NON-WORKER EXPOSURES: TARGETED HELP
I. NON-WORKERS WITHIN WORKER FAMILIES
Workers at AEC (now DOE) facilities may be, or may have been, career employees of the contractors operating the facilities, employees of subcontractors, or independent contractors themselves on short-term assignments.
These workers have or had families who most often lived very close to the site in question, and who almost always lived with the worker. Infants, children, and other adults were in close contact with the worker and may well have come in contact with radionuclides and chemicals tracked home on the worker's clothing, vehicle, lunch box, shoes, or other paraphernalia.
Additionally, non-worker members of worker families, since they normally lived quite close in to the site, may have come in contact with radioactive particles which were emitted from the site and then came back down to earth close in to the site, as well as to fine radioactive dust. Babies and small children may have crawled through tracked-home contaminants inside of homes, and may well have ingested contamination when putting hand to mouth after crawling about on the floor or rug.
These non-workers would also have been exposed to all of the airborne emissions from the site through ingestion or inhalation.
A. OUR FAMILIES MUST NOT BE DIVIDEDThe current assessment by the DOE of worker exposures and health outcomes of these exposures, while a very positive recognition of the exposure injuries of workers within the nuclear weapons production and testing complex, must not stop at workers. For, to do so is to divide our families down artificial lines, offering help to sick family members who are or were workers, while offering nothing to non-worker members of families who are also ill from tracked-home and offsite exposures. This is neither logical nor just.
Non-workers do not receive workers comp for injuries incurred from these involuntary exposures. Non-workers have, in fact, received no help at all from the DOE or the contractors who have put them in harms way.
B. WHAT SHOULD BE DONE FOR WORKERS' FAMILIES?
IDENTIFY HIGHEST RISK GROUPS OF EXPOSED:
l. Identify Highest Risk Groups: (suggest using the following risk factors):
a. Age at time of exposure and length of exposureLOCATE THOSE AT HIGHEST RISK AND DOCUMENT DISEASESb. Gender
c. Dietary Habits (e.g. cow's milk vs goat's milk, re I-131)
d. Radiosensitivity evident from family disease clusters (that is, do we see an entire I-131 exposed family with thyroid disease and no history of thyroid disease in that family?)
e. Multiple exposures (e.g. local site + Nevada Test Site exposures + global fallout) and risk accompanying these multiple exposures. Estimated cumulative exposures and risk accompanying these exposures can be calculated within 95% confidence intervals, but should be considered only ONE of the eligibility determinants.
2. Locate these highest risk individuals through tracking (such as that done within the Hanford Thyroid Disease Study) and document the illnesses they currently have.
ESTABLISH LIST OF PLAUSIBLY LINKED DISEASE (NO BURDEN OF PROOF ON THE EXPOSED)
3. Establish a list of the diseases plausibly linked to their exposures (i.e.- the diseases most often seen within this group, and which can logically be construed as plausibly related to the multiple exposures received, no burden of proof on those exposed to demonstrate the causal link.
COMPENSATION AND/OR HEALTH CARE
4. Either compensate these individuals for the diseases (medically verified) on the eligibility list (not just cancers, but to include other chronic, debilitating diseases such as hypothyroidism, certain autoimmune diseases, etc) or offer medical assistance and monitoring for these diseases for the rest of their lives, through use of vouchers to pay for this care. Some would advocate for providing both compensation AND health care to these individuals for these diseases.
II. THE DOWNWINDERSl. Exposure risks extended logically and reasonably to those within highest risk groups offsite of all DOE facilities, and those exposed to NTS fallout. Use the same risk factors as cited above to identify those exposed off-site (the downwinders) at highest risk. This would include those at highest risk from NTS fallout exposures.a. Note that, at Hanford, the Hanford Medical Monitoring Program (HMMP) and Exposure Subregistry for I-131 exposures has already identified those at highest risk due to Hanford's I-131 exposures, and has defined an eligibility group of approx. 16,000 for these programs. These programs are as yet unfunded by DOE.2. Track those at highest risk and document the (medically verified) diseases most often repeated by this highest risk downwinder group.3. Offer compensation and/or medical care for these diseases for these individuals for the rest of their lives.
III. FUNDING MECHANISMI would strongly suggest that this program be instituted as an invested trust fund, in order to generate interest in perpetuity, rather than be used as a lump sum to be paid out in one-time compensation benefits.
One possibility would be to allow a choice to those eligible- that is, that one could either take a lump sum in compensation or life time medical care for those diseases defined to be within the list as plausibly linked to the exposures.
IV. FUTURE MANIFESTATION OF ILLNESS
Because chronic "low" dose exposures can be followed by extended latency periods, it is important to allow members of highest risk exposed subgroups to enter the eligibility pool at a later time if disease is not yet manifest. As long as these individuals meet eligibility criteria, once medical diagnosis is confirmed, eligibility would begin.
V. ETHICAL QUESTIONS
A challenging question is that of how much latitude to allow with regard to eligibility for this program for those who are workers but who have diseases other than those on the recognized list for compensation or care. This question also arises with regard to those non-workers who fall outside the eligibility group or who manifest diseases not on the recognized list of diseases plausibly connected to exposures.
VI. PRACTICAL CONSIDERATIONS
It is clear that legislation supporting this compensation and/or health care program for workers, and highest risk members of workers families and offsite exposed populations for DOE facilities and NTS exposures must be in place and operational as a trust fund BEFORE any change of Administration. This requires progressive response and planning.
Thank you. I would be very happy to help, in a volunteer capacity, in any way I can, to move this effort forward. Thank you for what you are doing to address the harms inflicted upon American workers, their families, and offsite populations, by the Manhattan Project and its legacy.
Trisha Pritikin
(Daughter of Hanford workers)
