ATTACHMENT 5 Excerpts From a Collection of PHS Materials OUTLINE I. Historical Development of Radiation Activities in the Public Health Service Leading to Establishment of the Radiological Health Branch. II. Radiological Health Personnel as of June 1953. III. Radiological Health Program for Fiscal Years 1953 and 1954. 1. Organizational Development Activities. 2. Training 3. Epidemiology 4. Cooperative Research and Investigations. 5. Specialized Laboratory Investigations. 6. Consultation 7. Monitoring Services 8. Study of Legislation 9. Commentary 10. Distribution of Radiological Health Funds for Fiscal Years 1949 to 1954. IV. Radiological Public Health Problems and Needs. 1. Introduction 2. Increase in Radiation (a) Electrically Generated Radiation. (b) Radioactive Materials. (c) Production of Fissionable Materials. (d) Nuclear Reactors (e) Military Applications (f) Summary 3. Public Health Responsibilities (a) Summary 4. Need for Radiological Public Health Activities. 5. Radiological Public Health Organization. 6. Health Benefits Expected from Radiological Public Health Activities. V. The Radiological Public Health Activities of the Public Health Service. PART 1: History For many years the Public Health Service has studied _____ and effects of ionizing radiations and radioisotopes. Industrial hygiene and research personnel, in the years 1930 to 1940, shared in investigation of the radium _____ of clock dial painters. In 1940, Doctors _____ and _____ studied and reported on radium and x-ray health hazards in hospitals. Research conducted by Public Health Service employees (particularly _____, National Institutes of Health) contributed importantly to the Manhattan District's establishment of standards of human tolerance for radiation. (There are two more paragraphs on this page, but they weren't legible enough to type.) IN FISCAL YEAR, 19__ the Service established a Radiant Energy Unit as an Industrial Hygiene activity to assist States in limiting health hazards from radioactive isotopes and other sources of radiation in industry. The radiation researches of the National Institutes of Health were expanded considerably. A program of radiation research was established jointly by the Monsanto Chemical Corporation, the Clinton Laboratory of the Manhattan District, and the National Institutes of Health. By invitation of the Atomic Energy Commission and the Armed Forces Special _____ Project, three officers, as members of the Radiological Safety Staff of Joint Task Force ONE attended the tests designated as Operation Crossroads; seven other officers attended short training courses given under auspices of Joint Task Force ONE or the Joint Crossroads Committee (Appendix A); and the first medical officer was enrolled in radiobiology training at the University of Chicago under the auspices of the Armed Forces Special Weapons Project. In March 1947, the Public Health service prepared a statement of its views and its role in the field of radiation. (Appendix 3) The same month, Doctors Neal, Townsand, ___ Williams and Mr. _____ met with the three Bureau Chiefs and recommended that radiation activities remain assigned at National Institutes of Health. (The Division of Industrial Hygiene was located at the Institute at that time.) In March and May, the Surgeon General (Dr. Thomas Farren) arranged with Mr. Lilienthal of the Atomic Energy Commission for a series of meetings to explore "areas of mutual interest." IN FISCAL YEAR, 1945, the Service completed preliminary arrangements with the Atomic Energy Commission for co-sponsorship of training courses in radiation monitoring for State industrial hygiene personnel. During this year, Sanitary Engineer James O. Torrill, Jr., was assigned to assist on plans for the radiological health programs of the Service. In October 194_, a memorandum was submitted reviewing the staff planning to that date and making several suggestions on training for officers and development of a Radiation Unit. (Appendix C) To advance the Monsanto-Clinton Lab-RDI joint program, two officers were assigned to the Oak Ridge National Laboratory and one officer was assigned to the Los Alamos Scientific Laboratories of the Atomic Energy Commission for research on radioactive waste treatment and decontamination. An officer was assigned also to Johns Hopkins University to cooperate in a study of water and waste decontamination conducted jointly by the University, the Atomic Energy Commission and the Public Health Service. Many of the laboratories at National Institutes of Health had in progress studies on the biologic effects of ionizing radiation or were using radioisotopes as tracery in their investigations. FISCAL YEAR, 1949, marked the beginning of rapid expansion for the Public Health Service activities in radiological health. On July 7, 1948, a plan for radiological health activities was recommended by Assistant Surgeon General R. C. Williams, C. C. Williams, Sr., J. W. Mountin and H. D. Hollis, (Appendix C1). This plan outlined development of a "Radiological Health Office" and a "Radiological Health Laboratory" to be located in the Washington area. The two facilities were to operate as supplemental to each other and were to constitute an "overall Radiological Health program" for the entire Public Health Service. The Radiological Health Branch (then called "Radiological Health Unit") was established in the Bureau of State Services in accordance with the plan recommended by the Bureau Chiefs on July 7, 1948, (Appendix C1) with a budget of $17,639; and Sr. Surgeon Edwin O. Williams was transferred from the National Institutes of Health to the Environmental Health Services of the Bureau on September 1, 1948, to organize this activity. (Dr. Williams left the Branch April 1, 1951, for detail to FGDA). This Branch assumed major responsibility for the radiological public health program of the Service. The balance of this statement deals primarily with this public health program. During the remainder of the year, the "Unit" furnished Radiological Health consultation and assistance to the National Security Resources Board, the Armed Forces Special Weapons Project (contributions to Radiation Defense Manual III), and some State Health Departments. These activities are described in a statement dated March 17, 1949: "Radiological Health Program of the Public Health Service". (Appendix H) During the early part of this fiscal year, representatives of the Atomic Energy Commission consulted with the Public Health Service concerning the desirability of a cooperative study of the stream characteristics in the Columbia River Basin. A letter dated February 28, 1949, from the Surgeon General (Dr. Scheele) to Mr. Wilson (Appendix D & E), led to an agreement on joint conduct of the proposed study. The Surgeon General's budget statement of March 1949 reported AEC-PHS cooperation as follows: "The present interest of the Public Health Service in the field of radiological health stems from our direct responsibilities. . . and from numerous requests from State health departments for consultative and advisory services . . .to me the general public interest requires that the respective competencies of both agencies be focused on the related health problems as they arise." (See Appendix F & O) As the year progressed, the Industrial Hygiene section of the Service conducted seven one-week courses in radiation instrumentation at the National Institutes of Health. The Hospital Division supplied radon seeds to the Institutes for experimental purposes. The Environmental Health center began a radiation study of the Miami River, and the first two engineer officers were enrolled in the radiation engineering course of the Armed Forces Special Weapons Project. FOR FISCAL YEAR, 1950, the Radiological Health Branch budget was $67,198. These funds were expanded for staff planning in the Bureau, establishment of the Radiological Health Training Activity, the training outside the Service of seven officers and consultation to the States. Consultation on radiological health problems was also furnished to the National Institutes of Health, Bureau of Medical Services, the Divisions of the Bureau of State Services and to the National Security Board, Armed Forces Special Weapons Project, and the Atomic Energy Commission. On September 15, 1949, a meeting in Mr. Hollis' office reviewed the progress of planning and assignment of program activities in the radiological public health program. (See Appendix I, also Appendix N2) The Conference stressed the need for teamwork within the entire Service on radiological health activities. Starting November 4, 1949, there was an exchange of correspondence between the Surgeon General (Dr. Scheele) and Mr. Wilson (General Manager,AEC) (Appendix J & J1) suggesting preparation of a policy statement to clarify "certain questions relating to radiological aspects of stream pollution and environmental health". The Service prepared such a proposed statement (Appendix K), bur formal presentation of it was deferred within the Service itself. On April 12, 1950, the Service agreed with the Atomic Energy Commission and the Armed Forces on a joint project on radioactive water decontamination research at Oak Ridge National Laboratories. (Appendix L to L12 Sr. Scientist Oliver R. Placak and Sanitary Engineer Conrad Straub were transferred to this activity from the research on waste treatment already underway at Oak Ridge. Also, in June 1950 an officer was assigned to a radioactive air decontamination study. Radiation activities of the National Institutes of Health, the Division of Tuberculosis, the Division of Industrial Hygiene and other parts of the Service continued and expanded. The Division of Industrial Hygiene (now Occupational Health) began preliminary studies of radiation hazards in the mining and milling of uranium ore on the Colorado Plateau. (Annual Report of Public Health Service for 1950, page 56) FOR FISCAL YEAR 1951, the budget for radiological public health activities of the Service totalled $222,074. During this year, the study on stream characteristics in the Columbia River Basin was started at the request of the Atomic Energy Commission and the States concerned. (Appendix M) In July 1950 a "Health Study of the Uranium Mines and mills was begun by the Division of Industrial Hygiene (now Occupational health) and the Colorado State Department of Public Health. Assistance was given this study by the Atomic Energy Commission, the Los Alamos Scientific Laboratory, the Naval Radiological Defense Laboratory, the National Bureau of Standards, the Universities or Rochester, Colorado and Utah and the State Health Departments of New Mexico, Arizona and Utah. (Annual Report of Public Health Service for 1951, page 43) The Advisory Board for Research on the Decontamination of Radioactive Waters was formed and met for the first time, October 6, 1950. (Appendix N to N5) The Radiological Health Training Activity was transferred to the Environmental Health Center, Cincinnati, and its scope expanded. Staff and consultative activities of the Radiological Health Branch continued as did radiological health activities of the several Bureaus and Divisions and researches of the National Institutes of Health. And two Public Health Service members were appointed to the National Security Resources Board's Interdepartmental Committee on Radiological Monitoring. (Appendix O) IN FISCAL YEAR, 1952, the budget for radiological public health activities was $360,652. Several officers participated in atomic weapons tests at invitations of the Atomic Energy Commission and the Federal Civil Defense Administration. An officer and an alternate were appointed to represent the Service on the Atomic Energy Commission Screening Committee for the Biomedical Section of Atomic Test Operations. (Appendix R) Training of officers outside the Service for duty as radiation engineers and radiobiologists continued. A medical officer was assigned to the Naval Radiological Defense Laboratory in San Francisco for applied research in the medical effects of radiation, to act as liaison officer with the laboratory, and to be medical consultant in biological public health on the West Coast. A cooperative AEC-PHS study of the stream characteristics of the Savannah River was started July 2, 1951, (Appendix P to P3); a Technical Advisory Board for steering the project was convened December 12, 1951, for its first meeting; and the preliminary phase was completed in June 1952. Other phases of the study must be deferred until the Atomic Energy Commission facility on the River is in operation. The Radiological Health Branch prepared a proposed operational chart and statement of "Status and Pattern for Biological Health Activities" that was accepted as a working pattern by the Division of Engineering Resources and by the Associate Chief of the Bureau of State Services (Mr. Hollis). (Appendix Q to Q3) In April 1952, at a meeting of the Environmental Health Center, Radiological Health Branch, Division of Engineering Resources, Division of Occupational Health, and Communicable Disease Center, agreement was reached on respective responsibilities for and continuation of the several sections of the radiological public health activities of the Service, (Appendix S) an agreement was established between the Environmental Health Center and the Division of Engineering Resources relative to responsibilities in conduct of the Radiological Health Training Activity (Appendix T); and a steering committee for further development of the radiological health training program was established by the Radiological Health Branch (Appendix U). A policy statement on radiological health training for Service officers was established by the Training Committee of the Public Health Service (Appendix V). The AEC-Harvard University-PHS Air Decontamination Study was enlarged to include the radiological public health aspects of air decontamination. The radiation research of the National Institutes of Health and the special activities of the other Bureaus and Divisions in radiological health were continued and expanded. In the Spring, the APHA established a Subcommittee on Radiological Health of the Committee on Research and Standards with Dr. Samuel C. Ingraham as a member, and a Committee in the Engineering Section on Radiological Health with Mr. Terrill as Chairman. At the request of the Research Planning Council of the Service, a Radiobiological Activities Committee was convened to review all Public Health Service activities in health effects of ionizing radiation. The committee report (Appendix X) lists these major activities as well as radiation committee memberships and radiological health consultant assignments of Service personnel as of that time. On June 14, 1952, the status of the radiological health program and plans was reported to the National Advisory Health Council by Sr. Sanitary Engineer James G. Terrill, Jr., Acting Chief, Radiological Health Branch (Appendix _). And on June 28,1 952, he reviewed and discussed the radiological health program of the Service with members of the Biology and Medicine Division of the Atomic Energy Commission. Dr. Shields Warren, at this meeting, expressed the appreciation of the Biology and Medicine Division, AEC for the cooperation of the Service in the public health aspects of the atomic energy program, (Appendix Y) and stated, "It has been the desire of AEC since the beginning of its operations to have the help of the Public Health Service in approaching the solution of the problem of radiation and radioisotope control as it relates to the health protection of the public." Dr. Warren's remarks on this score are seconded by Dr. Paul Abersold's statements supporting the need for Public Health Department cooperation in the program of the Isotopes Division, AEC. (Appendix Z) For Fiscal Year 1953, the radiological public health activities appropriation is $351,000. II. Radiological Health Personnel - June 30, 1952 As of the beginning of fiscal year, 1953, there were possibly ten commissioned medical, engineering, and veterinarian personnel in the Public Health Service with sufficient training in their fundamental disciplines and in radiation to direct radiological health programs. There were twenty-two other commissioned and ten civil service personnel with training to a lesser degree. (See Appendix AA). III. Program, 1953 - 1954 The program for fiscal years 1953 and 1954 consists of organizational development, training, research and investigations. These are being conducted to meet radiological public health needs on the basis of their relative priorities and with due regard for the basic research and other activities being carried on by other agencies and other portions of the Service. Specifically, the program includes: 1. Organizational Development Activities Positive development of State radiological health activities -- Operational experience over the past few years has indicated a growing need for practical information about the radiological health program skills and planning needed to develop a State Health program in radiological health. For this reason a team consisting of a public health physician and a sanitary engineer has been assigned to the New Jersey Health Department to obtain actual field data on the specific information about radiological health program skills and planning needed in State health departments. The goal of this activity is to investigate the epidemiology of radiation exposure in New Jersey and by application of public health methods and procedures, to establish appropriate control measures. Consultation to States through the temporary loan of skilled personnel is being continued. Monitoring services are being established as needed. 2. Training The increasing role of State and local health agencies in protecting the public from radiological health hazards, and the shortage of workers trained in radiological health has resulted in a substantial increase in the demand for radiological health training. Therefore, the Radiological Health Training Section is increasing the tempo and volume of training of State and local health personnel at the Environmental Health Center. Specialists of the radiological health training staff are participating in courses, symposia, workshops and lecture series sponsored by State and local health agencies, universities, hospitals and others. Specialized training courses are being established in selected aspects of radiological health for certain professional groups such as water works operators, industrial hygienists, and other environmental specialists. Mobile field training units are being used in field courses and demonstrations. The radiological public health training program is designed to: a. Assist personnel in State and local health departments and related professional fields in achieving a working understanding of radiation hazards and methods of protection therefrom. b. Provide consultation and survey services regarding radiation protection problems. Within Service training is also continuing. This training is designed to place, in all operating programs of the Service, personnel capable of meting the radiological public health needs of the particular program. 3. Epidemiology As chronic radiation effects are cumulative, proper protection of the public requires knowledge of the total radiation exposure of individuals throughout life. The total accumulation of radiation exposure from both nuclear emissions and radiation-generating equipment should be known. The potential hazards should be determined to understand the effects that will appear years later in morbidity and mortality statistics. Therefore, a continuing evaluation of the radiological public health problem is essential. This includes studies to: a. Determine radiation sources and their location, persons involved in their use, and cause and extent of exposures; for this purpose, a continuing study of the published literature on radiation exposure in the United States has been established within the Radiological Health Branch. The goal of this study is to determine the known sources of radiation exposure in the United States and to evaluate them quantitatively. Preliminary reports have been completed on several of the sources of radiation exposure. These include, "X-Ray in the Healing Arts", "X-Ray in Industry" and "Shoe-Fitting Fluoroscopes". Other reports in process include "Reactor Produced Radioisotopes", "Radium and Other Natural Radioactive Materials", "Radioactive Static Eliminators", "Nuclear Reactors", "Nuclear Reactors", and "Particle Accelerators". This study has thus far shown that exposures of radiation workers are about what had been suspected but that exposures of the general population, although at a level well below present day maximum permissible standards for radiation workers, are appreciably above the level which had been generally assumed to exist. Further, little organized effort has been made to reduce exposures to all types of ionizing radiations to the lowest possible level as recommended by the National Committee on Radiation Protection. b. Evaluate the public health significance of reported radiation injuries. Initial results of this study have shown that the incidence of radiation injuries is much greater than had been suspected. c. Establish standard methods for measuring, in public health terms, the overall and accumulative growth of radiation exposure and its effect on community health. This study has revealed that few data are available on this subject. The search of the literature is continuing. Contact is being maintained with basic and applied research groups who are working on these problems, and as information becomes available, it will be applied. 4. Cooperative Research and Investigations. a. Investigation of the possible pollution of streams by radioactive substances and the effects of such materials on normal stream uses. The program for the study of stream characteristics in the vicinity of the Hanford Works and the Savannah River Project of the Atomic Energy Commission is for this purpose. The Columbia River project was started in 1951 and that on the Savannah River was initiated in 1952. The overall radiological public health objectives of the Columbia and Savannah River Studies by the Public Health Service are: (1) establishment of criteria for judging effects of wastes on water uses, (2) development of methods of measuring the effects of radioactive wastes, and (3) provision of reports which will help State health departments to meet local problems as they arise. Little practical information is available concerning the effects of wastes from atomic installations on the characteristics and normal uses of waters receiving such wastes. To provide data for the study of this problem, a survey of the characteristics of the Savannah River was performed before the building of the Atomic Energy Commission plant there. This work will be continued in cooperation with the Atomic Energy Commission and the State Health Departments concerned after the plant begins operations. The study will permit determinations of the effects of plant operations on water quality and plant and fish life. As a useful by-product of such studies new instrumentation and improved techniques are also being developed for collecting water pollution data. The cooperative study of the Columbia River will be concluded in 1954 with the preparation and printing of the final report. The report is to be written to give maximum guidance to the interested organizations. However, since one of the principle objectives of the Columbia River Studies was to provide basis information which would enable the responsible pollution control authorities to effectively perform their legal obligations, technical radiological competence will be needed by the several State agencies involved and the Public Health Service River Basin Office. Therefore, current plans call for the training of selected personnel in these agencies. The Columbia River Studies laboratory will be continued in operation to provide a field training headquarters for this program. b. Collaboration with the Atomic Energy Commission at Los Alamos, New Mexico, on the engineering development of methods for removing radioactive material from liquid wastes. This work has been most fruitful in providing the engineering and scientific development of suitable chemical and biological processes for the treatment of certain specific types of wastes, principally plutonium. Substantial economies in waste disposal have been effected as compared to alternative procedures. In 1954, the field investigation phase of Los Alamos will be continued with emphasis on solving additional treatment problems, and developing engineering standards, laboratory techniques, and instrumentation for fissionable material. c. Work at Oak Ridge, Tennessee, in collaboration with the Oak Ridge National Laboratory, on procedures for the protection of water supplies from radioactive pollutants. From experience gained in these studies, standard procedures will be developed for the protection of water. These standard procedures then can be used by health workers in dealing with similar radiological public health problems. The benefits of this research are to be made available to State and local health agencies as rapidly as possible, through publications and the training program. d. Applied studies on the evaluation and control of air pollution by radioactive substances. Those studies are a joint project with Harvard University, the Atomic Energy Commission and the Service. A considerable amount of investigative work has been carried out by others on non-radiation problems of air decontamination including the effects of fumes, dusts, smokes, etc. However, with the developing atomic age a new factor, radioactivity, has been added to these health hazards. As a result the pollution of air with radioactive materials will become a more significant problem in an increasing number of industries. Yet, operating air pollution control workers know little about the specific hazards of air carrying radioactive substances or the practical means of abating them. Studies of these problems will be closely integrated with existing activities on air pollution and its abatement. The results of those studies will form the basis for consultation to State Health Departments on problems concerning radioactive dusts in industry. The health study of the Uranium Mines and Mills is continuing. This study has been given impetus by the stepped-up production of uranium, which has accentuated the need to find and control all radiation and other hazards to the health of uranium miners and millers. Previous studies in the mines have revealed that extensive control measures were necessary. Thus emphasis is being placed on devising better control methods and simple procedures for checking the effectiveness of such control. c. Study of the effects of the over-increasing use of radioisotopes on sanitary facilities, on stream pollution problems, and promulgation of means or methods for protecting the public health from hazards arising from the use of radioisotopes. The radiological investigations are at all times subject to review and revision to assure that answers to the more pressing problems are being sought. Such a procedure is a must since the radiological public health demands associated with the rapidly growing radiation and atomic industries are continually changing. 5. Specialized laboratory investigations. This project, initiated during 1953, is concerned with the utilization of radioactive substance and radiation techniques to improve public health practices in the environment and the use of radioactive substances to trace the transmission of toxic material through air, water, and food. As an initial stop in this program, one officer of the Milk and Food Branch, Division of Sanitation, has been assigned to the Massachusetts Institute of Technology to study the latest techniques in the application of radiation for the sterilization of perishable foods. 6. Consultation Consultative services on radiological public health problems will be provided. Particular emphasis will be given requests for aid in placing new State radiological health programs on an operating basis. These services will be under the direction of the Radiological Health Branch but the radiological health competence in the entire Bureau will be utilized. The Division of Occupational Health uranium mine study group will handle general radiological health problems in the Rocky Mountain area. The Radiological Health Training Section at the Environmental Health Center will furnish consultative services in that area. 7. Monitoring Services The present, limited monitoring and film badge service is being continued. a. Assistance is being furnished to other government agencies, particularly with regard to the Atomic Energy Commission and the Nevada Weapons Tests. b. The radiological health surveys of the U. S. Public Health Service Hospitals are continuing. From experience gained in those studies, a survey procedure is being developed which can be used by health workers to assess these radiological health hazards quickly and efficiently. 8. Study of Legislation The Radiological Health Branch is collecting and collating State and local laws and regulations pertinent to radiological public health. Early results of this study indicate that radiation control in the United States ranges from a few having specific authority more restrictive than is desirable to some having no legislation concerning the health aspects of radiation. COMMENTARY A few phases of radiological health practice have reached the stage where supervision and control are adequate. In other phases, delineation of the public health problem is still in the epidemiological stage. In 1954, emphasis will continue on the epidemiological delineation of the total radiation load in the population and its effect on the health of the individual. Other portions of the program will shift from planning and preparatory to operational stages. Emphasis will shift from training Service personnel to training State and local personnel; from gathering information, to applying it; from finding sources of radiation, to determining what groups of people are affected. The program will seek to accelerate the establishment of radiological public health programs in the States. DISTRIBUTION OF RADIOLOGICAL HEALTH FUNDS October 24, 1952 1949 - 1954 Project Actual Actual Actual Actual Estimate Estimate 1949 1950 1951 1952 1953 1954 Epidemiology, $16,900* $46,771 $63,540 $89,100 $91,000 development, $67,198 and coordination Radiological health training $56,058 83,943 76,100 76,100 Radiological health investigations: Water decontamination studies (Oak Ridge) ** 80,177 69,000 69,000 Radioactivity stream studies (Columbia and Savannah Rivers) 99,762 101,049 75,600 50,700 Waste treatment studies (Los Alamos and ERC) ** 23,809 22,200 40,400 Specialized laboratory investigations (EHC) 8,134 24,000 28,800 TOTAL $16,900 $360,652 $356,000 $356,000 * Appropriation to NIH, comp. transfer to Engineering, Sanitation, and Industrial Hygiene in 1951. ** Financed from Surgeon General Reserve in 1951. IV. Radiological Public Health Problems and Needs 1. Introduction As indicated in the preceding sections, the Radiological Health Branch has been gathering baseline data on radiation exposures from all sources, (Appendix BB) developing organized competence in health aspects of radiation, and training personnel in radiological public health. Other portions of the Service have been conducting investigations and research in areas where immediate radiation problems confronted health agencies and have helped to work out public health radiation control measures to meet some of these problems. 2. Increase in Radiation The use of radiation is on the increase. This is reflected in data gathered by the Branch on the medical, commercial, industrial, and research uses of radiation generating units and radioactive materials. (See Appendix BB and Chart 1 on the following page). The health effects of radiation exposure are cumulative. Therefore, total exposures from all radiation sources, as well as exposures from separate sources, must be considered in the successful radiological public health program. The objective of such a program should be to keep radiation exposure, exclusive of that resulting from natural background, (Appendix CC), to a minimum. For presentation purposes, the major sources of radiation exposure in the United States will be separated into five categories: (a) Electrically Generated Radiation More than 140,000 x-ray units are used in the United States for medical, industrial, commercial and research purposes. More than 250,000 operating personnel are potentially exposed to radiation from these units. Data from x-ray sales companies and from x-ray film manufacturers indicate an approximately three-fold expansion in use of x-ray machines in the past 12 years. Particle accelerators have increased in numbers even more rapidly. (b) Radioactive Materials Distributed for Constructive Purposes (Chart No. 1) The Atomic Energy Commission reports that it distributed about 170 curies of radioactive isotopes per month, on the average, during the 10 month period, January 1, 1951, to June 30,1952. Currently, some 7500 persons working in about 1300 laboratories and departments are directly involved in the use of these materials. On the average, about one in 300 exceeds the recommended maximum permissible radiation dose (0.3 roentgen/week). Single organ doses to therapy patients may reach thousands of roentgens. There is a total of eighty cobalt-60 sources in use in industry. These sources generally range in size from 0.1 to 1.0 curie. Since they substitute for radium or x-rays in industrial radiography, it is probable that the number of such sources will multiply considerably over the years. FOR REFERENCE SEE (8bb23.gif) Radium, available through commercial suppliers, is used in the healing arts and in industry as a source of high energy photons and of alpha radiation. Some 50 curies are currently in use in industry alone. Radium is also the basic ingredient in self-luminous paints, several hundred curies being used for this purpose during World War II. Radium and naturally radioactive polonium are being used in thousands of radioactive status eliminators. (c) Production of Fissionable Material (Appendix BB and CC) The fundamental information for this section is largely classified, so a direct quantitative approach is difficult. Certain, unclassified, published information gives a basis adequate for the purpose here. A sum of approximately one half billion dollars has been spent on development, mining, transportation, milling and concentrating the raw materials of naturally fissionable elements. The uranium mining and milling activities in this country are predominantly restricted to the region of the Colorado Plateau. Some 2000 miners and millers are engaged in This work. The probable populations of the several Atomic Energy Commission production sites indicate a worker group of between 20,000 and 50,000 persons. The health and safety records of these plants are good so far as radiation exposures of personnel and detectable physiological effects are concerned. Extensive studies have confirmed, also, that the existing radiation health protection programs constitute practical protection for the surrounding communities. The cost of these programs is high, however. The Atomic Energy Commission reports costs of $204,000 per person per year for health physics services and plant construction costs approximately 10 times those for plants handling non-radioactive materials. (d) Nuclear Reactors (Appendix DD) The Atomic Energy Commission is emphasizing the development of nuclear reactors (atomic piles). A major division of the Commission is dedicated to production of many types of nuclear reactors. Large appropriations are earmarked for this work. The Department of Defense, also, has an interest in reactors for military propulsion. Breeder-reactors are being built to increase the supply of fissionable material. Power production reactors are being developed for military purposes and to increase our national power supply. The policy on reactor development is explicit in numerous press releases of the Atomic Energy Commission (Appendix EE). The effort is definitely to encourage participation of private industry in the atomic energy program. If only 5% of the power currently being used annually in the United States were produced by nuclear reactors, approximately 100 millicuries of fission products will be produced for every inhabitant (even allowing a decay time of 100 days). (Appendix FF) The need for control of this material is apparent. Maximum permissible amounts in the body are of the order of microcuries. Maximum permissible concentrations in air and water for many of the fission products range from 10-7 to 10-10 microcurie per cubic centimeter. The amount of radioactivity that must be handled after the fission reaction (Nuclear reactor or Atomic Bomb) is very much greater than prior to fission. (e) Military Applications (Appendix BB and DD) Currently the Atomic Energy Commission program is geared to the need for atomic weapons. The effects of this production may create public health problems as a consequence of fall-out from test explosions, reassignment of fissionable materials to the nuclear reactor program, and militarily used atomic blasts. The Atomic Energy Commission is on public record that the fall-out from tests, to date, has not resulted in significant health exposures. This belief is not fully concurred in by others who question the measurement and evaluation methods used by the Commission to study fall-out. Within the Commission and its contractor group, there are differences of opinion at the technical level. There are, as yet, no estimates of long term, industrial and property damage factors or of the potential effects of blasts of greater number and potency. Already, fall-out has complicated the production processes and cost of photographic films and film packaging materials. All responsible radiation control groups within and outside the Atomic Energy Commission concur in the need to maintain active measurement and evaluation groups. The fall-out concentrations are in the range where unique bomb, biologic variation or weather might have serious health consequences in a limited geographic area. Selection of test sites reflects awareness of these possible hazards. (f) Summary (1) There are many sources and potential sources of radiation exposure important to the health of individuals. Genetic and aging effects are cumulative throughout life so total exposure must be considered. (2) Present day radiation health hazards arise from the medical, industrial use of radiation-producing machines, and near future military applications. The latter can have a direct bearing on civil populations and on indirect lowering of the radiation reserve of soldier citizens. (3) In the future the major source of radiation of concern to public health organizations will probably be nuclear power reactors. (4) The planned diversion of fissionable material to private enterprise will increase the responsibilities of public health officials in radiological public health. (5) Radiation sources of current public health importance(x-ray, fall out and radioisotopes) are sufficient to provide an excellent background of experience for the future. 3. Public Health Responsibilities As pointed out in the previous section, the sources of radiation of public health importance are rapidly increasing both in the nuclear and non-nuclear field. Instances of overexposure to ionizing radiation are found in practically all fields where health and safety personnel have had the opportunity to make detailed surveys. This is true even while the amount of available radioactive material is relatively small, except within the Atomic Energy Commission establishments. (Appendix X) Every indication supports the promise that we must ready our public health organizations to meet a huge expansion of radiation use in industry, commerce, medicine and field-military applications. State officials have a direct, non-transferable responsibility for the health of all the citizens within their jurisdictions. This basic premise has never been questioned by experienced health administrators, regardless of their official responsibilities. In the atomic energy field, the normal interpretation of this fundamental law has been modified. The Atomic Energy Commission is a statutory monopoly, and has in its basic law the statutory responsibility to assure that the people are not injured by the radiation it produces. Parallel to this responsibility of the Atomic Energy Commission is the basic and traditional responsibility of the Public Health Service for providing leadership to the United States in the conduct of an effective public health program for the nation. These concurrent, overlapping responsibilities require experience and thoughtfulness to resolve. Because security poses many relationship problems, the Atomic Energy Commission can rarely be completely informative in its dealings with other groups. To assist in the delineation of these responsibilities, it was verbally agreed, at the start of the Atomic Energy Commission program that: ("Discussion" section of Appendix Y) (1) Within the Atomic Energy Commission activities, responsibility for maintaining safety and health standards belongs to the Atomic Energy Commission. (2) The States have the fundamental responsibility for off-site health and safety activities. However, the Atomic Energy Commission should provide the States with adequate data for effective and efficient radiological public health activities. While this concept has been recognized at the top technical levels, it has not been announced officially by either the representative of the health agencies or of the Atomic Energy Commission. Currently, 45 States and Territories have taken some concrete action to initiate radiological health activities. (Appendix HH) In many cases this has been limited to control one source of radiation. In others, a broader view has been taken. Eight (8) are actively engaged in planning, evaluation, and control on a multisource basis, so all aspects of potential radiation health hazards will be covered. At this stage of development the average State and large city health officer is faced with a dilemma. He has few, if any, personnel with competence in radiation work, little organization and less budget to evaluate current radiation sources. He has only the general health laws on which to base program plans and request budgetary assistance. And as he undertakes the task of developing a radiological health activity, his difficulties are compounded by the defense inspired expansion of the Atomic Energy Commission program, and the pronounced intention of the Atomic Energy Commission to place a considerable portion of their activities in private hands. Atomic Energy Commission workers have a remarkable safety record, but this outstanding record has been at a cost of $224 per person per year for health physics service operations; and plant construction costs of ten times those for plants handling non-radioactive materials. To assist in long range planning, the Radiological Health Branch has translated the various reports and policy statements into estimates of probable radiation activities and their public health impact. The attached charts give qualitative trends of expected developments in the atomic energy program. Chart No. 2 sums up the military and civilian aspects of Nuclear Radiation Public Health Activities. Chart No. 3 adds the Non-Nuclear Radiation load. And Chart No. 4 breaks the total into Public Health Service and State and local activities. The portions of the charts for the period 1947 - 52 are based upon the historical data available. In prognosticating the future the principle assumptions were: (1) The military emphasis would decline during the period 1955 - 1960, as predicted by military experts. (2) Concurrently the statutory monopoly of the Atomic Energy Commission would be modified, so private enterprise would have a larger stake on atomic energy. (a) Summary (1) The Atomic Energy Commission has statutory responsibility for health control of radiation resulting from its activities related to fissionable material. (2) Health agencies have traditional and basic responsibility for protection of the public health. Implicit in this responsibility is the duty of health protection in connection with radiation from all sources including atomic energy sources. (3) The Atomic Energy Commission and the Health Agencies should cooperate to develop a balanced radiological public health control program for the nation. Effective cooperative efforts are constantly broadening. FOR REFERENCE SEE (8bb24.gif) FOR REFERENCE SEE (8bb25.gif) FOR REFERENCE SEE (8bb26.gif) 4. Need for Radiological Public Health Activities Even as the Atomic Energy Commission is directing its program into private industry, and as the total radiation load of the Nation from natural, fission-produced, and electrically-conducted material increases, we find the recognized authorities agreeing that recommended maximum permissible dose standards do not provide the factor of safety originally assumed. The significance of chronic and genetic effects of radiation is being emphasized. And the aging of our population promises to make the long delayed or subclinical radiation injuries of greater and greater importance. Medical journals and societies are arousing interest in accidental, chronic, therapeutic and diagnostic exposures. Will industry willingly spend 3 to 4% of their operating funds for radiation protection services as has the Atomic Energy Commission unless all competing industries are confronted with similar standards? This is equivalent percentage-wise to half of the tax load of the U.S. Steel Company. It is equivalent to their full administrative and sales costs. Presently, to our knowledge, no State or local jurisdiction has data on the radiation load contributed by all sources in the community. They have only general or implied legal authority on which to build a radiological public health organization. Few trained personnel are available and fewer budgeted positions are established. Radiological public health activities are recognized only partially as fitting into present organizational units in most cases. There is as yet no body of public opinion which recognizes, as the Atomic Energy Commission has recognized, the possible dangers to public health from repeated low-level exposures to radiation. 5. Radiological Public Health Organization To meet their responsibilities in radiological health, the public health organizations must develop organized competence in the health aspects of the use of ionizing radiations in industry, medicine, commerce and research. Specific organization and activities to achieve this and will include: (1) Training and experience for health workers in the procedures and techniques of radiation health control. (2) Survey and investigation to locate the sources of potential radiation exposure of public health significance. (3) Establishment of liaison with the Atomic Energy Commission, technical experts in use and control of radiation, and civil defense authorities to assure integration of efforts in radiation control activities. (4) Adoption of radiation exposure standards and maximum permissible concentration standards. (Appendix GG) (5) Applied research to develop public health procedures for radiation and radioisotope hazard evaluation and control. These are significant radiological health problems today, in connection with a number x-ray and radioisotope uses. As the atomic program expands, radiological health problems will be compounded. The experience gained in developing public health control measures for the present problem, will act as a training program for the greater health problems expected with the development of atomic power and the other wonders of the atomic age. 6. Health Benefits Expected from Radiological Public Health Activities (1) The official health agencies will be in a position to evaluate the total radiation load in the community. Science can know with certainty the effects of exposure only after such data has been gathered over a period of generations. The accumulative effects of radiation require a knowledge of all exposures. (2) Through the police power of the State, controls can be planned and applied uniformly in accordance with need. (3) Reasonable, uniform development of controls can prevent emotional impacts which could injure the atomic energy industry unnecessarily. (4) Basis for a radiological monitoring service will be available for civil defense at all times. (5) Laboring groups, the public and industry can feel that an independent evaluation of radiation exposures and hazards is available from public health authorities. (6) All available resources will be used in radiological public health activities. (7) There will be local control of radiation sources and health jurisdictions will be informed about interstate and international sources of radioactive substances. (8) Specific evidence as to safety measures will be available. This can help avert need for imposition of unreasonably restrictive legal controls on users of radiation. (9) A competent official group will be available in each locality for necessary cooperative health efforts. Such a local official agency will be able to accept responsibility for drafting and applying uniform, equitable health controls on an area basis. (10) Field personnel will be available for on-the-spot health inspection services on a continual basis. (11) Health department activities will promote confidence that the public is being protected from radiation hazard incidental to energy production and research. (12) Records will be available to assist the administration of justice to industrial compensation and radiation accident cases. V. Radiological Public Health Activities of the Public Health Service. The Bureau of State Services has the fundamental responsibility of protecting the health of the people through the application of public health methods. The radiological public health program is thus defined administratively by the "Bureau of State Services Activities". (See Appendix II) Operational relationships for the Bureau are a satisfactory guide for radiological health activities, provided adequate emphasis is placed upon Atomic Energy Commission and Defense Department relationships. On the basis of the data outlined in the previous sections and substantiated in the appendices, we have evaluated the future radiological public health needs. Relative State and Public Health Service participation has been outlined. In this section, a plan of relative emphasis based upon the seven official Bureau activities has been plotted. 1. Consultative and Technical Services have been carried on at an increasing tempo by the several divisions of the Bureau since 1947. This activity is expected to increase until State and local competence increases significantly. 2. Administration of Interstate Programs This awaits the development of public health evaluation of interstate radiation factors. 3. Development, Operation, and Evaluation of Demonstrations and Methods. Currently the Radiological Health Branch is giving this activity top priority. At the moment eight (8) health departments are building broad radiological public health organizations. Thirty-seven (37) others have initiated some radiological health activities. 4. Research and Investigations In the future it is expected that the Public Health Service efforts in the healing art and water fields will taper off. Gases and air will be more significant, and industrial and commercial applications will require more research and investigations. 5. Collection and Analysis of Health Data This plan will be modified by the health data collected. Currently, this activity is the No. 2 priority of the Radiological Health Branch. In this field particularly, a broad gross evaluation of data may be far more significant than detailed research by the Public Health Service. Other groups are better equipped and financed for many detailed research efforts. However, the Public Health Service has unique facilities for collecting health data. APPENDIX "A" Report Transmitted 3-14-47 JOINT STATEMENT OF PUBLIC HEALTH SERVICE PERSONNEL WHO HAVE HAD EXPERIENCE WITH CROSSROADS A conference was held at the National Institutes of Health on February 10 and 11, 1947, for the purpose of preparing a joint report to be submitted through the various channels to the respective Assistant Surgeons General. Those present at the conference were: E. G. Williams, Sr. Surg. National Institutes of Health H. L. Andrews, Scientist National Institutes of Health A. B. Eschenbrenner, Surg. National Institutes of Health O. R. Placak, Sr. Asst. Sen. Eng.Stream Pollution Laboratory J. G. Terrill, Sen. Eng. Communicable Disease Center D. A. Holaday,Eng. (R) Division of Industrial Hygiene Harry Haimann, Surg. Division of Industrial Hygiene J. F. Bell, Sr. Asst. Surg. National Institutes of Health E. G. Murphy, Physicist Division of Tuberculosis Control J. B. Vander, Sr. Asst. Surg. Division of Commissioned Officers Absent: None Three of the officers spent 9 months or more on the assignment. They were assigned to the War Department and became members of the Radiological Safety Staff of Joint Task Force ONE. They were given theoretical and practical instruction, and field experience on the mainland and in the Pacific, and later assisted in the planning and teaching of the courses mentioned below. Four attended a 6-weeks' course given under the auspices of Joint Task Force ONE and had field training in the Pacific. Three attended a 3-weeks' course given under the auspices of the Joint Crossroads Committee primarily for medical officers. All of the group feel that the time was gainfully spent. The following is an attempt to present the group thought with regard to the role which the Service is destined to play in the field of radiation. Increasing interest in the wide-spread use of penetrating radiation (X-rays, gamma rays, and neutrons) and of radioactive isotopes in research and in industry present numerous practical health problems. The seriousness of these problems is greater than that of most of the other hazards with which we deal because of the fact that radiation injury is insidious, cumulative, irreversible and effects not only the individual exposed but also his progeny. Public health aspects will be discussed under the following convenient headings: 1. Training of personnel 2. Research 3. Coordination of safety procedures 4. Pollution of streams, ground water, soil, and air 5. Transportation 6. Medical aspects 7. Special considerations 8. Coast Guard 9. Accidents 1. Training of personnel is listed first because it is necessary to have trained people in order to accomplish any mission requiring special knowledge or skill. It is thought better, however, to delay a discussion of training until some mention is made of the tasks for which we think training is necessary. 2. Research: It is unanimously agreed and dismissed with acknowledgement that perhaps the greatest contribution the Service can make in this field is through its research activities. These have been under way for several years and are constantly expanding. Thought should be given to the feasibility of initiating research in the field of environmental pollution. 3. Coordination of safety methods: The present permissible exposure of the body to X- and gamma rays varies from 0.05 to 0.2 r per day. There is no generally accepted permissible exposure to other types of radiation, for example, alpha, beta and neutrons. For these, arbitrary limits have been set and, if rigidly followed, it is thought that there will be little need to fear serious immediate harmful effects. Those limits will probably need considerable revision and methods of meeting them must be improved as we gain more knowledge concerning the biological effects of radiation. Persons and organizations distributing radioactive substances are taking care that they do not fall into incompetent hands. Quantities now distributed are so small that disposal is of little consequence. It is obvious, however, that, with the increasing number of available isotopes and of investigators using them, some over-all coordination in safety measures must be accomplished. This will become much more urgent when power plants, either stationary or mobile, using nuclear reactions as a source of energy are built. The Service has had a number of requests from individuals, organizations, and States for advice regarding health hazards ranging from new radioactive luminous compounds to the question of pollution of rivers with radioactive substances. It is probable that such requests will increase in number and it is felt that the Service should keep itself sufficiently informed to be of benefit in an advisory capacity. The question of disposal is of increasing importance and difficulty. Some of the radioactive isotopes decay rapidly and become stable elements; others decay very slowly (some over periods of hundreds of years) and if reasonably large quantities are liberated or concentrated they may become hazardous. It has been suggested that areas must be segregated and designated as burial sites. Should this come to pass--and it is a reasonable probability--the Service would undoubtedly be interested in the health aspects involved. 4. Pollution of streams, ground water, soil, and air: Possible pollution of streams by radioactive wastes has been a matter ] of concern for some time and will become more so as additional laboratories and industries engage in certain phases of high energy radiation work. Should ground water and soil become appreciably polluted, it would constitute a serious problem in the area involved. This question should be seriously considered in the solution and method of use of burial sites, as well as other methods of disposal. Stream pollution might conceivable become harbor or estuary pollution and result in health hazards in connection with edible marine life and the commercial uses of seaweed. 5. Transportation of radioactive substances: The transportation of radioactive substances is of importance to health as well as to the fogging of photographic film, and in the matter of interstate shipment, the Service might be called upon to advise or prescribe in the matter of safety. Large shipments perhaps should never move by other than specially built trucks and then only in the hands of well-trained responsible personnel. International transportation of radioactive substances will undoubtedly be very rigidly controlled for security and economic reasons, but when, as, and if permitted the question of safety for the seamen and passengers and the inspection of ship's spaces for structural contamination which may be damaging to personnel might be considered a Public Health Service responsibility. The use of ships that have been contaminated, the repair of such ships, and the salvaging of such ships all pose problems in health and safety which the Service may be called upon to answer. 6. Medical aspects: Radiation sickness is a symptom complex familiar to all clinical radiologists and for which there is no specific treatment. It is not assumed that our officers will often be called upon to deal with it except in connection with radiation therapy. There are, however, late results from moderate over-exposure or chronic poisoning, the considerations of which cannot be dismissed lightly. There is also the very great probability that people with hysteria or neuroses with symptoms allegedly due to radiation will present themselves to our medical officers for treatment. 7. Special considerations: The group feels that special mention should be made of the status of the protection of X-ray workers in the field of medicine. A survey of hospitals made by the Service several years ago and the present impression of the group indicate that although the more serious hazards formerly associated with the clinical use of X-rays have been eliminated, an alarming number of doctors, nurses, and technicians are not sufficiently cognizant of or respectful of the potential hazards from repeated small amounts of radiation, and that renewed and continued effort might well be directed along those lines. 8. Coast Guard: Medical officers assigned to the Coast Guard may at any time be called upon to act as radiological safety advisors to the commander of the unit. They will find it their responsibility to assess the health hazard of various _____ of radiation of different types, to approve safety precautions incident to the detection and measurement of supported areas and render opinions as to the feasibility (from the health standpoint) of operations in fields of "activity." 9. Accidents: In the event of serious accidents or incident involving large amount of radioactive materials dispersed over a relatively large area a health hazard of great magnitude will be created. The populace would probably look to the Service for assistance. We may not return to a consideration of training of personnel. We do not feel that it is either necessary or wise for the Service to embark on an extensive program which has as its goal the training of a large number of experts in the field of radiological safety. We do feel, however, that officers serving in capacities encompassed by the above-mentioned categories should have a good indoctrination in this field. It is the opinion of the group that the Service can ill afford, at the present time, to give the type of instruction necessary for this purpose. The Navy is instituting courses of 6 weeks' instruction in Radiological Safety and has invited the Service to send up to 5 officers to each course. The first school is located at San Francisco and will open March 15, 1947. Navy plans call for at least one other school and in all probability other agencies or institutions will in time operate schools, some of which might be better suited to our purposes. For the present, however, this is the only opportunity that any of us are cognizant of and it is available with no teaching, administrative, or material expense to the Service. Officers given this training should be "career" personnel and should include some close enough to policy-forming groups to enable the Service to decide better what, if anything beyond research, should be undertaken in this field. The group feels that those definitely not interested should not be sent to the school. More special and extended training in research or safety procedures can be arranged through the National Institutes of Health to be given at Oak Ridge. Such training, however, should be proceeded by the indoctrination course. In view of the foregoing, it would seem that the Public Health Service will wish to formulate broad policies with regard to high energy radiation and within those policies to establish flexible long-range programs along which it can develop. The Service would then be in a position to anticipate and perhaps prevent situations parallel to the unfortunate experience of the radium dial painters. The over-all plan would include close cooperation with other governmental agencies and civilian groups interested in this general field. All of the activities envisioned in this report fall within the existing legal responsibilities and administrative structure of the Service. APPENDIX "B" March 1947 A PLAN FOR RADIOLOGICAL HEALTH ACTIVITIES This plan is intended to assist in the initiation of an overall Radiological Health program, which will complement the program of research underway at the National Institute of Health. This organizational plan is based upon the principle of concentrating, pooling, and developing the limited technical personnel and equipment now available. It is recommended that a Radiological Health office and a Radiological Health laboratory be established in the Washington Area, to supplement and cooperate with the research program at the National Institute of Health, and the other radiological units now in existence. A. RADIOLOGICAL HEALTH OFFICE I Services to be performed: (a) Collection and correlation of information. (b) The dissemination of radiological information. (c) The promotion of radiological training. (d) Consultation service to State and local health departments. (e) Consultation and assistance to existing and new radiological units. (f) Liaison with A.E.C., Department of National Defense, and scientific and professional organizations. (g) Promotion of the use of radiological techniques in research, treatment and control of disease, particularly in PHS activities. (h) Promotion of radiation control in the several divisions directly and indirectly concerned; for example, Hospital Division, T.B. Survey Groups, Coast Guard. (i) Consultation services for the Office of Emergency Health Planning. (j) Study of standard codes, laws, and regulations for consultation purposes. II Personnel Medical Officer 1 Engineer-Scientist 1 Medical-Engineer- Scientists in training 1-3 Technical Librarian 1 CAF 3 III Initial Annual Budget $60,000 per year B. RADIOLOGICAL HEALTH LABORATORY (It is believed that this development should preferably use the facilities of the existing Radiant Energy Laboratory of the Industrial Hygiene Division as a developmental base.) I Laboratory Services: (a) Continuation and extension of present services. (b) Act as laboratory arm of the Radiological Health Office. (c) Provide laboratory services for existing and new radiological units in the several Divisions as required. (d) Provide laboratory services for the State and local health organizations as required. (e) Provide laboratory services and instruments for training programs. (f) Contribute to the establishment of practical standards for health agencies purposes. II Personnel: (a) Professional and sub-professional personnel 8 (b) CAF and CPO personnel 5 III Initial Annual Budget $100,000 (including equipment) C. TOTAL INITIAL ANNUAL COST--$160,000 Appendix "C" Sometime after October 14, 1947 COMMITTEES Institute of Radio Engineers (Radiation H. L. Andrews Detection Instruments) NRC Atomic Energy Casualty Committee P. A. Neal A. Eschenbrenner Nuclear Energy Glossary Review Board ASMEE. G. Williams National Committee on Radiation Protection Executive Committee E. G. Williams Monitoring Methods & Instruments H. L. Andrews E. G. Williams N.R.C. Radioactivity - Radiobiology P. A. Neal H. A. Andrews A.F.S.W.P. - JRSTC Steering P. A. Neal Instruments H. L. Andrews Schools H. L. Andrews Med. E. G. Williams Terminology E. G. Williams Nat. Organization Terrell Decontamination Dressen & Kratz Personnel protectionH. Specht "Army" course E. G. Williams H. L. Andrews A.S.A. Z-37 (radon, Ra dust, and rays) P. A. Neal E. G. Williams (D.A.H.) N.R.C. Glossary E. G. Williams Warning Signs E. G. Williams and D.A.H. Adv. Comm. to Office of Emergency HealthE. G. Williams Planning Eagle, Harry Sebrell, W. H., Jr. Habel, Karl REPRODUCED AT THE NATIONAL ARCHIVES Appendix "_" OFFICE MEMORANDUM UNITED STATES GOVERNMENT To: Surgeon General From: M. D. Hollis Subject: In our luncheon discussions (attended by Drs. Scheals and Dearing and Mr. Hollis of the Public Health Service, and Dr. Warren and others of the Atomic Energy Commission) Friday with Dr. Shields Warren, I am hopeful we might reach some understanding on the problems of radioactive waste (liquid and gaseous) that reach beyond the boundaries of atomic energy plants. There follows summary background: 1. From the standpoint of polluting waste the PHS (also the States) consider federally operated or controlled industries in a category identical to private industries. Other than security, there appears no basis for viewing the atomic energy industry as different from the ammunition industry, the chemical industry, the steel industry, etc. I am sure no one holds the view that radioactive wastes are not pollutants. 2. The PHS (and most States) recognizes and respects the security bounds of AEC. For the predictable future sole responsibility for the intra-plant industrial problems should remain with AEC. What bothers the States and the PHS are the byproduct wastes that go beyond the industry boundaries. If it is necessary that investigations on the extent and effects of such wastes must be held within AEC for security reasons, this fact should be clearly stated and justified. 3. Under PL 845 (Water Pollution Control) the Service has the responsibility of developing, by river basins, comprehensive programs for water pollution control. The States are expecting that such programs will recognize radioactive waste. 4. Several States have made inquiry regarding the applicability of the Presidential Executive Order (No. 10014, copy attached) to AEC facilities. 5. At its annual meeting in 1948 the Conference of State Sanitary Engineers (46 States represented) discussed in executive session the radioactive waste question. The PHS, in recognition of security, counseled against a proposed resolution requesting immediate release of information on such wastes. In lieu of such a resolution the Conference requested the PHS to work out with AEC an acceptable policy by which States could secure data on both plant waste and problems relating to shipment and use of isotopes. A report in this regard is to be submitted to the Conference at the May 1949 meeting. 6. A status summary of the PHS program is attached. The PHS and State health departments have a high level of competency in the broad field of stream pollution and related surface water utilization. Admittedly there is an extreme paucity of personnel in States with significant training in the field of radiological health. The PHS has concentrated on training over the past year and its staff includes competent officers in this field. However, the staff is limited and an effort is being made to develop a program for F.Y. 1950 that will insure maximum utilization of trained personnel. In the public interest, it would seem desirable to coordinate the activities of the PHS with those of AEC in the waste control field. Based on relations thus far it seems that the AEC holds the view that they are solely responsible for all problems in atomic energy production including the handling and disposal of radioactive waste. This view may be sound because of security requirements. However, it is not sound that the SEC through its contract companies is to be the sole "judge and jury" regarding wastes disposal affecting public health and water uses. It is abundantly evident that the State health authorities do not subscribe to such a policy. I am disinclined to feel that the PHS should endorse this principle. /a/ N. D. Hollis Appendix "J" November 15, 1949 Dear Mr. Wilson: The Public Health Service is continually being pressed for a policy statement clarifying certain questions relating to radiological aspects of stream pollution and environmental health, many of which seem to be of mutual concern to us and the Atomic Energy Commission. I believe that there should be developed between the Service and the Commission a clearer understanding of related interests and responsibilities. Subsequent to a conference between Mr. Lilienthal and Dr. Parran, my predecessor, the Service has enjoyed a close relationship on an informal basis with the Commission and many of its contractors. During this period we have initiated a program of radiological health, which has become an integral part of our general public health program. It includes activities in the fields of industrial hygiene and water pollution control as well as cooperative operations in radioactive waste control at Oak Ridge and Los Alamos. We have a request from the Commission to conduct certain studies in the Richland area. In the spring we had a conference with Dr. Shields Warren, Mr. Warner and Dr. Jensen, during which we had a profitable discussion. Since that time both Dr. Jensen and Mr. Warner have left the Commission resulting in some loss of continuity of contact. In view of these matters I should like to discuss with you the possibility of formalizing our inter-relationships. May I suggest for your consideration a meeting some time during the week of November 28. Sincerely yours, /a/ Surgeon General Mr. Carroll Wilson General Manager U. S. Atomic Energy Commission Washington 25, D. C. EGWart Appendix "J1" Medical Director E. G. Williams believes a favorable reply was received to the letter of November 15, 1949, from Dr. Scheele to Mr. Wilson and that the meeting was canceled because of PHS budget hearings. September 17, 1952 Appendix "K" 11/4/49 Memorandum of Understanding Between Atomic Energy Commission and Public Health Service The Atomic Energy Commission and the Public Health Service recognize their responsibility, within their respective fields of authority for the protection of the public health in matters relating to ionizing radiation. The Public Health Service is legally charged with matters concerning physical and mental diseases and impairments of man and has been active in the fields of radiobiology and radiation protection for more than two decades. The Atomic Energy Commission is legally charged with matters concerning the protection of health during research and production activities related to atomic energy. Both agencies are concerned with the health aspects of the widespread use of radioactive substances distributed for the most part by the Commission. Both Agencies are concerned with the question of environmental contamination by radioactive substances whether produced or distributed by the Commission or others. This memorandum of understanding is designed to provide a framework within which the Atomic Energy Commission and the Public Health Service will work toward a more effective coordination of their respective programs. Background The Public Health Service and the Atomic Energy Commission (and its predecessor) have worked cooperatively since during the war years of World War II. Illustration of this interagency cooperation are the part played by the National Institutions of Health in the study of biological effects of radiation, the release of and assignment of officers for radiation protection of personnel in the Manhattan District and the bomb tests of 1946 and 1948, the assignment of officers to Oak Ridge and Los Alamos to work on special problems, the numerous conferences held between members of the two agencies and the request by the Atomic Energy Commission for the Public Health Service to conduct certain studies in the Hanford area. Cooperative Role of the Federal Government The goal of assuring the greatest benefit of atomic energy and its by-products to the general public and at the same time the greatest protection to the public health can best be served by the cooperative effort of all elements in the American community. This premise requires that the Federal Government conceive and execute its activities so as to facilitate such cooperative effort on the part of all who share responsibility for the safe handling of radiation and in the prevention of environmental contamination. The Atomic Energy Commission and the Public Health Service will jointly seek, within their respective areas of responsibility, the effective collaboration of all participants with whom they deal. In addition to State and local governments these participants include public and private institutions, other agencies of the Federal Government, and representatives of various professional, industrial, labor, and civic organizations. Basis for Future Activities While it is clear that each of the two agencies must initiate activities that lie within its own statutory responsibility, it is also recognized that greater public benefit will obtain if the two agencies cooperate in planning and conducting activities related to radiological health. To this and the Chairman of the Atomic Energy Commission and the Surgeon General of the Public Health Service will each designate a member of his staff to be primarily responsible for promoting mutual understanding of the programs of the two agencies and of the areas where they have common interests. These designated individuals will work out methods and procedures designed to provide for -- a. A continuous interchange of information of interest to both agencies; b. The cooperative planning projects to further the objectives of each agency and the preparation and exchange of work reports; c. The allocation of working funds and the assignment of technical personnel necessary to the undertaking and completion of specific projects; d. The technical and scientific evaluation of such projects and their results in terms of practical application; and e. The appraisal of these cooperative activities in terms of their contribution to the national welfare. Each agency will seek so far as practicable to utilize the resources of the other. Where such arrangements are made, the functions or activities will be financed by the agency with primary responsibility in the field involved. New projects and programs of common interest will be cooperatively developed between appropriate officials of the two agencies, and justifications for funds submitted to the Bureau of the Budget and the Congress in connection with such projects will indicate such cooperative planning, the benefits to be derived by both agencies, and the extent to which it is considered that such projects be supported from their respective funds. Agreements upon specific joint projects that are developed as a result of interagency collaboration will be recorded as appendixes to this basic memorandum. Appendix "L" December 9, 1949 COPY O P Y My dear Mr. Shugg: I have reviewed with my staff the verbal inquiry from your office as to the interest of the Public Health Service in conducting studies relating to the decontamination of radioactive water supplies. We also have studied your document of November 1949, "A Program for Research in Decontamination of Radioactive Water Supplies for Civilian and Military Use." To me the research in question is highly significant and is of fundamental importance to the public health and waterworks professions. The Public Health Service is willing to accept sponsorship of the proposed project. I am confident our respective technical staffs can work out mutually acceptable policies and procedures relative to operations. Details for financing this work during the current and next fiscal years will have to be arranged between the Atomic Energy Commission and the Public Health Service. Funds for the activity beyond fiscal year 1951 could be requested in our next budget submission. Obviously, close collaboration between the two agencies in planning and carrying on the research will be necessary. It would seem desirable to arrange with the Oak Ridge National Laboratory to carry out the project as presently planned so that the change in sponsorship would cause minimum delay. I presume concurrence of the Department of Defense in this proposal is assured. Beyond other considerations, the implications of your proposal will have a significant effect on the public health and related professions. You may be certain of our deep interest and assured collaboration. Sincerely yours, /a/ Leonard A. Scheele Surgeon General Mr. Carleton Shugg Deputy General Manager U. S. Atomic Energy Commission Washington 25, D. C. Appendix "L2" UNITED STATES ATOMIC ENERGY COMMISSION COPY O Washington 25, D. C. P Y January 6, 1950 L. A. Scheele, Surgeon General U. S. Public Health Service Washington 25, D.C. My dear Dr. Scheele: We are most appreciative of your letter of December 9, 1949, advising of the willingness of the Public Health Service to accept sponsorship of a proposed research project on decontamination of radioactive water supplies at the Oak Ridge National Laboratory to be financed in FY-1950 cooperatively by the A.E.C. and the Department of Defense. It appears we are in agreement on the timeliness and national importance of these studies. On problems of this type we agree with you that the public interest will be better served by bringing to bear our respective competencies in a collaborative approach. As a result of discussions between representatives of all agencies concerned it has been deemed advisable to proceed with the arrangements as planned to carry out the research at ORNL with the understanding that as soon as practical (preferably by July 1, 1950) the Public Health Service will assume technical responsibility for the project. Because of the increasing and continuing responsibility which the Public Health Service would assume in this project, it would seem appropriate that you take the initiative in organizing an Advisory Board with consultation with the cooperating agencies. It is recognized that details for financing the program beyond fiscal year 1950 will have to be worked out. The A.E.C. would prefer that action toward this end be initiated by the Public Health Service with appropriate support from the Commission. Sincerely yours, /a/ Carroll L. Wilson Carroll L. Wilson General Manager Appendix "L3" January 11, 1950 My dear Mr. Wilson: I am glad to have your letter of January 6, 1950, in further regard to the proposed research on decontamination of radioactive water supplies. The arrangements proposed are satisfactory to the Public Health Service. I am confident our respective technical staffs can proceed with this activity within the framework of policy suggested in our exchange of correspondence. I am asking Assistant Surgeon General M. D. Hollis to represent the Public Health Service on detailed arrangements. Sincerely yours, /a/ Leonard A. Scheele Surgeon General Mr. Carroll L. Wilson General Manager U. S. Atomic Energy Commission Washington 25, D. C. Appendix "L4" FOR OFFICIAL USE ONLY February 8, 1950 Lawrence R. Hafstad, Director, Reactor Development Division, Washington R. W. Cook, Manager, Oak Ridge Operations Office PROPOSED PROGRAM FOR RESEARCH IN DECONTAMINATION OF RADIOACTIVE WATER SUPPLIES FOR CIVILIAN AND MILITARY USES. Reference is made to your memorandum dated December 28, 1949, subject as above. The program as proposed in your memorandum has been discussed in detail with representatives of the ORNL. Essentially, both the Laboratory and this office are in agreement concerning the desirability of prosecuting this program. In order to avoid any possible misunderstandings, I feel it is desirable to clearly define the relationships of all concerned. Accordingly, acceptance of responsibility for this program is based on the following considerations: a. It should be recognized that the decontamination of radioactive water supplies for civilian and military uses is only one part of a much broader program, both fundamental and programmatic, in the general area of environmental sanitation at the ORNL. b. The entire program of environmental sanitation at ORNL including that research concerning decontamination of radioactive water supplies for civilian and military uses is considered a part of the ORNL program and, therefore, its prosecution is a direct responsibility of the Laboratory contractor. c. Since it is a regular ORNL program, it will be administered as is the rest of the ORNL program, by the Oak Ridge Operations Office. As you suggest, reports resulting from the work will be issued as regular ORNL reports. d. The potential value of the advisory committee which you suggest is apparent. It is desired that is functions be entirely limited to those of technical advice and that such recommendations and representations as the committee cares to make should be addressed to your office or to this office of the AEC, but not directly to the Laboratory. e. Your memorandum indicates your desire to have the Public Health Service assume responsibility for technical sponsorship of the project, preferably by July 1, 1950. Both the Laboratory and this office consider this feasible providing it is agreed the technical sponsorship consists of: FOR OFFICIAL USE ONLY FOR OFFICIAL USE ONLY (1) Assignment of acceptable qualified personnel to the Oak Ridge Operations Office for reassignment to the ORNL. (2) Presentation to the AEC, either directly or through the advisory committee for the program, suggestions and requirements of the Public Health Service. It is assumed that the Laboratory will undertake such programs as are suggested whenever sufficient funds, facilities and manpower are available. In the event such programs are not undertaken the Laboratory will state their reasons for not doing so. With respect to the draft of the proposed letter of invitation to acknowledged authorities to serve on the advisory committee, we would like to see the statement on page 2, paragraph 2, under conditions of agreements, changed to read as follows: "The Committee will be expected to make recommendations to the Division of Reactor Development concerning the technical aspects of the program but will not have any technical or administrative responsibility for the conduct of the program." It is requested that you consider this memorandum as constituting our formal acceptance of the responsibility to establish and administer this program. Accordingly, it is requested that funds in the amount of $145,000 be made available to this office in order that the program may proceed without further delay. /s/ R. W. Cook Holland:vh F O R O F I C I A L U S E O N L Y Appendix "L5" OAK RIDGE NATIONAL LABORATORY Division of CARBIDE AND CARBON CHEMICALS CORPORATION UCC Post Office Box P OAK RIDGE, TENNESSEE February 21, 1950 Vernon G. MacKenzie Public Health Service Environmental Health Center 1006-1020 Broadway Cincinnati 2, Ohio Dear Mr. MacKenzie: Attached you will find a draft of the reply to the memorandum received by the Oak Ridge Office of AEC regarding the proposed program of water decontamination research. Since this is primarily AEC business, at the moment and a question of propriety is involved, I should prefer that the attached memorandum be regarded as confidential and any distribution restricted to yourself, Mr. Pond and Mr. Hollis. However, since the PHS is concerned as a participant in the program and will be affected by these negotiations, it appears only reasonable that you should be kept informed. I am sure you will be interested in my personal interpretation of this memorandum. In general it might be stated that both the laboratory and the Oak Ridge Office of AEC support this program and wish it to proceed as soon as possible. When one considers that the program proposed originated from here this should be self-evident. The fact that delays have ensued is unfortunate, particularly regarding this proposal with which there has never been any objection raised on the grounds of technical desirability or feasibility. It would be more unfortunate if further delays occurred and the initiative were lost over interpretation that might in the final analysis be questions of semantics. The attached memorandum was drafted with the concurrence of the Oak Ridge AEC and ORNL. The intention was to define broad general relationships under which such a cooperative undertaking would be facilitated and administratively feasible. Whether or not one agrees with the promises stated, it should be apparent that the principle of such agreement in advance is desirable. These considerations are very concisely Vernon O. MacKenzie February 21, 1950 page 2 stated. I know that, at the time of writing, the authors of this memorandum felt some qualms that such conciseness might be misinterpreted but in the interests of clarity decided to maintain this form. I am willing to predict that within this framework all sorts of concessions are possible and that the importance of the part that the PHS would play would be only self-limited. In my opinion, the following interpretations should be read into this document. Part (a) -This program and those facilities as conceived here originally were considered as one facet of a broad integrated program. This section attempts to maintain this perspective. If my understanding of the objectives of the PHS is correct, they should welcome the chance for participation in a broader area of study. Part (b) -This recognizes the responsibility of the Laboratory for carrying out or assisting in such investigations. It is a sound public health principle that an industrial operator should accept responsibility for research concerning his problems. I am sure that there is no intent (at Oak Ridge) to deny the duties or responsibilities of the PHS in this field. Part (c) -The question of issuance of reports may be unsatisfactory to you. This is the method suggested in the original memorandum received at Oak Ridge. Standard distribution of ORNL waste disposal reports is only eighty-five copies. If simultaneous issuance or reprinting under PHS responsibility would be desirable and reach more people, I'm confident that this could be arranged. Part (d) -I believe that this is straightforward. Part (e) -Both the Oak Ridge AEC and the Laboratory have always felt that they were cooperating with the PHS and wish to continue doing so. I should like to reiterate, that I personally feel that the extent of PHS cooperation and participation would depend on the PHS itself and would not be limited in any sense at this site. To my knowledge, there is no sense of rivalry here, but only a very real desire to push through such a cooperative program. I am confident that in actual practice this will go much farther than this memorandum might seem to imply. Vernon O. MacKenzie February 21, 1950 page 3 In part (e)(2) it might seem that a loophole is left, whereby the laboratory might refuse programs. This is true, I suppose, but the real purpose was to prevent this from becoming a mere testing laboratory for specific equipment to the detriment of a broad research program. However, I have no evidence that there has been any objection to testing programs if they have a valid relationship to the research program and if additional facilities and personnel can be provided as necessary. Mr. Hollis had an opportunity to look over my copy of this memorandum, while I was in Washington, and if I am not mistaken in his reaction he felt that it would be workable and not out of line with other PHS cooperative activities in the past. Sincerely, Original Signed By Oliver R. Placak Scientist Health Physics Division ORP/r Appendix "L6" UNITED STATES ATOMIC ENERGY COMMISSION Washington 25, D.C. COPY O P Y March 22, 1950 Mr. Mark D. Hollis Assistant Surgeon General U. S. Public Health Service Washington 25, D. C. My dear Mr. Hollis: There has been discussions between our staffs of the attached memorandum from R. W. Cook, Manager, Oak Ridge Operations Office advising as to the conditions under which his office and the Oak Ridge National Laboratory would be willing to accept responsibility to establish and administer the proposed program for research in decontamination of radioactive water supplies for civilian and military uses. As this memorandum relates to previous correspondence with your office concerning participation by the Public Health Service, in this cooperative research program, I should like to obtain your comments relative to the conditions of acceptance presented by Mr. Cook before proceeding further in our negotiations for this research. Sincerely yours, /s/ L. R. hafstad Director of Reactor Development Appendix "L11" R. W. Cook, Manager April 19, 1950 Albert N. Holland, Jr., M.D., Director of Research and Medicine MEETING ON WASTE DISPOSAL RESEARCH PROGRAM, APRIL 12, 1950 SYMBOL: RM:JHR Those attending were: C. E. Larson, ORNL W. F. Bale, AEC S. C. Barnett, ORNL W. D. Claus, AEC E. J. Murphy, ORNL J. B. Chubbock, AEC K. Z. Morgan, ORNL A. E. Gorman, AEC F. Western, ORNL J. A. Lieberman, AEC R. J. Morton, ORNL E. McCrady, AEC M. D. Hollis, PHS J. H. Roberson, AEC M. A. Pond, PHS V. G. McKenzie, PHS O. Placek, PHS C. Straub, PHS The meeting was held at the suggestion of the Public Health Service to settle on details of organization and procedure involved in the cooperative program of research in the decontamination of radioactive water supplies for civilian and military use. Conclusions reached at the meeting were: 1. The necessary approvals were complete, and Oak Ridge Operations can proceed with the construction project upon receipt of funds. (Estimated cost of building and equipment is $145,000, which will be financed by $40,000 each from the AEC Divisions of Military Application, Reactor Development and Biology and Medicine, and $25,000 to be transferred to the Commission by the National Military Establishment.) 2. Equipment to be treated by the Oak Ridge National Laboratory for the National Military Establishment can be shipped to the Laboratory whenever it is desirable to do so. A thorough test program could not be completed until the new facility is available. 3. The Oak Ridge National Laboratory, the Public Health Service and the Atomic Energy Commission are in agreement on the basis of cooperation, which was outlined in the memorandum from R. W. Cook to L. R. Hafstad, dated February 8, 1950, and related correspondence. R. W. Cook - 2 - April 19, 1950 4. The participation of PHS in the water decontamination program should in no way affect the other Health Physics research activities carried on by the Laboratory group under Mr. Morton's leadership. (This conclusion was the result of Dr. Western's explanation that the scope of the Health Physics program included a wider field than the specific project on which discussion had been centered at the meeting.) 5. Budget procedures for the program in F.Y. 1952 would not change as far as the Laboratory was concerned. Public Health Service would budget for the cost of its own participation in the program. (A later conversation with Mr. Pond indicated that anticipated Public Health Service cost consisted of personal service and travel, plus such special equipment or other costs which were necessary to accomplish the objectives, which are of primary interest to the U. S. Public Health Service.) 6. Details of the assignment of additional Public Health Service personnel for the program would be decided by representatives of the Laboratory and the Public Health Service. 7. The Public Health Service would organize the Advisory Committee in the immediate future, and representation would include outside agencies. (Suggested representation was Atomic Energy Commission, Washington 3; Public Health Service, 2; National Military Establishment, 1; other agencies 2 or 3. The sense of the discussion was that this committee was larger than need be, and possibly the Commission representation might best be reduced. The Laboratory should be represented on the committee either by a number or an ex-officio member.) Albert N. Holland, Jr., M.D. cc: C. E. Larson, ORNL L. R. Hafstad, Att; E. A. Gorman, AEC, Wash. Shields Warren, Att; W.D. Claus, AEC, Wash. Gen. James McCormack, Att; J. B. Chubbock, AEC, Wash. K. S. Pitzer, AEC, Wash. W. J. Williams, AEC, Wash. M. D. Hollis, PHS O. R. Placak, PHS Appendix "M" Files January 31, 1950 Arthur E. Gorman, Sanitary Engineer, Division Engineering SURVEY OF COLORADO RIVER At the request of Assistant Surgeon General Mark D. Hollis of the U.S. Public Health Service a meeting was held this afternoon in the office of John Derry, Executive Officer, Biology and Medicine Division. The following were present: U. S. Public Health Service Mark D. Hollis, Assistant Surgeon General Vernon O. McKenzie, Officer in Charge, Environmental Health Center, Cincinnati, Ohio M. Allan Pond, Chief, Public Health Resources Division C. C. Ruchhoft, Chief, Chemistry Branch, Environ- mental Health Center, Cincinnati, Ohio Atomic Energy Commission Division of Biology and Medicine Walter D. Claus, Biology Branch Joe Deal, Biology Branch John Derry, Executive Officer Paul Pearson, Chief, Biology Branch Division of Engineering Arthur E. Gorman, Sanitary Engineer Joseph A. Lieberman, Asst. Sanitary Engineer Mr. Hollis stated that in accordance with the understanding at the previous meeting concerning the Columbia River Survey, the P.H.S. had prepared a statement covering the work they proposed to carry out in this cooperative survey. Copies were distributed to those present. He also stated that P.H.S. had requested an appropriation of $105,000 for this survey in their 1951 budget. So far, this request has received favorable consideration. Therefore, his office is anxious to develop a satisfying working arrangement with AEC-Washington and Hanford for carrying out the field work. - 2 - Mr. Hollis stated that the state departments of health in many sections of the country were becoming much concerned over the problem of atomic waste in relation to environmental sanitation, particularly the possibility of contamination of ground waters and surface streams. As recently as yesterday a state health officer conferred with him in regard to the establishment of a radiological laboratory in order that his state may properly control radioactive contamination. He said it is the policy of the P.H.S. to cooperate with states in their environmental problems. Under Public Law 845 authorization was granted P.H.S. to cooperate with the states in the control and abatement of contamination of streams. An early study of the Columbia River was among their first programs under this new law. Mr. Deal and Mr. Pearson wanted to know to what extent the P.H.S. surveys would involve determination of radioactivity in rivers and streams. Mr. Hollis replied that insofar as the Columbia River Survey was concerned this would depend largely on the extent to which the AEC was already making radiological and biological studies. He said the P.H.S. did not desire to duplicate to any marked degree work that was already being done by other competent agencies, but felt that a reasonable amount of overlap might be desirable. The prime effort of the P.H.S. survey will be to supplement information concerning the River already available. Mr. Gorman pointed out that the survey was concerned with much more than the study of the effect of radioactive contamination of the river; that it involved a comprehensive study of the stream before and after impoundment by the McNary Dam in order that knowledge of the effect of this impoundment might be obtained to permit forecast of similar effects in the case of other projects, particularly those upstream of the Hanford Works. He pointed out that several Hanford officials would have an interest in the river survey for different reasons. Among their interests are the following: (1) the quality of the River water with relation to pretreatment for use as a coolant in the reactors; (2) the effect of radioactive contamination of the pile effluent water on biological growth in the River and extent of contamination downstream; (3) the extent of bacterial and contamination of the river by plant sewers and the effluents from the village sewer systems. It was generally conceded that the best way to develop effective working arrangements concerning these proposed projects was to have a conference at a reasonably early date between officials of AEC-Washington and Hanford and the P.H.S. There was discussion as to whether the meeting should be held in Washington or Hanford with a preference for the latter. Mr. Gorman pointed out that it might be well to have representation at this meeting of the Hanford technical group controlling the quality of the water to the piles, Health Instrument Group interested in Radioactive contamination of the River and the Hanford Public Health Group interested in bacteriological aspects of the River. The conclusions drawn from the meeting were: (1) that representatives of the Biology and Medicine and Engineering Divisions would review the draft of the report submitted by the P.H.S. and make their comments and suggestions to Mr. Hollis; (2) after considering these comments the final draft will be prepared for submission to the A.E.C.; (3) the P.H.S. report will be transmitted to Hanford for comments; (4) negotiations will be entered into with the Hanford officials concerning a joint meeting with the P.H.S., preferably at Hanford. cc: Biology & Medicine Production Division Mark D. Holis Asst. Surgeon Gen. U.S.P.H.S. COPY UNITED STATES ATOMIC ENERGY COMMISSION Washington 25, D.C. May 2, 1951 Dr. Leonard A. Scheele Surgeon General U. S. Public Health Service Washington 25, D.C. Dear Dr. Scheele: Following my letter to you of April 11, 1951, there was held on April 20, 1951 at Wilmington, a meeting of representatives of the U. S. Public Health Service, the Atomic Energy Commission and the Du Pont Company. As a result of this meeting, it was agreed that it would be desirable for the U. S. Public Health Service to undertake, as soon as practicable, a survey of the Savannah River as generally proposed by your representatives at the Wilmington meeting. In your carrying out of the survey, I would feel it desirable to develop a close working relationship between the Public Health Service people on the survey in the Savannah River area and the Savannah River Operations Office activities of the Atomic Energy Commission. Our Sanitary Engineering group here in Washington will maintain liaison with the Savannah River Operations Office and will, therefore, be familiar with the program. It is noted that other organizations are, or will be, engaged in specific activities related to your survey operations. It is assumed that the coordination of these activities will be such to assure maximum mutual usefulness of the information obtained. I want to assure you of our continued interest and cooperation in connection with these activities. Sincerely yours, M. W. Boyer General Manager Appendix "Q" Organizational Requirements On August 27, 1951, a statement entitled "Status and Pattern for Radiological Health Activities" was prepared and accepted as a working pattern by the Chief of the Division (Mr. Pond) and the Associate Chief of the Bureau (Mr. Hollis). Practical experience rather than differences in principles have convinced the Branch the proper discharge of many of the proper functions of the organization require operating control as well as staff control of some functions. For the immediate future this implies budgetary program and personnel control over field representatives and other budgetary, program and personnel control over the training group located at E.H.C. on a specific contract with E.H.C. that will outline objectives completion dates, etc. For this purpose the organization chart which was tacitly approved by its budgetary use would be modified as indicated, and formally approved. Experience has shown that it is necessary for those responsible for planning radiological health activities to have representation when budgetary reallotments are made. REPRODUCED AT THE NATIONAL ARCHIVES Appendix "_" _____ UNITED STATES ATOMIC ENERGY COMMISSION Washington 25, D. C. December 10, 1951 Dr. Leonard A.Scheele Surgeon General U. S. Public Health Service Federal Security Agency Washington 25, D.C. Dear Dr. Scheele: The rapid development of the scientific programs in connection with the tests of nuclear weapons conducted by the Atomic Energy Commission has made it desirable that we achieve the best planning possible for these programs. It appears that there would be a great advantage in having a planning and _____ committee for the biomedical section of test operations. The functions of this committee would be the following: (1) To receive statements of requirements or planned experiments from all agencies genuinely concerned with biomedical experimentation in tests involving atomic weapons. (2) To analyze critically such requirements and suggestions in order to formulate experimental programs of greatest scientific reliability. (3) By informal discussions with the submitting agencies, to develop and refine the experimental program so that the needs of the services are adequately met in relation to the feasibility expressed by the test organization. (4) To develop and present the detailed plans of biomedical experiments for a particular test in such form that they may be approved by the Atomic Energy Commission and transmitted to the test organization for implementation without further discussion. (5) To maintain a continuous planning function and activity well in advance of any known test, and to make continual revision of the experimental plans in the light of changing needs and information. (6) To prepare estimates of the costs of conducting each planned experiment, and to formulate a distributed budget for the entire biomedical section of each test. Such a budget would specify the funds necessary and the sources from which they should be transferred. The membership of this committee is to be composed of representatives of all of the agencies that have a direct and lasting responsibility in the general area of the effects of atomic weapons. It is recognized that the Armed Forces Special Weapons Project has been specifically designated by the Joint Chiefs of Staff to be the formal channel through which all Department of Defense proposals for tests shall be transmitted. A coordinated program for the military services will be formulated by them. The functions of this working committee will be to receive the requirements and suggested proposals from the respective agencies; to screen, develop, and coordinate these plans; and elaborate a final and scientifically valid program for formal approval and implementation. Planning operations will be a continuing function. The duration of service of each committee member will be at the discretion of the agency which he represents, but it is contemplated that the continuance of the committee as a whole shall be at the pleasure of t he Division of Biology and Medicine of the Atomic Energy Commission. We would be very pleased to have you appoint to this duty the individual from your staff whom you consider most suitable. Sincerely yours, /s/ Shields Warren, M.D. Director Division of Biology and Medicine APPENDIX "X" Findings and Recommendations from the First Meeting of a Group to Consider Radiobiological Activities in the Public Health Service (Called at the request of the Research Planning Council) Room 138, Building I, National Institutes of Health, Bethesda, Maryland 9 A.M., February 28, 1952 Attended by: Dr. Roy E. Butler (O.S.G.) Dr. Waldron M. Sennot(B.M.S.) Mr. James G. Terrill(B.S.S.) Dr. Samuel C. Ingraham(B.S.S.) Dr. Howard L. Andrews(N.I.H.) Dr. Egon Lorenz (N.I.H.) Mr. C.V. Kidd (R.P.C.), Chairman Pro Tem. 1. Public Health Service Hospitals are not taking optimum advantage of the diagnostic and therapeutic tools provided by radioisotopes. The hospitals will fall further behind unless two steps are taken, (a) $5,000 to $10,000 is provided to equip at least a few hospitals to begin clinical work with tracers and (b) arrangements are made to provide the best training to an adequate number of physicians in the clinical use of isotopes. Trained radiologists - preferably Diplomats of the American Board of Radiology - are best suited to use these materials clinically. The group could not assess the relative importance of expenditures in this area against other expenditures, but felt that every avenue should be explored to keep the hospitals abreast of the best professional work in this field. 2. An informal meeting of the N.I.H., C.D.C. and E.H.C. ( including field projects) staff engaged in biological or engineering research and development relating to radiation should be held at Bethesda at an early date. Dr. Lorenz and Mr. Torrill will participate with the aid of other interested people in their Bureaus, in preparing an agenda and a list of people to attend such a meeting. The meeting should be informal and designed to produce a full interchange of information and views with respect to the full program of the Service in this area. This discussion can be held profitably without referring to classified information. After that meeting, whether any permanent committee should be established and if so, the functions of the committee would be determined. 3. Public Health Service _____ on every major Federal group dealing with problems of radiobiology. If there are any important committees with responsibilities in this field on which P.H.S. is not represented, they are not known to the group at the meeting. (See attached Notes on P.H.S. Interagency Relationships in the Field of Radiology.) Communication among those primarily responsible for work in this field in the N.I.H. is good, and there are no unresolved problems of representation by individuals who are not adequately informed on and responsive to the needs of other part of the Service. 4. From the viewpoint of those receiving funds from A.E.C., A.E.C. subsidiaries or contractors, or the Armed Forces for research or service jobs, the current method of handling funds causes waste of effort and time, and embarrasses them in dealing with the agencies disbursing the funds. The group expressed a strong preference for a lump sum transfer of funds from these agencies, to replace the current procedure of reimbursement to N.I.H. after N.I.H. has spent the money. Most of the groups on which P.H.S. staff are represented deal with technical research or engineering questions. The extent to which these technical decisions may have a general bearing upon the deployment of P.H.S. manpower, equipment and facilities was not discussed. 5. There appear to be a number of areas in which closer working relationships among those engaged in related lines of investigation can ' result in fuller use of existing equipment, reduction of purchases of expensive equipment, joint use of P.H.S. facilities and utilization of facilities of universities or other government agencies for P.H.S. research or development work in place of new P.H.S. facilities. The discussion at this meeting brought out enough specific examples of potential improvement to indicate the desirability of a more systems and thorough review. This will be discussed at the meeting mentioned above. 6. The activities of the Quarantine Division in monitoring ships for radiation should be reviewed to ensure that the instruments are accurate, since they require frequent calibration. The possibility of centering this work either in the Coast Guard or the Customs Service should be explored. The group bases these recommendations upon rather sketchy information and believes that whatever monitoring activities the Quarantine Division now conducts should be carefully reviewed by someone competent in instrumentation. 7. Working relationships between the Division of Occupational Health and the National Cancer Institute on the problem of radiation levels in uranium mines are clear. So far as the scientific and engineering staffs are concerned, the jobs to be done and the division of labor is clear. The Occupational Health Division is responsible for general guidance of the project, for checking the miners, taking air samples in the mines, selecting mines for tests of ventilating equipment, relationships with State agencies and related activities. At this time, the Cancer Institute (i.e., Dr. Lorenz) will provide assistance by working with A.E.C. on establishment of standards. A.E.C. has promised full cooperation, and Dr. Lorenz is awaiting word from Dr. Miller to proceed. 8. Security and other problems are creating some difficulties in working with A.E.C. contractors on Columbia River stream pollution studies, but no such problems are being encountered in the Savannah River study. These are primarily problems of working relationships at the site of the study, and can be effectively dealt with only at the site. 9. Since A.E.C. and the Armed Forces are the dominant groups in the radiation field, there was agreement that the only way in which the Public Health Service could retain the research status, and the access to information, essential to effective work in this field is to continue to serve on key advisory and technical groups created by these organizations, and to undertake work for those agencies which will link the P.H.S. staff to key A.E.C. and Armed Forces activities. So far as radiation as a public health hazard is concerned, the Public Health Service is the only Federal agency with the interest, staff and working relationships required for even a minimum program. (Revised March 13, 1952) NOTES ON P.H.S. INTER-AGENCY RELATIONSHIPS IN THE FIELD OF RADIOBIOLOGY (Based on discussions by a P.H.S. group on Feb. 28, 1952) 1. Armed Forces Special Weapons Project Dr. Andrews has had a contract with this organization for research of Dr. Andrews' choosing for three years, at a level of about $30,000 per year. Dr. Andrews was director of one of the large scientific programs at a recent series of atomic weapons tests. Two contracts which he let in that capacity were to N.I.H., for a total of about $140,000. This work will probably be completed by May 15. 2. Relationships with the Argonne Laboratory Dr. Lorenz has had a contract since 1942 for about $25,000 per year from Argonne to support work of his own choosing. 3. Test Planning and Screening Committee of A.E.C. This committee, advisory to the Division of Biology and Medicine of A.E.C. screens all proposals for tests at shot sites proposed by non-military agencies. Dr. Andrews is a member of this group, with Mr. Terrill as an alternate. The considerations taken into account by the Committee are technical -- i.e., scientific usefulness, relative efficiency of laboratory as opposed to test site exposures, experimental design, etc. The P.H.S. committee members _____ undertake to inform all interested groups in the Service of pending tests to the extent permitted by security regulations. Any P.H.S. personnel wishing to carry out biological experiments at any test should submit the proposal to the committee through the P.H.S. member. 4. Advisory Committee on Radiation Education (Office of Education.) This group advises the Office of Education on the content of school instruction related radiation. Mr. Terrill is a member. 5. Federal Civil Defense Administration The Radiological Health Branch of the Engineering Resources Division has trained monitors for F.C.D.A. F.C.D.A. has an item of $50,000 in its 1953 budget for this purpose, and has indicated that the funds will be largely transferred to P.H.S. if the item is approved. - 2 - 6. Navel Radiation Research Laboratory (California) Dr. Toke of the Radiological Health Branch is serving as P.H.S. liaison officer to this laboratory. 7. Harvard University Two engineering officers are assigned to Harvard University by the Radiological Health Branch to work on the engineering aspects of air decontamination methods. 8. Massachusetts Institute of Technology A man is being assigned by the Bureau of State Services to M.I.T. for training on methods of preserving food by irradiation. Since commercial models will ____ appear on the market, it is important to have a person who knows the benefits and the potential difficulties of this method of preservation. Two members of Dr. Lorenz's staff are in training at M.I.T. One is concentrating upon the design and operation of very high voltage particle accelerators and doing research in this field. The other is engaged in research on dosimetry with Dr. Evans and will be brought later to the Clinical Center. 9. Radiation Committee (General and Engineering) of A.P.H.A. In many States, responsibility for radiological health functions is split among a number of agencies. As a result many State programs are incomplete or out of balance. The function of these committees is to advise on the content and the most effective organization of the radiological health program of States. Mr. Torrill is a member of the A.P.H.A. Committees. 10. Cooperative Engineering Research on Stream Pollution and Decontamination (a) In cooperation with A.E.C. contractors, the Environmental Health Center is conducting studies of stream pollution in connection with the operation of the Savannah and Hanford works. (b) At Los Alamos and Oak Ridge, teams have set up treatment processes for all processing wastes. 11. National Committee for Radiation Protection Under the Auspices of the Bureau of Standards Drs. Andrews and Williams are members of the main committee. Dr. Andrews is Chairman of the Subcommittee on Monitoring Methods and Instruments. Dr. __choft and Mr. Placak are members of the Subcommittee on Waste Disposal. - 3 - 12. Medical Sciences Committee of the Research and Development Board Panel on Medical Aspects of Atomic Warfare) Mr. Torrill and Dr. Andrews are non-voting members of this panel, together with other interested government agencies. Most voting members are not Federal employees. 13. Armed Forces Study Group on Medical School Curriculum for Emergency and Defense Needs Dr. Butler is attending meetings of this group as an observer from the Public Health Service. 14. Advisory Committee to the Test Director for Continental Bomb Shots Dr. Andrews has served on this committee, which advises the test director as to when conditions -- meteorological and other -- are outside for a shot. 15. N.I.H. - A.E.C. Grant Program for Radiological Research The Cancer Institute is the central point for ensuring that competent professional opinion is brought to bear upon requests for research grants in this field. 16. N.R.C. Committees Cataract Committee - Dr. Andrews is a member. Committee on Radiobiology - Dr. Lorenz is a member. Glossary Committee for Nuclear Science and Technology - Dr. Andrews is a member. 17. Interdepartmental Committee on Internal Security (Subcommittee on Unconventional Warfare) Dr. Butler is a member of the subcommittee.