mixed function oxidase 

mg milligram 

mL milliliter 

mm millimeter 

mmHg millimeters of mercury 

mmol millimole 

mppcf millions of particles per cubic foot 

MRL Minimal Risk Level 

MS mass spectrometry 

NAAQS National Ambient Air Quality Standard 

NAS National Academy of Science 

NATICH National Air Toxics Information Clearinghouse 

NATO North Atlantic Treaty Organization 

NCE normochromatic erythrocytes 

NCEH National Center for Environmental Health 

NCI National Cancer Institute 

ND not detected 

NFPA National Fire Protection Association 

ng nanogram 

NHANES National Health and Nutrition Examination Survey 

NIEHS National Institute of Environmental Health Sciences 

NIOSH National Institute for Occupational Safety and Health 

NIOSHTIC NIOSH's Computerized Information Retrieval System 

NLM National Library of Medicine 

nm nanometer 

nmol nanomole 

NOAEL no-observed-adverse-effect level 

NOES National Occupational Exposure Survey 

NOHS National Occupational Hazard Survey 

NPD nitrogen phosphorus detection 

NPDES National Pollutant Discharge Elimination System 

NPL National Priorities List 

NR not reported 

NRC National Research Council 

NS not specified 

NSPS New Source Performance Standards 

NTIS National Technical Information Service 

NTP National Toxicology Program 

ODW Office of Drinking Water, EPA 

OERR Office of Emergency and Remedial Response, EPA 

OHM/TADS Oil and Hazardous Materials/Technical Assistance Data System 

OPP Office of Pesticide Programs, EPA 

OPPT Office of Pollution Prevention and Toxics, EPA 

OPPTS Office of Prevention, Pesticides and Toxic Substances, EPA 

OR odds ratio 

OSHA Occupational Safety and Health Administration 
CESIUM C-4 

APPENDIX C 

OSW Office of Solid Waste, EPA 

OTS Office of Toxic Substances 

OW Office of Water 

OWRS Office of Water Regulations and Standards, EPA 

PAH polycyclic aromatic hydrocarbon 

PBPD physiologically based pharmacodynamic 

PBPK physiologically based pharmacokinetic 

PCE polychromatic erythrocytes 

PEL permissible exposure limit 

pg picogram 

PHS Public Health Service 

PID photo ionization detector 

pmol picomole 

PMR proportionate mortality ratio 

ppb parts per billion 

ppm parts per million 

ppt parts per trillion 

PSNS pretreatment standards for new sources 

RBC red blood cell 

REL recommended exposure level/limit 

RfC reference concentration 

RfD reference dose 

RNA ribonucleic acid 

RQ reportable quantity 

RTECS Registry of Toxic Effects of Chemical Substances 

SARA Superfund Amendments and Reauthorization Act 

SCE sister chromatid exchange 

SGOT serum glutamic oxaloacetic transaminase 

SGPT serum glutamic pyruvic transaminase 

SIC standard industrial classification 

SIM selected ion monitoring 

SMCL secondary maximum contaminant level 

SMR standardized mortality ratio 

SNARL suggested no adverse response level 

SPEGL Short-Term Public Emergency Guidance Level 

STEL short term exposure limit 

STORET Storage and Retrieval 

TD50 toxic dose, 50% specific toxic effect 

TLV threshold limit value 

TOC total organic carbon 

TPQ threshold planning quantity 

TRI Toxics Release Inventory 

TSCA Toxic Substances Control Act 

TWA time-weighted average 

UF uncertainty factor 

U.S. United States 

USDA United States Department of Agriculture 

USGS United States Geological Survey 

USNRC United States Nuclear Regulatory Commission 

VOC volatile organic compound 

WBC white blood cell 
CESIUM C-5 

APPENDIX C 

WHO World Health Organization 

> greater than ≥ greater than or equal to 

= equal to 

< less than ≤ less than or equal to 

% percent α alpha β beta γ gamma δ delta 

μm micrometer 

μg microgram q1

* cancer slope factor 

– negative 

+ positive 

(+) weakly positive result 

(–) weakly negative result 

CESIUM D-1 

APPENDIX D. OVERVIEW OF BASIC RADIATION PHYSICS, CHEMISTRY, 

AND BIOLOGY 

Understanding the basic concepts in radiation physics, chemistry, and biology is important to the 

evaluation and interpretation of radiation-induced adverse health effects and to the derivation of radiation 

protection principles. This appendix presents a brief overview of the areas of radiation physics, 

chemistry, and biology and is based to a large extent on the reviews of Mettler and Moseley (1985), 

Hobbs and McClellan (1986), Eichholz (1982), Hendee (1973), Cember (1996), and Early et al. (1979). 

D.1 RADIONUCLIDES AND RADIOACTIVITY 

The substances we call elements are composed of atoms. Atoms in turn are made up of neutrons, protons 

and electrons: neutrons and protons in the nucleus and electrons in a cloud of orbits around the nucleus. 

Nuclide is the general term referring to any nucleus along with its orbital electrons. The nuclide is 

characterized by the composition of its nucleus and hence by the number of protons and neutrons in the 

nucleus. All atoms of an element have the same number of protons (this is given by the atomic number) 

but may have different numbers of neutrons (this is reflected by the atomic mass numbers or atomic 

weight of the element). Atoms with different atomic mass but the same atomic numbers are referred to as 

isotopes of an element. 

The numerical combination of protons and neutrons in most nuclides is such that the nucleus is quantum 

mechanically stable and the atom is said to be stable, i.e., not radioactive; however, if there are too few or 

too many neutrons, the nucleus is unstable and the atom is said to be radioactive. Unstable nuclides 

undergo radioactive transformation, a process in which a neutron or proton converts into the other and a 

beta particle is emitted, or else an alpha particle is emitted. Each type of decay is typically accompanied 

by the emission of gamma rays. These unstable atoms are called radionuclides; their emissions are called 

ionizing radiation; and the whole property is called radioactivity. Transformation or decay results in the 

formation of new nuclides some of which may themselves be radionuclides, while others are stable 

nuclides. This series of transformations is called the decay chain of the radionuclide. The first 

radionuclide in the chain is called the parent; the subsequent products of the transformation are called 

progeny, daughters, or decay products. 

In general there are two classifications of radioactivity and radionuclides: natural and artificial (manmade). Naturally-occurring radioactive materials (NORMs) exist in nature and no additional energy is 

necessary to place them in an unstable state. Natural radioactivity is the property of some naturally 

occurring, usually heavy elements, that are heavier than lead. Radionuclides, such as radium and 

uranium, primarily emit alpha particles. Some lighter elements such as carbon-14 and tritium (hydrogen3) primarily emit beta particles as they transform to a more stable atom. Natural radioactive atoms 

heavier than lead cannot attain a stable nucleus heavier than lead. Everyone is exposed to background 

radiation from naturally-occurring radionuclides throughout life. This background radiation is the major 

source of radiation exposure to man and arises from several sources. The natural background exposures 

are frequently used as a standard of comparison for exposures to various artificial sources of ionizing 

radiation. 

Artificial radioactive atoms are produced either as a by-product of fission of uranium or plutonium atoms 

in a nuclear reactor or by bombarding stable atoms with particles, such as neutrons or protons, directed at 

the stable atoms with high velocity. These artificially produced radioactive elements usually decay by 

emission of particles, such as positive or negative beta particles and one or more high energy photons 

(gamma rays). Unstable (radioactive) atoms of any element can be produced. 
CESIUM D-2 

APPENDIX D 

Both naturally occurring and artificial radioisotopes find application in medicine, industrial products, and 

consumer products. Some specific radioisotopes, called fall-out, are still found in the environment as a 

result of nuclear weapons use or testing. 

D.2 RADIOACTIVE DECAY 

D.2.1 Principles of Radioactive Decay 

The stability of an atom is the result of the balance of the forces of the various components of the nucleus. 

An atom that is unstable (radionuclide) will release energy (decay) in various ways and transform to 

stable atoms or to other radioactive species called daughters, often with the release of ionizing radiation. 

If there are either too many or too few neutrons for a given number of protons, the resulting nucleus may 

undergo transformation. For some elements, a chain of daughter decay products may be produced until 

stable atoms are formed. Radionuclides can be characterized by the type and energy of the radiation 

emitted, the rate of decay, and the mode of decay. The mode of decay indicates how a parent compound 

undergoes transformation. Radiations considered here are primarily of nuclear origin, i.e., they arise from 

nuclear excitation, usually caused by the capture of charged or uncharged nucleons by a nucleus, or by the 

radioactive decay or transformation of an unstable nuclide. The type of radiation may be categorized as 

charged or uncharged particles, protons, and fission products) or electromagnetic radiation (gamma rays 

and x rays). Table D-1 summarizes the basic characteristics of the more common types of radiation 

encountered. 

D.2.2 Half-Life and Activity 

For any given radionuclide, the rate of decay is a first-order process that is constant, regardless of the 

radioactive atoms present and is characteristic for each radionuclide. The process of decay is a series of 

random events; temperature, pressure, or chemical combinations do not effect the rate of decay. While it 

may not be possible to predict exactly which atom is going to undergo transformation at any given time, it 

is possible to predict, on average, the fraction of the radioactive atoms that will transform during any 

interval of time. 

The activity is a measure of the quantity of radioactive material. For these radioactive materials it is 

customary to describe the activity as the number of disintegrations (transformations) per unit time. The 

unit of activity is the curie (Ci), which was originally related to the activity of one gram of radium, but is 

now defined as that quantity of radioactive material in which there are: 

1 curie (Ci) = 3.7x1010 disintegrations (transformations)/second (dps) or 2.22x1012 disintegrations 

(transformations)/minute (dpm). 

The SI unit of activity is the becquerel (Bq); 1 Bq = that quantity of radioactive material in which there is 

1 transformation/second. Since activity is proportional to the number of atoms of the radioactive 

material, the quantity of any radioactive material is usually expressed in curies, regardless of its purity or 

concentration. The transformation of radioactive nuclei is a random process, and the number of 

transformations is directly proportional to the number of radioactive atoms present. For any pure 

radioactive substance, the rate of decay is usually described by its radiological half-life, TR, i.e., the time 

it takes for a specified source material to decay to half its initial activity. The specific activity is the 

activity of a radionuclide per mass of that radionuclide. If properly qualified, it can refer to activity per 

unit mass of related materials, such as the element itself or a chemical compound labeled with the 

radionuclide. The higher the specific activity of a radioisotope, the faster it is decaying. 
CESIUM D-3 

APPENDIX D 

The activity of a radionuclide at time t may be calculated by: 

-0.693t/Trad A = Aoe

where A is the activity in dps or curies or becquerels, Ao is the activity at time zero, t is the time at which 

measured, and Trad is the radiological half-life of the radionuclide (Trad and t must be in the same units of 

time). The time when the activity of a sample of radioactivity becomes one-half its original value is the 

radioactive half-life and is expressed in any suitable unit of time. 

Table D-1. Characteristics of Nuclear Radiations 

Typical Path lengthb 

Radiation Rest massa Charge energy range Air Solid Comments 

Alpha (α) 4.00 amu +2 4–10 MeV 5–10 cm 25–80 μm Identical to ionized 

He nucleus 

Negatron (β–

) 5.48x10-4 amu; –1 0–4 MeV 0–10 m 0–1 cm Identical to electron 

0.51 MeV 

Positron (β+

) 5.48x10-4 amu; +1 0-4 MeV 0–10 m 0–1 cm Identical to electron 

0.51 MeV except for sign of 

charge 

Neutron 1.0086 amu; 0 0–15 MeV b b Free half-life: 16 

939.55 MeV min 

X ray (e.m. – 0 5 keV–100 keV b b Photon from 

photon) transition of an 

electron between 

atomic orbits 

Gamma (p) – 0 10 keV–3 MeV b b Photon from 

nuclear (e.m. photon) 

transformation 

a

 The rest mass (in amu) has an energy equivalent in MeV that is obtained using the equation E=mc2, where 1 amu = 932 MeV. b

 Path lengths are not applicable to x- and gamma rays since their intensities decrease exponentially; path lengths in solid tissue 

are variable, depending on particle energy, electron density of material, and other factors. 

 amu = atomic mass unit; e.m. = electromagnetic; MeV = Megaelectron Volts 

The specific activity is a measure of activity, and is defined as the activity of a radionuclide per mass of 

that radionuclide. This activity is usually expressed in curies per gram and may be calculated by 

curies/gram = 1.3x108

 / (Trad) (atomic weight) or 

[3.577 x 105 x mass(g)] / [Trad x atomic weight] 

where Trad is the radiological half-life in days. 

In the case of radioactive materials contained in living organisms, an additional consideration is made for 

the reduction in observed activity due to regular processes of elimination of the respective chemical or 

biochemical substance from the organism. This introduces a rate constant called the biological half-life 

(Tbiol) which is the time required for biological processes to eliminate one-half of the activity. This time 

is virtually the same for both stable and radioactive isotopes of any given element. 
CESIUM D-4 

APPENDIX D 

Under such conditions the time required for a radioactive element to be halved as a result of the combined 

action of radioactive decay and biological elimination is the effective clearance half-time: 

Teff = (Tbiol x Trad) / (Tbiol + Trad). 

Table D-2 presents representative effective half-lives of particular interest. 

Table D-2. Half-Lives of Some Radionuclides in Adult Body Organs 

Half-lifea 

Radionuclide Critical organ Physical Biological Effective 

Uranium 238 

Hydrogen 3b 

Kidney 

Whole body 

4,460,000,000 y 

12.3 y 

4 d 

10 d 

4 d 

10 d 

(Tritium) 

Iodine 131 Thyroid 8 d 80 d 7.3 d 

Strontium 90 Bone 28 y 50 y 18 y 

Plutonium 239 Bone surface 24,400 y 50 y 50 y 

Lung 24,400 y 500 d 474 d 

Cobalt 60 Whole body 5.3 y 99.5 d 95 d 

Iron 55 Spleen 2.7 y 600 d 388 d 

Iron 59 Spleen 45.1 d 600 d 42 d 

Manganese 54 Liver 303 d 25 d 23 d 

Cesium 137 Whole body 30 y 70 d 70 d 

a

d = days, y = years

b

Mixed in body water as tritiated water 

D.2.3 Interaction of Radiation with Matter 

Both ionizing and nonionizing radiation will interact with materials; that is, radiation will lose kinetic 

energy to any solid, liquid or gas through which it passes by a variety of mechanisms. The transfer of 

energy to a medium by either electromagnetic or particulate radiation may be sufficient to cause 

formation of ions. This process is called ionization. Compared to other types of radiation that may be 

absorbed, such as ultraviolet radiation, ionizing radiation deposits a relatively large amount of energy into 

a small volume. 

The method by which incident radiation interacts with the medium to cause ionization may be direct or 

indirect. Electromagnetic radiations (x rays and gamma photons) are indirectly ionizing; that is, they give 

up their energy in various interactions with cellular molecules, and the energy is then utilized to produce a 

fast-moving charged particle such as an electron. It is the electron that then may react with a target 

molecule. This particle is called a “primary ionizing particle. Charged particles, in contrast, strike the 

tissue or medium and directly react with target molecules, such as oxygen or water. These particulate 

radiations are directly ionizing radiations. Examples of directly ionizing particles include alpha and beta 

particles. Indirectly ionizing radiations are always more penetrating than directly ionizing particulate 

radiations. 

Mass, charge, and velocity of a particle, as well as the electron density of the material with which it 

interacts, all affect the rate at which ionization occurs. The higher the charge of the particle and the lower 

the velocity, the greater the propensity to cause ionization. Heavy, highly charged particles, such as alpha 

particles, lose energy rapidly with distance and, therefore, do not penetrate deeply. The result of these 
CESIUM D-5 

APPENDIX D 

interaction processes is a gradual slowing down of any incident particle until it is brought to rest or 

"stopped" at the end of its range. 

D.2.4 Characteristics of Emitted Radiation 

D.2.4.1 Alpha Emission. In alpha emission, an alpha particle consisting of two protons and two 

neutrons is emitted with a resulting decrease in the atomic mass number by four and reduction of the 

atomic number of two, thereby changing the parent to a different element. The alpha particle is identical 

to a helium nucleus consisting of two neutrons and two protons. It results from the radioactive decay of 

some heavy elements such as uranium, plutonium, radium, thorium, and radon. The alpha particles 

emitted by a given radionuclide have the same energy and intensity combination. Most of the alpha 

particles that are likely to be found have energies in the range of about 4 to 8 MeV, depending on the 

isotope from which they came. 

The alpha particle has an electrical charge of +2. Because of this double positive charge and their size, 

alpha particles have great ionizing power and, thus, lose their kinetic energy quickly. This results in very 

little penetrating power. In fact, an alpha particle cannot penetrate a sheet of paper. The range of an 

alpha particle (the distance the charged particle travels from the point of origin to its resting point) is 

about 4 cm in air, which decreases considerably to a few micrometers in tissue. These properties cause 

alpha emitters to be hazardous only if there is internal contamination (i.e., if the radionuclide is inside the 

body). 

D.2.4.2 Beta Emission. A beta particle (&) is a high-velocity electron ejected from a disintegrating 

nucleus. The particle may be either a negatively charged electron, termed a negatron (&-) or a positively 

charged electron, termed a positron (&+). Although the precise definition of "beta emission" refers to 

both &- and &+, common usage of the term generally applies only to the negative particle, as distinguished 

from the positron emission, which refers to the &+ particle. 

D.2.4.2.1 Beta Negative Emission. Beta particle (&-) emission is another process by which a 

radionuclide, with a neutron excess achieves stability. Beta particle emission decreases the number of 

neutrons by one and increases the number of protons by one, while the atomic mass number remains 

unchanged.1

 This transformation results in the formation of a different element. The energy spectrum of 

beta particle emission ranges from a certain maximum down to zero with the mean energy of the 

spectrum being about one-third of the maximum. The range of betas is much less in tissue than in air. 

Beta negative emitting radionuclides can cause injury to the skin and superficial body tissues, but mostly 

present an internal contamination hazard. 

D.2.4.2.2 Positron Emission. In cases in which there are too many protons in the nucleus, positron 

emission may occur. In this case a proton may be thought of as being converted into a neutron, and a 

positron (&+) is emitted.1 This increases the number of neutrons by one, decreases the number of protons 

by one, and again leaves the atomic mass number unchanged. The gamma radiation resulting from the 

annihilation (see glossary) of the positron makes all positron emitting isotopes more of an external 

radiation hazard than pure & emitters of equal energy. 

D.2.4.2.3 Gamma Emission. Radioactive decay by alpha, beta, or positron emission, or electron 

capture often leaves some of the energy resulting from these changes in the nucleus. As a result, the 

nucleus is raised to an excited level. None of these excited nuclei can remain in this high-energy state. 

Nuclei release this energy returning to ground state or to the lowest possible stable energy level. The 

energy released is in the form of gamma radiation (high energy photons) and has an energy equal to the 

1

 Neutrinos also accompany negative beta particles and positron emissions 
CESIUM D-6 

APPENDIX D 

change in the energy state of the nucleus. Gamma and x rays behave similarly but differ in their origin; 

gamma emissions originate in the nucleus while x rays originate in the orbital electron structure or from 

rapidly changing the velocity of an electron (e.g., as occurs when shielding high energy beta particles or 

stopping the electron beam in an x ray tube). 

D.3 ESTIMATION OF ENERGY DEPOSITION IN HUMAN TISSUES 

Two forms of potential radiation exposures can result: internal and external. The term exposure denotes 

physical interaction of the radiation emitted from the radioactive material with cells and tissues of the 

human body. An exposure can be "acute" or "chronic" depending on how long an individual or organ is 

exposed to the radiation. Internal exposures occur when radionuclides, which have entered the body (e.g., 

through the inhalation, ingestion, or dermal pathways), undergo radioactive decay resulting in the 

deposition of energy to internal organs. External exposures occur when radiation enters the body directly 

from sources located outside the body, such as radiation emitters from radionuclides on ground surfaces, 

dissolved in water, or dispersed in the air. In general, external exposures are from material emitting 

gamma radiation, which readily penetrate the skin and internal organs. Beta and alpha radiation from 

external sources are far less penetrating and deposit their energy primarily on the skin's outer layer. 

Consequently, their contribution to the absorbed dose of the total body dose, compared to that deposited 

by gamma rays, may be negligible. 

Characterizing the radiation dose to persons as a result of exposure to radiation is a complex issue. It is 

difficult to: (1) measure internally the amount of energy actually transferred to an organic material and to 

correlate any observed effects with this energy deposition; and (2) account for and predict secondary 

processes, such as collision effects or biologically triggered effects, that are an indirect consequence of 

the primary interaction event. 

D.3.1 Dose/Exposure Units 

D.3.1.1 Roentgen. The roentgen (R) is a unit of x or gamma-ray exposure and is a measured by the 

amount of ionization caused in air by gamma or x radiation. One roentgen produces 2.58x10-4 coulomb 

per kilogram of air. In the case of gamma radiation, over the commonly encountered range of photon 

energy, the energy deposition in tissue for a dose of 1 R is about 0.0096 joules (J) /kg of tissue. 

D.3.1.2 Absorbed Dose and Absorbed Dose Rate. The absorbed dose is defined as the energy 

imparted by radiation to a unit mass of the tissue or organ. The unit of absorbed dose is the rad; 1 rad = 

100 erg/gram = 0.01 J/kg in any medium. An exposure of 1 R results in a dose to soft tissue of 

approximately 0.01 J/kg. The SI unit is the gray which is equivalent to 100 rad or 1 J/kg. Internal and 

external exposures from radiation sources are not usually instantaneous but are distributed over extended 

periods of time. The resulting rate of change of the absorbed dose to a small volume of mass is referred 

to as the absorbed dose rate in units of rad/unit time. 

D.3.1.3 Working Levels and Working Level Months. Working level (WL) is a measure of the 

atmospheric concentration of radon and its short-lived progeny. One WL is defined as any combination 

of short-lived radon daughters (through polonium-214), per liter of air, that will result in the emission of 

1.3x105

 MeV of alpha energy. An activity concentration of 100 pCi radon-222/L of air, in equilibrium 

with its daughters, corresponds approximately to a potential alpha-energy concentration of 1 WL. The 

WL unit can also be used for thoron daughters. In this case, 1.3x105

 MeV of alpha energy (1 WL) is 

released by the thoron daughters in equilibrium with 7.5 pCi thoron/L. The potential alpha energy 

exposure of miners is commonly expressed in the unit Working Level Month (WLM). One WLM 

corresponds to exposure to a concentration of 1 WL for the reference period of 170 hours, or more 

generally 
CESIUM D-7 

APPENDIX D 

WLM = concentration (WL) x exposure time (months) (one “month” = 170 working hours). 

D.3.2 Dosimetry Models 

Dosimetry models are used to estimate the dose from internally deposited to radioactive substances. The 

models for internal dosimetry consider the amount of radionuclides entering the body, the factors 

affecting their movement or transport through the body, distribution and retention of radionuclides in the 

body, and the energy deposited in organs and tissues from the radiation that is emitted during spontaneous 

decay processes. The dose pattern for radioactive materials in the body may be strongly influenced by the 

route of entry of the material. For industrial workers, inhalation of radioactive particles with pulmonary 

deposition and puncture wounds with subcutaneous deposition have been the most frequent. The general 

population has been exposed via ingestion and inhalation of low levels of naturally occurring 

radionuclides as well as radionuclides from nuclear weapons testing. 

The models for external dosimetry consider only the photon doses (and neutron doses, where applicable) 

to organs of individuals who are immersed in air or are exposed to a contaminated object. 

D.3.2.1 Ingestion. Ingestion of radioactive materials is most likely to occur from contaminated 

foodstuffs or water or eventual ingestion of inhaled compounds initially deposited in the lung. Ingestion 

of radioactive material may result in toxic effects as a result of either absorption of the radionuclide or 

irradiation of the gastrointestinal tract during passage through the tract, or a combination of both. The 

fraction of a radioactive material absorbed from the gastrointestinal tract is variable, depending on the 

specific element, the physical and chemical form of the material ingested, and the diet, as well as some 

other metabolic and physiological factors. The absorption of some elements is influenced by age, usually 

with higher absorption in the very young. 

D.3.2.2 Inhalation. The inhalation route of exposure has long been recognized as being a major 

portal of entry for both nonradioactive and radioactive materials. The deposition of particles within the 

lung is largely dependent upon the size of the particles being inhaled. After the particle is deposited, the 

retention will depend upon the physical and chemical properties of the dust and the physiological status of 

the lung. The retention of the particle in the lung depends on the location of deposition, in addition to the 

physical and chemical properties of the particles. The converse of pulmonary retention is pulmonary 

clearance. There are three distinct mechanisms of clearance which operate simultaneously. Ciliary 

clearance acts only in the upper respiratory tract. The second and third mechanisms act mainly in the 

deep respiratory tract. These are phagocytosis and absorption. Phagocytosis is the engulfing of foreign 

bodies by alveolar macrophages and their subsequent removal either up the ciliary "escalator" or by 

entrance into the lymphatic system. Some inhaled soluble particles are absorbed into the blood and 

translocated to other organs and tissues. 

D.3.3 Internal Emitters 

An internal emitter is a radionuclide that is inside the body. The absorbed dose from internally deposited 

radionuclide depends on the energy absorbed per unit mass by the irradiated tissue. For a radionuclide 

distributed uniformly throughout an infinitely large medium, the concentration of absorbed energy must 

be equal to the concentration of energy emitted by the radionuclide. An infinitely large medium may be 

approximated by a tissue mass whose dimensions exceed the range of the particle. All alpha and most 

beta radiation will be absorbed in the organ (or tissue) of reference. Gamma-emitting radionuclide 

emissions are penetrating radiation, and a substantial fraction of gamma energy may be absorbed in 

tissue. The dose to an organ or tissue is a function of the effective retention half-time, the energy released 

in the tissue, the amount of radioactivity initially introduced, and the mass of the organ or tissue. 
CESIUM D-8 

APPENDIX D 

D.4 BIOLOGICAL EFFECTS OF RADIATION 

When biological material is exposed to ionizing radiation, a chain of cellular events occurs as the ionizing 

particle passes through the biological material. A number of theories have been proposed to describe the 

interaction of radiation with biologically important molecules in cells and to explain the resulting damage 

to biological systems from those interactions. Many factors may modify the response of a living 

organism to a given dose of radiation. Factors related to the exposure include the dose rate, the energy of 

the radiation, and the temporal pattern of the exposure. Biological considerations include factors such as 

species, age, sex, and the portion of the body exposed. Several excellent reviews of the biological effects 

of radiation have been published, and the reader is referred to these for a more in-depth discussion 

(Brodsky 1996; Hobbs and McClellan 1986; ICRP 1984; Mettler and Moseley 1985; Rubin and Casarett 

1968). 

D.4.1 Radiation Effects at the Cellular Level 

According to Mettler and Moseley (1985), at acute doses up to 10 rad (100 mGy), single strand breaks in 

DNA may be produced. These single strand breaks may be repaired rapidly. With doses in the range of 

50–500 rad (0.5–5 Gy), irreparable double-stranded DNA breaks are likely, resulting in cellular 

reproductive death after one or more divisions of the irradiated parent cell. At large doses of radiation, 

usually greater than 500 rad (5 Gy), direct cell death before division (interphase death) may occur from 

the direct interaction of free-radicals with essential cellular macromolecules. Morphological changes at 

the cellular level, the severity of which are dose-dependent, may also be observed. 

The sensitivity of various cell types varies. According to the Bergonie-Tribondeau law, the sensitivity of 

cell lines is directly proportional to their mitotic rate and inversely proportional to the degree of 

differentiation (Mettler and Moseley 1985). Rubin and Casarett (1968) devised a classification system 

that categorized cells according to type, function, and mitotic activity. The categories range from the 

most sensitive type, "vegetative intermitotic cells", found in the stem cells of the bone marrow and the 

gastrointestinal tract, to the least sensitive cell type, "fixed postmitotic cells," found in striated muscles or 

long-lived neural tissues. 

Cellular changes may result in cell death, which if extensive, may produce irreversible damage to an 

organ or tissue or may result in the death of the individual. If the cell recovers, altered metabolism and 

function may still occur, which may be repaired or may result in the manifestation of clinical symptoms. 

These changes may also be expressed at a later time as tumors or cellular mutations, which may result in 

abnormal tissue. 

D.4.2 Radiation Effects at the Organ Level 

In most organs and tissues the injury and the underlying mechanism for that injury are complex and may 

involve a combination of events. The extent and severity of this tissue injury are dependent upon the 

radiosensitivity of the various cell types in that organ system. Rubin and Casarett (1968) describe and 

schematically display the events following radiation in several organ system types. These include: a 

rapid renewal system, such as the gastrointestinal mucosa; a slow renewal system, such as the pulmonary 

epithelium; and a nonrenewal system, such as neural or muscle tissue. In the rapid renewal system, organ 

injury results from the direct destruction of highly radiosensitive cells, such as the stem cells in the bone 

marrow. Injury may also result from constriction of the microcirculation and from edema and 

inflammation of the basement membrane, designated as the histohematic barrier, which may progress to 

fibrosis. In slow renewal and nonrenewal systems, the radiation may have little effect on the parenchymal 
CESIUM D-9 

APPENDIX D 

cells, but ultimate parenchymal atrophy and death over several months result from fibrosis and occlusion 

of the microcirculation. 

D.4.3 Low Level Radiation Effects 

Cancer is the major latent harmful effect produced by ionizing radiation and the one that most people 

exposed to radiation are concerned about. The ability of alpha, beta, and gamma radiation to produce 

cancer in virtually every tissue and organ in laboratory animals has been well-demonstrated. The 

development of cancer is not an immediate effect. Radiation-induced leukemia has the shortest latent 

period at about 2 years, while other radiation induced cancers, such as osteosarcoma, have latent periods 

greater than 20 years. The mechanism by which cancer is induced in living cells is complex and is a topic 

of intense study. Exposure to ionizing radiation can produce cancer at any site within the body; however, 

some sites appear to be more common than others, such as the breast, lung, stomach, and thyroid. 

DNA is the major target molecule during exposure to ionizing radiation. Other macromolecules, such as 

lipids and proteins, are also at risk of damage when exposed to ionizing radiation. The genotoxicity of 

ionizing radiation is an area of intense study, as damage to the DNA is ultimately responsible for many of 

the adverse toxicological effects ascribed to ionizing radiation, including cancer. Damage to genetic 

material is basic to developmental or teratogenic effects, as well. However, for effects other than cancer, 

there is little evidence of human effects at low levels of exposure. 

D.5 UNITS IN RADIATION PROTECTION AND REGULATION 

D.5.1 Dose Equivalent (or Equivalent Dose) 

Dose equivalent (as measured in rem or sievert) is a special radiation protection quantity that is used for 

administrative and radiation safety purposes to express the absorbed dose in a manner which considers the 

difference in biological effectiveness of various kinds of ionizing radiation. ICRP (1990) changed this 

term to equivalent dose, but it has not yet been adopted by the USNRC or DOE. 

The USNRC defines the dose equivalent, H, as the product of the absorbed dose, D, and the quality 

factor, Q, at the point of interest in biological tissue. This relationship is expressed as H = D x Q. The 

dose equivalent concept is applicable only to doses that are not great enough to produce biomedical 

effects. 

The quality factor or radiation weighting factor is a dimensionless quantity that depends in part on the 

stopping power for charged particles, and it accounts for the differences in biological effectiveness found 

among the types of radiation. Originally relative biological effectiveness (RBE) was used rather than Q 

to define the quantity, rem, which was of use in risk assessment. The generally accepted values for 

quality factors and radiation weighting factors for various radiation types are provided in Table D-3. The 

dose equivalent rate is the time rate of change of the dose equivalent to organs and tissues and is 

expressed as rem/unit time or sievert/unit time. 
CESIUM D-10 

APPENDIX D 

Table D-3. Quality Factors (Q) and Absorbed Dose Equivalencies 

Type of radiation Quality factor (Q) Radiation weighting factor (wr)* 

X, gamma, or beta radiation 1 1 

Alpha particles, multiple- 20 0.05 

charged particles, fission 

fragments and heavy particles of 

unknown charge 

Neutrons (other than thermal >> 10 20 

100 keV to 2 MeV), protons, 

alpha particles, charged 

particles of unknown energy 

Neutrons of unknown energy 10 

High-energy protons 10 0.1 

Thermal neutrons 5 

*Absorbed dose in rad equal to 1 rem or the absorbed dose in gray equal to 1 sievert. 

Source: USNRC. 2004. Standards for the protection against radiation, table 1004(b).1. 10 CFR 20.1004. U.S. Nuclear
 

Regulatory Commission, Washington, D.C. NCRP 1993 

D.5.2 Relative Biological Effectiveness 

RBE is used to denote the experimentally determined ratio of the absorbed dose from one radiation type 

to the absorbed dose of a reference radiation required to produce an identical biologic effect under the 

same conditions. Gamma rays from cobalt-60 and 200–250 kVp x-rays have been used as reference 

standards. The term RBE has been widely used in experimental radiobiology, and the term quality factor 

(or radiation weighting factor) used in calculations of dose equivalents for radiation safety purposes 

(ICRP 1977; NCRP 1971; UNSCEAR 1982). Any RBE value applies only to a specific biological end 

point, in a specific exposure, under specific conditions to a specific species. There are no generally 

applicable values of RBE since RBEs are specific to a given exposure scenario. 

D.5.3 Effective Dose Equivalent (or Effective Dose) 

The absorbed dose is usually defined as the mean energy imparted per unit mass to an organ or tissue. 

This represents a simplification of the actual problem. Normally when an individual ingests or inhales a 

radionuclide or is exposed to external radiation that enters the body (gamma), the dose is not uniform 

throughout the whole body. The simplifying assumption is that the detriment will be the same whether 

the body is uniformly or non-uniformly irradiated. In an attempt to compare detriment from absorbed 

dose of a limited portion of the body with the detriment from total body dose, the ICRP (1977) has 

derived a concept of effective dose equivalent. ICRP (1990) changed this term to effective dose, but it 

has not yet been adopted by the USNRC or DOE. 

The effective dose equivalent, HE, is 

HE = (the sum of) Wt Ht 
CESIUM D-11 

APPENDIX D 

where Ht is the dose equivalent (or equivalent dose) in the tissue t, Wt is the tissue weighting factor in that 

tissue, which represents the estimated proportion of the stochastic risk resulting from tissue, t, to the 

stochastic risk when the whole body is uniformly irradiated for occupational exposures under certain 

conditions (ICRP 1977). Tissue weighting factors for selected tissues are listed in Table D-4. 

D.5.4 SI Units 

The ICRU (1980), ICRP (1984), and NCRP (1985) now recommend that the rad, roentgen, curie, and rem 

be replaced by the SI units: gray (Gy), Coulomb per kilogram (C/kg), Becquerel (Bq), and sievert (Sv), 

respectively. The relationship between the customary units and the international system of units (SI) for 

radiological quantities is shown in Table D-5. 

Table D-4. Tissue Weighting Factors for Calculating Effective Dose 

Equivalent and Effective Dose for Selected Tissues
 

Tissue weighting factor 

Tissue NCRP115/ ICRP60 USNRC/ICRP26 

Bladder 0.05 – 

Bone marrow 0.12 0.12 

Bone surface 0.01 0.03 

Breast 0.05 0.15 

Colon 0.12 – 

Esophagus 0.05 – 

Gonads 0.20 0.25 

Liver 0.05 – 

Lung 0.12 0.12 

Skin 0.01 – 

Stomach 0.12 – 

Thyroid 0.05 0.03 

Remainder 0.05 0.30 

Total 1.00 1.00 

ICRP60 = International Commission on Radiological Protection, 1990 Recommendations of the ICRP 

NCRP115 = National Council on Radiation Protection and Measurements. 1993. Risk Estimates for Radiation Protection, 

Report 115. Bethesda, Maryland 

USNRC = Nuclear Regulatory Commission, Title 10, Code of Federal Regulations, Part 20 
CESIUM D-12 

APPENDIX D 

Table D-5. Comparison of Common and SI Units for Radiation Quantities 

Customary 

Quantity units Definition SI units Definition 

Activity (A) curie (Ci) 3.7x1010 becquerel (Bq) s-1 

transformations s1 

Absorbed dose (D) rad 10-2 Jkg-1 gray (Gy) Jkg-1 

-1 -1 Absorbed dose rate rad per second 10-2 Jkg-1s gray per second Jkg-1 s

(Ď) (rad s-1) (Gy s-1) 

Dose equivalent (H) rem 10-2 Jkg-1 sievert (Sv) Jkg-1 

-1 -1 Dose equivalent rate rem per second 10-2 Jkg-1s sievert per second Jkg-1 s

( ) (rem s-1) (Sv s-1) 

Effective dose rem 10-2 Jkg-1 Sievert (Sv) Jkg-1 

Equivalent dose (H) rem 10-2 Jkg-1 Sievert (Sv) Jkg-1 

Linear energy kiloelectron 1.602x10-10 Jm-1 kiloelectron volts 1.602x10-10 Jm-1 

transfer (LET) volts per per micrometer 

micrometer (keV μm-1) 

(keV μm-1) 

Jkg-1 = Joules per kilogram; Jkg-1s

-1 = Joules per kilogram per second; Jm-1 = Joules per meter; s-1 = per second 

REFERENCES FOR APPENDIX D 

ATSDR. 1990a. Toxicological profile for thorium. U.S. Department of Health and Human Services. 

Public Health Service. Agency for Toxic Substances and Disease Registry. Atlanta, GA. 

ATSDR. 1990b. Toxicological profile for radium. U.S. Department of Health and Human Services. 

Public Health Service. Agency for Toxic Substances and Disease Registry. Atlanta, GA. 

ATSDR. 1990c. Toxicological profile for radon. U.S. Department of Health and Human Services. 

Public Health Service. Agency for Toxic Substances and Disease Registry. Atlanta, GA. 

ATSDR. 1999. Toxicological profile for uranium. U.S. Department of Health and Human Services. 

Public Health Service. Agency for Toxic Substances and Disease Registry. Atlanta, GA. 

BEIR III. 1980. The effects on populations of exposure to low levels of ionizing radiation. Committee 

on the Biological Effects of Ionizing Radiations, National Research Council. Washington, DC: National 

Academy Press. 

BEIR IV. 1988. Health risks of radon and other internally deposited alpha emitters. Committee on the 

Biological Effects of Ionizing Radiations, National Research Council. Washington, DC: National 

Academy Press. 

BEIR V. 1988. Health effects of exposure to low levels of ionizing radiation. Committee on the 

Biological Effects of Ionizing Radiations, National Research Council. Washington, DC: National 

Academy Press. 
CESIUM D-13 

APPENDIX D 

Brodsky A. 1996. Review of radiation risks and uranium toxicity with application to decisions 

associated with decommissioning clean-up criteria. Hebron,Connecticut: RSA Publications. 

Cember H. 1996. Introduction to health physics. New York., NY: McGraw Hill. 

Early P, Razzak M, Sodee D. 1979. Nuclear medicine technology. 2nd ed. St. Louis: C.V. Mosby
 

Company.
 

Eichholz G. 1982. Environmental aspects of nuclear power. Ann Arbor, MI: Ann Arbor Science. 

Hendee W. 1973. Radioactive isotopes in biological research. New York, NY: John Wiley and Sons. 

Hobbs C, McClellan R. 1986. Radiation and radioactive materials. In: Doull J, et al., eds. Casarett and 

Doull's Toxicology. 3rd ed. New York, NY: Macmillan Publishing Co., Inc., 497-530. 

ICRP. 1977. International Commission on Radiological Protection. Recommendations of the 

International Commission on Radiological Protection. ICRP Publication 26. Vol 1. No. 3. Oxford: 

Pergamon Press. 

ICRP. 1979. International Commission on Radiological Protection. Limits for intakes of radionuclides 

by workers. ICRP Publication 20. Vol. 3. No. 1-4. Oxford: Pergamon Press. 

ICRP. 1979. Limits for Intakes of Radionuclides by Workers. Publication 30. International 

Commission on Radiological Protection. Pergamon Press. 

ICRP. 1984. International Commission on Radiological Protection. A compilation of the major concepts 

and quantities in use by ICRP. ICRP Publication 42. Oxford: Pergamon Press. 

ICRP. 1990. International Commission on Radiological Protection 1990 Recommendations of the ICRP 

ICRU. 1980. International Commission on Radiation Units and Measurements. ICRU Report No. 33. 

Washington, DC. 

James A. 1987. A reconsideration of cells at risk and other key factors in radon daughter dosimetry. In: 

Hopke P, ed. Radon and its decay products: Occurrence, properties and health effects. ACS Symposium 

Series 331. Washington, DC: American Chemical Society, 400-418. 

James A, Roy M. 1987. Dosimetric lung models. In: Gerber G, et al., ed. Age-related factors in 

radionuclide metabolism and dosimetry. Boston: Martinus Nijhoff Publishers, 95-108. 

Kondo S. 1993. Health effects of low-level radiation. Kinki University Press, Osaka, Japan (available 

from Medical Physics Publishing, Madison, Wisconsin). 

Kato H, Schull W. 1982. Studies of the mortality of A-bomb survivors. Report 7 Part 8, Cancer 

mortality among atomic bomb survivors, 1950-78. Radiat Res 90;395-432. 

Mettler F, Moseley R. 1985. Medical effects of ionizing radiation. New York: Grune and Stratton. 

NCRP. 1971. Basic radiation protection criteria. National Council on Radiation Protection and 

Measurements. Report No. 39. Washington, DC. 
CESIUM D-14 

APPENDIX D 

NCRP. 1985. A handbook of radioactivity measurements procedures. 2nd ed. National Council on 

Radiation Protection and Measurements. Report No. 58. Bethesda, MD: 

NCRP. 1993. Risk estimates for radiation protection. National Council on Radiation Protection and 

Measurements. Report 115. Bethesda, Maryland 

Otake M, Schull W. 1984. Mental retardation in children exposed in utero to the atomic bombs: A 

reassessment. Technical Report RERF TR 1-83, Radiation Effects Research Foundation, Japan. 

Rubin P, Casarett G. 1968. Clinical radiation pathology. Philadelphia: W.B. Sanders Company, 33. 

UNSCEAR. 1977. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources 

and effects of ionizing radiation. New York: United Nations. 

UNSCEAR. 1982. United Nations Scientific Committee on the Effects of Atomic Radiation. Ionizing 

radiation: Sources and biological effects. New York: United Nations. 

UNSCEAR. 1986. United Nations Scientific Committee on the Effects of Atomic Radiation. Genetic 

and somatic effects of ionizing radiation. New York: United Nations. 

UNSCEAR. 1988. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources, 

effects and risks of ionization radiation. New York: United Nations. 

UNSCEAR. 1993. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources 

and effects of ionizing radiation. New York: United Nations. 

USNRC. 1999. Standards for the protection against radiation, table 1004(b).1. 10 CFR 20.1004. U.S. 

Nuclear Regulatory Commission, Washington, D.C. 
CESIUM E-1 

APPENDIX E. INDEX 

absorbed dose.......................................................................................................... 13, 14, 21, 39, 45, 58, 94 

active transport........................................................................................................................ 63, 87, 92, 108 

adipose tissue ........................................................................................................................................ 81, 84 

adsorbed .............................................................................................................................. 20, 139, 152, 156 

adsorption..................................................................................................................................................139 

ALT.............................................................................................................................................................38 

ambient air ................................................................................................................................................148 

anemia.........................................................................................................................................................37 

AST.............................................................................................................................................................38 

azoospermia ...................................................................................................................... 14, 35, 40, 53, 104 

bioaccumulation........................................................................................................................ 138, 156, 158 

bioavailability ................................................................................................................................... 139, 156 

bioconcentration factor .............................................................................................................................138 

bioconcentration factors............................................................................................................................138 

biodistribution.............................................................................................................................................21 

biokinetic ............................................................................................................................ 21, 51, 58, 68, 80 

biokinetics..................................................................................................................... 16, 17, 21, 33, 36, 87 

biological half-time......................................................................................................... 59, 64, 66, 106, 108 

biological half-times ..................................................................................................................... 59, 64, 108 

biomarker .............................................................................................................................................. 93, 94 

biomarkers .................................................................................................................... 93, 94, 106, 108, 159 

blood cell count................................................................................................................... 34, 38, 39, 52, 94 

blood cell counts ....................................................................................................................... 34, 38, 52, 94 

body weight effects .....................................................................................................................................28 

Body Weight Effects...................................................................................................................................28 

bone marrow aplasia ................................................................................................... 22, 34, 38, 53, 94, 106 

bone marrow depression ............................................. 14, 16, 17, 23, 33, 34, 36, 37, 39, 44, 45, 52, 53, 104 

breast milk....................................................................................... 4, 58, 60, 62, 66, 92, 108, 150, 152, 157 

cancer .................................................. 5, 6, 13, 14, 15, 16, 23, 27, 30, 35, 43, 51, 62, 64, 91, 102, 121, 173
 

carcinogenic .................................................................................................................. 15, 22, 24, 25, 32, 51 

carcinogenicity...................................................................................................................................... 15, 51 

carcinoma....................................................................................................................................................51 

carcinomas ................................................................................................................................ 16, 23, 51, 54 

cardiac arrhythmia ........................................................................................................ 12, 16, 19, 26, 27, 88 

cardiac arrhythmias................................................................................................................... 12, 16, 19, 26 

cardiovascular ............................................................................................................. 27, 30, 37, 44, 52, 101 

cardiovascular effects..................................................................................................................................27 

Cardiovascular Effects .......................................................................................................................... 27, 32 

caribou .................................................................................................................... 4, 20, 145, 154, 156, 157 

Chernobyl..... 4, 11, 12, 33, 57, 59, 60, 64, 65, 102, 103, 125, 134, 136, 137, 139, 140, 141, 143, 144, 145, 

149, 152, ...............................................................................................................................................153 

chromosomal aberrations ...................................................................... 13, 22, 54, 57, 58, 94, 102, 103, 106 

clearance ................................................................................................... 66, 68, 70, 72, 73, 75, 77, 86, 163 

cognitive function ........................................................................................................... 15, 46, 92, 104, 105 

death........................................................ 6, 13, 15, 16, 17, 22, 23, 24, 26, 27, 30, 31, 32, 33, 36, 44, 52, 89
 

deoxyribonucleic acid .................................................................................................................................55 

dermal effects.................................................................................................................... 22, 30, 38, 44, 100 

Dermal Effects ................................................................................................................................ 30, 38, 45 
CESIUM E-2 

APPENDIX E 

DNA................................................................................................................................................ 55, 89, 94 

dopamine.....................................................................................................................................................88 

dose coefficients.................................................................................................................................... 22, 70 

dose equivalent................................................................................................................................ 17, 21, 80 

elimination half-time..................................................................................................... 60, 65, 66, 67, 80, 92 

elimination half-times ................................................................................................... 60, 65, 66, 67, 80, 92 

elimination rate ....................................................................................... 63, 64, 65, 66, 87, 91, 95, 107, 108 

elimination rates...................................................................................... 63, 64, 65, 66, 87, 91, 95, 107, 108 

endocrine........................................................................................................... 27, 30, 32, 37, 44, 52, 89, 90
 

erythema.................................................................................................................................... 20, 22, 44, 45 

external radiation .......................................................................................... 7, 14, 22, 23, 46, 54, 57, 92, 94
 

fetal tissue ........................................................................................................................................... 66, 108 

fetus............................................................................................................................... 46, 58, 62, 66, 90, 92 

fractional absorption ...................................................................................................................................60 

gastrointestinal effects .................................................................................................................... 27, 28, 37 

Gastrointestinal Effects......................................................................................................................... 27, 37 

general population........................................................................... 12, 51, 93, 129, 148, 150, 153, 154, 155 

genotoxic......................................................................................... 13, 17, 23, 24, 54, 57, 58, 101, 103, 106 

genotoxicity................................................................................................................................. 89, 102, 103 

germinal cell.................................................................................................................. 16, 17, 23, 33, 36, 52 

germinal epithelium ................................................................................................................ 14, 35, 53, 104 

groundwater ...................................................................................................................... 135, 136, 142, 143 

growth retardation.......................................................................................................................................50 

half-life........................................................................................ 2, 12, 75, 93, 111, 116, 129, 141, 142, 162 

hematological effects .......................................................................................................... 22, 34, 37, 38, 53
 

Hematological Effects..................................................................................................................... 34, 37, 52 

hematopoietic........................................................................................................................................ 13, 52 

hepatic effects ....................................................................................................................................... 28, 38 

Hepatic Effects...................................................................................................................................... 28, 38 

homeopathic........................................................................................................................ 12, 16, 19, 27, 88 

hydrolysis..................................................................................................................................................119 

immune system ...........................................................................................................................................37 

immunological .................................................................................................. 24, 28, 29, 31, 32, 34, 39, 45 

Kow ............................................................................................................................................................113 

LD50............................................................................................................................. 16, 19, 26, 44, 50, 100 

leukopenia....................................................................................................................................... 13, 22, 52 

lichen................................................................................................................................................... 20, 156 

lichens ................................................................................................................................. 20, 145, 154, 157 

lymphatic ....................................................................................................................................................70 

lymphoreticular............................................................................................................. 28, 29, 31, 34, 39, 45
 

metabolic effects ................................................................................................................. 27, 30, 32, 37, 52 

micronuclei ..................................................................................................................... 23, 57, 58, 102, 103
 

milk ......................................................................................................... 4, 60, 107, 148, 150, 152, 157, 161 

mucociliary ........................................................................................................................................... 70, 77 

neonatal......................................................................................................................................... 67, 95, 150 

neurobehavioral...........................................................................................................................................90 

neutropenia............................................................................................................................................ 22, 45 

norepinephrine ............................................................................................................................................88 

nuclear ......1, 2, 3, 4, 6, 7, 11, 12, 19, 20, 33, 59, 60, 64, 102, 103, 106, 111, 120, 121, 122, 125, 129, 130, 

134, 135, ............................... 136, 137, 140, 141, 142, 143, 144, 145, 149, 150, 152, 153, 155, 157, 158 

ocular effects...............................................................................................................................................39 
CESIUM E-3 

APPENDIX E 

odontogenesis.................................................................................................................... 14, 23, 46, 92, 104 

orofacial ................................................................................................................................................ 22, 38 

pancytopenia ...............................................................................................................................................52 

passive transport.................................................................................................................................... 63, 87 

pharmacodynamic.......................................................................................................................................67 

pharmacokinetic........................................................................................................................ 59, 67, 68, 69 

pharmacokinetics ............................................................................................................................ 89, 91, 92 

placenta ........................................................................................................................................... 58, 62, 66 

placental barrier .......................................................................................................................... 92, 107, 108 

radiation syndrome.................................................................................................. 6, 13, 22, 37, 44, 89, 105 

radiation weighting factor ...........................................................................................................................21 

radiation weighting factors .........................................................................................................................21 

rate constant ................................................................................................................................................80 

rate constants...............................................................................................................................................80 

reindeer ........................................................................................................................... 4, 20, 145, 154, 157 

renal effects.................................................................................................................................................28 

Renal Effects...............................................................................................................................................28 

retention ............................................ 21, 51, 59, 62, 65, 66, 67, 73, 75, 77, 78, 82, 86, 87, 92, 95, 108, 162 

sodium pump................................................................................................................................... 59, 63, 87 

solubility ................................................................................................................. 58, 70, 73, 111, 140, 162
 

spermatogonia............................................................................................................................... 57, 58, 103 

spermatozoa .......................................................................................................................................... 14, 55 

thrombocytopenia ........................................................................................................................... 22, 45, 52 

thyroid................................................................................................................................................. 54, 130 

toxicokinetic........................................................................................................................................ 19, 107 

toxicokinetics ...................................................................................................................................... 95, 107 

tumors ............................................................................................................................... 14, 16, 23, 51, 100 

vapor pressure ...........................................................................................................................................111 

weanling................................................................................................................................................ 67, 95