2

Committee’s Approach to Its Statement of Task

The committee’s approach to its statement of task included perspectives drawn from the intersection of multiple disciplines informed by history and politics, information availability, industry, federal institutions and contractors, and science. The exigencies of World War II were a major factor in the top-secret Manhattan Project by the federal government: to develop and deliver the first nuclear weapons. Multiple interconnected sites across the United States involved hundreds of thousands of civilians and thousands of military personnel working in a variety of jobs toward that goal. Based on prewar experiences with ionizing radiation and concerns about exposures to materials never before experienced, safety policies and protocols were created at the same time as developing and producing a nuclear weapon (Kathren and Ziemer, 1980).¹ Many individuals were exposed or potentially exposed to a variety of toxic substances, not only radioactive materials, as a result of these novel processes, leading to the potential for complex exposures and adverse health outcomes. After the end of World War II, most Manhattan Project–associated scientific and technical military personnel returned to civilian life as veterans. Some of them became residents of the communities created by or involved in the Manhattan Project.

After the official end of the Manhattan Project on August 15, 1947, its sites experienced changes in management and oversight, resulting in separate operational entities across locations and widely different processes

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¹ Despite many names for the end product of the Manhattan Project, including the gadget, atomic bomb, and atomic weapon, the committee preferentially uses nuclear weapon because it is a more encompassing term.

of recordkeeping and document retention. Site administrators transferred records to various locations and sometimes destroyed handwritten or typed documents that no longer seemed relevant (some of these documents described the wartime work, including lists of involved civilians and military members), substantially fragmenting the historical record.

This chapter describes the committee’s approach to, considerations of, and methods for conducting its feasibility assessment. It describes how the committee interpreted its statement of task (see Chapter 1, Box 1-1), including aspects that were considered to be beyond the scope and key terms and definitions used throughout this report. The chapter then describes the committee’s overall approach to its charge, discussing key elements of epidemiologic study designs, information gathering, and other considerations that it kept at the forefront as it conducted its assessment.

INTERPRETATION OF THE STATEMENT OF TASK

The statement of task is limited to military veterans who participated in the Manhattan Project between January 12, 1942, and August 15, 1947, at 13 specified locations. The term veteran has at times been adopted and used more broadly than for people who served in the military or armed forces alone. For this report, veteran refers to those who served on active duty in any service branch of the U.S. military (Army, Navy, Marines, or Air Force²); it does not include civilian scientists or contractors, families of veterans, or other individuals who were present during the same period or at the same locations. Early in its deliberations, the committee learned that not all discussions regarding the Manhattan Project, its related activities, and resulting waste are confined to the official dates. For example, the committee learned from a historian in St. Louis, Missouri, that residents of that area refer to the waste deposited in that community as “Manhattan Project–related waste” even though the contamination occurred much later than the official Manhattan Project dates.³ Therefore, while the three St. Louis sites were included in the statement of task, their contamination was after August 15, 1947. The committee kept in mind such contexts, although its feasibility assessment was limited to the official dates as specified in the statement of task.

The Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics Act (PACT Act) of 2022 (PL 117-168)

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² The Army Air Corps was the predecessor of the Air Force. The Air Force was not established as a separate service branch until September 18, 1947, just after the inclusive dates for the statement of task.

³ Personal communication, Gwendolyn Verhoff, professor, St. Louis Community College, November 18, 2024.

section 506 specified five sites, three of which are in St. Louis County, Missouri (Coldwater Creek, St. Louis Airport Project Site, and West Lake Landfill). The other two sites were Oak Ridge, Tennessee, and Hanford, Washington. The legislation also allowed VA to add locations “proximate to covered waste,” and VA added eight more—Los Alamos and Alamogordo, New Mexico; Lake Ontario Ordnance Works, Buffalo, New York; University of Chicago, Illinois; Iowa State, Ames, Iowa; Dayton Project, Dayton, Ohio; Monticello, Utah; and Uravan, Colorado. Manhattan Project activities also occurred and had military presence in several locations that were not specified in the legislation or statement of task, and although they are not a focus of the feasibility assessment, Chapter 3 presents a brief overview of some of them for additional context.

For each of the 13 sites, the committee determined what information might be available (and its sources and condition or state) specific to the demographic and military characteristics of the veterans, their potential exposures to Manhattan Project–related waste, and potential data on their health outcomes. As this is a feasibility assessment, the committee was not permitted to collect data or records or perform quantitative analyses, although it requested examples of such records and information by subject-matter experts who presented to it or responded to information requests. Because some information relating to nuclear research and technology continues to be classified, this assessment was limited to identifying and characterizing information that is unclassified or has been declassified and can be made public.

The first subtask calls for determining the “approximate number of veterans exposed to toxic substances during the Manhattan Project (January 12, 1942–August 15, 1947) at the following sites across the United States . . .,” but the committee considered that the entire veteran population for these dates and locations must first be identified before exposures to toxic substances can be ascertained. The committee began by attempting to identify sources of service member and veteran records and lists of personnel by site but quickly discovered that a comprehensive roster identifying all service members who participated in Manhattan Project activities is not readily available for the entire Manhattan Project or by dates or service location (see Chapter 4: Identifying the Veteran Population). The committee also determined that its ability to complete its second subtask (understanding the demographic and military characteristics of the veterans in the first subtask) was also restricted, as the individual veterans in the cohort would first need to be identified and their records reviewed for these characteristics.

The third subtask asks the committee to determine the “types of exposures (e.g., chemical, radiation, combined exposures)” that the veterans may have encountered during Manhattan Project activities at the specified sites. The committee determined that this task depended on determining

military jobs and duties and their time frame (months and years during the Manhattan Project) and location (specific areas or buildings on a site), as amounts and types of exposures were not consistent over time or by or within a location. In response to committee questions, VA representatives noted that the “Manhattan Project activities” of interest in which veterans may have participated are not limited to specific activities, and, in general, may have included mining, processing, refining, and enriching uranium or plutonium ore; scientific research; site security; and transportation. Despite the legal definition of waste in the PACT Act (see Terms and Definitions section), VA asked the committee to consider “Manhattan Project–related waste” as anything that is not the intended by-product of an activity or process and was required to be put in a specific location or managed by the site or group that produced it. An example of such broadly defined waste would be results of production that were placed in large drums or tanks and buried. Waste, in this context, is not only radiological but also includes chemicals and other toxicants that have since been recognized as hazardous to human health. Similarly, exposures are not limited to waste products but also include those as a result of industrial and scientific processes, such as to non-radiological chemicals (for example, solvents, acids, or beryllium) or processes that created the waste (such as the nuclear fuel cycle process).

The committee interpreted its fourth subtask, “Other missions these veterans were involved in before or after the Manhattan Project that may have exposed them to toxic substances and may have contributed to their overall health risks during their military service” to mean confounders and other considerations that would affect the design of or ability to conduct an epidemiologic study. These might include other military or non-military jobs, exposures associated with those jobs, duration of the exposure, or lifestyle factors, such as smoking.

The fifth subtask relates to determining health outcomes, including cancer occurrence and cause of death, for the veterans determined to be exposed to toxic substances. Connecting a diagnosable medical condition to a specific military environmental or occupational exposure is difficult in general and more so when the exposure and outcome occurred decades earlier and the availability and completeness of health records are unknown.

The final portion of the statement of task requires the committee to provide conclusions regarding its assessment of the available records and information for a study to be conducted on exposures and health outcomes of the veteran population. If that were determined to be possible, the committee would provide a study design framework and estimate the time and funding required to conduct it.

Aspects Beyond the Bounds of the Statement of Task

The committee held its first meeting on January 10, 2024, at which VA representatives formally charged it with its statement of task. In addition to describing the origin of the requested feasibility assessment, VA clarified aspects of the charge and issues deemed to be beyond the committee’s task, and therefore, not to be included in the assessment. VA emphasized that the purpose of this feasibility assessment was to (1) identify what information exists, (2) determine the availability and condition of the information, and, (3) given those findings, determine the extent to which the available information could be used to conduct a full study on exposures and health outcomes in this population of veterans.

Although popular cinematic and scholarly histories of the Manhattan Project focus substantially on the detonation of the world’s first nuclear weapon (the Trinity test) near Alamogordo, New Mexico, this activity was not included in the statement of task. Rather, given the volume of research and published studies regarding the health outcomes of radiation and toxic-chemical exposure during atmospheric testing, and that those who participated in those tests were a very distinct group of military service members, VA explicitly stated that the scope of the committee’s work should exclude nuclear atmospheric and weapons testing, which would include the Trinity test and its aftermath. However, the historical context and military presence and activities at Alamogordo during the lead-up to the test and its connection to the history of Los Alamos (see Chapter 3) are included in the task. Thus, the impacts of the Trinity test on participating service members as well as surrounding communities of so-called downwinders are excluded from this feasibility assessment, as are Manhattan Project activities that took place outside the continental United States in U.S. territories, such as Enewetak, Bikini Atoll, the Northern Mariana Islands, or Guam.

Also excluded from the committee’s charge is the broader population that participated in Manhattan Project activities or resided at or near these locations, including civilians, contractors, and veterans’ families. Likewise, although the committee recognized and respected that intergenerational health effects are of interest and concern, especially in the context of social and environmental justice as articulated by the Honorable Cori Bush, the U.S. Representative who authored section 506 of the PACT Act, VA specified that this feasibility assessment is not to include reproductive or intergenerational health outcomes in exposed veterans’ descendants (Hastings, 2024). VA added that assessing environmental contamination due to Manhattan Project–related wastes, such as leaching into soils or groundwater, is outside the scope; however, should the committee discover such information, that should be noted as potential sources of contamination and exposure that may inform exposure pathways in study design (Hastings, 2024).

The committee did not conduct any original data analysis, nor did it perform a comprehensive assessment or weight-of-the-evidence analysis of the published scientific literature regarding any associations between exposures that may have been encountered during military service on the Manhattan Project and health outcomes. As this report is a feasibility assessment of available information and records for a specific military population, time frame, and locations, the committee was not asked to—and did not—make judgments regarding individual cases in which a veteran, civilian worker, or member of a community with ties to the Manhattan Project have claimed injury from radiation or chemical exposures associated with it. Relatedly, although the committee considered the underlying data used for compensation by other prior or existing federal programs (such as the Radiation Exposure Compensation Act, the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), and VA benefits), the processes used to determine compensation and costs of those programs were not within its scope. To strike a necessary balance between brevity and the detail required for this assessment, the committee recognizes that it could not possibly capture every nuance or view within or across the scientific or geographic communities that this assessment touches.

Terms and Definitions

Several terms appear in section 506 of the PACT Act and the committee’s statement of task that may have different meanings depending on context and within or between fields of study. Therefore, to ensure consistent language throughout this report, the committee adopted and used several standardized terms, as discussed in this section. The names of several agencies and organizations have changed. For example, the U.S. Atomic Energy Commission, created in 1946 to manage the development, use, and control of atomic energy for military and civilian applications, was abolished in 1974 and its mission subsumed in part by the Energy Research and Development Administration (which then merged with the Federal Energy Administration, the Federal Power Commission, and pieces from other agencies to create the Department of Energy (DOE)) and the U.S. Nuclear Regulatory Commission. Similarly, in 1943, the Women’s Auxiliary Army Corps became the Women’s Army Corps. The committee uses the current or most recent name of an agency, organization, or unit, unless quoting directly from a source that uses a previous name or term. Other terms that require a description are as follows:

• Atomic veteran is a specific term for a military veteran who was present for atmospheric nuclear tests or post-test cleanup;⁴ however, atmospheric testing was considered out of scope (see previous section). Despite a small amount of potential overlap (i.e., some atomic veterans may also have served at the 13 specified sites), it is not a synonym for the population that forms the basis for this feasibility assessment. Instead, the committee preferentially uses veteran to refer to a military veteran who served on the Manhattan Project.
• Per 38 United States Code §1112 (c)(3), the term radiation-exposed veteran means (i) a veteran who, while serving on active duty, participated in a radiation-risk activity or (ii) an individual who, while a member of a reserve component of the Armed Forces, participated in a radiation risk activity during a period of active duty for training or inactive duty training (PL 101-426). This definition does not adequately apply to the veteran population for the committee’s assessment; some of the activities that they participated in are not recognized as “radiation-risk activities,” and the population is not synonymous with or all-encompassing of “radiation-exposed veterans.”
• While a definition of toxic exposure has been codified in public law by Title 38 section 101 and amended by section 102(b) and is referenced in the legislation on which the statement of task is based, the committee uses a broader definition of exposure.
• Waste was defined during VA’s charge to the committee as “anything that is not the intended [by-]product of an activity or process and that was required to be put in a specific location or managed by the site or group that produced it” (Hastings, 2024).
• Exposures of interest are not limited to exposure to waste, as has been defined, but include those experienced during the industrial and scientific processes. For this report, occupational exposures include those that result from processes that created waste, such as uranium refinement, but not other types, such as to general cleaning products.
• The committee interpreted health outcome(s) to broadly include physical and mental health conditions that may be common or rare, be physical or psychologic, have short or long latency periods, and have different levels of etiologic complexity (e.g., single versus multiple causes, single insult versus confluence of multiple factors).

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⁴ From 1946 to 1962, the United States conducted about 200 atmospheric nuclear tests. Approximately 400,000 service members from the U.S. Army, Navy, and Marines were present, as either witnesses to the tests or post-test cleanup crews (DTRA, 2015).

OVERALL APPROACH

No single source or database contains all the information to be addressed by the statement of task owing to the fragmented historical record of who participated in the Manhattan Project, what exposures were known to be present, what health outcomes might have resulted, and the physical disposition and stewardship of the individual personnel and site records over time. Therefore, the committee’s task emphasizes information discovery and characterization on a select group of military veterans, defined by time (January 12, 1942–August 15, 1947) and location (the 13 specified sites).

The committee cast a broad net to understand what information may be available to support research on the associations between exposures and health outcomes in this population. As the statement of task contains specific wording regarding feasibility of a study on the health effects of active-duty military veterans exposed to Manhattan Project waste, the committee interpreted this to mean feasibility of an epidemiologic study. It began by discussing the ideal design elements and information required for an epidemiologic study and used these considerations to assess where gaps or limitations exist in available information. It then developed its approach to information gathering by prioritizing sources where records or information were thought to be available, standardized, and reliably captured or curated (such as federal agencies and archives); lower-priority sources were those that were less robust or might provide supplemental information, such as employee yearbooks, site phone books, personal accounts, or journal entries.

Epidemiologic Design Considerations

An important use of epidemiology is to determine whether a causal relationship exists between a specified exposure and a particular health outcome. Randomized controlled trials, which are experimental studies in which individuals are randomly assigned to an exposure (or treatment) group, can, in some settings, provide strong evidence regarding a causal relationship between exposure and disease. However, these are rarely conducted to understand the health outcomes of exposure to harmful agents. Instead, scientists often draw upon evidence derived from observational studies, which include cohort and case-control observational study designs.

Key Elements of an Epidemiologic Study

The committee identified key elements needed to conduct an epidemiologic study after reviewing the elements of such studies of service members and veterans used by prior National Academies consensus

committees to assess exposures and health outcomes (NASEM, 2016, 2018, 2020a,b, 2022). This committee chose five elements that correspond to standard methodologic concerns in observational epidemiologic studies (Table 2-1). These characteristics are not a checklist or scorecard but rather considerations most applicable for research on health outcomes of radiological and chemical exposures. The committee considered other characteristics, such as longitudinal data with multiple time points of information, and determined that, while they can aid in epidemiologic studies and research, they are not necessary or frequently not available.

The key elements inform critical thinking of any future observational study on exposure and health outcomes of Manhattan Project veterans. For example, exposure misclassification is an important potential limitation in an observational study that lacks ability to classify veterans’ exposures in terms of their magnitudes, timings, and routes. To avoid it, the investigator is encouraged to clearly define what is meant by exposure at the outset and what exposure contrast(s) are to be examined. Similarly, confounding may be an important limitation in an observational study that lacks the ability to classify veterans with respect to risk factors such as smoking for the health outcomes of concern. Similar to clearly defining exposure, health outcomes should also have a priori definitions.

Other considerations include the following:

• Inclusion criteria: Clearly defined inclusion (and exclusion) criteria, leading to a well-defined target population. Those eligible to be included are defined in terms of place, time, and other baseline characteristics, as are those who are not eligible (i.e., exclusion criteria).

TABLE 2-1 Selected Key Elements of an Epidemiologic Study

• Time on study: A clearly defined start date for each study participant and period of observation over which outcomes will be assessed. The statement of task has several time-varying components. The first is time related to military service and veteran status. Individuals were recruited to and left military service before, throughout, and after the period of interest. During military service, they may have been stationed at one or more of the 13 specified locations and at other locations. Additionally, as described in further detail in Chapter 5, exposures to Manhattan Project waste were not uniform in frequency, composition, or dose. Therefore, an individual’s time at risk is a compilation of locations of service and associated exposures over the period of interest.

The committee kept these elements at the forefront as it considered its approach to information gathering. It also considered other types of study designs (e.g., risk assessments) that might be used or applied to this task should key sources of exposure or health outcome information be limited or unavailable.

Risk Assessment

The committee prioritized assessment of an epidemiologic study, as it would offer the greatest specificity with regard to the statement of task. Risk assessment was considered as a potential alternative study design should the committee conclude that the epidemiologic approach was not feasible. A risk assessment is a “systematic approach to organizing and analyzing scientific knowledge and information for potentially hazardous activities or for substances that might pose risks under specified conditions” (NRC, 1994, p. 4). It draws on existing information regarding exposure–health outcome associations (e.g., risk models). A risk assessment does not rely on known or identified individuals and their exposure status and can be conducted for a specific or hypothetical population (NRC, 2009).

Key elements of a risk assessment depend in part on its nature and scope, as there is “not a single, fixed method of analysis” (NRC, 1994). In the context of this feasibility assessment, it would focus on estimating the risk of potential health outcomes for Manhattan Project veterans associated with exposure to toxic substances. The necessary information would include types and activities of workers, types and sources of exposures or potential exposures, and health outcomes. As with epidemiology, the detail and rigor of a risk assessment depends on the availability of data and resources.

General Approach to Information Gathering

The statement of task requires an understanding of a complex landmark historic scientific undertaking and the identification and assessment of available information from that period and at the specified locations to ultimately inform the feasibility of conducting a present-day epidemiologic study. To identify and characterize any information, records, and data that may be available, the committee used a variety of information-gathering activities:

• 24 invited speakers who offered topic-specific presentations and multiple people who accompanied the speakers and were available to answer the committee’s questions (see Appendix B for a list of speakers and those who accompanied them by date);
• information requests to federal agencies—program directors, archivists, and federal historians who contributed to the responses of their agencies;
• presentations from and information requests to multiple historians employed by universities and nongovernment organizations whose expertise complemented that of federal historians and archivists;
• information requests to advocacy organizations and site-specific museum curators;
• requests for public comment;
• targeted scientific literature searches; and
• searches for other supplemental documentation, including government and government-contractor reports, historical documents, databases on locations and exposures (e.g., Department of Labor (DOL) Site Exposure Matrices and National Institute of Occupational Safety and Health (NIOSH) Special Exposure Cohorts).

To the extent possible, the committee used a comprehensive, systematic, and standardized approach in its solicitation of information. However, because the 13 specified sites are not homogeneous in their purpose, area (urban versus rural), or administrative history, as described in Chapter 3, the questions asked and experts contacted varied slightly by site. The major areas of inquiry used in the information-gathering process included:

• knowledge of the location of information or records on the military veterans who served at site-specific locations;
• any records, lists, or rosters that would enable researchers to quantify the military personnel who served in these locations and their demographic and military characteristics;

• existence and availability of individual or area-level exposure records (dosimetry reports, accident reports, chemical exposures, and combined exposure reports) from 1942–1947 of military personnel or workers with similar jobs, duties, or locations at each of the sites;
• health records of the population of interest, both during and after active-duty service;
• if any of the record types listed are available, descriptions of their chronological scope, format, and availability to researchers; and
• knowledge of other entities holding archival material pertaining to the veterans of interest.

Information-Gathering Sessions

The committee held eight public information-gathering sessions during the course of its deliberations (see Appendix B). Because the majority of service members who were potentially exposed to wastes from Manhattan Project activities were stationed at Oak Ridge, Hanford, or Los Alamos (see Chapters 3 and 4), the committee focused on these three locations and held information gathering sessions near them on May 8, 2024, July 18, 2024, and September 19, 2024, respectively. The committee heard from site-specific experts, including DOE records management field offices, dosimetry experts, non-radiological exposure experts, historians, and researchers. One session was held in the St. Louis area (December 16, 2024), given its role in the origin of the legislation for this feasibility assessment. Having information gathering sessions at these different sites allowed the committee to hear from experts in these geographic areas and compare the availability of information across sites. To the extent possible, the committee developed a consistent list of questions to ask each presenter, and it heard from the same types of experts at each location (i.e., record managers, experts who have used historic dosimetry records to reconstruct exposure levels, and site-specific historians who could give insight to the military presence at each during 1942–1947).

Other information-gathering sessions included presentations from VA, as the sponsor of the committee’s task; the Honorable Cori Bush, who sponsored section 506 of the PACT Act on which the task is based; representatives from federal agencies (DOE, National Nuclear Security Administration (NNSA), National Archives and Records Administration (NARA)) and offices and programs within those agencies that hold records and information related to the task; archivists of military personnel records; and researchers and experts of various disciplines who are knowledgeable about Manhattan Project–era history and records. Recordings of presentations are available on the project website: https://www.nationalacademies.org/ourwork/feasibility-of-assessing-veteran-health-effects-of-manhattan-project-1942-1947-related-waste.

Information Requests

In addition to invited presentations of experts, the committee also made several requests for written responses to specific questions where it identified information gaps in agency reports and documents and specific follow-up questions to invited presentations. In total, the committee made 20 unique information requests, independent of requests to invited speakers and their presentation topics, to VA Office of History and VA Health Outcomes Military Exposures; NARA headquarters and National Personnel Records Center; DOE headquarters, DOE’s Office of Environment, Health, Safety, and Security, EEOICPA, and field offices; NNSA; the Army Center for Military History; and the Army Dosimetry Center. Information requests were also made to the Atomic Heritage Foundation, a key advocacy organization that has compiled information on Manhattan Project military veterans and civilian workers, and to the National Museum of Nuclear Science & History that manages its database. Requests for information were also made to site-specific museum curators and directors of Manhattan Project–associated exhibits and to hospital records departments that replaced clinics known to exist during the Manhattan Project at Oak Ridge, Hanford, and Los Alamos.

As it is not the practice of the National Academies or its committees to submit Freedom of Information Act requests, the committee was dependent on information requests to agencies, officials, and individuals; their responses are available in the study’s public access folder.⁵ The information received is summarized in the relevant chapters. The committee appreciates the responses, presented material, and follow-up responses of those experts and offices who took the time and effort to address its requests.

The committee received various levels of responsiveness and detail to its many requests. For example, the Army Center of Military History was contacted multiple times for clarification of information on its website pertaining specifically to Manhattan Project–era records. The committee hoped to gain an understanding of the quantitative and qualitative data they might contain, whether they are available digitally, and if the center staff are aware of any unprocessed archival materials documenting activities of any active-duty military personnel assigned to the Manhattan Project. Although National Academies staff had one brief conversation with the center’s director of historical services, the requested information was not provided, and the committee never received a written response, resulting in an inability to assess information from this source.

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⁵ Requests to view and access materials may be made online at https://www8.nationalacademies.org/pa/managerequest.aspx?key=HMD-BPH-23-03.

Similarly, the DOE Office of Legacy Management was contacted multiple times for responses to questions regarding its holdings that are applicable to the task. The committee’s information request to the Office of Legacy Management included eight questions, one of which was a request to complete a table of site-specific information that would address (1) if Legacy Management is the owner or custodian of site records (this can include certain types of facilities, such as hospitals or old production plants), (2) the types of records and the information they contain (e.g., demographics, exposures, health outcomes), and (3) the format of the records in (2) (e.g., hard copies, scanned copies, microfiche). Other questions included describing the process for requesting records and if records are restricted to certain uses (e.g., EEOICPA versus academic researchers); examples of redacted records that could be shared with the committee; time frame and process for determining maintenance (indexing) or destruction of records acquired from a closed site; record organization (electronic databases or physical records that must be manually searched); whether a variable or mechanism exists within records to identify military or veteran status of workers and, if not, how one might be added; and how frequently the information that the Office of Legacy Management oversees is updated. Without responses to these questions, many unknowns affect the committee’s ability to offer a more complete assessment of available data and their use in a study.

National Academies staff had one brief conversation with the records and information management specialist at the Office of Legacy Management, but the requested information was not provided, and representatives declined to present to the committee, instead deferring to colleagues at EEOICPA to discuss its holdings and role. Although the committee never received written answers, responses to specific questions were provided if a third party asked them, such as when the Office of Legacy Management shared with VA two lists of veteran employees at Uravan, Colorado, that were then given to the committee by VA. As the committee was preparing for its information-gathering session at Los Alamos, New Mexico, personnel at Legacy Management replied to Brye Steeves, director of the National Security Research Center at Los Alamos National Laboratory, confirming that the Los Alamos hospital and medical records for 1943–1963 were physically transferred to the Office of Legacy Management, and held in Morgantown, West Virginia. At each site-specific information-gathering session, the presentations from records managers and experts in DOE field offices and headquarters and NNSA were extremely helpful, but each presenter noted that the committee should speak with the Office of Legacy Management as it would likely fill some information gaps because it is responsible for closed sites, several of which appear in the statement of task.

In a few cases, the agency or office acknowledged an information request but did not have the information or was unable to provide details to inform the committee’s assessment. For example, requests to the chief historians for VA and DOE included questions about what information for 1942–1947 is available from each agency and how to characterize available data or records, including their chronological scope, origin/source, format, and access status (and, for DOE, whether there is a mechanism to select for those who served in the military).

In addition to its sponsor, VA’s Health Outcomes Military Exposures, the committee contacted VA’s chief historian, Dr. Michael Visconage, regarding information or records on Manhattan Project military veterans. He replied that, “The National VA History Center Archives do not contain material related to Veterans serving at Manhattan Project sites.” He added that no information is available on veterans who served in Manhattan Project–site-specific locations because they do not keep medical records; no collections of veterans who served at the sites exist to characterize, as the bulk of these records have been transferred to NARA’s Research Services or are awaiting disposition at NARA’s Federal Records Center.⁶ Robyn Rodgers, senior archivist in the VA National History Center, referred to the U.S. Army Green Book series, which gives an estimate of the peak strength of military personnel across the entire Manhattan Project as a starting point for quantifying this population. She added that some demographic and health outcome information might be found in the Veteran’s Consolidated Medical Record, which have 75-year temporary status after the last interaction: “The bulk of those records are sitting in the Federal Records Centers, waiting out their time until they’re destroyed. To find the records, the committee would at the very least have to know the individual veterans’ names, which may be difficult and not available from VA sources. Once a list of names has been made, the individuals could be checked against VBMS [Veterans Benefits Management System] to determine if they are deceased, and although most likely will be deceased, their date of death is going to determine whether their records were scanned into VISTA.⁷ Even if the records are still paper, anyone who died after 1949 are still in the 75-year hold which means that Records Management is going to have to get involved to have the records recalled….”⁸

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⁶ Personal communication, Dr. Michael Visconage, chief historian, Department of Veterans Affairs, February 9, 2024.

⁷ VISTA is the Veterans Health Information Systems and Technology Architecture, which is the electronic health record system used in VA hospitals, medical centers, and clinics to record and manage clinical, administrative, and financial operations of the Veterans Health Administration (VHA, 2024).

⁸ Personal communication, Robyn Rodgers, senior archivist, Department of Veteran Affairs, February 9, 2024.

A separate information request that included questions for both the Veterans Health Administration and the Veterans Benefits Administration (VBA) was sent through Health Outcomes Military Exposures to coordinate response. In short, VA does not have any databases with identifiers for Manhattan Project service members or veterans. VBA has no identifier for the Manhattan Project or indicator to facilitate locating records for those veterans in its system. VBA can request claims data for veterans by period of service, and specifically World War II (1941–1946), but no identifier or indicator would allow it to search or stratify those records by site. VBA indicated that 11,448 total compensation claims existed for all World War II–era veterans as of September 30, 2023, but with no master roster for those who participated in activities relating to the Manhattan Project, VBA is unable to determine how many submitted a claim.⁹ Within the response to the committee, VBA included PDFs of the full annual reports for each year 1942–1947 that contain numbers of living and deceased veterans by conflict era and aggregated benefits and health data. Each report is about 150 pages and has a section of aggregated tables of medical treatment, but individuals or units are not specified.¹⁰ VA also stated that it has no dosimetry information. Additionally, VA made an inquiry of the Department of Defense (DoD) Defense Threat Reduction Agency, which has rosters of veterans who participated in nuclear and atmospheric weapons testing, but that agency responded that it does not maintain a list of veterans who worked on the Manhattan Project.

DOE Chief Historian Dr. Eric Boyle replied that

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⁹ Personal communication, Carla Ryan, assistant director, Military Exposures Team, Department of Veterans Affairs, September 17, 2024.

¹⁰ Ibid.

¹¹ Personal communication, Eric Boyle, chief historian, Department of Energy, February 8, 2024.

Although the committee encountered several difficulties obtaining information from some agencies, that lack did not impede its ability to respond completely to its statement of task or to form its conclusions. All responses are included in the project public access file, available by request at https://www8.nationalacademies.org/pa/managerequest.aspx?key=HMD-BPH-23-03.

Identification and Review of Prior Epidemiologic Literature

Epidemiologic studies can provide insight on sources of information and methods that may be of use to both assess feasibility and to inform the study design of future investigations. While a systematic literature review was not within the committee’s task, key occupational studies conducted at Manhattan Project sites of interest were identified and supplemented with studies identified from prior reviews, including those by the United Nations Scientific Committee on the Effects of Atomic Radiation¹² and International Agency for Research on Cancer, reviews of reference lists, and targeted keyword searches.

No epidemiologic studies specifically of service members or veterans who served at one of the specified locations were identified. The committee then examined epidemiologic studies of workers at the specified Manhattan Project sites, as well-characterized worker populations could provide more precise quantification and evaluation of the risks of adverse health outcomes associated with occupational exposures. Including populations with more objectively measured exposures measured closer to the time of exposure is advantageous in that these studies were likely to have greater statistical power to detect any adverse effects that might result. Due to the substantial differences in the nature and intensity of the worker exposures, studies of production workers at the Manhattan Project locations were prioritized over studies among the community or ecologic areas. Some of the occupational studies may have included veterans, but veteran status was not noted or included. Key epidemiologic studies at the sites are summarized in Chapter 3, including their data sources and methods.

Other Documentation

During its deliberations and information gathering, the committee identified and examined government and government-contractor reports,

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¹² The committee assesses and reports levels and effects of exposure to ionizing radiation. Its estimates are used as the scientific basis for evaluating radiation risk and for establishing protective measures (United Nations Scientific Committee on the Effects of Atomic Radiation, n.d.).

historical documents, books, databases on exposures at specific locations (e.g., DOL’s Site Exposure Matrices and NIOSH Special Exposure Cohorts) and databases that may contain information on health outcomes in the veteran population (VA and NARA National Personnel Record Center). The committee sought to determine the availability of an existing full or partial list of individuals who served at any of the specified locations, but it was unable to find more than a few documents. For example, DOE provided two lists of military personnel at Uravan, Colorado, and the Atomic Heritage Foundation has two online yearbooks (pictures, names, and ranks), one for 1945 Special Engineer Detachment members at Oak Ridge, Tennessee (U.S. Army, 1945), and the second for the 1945–1946 9812th Technical Service Unit Detachment of Women’s Army Corps who served the Manhattan Project (U.S. Army, 1946). Records managers at Hanford provided copies of phone books that include rank next to names.

Discussions with presenters at the locations visited by the committee yielded other documentation of numbers of military personnel at each site, site-specific exposure monitoring reports, and health records (mainly accident reports) of personnel at the site. The committee was also directed to historical documents and databases on locations and exposures and health outcomes data held by different federal agencies (VA, DoD, NARA, DOE Office of Legacy Management, NIOSH, DOL). Information that it was able to glean from these sources is discussed in subsequent chapters.

SYNOPSIS

This chapter described the committee’s interpretation of and approach to its statement of task, including aspects within and beyond the task, definitions of terms used in the report, and use of guiding epidemiologic principles to drive its approach to information gathering and deliberation. As this feasibility assessment is intended to identify and characterize exposure and health outcomes information, records, and data that may be available on military veterans who were potentially exposed to radiological and non-radiological hazards from Manhattan Project–related activities at 13 specified sites, the committee used a variety of information-gathering activities to inform its deliberations. These included 24 invited speakers for topic-specific presentations; 20 unique information requests to federal agencies, researchers, advocacy organizations, and individual historians (excluding requests to invited speakers); requests for public comment; targeted literature searches and reviews; and searches for other supplemental documentation (e.g., government and government-contractor reports, historical documents, and databases on locations and exposures). Details and summaries of presentations and reports and examples of applicable records are discussed in Chapter 4: Identifying the Veteran Population, Chapter 5:

Manhattan Project Exposures and Associated Records, and Chapter 6: Sources of Health Outcome Information. Next, in Chapter 3, a brief history of each site is presented with regard to military presence and activities that could have resulted in exposures to toxic materials and wastes.

REFERENCES

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