- 22 Page 11, lines 15-17 - "For all of these reasons it is proposed
that inhaled insoluble alpha emitting amoke particles are very Likely
to be the mutagenic agent which gives rise to atherosclerosis in

cigarette smokers."
Comments:

This statement is a string of poorly founded presumptions covered
by previous comments.
Page 11, lines 18-21 - "If this is the case, similar increased
risk of early coronaries are to be expected for other groups of
individuals who are occupationally or environmentally exposed to the
inhalation of insoluble alpha emitting particles of respirable size,"
Comments:

"Tf. this is the case" is a poorly founded presumption, for reasons
covered in previous comments,
Page 11, lines 26 to Page 12, line 2 - "Very significant increases
in the incidence of early coronaries as well as lung cancers and cancers
at other sites is observed among cigarette smokers‘*6) with insoluble
alpha emitting particle burdens of only a few picocuries of 210p5 in
the lung 14)
and similar total alpha activity per 100 grams of arterial
wall tissue(41-43) .»
Comments:

This sentence is misleading in tying the alpha activity of arterial
wall tissue to the statement about incidence of diseases among cigarette
smokers.

The references (41-43) refer to Elkeles' papers reporting

alpha particle activity in calcified atherosclerosis and in coronary
artery disease, based on measurements in plaques and vessels, where
it is most likely that calcium, and alpha radioactivity with it,

increase after alterations of the arterial tissue that lead to the
rest of the atherosclerotic mechanisms have occurred (see comments on
page Ll, lines 3-7 and 10-12).
Page 12, line 3 to Page 13, line 2 - "By comparison, plutonium workers

exhibit plutonium organ burdens ranging from a few picocuries to a few

Select target paragraph3