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Who Knew Too

3 with multiple inj
with a given level q
+ “This shows that
hly select group, quit
favor of resistance
to be a single hom
ople under ten and o
with and without mu
ching like those withoy
id conclude that this
population.” Alice b
that there were oppos+
ting the appearance of
:, on the one hand, ands

e delivered a body blow
| standards on low-levef#
ig it heard. Their pa
e at Ben Gurion Univer-
esented the findings, but

Socrwoy

chanter 10
Rogue Scientists

“It smells, doesn’t it? when those who are
assessing the danger of the industry are
in the pay of the industry. It’s like the
fox guarding the henhouse.”

‘After the Mancuso affair the Department of Energy split the study of
the workers’ records into groups, assigning them to government contrac-
tors in Hanford, Oak Ridge, and Los Alamos. From now on, research
on nuclear health was to be performed solely by labs under contract to
the DOE.

conquer—in this case, literally,” says Alice. “The gov-

“Divide and
ernment determined never again to let the records fall into the hands of

one person. And it determined not to allow any researchers from outside
the DOE to have access—now only their own people could come any-
where near them. From now on, the research would be strictly in-house.”
Mancuso’s data on the Hanford workers were given over to Battelle-
Pacific Northwest Laboratories, a major contractor at Hanford, located
on the Hanford site—which meant that Hanford was now in the position
of evaluating the health of its own employees. The study was put under
the direction of Sidney Marks, formerly of the Energy Research and
Development Administration (ERDA, formerly AEC, soon to be DOE)—
the same Sidney Marks who had urged Mancuso to issue the press release
contradicting Milham’s findings and who by this time had left the federal
agency to take a position with Battelle. (Battelle had been awarded $80
million in government business by ERDA.) It happened that in transfer-
ring Mancuso’s work to Battelle, federal officials violated the usual proto-
col: they failed to put the contract out for competitive bidding, to submit
the contractor’s past work or present capabilities to peer review, or to ask

Battelle to submit a research design. It also happened that Battelle had

never done a human epidemiological study before."

Mancuso’s Oak Ridge data were assigned to Dr. Clarence Lushbaugh

147



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in Who Knew Too Much: 4

o testify at congressional *"

aary and again in Augugg.

the DOE to lock up the;

xers, since they were, in *
sts of low-level radiation,

.
s obstructing freedom of

aad become head of the
pons complex had been
ion to the production of
protecting the environ-
Id be made available to
‘tment of Energy should
rere is no other agency
sropriately positioned to
‘eld,” he insisted; “As an
nsibility to monitor the

ud set up a repository of
ified researchers but re-
ete this repository was
would then be left to the
yes of researchers would
ild be made accessible.>+
le years and years that
1 be allowed access, She
y and argued that Wat-
delay and interference
‘imothy Wirth of Colo-
s nuclear weapons facil-
10 are working in those
ieve the health research
pons?” To address this
would transfer epidem-
the Department of En-
Services and create an
anel to assist in develop-

reed Alice, who argued
tisk at weapons plants

Fallout

187

were badly flawed. “It’s high time they let in some fresh air. There are a
Jot of questions to be answered about the weapons complex facilities.”*7

Her position was supported by Dead Reckoning, a 1992 review of
124 DOE epidemiological studies of nuclear workers, conducted by the
Physicians for Social Responsibility. It found that the department had
Jooked at only a fraction of the 600,000-person workforce and there had
been major problems with the design and methodology of the few studies
it had done. It found also that most DOE studies had neglected the
healthy worker effect, which made it possible to come in with more
cheerful risk assessments than warranted.

“And these are the epidemiological studies that have been the basis
of DOE’s endless assurances over the years that there’s no evidence that
anybody has been harmed, either in the workforce or in surrounding
populations, by DOE weapons-producing activities,” said Dr. Jack Gei-
ger, one of the authors of the study. “All of this was occurring behind a
virtually impenetrable wall of secrecy—none of it was subject to external
scientific review.” Geiger refers to “an ugly combination of monopoly

and secrecy—secrecy with regard to access to the most useful kinds of

basic data on the exposure of human populations to low-dose radiation
and monopoly in which so many of the people in the field were funded by
ies that were producing the hazards. Secrecy corrupts and abso-

the agenc’
lute secrecy corrupts absolutely.
Dead Reckoning found that the DOE had discounted findings that

might be alarming to the workers and the public and that the secrecy
protecting its operations had allowed it to censor, intimidate, demote,
and dismiss scientists whose discoveries were seen as harmful to DOE
interests. It cited Mancuso as the primary, though by no means the only,
instance. It saw this pattern of denial and manipulation as part of the
DOF’s effort to minimize its liability for compensation and recom-
mended that the DOE get out of the health research business.

Alice Gets Her Data

Finally, in 1990, under pressure of a Freedom of Information Act lawsuit
and the threat of congressional legislation that would transfer epidemi-
ological research to the Department of Health and Human Services, the
DOE consented to transfer the workers’ records to the Three Mile Island
Public Health Fund.

The attempts at legislation had gone nowhere. Senator Timothy
Wirth and Senator John Glenn had introduced bills in 1984, then again in



V

a

148 The Woman Who Knew Too Muck

at Oak Ridge Associated Universities. Lushbaugh had no one on staff with 4
the expertise to handle the project; this assignment was made, again, with. 3

out proper protocol.*

The data on the nuclear workers became the virtual monopoly of a
small group of government-sponsored scientists and were made unavail-

able to the larger scientific community. Research on the nuclear workers
now went on entirely without reference to the Mancuso/Stewart/Kneale
findings, without reference to their caution about the healthy worker effect
or the sensitive methods George Kneale was developing to measure expo-
sure over time. “It’s as though the MSK study never happened—except for
the rebuttals that were flying about the world,” comments Alice.

Behind the walls of secrecy, ERDA, then DOE carried on research
without independent oversight, shielded from the open processes of scien-
tific inquiry or public accountability. The agency had established a princi-
ple of state ownership of science. “Talk about the fox guarding the
chicken coop,” says Alice: “here you have the fox reporting on morbidity
and mortality in the chicken coop.”

Not surprisingly, this research turned up no cancer hazards for low-
level radiation.>

State-Controlled Science

But the Mancuso affair had opened a Pandora’s box, and try as the
government might to put the lid back on, the scandal was attracting the
attention of scientists throughout the world.

Dr. Joseph Rotblat, who would win the Nobel Peace Prize in 1995,
wrote in the Bulletin of Atomic Scientists in 1979 that the Mancuso
incident highlights the “contradictory objectives” of the AEC/ERDA/
DOE, to promote nuclear energy and “prevent its misuse,” and has ramifi-
cations “beyond the U.S. administrative arrangements, because similar
situations (whereby the same body is given the task of protecting against
the harmful effects of products it promotes itself) can be found all over
the world.”4 Dr. Karl Morgan sent a scathing letter to Secretary of Energy
James Schlesinger: “One can only suppose that the new Oak Ridge team
must get the right answer, i.e. prove there is no radiation risk to Hanford
workers, if it cares to have a continuation of funding.”5

The scandal raised an outcry from concerned citizens groups, work-
ers, and unions demanding that Mancuso be allowed to continue his
study. In a joint letter to the Secretary of Energy in November 1977,
representatives of the Oil, Chemical and Atomic Workers Union and
seven environmental organizations charged that the termination of Man-

cuso’s contri
ation ©!
é » The United Steelworkers Un
Machinists
issued 2 sta’
Health,
restored
the DOE.

happens

Rogue Scientists

act “reflects a well defir
f scientists who do not agres

and Aerospace Worker
tement to Joseph Cali
Education and Welfare, d
and research on the healt!

“The suppression of scientis
in countries like the Sovie
Environmental Policy Institute; “4
ing right here.””

So began a struggle to wrest
and put it under the auspices of a
that would succeed—though it \
research to the Department of H

From Silkwood to Stewart

Tt was the lobbying efforts of B
Paul Rogers (Democrat, Florida
Jook into the Mancuso affair. A
mental Policy Institute, a nOnP
DC, and had become interest
health.
‘Alvarez had been drawn
serendipitous route: his wife.
bringing a case against Kerr-}
Crescent, Oklahoma, on beh:
enlisted Mancuso as @ witnes:
young, technician at Kerr-M
plant, had approached AEC
Kerr-McGee was violating he
produce documentation; som
nated with plutonium—ine
was located in her apartmet
that, on November 13, 19
driving to meet with a labc
porter with the intention ©
tions. The Oklahoma highv
wheel, though later investig


man Who Knew Too Much

vould be difficult to ascribe
i concluded that “participa-
not have a detectable effect
their total risks of develop-

eport in December 1993.25
veterans, admitting that the
€ test veterans but attribut-
cipation in the nuclear tests
‘e nor on incidence of can-
relatively high number of
sing” and there may well
siated with participation in
en. “I do hope that partici-
iting as we do,” Doll said;
ied to substantial risks as a
‘ill be reassured.”26

1g. John Armstrong, secre-
tion, said, “this is the very

: for this for ten years, and

ancer!” Ken McGinley, a

expressed disbelief: NRPB

red independent, he said,

t to lose if the study had

ice concludes, “there was
‘oll and Darby, and—the
2 nothing—Tom Sorahan
: data, how you read the
» turning up in situations
safe.”

or

tion cases in the United
{n 1980-81, she was star
ing radiation and cancer
‘epartment of Energy.

ept stretch between the
a dismal safety record,

The Invisibilizing of Alice 203

though there had been, as usual, no serious studies of workers’ health. It
would later be ranked as the worst facility in the entire DOE complex.
Leroy Krumback worked there from 1959 through 1974, when he died at
age sixty-five of colon cancer. His widow Florence remembered her hus-
band’s accounts of contamination on the job, how he’d come home with
his hands rubbed raw from scrubbing with Clorox, which was supposed
to remove the plutonium. Her attempts to receive compensation for his
death dragged on until she gave up, in 1979.

By 1980 public sentiment in the area was turning against the facility
and there was pressure to shut the plant down. Alice had been invited to
lecture in Denver by Dr. John Cobb, professor of Community Health at
the University of Colorado medical school. Cobb was fascinated by what
‘Alice had discovered at Hanford and invited her to talk on Mancuso/
Stewart/Kneale. “I’d just given my lecture, and Cobb and I were walking
back from the hospital, and we got to talking about these compensation
cases, and he said, ‘what a pity it is that the MSK analysis hasn’t reached
the stage of being able to help individuals seeking compensation’; I said,
‘oh, but it has.’

“I said, ‘what you've got to do is find out what dose the person
received, how old he was when he got it, do this for every year he was
exposed in order to obtain a cumulative dose, and calculate how long an
interval elapsed between exposures and death. You modify the dose he
received with these variables to come up with the effective dose. On the
basis of this, you can estimate how much his work exposure has increased
his risk.’ I call our system the Ready Reckoner after that little printed
book you got in math classes as a child which would help you do
conversions—you know, translate yards into miles and pence into

pounds, and old forms into new forms.28
“] said, ‘give me this man’s doses and I'll tell you whether he should

get compensation.’ Cobb pricked up his ears and the next day he came
back with this man’s records and said, what a pity it was he hadn’t
known about this when he’d been approached by a lawyer and asked to
help with the Krumback case. And I said, ‘well, leave the records with me,
PIl put them through the mill and we'll see what we come up with.’ So I
submitted this man’s case to our calculations—I did it by way of my
thank you letter—and sure enough, we found that he was three times as
likely to have gotten his cancer from exposure as from natural causes,
which meant he was highly eligible for compensation.

“So Cobb went and called Krumback’s lawyer, who was no longer in
practice, and was told that too long a time had elapsed since the case had



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chapter 14
Epidemiology and
Alice Stewart

“1 have two of the ingredients for success
in radiation epidemiology—longevity
and persistence. Sheer doggedness. I’ve
hung on and here Lam, still quietly

going on. ”

t believe in radiation is, it’s out of sight, out of

hirty years later, someone drops dead. We are
fhe senses and with such late

n effects—that we are very

“The reason people don’
mind—then, twenty or d
dealing with something so imperceptible to t
effects—sometimes third and fourth generatio
far from solving the mystery.”

Alice Stewart sees herself as a kind of medical detective, practicing @

Sherlock Holmes type of medicine.

Epidemiology is the search for the causes of a disease, for its etiology.
What makes this so difficult with cancer is that the disease may take
decades to manifest, and human populations tend to be highly mobile
and subject to many influences. “You can’t experiment on human popula-

| tions, you can’t give people doses of radiation to see how they react—or

you're not supposed to. You can only observe the health of people who
have been exposed to radiation. You can’t control your experiment as
you can in a laborat: ise” Yet you must ii

‘ory. You can’t eliminate the ‘noi:
somehow tease out, from the tangle of human life, that a particular
exposure has led to a partic

jcular cancer, years later.”
Background radiation complicates the question: “you're not looking
for a spot of trouble against a spotless bac

drop; you're looking for a
spot of trouble in a very messy situation. You can expect 4 fifth to a
quarter of the population to die of cancer in the normal course of
things—so how do you sort out the naturally occurring cancers from
those brought about by influences that are over and above?

213



192 The Woman Who Knew Too Much

bogged down with unnecessary interference. I suppose there are a lot of
people hoping we’ll go away, or disappear, by shortage of money or by
old age.”

A further follow-up, a 1995 Hanford paper, once more corroborates
the age effect.1° “We’re doing our best to convince the world about this
important question—it’s very crucial because whoever wins this battle
will determine whether the A-bomb data are of value in assessing risk to
workers and the public.” She is gratified to see others validating her
findings—including “some of the DOE’s own people.” Steve Wing, a
University of North Carolina epidemiologist working under DOE con-
tract, found a cancer effect in the Oak Ridge data and published his
findings in March 1993; in a subsequent study, he corroborated the age
effect—as we'll see in chapter 14.

Epidemiological studies need time, as Alice is fond of saying. They
also need patience, and it helps, if you are an epidemiologist, to be long
lived. But the Three Mile Island Fund that’s supported her and George
ran out in June 1996. “I may be a bit gloomy, but I’m very old, and time is
running out.”

a

Shapter 13

The Invisihiliz
of Alice

“The best way not to fin
is not to look for it.”

There are a lot of people wis
findings imply that there are
around facilities, risks that are
at worst, financially ruinous.
The reason the nuclear in:
that it is a clean, safe industr
beyond a shadow of a doubt t
actually been caused by wor
installations. Cancers don’t ¢
period is long and variable,
background radiation that be
ous logic, it is left up to those
are the least likely to have
rather than to the multibillio
contaminant.
Alice and George have t
ful in establishing proof—if

Do Nuclear Installations :

Cancer clusters had been det
in the U.K. public inquiric
Point. All these facilities had
investigations confirmed tha
ronment, acknowledged tha
cess of what would be ex



Knew Too Much

yr such and such,’
te basis of what’s

hey said, ‘oh, you

won't let us have
rt vault, but forget
of money for it—
Us a joint venture
‘or it, they say it’s
anese they say it’s

ountered from the
of this finding, this
1e data, here is my
ig and explains the
ion experts to say
same thing—this is

heir minds and let
politicized, there’s
hat these scientists
‘we may have been
cancer itself, domi-
faculties have been

smains. As Sue Roff
sidual effects from
inergy Commission
i strong reasons for
ng a safe threshold
na data were being
ur weapons and pro-

w doses of radiation
jed as the gold stan-
ze grim death.” They
imates of how much

Taking 01

radiation the bombs gave off, reanalyse

calculations.>*

estimated the number of cancers Pro’

in the International Nuclear Regulatory System 143

s that call into question all further

“The RERF and the international standard-setters have under-
duced by the bombs. They have

underestimate: — genetic damage, immune sys-
tem damage, lowered resistance to disease, infection, heart disease. These
are serious misrepresentations because they suggest that it’s safe to in-
crease levels of background radiation.

“The approval of standards based on this skewed data is irrespon-

sible and actually wicked.”

4 radiation’s other effects

The Standard-Setters
The International Commission on Radiation Protection (ICRP) came into
to review what was known about radiation

existence in the late twenties,
and draw up guidelines by which workers and the public would be pro-

tected. It set permissible radiation doses of up to 75 rem a year for
doctors and dentists and those working with radiation. By 1936, ICRP
had reduced its recommended permissible doses for workers to 50 rem,
then to 25 in 1948, to 15 in 1954—and to 5 in 1958. There the level has
remained.2>

But “there is something,
“this time folks, we have got it right,’
a senior public health official for the
Britain, “when on each occasion, a previou:

disturbing about the repeated assurances,
» comments Dr. Morris Greenberg,
Health and Safety Commission in
s understatement of hazard is

revealed.”34
The ICRP has set a standard of five rem pet annum exposure accord-

ing to a risk-benefit principle that allows a one in five thousand chance
The standard was proposed with full knowledge

of contracting cancer.
that there will be health injury and death to some, but it was decide:
that the overall societal benefits of atomic energy would outweigh dam-

age to the few.
The five rem standard has been “plucked out of a hat,” says Alice.
Who or what is the ICRP, that it has the power to make these

decisions?
ganization I would trust with my life,” says

«Pm not sure it’s an oF
Karl Morgan, one of its founders and a member for more than a quarter
of a century. After the war, it came to consist mainly of physicists who

worked on the Manhattan Project. Its members have associations with
the military and with the medical radiological societies, all of which have



This engaging biography illuminates the achievements of the remarkable
woman scientist who revolutionized the concept of radiation risk. For more:
than 40 years, Alice Stewart (born in 1906), se psyrag ee dose radiation...

astounded the scientific world with a study showing that the U. S. nuclear

weapons industry is about 20 times more dangerous than safety regulations,

permit. She has in recent years become one of a handful. of in pendent scien-

tists whose work is a lodestone to the anti-nuclear movernont aed ses valiedy
“perhaps the Energy Department’s

critic” by the New York Times. °

“Gayle Greene’s The Woman Who Knew Too Much seeks to trace

Stewart's unconventional approach in investigating the effects of *
man-made radiation. It provides some shrewd insights into: her: 40% obi
personality and methodology.” ., sipincaica asin cait

“Stewart's story is one of lapaiings ingenuity, companion

scientific passion, her feistiness, her political naivete 3 4
in each chapter.” —Women’s Review of Books

“This story of Dr. “Alice Stewart, an audacious,
researcher, stands as a monument to the grit that allowed her to
challenge tenets of mainstream scientific opinion.” _—Steward Udall

GAYLE GREENE is Professor of ‘Women’s Studies and Literature at
Scripps College.

www.press.umich.edu = 9'780472"0

The University of i rT 7 TTI .29009>



No. 245/ ‘Thursda) December 22, 2005 / Rules and Regulations sve
consider designating

whether the injury was self-in! cted or its procedures to

whether a loss of hearing was total and classes of employees to pe added to the
permanent, ‘must be in writing. An Special Exposure Cohort under the
appeal must be submitted by & member Energy Employees Occupational Tilness
or a member's legal rej resentative or by Compensation Program Act of 2000

the beneficiary oF the beneficiary's legal (“EEOICPA”), 42 U.S.C. 7384-7385.

representative, within one year of the HHS must change these procedures to
date of a denial of eligibility, to the implement ‘amendments to EEOICPA.
Office of the uniformed service cnacted on October 26, 2004, 8° part of
identified in the decision regarding the the Ronald W. Reagan ‘National Defense
member's eligibility for the benefit. ‘Authorization Act for Fiscal Year 2005,
(2) An appeal regarding whether a Public Law 108-375 (codified as
member was insured under amended in scattered sections of 42

Servicemembers" Group Life Insurance U.S.C).

when the traumatic injury Was . oe
sustained must be in writing. An appeal pares: Effective Date: This interim final

‘aust be submitted by a member oF & rule is effective December 22, 2005.
member's legal re] resentative or by the Comments: The Department invites
beneficiary OF the eneficiary’s legal written comments On ‘the interim final
representative within one year 0) the rule from interested parties. Comments
date of a denial of eligibility to the on the rule must be received by

Office of Servicemembers’ Group Life February 21, 2006.

Insurance. appresses: Address written comments

(3) Nothing jn this section precludes
a member from pursuing legal remedies
under 38 U.S.C. 1975 and 38 CFR 9.13.

on the interim final rule to the National
Tnstitute for Occupational Safety and
Health (* “NIOSH”) Docket Officer
electronically ‘by e-mail to

Pr USC. 1980A &xC lancevwthe _clectronic filing, Alternatively, submit
tile 38 US ances jerthe — Frinted comments to NIOSH Docket

(ayia member is Tegally Bifice, Robert A. Taft ‘Laboratories, MS—
incapacitated, the member's guardian oF C34, 4676 Columbia Parkway,
attorney-in-fact will bbe paid the benefit Cincinnati, OH 45226.

on behalf of the member. FOR FURTHER: INFORMATION CONTACT:

_ (2)ifa ‘member dies before payment Larry Eliott, Director, Office of

is made, the beneficiary OF beneficiaries Compensation ‘Analysis and Support,

‘sno will be paid the benefit will be National Institute for Occu ational

determined in accordance with 38 Safety and Health, 4676 Selumbia

U.S.C. 1970(8)- Parkway, MS-C-46, Cincinnati, OH

(Authority: 38 U.S.C. 501(a) and 1980A) 45226, Telephone 513-533-6800 (this is
_ oq 1-20-08; 10: sea toll free number), Information

UFR Doe. 08 24900 Filed 12-20-05: 1053 requests can also be submitted by e-mail

pose cove 320-01-F to OCAS@cdc.gov.
————— SUPPLEMENTARY INFORMATION:
1, Comments Invited

DEPARTMENT OF HEALTH AND

HUMAN SERVICES Interested persons OF organizations
are invited to participate in this

42 CFR Part 83 rulemaking by submitting written views,

RIN 0920-AA13 arguments, recommendations, and data.

Comments are invited on any topic
Procedures: tor Designating Classes of related to the changes in the Special
Employees as Members of the ‘Special Exposure Cohort (‘the Cohort”) rule (42
Exposure Cohort Under the Energy CFR part 83) effectuated by this
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—


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