Chapter Title: Technical Error: Measures of Life and Risk

Chapter Title: Technical Error: Measures of Life and Risk
Book Title: Life Exposed
Book Subtitle: Biological Citizens after Chernobyl
Book Author(s): Adriana Petryna
Published by: Princeton University Press
Stable URL: https://www.jstor.org/stable/j.ctt1r2fhh.8
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Chapter 2
Technical Error: Measures of life and Risk
A Foreign Burden
Dmytro is a miner from the coa l-mining region of Donbas in Ukraine. I
met him at the Radiation Research Center where he came to “settle his
social matters.» Within ten days following the Chernobyl accident, he
was one of two thousand coal miners from his region mobilized to carry
out work at the disaster site. Dmytro said he underwent an occupational
health screening before his mobilization: ‘” knew I was healthy before
going there.” Dmytro lacked a specia l protective mask during his monthlong work, which involved digging tunnels under the reactor. Miners injected these tunnels with liquid nitrogen and other gases in attempts to
cool the reactor core. Dmytro received five times his average salary for
this work.
Since his work at Chernobyl, Dmytro has undergone annual hospital
examinations and monitoring at the Radiation Research Center. In August 1996, he was admitted to the center’s Division of Nervous Pathologies with cerebral, cardiac, and pulmonary disorders. Dmytro said he had
one daughter, born five years before the disaster. He decided not to have
any more children because he believed himself to be genetically damaged .
.. A hea lthy child cannot come from a sick father,” he reasoned. 1
His documents showed him to be categorized as a disabled person
(level three). This meant he was officially recognized as having lost 50
percent of his labor capacity. Before entering the center, Dmytro decided
to quit his job and secure full disability benefits from the state. He wanted
to qualify for higher disability status, a certification that he had lost 80
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percent or more of his work capacity. This move would have doubled his
pension and allowed him to pay for his medical treatments. Behind his
hospita l referrals, institutional rubber stamps, dose assessments, diagnoses, corrections to diagnoses, further diagnoses, and other papers conferring his Chernobyl identity was a person who perceived himself to have
lost the capacity to father, to work, and to live a normal life. Dmytro
complained of emotional stress and gastritis. Like many patients I met at
the center, he no longer identified himself as a worker of a state enterprise; he had come to see himself as a “prospective invalid.” This was an
interesting word choice since the related Russian words perspektillnyi I
neperspektillnyi were vintage statist terms for deciding the fates of financial investment in Soviet towns and villages. He was engaged in an everyday form of life science to increase his chances of becoming worthy of
investment. Dmytro knew the level of internal radiation he had received
on the basis of a count of aberrations in his chromosomes. He calculated
his lost work ca pacity and amassed diagnoses. He referred to the radiation in his body as a ” foreign burden” (chllzhe hore)-unnatural in origin
and creating a new locus where “there is no peace.” He was but one of
many left to assess, but without an exact numerical equivalent for, his
fo reign burden. His narrative also suggests that technical measures used
to define the biological effects of Chernobyl were malleable. They acquired different values over time depending on the contexts of their use.
What is the relationship between individual suffering caused by the
Chernobyl accident and the technical measures and scales of expertise
used to assess radiation-related biological injury? In this chapter, I trace
the work of international scientific networks in patterning initial Soviet
remediation strategies and public health responses. I explore key aspects
of the initial Soviet management of the Chernobyl disaster and show
how definitions of radiation-related injury were informed by an array of
international scientific and political interests, and ela borated through a
parricular set of technical strategies. Accounts of injury were limited to
biomedical measures derived from a group of acute accident victims in
the first few weeks following the disaster. Such activities limited Soviet
government liability for the many populations that were not screened or
that were possibly made vulnerable to radiation-related injuries in the
future.
Such interventions illustrate the ways experiences of illness are engendered and understood within the technical and political domains where
they come to be addressed. With the collapse of authoritarian power, they
clearly opened the way to a new form of politics based on the (unaccounted-for) scope of biological injury in the future. Adding further perspective on how this politics could take shape, we must also recognize
that among radiation research scientists working in U.S. laboratories,
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there is considerable disagreement as to suitable parameters for interpreting radiation-induced biological risk in human populations. There is also
disagreement among them as to how various experimental data may be
unified in terms of a systematic theoretical approach (Chatterjee and Holley 1994:222). This lack of consensus at the basic science level deals a
blow to the confidence that inspires expert claims to knowledge in the
field. Ambiguities related to the interpretation of radiation-related physical damage subjected post-Chernobyl state interventions and medical surveillance to a variety of competing scientific and political interests. Scientists and government leaders garnered resources on the basis of those ambiguities to make claims for their own legitimacy and to push their scientific research and political agendas forward.
Saturated Grid
Scientist and Soviet political observer Zhores Medvedev has authoritatively detailed emergency measures taken after the Chernobyl accident,
with particular emphasis on the first ten days, when officials were acting
under the protection of a news blackout (1990:41 ).2 In the following paragraphs, I want to convey something of the technical responses that ensued to assess a radioactive Chernobyl plume. The work of estimating its
fallout was based upon approximations and semiempirical models. In
retrospectively surveying this technical work and its inherent problems,
we arrive at a finer map of a domain of anthropologica l inquiry. I approach this surveying work as a multi locale investigation of transnational, state, and local forces and actions that to some extent framed what
we currently know and do not know about the human toll of the Chernobyl aftermath.
I turn first to the question of the size of the plume and how best to
image it. Tom Sullivan is (he forme r director of the Atmospheric Release
Advisory Capability (ARAC) at Lawrence Livermore National Laboratory (LLNL) in Livermore, Ca lifornia. Sullivan’s team worked with the
U.S. Nuclear Regulatory Commission to assess the severity of the disaster. When I interviewed his research team in 1997, members were still
refining estimates of the height of the Chernobyl explosion’s plume.
Prior to Chernobyl, the ARAC researchers compiled meteorological
data, satellite photos, wind pafterns, and atmospheric activity data to
model sizes and movements of nuclear plumes associated with aboveground American and Chinese nuclear weapons tests and the Three Mile
Island accident. They developed computer codes calculating concentrations of contaminated material at a certain location; they tracked contaminated plumes for a distance and, based on certain meteorologica l condi36
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tions, estimated concentrations of radioactive contamination at any point
in time along a trajectory.
The historical context of the Cold War prevented ARAC from modeling the movements of the Chernobyl plume in real time. Limitations on
the sharing of sensitive data between Western and Soviet regimes made it
difficult for U.S. scientists to locate the plume in Soviet air space. “The
problem was there were no weather charts for that part of the world.”)
Additionally, the source of the plume was difficult to locate, since maps of
Soviet nuclear installations were kept secret.
Sullivan’s team relied on meteorological data showing the arrival of
the plume in Sweden and used Swedish measurements to “invert the
mathematics of the calculation. Given the concentration in Sweden …
we estimated on the order of 2 megacuries of iodine and cesium were
being released.” Their mathematically generated trajectory showed the
source of the plume to be “at or near the Baltics.”4
After intense international pressure, the Soviets admitted that a catastrophic meltdown had occurred at Chernobyl. ARAC’s computers were
coded to map plumes within a limited spatial range. Once the team had
refined their trajectory and located the source of the Chernobyl plume in
northern Ukraine, Sullivan told me, his computer programs “weren’t
ready” for what they had found:
We typically operated within a two-hundred-by-two-hundred-kilometer area. This area had been sufficient to model prior releases such as
the one at Three Mile Island and American and Chinese nuclear weapons tests. Our first calculations were on a two-hundred-kilometersquare grid. We did the imaging near the Chernobyl plant, but the grid
was so saturated, I mean, you couldn’t even make sense of it because
every place had these enormously high va lues-they filled the whole
grid, in every direction . … Our codes were not prepared for an event
of this magnitude.
Sullivan’s team fo und something “far worse” than a meltdown. A runaway chain reaction of uranium-235 contributed to a powerful explosion, capable of rupturing any modern form of structural containment.
“We knew there had been a core meltdown after Swedish scientists sampled the plume. They found mono-elemental particles of pure ruthenium,
indicating that a meltdown of the reactor core had occurred.”5
Sullivan’s team conducted real-time atmospheric modeling of hazardous airborne materials. Computer codes were designed to do this modeling within a limited space. Assessment of the situation required a technical upgrade, which the Nuclear Regulatory Commission was ready ro
support. The team had initially tried to adjust the system to account for
a larger territory “to get us into Scandinavia and Western Europe.” In the
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second week following the explosion, there were reports that the radioactive plume had reached Japan. The team decided that they needed a hemispheric model. 6 According to Sullivan, “that was another step in changing the whole system and implementing new capabilities.” New technologies allowed them to “drive [their] transport models and model the entire
plume as it moved around the Northern Hemisphere.,,7
• • •
The Soviets rejected Western offers to help assess the meteorological situation. (Tom Sullivan offered his team’s assistance through a Swedish intermediary, but his offer was refused.) Within the Soviet Union, a special
military radiological service was charged with the task of monitoring radiation levels around the plant. 8 No information was released (Medvedev
1990:46). The service finally presented crude data, indicating the distribution of the plume within the Soviet Union, in its August 1986 report to
the International Atomic Energy Agency (IAEA). In that report, the Soviet
State Committee on the Utilization of Atomic Energy made a seemingly
definite statement:
None of the populations received high doses that would have resulted
in acute radiation syndrome …. On the basis of an ana lysis of the
radioactive contamination of the environment in the Zone, assessments
were made of the actual and future radiation doses received by the
populations of towns, villages, and other inhabited places. As a result
of these and other measures, it proved possible to keep exposures
within the established limits. (USSR State Committee on the Utilization
of Atomic Energy 1986:38)
As Medvedev reported, radiation on the ground “was well in excess of
the scales on the available dosimetric equipment” (1990:45). He also
noted that “in some spots . .. it killed four hundred hectares of pine forest
within a matter of days” (103). Skeptical of Soviet claims that no genetic
effects from Chernobyl could ever occur, Medvedev wrote, “Pine trees
may be more sensitive to radiation than oak trees, but they are much
more resistant than rodents and vertebrates in general” (ibid.).
Buttressed by crude maps, the Soviet truth (as presented to the IAEA)
prevailed above and beyond observable evidence and realities of the
plume; that truth authorized a domain of government activity and limited
intervention. Facts that did not suppOrt this domain were either disregarded or eliminated. For example, a follow-up report from the SovietAmerican bioscientific collaboration (which I will discuss shortly) stated
that “external measurements were unavailable at the time of the accident;
they were either not designed fo r these levels of radiation or were de38
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stroyed or lost as a consequence of circumstances associated with this
accident” (Baranov et al. 1989:205). ~
My interview with Sullivan’s ARAC team, together with the informarion derailed above, underscores the constructed nature of the unknown in
this setting. A catastrophe whose scale was unimaginable, difficult to map,
and “saturating” became manageable through a particular dynamic: nonknowledge became crucial to the deployment of authoritative knowledge,
especially as it applied to the management of exposed populations.
Institute of Biophysics, Moscow
Information about the radioactive explosion and fire was transmitted to
the Soviet Ministry of Health in Moscow. Angelina Guskova, chief radiologist of Clinic No.6 of the Institute of Biophysics, was contacted one hour
after the initial explosion, “on my phone at home, I was in my bed,” she
told me in 1996. Guskova and her colleague, Aleksandr Baranov, were
charged with organizing emergency aid measures, providing biomedical
care, treatment, and monitoring for the first victims of the disaster.
Guskova was trained as a hematologist and neurologist; both skills
would serve her well in this situation. She has been a member of UNSCEAR (UN Scientific Committee on the Effects of A[Qmic Radiation)
since 1967, and she worked under Professor 1. A. Iiyin, chairman of the
Soviet Radiological Protection Board and director of the Institute of Biophysics in Moscow. Since the mid-1950s, Guskova and her colleagues
had been engaged in the clinical study of radiation effects in humans.
Prior to working at Clinic No.6, she headed the Neurological Division of
Medical Services of the Mayak nuclear plant, a munitions industry complex producing plutonium in the once closed city of Cheliabinsk, the capital of the southern Ural region. This area had been wrecked by two nuclear disasters, both of which were covered up by the Soviet government.
The first one lasted a decade, when, beginning in 1951, the Mayak plant
began dumping waste from nuclear bomb production into a small lake. 10
In 1957, a failure in the nuclear waste cooling system at the nearby
Kyshrym plant released at least seventy tons of waste containing about
twenry million curies of radioactivity-roughly one-fourth the amount
released in the Chernobyl accident.
Guskova oversaw research involving two hundred individuals who became part of her official Acute Radiation Sickness (ARS) cohort.
Until Chernobyl, this group was considered to be the largest cohort of
ARS patients in the world. I I Her clinical experience was multifaceted,
reflecting the variety of radiation-related injuries these workers experienced, from direct contact with ionizing sources to inhalation and whole39
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body exposure. She developed surgica l procedures for removing radiation-induced lesions and scars. She established medical classifications and
methods for clinical observation of occupational radiation-related diseases. She developed the protocols for clinical monitoring and legal-medical evaluation. In short, Guskova “formulated radiobiological questions
which could only be answered by the clinica l observation [of manJ”
(1997:604).1 2
Guskova also formulated what she referred to as a “semi-empirical
model” fo r estimating dose exposures in cases where doses were not
known. This model was based on an examination of patients’ external
symptoms and linked the time of symptom appearance to an estimation
of dose. Based on this model, she organized treatments and projected
patients’ recovery or death.1l Acute radiation sickness occurs at dose
ranges between 200 and 400 rem. At 400 rem, bone marrow failure sets
in. Up to approximately 1,000 rem, there is a chance fo r survival with
intensive treatment.
ARS consists of a series of clinical events (“syndromes”). These syndromes include the central nervous system syndrome, characterized by an
onset of apathy, lethargy, seizures, ataxia, and prostration, appearing immediately after exposure. The gastrointestinal syndrome is characterized
by anorexia, nausea, vomiting, fever, and severe systemic infections.
These symptoms manifest within a few days to a few weeks after exposure. The hematopoietic or bone marrow syndrome is characterized by an
absolute fall of the patient’s peripheral lymphocyte and granulocyte
count and by an increase in leukocyte counts. Changes in these blood
indicators can occur within the first few hours of exposure; they can keep
fluctuating over severa l months, and, some say, over an individual’s lifetime.
Guskova went to meet the first planeload of possible ARS patients airlifted from the Chernobyl accident site and flown to Moscow on April 27,
1986. Initially, over four hundred people were taken from the disaster site
to Clinic No.6. This group consisted mainly of firemen who had extinguished fires in areas around the burning reactor core. Patients described
this flame to me as a long green-blue radioactive phosphorescing column.
In our interview, Guskova blamed the Soviet radiological service fo r failing at the outset to provide enough dose-related information fo r her to
make an appropriate assessment of patients’ doses. “We had patients expressing symptoms that were the same as symptoms of ARS, but we did
not know the radiation situation.” She relied on semiempirical models to
assess patients’ doses. The individuals selected exhibited symptoms of the
central nervous system and gastrointestinal syndromes, including fevers,
vomiting, and nausea. Changes in the blood composition of these patients
were recorded within three days of exposure.14
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Guskova’s high-dose human know-how, for lack of a better phrase,
was a unique achievement of Soviet radiation science. Chernobyl’s scale
and lethality posed challenges that Guskova and her colleagues had not
confronted before. Guskova told me that these patients received much
higher doses than those she had observed in previous accidents. In one
scientific article, she referred to these doses as “overlethal” (1997). An
intense graphite fire in the reactor’s graphite-moderated core resulted in
combined injuries (burns with symptoms of ARS), making categorization
of the victims difficult and “complicat[ingJ the nature and effectiveness of
interventions” (Baranov et at. 1989:205). IS The majority of deaths in the
first three months after exposure were attributed to skin lesions (burns)
that involved 50 percent of the body’s total skin surface (Wagemaker et
01. 1996,29).
5oviet–American Cooperation
In their 1971 monograph, Radiation Sickness in Man, Guskova and her
collaborator 8aysogolov conceptualized the organization of medical services for victims of large-scale nuclear catastrophes. They wrote that a
“large number of victims introduces a number of forced corrections and
apparently somewhat changes therapeutic arrangements.” They considered the introduction of a triage mechanism essential because “detailed
investigation is extremely limited in these cases.” They also recommended
“using more tranquilizers than is warranted under normal circumstances,
considering the mass nature of the injuries and seriousness of the psycho·
logical situation” (245).
Guskova relied on a higher threshold dose to facilitate sorting patients
at the Chernobyl plant in days following its explosion. A threshold dose
is me dose limit above which radiation exposure would likely produce
long·term biological effects. Symptoms of ARS begin to manifest themselves at 200 rem. Guskova set the dose at which patient recruitment
would begin at roughly 250 rem. The use of a threshold generated an
on-site social dynamic. For example, because preclinical examinations
were limited, some of the initial selections were faulty. Indeed, during
fieldwork in the Radiation Research Center, I met one man who had panicked over having to work at the disaster site. He self-induced vomiting
and nausea and was among those airlifted to Clinic No.6. Later he was
released and never returned to the Zone. 16
Such were the semiempirical models at work at the disaster site.
Through their implementation, Guskova enacted a procedure, a set of
“dividing practices” (Foucault 1984). She limited the group of victims
who would be subject to early active therapy and delayed medical
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CHAPTER 2
FIGURE 2. Volume of concentrations of cesium-137 in the air at different moments
in time aher the Chernoby\ accident (month, day, hour) according to an atmospheric transfer model. The increase in isopleth number indicates a tenfold increase of concentration (World Health Organization 1996)
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TlCHNICAL … 0.
evaluation and therapies fo r workers who were potentially injured at
doses below 250 rem. I met a person who estimated her dose to be 220
rem, 30 rem shy of the threshold, but who was excluded from the ARS
cohort and therefore required to continue working at the disaster site .
• • •
Thousands of people like Dmytro were either voluntarily or involuntarily
mobilized to work at the site under perilous circumstances. Administrators simultaneously withheld meteorological information and set occupational standards of radiological exposure artificially high. They also introduced a psychological technique in the effort to control perceptions of
risk and interpretations of symptoms fo r anyone living “beneath” this
threshold–evacuees, workers, and inhabitants of unmarked contaminated tertitories.
Declassified documents illustrate how this technique was introduced. 17
In late May 1986 and at the height of East-West bioscientific collaboration, leaders in the Soviet Health Ministry issued an order to Anatolii
Romanenko, then Ukrainian health minister, who had not achieved full
control over the activities of local medical personnel. Romanenko was
ordered to make sure that Ukrainian republican scientific and clinical administrators used a medical diagnosis, “vegetovascular dystonia” (VvD),
to filter out the majority of radiation-related medical claims. This condition is akin to panic disorder in the West, but its etiology is different. It
was introduced into Soviet medical classification in the 1960s to account
for environmental factors, including “mental fac tors, pollution, stress, or
atmospheric factors,” in the initiation of disease. 18 The external symptoms of VvD include anything from heart palpitations, sweating and
tremors, nausea, and hyperrension to hypotension and neurosis-like disorders, spasms, and seizures. VvD resembles the central nervous system
syndrome of ARS, hut its cause differs: one is radiation-induced, the other
is “environmentally” induced. Romanenko’s directive to Ukrainian medical personnel read as follows:
This directive concerns diagnosing early symptoms of exposed persons
who are in clinics and who do not show signs of ARS. Indicate the
diagnosis of “vegetovascular dystonia” in the patient’s medical record.
Also indicate “vegetovascular dystonia” in the medical records of
workers who are entering clinics for monitoring and who have received
the maximum allowable dose. (Emphasis added)1 ‘1
Six months after the Soviet Health Ministry issued this decree, the
Ukrainian health minister confidently reported that his medical cadres
had successfully fulfilled the command to enter the VvD diagnosis in the
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medical records of the exposed. He also stated, ” In the period following
the disaster, 17,500 people have been hospitalized with various illnesses.
Following the directive of the Soviet Ministry of Health, all persons from
the Zone who are being hospitalized and who lack signs of immediate
acute injuries have received the diagnosis of vegetovascular dystonia [emphasis added]. “20
This official intervention reinforced a dynamic we have already seen at
work with respect to Soviet radiological monitoring. Nonknowledge became crucial to the deployment of authoritative bioscientific knowledge.
Technical laxity fit well with this process, as well as with the way the
Soviet administrators attempted to adapt a general population to the
postaccident situation (this process will be assessed in terms of its impact
on individual lives in chapter 5).21 A Union-wide clinic and research center was established in Kyiv in 1986 to monitor 600,000 children and
adults. Romanenko became its acting director and held this position until
2000.
• • •
I turn now to the initial focus of Soviet bioscientific concerns and interventions and their politica l outcomes. Within two weeks of the disaster’s
onset, unprecedented Soviet-American bioscientific cooperation began.
This endeavor, an example of high-profile “techno-diplomacy” at the end
of the Cold War (Schweitzer 1989), became focused on a limited group of
237 acute accident victims. Their extreme injuries became the measure by
which the scope of populationwide injury was defined, justifying immediate remedial actions. International experts used the accident context as a
scientific “ready-made,” evaluating preparedness for future accidents and
accelerating bioscientific research.
This techno-diplomacy was initiated by Dr. Robert Gale, under the
auspices of Armand Hammer. Gale was a leukemia specialist at the
School of Medicine of the University of Ca lifornia at Los Angeles, who
offered to conduct bone marrow transplants on workers who were irradiated in lethal doses and to treat less severe cases experimentally.22
Significantly, Gale’s fi ve-member team had little background in radiation medicine, radiobiology, or accident management. Richard Champlin
was a bone marrow transplant specialist and a specialist in the treatment
of leukemia. Paul Terasaki was a kidney transplant specialist involved in
researching problems of donor-recipient matching. M. Ray Mickey was
a leukemia specialist involved in problems of genetic (HLA) matching.
Yair Reisner was a bone marrow transplant specialist researching hematopoietic reconstitution using stem cells and developing methods of ob44
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taining high yields of bone marrow cells from murine models. All were
part of a growing international network of transplant specialists, and
some were affiliated with the International Bone Marrow Transplant
Registry. Angelina Guskova’s team consisted of twelve members, medical
workers, leukemia and radiological specialists of Clinic No.6.
Gale considered his cooperative biotechnological gesture a breakthrough in Soviet-American political relations. He felt that both parties
stood to benefit: “I had a series of clicks in my mind, which was that, you
know, this is exactly what we do every day. These guys don’t have the
resources to deal with it, and we do.” He used the media attention on the
Chernobyl affair to get the Soviets to agree to let his team in. “No one was
going to believe what Gorbachev had to say about Chernobyl. I convinced them of that [in my negotiations} …. They had no credibility.”
Gorbachev personally invited the American specialists to conduct experimental bone marrow transplants, hoping to improve the image of Soviet
remedial actions in the international media .23 American biotechnological
assistance was the only form of humanitarian help the Soviets agreed to
accept in the initial crisis period.
Thirteen patients, with estimated doses ranging from 440 to 1,340
rem, were slated for high-profile bone marrow transplants. All had a high
risk of dying from bone marrow failure. But there were risks inherent in
the transplant procedures themselves. Immunities must be adequately
suppressed for transplants to engraft. In clinical settings, adequate suppression is achieved under conditions where the administration of dose is
controlled. It was particularly important for clinical examinations and
dose assessments to be accurate in uncontrolled circumstances and where
the radiological situation was not known. Dose miscalculations lead to
misrepresentations of levels of immunosuppression. Inadequate immunosuppression leads to transplant rejection and to a host of unanticipated
secondary diseases.
Questions of risk aside, both sides did indeed have much to ga in from
this short-term therapeutic collaboration. Ga le’s team and their major
financial backer, Sandoz Corporation, got a jump start on the emerging
biotechnological market in growth factor molecules that I will discuss
shorrly.H Guskova told me, “Contact with Gale upgraded our hematological department not in the problem of radiation, but in the problem of
hematological disease and in the treatment of leukemia. We had contact
with Dr. Hammer and needed the American specialists for treatment,
equipment, diagnostics.”
Yet the American team, unlike the Soviet team, was uninterested in
long-term assessments of the health impact of Chernobyl. During our
1996 interview, Ga le told me that his interests were short-term, and that
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the accidental situation offered his team a ready opportunity: “The Chernobyl accident for the firemen at the power plant was exactly what we do
at the clinic every day. Potentiall y, there were patients with [leukemic)
cancer exposed to acute whole body irradiation.”
Gale told me that the way Guskova selected patients at the accident
site was, in part, arbitrary. This arbitrariness generated a group of over
four hundred patients. He sa id that his initial impulse was to help
“what was not a clear number of acute radiation victims …. Actually,
we brought genetically engineered molecules in here that had never
been given to humans before, one of these cloned hematopoietic growth
factors [rhGM_CSF).ls We were working with it for about two years,
for Sandoz actually.” The bone marrow transplants were a venue for
testing of a new product. The genetica lly engineered molecule was believed to be useful for treating bone marrow failure by accelerating the
recovery of stem cells and other blood products. “We used hematopoietic growth factors subsequently in an accident in Brazil. The point, another idea I had at the time, was that it wasn’t just useful for transplanting. We could use these growth factors for a whole bunch of things. ”
Ethica l standards in the United States allow fo r untried experimental
treatments if a patient’s life expectancy is minimal. That there was some
uncerta inty regarding the acute radiation sickness sta tus of patients at
the disaster site does raise questions about the ethics of research in this
instance.l6
In the United States, the in vitro activity of GM-CSF had been investigated intensivelyP Little was known, however, about the activity of this
protein molecule in vivo. Anima l research had gone from murine to primate model testing. In monkeys lethally irradiated (900 rem), GM-CSF
had been shown to promore bone marrow recovery by initiating stem cell
growth. The product had nOt yet been tested on humans because of federal laws banning human experimentation (in this case, subjecting humans to lethal radiation doses). The American team ran GM-CSF trials
on patients to see whether the molecule could stimulate recovery where
recovery would orherwise be improbable.
When I asked Gale whether he felt that the product was successful , he
said:
It’s very hard to say. Alii ca n say is that we had about 499 people in the
hospita l, 29 died. So we were either incredi bly sk illful or incredibly
lucky. I would favor incredibly lucky …. And most of the deaths we
did have were not from bone marrow failure, which was the th ing we
were trying to treat. The deaths were mostly from burns or orher injuries, not related to radiation. The same guy who was in the middle of
the fire was the guy who got irradiated and who had steam fall over his
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head. People don’t understand that really, you can save them from one
thing, only to die of another, and these things are tending to occur in
the same people.
From his point of view, causes of death associated with the disaster except
bone marrow failure became scientifically insignificant.
The Soviet-American team published the results of the transplants in
the Journal of American Medical Association. Out of the thirteen transplant recipients, five died of burns, three of interstitial pneumonitis, two
of graft-versus-host disease, and one of renal failure and respiratory distress. Two survived. The Soviet team later criticized Gale’s drive to conduct bone marrow transplants. The team published in Hemato/ogiia I
Transfuzi%giia, without including the American participants’ names in
the list of contributors. The American team had introduced biological
dosimetry using biological markers (such as chromosome aberrations of
peripheral blood lymphocytes) rather than Guskova’s symptom-based
markers of estimating dose exposure. The Soviets reported that out of the
thirteen, at least two who underwent bone marrow transplants died as a
result of the inaccuracy “inherent in estimating doses by the use of biological parameters.” Guskova told me that Gale was a “good hematologist
but he projects knowing more than he does.” The article criticized technological quick fixes and reaffirmed the value of the Soviet clinical model
based on long-term observation and treatment of syndromes.
The success or failure of GM-CSF was never commented on directly in
subsequent scientific articles. Soviet administrators, as documents show,
were worried about sensationalism stemming from this human research
(Chornobyl’ska Tragediia 1996:214). Judging from the lack of follow-up
studies, the whole matter was dropped. But the authority of these initial
interventions remained uncontested. A joint meeting in August 1986 between Soviet scientists and members of the International Atomic Energy
Agency confirmed the scope of injury as being limited to the 237 cases of
ARS. Thirteen patients received bone marrow transplants. Eleven died. In
the next months, seventeen more ARS patients died. Two others were
reported to have died from injuries unrelated to radiation exposure. By
September, the death toll was thirty-one. The joint medical team, in its
1986 report to the IAEA, did not try to minimize the consequences of the
accident. By 1987, neither Gale nor Guskova and colleagues commented
on the possibly greater general health impact of the accident (Medvedev
1990,165).
In her clinic today, Guskova treats “mainly local skin burns.” She also
screens claims of radiation illnesses by all nuclear workers throughout
Russia. Guskova told me that she was a strong advocate of rehabilitation,
and that typically her patients “recovered within two years only if
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patients help in the process.” She expected patients to “react and work. ”
She made a distinction between the workers she immediately registered as
sick and the subsequent six hundred thousand workers sent into the
Zone. Her original patients could recover. Her new patients “are psychological. ” She blames these patients fo r impeding physicians’ efforts in the
recovery process. “The new patients don’t wish to recover.” For her, the
real cause of their illness is not radiation but the loss of a work ethic and
of lichnost’-a Russian word denoting a virtuous personality and often
associated with a desire to wock. She connected the illnesses of these new
patients with a “struggle for power and material resources related to the
disaster” (1995:23) and downplayed their symptoms as nonradiogenic.
She summarized their medical particularities by stating that “there have
been no new cases of ARS; but social, psychological, economic problems
facilitate psychosomatic realizations that result in light changes in cardiovascular regulation and psychosomatic and neurotic realizations.” In
Guskova’s Soviet model of health, such “realizations” become the readable equivalent of social vice and individual weakness; the desire to work
and the possession of /ichnost’ counteract any individual tendencies toward physiological vulnerability.
For his part, Ga le went further in annulling the medical signifi cance of
the event. During our 1996 interview he noted that with the exception of
those initial ARS patients he attempted to treat, from a medical point of
view, “Basically nothing happened here. Nothing happened here … and
nothing is going to happen here.”
• • •
In completing their containment mission, international experts and Soviet
administrators had internationalized the problem of radiation protection.
In genetalizing, they redefined the problem in abstract terms, removing it
from the human horror of the immediate context. Only the experts, they
claimed, could make objective sense of the situation by constructing parameters of biological risk and safety, assessing levels of individual and
population wide exposure, and, by extension, arbitrating emergent claims
of illness. In the process of this internationalization, an internalization
process ensued: the narrative of the human effects and the number of
workers it took to contain environmental contamination at the accident
site was relegated to the domestic sphere of Soviet state control.
The first half of this chapter traced the trajectory of ChernobyJ’s ill
wind, showing how perception of that wind was reconfigured through a
series of informational omissions, technical choices, semiempirical models, approximations, dividing practices, and interventions. Combined,
these official practices, with international scientific assistance, produced
a picture of a circumscribed biological reality. The biological effects of
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FIGURE 3. Map of 30-km Exclusion Zone, showing levels of cesium-137 contamination as measured in 1988 (adapted from Medvedev 1990)
Chernobyl became inseparable from the political interventions that contained them.
Safe Living Politics
The Soviet period continued to be marked by controversy over the level
at which the radiation threshold dose should be set. By March 1989, the
first maps of the spread of contamination were published, and a “Safe
Living Concept” was outlined for persons residing in contaminated zones
beyond the Exclusion Zone in Belarus, Ukraine, and Russia. Under the
concept, the threshold dose for populations was set at 35 rem over an
average seventy-year life expectancy. Persons living in areas exceeding
this lifetime threshold dose were eJigible to receive health and housing
benefits elsewhere. Throughout the Soviet period, an image of containment was partially achieved through selective resettlements and territorial delineations of contaminated zones.
The Ukrainian state inherited a technically unresolved and socially volatile Chernobyl aftermath. By 1991, it had declared independence from
the former Soviet Union and took on responsibility for the maintenance
of the damaged reactor and for ongoing containment strategies. The beginning of the Ukrainian administration of Chernobyl was characterized
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by a dramatic lowering of the lifctime threshold dose. The Ukrainian
version of the Safe Living Concept was pa rt of a fi rst set of laws
formu lated by the new independent Parliament. “We agreed that over
seventy years, a person’s dose could not exceed 0. 1 rem per year. ,, 28 The
Ukrainians claimed their own expertise and introduced a new sta ndard
for biological safety.
These claims and new standards became part of a politics of national
autonomy. Their social effects will be considered in more detail in subsequent chapters. In sum, Soviet interventions sought to provide technical
solutions to the problem of politica l disorder. A relatively high threshold
dose regulated levels of state intervention and liability and limited the size
of populations considered to be at risk. Below this threshold, clinically
observable effects were deemed insignificant. In such a technica l universe,
key ethical questions about the health effects of Chernobyl were evaded.
Those questions concern the uncerta inties around the fate of the clean up
workers-the so-ca lled bio-robots-who were not airlifted to Moscow
and continued to work in the Zone. They also concern the significance of
health effects among people who lived in contaminated areas and were
resettled, or who continue to live in contaminated areas.
In the remainder of this chapter, I continue to elucidate the val ues that
are both implicit and explicit in technica l responses to Chernobyl, this
time by turning attention to the mainly American experts who took pa rt
in subsequent assessments of the toll of the aftermath. In the post-Chernobyl context and in meetings with Soviet colleagues, radiation safety
experts affiliated with the Internationa l Atomic Energy Agency made as·
sessments of the health effects of Chernobyl-rclated radiation exposure,
which, among other things, tended to undercut the veracity of local scientific claims of radiation-induced damage. My concern here is not to reiter·
ate the story of their complicity with Soviet attempts to downplay the
sca le of the disaster but to reexamine the basis of expert authority more
generally. Experts promoted their authority, in part, on the basis of their
allegedly firm grasp of wha t constituted proper evidence of Chernobylrelated damage. One goa l of their mission was to instruct their Soviet
counterparts on how to evaluate the kind of damage that was considered
relevant to expert assessment; it was to turn their disaster-fatigued Soviet
counterparts into “valid witnesses” of the disaster’s human toll, and to
make the witnessing of the un initiated marginal and inva lid (Shapin and
Schaffer 1985). I counterpose this expertise with the ways other valid
witnesses- namely, basic scientists working in U.S. radiation laboratories, who are less invested in the a rts of Chernobyl truth making-thin k
about the human hea lth effeers of radiation induerion. In this light, I look
at scientific constructions of biological risk and sa fety and situate them in
the context of their laboratory production and testing. In the process, we
learn about the extent to which ways of monitoring radiation’s health
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effects are contested at the level of basic science research, and how dependent such research is on the political and economic arenas in which
knowledge of radiation risk and safety is brokered.
• • •
The journal Nature published an editorial on the tenth anniversary of
Chernobyl urging politicians to make funds available for further studies
of the unique scientifi c and medical experimem afforded by that nuclear
accident (“Chernobyl’s Legacy” 1996:653). Chernobyl’s “legacy to science” is knowledge of the impact of radiation on living organisms, and
this, according to the editor, should not be lost. Some of the immediate
lessons learned, the editorial notes, include the knowledge that bone marrow transplantations for patients with acute radiation sickness are relatively ineffective; that previous calculations of the impact of likely dose
exposures were correct (this claim is questionable); and that taking measures to prevent thyroid cancers resulting from radioactive iodine exposure can be effective. Moreover, an alleged absence, to date, of documented cases of leukemia among exposed groups is also consistent with
predicted dose-response relationships based on relatively low exposure to
cesium in the ground. The editoria l calls for continued research on the
Chernobyl accident aimed at achieving greater refinement in approaches
to nuclear risk management (especially with regard to the massive effort
to clean up nuclear facilities in the United States). Supporting arguments
are framed in the language of a cost-benefit analysis.
[The extent of the effort] depends critica lly on the social acceptability
of radiation levels that will be left after the clean-up has been completed. If there is a threshold Idose] below which radiation has no
long-term biological effect, will much be gained by achieving complete
elimination? Conversely, if no threshold [dose) exists, can the cost of
eliminating radiation risks entirely be justified by the likely medical
benefits if these are, ultimately, insignificantly small? (653)
Such statements elucidate the capitalist social contexts and values that are
implicit and explicit in data-production with respect to radiation-contaminated sites. More broadly, they illustrate how interrelated spheres of
scientific, social, and economic prod uction are in the area of radiation
safety. In later chapters, we will see in Ukraine how the radiation sciences
and sa fety issues (as applied to Chernobyl) are embedded in particular
forms of institutional and individual politics of nationhood, market economic policies, and the welfare struggles of post-Soviet citizens. In the
United States (as exemplified by the editorial in Nature), the aims of such
sciences are similarly multipurpose. They are to refine knowledge about
the impact of radiation on living organisms, offet methods for evaluating
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epidemiological intervention, and, most important, to develop an empiri·
cal database fo r rationalizing the cost-effectiveness and potential medical
benefits of cleanup efforts-for all of which, incidentally, Chernobyl is
named a “living laboratory. “29
Within radiobiologica l laboratories, the impact of radiation induction
on experimental animals or human cells is described in terms of a biological event. Indicators of biological events, or “biomonitors” (for example,
dosage, type of damage, repair, fixation, cell cycle status, differentiation
status, microenvironment, hormona l status, and the age of the organism),
help identify stages of a carcinogenetic process in experimental animals
and inform an etiology of occupationally induced cancers in humans.
These indicators are part of the technical means for monitoring exposed
populations. However, values internal to the strategies and goals of scientific institutions often drive the selection of the biological sites considered
(for example, a cleft palate versus a genetic mutation on chromosome 2).
The particular “site” chosen influenc_es the interpretation of the medical
consequences of a radiation exposure event; this interpretation, in turn,
may serve as a measure for what counts as normal life and a normal life
expectancy in populations identified as being at risk.
In the paragraphs that follow, I describe how the issue of biomonitoring for populations was introduced and exchanged between Western
(mainly American) and Soviet-bloc scientists in the context of the International Chernobyl Project (1991).30
In October 1989, three years after the accident, the Soviet government
requested assistance from the International AtOmic Energy Agency (IAEA)
to coordinate an international expert assessment of the Soviet Safe Living
Concept, which the government had introduced in the previous year, for
inhabitants of contaminated areas. A meeting held in Vienna in May 1991
brought the authority of the world’s leading scientists and specialists to
bear on the expressed-tssk of instilling confidence in the affected populations, with the objective of stamping out the “obscurantism” and “sensationaljsm” that arose concerning the accident’s medical effects. The project had the exclusive aims of radiation protection and the restoration of
public trust among unresettied populations; it “sought to provide a sound
scientific basis for a decision yet to be made.” It noted that a ” poor understanding in affected areas of the scientific principles underlying radiation
and its effects … was the root of many medical and social problems observed” (lAEA 1991a:6). An official report, published later that year, accentuated state-of-the-art measures that were being taken into account in
the assessment of the accident’s long-term hea lth effects.
On the one hand, the Soviet scientists claimed to have lacked an acceptable system of biodosimetry (a system of internal biological dose calculation and estimation ).]1 The United States, on the other hand, had sponsored sustained research in biodosimetry and radiation health effects
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since the bombings of Hiroshima and Nagasaki, and in the wake of nuclear weapons testing, human experimentation, and various medical radiological procedures. One immediate effect of this scientific collaboration
was the transference of Western biodosimetric technologies to the Soviets
as part of consensus-building efforts. Another effect of this collaboration
was the international confirmation (under severe public criticism) of Soviet selective remediation strategies and the Safe Living Concept.
Some issues remained unsolved, however. How were the scientists to
convert the scale of the Chernobyl accident into plausible biodosimetric
data five years after the event? Recall that in the radiobiological experimental context, data are unique to the indicators and the biological
events that are selected. Similarly, biodosimetric systems are interpretive
measures associated with specific radiation exposure events (the first biodosimetric system related to Hiroshima was the result of roughly twenty
years of research on human subjects). Not surprisingly, the Vienna meeting was marked by negotiations over the value of individual radiobiological claims. The specifics of where, when, and how researchers should
medically interpret radiation induction in biological samples taken from
affected individua ls became a source of contention and scientific collaboration. This was especially true with respect to the question of how
human inhalation of hot particles (radioactive dust and debris from the
reactor core) could best be addressed. The following samples of the discussions among the scientists provide a sense of this give-and-take.
E. P. Petryaev of the Department of Radiation Chemistry, State University of Belarus, presented photographs of necrosed lung tissue of Chernobyl accident cleanup workers who were not included in the official
patient cohort, and who had died.
The content of these [hot) particles on the surface varies but attains
very high levels, particularly for samples from the Zone where we observed up to 10 particles per cmz .. .. So far we have studied the autopsy material from the lungs from about 300 people whose deaths
were due to various causes. Samples of lung were also obtained after
operations. A definite relationship between the content of particles and
the concentration of radioactive substances on the surface was
found …. , hot particles were found in the lungs in about 70% of the
300 samples. (IAEA 1991b:27)
Petryaev’s claims were essentially dismissed as irrelevant to radiation protection. L. R. Anspaugh of the IAEA and Lawrence Livermore Nationa l
Laboratory of the United States responded:
After severa l trips to the USSR, I am absolutely convinced that ‘hot
particles’ do exist. I have certainly seen many radiographs in several of
the laboratories I visited.
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The really important question is: What do they mean in terms
of dose and health effects? … , the next importa nt questions are:
How many of them are there and how much activity is in the lung?
(Ib;d.)
IAEA ex perts’ dismissive approach should not be surprising as one of
their concerns is to advance nuclear energy. But there are ethica l issues
for which experts need to be held accountable in their readiness to ignore the significance of raw tissue data and then to blame the local scientists fo r an alleged inadequate knowledge of radiation protection. In
th is vein, Anspaugh shifted discussion away from the samples to more
abstract questions of “counting the hot pa rticles.” A. J. Gonzalez of the
Division of Nuclea r Safety of the IAEA, Vienna, seconded Anspaugh’s
move:
At the risk of repetition, I should say that there is a very clear recommendation . .. wh ich basica lly indicates that a given activity incorporated into a tissue as hot particles ca rries less risk of cancer induction
than the same activity uniformly distributed in such tissue …. If the
activity is uniformly distributed, the number of target cells will be
higher, and therefore the risk will also be higher. The photographs
showing tissues with necrosis due to hot particles presented here are
very impressive but have little reieVa11Ce to radiation protection.
(lbid.:28; emphasis added)
There was a striking variety in the kinds of evidence submitted by Soviet
and Western scientists to suppOrt their differing interpretations of the
Chernobyl event’s health effects. For loca l scientists, photographs of neerased lung tissue mattered most. For IAEA experts, it was the number of
“potentiall y activated target cells.” Implicit was a consensua l va lorization of public health, understood in specific terms: a normative notion of
risk was quantified in rhe correct biological contexts (target cells, as opposed to necrosed lungs), with the correct biologica l value, and in the
correct representational form.
The exchange of measures noted above occurred in a context of hu –
manita rian relief esta blished by the United Nations and its subsidiary
groups. Accordingly, an international Cherno byl Fund was set up in
199 1 to provide monitoring and health care fo r the people stit! residing in
contaminated zones. Representatives of the World Hea lth Orga niza tion
who took part in the International Chernobyl Project recommended the
following: a long-term epidemi ological study, an investigation of the psychosocia l health effects, a retrospective analysis of dose intake to sharpen
the biodosimerry rela ted to those effects, and the establishment of radiation health data banks.
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By 1995, however, the Chernobyl Fund was out of money. The undersecretary-general for humanitarian affairs of the United Nations and
spokesman for the fund stated that in most catastrophes, officials can
sooner or later see an end to suffering and dislocation. “It is not easy to
see an end here …. In fact, we don’t really know where we are in the
process” (Crosseue 1995:A 11). According to one scientist affiliated with
the project, most American life scientists interested in Chernobyl are finding less and less funding fo r studies related to that accident.
Ufe Sciences
Life overcomes error through further trials
(and by error I mean simply a dead end).
{Canguilhem 1994:318)J2
When 1 first traveled to Kyiv in 1992, I had to consider seriously some of
the unknowns related to this ethnographic work, especially the possibility
of my own exposure to low-level radiation and related risks. The U.S.
State Department’s travel advisories made no mention of risk; Ukraine
was and is deemed safe for travel. In a 1988 article in Science, Anspaugh
and colleagues of Lawrence Livermore National Laboratory were already
saying: “Probably no adverse health effects will be manifest by epidemiological ana lysis in the remainder of the Soviet population or the rest of the
world. Projections of excess cancer risk for the Northern Hemisphere
range from an incremental increase of 0% to 0.003%” (1988:1518),JJ An
additional 0.003 percent of cancer deaths caused by Chernobyl among the
approximately five billion residents of the Northern Hemisphere wou ld be
about 150,000 deaths. When I ta lked about safety measures with a representative of the World Health Organization, I was told that “flying to
Denver was more dangerous in terms of radiation exposure than entering
Ukraine.” That same year (1993), I bought a personal dosimeter and wore
it on my chest aU summer. It registered nothing unusual.
Nevertheless, there are currently almost no foolproof measures for ascertaining claims regarding radiation (particularly low-dose) from Chernoby!. Biodosimetric systems have changed over time, depending on the
nuclear event. For example, there is one system related to the bombings at
Hiroshima, but for the Chernobyl accident, a different system is being
devised. The absence of a standard measure of threshold dose and its
biological relevance has serious consequences not only fo r interpreting
the medical effects of exposure to radiation released during the Chernobyl accident but also for the acceptance of the medical status of that
nuclear event itself.3~ In addition, the absence of an agreed-upon set of
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biological criteria in experimenta l organisms makes it difficult for scientists to scale up estimates of radiation effects for individuals and populations. Not only does the mutability of species of organisms differ, “but
there are a number of intervening steps that will influence the frequency
of mutations observed and …. the type of mutation event scored by a
particular test will determine the mutability of the genetic endpoint
screened” (Favor 1989:844). What is meant by genetic or biological endpoints?
To find out, during spring 1995, I attended weekly meetings of the
Radiation Biology Group of the Life Sciences Division of the Lawrence
Berkeley National Laboratory (LBL) on the University of Califo rnia campus. At the time, this group consisted of radiation biologists, radiologists,
and biophysicists, whose research methods aimed to represent quantified
independent causal realities in the form of linear energy transfers (LETs),
and the mechanisms of radiation damage and repair processes in a oneto-one linear model (that is, the dose-response curve). NASA funded the
group’s study of the health effects of prOtons and high-energy heavy ions
of the kind encountered by astronauts in space travel, and the space
agency also supports its efforts to define relevant experimental endpoi nts
for carcinogenetic processes. The group relied heavily on the BEVALAC,
a large-partide accelerator and source of LETs for animal experiments on
the LBL campusY At the weekly meetings, individual scientists made
presentations on their work in radiation biology, cell death, and DNA
damage related to cancer formation.
As part of experimental design, each investigator studies what is biologically turned on and off, and the types of genetic products produced,
when LETs are applied at a specific rate and dose to experimental organisms, usually mice. LETs at the biological target are counted from the
residual range of LBL’s eighty-eight-inch cyclotron beam line. The mice
are sacrificed, and the necessary biological material is harvested, frozen,
sectioned, stained, mounted, and photographed. Reactivity to radiation
exposure is measured by observed changes as biological events at selected
endpoints: immunoreactivity of proteins and cell kill.
Other important endpoints include mechanisms of DNA repair after
irradiation. Radiation induction is known to cause breaks in DNA, and
so much of the experimental activity of the radiation biology group focuses on providing information on the induction of DNA damage in patented human cells by exposing those cells to high LETs and determining
the extent to which that damage can be modified by natural DNA repair
processes. After irradiation, researchers construct a dose-response curve
by noting induction, cell survival, damage, and repair of DNA breaks
according to LET dose. They measure breaks in the arms of specific chromosomes using techniques such as pulsed field gel electrophoresis and
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Southern hybridization. Gene-specific probes are used to demonstrate biological “slow spots” and “hot spots ” for repair.
Some of the rarionale behind the investigation of DNA damage and
repair relates to the current Department of Energy-specified need to identify biological forms of dose monitoring that could be used as a base for
designating threshold measures for individuals and populations exposed
at lower doses. The model assumes that biological monitors, if identified
correctly, can predict future radiation-related health risks in an individual
person or human population.
The certainties (considered in terms of endpoints where biological
events occur, which can be scored as such) and uncertainties (rooted in
assumptions in radiation biology that attempt to make the match between damage at endpoints and diseases in populations) combine so as to
make the biodosimetric enterprise a source of proliferating questions
through which more resources can be enrolled.
The import of basic research such as the kind sketched above is argued
from the perspective of improving the accuracy of population-based epidemiological studies of radiation-related cancers: risk assessment for
human carcinogenesis requires determining the levels at which DNA
damage produces malignancy (Department of Energy 1993:3). Research
into the basic response mechanisms of organisms after irradiation sheds
light on unproven assumptions built into epidemiological extrapolations
of health risks for nuclear workers, as well as for genera l populations.
Improved understanding of the mechanisms of radiation carcinogenesis
through basic research at the cellular and molecular level is essential to
valid epidemiological extrapolation (ibid.).
The director of the LBL group is accountable to the goals of the NASA
grant. He acknowledges the challenges facing radiobiologists in creating
an integrated body of data about risk, noting the increasing volume of
primary data. The director strongly encourages his group to produce theoretical frameworks for unifying various experimental data, especially
regarding cancer formation. The weekly meetings were instituted to make
that goal easier to achieve.36
While members of the group say they produce and study DNA and cell
damage involved in particular cancer-selection processes, it is also true
that individual scientists draw different conclusions about radiation’s
damaging effects at this level. As one researcher told me, “What one researcher says about radiation is not what another might say.” Such differences challenge the notion of a single approach and present opportunities
for funher research. All the while the links between biological events in
laboratories and courses of disease in populations are left unclear; at
stake is the more immediate interest of finding legitimacy for one’s own
individual experimental work.
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What is the link between experimental animals and human populations? To ask these scientists [Q relate their knowledge of the micro-levels
of radiation-induced biological events to the macro-level projections of
radiation risk for humans seemed out-of-field, although finding those associations was a part of their mission. Conversely, the director asked me
several times what bearing his group’s experimental investigations had on
my work on Chernobyl. Perhaps this impatience points to the fact that his
group’s work is relevant only in a world of potential radiation exposure
events.
Clearly, no coherent woddview, except that of cancer risk,links radiobiological bodies of data. Si nce 1902, when cancer risks were first attributed to overexposure to X rays, the U.S. government has spent $2 billion
on research on the health effects of ionizing radiation, and more than
eighty thousand scientific articles have been published on the subject
{Yalow 1993:436}. The radiobiology that induces illness through a single, direct-acting carcinogen introduced into experimental organisms in
order to illuminate the biological parameters for the staging of cancer,
and searches for forms of monitoring doses to guarantee a future health,
is a science undergoing change. These approaches are no longer accepted
as the exclusive grounds for predicting radiation risk to human life; their
claims are being rescaled in the face of current developments related to the
Genome Project and the growth of molecular biology. It is debatable to
what extent such a rescaling has been part of a larger public health process in which there is an increasing institutional gap between diagnostics
and therapeutics (Rabinow 1996a: 100}.37 Predictive risk models, meanwhile, continue to be developed, transferred, and evaluated for their use
or obsolescence.
Interestingly, the editor of a U.S.-based radiobiology journal, Radiation Research, recently bemoaned continued cuts in government funding
of outstanding basic and applied problems in radiation in favor of support for the genome program at the Department of Energy. The government, the editor noted, has recently been ready to spend large sums of
money looking back at studies that involved the development of isotopes,
radiotherapy, and investigations of the potential harmful effects of radiation in humans. ” It is ironic that there should be great concern about
exposures in the past but a marked reduction of funds for research required for improving the recommendations about limits and safety that
will protect people in the future” {‘”‘Some Material” 1996:145}. What
kind of matrix for the administration of life is in the making now?
Reflecting on a recent congressiona l mandate [Q monitor the effects of
low-level radiation among American nuclear plant workers, physician
and scientist Ron Jensen writes, ‘”‘[I]t is clear that techniques are needed [Q
assess the exposure and/or risk of genetic diseases associated with a broad
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range of contaminants” Uensen et al. 1994:100). The cell and molecular
biology laboratory he directed at the University of California collected
blood samples from a variety of persons exposed to radiation, including
Russian and Bahic cleanup workers sent to Chernobyl. The lab analyzed
these samples as part of a va lidation study of a new biomonitor indicating
radiation-induced somatic mutations in peripheral blood. Both he and his
research technician are former associates of Lawrence Livermore National Laboratory (LLNL) where important human biomonitoring techniques related to radiation exposure are being continually refined.
Thus far, the most reliable and widely used technique involves scoring
aberrations and their specific formations (translocations) in chromosomes, derived from the peripheral lymphocytes of irradiated organisms
and revealed through a technique called Ouorescence in situ hybridization
(FISH) and chromosome-painting technology.38In this technique, a small
sample of human blood is obtained from an occupationally exposed
worker; lymphocytes are cultured, metaphase spreads are prepared on
glass slides, and chromosomes are examined.
When I spoke with the technician about the FISH technique, she described the difficulties associated with its wide-scale application for occupationally exposed populations. According to her, the associated laboratory work is “tedious.” To facilitate the task of scoring, the technician
travels to LBL to use an automated microscope to help locate chromosomes on slides (at the time we spoke she was working with the blood
samples of seventy X-ray technicians). The automated finder is designed
to shift around the surface of the glass slide to find and focus on abnormalities and translocations that are highlighted by Ouorescent stains of
green, red, and yellow. The technician estimates that she scored over
54,000 meta phases (a metaphase is a particular phase of cell division) as
part of her job. She continued, “Each worker will have a bout 1,000 metaphases …. They have selected chromosomes 1, 2, and 4 beca use they
are the longest and represent about a third of the total genome.” This
cytogenetic technique has been transferred to and is being used in medical
research institutes in Kyiv as partial support for a diagnosis of radiationrelated abnorma lity,39
Risk In Vivo
Can the data obtained from this cytogenetic technique be scaled up to
represent the total translocation frequency in the entire genome, as the
amhors claim? (Straume et al. 1993:176). State-of-the-art research on
biomonitoring considers stem cells (vital for ongoing blood cell production) to be the better, if not the premier, internal monitor for representing
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CH””HIt 2
biological events at low-dose exposures (Trosko 1993). Stem cells provide a different point of reference since the ability of the translocation
frequencies in vivo to indicate dose and risk of the individual’s developing
radiation-induced cancer has not been rigorously established. According
to one researcher, molecular biologica l techniques related to biomonitori ng at stem cells are expected to allow for more informed evaluations
of individual exposures and compensation claims related to leukemia and
other types of cancer among U.S. nuclear facilities workers, provided
their blood is stored first.
Such careful monitoring of exposures and claims, according to Robert
Gale, the leukemia specialist who worked with Angelina Guskova in the
initial Chernobyl intervention, could never be established in Uk rainenot only because of the lack of these technologies, but because political,
economic, and social factors conspire to make the identification of radiogenic cancers “impossible.” He argues, more generally, that it is impossible to detect statistically the stochastic-related increases in cancer
deaths. Gale periodically reviews compensation lawsuits for a nuclea r
power plant in Sacramento. According to Gale,
If a person who was exposed to radiation gets leukemia, it’s nOt proof
it’s radiogenic. We have a terrible problem in the United States right
now. We have 600,000 nuclear workers, you can say that 20-25 percent will die of cancer, normally, just like in the rest of the population.
And every one of these workers is going to ascribe the cause of his
cancer and death to radiation. And there is not going to be any way of
convincing anyone of them that it’s not from that. And every one will
be a lawsuit. No one imagined there would be 200,000 lawsuits.
Rather than focusing on those Ukrainians and 8e1arussians who will get
cancer, Ga le prefers to emphasize those who will not. “Even if you could
show that a person with leukemia got 25 rads,40 what does that mean?
Most of the people who got 25 rads at Hiroshima didn’t get leukemia. I
think that it does this population a disservice by implying, JUSt because
you can prove that it might be possible, that this is a knowable thing. ,,41
For the fraction of those U.S. nuclear workers who will get cancer and
who might ascribe their cancer deaths to radiation, laboratory efforts to
turn radiogenic cancers into a knowable thing continue to find government funding. A collaborative experiment testing stem cells as potential
biomonitors is now underway. The links between individual genetic susceptibility and what radiation scientists regard as a known form of radiation-induced leukemia are being examined. The experimental subjects are
mice altered by the addition of a specific human chromosome (this chromosome is the location fo r the individual susceptibility gene for the form
of radiation-induced cancer under investigation). Under conditions of ir60
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TlCHNICA~ .. ROR
radiation, susceptibility genes of these transgenic mice are turned on, initiating the radiation-induced cancer. Stem cells are isolated, and their
ability to respond to increased radiation-induced biological loads is observed and graphed. Through a combination of molecular biological and
genomic mapping techniques, these researchers hope [Q be able to monitor radiation-induced biological events and predict the outcome of radiation-induced cancer in exposed populations, while at the same time examining potential treatment interventions that could be transferable to
exposed workers.
This combination of activities-all at the same stem cell site-points to
an evolution in the fo rms of quantifying radiogenic cancer risk, from the
monitoring of external radiation dose, to internal biological forms of
monitoring dose, to productive internal biomonitors. Stem cells are now
seen as holding the key to knowledge precisely because of their fundamental biological function, their inherent manipulability, and their capacity to elucidate the mechanisms of radiation-induced cancers-all in
one site.
In the meantime, in Ukraine, the Chernobyl event and its errors constitute a new daily rational-technical reality that has mobilized lawmakers,
groups of sufferers, radiation scientists, and health professionals. The deputy director of the Radiation Research Center noted the emergence of a
“social Chernobyl”-evidenced by a perceived increase in psychosomatic
illnesses and personality disorders among affected individuals and groups,
and by an unprecedented increase in the number of citizens demanding
medical services. It is important to keep asking which biological values,
health provisions, and clinical practices can ethically be brought to bear on
the complexity and magnitude of individual and socia l disturbances.
One immunologist, a senior member of a medical-labor committee
charged with registering the connection of illness, disability, and death
with ionizing radiation, works daily on the social welfare issues of his
neurological patients at the center in Kyiv. He notes a current probabilistic measure;
It seems to me that from the immunological point of view we have no
specific radiation markers-we can only say that the probability of
[neurological] disturbances is much higher or much lower. There are
patients, though, who insist that they have specific illnesses linked to
immunological deficiency, and that this is due to the influence of radiation. I don’t know. Who knows? The specificity of this influence happens only during the moment of exposure, when radiation makes contact with immune cells or any other cells, membranes, and structures.
And what comes after that exposure are the repairs, compensations,
adaptations, and decompensations. All these reactions have their usual
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CHAPTlR 2
rights of order, of physiological order. Say, for example, an evacuee
from Prypiat’ enters my office. I don’t know in advance where he lives
and I only have the laboratory tests before me. I ask him; Are you from
Prypiat’? He looks surprised and responds, Why do you ask me? Then
I respond, I see it, by your immunological report.
The cla imant was surprised to learn that through his potentially damaged
biology he had been accorded a new social status and identity. Before
examining the sociopolitica l dimensions of this biological identity, I step
back in the following chapter to examine Chernobyl’s reception in the
immediate postsocialist period, when national politics focused on the reassessment of past Soviet abuses, and the writing of a Ukrai nian history
was underway. Individual na rratives of experiences of Chernobyl critique
the role of state power in everyday life. They tell us as much about the
ways daily structures of Soviet authority collapsed as about the ongoing
skepticism citizens felt toward new nationa l authorities and their political
promises to prOtect citizens’ hea lth. Definitions of health and disease
move fa r beyond ca lcul able physiologica l dimensions and become deeply
entangled with historical and political determinations.
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