Connections: the Newsletter of the Hanford Health Information Network (Includes Notification of the Department of Defense Radiation Experiments Command Center Website and Letter from the Execut ..

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HHIN on the New at the The Newsletter of the Hanford Health Information Network Radiation Science Update: HEDR’s Columbia River Work Undergoes Additional Review by Jim Thomas, HHIN Research Director A new assessment requested by the Agency for Toxic Substances and Disease Registry has identified several weaknesses in the work of the Hanford Environmental Dose Reconstruction Project (HEDR) on the Columbia River pathway. A “pathway” is the way people might have been exposed to radioactive materials. HEDR considered the Columbia River pathway to include consuming contaminated river water, fish or shellfish, and spending time along, on or in the river downstream from Hanford. According to the new assessment, a key weakness in HEDR’s Columbia River work is failing to consider another pathway: eating whole fish (including the bones) rather than fillets. This would apply to Native Americans and possibly to other groups of people. The HEDR reports reviewed in this assessment were not intended to apply to Native Americans, however. HEDR’s reconstruction of dose estimates for Native Americans is continuing. The assessment of HEDR was done by Owen Hoffman, Ph.D., and his colleagues at SENES Oak Ridge, Inc. Hoffman presented their conclusions to the December 1996 meeting of the Hanford Health Effects SubEarly in HEDR’s work, some initial calculations (called scoping calculations) were done to help focus the work on the pathways and radionuclides that contributed the most to people’s exposures. Based on these calculations, HEDR chose five radionuclides (phosphorus-32, 239) and used them in estimating the Columbia River doses to representative individuals. HEDR reported these estimates in 1994. Hoffman reviewed the HEDR scoping calculations and found another key weakness. The calculations were done only for adults at the time of exposure and not for children. Generally, children are more sensitive to radiation exposure than are adults. Hoffman’s own scoping calculations identified three radionuclides that he believes need to be reconsidered for future Hanford was released to the Columbia River during fuel element failures at Hanford’s plutonium production reactors. HEDR estimated that there were approximately 2,000 failures, mostly from 1955 to 1965. The main route of exposure from iodine- 13 1 in the river would have been internal: from drinking river water, especially in the Tri-Cities. 0 Cobalt-60 was released with the reactors’ regular effluent and settled in the river’s sediments. It has a five-year half-life and is a very strong emitter of radiation. The main route of exposure would have been external: from getting near the sediments, by walking along the shoreline or by swimming. 0 Strontium-90 concentrates in the bone when it enters the body and has a half-life of about 30 years. Hoffman recommended hrther consideration of strontium-90 for people who ate whole fish (including the bones). Radiation Risk Estimates Hoffman also estimated risk to people exposed to the Columbia River pathway and See RADIATION SCIENCE page 2

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expressed in this newsletter are those of the author, not necessarily of the The Hanford Health tion among three states and nine Our work is based on respect for the als and their right to make personal decisions with the For information, or for this newsletter, contact the Hanford Line for your state In other states HHIN Home Page World Wide Web: HHIN Publications Now on the Web Many of HHIN’s publications are now available on a newly expanded World Wide Web site. The site address is: http:/lwww. At this site you will find 15 HHIN publications about Hanford’s releases and radiation health effects, a directory of organizations and agencies, a calendar of meetings, and frequently asked questions, along with forms to order other publications or get on HHIN’s Radiation Science Update compared it with his estimate of risk for those exposed to the air releases of iodine-13 1. He concluded that some people exposed to the radioactivity in the river were at a similar level of risk as those exposed to airborne Based on HEDR’s 1994 reports, most scientists and government officials had considered the risks from the river pathway to be much lower than the risks from the air. Last year, the HHES recommended developing a medical monitoring program for those most heavily exposed to the iodine- 13 1 releases to the air. Impacts of New Assessment Officials with the Centers for Disease Control and Prevention (CDC), which is funding the remaining HEDR tasks, have said that additional work may be necessary before more dose estimates are calculated for the river pathway. CDC will make this decision after it report will be reviewed by other scientists (called a peer review), and the final written report released in February or March 1997. State coordinators of the Individual Dose Assessment Project (IDA) are also awaiting Hoffman’s written report before deciding if additional work is required. By late 1997, IDA plans to begin offering dose estimates for individuals exposed to Hanford’s radioactive The site makes it easy to find further information on a topic that interests you. Links to HHIN’s Glossary will let you quickly find the meaning of a term that is new to you. Links to HHIN publications will take you to the places on the site where a subject is discussed in more detail. Still other links are to organizations that have their own Web sites. If you’re new to searching on the Web, or want to know about other Web sites of interest, two new HHIN publications may help. Online Resources: How To Use the /nter.net To suggestions for getting started and for finding free or low-cost Internet access. Selected Sites on the World Wide Web lists a sampling of sites about radiation and health concerns. Call HHIN toll-free to get a copy of either of these publications mailed to you. 8 Documents Offered Online A new government World Wide Web site offers historical documents about human radiation experiments and research. The HREX (Human Radiation Experiments) thousands of documents from federal archives and records centers, and offers a way to search the records by date, author, agency, subject matter and full text. The Department of Defense located these documents for review by the Advisory Committee on Human Radiation Experiments. One of the experiments the Advisory Committee looked into was the December 1949 Green Run at Hanford. The Advisory Committee published its final report in October 1995. The report is available at another Web site: http:/lwww. For more information about HREX, contact Department of Defense Radiation Experiments Command Center, 680 1 Telegraph Road, Alexandria, VA 223 10-3398,

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ow that the Hanford Health Information Archives has been accepting material for a year, it’s time to begin sharing excerpts of personal memories and health histories people have contributed. Elizabeth Wilson of Yakima, Wash., wrote an account of her own and her family’s health histories. Here are several excerpts: “My husband and I grew up in Yakima and married in Nov. 1949. Our oldest son was born in Walla Walla on Oct. 8, I950 and our second son in Richland on Dec. 15, 1952. “My husband worked in the Hanford restricted areas for six years from 1951 to 1956. I worked in the restricted area for six months in 1953. We lived worked and played in Richland. In the hot suminers we enjoyed water sports. “My husband had his first heart attack at age 48. By then ...he already had congestive heart failure. He died at age 50.. . . “I had breast cancer in 1992. In 198 1 I began to have mysterious aches and pains. In 1982 I went to eight different specialists and no one could find anything wrong. It was that old ‘it’s all in your head.’ The pain was acute and my arm was frozen and I even needed help to undress. Lucky I found a doctor in Phoenix who helped me with that problem but he could not help me with the tingling in my legs or the other pains that I had. I went to orthopedics, neurologists, internists and any kind of doctor that I thought might help me. Radiation Risk Communication Audio tapes are available from the Radiation Risk Communication conference which HHIN’s Washington program held for health care providers in September. Topics included radiation health effects, risk communication, and ethical and psychosocial issues. HHIN is placing tapes at regional libraries in Washington state. The tapes also can be ordered from one session or $23 for the set of seven tapes, plus tax and shipping. * My own internist would ask every year when I had my physical, ‘I suppose you are still having tingling in your legs?’ and I would say ‘yes’ and he would look at me like I was making it all up. I had finally stopped telling him about it. The pain was real. and it sounded so much like my symptoms and I went to a rheumatism specialist and he gave me a complete physical and the diagnosis was fibromyalgia. What a relief - for 1 I years I had no idea what was wrong and furthermore no doctor seemed to know.. .. “In 1992 I read an article about fibromyalgia “It is much easier to live with something when you know what it is. I actually cried when the doctor gave his diagnosis.” The full text of this and other contributions are available by request from the Archives. * HEDR Task Completion Working Group The milk producer survey and the work on short-lived particles and worst case doses are currently underway by LTG Associates, Inc. and Radiological Assessments Corp. (RAC), respectively. Dr. Gary Chisum of LTG and Dr. Paul Voilleque of RAC will give progress reports at the March 1 1 HEDR Task Completion Working Group meeting in Seattle. Global Research Systems will conduct a scoping study of migrant farm workers. It is anticipated the study will be complete in April 1997. CDC has reviewed Dr. Alex Klementiev’s reports for any new technical information. The review did not suggest there are major, unresolved methodological issues associated with the HEDR reports produced to date. For more information, call Elke ShawThe day before Projects is held. for your area Call for dates: bers on page 2) Dates and times may change. Please in organization for HHIN Connections. Winter 1997 *3

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This column ji)cii.se.s on ways to cope with health concerns downwindws have expressed to HHIN. HHIN does not advocate particular treatments but offers information to help you make your own decisions. Ifyou have concerns about radiation Rebecca Leonard lived in The Dalles, Ore., from 1953 to 1957. Her family ate fruit and vegetables from their garden and fish from the Columbia River. She has hypothyroidism and scleroderma. We asked about her experiences in choosing health care. Responding are two naturopathic physicians, Debra Clapp, N.D., and Ralph Wood Wilson, N.D., M.S. Acupuncture; and a primary care physician, Suzanne Staudinger, M.D. Rebecca: It’s difficult to find a doctor that truly knows about scleroderma and how to treat it. When you mention “Hanford downwinder,” doctors look at you like you are nuts or want to sue someone. Where would you find a doctor that knows about this condition? How would 1 find others with this condition‘? Drs. Clapp and Wilson: You deserve respect and attention from your caregiver. Scleroderma is onc of many connective tissue diseases, possibly with an autoimmune component. These are not well understood. Different types of health care providers take significantly different approaches to health and disease. You might like a team approach. Holistic turists, Chinese herbalists, homeopaths, etc.) do not see all scleroderma patients as the same, and will tailor the therapy to your experience. Rare Disorders, Inc. families having the and Web site offer tions and other Call HHIN or search on the Internet. makes referrals to doctors and has Interview several about their training, diagnostic methods, therapies and time spent with patients. Would they cooperate with a diverse team‘? Ask about their experience with your diseases and how they would approach your situation. Naturopaths (N.D.) use nutritional, herbal and other therapies to support connective tissue integrity and the immune system. N.D.s strive to maximize health as well as relieve symptoms, in part by correcting imbalances that 44: HHIN Connerlions, Winter 1997 may have contributed to your disorder. A computer search of natural medicine databases shows therapy combinations that can be tailored to a scleroderma patient. was radioactive iodine. Because the thyroid concentrates iodine, it is thought to be most at risk, although other sites may be at risk. Health history, physical exam and labidiagnostic tests help detect abnormalities at early, treatable stages. Many N.D.s treat hypothyroidism and can provide care for cancer patients to decrease side effects of chemo- and radiation therapy and to maintain viable immune function. The main radionuclide released from Hanford Dr. Staudinger: I can imagine that you had trouble finding a doctor to answer all your questions. Because scleroderma is uncommon, not all doctors are familiar with it. Scleroderma is a disorder in which the ened. It can affect the skin, blood vessels, lungs and kidneys. Patients who just have involvement of the skin usually consult with a dermatologist. If internal organs are affected you would want to see a rheumatologist (specialist in the musculoskeletal system and joints) in addition to your primary care doctor. In some areas, your county or state medical society or a community hospital may be able to refer you to a specialist in your area. Or try contacting a national group. For example, there are national organizations for scleroderma patients (see box). HHIN may be able to help you locate a support group or connect you with other downwindzrs in your area. Another option is to ask your primary care doctor if he/ she is interested in becoming your “expert” about the health effects of living downwind of‘Hanford. You could help by sharing information you have found (such as HHIN’s health care provider packet) and letting your doctor know how to stay updated. If your doctor doesn’t feel comfortable doing this, respect that decision and keep looking until you find a doctor who is interested. They do exist! * Printed on recycled paper

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Hanford Health Information Network Sponsored by the states of Washington, Oregon and Idaho in concert with nine Indian tribes and nations This letter brings you: 1) the latest edition of the HHIN newsletter; 2) a post card for you to return to us if you are interested in having your oral history recorded; 3) a new way for you to help us reach other organizations; and 4) information about four articles now available through the HHIN. What’s in the newsletter? Enclosed you will find the Winter 1997 issue of describes a recent scientific review by Owen Hoffman, Ph.D., regarding the Hanford Environmental Dose Reconstruction Project’s Columbia River work. On page 3, you can read an excerpt from an Archives contribution -- a letter written by a Yakima, Wash., native about her health history and experiences in the downwind area. This issue’s “Coping” column (back page) focuses on making health care choices. We interviewed a Hanford downwinder about her questions; two naturopathic physicians and …