Conclusion

Chapter 12: Introduction

This chapter examines whether the U.S. government wronged or harmed uranium miners in the American West and Marshall Islanders in the mid-Pacific, in both cases by exposing them to radiation hazards: in the case of the miners by failing to inform them about the risk and failing to mitigate it; and in both cases, perhaps to different degrees, by studying them without having obtained adequate consent. Although the mines of the Colorado Plateau and the seas surrounding the atolls of the Marshall Islands were seen by U.S. policy planners as ideal sites for the government's primary missions--mining uranium and detonating atomic and hydrogen bombs--they became laboratories for studying radiation damage to humans. We also touch briefly on a radiation experiment conducted with a view to the natural laboratory in which the subjects were set: in 1956 and 1957 the Air Force administered iodine 131 to Alaskan residents to determine the role of the thyroid gland in adapting to extreme cold.

The uranium mines, the Marshall Islands, and Alaska were not, of course, the first such occasions for studying the effects of radiation on people. As has been reported in earlier chapters, radium dial painters were studied, and in the largest epidemiological study of radiation effects ever, the survivors of the Hiroshima and Nagasaki bombs continue to be followed. The Atomic Bomb Casualty Commission (now the Radiation Effects Research Foundation) began its work soon after World War II. The organization's projects include a mortality study, a periodic health examination study, a study of people exposed in utero, and a genetic effects study. Some of the most important data available on long-term radiation risks have come from these studies. These data have also provided the basis for most current radiation exposure standards. The Hiroshima-Nagasaki studies are different from the cases of the uranium miners and the Marshallese, however, because the exposure ended before the epidemiologic study got under way.

While the miners, and the Marshallese after their high initial exposure, were subjected to continuous exposure to radiation--relatively high for the miners, relatively low for the Marshallese--they were not exposed for the purpose of studying the effects of radiation on their health. But the exposures resulting from the mining and bomb tests provided the government an opportunity, and some would say a duty, to collect needed information on radiation effects on human beings. In both cases researchers were interested in determining the health consequences of exposure to specific and quantified forms and levels of ionizing radiation over a long term. For the miners it was radon gas and its radioactive decay products. For the Marshallese it was the fallout products of nuclear explosions such as iodine 131, strontium 90, and cesium 137. Also, in both cases, the United States has provided, and in the case of the miners, continues to provide, financial compensation. In addition, a class-action lawsuit, Begay v. United States, was brought on behalf of a group of Navajo miners.

There were, however, major differences between the situation of the miners and that of the Marshallese. In the case of the miners, the research was conducted even though there were data from European studies clearly indicating that uranium miners were at high risk for lung cancer, which could have been substantially mitigated by ventilating the mines. The study of the miners, conducted by the Public Health Service, was epidemiological in nature and unrelated to their clinical care. The Marshallese were the first population exposed to amounts of fallout perceived as acutely dangerous.[1] The long-term effects of exposure to fallout were unknown; therefore it was important to gather data while treating the exposed population. It appears that the medical monitoring of the exposed population was directly integrated with the management of their health care.

To gather information on the health effects of radiation, federal government agencies mounted observational studies, a term indicating that the conditions of exposure are not under the control of the investigator who is studying the health effects.

For a long time, while they were being studied, it seems evident that no one explained to the miners the extent to which their exposure to radiation might be hazardous and, in many cases, lethal. Nor, it appears, were they told that ventilation of the mines could significantly reduce the hazard. And, evidently no one seems to have told the miners the true purposes of the research. With respect to the Marshallese, efforts to explain to them the purpose of the studies and the hazards of their contaminated environment were inadequate well into the 1960s, and the difference between medical care and treatment-related research was not clearly explained. The Advisory Committee reports here on both studies and concludes with a discussion of the cold-weather experiment in Alaska in which servicemen, Eskimos, and Indians were given tracer amounts of iodine 131. We begin with the uranium miners.