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Epidemiology of internal contamination with polonium-210 in the London incident, 2006
  1. G Fraser1,
  2. I Giraudon1,
  3. S Cohuet1,2,
  4. L Bishop1,
  5. H Maguire1,
  6. H L Thomas1,
  7. S Mandal1,
  8. K Anders1,
  9. E Sanchez-Padilla1,3,
  10. A Charlett4,
  11. B Evans4,
  12. R Gross1
  1. 1Local and Regional Services, Health Protection Agency, London, UK
  2. 2European Intervention Epidemiology Training Programme, ECDC, Stockholm, Sweden
  3. 3Spanish Public Health Training Programme, Hospital Clinico San Carlos, Madrid, Spain
  4. 4Centre for Infection, Health Protection Agency, London, UK
  1. Correspondence to Dr Graham Fraser, Health Protection Agency (HPA), 151 Buckingham Palace Road London SW1W 9SZ, UK; graham.fraser{at}


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.

  • Epidemiology ME
  • public health epidemiology
  • radiation

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  • Funding This work was funded by the Health Protection Agency. SC was recipient of a fellowship from the European Intervention Epidemiology Training Programme, and ES was funded by the Spanish Public Health Training Programme.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.