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Historic American Engineering Record, View of a worker holding a plutonium "button" at the Rocky Flats Plant, 19 September 1973, Library of Congress

Issue Brief

Exposures and Health Effects: Worksites, Downwind Damages, and Tribal Sacrifice Zones

During the height of the Cold War, both workers producing nuclear weapons and the communities living near these facilities have received exposure to potentially hazardous substances. Those who live downwind or downstream of nuclear contamination and/or whose Tribal lands have been subjected to uranium extraction or nuclear testing know intimately the extensive and invasive damage of radiation and other toxic substances involved in the nuclear fuel cycle, from mining and processing to industrial machining, testing, and so-called disposal. Secrecy, misinformation, denial, and, in many cases, overt racism have compounded the negative health effects of nuclear exposure and contributed to a lack of public awareness of these harms. This issue brief offers an overview of the most egregious examples of radioactive exposure in the United States context, encompassing uranium extraction and weapons testing on Indigenous lands.

The toxic combination of government denial and the invisibility of atomic exposures has had devastating effects on Indigenous communities subject to both direct and indirect exposure to toxic materials stemming from the U.S. nuclear complex. For example, the involvement of the Dinè (Navajo People) in uranium mining and their ongoing proximity to mine tailings and radioactive waste are a significant environmental justice issue. The Navajo Nation experienced a doubling of cancer rates alongside the growth of uranium mining on Tribal lands and continues to experience health decline linked to mining, This finding is from the Agency for Toxic Substances and Disease Registry's (ATSDR of the CDC) "Navajo Birth Study"—the first prospective epidemiologic study of pregnancy and neonatal outcomes in a uranium-exposed population. The formal title is “A Prospective Birth Cohort Study Involving Environmental Uranium Exposure in the Navajo Nation.” Initiated in 2009, the study seeks to better understand the relationship between uranium exposures and birth outcomes and early developmental delays experienced by the Navajo Nation. In order to evaluate the potential association between environmental contaminants, such as uranium and other heavy metal exposures, and reproductive birth outcomes, the project recruits Navajo mothers and assesses their uranium exposure at key developmental milestones; the study then follows their children post-birth to evaluate any associations with birth defects or developmental delays, using bio-monitoring, home assessments, and surveys to assess exposures.with nearly a third of participants in a study sponsored by the Center for Disease Control and Prevention and its institutional partners showing elevated levels of uranium in urine samples. David Michaels, Doubt is Their Product: How Industry's Assault on Science Threatens Your Health (Oxford, UK: Oxford University Press, 2008), 220.Historically, the Atomic Energy Commission (AEC) and government public health agencies allowed thousands of these miners to work in an environment so full of radon that much of them would develop lung cancer: they had received some of the highest doses of radon—a radioactive gas generated by the breakdown of uranium in rock and soil—ever recorded. Until the environmental regulations of the 1970s, uranium mining companies simply vacated mine sites and left behind open pits, radioactive soil heaps, and other hazardous materials that continue to endanger communities near the over 1500 abandoned uranium mines in Colorado.

Moreover, Indigenous lands have been subjected to massive nuclear weapons testing, both in North America and the Pacific. The western U.S. has served as a giant extraction zone (of uranium and other minerals), experimental “proving grounds,” and dump site for the entire nuclear project—what scholars and activists have called “national sacrifice zones.” Such practices sanction mass devastation of people and lands and further advance historical westward expansion and settler exploitation while appearing to contain the damage to particular “remote” zones, even as the entire project belies American exceptionalism. As activist-scholar Valerie Kuletz argues, Valerie Kuletz, The Tainted Desert: Environmental and Social Ruin in the American West (New York: Routledge, 1998), xv.“Whether they exist alongside the uranium mining districts, the nuclear research and development centers with their testing grounds, or the nuclear waste dumps, Native people and their lands constitute an invisible presence in areas heavily occupied by the U.S. military and Department of Energy. . . . a consistent pattern of internal nuclear colonialism. Western Shoshone and Southern Paiute communities, whose traditional lands were appropriated for the Nevada Test Site, have reported increased incidences of cancer and birth defects. The Indigenous and Latinx people of the Tularosa Basin have suffered and are still suffering from radiation that spread across the valley downwind from the first atomic bomb test in history—known as the Trinity test—at the White Sands Missile Range in southern New Mexico. The Marshall Islands, where the U.S. conducted nuclear weapons testing from 1946 to 1958, provides further evidence of the colonial subjugation of Native populations to radiogenic illnesses and other harmful effects. Even following independence from the U.S. in 1986 and the U.S. Government’s establishing of a Nuclear Claims Tribunal to award monetary compensation to atomic survivors, Marshall Islanders have faced inadequate claims processing and overall lack of funding to redress health and land damages.

In the industrial workplace, improper handling and inadequate safety procedures sometimes exposed workers to large doses of radiation, while nearby towns were often exposed to radioactive waste and dust particles that contaminated air and water sources. In addition to daily exposure to radon, uranium, and/or plutonium, nuclear workers often directly handled other toxic materials, such as radio-iodine, tritium, and radionuclides. Workers were often exposed to highly concentrated doses, while those living near facilities and mines were likely exposed to small doses over a longer period of time. Secrecy, poor records, misinformation, and purposeful production of uncertainty and denial surrounding the negative health effects of radiation and other hazardous substances at work sites obstructed attempts by workers to file for and receive worker’s compensation. Nearby towns and local populations have also faced difficulty tracking negative health effects and showing causal links, due to the lack of data and in the face of government entities like the AEC that claimed “sovereign immunity” from any responsibility for public sacrifices and civilian casualties. Few systematic studies have been conducted to determine potential health effects faced by the communities surrounding nuclear production sites. For example, Kristen Iversen, Full Body Burden: Growing Up in the Nuclear Shadow of Rocky Flats (New York: Crown Publishers, 2012); Colorado Department of Public Health and Environment, "CDPHE Rocky Flats Cancer Study," Colorado.gov, last updated January 5, 2017.some nearby towns/suburbs to the Rocky Flats facility have been found to have higher cancer rates and birth defects, while other cities have not had a statistically significant increase in cancer rates. Lawsuits over the trespassing of contamination onto private property have met with more success in the courts than connecting exposures to embodied harm.

As early as the 1950s, scientists saw the link between lung cancer and the inhalation of radioactive particles. While radioactive alpha particles (released by plutonium) can be washed off the skin, they cause severe damage to internal organs when ingested or inhaled. Generally, Michele Stenehjem Gerber, On the Home Front: The Cold War Legacy of the Hanford Nuclear Site (Lincoln, NE: University of Nebraska Press, 2007), 172.radiation can cause cancer, genetic mutations, cataracts, and various forms of damage to the central nervous and immune systems. Other toxic chemicals can contribute to various cancers, tumors, and diseases. Lung and brain cancer are among the most common for both nuclear complex factory workers and nearby residents. Studies of workers at Rocky Flats have shown increased risk of brain tumors, lung cancer, and beryllium disease. Beryllium disease leads to the build-up of scar tissue in the lungs, making it more and more difficult to process oxygen. Long-term exposure to these chemicals can also lead to genetic mutations, sterility and infertility, and birth defects among workers and residents. Even though some workers and community members have suffered from these negative health effects, it has been difficult to draw clear lines between exposure from active or deactivated plants to negative health effects. Due to this, the government and related entities have either denied responsibility or made it difficult for potential victims to receive compensation.

In the 1980s, veterans of the armed forces lobbied for compensation and demanded a government response to the excess cancers afflicting uniformed soldiers who had been ordered to march out onto the Nevada Test Site without protection and/or stationed near other atomic tests for experimental purposes. Congress responded with the Radiation-exposed Veterans Compensation Act of 1988, which provided benefits for veterans with certain cancers and who had been exposed to radiation not only from detonations in Nevada and in the Marshall Islands but also in Japan (if they had been stationed in Hiroshima or Nagasaki) and weapons-production facilities like Hanford, where large quantities of radioactive material were released into the environment intentionally and unintentionally. Congress linked compensation to the likelihood of radiation-related disease by stipulating certain types of radiation-sensitive cancers that could be presumed to be service related and thus warrant automatic compensation. Congress also directed the National Cancer Institute to develop a system to calculate the “probability of causation” for other cancers that may have additional causes. Epidemiologic studies of survivors in occupied post-war Japan helped the scientists develop the best available “dose-effect curve” that would then be used to determine the success of a U.S. atomic veteran’s case. In other words, data from bomb survivors in Japan became the “gold standard” data used to develop “radio-epidemiologic tables” to assess the cases of atomic veterans—who were filing for compensation for occupational illnesses accrued from developing the very bomb materials that had harmed those Japanese survivors. These tables showed whether a U.S. atomic veteran’s probability of radiation causation was “as least likely as not”—the threshold to be met in order to receive compensation.

Two years after passing the atomic veterans compensation legislation, Congress responded to the ongoing demands for justice by communities and individuals suffering from diseases and negative health effects related to nuclear weapons production and testing by passing legislation to compensate additional categories of people—beyond atomic veterans. The Radiation Exposure Compensation Act (RECA) would now cover downwinders (certain areas only), uranium miners, and also civilian test site workers. When the government conducted its nuclear testing program north of Las Vegas in the early 1950s, it assured residents that little risk was associated with the radiation released in the giant fireballs that drew spectacular attention in atomic-era popular culture; they were told the radiation would not affect them downwind of the site. Yet evidence now shows the AEC had extensive knowledge of the radiation dangers from the first nuclear test, detonated in New Mexico just prior to the bombing of Hiroshima and Nagasaki. David Michaels, Doubt is Their Product: How Industry's Assault on Science Threatens Your Health (Oxford, UK: Oxford University Press, 2008), 219.The photographic film industry also understood the extensive harm of radioactive fallout, after radioactive dust from the Trinity blast in New Mexico fell on an Iowa cornfield and contaminated shucks used by Eastman Kodak to manufacture the paper used to separate sheets of X-ray films. The paper had enough radioactivity to cause black spots on the X-rays. While downwinders in New Mexico were passed over in the RECA legislation (many attribute this to racism), downwinders in areas like southern Utah who were plagued by excess cancers and profoundly distrusted the government demanded that science-based determinations were not good enough: only “presumption” and not “probability of causation” would begin to address the toxic legacies and ruination of American citizens caused by the nuclear complex. However, the RECA compensation program was ultimately placed under Department of Justice administration, and the payments became filed under the DOJ’s general budget, thus pitting radiation compensation against budgetary lines needed for other law enforcement and justice activities. RECA ran out of money in 2000 and widows of uranium miners who had died of lung cancer received IOU letters, just as legislation was passed to provide compensation to nuclear workers who had radiogenic illnesses and/or died after working in the national assembly line of atomic bomb manufacturing.


Colorado Department of Public Health and Environment. “CDPHE Rocky Flats Cancer Study." Colorado.gov. Last updated January 05, 2017. Accessed August 18, 2020.

Gerber, Michele Stenehjem. On the Home Front: The Cold War Legacy of the Hanford Nuclear Site. Lincoln, NE: University of Nebraska Press, 2007.

Gusterson, Hugh. People of the Bomb: Portrait’s of America’s Nuclear Complex. Minneapolis, MN: University of Minnesota Press, 2004.

Iversen, Kristen. Full Body Burden: Growing Up in the Nuclear Shadow of Rocky Flats. New York: Crown Publishers, 2012.

Kuletz, Valerie. The Tainted Desert: Environmental and Social Ruin in the American West. New York: Routledge, 1998.

Kyne, Dean and Bob Bolin. “Emerging Environmental Justice Issues in Nuclear Power and Radioactive Contamination.International Journal of Environmental Research and Public Health 13, no. 7 (2016): 700. Accessed July 15, 2020.

Makhijani, Arjun and Stephen I. Schwartz. “Victims of the Bomb.” In Atomic Audit: The Costs and Consequences of U.S. Nuclear Weapons since 1940, edited by Stephen I. Schwartz. Washington, D.C.: Brookings Institution Press, 1998, pp 395–431.

Malin, Stephanie. The Real Price of Nuclear Power: Uranium Communities and Environmental Justice. New Brunswick, NJ: Rutgers University Press, 2015.

Michaels, David. Doubt is Their Product: How Industry's Assault on Science Threatens Your Health. Oxford, UK: Oxford University Press, 2008.

Morales, Laurel. “For the Navajo Nation, Uranium Mining’s Deadly Legacy Lingers.National Public Radio, April 10, 2016. Accessed June 11, 2021.

Parascandola, Mark. “Compensating Cold War Cancers.Environmental Health Perspectives 110, no. 7 (July 2002): A405-A407. Accessed July 15, 2020.

Pasternak, Judy. Yellow Dirt: An American Story of a Poisoned Land and People Betrayed. New York: Simon and Schuster, 2010.

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