Background More than 700 UK residents were tested for possible contamination with polonium-210 (²¹⁰Po) following the alleged poisoning of Mr Alexander Litvinenko in London in November 2006. This paper describes the epidemiology of internal contamination with the radionuclide in this group.

Methods 11 locations in London had been identified as sufficiently environmentally contaminated with ²¹⁰Po to present a health risk to people associated with them. Public health consultant teams identified individuals at risk and offered 24-h urine testing for ²¹⁰Po excretion. Prevalence of internal contamination was estimated, and a retrospective cohort analysis was completed for each location.

Results Overall 139 individuals (prevalence 0.19 (95% CI 0.13 to 0.27)) showed evidence of internal contamination with ²¹⁰Po, although none with uptakes likely to cause adverse health effects. Substantial prevalence was seen among specific hotel service staff, customers, staff and other users of a hotel bar, office and hospital staff, staff of one restaurant and residents of and visitors to the family home. Increased risks of contamination were seen for a hotel bar in association with occupational, behavioural and temporal factors. Occupational and guest exposure to contaminated areas of hotels were also associated with increased contamination risk. Nurses were more likely to become contaminated than other staff involved in direct patient care.

Conclusions Uptake of trace amounts of radionuclide in this incident was frequent. Occupational, behavioural and temporal gradients in contamination risk were mostly consistent with a priori site risk assessments. Utility of the investigation methods and findings for future accidental or deliberate environmental contamination incidents are discussed.