Risk Society and Contested Illness: The Case of Nuclear Weapons Workers

Author(s): Sherry Cable, Thomas E. Shriver and Tamara L. Mix

Source: American Sociological Review , Jun., 2008, Vol. 73, No. 3 (Jun., 2008), pp. 380-
401
Published by: American Sociological Association

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 Risk Society and Contested Illness:
The Case of Nuclear Weapons Workers
Sherry Cable Thomas E. Shriver
University of Tennessee Oklahoma State University

Tamara L. Mix
Oklahoma State University

Wealth production within a "risk society " typically depends on production technologies
that expose citizens to dangerous substances. Knowledge of such exposure is, more often
than not, hidden from the public. Empirical analyses show that citizens 'claims of
illnesses caused by risky exposures are frequently contested by the institutions that select
production technologies and control information: the government, corporations, and
physicians. In this article, we use the risk society thesis as a framework for addressing
gaps in the environmental illness literature?specifically, the basis for authorities'
contestations of illness claims for which the exposure-illness link is scientifically
confirmed. Using case methods, including in-depth interviews with 124 citizens, analyses
center on the contested illness claims of nuclear weapons workers at the federal Oak
Ridge Nuclear Reservation. Results highlight how institutional and organizational
resources provided authorities with tactical leverage, and allowed them to manufacture
an ambiguous climate for public discourse. This discourse focused on the
exposure-illness link for a particular individual and their specific symptoms rather than
the established exposure-illness links in general. We conclude by discussing the
implications of our findings for analyses of environmental exposure specifically, but also
the seemingly contradictory tension between the risk society s need to restrict
information to experts and democracy's need for open discourse.

ronmental hazards created by modern agricul

Contemporary societieshazards
exposures to environmental consciously
that invite tural and industrial production technologies.
Risks derive from hazards deliberately "induced
pose unique risks to human health. Beck (1992,
and introduced by modernization itself" (Beck
1995, 1996) uses the term "risk society" to
1992:21) through technologies developed to
describe societies organized around the envi generate increased capital accumulation. Since
about 1945, production technologies have relied
significantly on radioactive substances, heavy
Direct correspondence to Sherry Cable, University metals, and synthetic organic chemicals?
of Tennessee, Department of Sociology, 901 McClung substances scientifically demonstrated to be
Tower, Knoxville, TN 37996-0490 (scable@[Link]). associated with specific human ailments (Cable,
We are grateful to Oak Ridge residents who allowed Hastings, and Mix 2002; Commoner 1972;
us into their homes and their histories. For inter
Schnaiberg 1980).
viewing and transcribing assistance, we thank
A society's reliance on risky and complex
Lachelle Norris, Amy Gibson, Lisa White, Chuck
Wright, and Valerie Hulett Hurd. Comments on pre
production technologies elevates experts to
vious drafts by the editors and the thoughtful anony prominence in private and public decision-mak
mous reviewers provided excellent guidance for ing arenas. It also restricts citizens' access to
strengthening this article. Any failures of omission
information about environmental hazards.
or commission, of course, belong to us. Information restriction occurs, often uninten

American Sociological Review, 2008, Vol. 73 (June:380-401)

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 RISK SOCIETY AND CONTESTED ILLNESS 381

tionally, because technologies require multiple open democratic discourse on issues of pro
specialized experts who create abstract knowl found significance.
edge systems that are incomprehensible to the In this article, we build on the risk society the
majority of citizens (Giddens 1991). Inten sis to advance understanding of authorities'
tionally restricted access, on the other hand, contestations of disease claims linked to risky
derives from private and public institutions' production materials. We draw on documents,
close control over scientific knowledge related observations, and in-depth interviews with 124
to economic production. Private institutions, residents, workers, and activists in East
such as corporations, guard knowledge as a Tennessee to investigate the public dispute over
proprietary commodity, and the state withholds the environmental illness claims of nuclear
certain information for ideological and securi weapons workers. Attention centers on Oak
ty reasons. Without full access to information, Ridge Nuclear Reservation, a key installation of
citizens cannot assess specific risks and make the federal nuclear weapons complex. Under
informed decisions about where they work and what conditions do institutional authorities con
live, nor are they prepared to protect themselves test environmental illness claims of known dis
from the risks they cannot avoid. eases? Which authorities contest illness claims?
Without resources to protect themselves from And how is institutional power exercised to
exposures, people inevitably get sick. How does withhold technical knowledge from the pub
the risk society respond to claims that illness lic? Such questions, which make up the core of
es are caused by the production technologies that our analyses, contribute to sociological schol
define the age? Research shows that individu arship on environment, illness, and workplace
als who attribute their symptoms to environ power dynamics, but also to broader social sci
mental exposures and turn for aid to their entific concerns pertaining to knowledge and
physicians, employers, and political leaders fre open, democratic discourse.
quently receive little support. Instead, they find
themselves embroiled in public conflict. We RISK SOCIETY AND CONTESTED
refer to illnesses that "engender major scientif ENVIRONMENTAL ILLNESSES
ic disputes and extensive public debates over
Contemporary Ecological Hazards
environmental causes" (Brown et al. 2003:213)
as contested environmental illnesses.
Analysts have applied various terms and empha
Public disputes over the relationship between sized different factors in describing the distinct
illnesses and exposures to risky production tech characteristics of contemporary postwar socie
nologies are a crucial area for sociological inves ty. Members of the Frankfurt School examined
tigation. Analyses of contested environmental the costs of postmodern societies, stressing the
illnesses, in fact, can cast a revealing light on inherent dangers of advanced technological
economic structures, institutional and organi societies and their habitual modes of acting
zational dynamics, power differentials, and dem (Horkheimer and Adorno 1973). Bell (1973)
ocratic participation?all fundamental and analyzed the postindustrial society, in which
enduring sociological foci. Conflicts over the the provision of services competes with the pro
environmental causes of illnesses pit individual duction of material goods, and both economic
citizens against the forces of economic pro venues depend on science as the means of
duction. The claims of the environmentally ill progress and growth.
are contested by the social institutions that most Increasingly, analyses have focused on the
benefit from the economic system?the insti risks associated with relying on scientific
tutions that possess the power to both control experts to direct economic growth. Douglas
scientific knowledge and define the risks posed and Wildavsky (1982) highlight a rapid cultur
by production technologies. "Risk definition, al shift in common perceptions of science and
essentially, is a power game" (Beck 2006:331). technology?from the perception of science as
The use of institutional power to retain risky pro a source of safety to that of science as a source
duction technologies at the expense of citizens' of risk. Perrow (1984) describes the routiniza
understanding of widespread environmental tion of accident risks in technological systems
hazards truncates democratic participation. This that are harnessed to economic growth, and
effectively denies citizens the opportunity for contends that the complexity and tight coupling

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382 AMERICAN SOCIOLOGICAL REVIEW

of systems inevitably result in accidents that though medical researchers acknowledge the health
threats.
may be catastrophic. Commoner (1987) identi
fies the source of contemporary risks as the A politics in which risk is linked to power and
knowledge; prominence is granted to scientists in
postwar proliferation of the petrochemical
decision-making processes; and symbiosis charac
industry and its inevitable companion?highly
terizes relationships among scientific experts who
toxic wastes.
seek research funding and prestige, corporate actors
Since the 1990s, "risk society" is the tag who seek ever-higher profits, and state actors who
most commonly used for reference to postwar seek continued economic growth to maintain a
societal changes (Beck 1992, 1995, 1996; nation's wealth and to fund popular public services.
Eder 1996; Gare 1995; Giddens 1990, 1999;
The most extensive production technologies
Habermas 2001; Jameson 1991). Beck (1992)
of the risk society are those associated with the
argues that contemporary societies' wealth is
Cold War's nuclear arms race and with the petro
inextricably linked to environmental hazards?
chemical industry. The nuclear arms race
surplus capital is complemented by surplus
increased reliance on production technologies
dangers to human health. He writes: "In the that use materials associated with serious human
risk society, the unknown and unintended con
health problems, such as uranium, mercury,
sequences [of production] come to be a dom
cyanide, nickel, chromium, and beryllium. The
inant force in history and society" (p. 22).
petrochemical industry's postwar expansion
Fearing such consequences, citizens often
replaced many naturally occurring materials
question the premier roles of science and tech
used in agriculture and manufacturing with
nology in directing economic expansion. synthetic organic compounds. Fabricated as
Giddens (1999) illuminates the nature of unin artificial combinations of amino acids, petro
tended consequences by stressing the differ chemicals have no corresponding enzymes to
ences between industrial societies' natural, help them biodegrade. Consequently, they accu
acts-of-the-gods risks, such as flood and mulate in food webs, where they pose constant
famine, and the risk society's decidedly anthro threats to life. The emergent technologies of
pogenic, deliberately assumed risks, such as genetic engineering and nanotechnology con
exposures to radiation and synthetic pesti tinue the risk society's trend of introducing
cides. Risk analysts depict societies as dom unnatural substances to the natural environ
inated by knowledgeable experts whose ment.
technological choices carry ecological threats Ubiquitous health threats inevitably bring
that are deliberately borne for the anticipated illnesses?eventually. Because contemporary
benefits of increased capital accumulation. risks have a long latency period, technolo
But the risks are not equally distributed in gies' toxic byproducts sleep as ticking time
society. Politically powerful private-sector bombs in many communities. The first bombs
groups who make technological decisions began exploding in the 1980s when citizens
advocated by the experts in their hire reap confronted health threats in their workplaces
significant benefits, yet the costs?adverse and communities (Bullard 2000; Cable and
health effects?disproportionately affect the Cable 1995; Cole and Foster 2001; Nelkin
general public. and Brown 1984). Many people now com
Although such analyses carry somewhat dis plain of illnesses that they attribute to haz
tinct emphases, the commonalities are striking. ardous exposures. Symptoms include multiple
At the core is the momentous postwar shift to chemical sensitivities, immune system defi
production technologies that rely on radioactive ciencies, tremors, chronic fatigue, memory
substances, heavy metals, and unnatural mate loss, unexplained rashes, chronic headaches,
rials. Other seminal features of the risk society tumors, and clinical depression. These ill
include the following: nesses are now so frequently reported that
researchers refer to them as "environmental"
The proliferation of contested or conflicting risk
definitions (Ekberg 2007). illnesses-?a commonality portending that, in
The long latency period of technological risks, the near future, the defining characteristic of
which diminishes the capacity to determine accu risk societies may well be widespread envi
rate cause-effect relationships (Beck 2006), even ronmental illnesses.

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 RISK SOCIETY AND CONTESTED ILLNESS 383

Research Emphases in the Study of tained in the 1950s when they witnessed above
Environmental Illnesses ground nuclear bomb tests. Similarly, Vietnam
War veterans were dismissed as troublemakers
The literature on environmental illnesses con
when they attributed medical problems to
sistently indicates that people who question wartime exposures to the herbicide Agent
whether their illnesses are caused by exposures
Orange (Jacobs and McNamara 1986; Scott
to the hazardous materials of risky technologies
1988).
are likely to encounter resistance to their claims.
Specific reference to contested environmen
Brown, Kroll-Smith, and Gunter (2000:9) sug
tal illnesses marks more recent analyses. Kroll
gest that because environmental illnesses are
Smith and Floyd (1997) describe a "pandemic"
linked to production technologies, "virtually all
diseases and conditions that can be attributed to of multiple-chemical sensitivity and argue that
no disease is more fiercely contested. Claims of
environmental causes are highly contested and
environmental causes of breast cancer are typ
the source of considerable confusion, anger,
and resentment." Research on contested envi ically contested (Brown, Kroll-Smith, and
ronmental illnesses exhibits three cardinal foci: Gunter 2000), as are claims of environmental
documentation of contested illness claims, eti
causes of endometriosis (Capek 2000) and
asthma (Brown, Kroll-Smith, and Gunter 2000).
ological uncertainty as the basis for contesting
Das (2000) analyzes contested illness among
illness claims, and the key contesting actors.
Research has documented cases of contest victims of the 1984 release of toxic gas from a

ed environmental illnesses, including earlier

Bhopal chemical factory. Perhaps the most
accounts that do not use the same term but are detailed analyses of contested environmental
illness claims, however, concern those by Gulf
consistent with recent descriptions. One of the
most obvious examples came with the interna War veterans seeking compensation and treat
ment for illnesses they attribute to exposures to
tionally publicized revelation of a leaking land
fill at Love Canal in 1978. Lois Gibbs's struggle various hazards during active service in the
to transfer her asthmatic son from the elemen 1992 Persian Gulf War (Brown et al. 2000;
Brown et al. 2003; Shriver 2001; Zavestoski et
tary school, knowingly constructed by the city
atop the Love Canal landfill, is emblematic of al. 2002).
contested environmental illness. Despite letters When "the relationship between the envi
ronment and human health is debated in scien
from the child's physician testifying that his
asthma was likely related to the chemical wastes tific forums" the ill are effectively barred from
lying beneath the school, the local school board access to "health services, welfare benefits,
refused to transfer the boy (Levine 1982). unemployment certification, worker's compen
Similar cases abound. In the late 1970s, sation claims, and pensions" (Brown et al.
Michigan residents discovered that local cattle 2002:194). Furthermore, the rejection of ill
had consumed feed accidentally contaminated ness claims often involves a variant of blaming
with a flame retardant. State officials, though, the victim: causality for symptoms is assigned
denied residents' claims of illness caused by to a person's defective character or conscious
the ingestion of dairy foods produced from the misbehavior. Such attributions frequently
poisoned animals (Chen 1979; Reich 2000). involve accusations of hypochondriasis (Shriver,
Local officials in Legler, New Jersey denied Webb, and Adams 2002; Vyner 1988).
residents' claims that their illnesses were caused Most scholarship maintains that etiological
by the officially acknowledged toxic contami uncertainty is the necessary condition for con
nation of private wells (Edelstein 1988). tested environmental illnesses. "Etiological
Residents attributed unusual rates of childhood uncertainty" means that no link between a spe
leukemia in Woburn, Massachusetts to con cific disease and exposures to a particular sub
taminated public wells, but these claims were stance has been demonstrated scientifically
refuted in court by corporate officials' counsels (Brown, Kroll-Smith, and Gunter 2000; Vyner
(Brown and Mikkelsen 1990 [1997]). Vyner 1988). The ambiguous atmosphere produced
(1988) and Caufield (1990) describe struggles by etiological uncertainty generates multiple
by military personnel to obtain treatment from plausible explanations for patients' symptoms,
the federal Department of Veteran Affairs for ill which are then debated by knowledgeable
nesses they ascribed to radiation exposures sus experts (Brown, Kroll-Smith, and Gunter 2000;

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384 AMERICAN SOCIOLOGICAL REVIEW

Shriver 2001; Vyner 1988). Illness claims are tect the public from corporate excesses such as
contested on the basis that, although the ill pre hazardous exposures. Consequently, contesta
sume a link between their symptoms and envi tion by federal authorities is not inevitable.
ronmental exposures, no singular syndrome is Physicians and medical scientists such as
medically identifiable. Brown and colleagues epidemiologists also play pivotal roles in con
(2000, 2002) refer to the illness claims at the testing environmental illness claims. Some sug
center of these disputes as "presumptive gest that they do so to preserve professional
diseases." hegemony and to protect their social status. The
The literature also cautions that the absence medical community's hegemony was estab
of etiological uncertainty does not ensure that lished with the American Medical Association's
environmental illness claims will not be con skillful use of the scientific model to establish
tested. Many specific diseases have been linked exclusive rights in defining, diagnosing, and
by medical experts to exposures to a particular treating illness (Conrad 1997). In contesting
substance, and the exposure-illness link for illness claims, medical authorities tout expert
these known diseases (Brown and Kelley 2000; over lay knowledge to diminish challenges to
Brown et al. 2002) is accepted by key institu their approach to science (Brown 1991; Brown
tions and acknowledged in government regula and Kelley 2000). Many physicians and medical
tions imposing standards for emissions and scientists occupy the same social status as cor
exposures. Yet claims for these known diseases porate and government elites, and they use
are also sometimes contested. Most studies of monopolistic powers to protect this status
contested illness claims, though, consist of case (Freund and McGuire 1995).
studies concerning presumptive diseases, such
as Gulf War illness. The literature contains few Analytic Frame and the Case of
empirical details on illness claims concerning Nuclear Weapons Workers
known diseases.
Although most analyses reveal little about Risk societies are accompanied by citizens'
the tactics used by those who contest environ claims of environmental exposure-induced ill
mental illness claims, they do tend to identify nesses, as well as contestations of those claims
the same set of key contesting actors: corporate, by corporate, government, and medical author
government, and medical authorities. Corporate ities. These authorities often prioritize organi
and government authorities contest environ zational needs over citizens' needs in the service
mental illness claims because such claims fun of profit, power, and ideology. Contestation
damentally target the production technologies denies the ill access to needed services and ben
that generate the wealth on which institutions efits. Although prior work has advanced the
rely. Corporate authorities also preserve their understanding of contested environmental ill
economic hegemony by contesting illness ness claims, two gaps warrant further investi
claims. Bound by the rules of a profit-driven gation.
system, they develop and select production tech First, there has been a lack of detailed case
nologies solely for the increased capital accu studies where the analytic focus specifically
mulation they generate. Conceding harm and centers on the contestation of known diseases.
awarding compensation would reduce profits Contestation of presumptive diseases is a rea
and risk increased government regulation. sonable response because there is no scientifi
Federal authorities' motivation for contesting cally confirmed exposure-illness link. But the
environmental illness claims, on the other hand, link for known diseases is scientifically estab
derives from both ideological and pragmatic lished, and exposures are officially regulated.
needs: the state supports increased corporate How then are disputes triggered? What leverage
wealth to retain national prestige as a global eco do institutional authorities possess that trumps
nomic power and to sustain revenues that secure etiological certainty? The literature offers insuf
acceptable standards of living and fund pro ficient clarity on (1) the grounds contesting
grams that preserve the public trust. But the authorities have for disputing claims and (2)
state is not monolithic. In a bureaucracy as their organizational capacity for contestation.
enormous and varied as the U.S. federal gov Second, we know little about the specific
ernment, some authorities are motivated to pro actions that constitute the contestation of illness

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 RISK SOCIETY AND CONTESTED ILLNESS 385

claims?claims of either known or presumptive Third, records of hazardous exposures, which

diseases. The typical contesting actors are iden can be used to demonstrate the exposure-illness
tified as corporate, government, and medical link for a particular individual, are more like
authorities, but little insight has been afforded ly to be maintained for workers than for the gen
regarding the process and actions of contesta eral public. The public's protection from
tion. What do authorities actually do to contest exposures consists of Environmental Protection
illness claims? How is institutional or organi Agency (EPA) regulations on toxic emissions
zational power deployed to block the environ that establish standards for air, water, and land
mentally ill from services and benefits? quality. Emissions records are required of
We address these gaps through an investiga organizations, but exposure records for mem
tion of contested environmental illness claims bers of the public are not. In contrast, workers
by nuclear weapons workers at the federal gov are protected from exposures by the Occu
ernment's Oak Ridge Nuclear Reservation. One pational Safety and Health Administration
of the three original Manhattan Project sites, the (OSHA). OSHA regulations establish limits
Oak Ridge facility produced the enriched ura on workers' hazardous exposures and also
nium that fueled the Hiroshima bomb. impose requirements for worker safety that
Throughout the subsequent Cold War, workers include regular monitoring of workers' expo
continued to handle hazardous materials as they sures and maintaining accurate individual
developed the hydrogen bomb, enriched urani exposure records. Exposure records constitute
um to weapons- and commercial-grade levels, a database for connecting individuals' expo
sures to their illnesses.
researched the use of radioisotopes, and man
ufactured components for nuclear weapons We use the following questions to guide our
systems. case study analysis: What was the institutional
context for nuclear weapons workers' hazardous
This case is itself opportune for three signif
icant reasons. First, the nuclear weapons indus
exposures and claims of known illnesses?
try is emblematic of the risk society's production
Without the ambiguous climate created by the
etiological uncertainty of presumed diseases,
technologies that use hazardous substances. The
what was the basis for authorities' contestation
chief production substances used at the Oak
of workers' claims of known illnesses? What
Ridge Nuclear Reservation were mercury,
powers specific to the contesting institutions
cyanide, uranium, and beryllium.
were used to dispute illness claims, and what
Second, Oak Ridge workers' claimed illnesses
particular tactics did authorities use to contest
are known diseases. Medical experts have sci workers' claims of known diseases?
entifically established links between exposures
to weapons production materials and adverse
health effects. Exposures to mercury, particu
DATA AND RESEARCH STRATEGY
larly in vapor form, are associated with tremors,
We collected data in a multiyear effort through
respiratory problems, emotional instability, in-depth interviews, document analysis, and
sleeplessness, memory loss, muscle weakness, observation. Our primary data source is in
headaches, and numbness. Acute and chronic depth interviews with 124 respondents. We con
cyanide exposures may cause headaches, pal ducted interviews in four distinct waves,
pitations, convulsions, skin disorders, nasal irri reflecting our increasing accessibility to resi
tation, and tremors. Radioactive exposures are dents, and we use the entire data set for our
associated with malignant effects such as can analyses. In the initial wave, our focus was on
cers of the bone, liver, thyroid, and lung, and local activists concerned about the health
with nonmalignant effects such as degenera impacts of nuclear weapons production. The
tive changes and impaired function of bone first author, in contrast to her prior experiences
marrow, kidneys, lungs, and the eyes. Beryllium in which activists were eager to participate, per
is associated with life-threatening respiratory sisted for a year before securing the first inter
problems, including lung cancer. Institutional view. Ill and wary, the interviewed activist was
acknowledgment of these known associations slow to provide the names of others. The
between exposures and specific diseases is man researcher was granted credibility in the activist
ifested in federal regulations for worker safety. community only after they learned she had been

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386 AMERICAN SOCIOLOGICAL REVIEW

dismissed by state officials as the principal protection to those who spoke out encouraged
investigator in a state-funded study of residents' ill workers in 1996 to found the Coalition for a
attitudes toward Reservation environmental Healthy Environment. Our fourth wave of in
remediation projects. We obtained 29 inter depth interviews centered on the stories of 16
views with Oak Ridge activists, counteractivists, ill workers and five of their family members.
activists from outside Oak Ridge, lawyers, a Additionally, these interviews provided impor
journalist, and a physician whose actions were tant information about events that encouraged
relevant to activism. Seven respondents in the ill workers to speak out.
first wave were ill and described official rejec We solicited respondents via snowballing
tions of their illness claims. The remaining inter from original contacts and through cold con
views help describe the community's reaction to tacts. The unstructured interviews averaged two
those who spoke out and the significant role to three hours per respondent. We conducted,
played by the physician and the lawyers. audiotaped, transcribed, and coded approxi
Finding that local activists feared retaliation mately 340 hours of interviews. Table 1 contains
because their neighbors vehemently denied links summaries of all the respondents. The sample
between illness and hazardous exposures in the is predominantly white, evenly split in terms of
community, we launched a second wave of inter gender, and 29 percent lived in Oak Ridge since
views focused on the oral histories of 52 resi at least early childhood. The bulk of the respon
dents. We intended this wave to explore the dents are employed as professionals (30.6 per
creation of a community in which most residents cent), technicians (25 percent), and laborers
resented the questioning of a link between ill (15.3 percent). Because of the way we selected
ness and exposures to weapons production mate respondents, the majority believe that expo
rials. We learned that World War IPs legacy of sures to weapons production materials had
secrecy and patriotism combined with postwar caused illnesses. Neutral and nonbeliever
economic dependence on the Reservation to respondents (37.9 percent) dominate in the sec
forge a culture in which residents not only ond interview wave. Over half of the respon
accepted governmental restrictions on access to dents work at the Reservation, and 25
information but also derogated their neighbors respondents (20.2 percent) claim illnesses from
who violated norms of secrecy. The data from exposures to weapons production materials.
this wave help establish the community's eco Table 2 summarizes the characteristics of the
nomic dependence on the Reservation, resi 25 ill respondents. Nearly all are white, and 65
dents' patriotic pride in their community's percent are female. As shown, 64 percent lived
contribution to national security, and residents' in Oak Ridge since at least early childhood, and
internalization of secrecy norms that permeate 32 percent spent adulthood as Oak Ridge resi
the community. dents. One ill respondent is a lifelong resident
After environmental racism concerns were of nearby Knoxville, but his father worked for
publicly voiced in the African American neigh decades at the Reservation. The respondent
borhood of Scarboro, we conducted a third wave himself had been a Reservation employee for
of interviews with 22 residents and two white three years. Ill respondents worked predomi
environmental justice activists. Residents attrib nantly as technicians (44 percent) and laborers
uted the neighborhood's high levels of childhood (24 percent). Most (96 percent) were either
asthma to proximity to the Y-12 plant. We Reservation workers (76 percent) or lived with
learned that environmental injustices are a com Reservation workers as children or spouses (20
plex product of historical factors, including the percent). All 25 ill respondents report that their
government's deliberate wartime creation of a illness claims were contested.
segregated community and the subsequent relo We checked interview data for verification
cation of black residents to a site near the Y-12 against documents including local and region
plant. None of the respondents were ill, but the al newspapers (The Oak Ridger, the Knoxville
insights gained from these interviews are use News-Sentinel, and the Nashville Tennessean),
ful for understanding the mystique of science local historical accounts of Oak Ridge, docu
that pervades the community's culture. ments obtained from the Department of Energy
Continuing revelations of off-site contami (DOE) Reading Room and through Freedom of
nation and legal changes that provided greater Information Act requests, State of Tennessee

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 RISK SOCIETY AND CONTESTED ILLNESS 387

Table 1. Characteristics of All Respondents (N = 124)

Respondents
Characteristics Number Percentage
Gender
Female 62 50.0
Male 62 50.0
Race
White 88 71.0
Black 34 27.4
Asian 2 1.6
Oak Ridge residenc
Lifelong 16 12.9
Since childhood 20 16.1
Adult only 69 55.6
Briefly as child or adult 2 1.6
Never 6 4.8
Unable to determine
Occupational status
Professional 38 30
Management/admin
Technical 31 25.0
Teacher 7 5.6
Farmer 1 0.8
Clerical 6 4.8
Labor 19 15.3
Unable to determine 1
Stance on weapons-produ
Believers 68 54.8
Neutral 19 15.3
Nonbelievers 28 22.6
Unable to determine 9 7.2
Relationship to Reservation
Workers 67 54.0
Lived with workers 32 37.9
Residents only 15 4.8
Non-residents/Unable to determ
Illness claim
No 99 79.8
Yes_25_20.2

public documents, and personal

struction, assembc
between physicians and at
warheads patien
17 m
activists. Additionally, we1990).
and Birks engagC
tion at various government-sp
that the governme
activist-sponsored
vate public meeti
enterprise, t
such as the American Museum
than 70 of
corporati
Energy and the General
Oak RidgeElectr
Visito
Marietta, Lockhee
THE INSTITUTIONAL
about 12,000 C
OF WORKERS' CONTES
Reservation maint
of fissile materi
ILLNESS CLAIMS
context for the
The Oak Ridge nuclear Reservati
Nuclear weapons
the nuclear weapons productio
DOE delegates aut
which the DOE supervises
(ORO) the
for super

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388 AMERICAN SOCIOLOGICAL REVIEW

Table 2. Characteristics of 111 Respondents (N = 25)

111 Respondents
Characteristics Number Percentage
Gender
Female 16 64.0
Male 9 36.0
Race
White 22 88.0
Black 3 12.0
Asian 0 0
Oak Ridge residenc
Lifelong 13 52.0
Since childhood 3 12.0
Adult only 8 32.0
Briefly as child or adult 0 0
Never 1 4.0
Unable to determin
Occupational status
Professional 3 12.0
Management/admin
Technical 11 44.0
Teacher 1 4.0
Farmer 0 0
Clerical 2 8.0
Labor 6 24.0
Unable to determine
Stance on weapons-pro
Believers 25 100.0
Neutral 0 0
Nonbelievers 0 0
Unable to determine 0 0
Relationship to Reservation
Workers 19 76.0
Lived with workers 5 20.0
Residents only 1 4.0
Non-residents/Unable to de
Illness claim contested
No 0 0
Yes_25_100.0

coordination with corporate management worked under a security system known as com
authorities. Consequently, both the federal and partmentalization. Originally established to limit
the local organizational contexts are critical interaction among scientists, the system was
factors in Reservation workers' exposures and refined in wartime to restrict the flow of all
illness claims. information to a "need-to-know" basis. Workers
were prohibited from discussing any aspect of
The DOE and the Federal Nuclear their jobs on penalty of forfeiting their securi
Weapons Complex ty clearances. Revocation of security clearance
meant that the worker was suspended without
The Manhattan Project was initiated in 1942 as due process pending an investigation; convic
one of three research and production facilities tion would bring imprisonment. As a result,
constructed by the U.S. Army to produce the most workers remained as uninformed about
world's first atomic bomb. National security the Manhattan Project's mission as the public?
demanded that project operations remain secret. until the second bomb exploded over Nagasaki.
All employees, from physicists to janitors, The government then released the Smyth

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 RISK SOCIETY AND CONTESTED ILLNESS 389

Report, a semi-technical account of the scien participating in atomic policy making. It also
tific developments that culminated in the mili created an echelon of decision makers who
tary use of atomic energy. were, in the main, accountable only to them
The motives of key actors for releasing the selves" (Udall 1994:174).
Smyth Report varied, revealing a fundamental Kinsella and Mullen (2007:74) describe the
contradiction that remains unresolved: the with contradiction in government responsibilities as
holding of information from citizens by a dem a paradox: "Citizens must be informed partic
ocratic government. Author and physicist ipants in atomic matters, while national securi
Smyth's motivation was shared information. In ty limits their access to information." The AEC
the report's summary, he states that the further embodied the paradox and initiated the gov
development and use of atomic bombs should ernment's perennial dilemma of simultaneous
be determined in a public process: ly promoting and regulating nuclear energy.
In a free country like ours, such questions should Kinsella and Mullen describe the government's
be debated by the people and decisions must be control of information as the deliberate attempt
made by the people through their representa to constrain public knowledge about nuclear
tives. . .. The people of the country must be matters so as to contain democratic public dis
informed if they are to discharge their responsi course. They label these efforts "discursive con
bilities wisely. (Smyth 1945:13.7-8) tainment" (Kinsella 2001; Kinsella and Mullen
Smyth's objective was in sharp contrast to 2007).
pronouncements by Secretary of War Henry Congress periodically challenges discursive
Stimson and Manhattan Project Director containment, but with mixed results. Legislators
General Leslie Groves. Stimson (1945) hoped perceived that the 1946 Administrative
that the report would "backfire reckless state Procedures Act, originally designed to open
ments by independent scientists after the demon government to the public, was routinely manip
stration of the bomb." He said, "If we could be ulated by the executive branch to withhold infor
sure that these could be controlled and avoid mation, rather than to distribute it (Rosenbloom
ed, all of us would much prefer not to issue 2003). They passed the 1966 Freedom of
such a paper." In the foreword to the report, Information Act (FOIA), mandating that federal
Groves emphasized the need for strict limits on agencies provide information about their activ
the release of information because of national ities to the public upon request. But the FOIA's
security requirements, and he warned that pub first exemption prohibits agencies from pro
lic requests for further information were inap viding information in records authorized as
secret in the interest of national defense or for
propriate and violators would be subject to the
Espionage Act. eign policy (5 U.S.C. 552 [b] [1] 2002).
Secrecy prevailed; the Cold War began as Legislators again challenged the principle of
the heated war ended. Political tensions with the secrecy when criticisms that the AEC favored
USSR heightened security concerns, which research and development over safety and reg
were manifested in the dramatic enlargement of ulation led them to pass the 1974 Energy
the weapons complex in pursuit of a superior Reorganization Act. It replaced the AEC with
nuclear arsenal. Stringent secrecy norms two new agencies: the Nuclear Regulatory
imposed at weapons production sites exceeded Commission, charged with regulating com
wartime restrictions on information flow to the mercial nuclear energy matters, and the Energy
point of contradicting the constitutional imper Research and Development Administration
ative to preserve an open democratic govern (ERDA), designed to promote nuclear energy.
ment safeguarded by checks and balances. The In 1977, ERDA's responsibilities were trans
1946 Atomic Energy Act, which transferred ferred to the newly established DOE, which is
control of nuclear weapons production from now responsible for nuclear weapons production
facilities.
military to civilian authorities via the Atomic
Energy Commission (AEC), contradicted con In the 1980s, residents of communities host
stitutional mandates by authorizing the agency ing weapons facilities challenged nuclear
to function with only minimal congressional secrecy:
surveillance. The act, "prevented the American Amid concerns about mercury releases at the Oak
people and their elected representatives from Ridge Nuclear Reservation, the Knoxville office of

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390 AMERICAN SOCIOLOGICAL REVIEW

the Legal Environmental Assistance Foundation umes of highly technical information?so tech
filed a federal class action lawsuit to force the DOE
nical that the EPA subsequently developed the
to abide by environmental laws at Oak Ridge's Y-12 Technical Assistance Program to provide grants
plant (LEAF v. Hodel). When the court ruled for the
that enable communities to hire expert help in
plaintiff in 1984, DOE officials decided to comply
interpreting DOE documents. But the massive
at all weapons facilities, leading to the 1992 Federal
Facilities Compliance Act. ly increased flow of technical information failed
The Fernald Feed Materials Production Center in to produce a more informed public. This failure
Ohio produced uranium products. In 1984, con is seen in the Final Report of the United States
cerned residents formed Fernald Residents for Senate Commission on Protecting and Reducing
Environmental Safety and Health and filed a fed Government Secrecy (1997). The commission
eral class action lawsuit, forcing the DOE to report concluded that secrecy is a form of government
that nearly 300 pounds of enriched uranium oxide regulation, that excessive secrecy has significant
had been released into the environment.
consequences for the national interest when
Consequently, the DOE agreed to pay $73 million
policy makers are not fully informed, and that
in compensation (Hardert 1993; Sheak and
the government is not held accountable for its
Cianciolo 1993; United States Department of
actions.
Energy, Office of Environmental Management
2007). DOE officials maintained discursive con
Residents near the Hanford Nuclear Reservation, a tainment while appearing to address criticisms
producer of weapons grade plutonium, formed the about the public's right to know. Kinsella and
Hanford Education Action League and used FOIA Mullen (2007) point to the need for technolog
requests to reveal radioactive iodine releases from ical expertise in interpreting information as crit
the Hanford plant. In 1986, the DOE publicized ical to continued discursive containment. By
previously classified documents describing inci
dents of radioactive iodine releases. Other residents shifting the emphasis from the provision of
information to the need for expert interpretation
mobilized as the Hanford Downwinders, training
themselves as radiation experts and seeking com
of the information, DOE officials limited the
pensation for medical treatment (Kaplan 1997, range of voices that could legitimately speak
2000; Kinsella and Mullen 2007). about hazardous exposures:
In 1988, workers at the Rocky Flats Plant, which
The principles of secrecy and expertise interact
fabricated plutonium fission triggers for hydrogen
ed as complementary resources for containing dis
bombs, were seriously contaminated. The following course. Those principles, in turn, were warranted
year, FBI and EPA agents searched the plant for evi in a broader discursive formation that linked sci
dence of procedural violations. A corporate con ence, technology, government authority, and
tractor, Rockwell Industries, subsequently national security in powerful... ways. (Kinsella
relinquished management responsibilities, pled and Mullen 2007:94)
guilty to criminal violations, and paid $18.5 million
in fmes (United States Department of Energy, Office
of Legacy Management 2003). The ORO and Corporate Management
In 1990, activists across the country founded the
Military Toxics Network to advocate for citizens' The Oak Ridge Nuclear Reservation consists of
right to know about hazardous materials in their three large facilities. K-25 is a gaseous diffusion
communities and to participate in local environ
plant for uranium enrichment (closed in 1985),
mental cleanup efforts (Shulman 1992).
X-10 is a national research laboratory, and Y-12
Freudenburg (1993) created the term "recre fabricates warhead components. During the
ancy" to refer to public disenchantment with war, the plants and the town were managed by
institutions (e.g., the feelings of residents of the U.S. Army. The entire site was enclosed by
host communities). Recreant institutional actors barbed-wire fencing and the gates were guard
fail to fulfill their responsibilities "with the ed by armed soldiers. Only at the war's end was
degree of vigor necessary to merit the societal it revealed that the Reservation had produced the
trust they enjoy" (p. 909). Widespread charges enriched uranium for the Hiroshima bomb. The
of recreancy against a state can trigger a legit Reservation's postwar mission changed little
imacy crisis. The federal government avoided a because the subsequent nuclear arms race
crisis with the 1993 announcement of DOE's demanded increased production. In 1946, when
new "openness policy." In accordance with this control of the plants and the town was trans
policy, the DOE declassified and released vol ferred to the AEC, agency authorities wanted to

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 RISK SOCIETY AND CONTESTED ILLNESS 391

relinquish control of the town and urged resi load remained in place only briefly. Activists
dents to incorporate. The residents agreed in were forced to photocopy the documents quick
1959 only after the federal government prom ly and examine them later. The documents were
ised to subsidize town revenues (Cable, Shriver, housed in the public library, which had regula
and Hastings 1999). The AEC managed the tions prohibiting their removal from library
Reservation until the 1974 creation of the short premises and stringently restricted patrons' use
lived Energy Research and Development of the sole photocopier.
Administration, which was eliminated with the Workers increasingly claimed exposure
1977 establishment of the DOE. Local super induced illnesses in the mid-1990s. In 1995,
vision was implemented through DOE's Oak ORO created a cyanide working group as part
Ridge Office and contracted corporate man of a study by the National Institute of
agement. Weapons production remains the Occupational Safety and Health. Group mem
town's sole economic base. bers met regularly, on site and on the clock, for
In 1983, rumors of a secret government study discussions led by Reservation physicians.
to investigate mercury releases from Y-12 led a Although discouraged from meeting alone off
local journalist to file a FOIA request. The site, many members did so, and in 1996 the
report he received documented management's support group morphed into an activist organ
1977 discovery of significant off-site mercury ization: the Coalition for a Healthy
contamination. The journalist's published stories Environment. A worker explained the mem
forced DOE officials to acknowledge that 2.4 bers' drive to transform the support group:
million pounds of mercury had been uninten
The doctors were telling me they couldn't find
tionally released from Y-12 between 1950 and
anything?basically telling me that it was in my
1977. A subsequent congressional investiga head. I've been healthy all of my life then?all of
tion concluded that the DOE "released incom a sudden?I couldn't function. Then I found out
plete and misleading information about mercury that other people feel the same way. The doctors
to the public" and had "used national security are telling them the same thing. We found a lot of
as a convenient shield behind which the non people that had a lot of the same symptoms but
sensitive but politically volatile data on the didn't have a clue as to why they might be feeling
quantity of mercury releases could be buried and this way. (Mix, Cable, and Shriver 2007)
obscured" (Cable et al. 1999).
In 1989, the Reservation was placed on the THE CONTESTATION OF NUCLEAR
EPA's Superfund list. More than 700 separate
WORKERS' ILLNESS CLAIMS
contaminated sites, totaling 5,000 acres, were
identified. The list included 247 buildings, some Workers' long-time silence about hazardous
the size of auto plants, contaminated with radi exposures and illnesses should not be construed
ation and other toxic substances; 56 waste bur as ignorance?workers were keenly aware that
ial grounds, contaminated with solvents, they were exposed to hazards and sometimes
lubricants, chemicals, uranium, mercury, stron knew which substances they were exposed to.
tium, thorium, tritium, and substances still clas When the institutional and organizational con
sified as secret; and 52 settlement ponds with text changed enough to allow public voicing of
chemicals, metals, and PCBs (Thomas, Frank, concerns, workers spoke out about their ill
and Paine 1997). nesses. But their claims of known diseases,
A handful of residents began claiming ill although associated with ORO-documented
ness from exposures to the known hazards and exposures to hazardous substances, were con
formed a citizens' organization. Mobilization tested by government, corporate, and medical
was hampered by members' periodic health set authorities.
backs and harsh criticisms from neighbors. The
ill citizens were particularly overwhelmed by the Workers9 Exposures to Risky
flow of documents released by the DOE. Technologies
Respondents described the difficulties in col
lecting, reading, and interpreting the highly Respondents offered graphic descriptions of
technical information. Documents were shipped their exposure experiences. An African
from site to site on a tight timetable, and each American woman with multiple cancers, who

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392 AMERICAN SOCIOLOGICAL REVIEW

moved to Oak Ridge in 1944, described her ill worker described her job as a trained haz
wartime exposures on a job cleaning up radioac ardous waste sampler:
tive materials at shift's end:
It wasn't anything for us to do 700 samples in a 16
We had to wear meters all the time. And we had day period?just two people for the whole plant!
to have goggles over our eyes and over our ears and We would get requests like, "It looks like ice cream
over our mouths. And you had to go out every salt," but it was actually something that had been
time the bell rang and catch air for about 10 min used in an experiment. We didn't know what it was
... we were given orders to go sample and, after
utes. And I would forget to go out! They would
we took it to Analytical Chemistry and they had a
come back and I'd be done stayed overtime?that's
what I believe made me sick. One time I see this chance to analyze, then we would know what was
in it. To keep from having a big hassle, a lot of
man come in there to pick up his tube [respirator]
times they would tell us, "This is only distilled
without his goggles on?without his eyes covered
water?I just have to have it checked because I
up. Blood come out of his eyes, nose, mouth,
have to," and then it would come back [from chem
ears?everywhere! He didn't live?he died on his
ical analysis] as tritium or whatever in it.
way there [to the hospital]. That hot stuff eat
him up. Workers described a broad range of symp
toms including thyroid problems, chronic
Postwar improvements increased worker safe
fatigue, rashes, memory loss, dizziness, respi
ty, but exposures remained routine. A female
ratory problems, and vision and hearing loss. A
machinist who began work in 1974 and is now technician and her coworkers were moved from
plagued with memory lapses, thyroid problems,
their office building because of a criticality
and extreme fatigue emphasized management's incident. She summarized her suffering:
forceful control: "They told you what to do,
Headaches! Terrible headaches, daily, every single
you did it, and that was it." She described an
day! Dizziness, instability. I'd have [headaches]
example of her exposures: every single morning, so I never slept well. I was
We would have to go down to the burial ground to dizzy all the time. I'd wake up with this terrible
do some jobs there. That's when we would see the headache, and I would feel terrible every day.
uranium burning up out of the ground. There would
A worker whose position in the plant's fire
be areas that looked like little lava pits! I mean, [it
department took him into nearly all of the
was] just oozing up ... it looked like a heavy
cream oozing up out of the ground. I said, "What's
Reservation's buildings described his deterio
all that?" and they said, "That's all the junk that we rating condition from cyanide exposures:
buried here for years." I couldn't drive my own vehicle. When it got to that
point and I couldn't drive, I had to have help with
An engineer who designed radiation instru a lot of things. I couldn't remember how to get back
ments at X-10 described a dramatic radiation home. I started having to have somebody drive me
exposure: from that point on.
I got splashed! I walked through a low-hanging Most workers described a gradual onset of
cloud. I got called down to medical. They said, symptoms and a slow deterioration of their
"Take your clothes off." They took my shoes, and
health. A former plant security officer
they brought them back later. They did some
explained:
smears on my skin and then came back and said,
"Okay, we have enough. See ya later." They didn't Your loss of energy is so subtle that you're not
tell me what they were up to, but I knew?they aware of it until you're really getting stressed.
were checking to see if I had absorbed too much. Peripheral vision begins to deteriorate ... blurred
vision is normal. I keep a low-grade headache all
Perhaps the most striking example showing the time?it never goes away. I've just learned to
the routine nature of hazardous exposures was live with it. The angina pain that I suffer is a con
related by a female whose exposures occurred stant reminder. The joint pain, the fibromyalgia
stuff... Dr. [name] says that is an exact sign of ura
after the implementation of rigid compliance
nium poisoning.
rules associated with the Reservation's listing as
a Superfund site. As stipulated by EPA require Ill workers resented not being adequately
ments, all hazardous wastes stored on the informed about occupational risks. The haz
Reservation had to be sampled, analyzed, and ardous waste sampler quietly stated: "We didn't
characterized for proper disposal. The severely know what we were dealing with?we were just

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 RISK SOCIETY AND CONTESTED ILLNESS 393

a sampling tool. We were more or less expend Lockheed's attorneys were planning to contest the
able." fact that exposure to beryllium could cause asth
ma, even though it was documented in my med
ical report by one of the world's experts on
Contestation Tactics and Corporate beryllium disease! It was a matter of record that
Management that's what caused my problems, yet they were
going to contest it!
Although DOE supervision of Reservation pro
duction activities was implemented through Other claims were contested through man
ORO, corporations contracted for on-site man agement's refusal to permit workers access to
agement were directly responsible for staffing, their own on-site medical records. A security
managing, and supervising Reservation work officer with heavy metal poisoning expressed
ers. Consequently, workers' illness claims were his determination to force the release of infor
contested by corporate management authori mation on medical tests ordered and performed
ties who used three tactics: denial of individual on him at the Reservation:
exposures, refusal to allow access to health Me and my lawyer are currently filing a new
records, and reassignment to unfavorable job FOIA?I want every record they got on me! I
tasks. want to know what they did with every drop of
Corporate management contested illness blood that come out of me, or any other biologi
claims by denying that a worker was exposed to cal samples they may have taken from me. If they
the substance as claimed. A pollution prevention were aware that we were being exposed to this
technician who worked for two years in one of stuff?there's not much of a way that they could
not have been aware of it. For years, I wondered
the most heavily polluted K-25 buildings test
why they didn't do the tests for heavy metals and
ed positive for cyanide poisoning. She regular
things on us. You work in a uranium enrichment
ly "rationalized away" her health problems plant?why in the world would you not look for
before recognizing them in a written description uranium?
of cyanide poisoning. When she spoke with her
plant supervisors, expecting their support, she Some respondents who were able to retrieve
was stunned at their denial that cyanide was their medical records reported that information
even present in her work environment. She about their exposures was deleted or falsified.
exclaimed: A respondent related an anecdote about a friend
who requested his radiation exposure history
The managers were saying there was no cyanide
when he learned that several of his work group
out there! I write monthly reports to DOE, and I've
members had died of cancer. The records were
got at least three or four projects that have got
"cyanide" in the title! Don't tell me there is no finally provided eight months after the request,
cyanide out there! and they indicated his employment for time
periods in which he was not employed and
Another K-25 worker reported a similar expe
showed no exposures for periods when he knew
rience. After a test by his family doctor found he was exposed.
cyanide in his urine, he approached management
authorities: In preemptive strikes against future illness
claims, corporate authorities reassigned com
The plant was trying to make it like, "we don't even plaining workers to unfavorable tasks. A K-25
have any cyanide here." So they got this quack from process operator who questioned management's
Vanderbilt to come in ... the doctor said, "If you
procedural compliance was reassigned to the
think it is cyanide giving you problems, you've got
steam plant "because it was a whipping post?
another thing coming! Cyanide didn't do it?in
if you caused too much trouble over on the cas
fact, they don't have any cyanide here."
cade or something, that's where you ended up
Even claims based on substantiated evidence because it was so nasty." A technician trained in
of links between an individual's specific expo health physics described these punitive reas
sures and subsequent illness were subject to signments:
denial by the management. A Y-12 machinist,
They would move you to the dirty jobs, if you
whose 1993 diagnosis of beryllium disease was questioned that something wasn't being done right.
the fifth such Reservation case, reported that You'd get shipped off, maybe down at the scrap
corporate manager Lockheed originally planned yard alone in the summer, surveying pipes?with
to contest his beryllium exposure case in court: swarms of bees and wasps around you.

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394 AMERICAN SOCIOLOGICAL REVIEW

She described being isolated on the job after I don't know how I would be right now, if I were
voicing concerns about exposures: "I got put in single and out there having to make my own liv
a building totally by myself. It was scary! ing?just totally dependent on myself like I was
when I was divorced. I don't know that I could have
Basically, I was locked up in the basement sur
been as outspoken as what I've been. 'Cause it's
veying lead bricks."
real scary if you think about it?just, all of a sud
Punitive task reassignment was involved in den, they can just take your whole livelihood away.
the first Reservation whistleblower case. Bud
Varnadore complained of safety violations in the
handling of nuclear materials. His lawyer told Contestation Tactics ry Reservation
us: "Despite his background as a skilled Employed and Contract Physicians
mechanical technician [who was] developing
Two sets of Oak Ridge physicians were distin
technologies like the uranium enrichment tech
guishable by their organizational contexts. One
nologies at K-25, they had him doing manual
set consisted of physicians engaged by ORO to
labor in waste disposal." Varnadore was reas
work at the Reservation, conducting workers'
signed to an office containing barrels of radioac
annual physical examinations, treating acci
tive wastes. After complaints, he was reassigned
dental exposures, and performing monitoring
again?to conduct a chemical waste inventory
in a former mercury reclamation room. He filed
tasks such as administering blood tests and
a whistleblower case in 1991 in which an admin examining the dosimeters that measured indi
viduals' radioactive exposures. The other set of
istrative law judge recommended to the
physicians was made up of local, private-care
Department of Labor that Varnadore receive
physicians who were part of an unorthodox
$30,000 in damages. But the department dis
medical establishment in which the sole hospi
missed the complaint on the grounds that it had
tal, a nonprofit organization, wholly owned a
not been filed within the required 30 days after
for-profit subsidiary that contracted with near
the alleged acts (Cable et al. 1999; Munger
ly all Oak Ridge physicians. The subsidiary
1996).
Such actions made some workers reluctant to owned the medical practices, including nursing
and clerical staffs, office space, equipment, and
voice their concerns. A reactor operator and
phone and computer services, and hired the
instrument mechanic suffering from fatigue and
physicians on annually renewable contracts.
allergies explained:
The operations of both the nonprofit hospital
Short of losing their jobs, they're afraid of getting and the for-profit subsidiary were overseen by
an unpopular job assignment. Salaried ranks are a board of directors on which ORO and corpo
afraid of losing promotions or pay raises. And that
rate management officials routinely served.
has happened to a few individuals that spoke out?
This structural setting was highly conducive
they're pretty good at making examples of some
people in order to keep other people in line. for transforming independent medical authori
ties into captive professionals (Daniels 1969).
Fear of reprisals against family members kept Daniels explains that when a professional accus
some ill workers from speaking out. An African tomed to performing expert service for a client
American woman who worked with various
is employed by a bureaucratic organization,
chemicals for 13 years before falling ill "the organization often supersedes the ultimate
explained: control and authority normally invested in his
I didn't get a lawyer, and I didn't try to sue them professional colleagues, and the professional
because I didn't want nobody to know I was that thus becomes a 'captive'" (p. 255). Captive pro
sick. My mom was working at Y-12, and my dad fessionals are pressured to "adjust their own
was at ORAU [Oak Ridge Associated Universities, traditional hierarchy of values to conform to
a nonprofit corporate contractor with DOE]. I that of their employing organization" (p. 255).
didn't want the backlash to come back on them, so
Reservation and contract physicians at Oak
I silently took myself out of the picture.
Ridge were likely pressured to adopt corporate
An outspoken ill worker suffering from cyanide management's norm of contesting workers' ill
poisoning reflected that only the economic secu ness claims. Physicians contested claims
rity afforded by her spouse allowed her to voice through three tactics: failure to inform workers
her concerns publicly: of their medical test results, discrediting of

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 RISK SOCIETY AND CONTESTED ILLNESS 395

peers who legitimated workers' illness claims, ed and treated his patients for conditions such
and derogation of patients. as heavy metal poisoning. He described his
Reservation physicians contested illness patients' predicaments to us:
claims by failing to inform workers of the test Their symptoms are so vague that they just get
results. A laundry room supervisor described written off. All the flags are up that would normally
what happened when she received the results of bring studies, bring clinical work. But they [ORO]
her two subordinates' annual examinations, have been about to kill anybody doing anything.
which showed high levels of cyanide: Most of the people are dying long before they get
cancer?of infections and other problems.
They [medical services] made it a point to tell me
that I was not to let them know that there was a
Although Reid's patients were gratified to
problem, because "we don't want to concern any receive sympathetic care that confirmed their
body?we don't want to upset anybody!" I was just
to send the workers down to do theirs over and
own suspicions, his peers retaliated by dis
crediting him. They publicly vilified him as a
check it again. Management said, "Keep your
mouth shut." Not in those words, but that's what drug addict and a medical incompetent, sub
they were telling me. jected him to a punitive peer review, suspend
ed his hospital privileges, and warned at least
Her coworker husband concurred: "If they one of his staff members that if she continued
thought that whatever [illness] it was had to do to work for Reid, she would never find employ
with the plant?you wouldn't know about it. If ment again in the county. Reid was eventually
it was something just natural, then they would vindicated in the peer review, but the subsidiary
tell you." A plant firefighter exclaimed: "They refused to renew his contract, and he was forced
did lots [of tests], but you never did know the to leave Oak Ridge.
results of them!" Additionally, some workers When workers were informed of abnormal
who were told they had tested within normal medical test results, they were frequently blamed
ranges did not trust the reports. The plant fire for their own symptoms by Reservation and
fighter asserted: "I know that the badges contract physicians who attributed the negative
[dosimeters] should have come back [positive] results to workers' personal habits rather than
because I've had them take my boots and stuff
occupational exposures. A materials handler
away from me that had stuff on them."
applying for disability followed instructions to
Workers described situations in which
retrieve her medical records from her physi
Reservation and contract physicians contested cian and deliver them to X-10's medical depart
their illness claims by discrediting peers who ment. She described her exchange with the
legitimated them. A female mechanic, for exam department's head:
ple, was initially informed by Reservation physi
When I took them the medical results, he said,
cian Dr. A that her test results indicated cyanide
"Some of these are just a little bit out and?I tell
poisoning, only to have his word repudiated by
you?heavy drinking can cause these tests to be
Reservation physician Dr. B: abnormal." I told him that I don't drink. He said,
I got to feeling so bad that I went up to see Dr. [A] "I'm just saying, heavy drinking on the weekends
again, but they wouldn't let me see him. They can cause these tests to be abnormal." I told him,
gave me Dr. [B]. I said to him, "I need a cyanide I don't drink periodl He said, "I'm just saying,
urinalysis test." He said: "That's a bunch of bull heavy drinking can cause these test results. We have
shit! That is a crock! And we know who started it." a lot of information, but not enough data?we
And he pushed his head over to Dr. [A]'s office. need more datal" He said it three times!

Dr. Bill Reid provides the most striking and Many workers reported that their physicians
well-documented example of contract physi summarily dismissed their questions about pos
cians discrediting a peer. Reid, an oncologist, sible links between their illnesses and occupa
was actively recruited by the hospital's sub tional exposures and treated them instead for
sidiary in 1992. Concerned about high inci depression and similar emotional disorders. A
dences of unusual symptoms among his patients worker said quietly: "A lot of doctors don't
and reasoning that the illnesses might be relat believe me. It's like?'This guy is crazy! There's
ed to hazardous exposures at the Reservation, nothing wrong with him.' I've actually had the
he contacted ORO authorities to request a list doctors label me psycho?'He's crazy!'" An ill
of his patients' most likely exposures. Reid test worker's spouse complained: "When we go in

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396 AMERICAN SOCIOLOGICAL REVIEW

with a list of problems that he has, they literal duction typifies risk society technologies, (2)
ly think he is crazy, or a hypochondriac, because exposures to production materials are linked to
he has so many problems." A technician trained known diseases, and (3) federal regulations
as a health physicist described a heated require that workers' exposures be monitored
exchange with her physician when she received and recorded. The institutional context for
conflicting medical accounts from him about a Reservation workers' claims consisted of the
diagnosis: DOE and its predecessor, the AEC. Throughout
He said, "Everything that is wrong with you is psy the Cold War, federal directives placed nation
chological." What?like the tremors? "Yeah," he al security interests above the ideal of an
said, "you can talk yourself into getting sick? informed citizenry. Greater institutional open
you can talk yourself into having any symptom that ness in the 1990s generated a deluge of for
you read in a textbook." merly classified documents shipped by rail from
The angry worker recounted pressing her physi site to site on a rigid timetable. DOE directives
cian further: were implemented by the agency's on-site rep
resentative, ORO. The organizational context left
Why does this test that you did show that I have
Reservation workers largely uninformed about
cyanide poisoning, if everything is psychologi
the sources and durations of their exposures
cal? Why did I have neurological testing that said
I have chemical encephalopathy, and now you tell and the results of medical tests performed on
them at work. Even when the institutional con
me it's all psychological? He told me, "All you need
is a good psychiatrist and some decent medication." text changed toward less secrecy, the organiza
tional context remained essentially the same, as
indicated by ORO authorities' failure to inter
DISCUSSION AND CONCLUSIONS vene when workers' ability to take advantage of
Risk societies are characterized by multiple DOE openness was hindered by the communi
contradictions and by a lopsided concentration ty library's budgetary limits. The organization
al context at the Reservation was characterized
of power. They produce unprecedented wealth
but pose known unique hazards. They rely on the by a symbiotic relationship between ORO and
logic of science yet hold scientists captive to corporate managers who retained employing
organizational and production goals. Risk soci powers but whose continuing contracts hinged
eties are fueled by the informed, private deter on production performance. The organization
mination of risks whose consequences are borne al symbiosis of ORO and corporate management
by the uninformed public. Power in risk societies extended to the community's private-care physi
is concentrated in the same institutions and cians through contracting arrangements.
organizations that reap the greatest rewards Physicians hired by a corporation whose board
from the system: risk authorities retain the power of directors includes ORO and corporate man
to define risks, direct production technologies, agement authorities may find their contracts
control the dissemination of both scientific unlikely to be renewed if, like Reid, they legit
knowledge and personal data, and perpetuate? imate workers' health concerns with their expert
even accelerate?the risk society. The implica interpretations. As Kinsella and Mullen (2007)
tions of the risk society for less powerful social found, the need for expert knowledge shored up
actors appear bleak. The public is involuntari ragged corners on the foundation of secrecy by
ly exposed to singularly hazardous substances which institutional and organizational authori
ties maintained discursive containment.
about which they are deliberately kept igno
rant. When inevitable illness claims point to Without etiological uncertainty, authorities'
the cause as the very wellsprings of the risk basis for contesting illness claims had to shift?
and it did. The new basis arose from three fac
society's wealth, their claims are forcefully
rejected. Workers are on the front lines of this tors: motivation, strategy, and tactical base. The
relatively powerless, exposed, and uninformed risk society literature indicates that the institu
public. They are the risk society's canary in the tional and organizational motivation for con
coal mine. testing claims of illness linked with exposures
Our case study has centered on contested ill to risky production technologies is to ensure
ness claims by workers at the Oak Ridge the persistence of the risk society's engine of
Nuclear Reservation, where (1) weapons pro wealth. Within that overarching motivation, we

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 RISK SOCIETY AND CONTESTED ILLNESS 397

found slight variations. Both DOE and ORO responsible for the symptoms. Within these
authorities favored the continued use of risky parameters, authorities drew on professional
technologies because of concerns about nation expertise to generate alternative explanations for
al security and commitment to the ideology of the symptoms. This created an ambiguous
nuclearism. Secrecy carried the additional ben atmosphere for discourse, which enabled them
efit of avoiding public charges of agency recre to promote the interpretation of illness as an
ancy (Freudenburg 1993) for failing to protect individual problem.
the public from harmful exposures. Corporate The DOE's enabling statutes endowed the
management authorities favored the use of the agency with prodigious resources for enforcing
technologies to maintain and increase profits. secrecy and restricting information to all but
Their promotion of secrecy not only fulfilled knowledgeable experts. Assigned oversight
contract responsibilities but also covered pro responsibility for the federal nuclear weapons
cedural violations that could have endangered production complex, the agency was directed to
their lucrative position in the military-industrial prioritize the protection of national security.
complex. Physicians favored the risky tech DOE authorities used the statutory powers
nologies in part to preserve professional hege intended for the protection of national security
mony and to protect the interests of co-elites. An
to withhold significant information from the
equally likely motivation, though, was to ensure public, including information about production
annual renewal of their contracts. As captive pro materials and hazardous exposures at weapons
fessionals, physicians were subject to organi
production facilities. The DOE's openness pol
zational pressures to contest workers' illness
icy simply reiterated the risk society's reliance
claims in conformity with group norms.
on scientific expertise, keeping technical infor
The institutional and organizational strategy
mation from citizens. With the DOE providing
for contesting illness claims was to promote an
the necessary resources, ORO engaged its del
interpretation of illness as an individual prob
egated powers locally to enforce secrecy and
lem, a private issue between patient and physi restrict information on the Reservation. In addi
cian rather than a social problem requiring a
tion, ORO maintained the local power of the
political solution. This strategy is most easily
purse strings. Oak Ridge is a company town,
mounted when the etiological uncertainty of
dependent on the government for employment
presumptive diseases is used as the tactical base
and for federal subsidization of city revenues.
for contesting illnesses: it creates an ambiguous
ORO transmitted norms of secrecy and infor
climate for discussion of the symptoms and
promotes a public discourse on multiple pro
mation hoarding to corporate management
fessional interpretations of symptoms. In the risk authorities. Corporate management's primary
resources were the control of information via
society, lay interpretations are dismissed as
unscientific and therefore without merit. claims of national security and the power to
Contesting authorities exploit ambiguity to pro hire and fire workers and allocate job tasks.
mote the interpretation of illness as an individ Authorities' nearly absolute power to control
ual problem. information denied ill workers the opportunity
to demonstrate the connections between their
Without etiological uncertainty, the tactical
basis for contesting Reservation workers' claims individual exposure histories and their symp
of known diseases revolved around institution toms. Discourse was routed to focus on non
al and organizational resources. Authorities technological causes of symptoms. Alternative
deployed resources to manufacture an ambigu explanations, such as questions of genetic inher
ous climate, setting the parameters for discourse itance, non-occupational exposures, careless
to shift the focus from scientifically established ness, and psychiatric diagnoses, created an
links between exposures and illnesses in general ambiguous atmosphere that was exploited by
to the exposure-illness link for a particular indi authorities to avoid accusations of negligence
vidual. Conceding the scientific finding of an and to blame the patient for the illness.
exposure-illness link, authorities argued that Furthermore, authorities' economic power kept
without evidence proving a particular individ workers from publicizing accidental exposures
ual was sufficiently exposed to a substance to and procedural violations?a breaching of secre
contract the illness, another agent could be cy norms that could have influenced public per

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 398 AMERICAN SOCIOLOGICAL REVIEW

ceptions and damaged institutional and organi place power dynamics, discursive containment
zational legitimacy. goes far beyond nuclear matters?it is a feature
Corporate management authorities, of the risk society in general, not to mention a
Reservation-employed physicians, and contract form of social control that violates democratic
physicians contested workers' illness claims principles.
using a combination of their own and federal Curtailing public discourse bars citizens from
resources. Corporate management used infor deciding whether a specific risk is acceptable.
mation control in tactical denials that an indi It excludes citizens from participation in
vidual had been exposed to a specific hazard, decision-making processes that impact their
and to refuse a worker's access to health records lives. It prevents the opportunity for an open
maintained by the corporation. They wielded democratic debate on the costs and benefits of
power in tactical reassignments of troublesome risky technologies. Risk society and democra
workers to unfavorable tasks. Illness claims cy, we believe, cannot coexist indefinitely.
could not be legitimated without accurate expo Cohen (1997) concurs, and envisions two pos
sure and health records, leaving the cause-effect sibilities for the future: democracy's demise or
question open and the discourse focused on democracy's revitalization. Democracy's demise
alternative causal factors. The threat of unfa would occur with increasing reliance on risky
vorable task reassignments kept workers from production technologies and the global spread
publicizing procedural violations related to haz of risk societies, causing continued detonation
ardous exposures and consequently barred such of toxic time-bombs. In this scenario, ever larg
information from public discourse. er segments of the population become ill, and
Reservation and contract physicians drew on authorities escalate social control tactics to deny
their resources of expert knowledge and scien illnesses related to risky production materials.
tific authority. Science applies "a standards set Increasingly harsh social control erodes indi
ting logic, with scientifically based risk analyses vidual rights and alienates citizens until "dem
which do not answer the new questions" (Mol ocratic governance slips away" (Cohen
and Spaargaren 1993:441), but which do sustain 1997:108). In the revitalization of democracy
a kind of scientific mystique. Reservation and scenario, in contrast, technical knowledge is
contract physicians tactically employed the man shared and interpreted. Public debate on issues
tle of expert knowledge to discredit peers who of significant social import is encouraged, gen
were sympathetic to workers' illness claims. erating "the possibility for the lay public to gain
They applied scientific authority in the dero control over its technology" (Cohen 1997:108).
gation of ill workers. Reservation physicians With access to accurate information and open
held the additional resource of their superior discourse to assess risks, citizens decide which
position in the work bureaucracy. From this risks they will not accept and can protect them
position, they could make the tactical decision selves from the risks they deem acceptable.
not to inform workers of the results of their WHiich scenario will prevail remains unclear.
medical tests, denying critical information to ill Events since the 9/11 terrorist acts, however,
workers. suggest increased discursive containment and a
Reservation authorities used their consider corresponding anti-democratic trajectory. The
able powers to hide the truth about hazardous establishment of a Department of Homeland
exposures, and they invoked the mystique of sci Security conjures eerie images of police states.
ence to hide the truth in plain sight. The con Increased federal grants for university
sequences were significant for exposed researchers studying security issues reinforce the
workers?life-threatening illnesses that might already symbiotic relationship between scien
have been avoided?but the consequences for tists and the state. Moreover, security measures
democratic society are even more profound. have been heightened and individual rights dilut
The exploitation of authority to cloak knowledge ed through passage of the Patriot Act and
of hazardous exposures with the robes of nation changes in the FOIA to restrict the disclosure
al security directly challenges democratic of information to the public. The legislative and
processes. Indeed, and despite the obvious con executive branches continue to dispute where to
tributions of our analyses to sociological draw the line between national security and the
scholarship on environment, illness, and work public's right to know, as seen in the controversy

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 RISK SOCIETY AND CONTESTED ILLNESS 399

over warrantless wiretapping of U.S. citizens. Journal of Health Politics, Policy and Law
16:595-604.
With so much at stake, sociological investiga
tions of contested illness claims, the power Brown, Phil and Judith Kirwan Kelley. 2000.
"Physicians' Knowledge, Attitudes, and Practice
dynamics that undergird them, and the com
Regarding Environmental Health Hazards." Pp.
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P. Brown, and V J. Gunter. New York: New York
Sherry Cable is Associate Professor of Sociology at
University Press.
the University ofTennessee-Knoxville. Her primary Brown, Phil, Steve Kroll-Smith, and Valerie J. Gunter.
research interests are in environmental conflict, envi
2000. "Knowledge, Citizens, and Organizations:
ronmental inequalities, and the linkages between An Overview of Environments, Diseases, and
neo-liberal economic imperatives and environmen Social Conflict." Pp. 9-28 in Illness and the
tal degradation. She is currently examining the struc Environment: A Reader in Contested Medicine,
tural causes and consequences of unsustainable edited by S. Kroll-Smith, P. Brown, and V. J.
national and transnational environmental policies Gunter. New York: New York University Press.
in the context of an increasingly integrated global and Brown, Phil and Edwin J. Mikkelsen. 1990 [1997].
neo-liberal economy.
No Safe Place: Toxic Waste, Leukemia, and
Thomas E. Shriver is Professor of Sociology at Community Action. Berkeley, CA: University of
Oklahoma State University. His primary research
California Press.
interests are health and environment, social move Brown, Phil, Stephen Zavestoski, Meadow Linder,
ments, political sociology, and inequality. He is par Sabrina McCormick, and Brian Mayer. 2003.
"Chemicals and Casualties: The Search for Causes
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Czech Republic. Brown, Phil, Stephen Zavestoski, Brian Mayer,
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Tamara L. Mix is Assistant Professor of Sociology "Policy Issues in Environmental Health Disputes."
at Oklahoma State University. Her primary research Annals of the American Academy of Political and
interests include environmental justice, inequality, Social Sciences 584:175-202.
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energy and environmental inequality issues in com Difference: Disputes Over Gulf War-Related
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