ATSDR Tribal Programs
Hanford Affected Tribes - American Indian Tribes located down wind and stream from the Hanford Nuclear
Reservation (HNR) are concerned if their tribal members are affected by off-site contamination. The Tribes are inter-
ested to learn if tribal members are directly exposed to off-site contamination from the HNR, and if they experience
health effects from exposures. The Tribes are also interested to learn how off-site contamination affects native food
sources and organic materials used in tribal products such as baskets, mats, and clothing. Under a new funding agreement,
ATSDR is working with seven Northwest Indian Tribes to build tribal environmental health capacity. The tribal environ-
mental health programs will evaluate the impact of environmental contamination from the HNR on the health of tribal
members and will develop culturally appropriate environmental health education materials.
Suquamish Indian Reservation - ATSDR obtained Department of Defense funding for the Tribe to conduct a
subsistence dietary consumption study. This data is being used on other Northwest Indian reservations.
Additional work has been supported by ATSDR for the following sites and tribes: Rayonier Mill (Lower Elwha
Klallam Tribe), Yakama Indian Reservation, Midnite Mine (Spokane Indian Reservation), and Colville Confed-
erated Tribes.
Hanford Nuclear Reservation Activities
Hanford Health Effects Subcommittee In December 1994, the Citizen's Advisory Committee on Public Health
Service Activities and Research at Department of Energy sites was chartered and subsequently established the Hanford
Health Effects Subcommittee (HHES). Composition includes representatives of the Hanford area American Indian
Tribes, affected downwinders, organized labor, affected Columbia River users, scientific and medical experts, as well as
ethnic minorities. The subcommittee has provided ATSDR and CDC with a wide variety of advice and recommenda-
tions concerning Hanford public health activities. Although ATSDR has been unable to secure funding for either program
from the Department of Energy, the subcommittee has steadfastly maintained its two highest priorities: the implementa-
tion of a medical monitoring program for Hanford downwinders to include a medical evaluation for thyroid and
parathyroid disease, and the establishment of an iodine-131 exposure subregistry.
Hanford Infant Mortality and Fetal Death Analysis The HHES recommended that ATSDR undertake this study
following unpublished reports of an increased infant mortality rate during 1945 in counties receiving high doses of
iodine-131 from Hanford. This study evaluated the rates of infant mortality and fetal death in eight southeastern Wash-
ington counties during the years 1940 through 1952. Infant and fetal mortality rates were analyzed by geographic region,
level of exposure to radionuclides, time period of exposure, and maternal and infant risk factors. Study findings suggest
that residence of the mother in a geographic area with relatively high estimated iodine-131 exposure in the year of the
largest iodine-131 releases at Hanford may have resulted in preterm birth.
Hanford Medical Monitoring Program (HMMP) - In 1997, pursuant to a unanimous recommendation from the
HHES and the Hanford American Indian tribes, the Administrator of ATSDR authorized the establishment of a medical
monitoring program for an estimated 14,000 people who lived downwind of the HNR between 1944 and 1951. The
program would target people who, as children, were exposed to sufficient amounts of iodine-131 to be at increased risk
of developing thyroid and parathyroid disease. The program would provide education, periodic medical evaluations for
thyroid and parathyroid conditions, including thyroid cancer, and referral of positive findings for treatment. A recent
survey of 500 Hanford downwinders showed that 84% would utilize this thyroid examination service if it were available.
The program has been on hold since 1997 due to a lack of funding from the Department of Energy. The HMMP
remains the highest priority activity recommended by the Hanford Health Effects Subcommittee.
Hanford Community Health Project (HCHP) In 1999, ATSDR initiated a program focused on outreach, educa-
tion, and risk communication for people exposed to iodine-131 releases from Hanford, and for their health care provid-
ers. A survey of 500 Hanford downwinders was completed in 2001. Important findings from this survey included:
91% were aware of past releases of iodine-131 from Hanford;
46% felt their health care professional knew little about Hanford health issues;
81% would like more information about radioactive iodine and thyroid disease; and
84% would use a thyroid examination service if it were available free of charge.
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