The Mancuso Report
At the heart of the conflict sits a quiet, unassuming health-research pioneer named Dr. Thomas Mancuso. A spry man in his late sixties, Mancuso walks daily to an office cluttered with computer printouts at the University of Pittsburgh. The printouts form the basis of Mancuso’s research in occupational health, a field he has helped nurture since seventeen years of service as director of the Ohio Department of Industrial Hygiene in the 1940s and 1950s. During those years Mancuso helped write one of the nation’s first occupational disease codes, and he pioneered a method of studying long-term health effects based on Social Security data, which has essentially revolutionized occupational cancer research. Given a career award by the National Cancer Institute as one of America’s top researchers, Mancuso linked heightened cancer rates to work in the rubber, chemical dye, asbestos, chromate, and beryllium industries.7
Because of his unique prestige and unquestioned scientific integrity, Mancuso was approached in 1964 by the Atomic Energy Commission to study the potential health effects of work in their facilities at Oak Ridge, Tennessee; Savannah River, South Carolina; Los Alamos, New Mexico; and Hanford, Washington.
The AEC was then under fire from opponents of bomb testing and, as AEC adviser Brian MacMahon put it, "much of the motivation for starting this study arose from the ‘political’ need for assurance that AEC employees are not suffering harmful effects." Though they knew Mancuso’s study would be extensive, AEC administrators expected it to prove nothing. Some referred to it as "Mancuso’s folly" and openly viewed it as a public-relations sham.8
But what Mancuso actually found turned out to be more than they bargained for. His investigation—which constituted one of the largest and probably the most reliable of all the epidemiological studies on the health effects of radiation—proved conclusively that exposure levels in industry were far too high, and that the health effects of emissions from nuclear power plants and fallout from nuclear bombs may be far worse than suspected. When Mancuso’s first results were finally published in 1977, the industry response changed rapidly from bemused tolerance to outright suppression, including attacks on Mancuso’s findings and reputation, and an attempt to physically remove the data from his possession.
Trouble had surfaced even before 1977. Mancuso’s methods were necessarily slow, but the AEC desperately wanted to have something with which to assure the public their industry was safe. In the early 1970s, after about a decade, the commission was looking for ways to phase Mancuso out. Mancuso, however, continued to resist pressure to force publication of his preliminary findings, essentially because he knew it could take up to thirty years for cancers to surface in affected workers. His data only began in the mid-1940s, and Mancuso wanted to wait before terming any findings "conclusive."9
Then, in the summer of 1974, the situation changed abruptly. The problem focused on the massive AEC installation at Hanford, Washington, where a reactor complex—which produced the plutonium for the bomb dropped on Nagasaki—a waste dump, and other nuclear facilities were operating. As one of the oldest and largest nuclear facilities in the world, Hanford was—and is—a keystone to the American nuclear weapons program.
The controversy began there when Dr. Samuel Milham, an epidemiologist with the Washington State Department of Health, noticed a 25 percent cancer excess among Hanford nuclear workers when compared with the rates among the state’s nonnuclear workers. Milham also found four cases of multiple myeloma, when less than one would normally be expected.10 It was the same disease found among GIs who first went into Hiroshima and Nagasaki after the bombings.
When the AEC got wind of Milham’s findings, Mancuso’s contract officer called on Mancuso to issue a statement attacking Milham and contending that his own figures showed there was no problem at Hanford. Mancuso was stunned. He knew Milham to be a reliable researcher, and he had no intention of publishing any of his own data at that point. His initial findings were proving negative, but he felt that publishing anything then—especially in light of what Milham had found—was "premature."11
That, apparently, was intolerable to the AEC. In less than a year Mancuso got word that his funding would be gradually shut off, and that by 1977 he would be compelled to turn over his enormous store of data to the federal government. The 18-month "grace period" was essentially to allow Mancuso time to organize his files, and to ease the political impact of an action the authorities hastened to describe as strictly "administrative."12
Meanwhile the AEC commissioned Battelle Northwest, a think tank with extensive Hanford contracts, to reassess Milham’s findings. According to AEC records, the study found precisely what the government did not want to hear—"that there is a relationship between cancer as a cause of death and the total dose of external radiation received."13 Alex Fremling, manager of the Hanford Research Lab, lamented that "the message is clear that Battelle’s data suggests that Hanford has a higher proportion of cancer deaths for those under 65 than the U.S." But, Fremling continued, "even more disturbing from our standpoint" was the fact that "the analysis tends to show a much higher incidence of certain types of cancer" even among those exposed to levels of radiation believed to be "safe." Thus, Fremling concluded, "we hoped to get a good answer to the Milham report, and instead it looks like we have confirmed it."14 The Battelle study was quickly buried.
But Thomas Mancuso persisted. In the wake of the Milham affair he turned to Dr. Alice Stewart, the internationally recognized British X-ray researcher and a member of his advisory committee. With the help of statistician George Kneale, Stewart carefully examined Mancuso’s data at their office at England’s University of Birmingham. In the summer of 1976 they showed definitively that there were indications of 5 to 7 percent excess in radiation cancer deaths among Hanford workers at exposure levels as much as thirty times below what had been considered safe.15
The Mancuso-Stewart-Kneale findings were shattering not only to the industry, but to public perceptions of what might be a safe dose of radiation from reactors, bomb tests, or a nuclear war. As described by the 1980 Encyclopaedia Britannica, the survey had become "the largest study of a normal adult population exposed to lowlevels of ionizing radiation" in the world.16 Because it was a largely homogeneous sample of relatively healthy white males whose exposure and health histories had been carefully recorded, there was little reason to doubt its conclusions. And the study had shown, quite simply, that human beings were up to thirty times more sensitive to radiation-induced cancer than previously believed.
Now the AEC turned the tables on Mancuso. Having demanded that he publish his preliminary findings to attack Milham, the AEC now exerted enormous pressure to keep Mancuso’s final statistics out of print. "They were clearly unhappy," Mancuso told us. "They urged us not to publish. . . . My job in their eyes was simply to transfer the data to them."17
By the fall of 1977 Mancuso’s research funds had run out. In November he published his paper in Health Physics, creating a firestorm of controversy. Though he continued to draw a salary from the University of Pittsburgh, Mancuso had no funds with which to continue his research. Though it was a bare fraction of what was needed, Mancuso began cutting into his personal retirement money to continue working on the Hanford study. Meanwhile the federal government persisted in its attempts to take the data away from him.
But it also had come under public attack for its treatment of Mancuso. Under pressure, Dr. James Liverman, who had been director of the AEC’s Division of Biology and Medicine, explained that Mancuso was being fired because of his "imminent retirement" from the University of Pittsburgh. On that basis, he said, the Mancuso study was being moved to the government-controlled Oak Ridge Associated Universities. Liverman failed to note, however, that Mancuso had a full eight years left in his position with the University of Pittsburgh. Liverman arranged for the Hanford portion of the Mancuso study to be handed over to Battelle Laboratories, where the same former AEC official who had tried to use Mancuso to attack the first warning signals of a problem at Hanford would now be in charge of further investigations into the situation at Hanford.18 Liverman also charged that an early peer review of Mancuso’s work had been critical of him, when in fact it had lauded his capabilities and recommended that the study be continued under his control.19
By January of 1978 the public furor over Mancuso’s findings and other radiation-related issues had led to a congressional investigation and to hearings in front of the House Commerce Subcommittee on Health and the Environment. The hearings marked a major watershed in the controversy over the health effects of radiation, signaling the first major congressional attention given not only the Mancuso report but also the facts of high exposures to the 250,000-plus military personnel used as "guinea pigs" during atomic bomb tests.20
In the course of the hearings Congressmen Paul Rogers (D-Fla.) and Tim Lee Carter (D-Tenn.) charged that the justifications for the decision to fire Mancuso were "not supported" and the decision to transfer Mancuso’s study to Oak Ridge was "highly questionable at best." The whole process, they said, reflected "serious mismanagement and is of highly questionable legality."21
Nonetheless the attacks continued. Mancuso kept the study going with private donations and his retirement money until August of 1979, when labor-union pressure forced the National Institute of Occupational Safety and Health to reinstate the study. But in the spring of 1981 the Reagan administration notified Mancuso his funding would once again be cut off.
7. Thomas F. Mancuso, "Methods of Study of the Relations of Employment and Long-term Illness by Cohort Analysis," American Journal of Public Health, 1959.
8. Thomas F. Mancuso, interview, October 1980; Professor Brian MacMahon, letter to Leonard Sagan, AEC contract officer, November 8, 1967.
9. In a draft memorandum from Sidney Marks, Mancuso’s AEC contract officer, dated February 20, 1973, Marks stated that "unless an immediate replacement [for Mancuso] is found, a public charge may be made that the AEC is stopping the program out of fear that positive findings will emerge." Marks continued by adding ". . . overtures to possible candidates must be carried out in a clandestine atmosphere . . ." to phase out the uncooperative Mancuso.
10. Samuel Milham, Jr., "Increased Cancer Mortality Among Male Employees of the Atomic Energy Commission, Hanford Facility, Washington, June 1974," unpublished manuscript.
11. Mancuso interview.
12. U.S. Congress, House Committee on Interstate and Foreign Commerce, Subcommittee on Health and the Environment, Effect of Radiation on Human Health, 95th Cong., 2nd sess., January 24-26, February 8, 9, 14, and 28, 1978, Serial No. 95-179, Vol. 1, p. 523.
13. Draft AEC Memorandum, from Alex Fremling, AEC Director of the Hanford Research Laboratory, July 17, 1975.
14. Ibid.
15. Thomas F. Mancuso, Alice M. Stewart, and George W. Kneale, "Radiation Exposures of Hanford Workers Dying from Cancer and Other Causes," Health Physics Journal 33, No. 5 (November 1977): 369-384; Mancuso, et al., "A Reanalysis of Data Relating to the Hanford Study of the Cancer Risks of Radiation Workers," International Atomic Agency Symposium Proceedings on the Late Biological Effects of Ionizing Radiation, Vienna, Austria, 1978, IAEA-SM-224/510; Stewart, et al., "Hanford IIb, The Hanford Data—a Reply to Recent Criticisms," Ambio 9 (June 1980): 66-73; Kneale, et al., "Hanford III, a Cohort Study of the Cancer Risks from Radiation to Workers at Hanford (1944 to 1977 deaths) by Method of Regression Models in Life-Tables," British Journal of Industrial Medicine (in press), summer 1981; Mancuso, et al., "Hanford IIIb, Delayed Effects of Small Doses of Radiation Delivered at Slow Dose Rates," Proceedings of a Symposium on Industrial Cancers, Cold Spring Harbor, Banberry Center, Long Island, N.Y., March 1981.
16. Karl Z. Morgan, "The Hazards of Low-Level Radiation," Encyclopaedia Britannica, 1980 edition.
17. Mancuso interview.
18. U.S. Representatives Paul Rogers and Tim Lee Carter, letter to James Schlesinger, secretary, Department of Energy, May 4, 1978 (hereafter cited as "Rogers, Carter letter to Schlesinger").
19. Ibid.
20. "Statement of Donald M. Kerr, acting assistant secretary for defense programs, Department of Energy," Effect of Radiation on Human Health, January 26, 1978, pp. 331-404.
21. "Rogers, Carter letter to Schlesinger."