Albert Stevens (1887–1966), also known as patient CAL-1, was an American house painter from Ohio who was subjected to an involuntary human radiation experiment and survived the highest known accumulated radiation dose in any human. On May 14, 1945, he was injected with 131 kBq (3.55 μCi) of plutonium without his knowledge because it was erroneously believed that he had a terminal disease.

Plutonium remained present in his body for the remainder of his life, the amount decaying slowly through radioactive decay and biological elimination. Stevens died of heart disease some 20 years later, having accumulated an effective radiation dose of 64 Sv (6400 rem) over that period, i.e. an average of 3 Sv per year or 350 μSv/h. The current annual permitted dose for a radiation worker in the United States is 0.05 Sv (or 5 rem), i.e. an average of 5.7 μSv/h.

Background Plutonium was first synthesized in 1940 and isolated in 1941 by chemists at the University of California, Berkeley. Early research (pre-1944) was carried out on small samples manufactured using a cyclotron. The Manhattan Project built mass scale production facilities for the war effort, specifically for the manufacture of nuclear weapons. In November 1943, the X-10 Graphite Reactor at the Oak Ridge National Laboratory began producing significant amounts of the element, and industrial–scale production began in March 1945 with the commissioning of the B Reactor at the Hanford Site in Washington State. The plutonium produced by the B-reactor was earmarked for the implosion-type, plutonium cored nuclear weapons that were being developed as part of the Manhattan Project. Of the three nuclear weapons made during the war, two of them used plutonium as their fissile material.

Plutonium was handled extensively by chemists, technicians, and physicists taking part in the Manhattan Project, but the effects of plutonium exposure on the human body were largely unknown. A few mishaps in 1944 had caused certain alarm amongst project leaders, and contamination was becoming a major problem in and outside the laboratories. Plutonium was tracked into civilian areas, plutonium dust was being inhaled by workers, and accidental ingestion was a grave concern for those who routinely handled it. In August 1944, a chemist named Donald Mastick was sprayed in the face with liquid plutonium chloride, causing him to accidentally swallow some.After immediate treatment including scrubbing, stomach pumping, and citrate chelation (see Donald Mastick), less than 1 microgram of plutonium remained in his body. He lived to the age of 87.

Manhattan Project Plutonium-238 and plutonium-239 are exceedingly difficult to detect inside the body because they are alpha particle emitters. Unlike the case of radium, which can be detected quite easily, there are no gamma rays to detect from outside the body. As long as a person is alive, the simplest way to detect plutonium would be to analyze a person's excretion through urine and feces. Unfortunately, this method has its limits in that only a small fraction of Pu is excreted, for example 0.01% of the body burden per day is typical, 2 to 3 weeks after exposure.

As the Manhattan Project continued to use plutonium, airborne contamination began to be a major concern. Nose swipes were taken frequently of the workers, with numerous cases of moderate and high readings.Plutonium in Man: A Twenty-Five Year Review, UCRL 20850, TID-4500 (58th Ed.), Patricia W. Durbin, 1971. While Dr. Robert Stone was the Health Director at the Met Lab in 1944, lead chemist Glenn Seaborg, discoverer of many transuranium elements including plutonium, urged that a safety program be developed and suggested: "that a program to trace the course of plutonium in the body be initiated as soon as possible ... [with] the very highest priority."Final Report , Advisory Committee on Human Radiation Experiments, 1985

Tracer experiments were begun in 1944 with rats and other animals with the knowledge of all of the Manhattan Project managers and health directors of the various sites. In 1945, human tracer experiments began with the intent to determine how to properly analyze excretion samples to estimate body burden. Numerous analytic methods were devised by the lead doctors at the Met Lab (Chicago), Los Alamos, Rochester, Oak Ridge, and Berkeley. The first human plutonium injection experiments were approved in April 1945 for three tests: April 10 at the Manhattan Project Army Hospital in Oak Ridge, April 26 at Billings Hospital in Chicago, and May 14 at the University of California Hospital in San Francisco. Albert Stevens was the person selected in the California test and designated CAL-1 in official documents.

The plutonium experiments were not isolated events. During this time, cancer researchers were attempting to discover whether certain radioactive elements might be useful to treat cancer. Recent studies on radium, polonium, and uranium proved foundational to the study of Pu toxicity. For example, polonium (another alpha emitter) research indicated that test sample contamination was a major concern, which is why a cleanroom had to be established at Los Alamos in February 1945 in the Medical Labs Building.

Behind this human experiment with plutonium was Dr. Joseph Gilbert Hamilton, a Manhattan Project doctor in charge of the human experiments in California. Hamilton had been experimenting on people (including himself) since the 1930s at Berkeley. He was working with other Manhattan Project doctors to perform toxicity studies on plutonium. It was Hamilton who had begun the 1944 tracer experiments on rats. The opportunity to select a human patient was relatively easy: Hamilton was not only a physicist assigned to U.C. Berkeley, he was "professor of experimental medicine and radiology" at U.C. San Francisco. Hamilton eventually succumbed to the radiation that he explored for most of his adult life: he died of leukemia at the age of 49.

Although Stevens was the person who received the highest dose of radiation during the plutonium experiments, he was neither the first nor the last subject to be studied. Eighteen people aged 4 to 69 were injected with plutonium. Subjects who were chosen for the experiment had been diagnosed, sometimes falsely, with a terminal disease. They lived from six days up to 44 years past the time of their injection. Eight of the 18 died within two years of the injection. All were logged as having presumably died from their respective preexisting terminal or cardiac illnesses. None died from the plutonium alone. Patients from Rochester, Chicago, and Oak Ridge were also injected with plutonium in the Manhattan Project human experiments.

As with all radiological testing during World War II, it would have been difficult to receive informed consent for Pu injection studies on civilians. Within the Manhattan Project, plutonium was referred to often by its code designation "49" (from its atomic number 94 and its atomic mass 239) or simply the "product". Few outside of the Manhattan Project would have known of plutonium, much less of the dangers of radioactive isotopes inside the body. There is no evidence that Stevens had any idea that he was the subject of a secret government experiment in which he would be subjected to a substance that would have no benefit to his health.

Experiment on Stevens Stevens was a house painter, originally from Ohio, who had settled in California in the 1920s with his wife. He had checked into the University of California Hospital in San Francisco with a gastric ulcer that was misdiagnosed as terminal cancer. According to Earl Miller, acting chief of radiology at the time, he was chosen for this study because "he was doomed" to die.

Stevens was injected with a mixture of plutonium isotopes having the Pu(VI) chemical species () as the nitrate PuO2(NO3)2. The injection consisted of 0.2 micrograms of 238Pu and 0.75 micrograms of 239Pu. According to Kenneth Scott, a scientist who worked at the U.C. Berkeley Rad Lab alongside Dr. John H. Lawrence and his brother, Nobel laureate Ernest Lawrence, U.C. San Francisco radiologist Earl Miller injected the plutonium into Albert's body. Scott transported the plutonium from the lab to the hospital where Albert Stevens was being treated for stomach cancer. Miller repeatedly denied that he injected plutonium.

According to Scott, "Albert Stevens got many times the so-called lethal textbook dose of plutonium."

Although the original estimates (and some later figures) concerning the activity of the injected solution were erroneous, modern research indicates that Stevens (who weighed ) was injected with 3.5 μCi 238Pu, and 0.046 μCi 239Pu, giving him an initial body burden of 3.546 μCi total activity.Rowland, R.E., and Durbin, P.W. Survival, causes of death, and estimated tissue doses in a group of human beings injected with plutonium. United States: N. p., 1975. Web. The fact that he had the highly radioactive Pu-238 (produced in the 60-inch cyclotron at the Crocker Laboratory by deuteron bombardment of natural uranium) contributed heavily to his long-term dose. Had all of the plutonium given to Stevens been the long-lived Pu-239 as used in similar experiments of the time, Stevens's lifetime dose would have been significantly smaller. The short half-life of 87.7 years of Pu-238 means that a large amount of it decayed during its time inside his body, especially when compared to the 24,100 year half-life of Pu-239.

When specimens were taken during Stevens's cancer surgery, Earl Miller took them for radiological testing; Scott collected urine and stool samples. When the hospital's pathologist analyzed the materials removed from Stevens during surgery, a startling conclusion was made: Stevens had no cancer. Evidence was that surgeons removed a "benign gastric ulcer with chronic inflammation." The hospital staff reacted with disbelief. There had been no reason for surgery, although the size of the inflammation was extraordinary. There had also been no therapeutic intent for the experiment, although surgeons assumed that Stevens had received radioactive phosphorus for "special studies".

While at the hospital, "both a radiologist and a surgical consultant concluded that Albert probably had cancer but suggested a gastroscopy be done to confirm the diagnosis." This had never been done. Prior to Stevens's trip to the hospital, "A local physician suspected Albert had a malignant ulcer that had spread to the liver and advised him to consult specialists at the University of California Hospital." Stevens's surgeons found a "huge, ulcerating, carcinomatous mass that had grown into his spleen and liver... Half of the left lobe of the liver, the entire spleen, most of the ninth rib, lymph nodes, part of the pancreas, and a portion of the omentum... were taken out" to help prevent the spread of cancer that Stevens did not have.

After surgery Once Stevens was out of surgery, his urine and stool samples were analyzed for plutonium activity. The Pu-238 helped the researchers in this respect because it was much easier to detect. But as Stevens's condition improved and his medical bills soared, he was sent home to recover. The Manhattan District decided to pay for his urine and stool samples to keep him close to San Francisco on the pretext that his "cancer" surgery and remarkable recovery were being studied.