A Personal perspective by a participant of the Enewetak Atoll Clean-up (1977-78) by Jeff Fortin, USA

Dear to Whom it may Concern,

I wish to bring to your attention the plight of service members who participated in the 1977-1980 Enewetak Atoll Cleanup Mission, they served with honor and answered the call to duty for this humanitarian mission. These brave men served our government and the peoples of the Marshall Islands in the remediation, clean-up of atomic waste, debris and contamination from the decades of Atomic Testing in the South Pacific.

During the cleanup over 8,033 participants of the US Army, US Air Force, US Navy, US Coast Guard, and Civilians worked tirelessly in implementation of OPLAN 600-77.

The clean-up project was a three year project from 1977 to 1980, three year effort. I was one of the service members who served at Enewetak from March 1978 to March 1979 as part of the US Air Force Element as the air passenger specialist at the air terminal. The purpose of this letter is to highlight the dangers of our service on the islands and our 40-year fight for healthcare parity for the participants of this clean-up project. As of today, we have found 466 participants who served on this project, and advise you that 55% of them are suffering life threatening illnesses with chronic issues, as well as various types of cancer and disabilities.

Under the guidelines of the Energy Research and Development Administration (ERDA) issued guidelines in October 1973 related to personnel working as part of the clean-up operation. Under these rules all personnel visiting and/or working on a “controlled Island” which is a defined area in which the exposure of personnel to ionizing radiation is under the supervision of an individual for radiation protection.

These personnel who are exposed to more than 10 percent of the basic radiation protection standards as a result of his employment or duties in a controlled area qualify to be called “radiation worker”. The VA considers Enewetak Atoll veterans as only “occupational exposure” to the various contaminates on the various islands at Enewetak, due to not being classified “Atomic Veterans”. The ERDA rules also state “These personnel preforming radiological clean-up functions will be classed as radiation workers, and islands suspected of having radioactive materials are classed “controlled” islands.

Attached to this letter is a list of known radioisotopes found in the Soil, Debris, and Water as well as the metal and scrape. Included with this listing is a map of the Enewetak Atoll Island chain with listing of the 43 Atomic Tests conducted on the atoll. A memorandum for The Commander, Joint Task Force Group, Enewetak Atoll sated January 6, 1978 stated that “the Enewetak Atoll cleanup operation may result in exposure of personnel to ionizing radiation”, further stating “Approximately 700 personnel may be exposed each month over a period of 36-months. The majority of these personnel will rotate every six-months.”

Over the past five years our group has been lobbying Congress to change the existing law to classify our service as “Atomic Veterans” just as the down winders and participants in the actual testing have had for decades. In the 113th Congress the effort resulted in the submission of the Atomic Veterans Healthcare Parity Act, however this legislation died in committee, and was lost with the end of the congressional session.

In 2015, the late Mark Takai introduced similar legislation in the 114th Congress with H.R. 3870, gaining 107 co-sponsors, as well as Senator Al Franken introduced companion legislation with S2791, gaining five co-sponsors.

In 2016, Mark Takai, passed away and his legislation died as well. Then Representative Grace Meng sponsored the Mark Takai Atomic Veterans Healthcare Parity Act with H.R. 5980, gaining 102 co-sponsors. However, all these bills did not succeed getting out of committee, and the congressional session ended January 2, 2017 eliminating our success with healthcare parity.

The basis of the healthcare parity act was to change the “occupational exposure” to a “presumptive exposure” thereby allowing for the priority access to VA healthcare and additional benefits. This change would allow for the expedited review of claim by Enewetak Atoll veterans by the VA and assist with the access to healthcare benefits.

As you can see, the photo above is the Runit concrete dome, the highest levels of contamination.

As of today, many of the known survivors suffer lack of proper healthcare, creating massive financial burdens on their family and undue pain and suffering. Over 8,000 service members served at Enewetak, many have died over the past 40-years, and many more will succumb to their plight before the law is changed. They are holding on with faith the government, congress and the VA will do the right thing.

I myself am suffering from my service, and have been unable to work since 2014, I have filed VA and Social Security disability claims and am moving slowly through the process. I have been diagnosed with initial stages of Ankylosing spondylitis (AS) of the spine, degenerative disc disease, along with focal gliosis of the spinal cord, and Scaroilliitis and reactive arthritis which has not been rated by the VA, as well as asthma and moderate obstructive airway disease which limits my ability to work, which has been rated at 40% with additional claims under review and appeal.

My service on the islands consisted of air and cargo air terminal operations. I served and lived on the islands for over a year, working 12-hour days. I was able to visit all 40-islands over a 10-day period in a search and rescue operation in search of a lost 12-foot Sunfish Sailboat with two service members lost during Typhoon Alice in January 1979, which created devastating effects on all the islands damaging buildings, roads, work areas, moving dirt, debris and contamination outside of various contaminated areas. We never found the two lost service members at the atoll, but their bodies were found later out at sea.

I was flown by helicopter to the northern and southern islands spending hours at a time on each of the 40-atoll outlet islands. As you can see by the above image damage on the main island was not limited, this type of damage, debris and spreading of contamination as a result of the typhoon created further risk to the participants in the project. Especially where the army personnel resided, on Lojwa a quarantined island, yet housing the base camp of the 84th Combat Engineers. The damage from the typhoon effected all living and working areas, including the hot spots and debris area.

My tour on the island ended when I was diagnosed with cyst growths appearing in my left arm, there were two growths found in a medical review and it was recommended that I be sent to Tripler Army Medical Center for further review. Upon arrival at Hickam, and proceeding to Tripler I had surgery to remove these growths. At the time, they told me they there was nothing to worry about, however I was advised that should I have been exposed to radiation due to my service any health problems may not appear for 25 to 30 years. I have attached my medical referral and issues causing my temporary duty to Enewetak to be cut short, two growths appearing within a three-week time frame.

It is unfortunate, some 40-years later I am suffering issues and conditions which may have been seeded during my service on the Islands, I have been fortunate that I have gained medical care due to other service-related conditions, yet in the event of developing a more serious aliment, I would have to be covered as an Atomic Veteran.

The VA was asked by Congress (the late Hawaii Congressman Mark Takai in 2013) to cover the Enewetak Atoll Veterans without changing the law which they can, and internally change the regulations, however they have declined. Therefore needing legislation to change the law.

Even with the support of the American Legion, the Veterans of Foreign Wars and many members of congress we have failed in our parity efforts to be treated with the same quality of medical care as those who participated in the atomic test era.

In the preplanning for the execution of the cleanup project there were many positions taken with the Defense Nuclear Agency, the Environmental Protection Agency, the Atomic Regulatory Commission, as well as the Department of Defense discussions were held on the risk being considered with the cleanup. Discussion was help on using civilians for the cleanup, but due to costs, possible delays and exposure risk, the Department of Defense took the lead role for the active cleanup participants. With Freedom of Information Requests and the declassifying of cleanup documents a clearer picture has emerged on the development, discussion and implementation of the mission of all involved.

The risks facing participants were numerous internal exposure to ionizing radiation occurs when a radionuclide is inhaled, ingested or otherwise enters into the bloodstream (for example, by injection or through wounds). Internal exposure stops when the radionuclide is eliminated from the body, either spontaneously (such as through excreta) or as a result of a treatment. External exposure may occur when airborne radioactive material (such as dust, liquid, or aerosols) is deposited on skin or clothes. This type of radioactive material can often be removed from the body by simply washing.

The 84th Combat Engineers were tasks with the majority of the cleanup of the contaminated islands in the controlled zones. The safety precautions were mixed, although protection gear, respirators, film badges were given to hot-spot participants many conducted this work in shorts, and tee-shirts. When protection gear was provided it was shabby, flimsy and did not keep particles, dust and debris off body or out of lungs, eyes, wounds and cuts.

The Issue: Servicemen and civilians who worked on this project have developed cancers, tumors, skin lesions and other illnesses due to radiation exposure.

The Enewetak Atoll Radiological Cleanup Project was an attempt to make the islands of Enewetak Atoll safe for re-inhabitation. The cleanup effort failed and some of the Northern islands all the islands in the controlled zone remain uninhabitable to this day. However, unlike the atomic veterans of the cleanup, the Marshallese people have been compensated monetarily for their losses and illnesses. Their health care needs will also be covered by the U.S. Government for the remainder of their lives. Their illnesses are not recognized by the U.S. Government as being associated with their exposure to these extreme conditions. Consequently, there is no mechanism to help them or their families with the health problems they have developed.

Radiation Exposure of Cleanup Workers: During the cleanup project, servicemen and civilians were subject to around-the-clock radiation exposure, intense sun, heat and humidity, with very little safety gear. A majority of the time the work was done in shorts, tee-shirt and hats.

The service at Enewetak has caused hardships and consequential health damages to its participants. The main pathway for human exposure to plutonium is through inhalation of contaminated dust particles in the air that people breathe.

The work being accomplished by our service members do create possibility of contaminates being inhaled. Plutonium in the debris that enters the body will eventually ends up in various organs—especially the lung, liver, and bone. Moreover, radioactive debris deposited in lagoon sediments of coral atolls formed a reservoir and potential long-term source for remobilization and transfer of plutonium through the marine food chain and potentially to man.

We have fished the waters, snorkeled in the lagoon, drank the lagoon water that has been desalinated, which included bathing and washing from potentially contaminated water. Elevated levels of plutonium in the terrestrial environment also represent potential inhalation and/or ingestion hazards. One hundred and eleven thousand cubic yards of radioactive debris lies within Runit Dome in the Marshall Islands, a “hulking legacy of years of U.S. nuclear testing” whose fragile structure is vulnerable to breaking from violent weather associated with climate change.

As of this date, the safety and containment of this tomb is in jeopardy with raising ocean levels. Given the mega-tonnage of nuclear testing that the US conducted in the Pacific, it appears plausible that excess cancer would have occurred in areas of Micronesia other than the Marshall Islands. "Six Islands in Bikini were vaporized by the tests.

The northern most islands in Enewetak Atoll are still uninhabited due to high levels of radiation. A thyroid study conducted by Japanese physicians in 1994-1995 confirmed hundreds of thyroid tumors among Marshall Islanders from islands throughout the Republic. This led U.S. Congressional leaders to comment in 1994 “that the thyroid cancer rate in the Marshall Islands was 100 times higher than anywhere else in the world”.

The radiological illnesses in the Marshall Islands include thyroid cancer, breast cancer, and stomach cancer, cancer of the brain, cancer of the liver, cancer of the ovary, and cancer of the bone."

As early as 1956, the Atomic Energy Commission had characterized the Marshall Islands as "by far the most contaminated place in the world."

In 1998, staff from the U.S. Centers for Disease Control and Prevention (CDC) made a comparison study to compare the amount of radioactive Iodine-131 at four different radiation-polluted sites, measured in curies (1,000 curies of Cesium-137, as found in a radiation therapy machine, could produce serious health effects in a direct exposure of just a few minutes).” “The CDC team reported its finding that the atmospheric release of curies of Iodine-137 at the Hanford nuclear processing plant was 739,000 curies; at Chernobyl the release was 40 million curies; at the Nevada bomb test site, 150 million curies; and in the Marshall Islands, 6.3 billion curies (more than 30 times as much radiation as the other three sites combined).”

In a letter Feb 1974 from the EPA to AEC – “We have serious reservations as to the adequacy of the AEC recommendations for environmental protection.

The exposure situation at Enewetok is expected to continue indefinitely with the return of civilians into a contaminated area.

These Trust Territory people are entitled to as much protection as that afforded residents of the U.S. We also believe the EPA position on ocean disposal of radioactive wastes, which is sufficiently flexible to give a fair consideration of an appropriate EIS, is seriously misrepresented, we request this material be deleted from the task force report.”

In a telex message from USAEC to Gen Gates “telephone conversation Wednesday with Bob Law, trust territory liaison office Honolulu I learned that there are rumors here approximate quote that the "AEC may be having second thoughts about Enewetak atoll and may not let the people return after all unquote”.

As well in June 1974 from Dr. Ray Chair AEC from the DNA “There is some controversy over what constitutes an acceptable level”.

From the EPA to DNA – “Due to the large amount of plutonium on the atoll and the uncertainties in predicting resuspension factors it is very important that the actual conditions be determined rather than calculated. We have no specific comments to make about this phase except to note that there will be significant possibilities for inhalation exposures to workers and. And transport of radioactive material from greater to lesser contaminated portions of the atoll.

Constant health physics support will be needed. DNA has recommended that a risk-benefit study should serve as a basis for the decision on dose criteria. The Task Group had severe reservations about the validity of the estimates.” In a letter to Senator Rogers from Vice Admiral Monroe on behalf of the Secretary of Defense “Of the 650 DoD personnel on the Atoll, possibly 400 have the potential for being exposed to radiation".

Whenever earth-moving operations were being conducted on a controlled island in the northern Enewetak Islands water sprinklers were supposed to be set up to minimize resuspension of contamination, rarely did such activity occur and the cleanup went forward with no sprinklers. Rarely were water trucks used. Minimal air sampling was conducted downwind of the operation cleanup activities. Personnel involved in earth-moving operations rarely wore respirators and protective clothing. Most were done in shorts, short sleeves, and hat – unprotected.

AEC Health Physicist to File “The government planners stated that there would be a pre-employment physical, screenings, and prior to being deployed to the islands for all personnel. “Such medical physicals did not occur for a majority of its clean-up personnel. Individuals undergo pre-deployment physical examinations which pay special attention to past history of exposure to ionizing radiation and baseline blood counts.

Regarding clean-up operations – in a letter from the NRDC to DNA, EPA and AEC March 1975: “We have no specific comments to make about this phase except to note that there will be significant possibilities for inhalation exposures to workers and transport of radioactive material from greater to lesser contaminated portions of the atoll.”

Constant health physics support will be needed the in a report from NRDC to file finds the “Draft Environmental Impact Statement, Clean Up, Rehabilitation, Resettlement of Enewetak Atoll -- Marshall Islands,” to be incomplete and inadequate. Furthermore, the proposed (preferred) clean-up operation is totally inadequate to protect the health of “the Enewetak people from exposure to hot, particles of plutonium which carry. The basis for these conclusions high risk of producing lung cancer, and other ailments.”

NRDC Staff Scientist in a letter to DNA Sept 1974: “Exposure can produce roughly 10 times as many cancers as 100 rad of X-Rays. The total elimination of any radiological health risk at unrealistic objective which can never be attained.

The risks personnel are exposed to and the environment, and concentrations increase risk of generating bone deformities, bone tumors, and cancers of the blood-cell-forming organs. Irradiation of the bone marrow also impairs the immune system.”

“Cesium-137 and because of the chemical nature of cesium, it moves easily through the environment at increasingly concentrated levels. Upon entering the human body, cesium-137 can produce acute and chronic health effects, including cancer. Acute exposure causes thyroid disease and tumors. Long-term exposure to lower levels of iodine-131 causes thyroid cancer”

From the DNA to AEC May 1974 - With the radioactive contamination being beyond our ability to turn off or wholly eliminate, it is an uncontrolled localized contamination event in the definition of the Federal Radiation Council (FRC).

Being the release of radioactive material from nuclear explosions of many years ago, the Enewetak situation is Category III of p. 30 of FRC Staff Report No. 7.

For this category, protective action is to be considered on a case-by-case basis (p. 38). Any situation resulting in a bone marrow dose greater than 0.5 rad per year is to be appropriately evaluated.

FRC Report No. 7 does not include any criterion for bone dose for this Category III, but the present AEC Report numerically uses bone dose criteria to advise against the desired return of the Enewetak people to the island of Enjebi and to advise against full use of other islands.

Over the past five years the veterans of Enewetak have sought to gain government acknowledgment of their plight and recognition as Atomic Veterans. With letter writing campaigns and supportive many reporters we have been covered in the media (both newspapers and broadcast news) sharing our cause with the public. We have been on 60 Minutes (during the actual period of the cleanup) and for healthcare parity in local news shows, regional and local newspapers. Yet we still have failed to get Congress to right the wrong of the past and classify us as Atomic Veterans. We have developed numerous websites, Facebook pages announcing our goals, rally point for veterans and the sharing of information.

Our group is suffering cancers of various types, bone degeneration, esophageal, stomach, and brain ailments, including lung disease, asthma and airway obstruction, skin aliments to name a few.

This also includes blood disorders and other life threatening ailments. Many veterans are without proper medical care and benefits from the Veterans Administration. We conducted a survey of the 555 known known survivors and asked how their health status is, based on this over 55% of them suffer from aliments, cancers, tumors and other illness not covered by the veterans administration.

The original group of cleanup participants consisted of 8,033 service members. It is though the freedom of information act and declassifying of atomic testing and clean-up files that we can now share our story for recompense from the government and VA. Extrapolating estimated medical conditions from the 8,033 is could possibly effect over 4,418 veterans with life threatening issues, very unacceptable, and change in law and classification is warranted. Enewetak Atoll was a very contaminated and hostile environment to blindly place service members in harm’s way with the forewarned dangers of illness, cancers and death some 20, 30 and 45 years later without acknowledgment and coverage in healthcare parity.

The purpose of this narrative is to bring awareness and understanding to our cause. To rally support for the reintroduction and passage of the Atomic Veterans Healthcare Parity Act within the 115th Congressional session. We need to right a wrong and have available healthcare, expanded benefits for the participants of the Enewetak Atoll Cleanup Mission rather than just a Humanitarian Service Medal. Many have preceded us in death, many more are suffering, and many more are caught in the red-tape of government Bureaucracy. The time to change is now!

Congress must act, the Veterans Administration should stand ready to help the Enewetak Atoll Veterans, and the public become aware of our plight, need and resolution.