The Worker's and Resident's Illnesses
A Brief Overview of the Problem

The question of worker and resident health has become a public issue in which all stakeholders are involved. There is a disturbing lack of sound information on which to base an opinion. The following is a brief overview of the problem from the public's view.

There are several groups of reportedly ill persons:

1. the K-25 workers and nearby residents
   This group is the primary focus of the current discussions. The source of the alleged cause is presumed to be the K-25 plant environment including the TSCA incinerator. There have been several studies of the problem but no consistent cause has been reported. The public information has included anecdotal information and partial information on the results of the studies.
2. the Y-12 beryllium-affected workers
   This nature of this problem is understood and acknowledged. Several workers were exposed to beryllium dust, some to negligible quantities. Extreme sensitivity seems to be a factor in several of the minimally exposed workers. The cause of the problem is no longer controversial and there is little need for further review.
3. the MSRE office workers
   This is a new group at ORNL. The MSRE offices, adjacent to the idle MSRE reactor have been carefully studied and deemed within the prescribed safety limits. There is little public discussion and the problem is not understood. There is little on which to base a review except to say do not neglect it.
4. the Scarboro residents
   This neighborhood is located near the Y-12 Plant. The concerns are long standing and have been the subject of several studies. Opinion on the results of the studies varies. The problem has only very recently been combined into the discussion of the K-25 problem.
5. a group of non-Scarboro residents located in or around Oak Ridge
   This group is diffuse, living in several locations at varying distances from the plants. Although the group has been reasonably vocal, there is little publicly available information aside from anecdotes for the public to consider. The public discussion is now joined into the K-25 problem. Recently it has been suggested that the number of special education students in Roane county has increased and it is suggested that pollution may be the cause.

Of the above groups, the K-25 group, the Scarboro group and the resident group have the following in common:

1. The DOE nuclear operations and emissions are the alleged cause. The exposure scenarios have been diverse, from direct involvement with hazards to office space in clean buildings to residents living several miles away.
2. For the most part, the studies have been retrospective in nature consisting of dose reconstruction, environmental levels, and epidemiological studies. For the most part, the studies have shown no clear evidence of substantive exposures and , in fact, show quite low levels of contaminants being released from the DOE operations. Several Federal agencies other than DOE have been involved: CDC, NIOSH, ATSDR, TDEC, ORHASP, etc. University groups have also been involved.
3. The studies primarily have not examined the reportedly ill populations in a clinical approach and this has been a concern.
4. The range of symptoms has been large and they have been vague. To somelay persons, they suggest a common cause but, to many of the medical community, they do not.
5. The traditional medical system, i.e., the general practitioner, the local specialists, the hospital, the usual referral centers, medical laboratories, etc., have been unable to successfully diagnose and treat the illnesses to the satisfaction of the patients.
6. There is a conflict between the objectives of the HMO system and the medical processing of poorly understood symptoms. The LMES attempt to resolve this conflict for the K-25 group in the current study have not been entirely successful.
7. The data which has been obtained by the medical system has not been available to affirm or deny the anecdotal evidence. Even the State Department of Health remains uninformed for reasons of privacy.
8. Lastly, there is great distrust for DOE, CDC, NIOSH, ATSDR or any group funded by them. It has been suggested that there is a conspiracy of silence including the local press and the medical profession to a distance of 200 miles.

Currently for the K-25 workers, there is a review by three medical specialists whose final report hopefully will yield some insight into the problem. Preliminarily, they have stated the workers are ill. In addition, the Governor's Independent Panel has examined the operations of TSCA and other aspects of the K-25 working environment. Their report is also due soon. Any firm conclusions about the problem or a path forward should wait on these reports.

One thing that is lacking is a publicly available, summary report that lists the problems with a brief historic description, the past actions and studies with conclusions and references as well as current efforts and any plans for further actions. Granted that this information may be available in old reports but it is often arcane and its conlusions not stated within the context of the entire problem nor in user friendly terms.

Recently (10/30-31/97) in Oak Ridge, there was a workshop attended by the DOE Department of Health Studies, NIOSH, CDC, ATSDR, and the Tennessee Department of Public Health to discuss these problems. The public was given ample opportunity to be heard and they were vocal, explicit and constructive. The main emphasis was on public and worker involvement including a clinical medical research approach to problems like the K25 worker illnesses. Dr. Paul Seligman of DOE gave a summary of the worker's and public's position that indicated he had heard and was sympathetic. Hopefully, this meeting will make a difference in future DOE programs.