Letter Submitted to the Health Studies Workshop

October 30, 1997

To: OR Health Research Workshop
Re: Comments on the Worker Illness problem
Fr: Alfred A. Brooks

There is little dispute that the K-25 workers are ill or that DOE/LMES should be concerned. The area of disagreement is what is the cause of the illness and what should be the preferred approach to the problem. To date, the approach has been to use the traditional health care services augmented by assistance by various outside agencies and clinics. Recently DOE/LMES has engaged the services of outside physicians to review and pursue the problem. Unfortunately to date, the efforts have been misunderstood and have fallen short of providing answers to either the workers or the concerned public. This approach has produced a paucity of publicly available data on which the public can base a sound decision about the legitimate public concerns described below.

During the several years that the problem has extended beyond the immediate concerns for ill workers. it was escalated by a series of inflammatory newspaper articles into a challenge of:

· the quality of life in the Oak Ridge Community and surrounding counties, · the safety of the incinerator technology to dispose of waste and the nuclear technology in general, · the sincerity and honesty of the DOE/LMES management and the OR medical establishment, · the role of ORR in the National waste management program · the acceptable methodology to be used in OR on-site waste management · the very nature of exposure to and management of industrial contaminants beyond the ORR

The problem now extends to the State legislature and to the Governor's office. In spite of the data and experience to the contrary, these accusations have become so widespread that they discourage newcomers from living in Oak Ridge and have an adverse effect upon its economic future. The problem is now in litigation and appears to be spreading to other ORR sites.

This is a problem that cries out for resolution and yet, in spite of sincere efforts, it remains unsolved. Whatever the causes of these illnesses and the associated spin-off effects, a technological society must understand them. If the cause is pollutants, they must be more rigidly controlled. If the cause is not pollutants, society needs to understand and manage them.

For these reasons, many citizens in Oak Ridge after much observation and discussion have concluded that Oak Ridge provides a real life setting both for the study of affected workers as well as other populations exposed to environmental pollutants. The presence of the analytical capabilities of the ORNL and its environmental sciences program will provide a support foundation for such an effort. Further, it is felt that groups of workers, such as, the K-25 group, offer an opportunity to conduct a clinically oriented research program to further understand this phenomenon and provide insight into matters of occupational health. Similarly, there are opportunities to examine the body burdens associated with occupational exposures as well as environmental exposures. Such data would remove some of the assumptions, which are necessarily made in risk assessment models. Limited activities of this nature are ongoing but more applications of the experimental approach are needed. The results of such work could be made available in research papers and thus would guide public actions.

I strongly urge you to consider such a research program.

Addendum: The use of the term "clinical" above does not imply the establishment of a clinic for continuing care but rather the approach to ill workers to determine the contributing environmental causes, if any, and the counsel the traditional care-giving services.

The terms "public control" and "public design" have been applied frequently to both the concept of a clinic and to epidemiological studies. While I strongly endorse strong public participation, early input in the setting of goals and scope, review and overview, I do not endorse public control to mean the power to administer (or to shut down as some have suggested of TSCA). There is ample evidence that public advisory groups may or may not ensure public access. In some cases, they are less accessible than DOE itself. To ensure effective public access, the participation in discussion must be "open". Oak Ridge has examples of both success and failure.