Three decades after the end of uranium mining on the Navajo Nation, a study is being launched to see how ongoing exposure to contaminated sites may be affecting pregnant women and children.
In 2009, Congress awarded funding for the Navajo Birth Cohort Study, recently launched on the Navajo reservation. The initial money supports a three-year cooperative agreement with the University of New Mexico Community Environmental Health Program to design and conduct the study with the Centers for Disease Control/Agency for Toxic Substances and Disease Registry, the Navajo Area Indian Health Service and the Navajo Nation.
In June 2012 the House Committee on Appropriations passed a bill continuing support of the health study – the first study to focus on pregnancy and neonatal outcomes in a uranium-exposed population – through 2013.
“It is a valuable study and an important step toward understanding the impact uranium- mining had on non-miners who lived near or were exposed to uranium tailings,” said Doug Brugge, PhD, now chairperson of the Community-Level Health Promotion Study Section at the National Institute of Heath’s Center for Scientific Review, in an email to the Free Press.
In October, the project will begin enrolling women in the study.
A toxic legacy
Nearly 4 million tons of uranium ore was mined from the Navajo reservation between 1944 and 1986. Hundreds of underground or open-pit mining, exploration, crushing, and transfer operations plus four processing sites at Tuba City, Mexican Hat, Shiprock and Church Rock produced yellowcake for the then United States Atomic Energy Commission charged with developing the U.S. nuclear arsenal, promoting world peace, improving the public welfare and strengthening free competition in private enterprise.
The last operating mines closed in the mid-1980s, leaving behind 1,100 abandoned waste sites associated with 520 un-remediated abandoned uranium mines on the Navajo Nation, all unmarked and in proximity to communities where children live and play.
Since then, the continual exposure of Navajo people to physical hazards contributes to a feeling quietly smoldering among some Diné that the people have been part of a macabre human-research project designed to test the consequences of radiation exposure.
Testifying in 2007 before the U.S. House Committee on Oversight and Government Reform on the environmental effects of uranium- mining, George Arthur, then-chair of the Navajo Resources Committee, said, “[We are] undergoing what appears to be a never ending federal experiment to see how much devastation can be endured by a people and a society from exposure to radiation in air, water, in and on the surface of the land. We are unwilling to be the subjects of that ongoing experiment any longer.”
He iterated that the Navajo Nation council passed legislation in 2005 detailing findings about the devastation caused by uranium mining and processing. The council found that the damage continues, he said, in the form of “… monetary compensation owed to uranium workers, the presence of hundreds of un-remediated or partially remediated uranium mines, tailings piles and waste piles, and the absence of medical studies on the health status of [Navajo people] who live in uranium-mining impacted communities.”
A lack of health studies
The 2007 hearings established that no comprehensive health studies had been done in spite of the potential for long-term chronic exposures to people living near the perilous waste.
Another witness at the hearing, Brugge, told the House committee that the one study under way in 2007 addressed kidney disease – not birth defects or cancer.
“Today, I can only hope that the path is far shorter than the one traveled by the uranium miners and their families,” Brugge said.
Appealing to Congress at the 2007 hearing, he explained that “tens of thousands of Navajo people still live next to abandoned mines and/or exposed to uranium from the contaminated dusts brought home by their working relatives.” He continued, “If we are to understand the full extent of this injustice, we need additional health studies.”
The hearing resulted in a congressional directive to come up with a remediation plan for abandoned mines as well as homes made with mine wastes, and to locate and replace water sources contaminated with uranium and other hazardous substances.
Congress also mandated support for health studies in uranium-impacted communities, including non-occupational uranium exposure.
Peanut butter vs. uranium
The failure to address the ongoing exposure was caused not only by political and corporate apathy and a shortage of research funding, according to Malcolm Benally, media specialist for the project. Mainstream media’s disregard for the issue is a factor as well, he said.
“Today’s popular media can easily catch on to how a student’s peanut-butter-and jam sandwich can be banned from public school lunches because one child is allergic to peanut butter,” Benally said. “After reading the ‘peanut butter’ article, I immediately wondered, how does that issue fascinate the media more than the ongoing issues of uranium, which raises important questions for the whole country to answer?”
The project, although mandated by Congress, is primarily a response to community concerns about the effects of exposure on pregnancies and child development.
The target group, Navajo mothers-to-be and their babies, are the grandchildren of the mine-working generation. They, and their families, continue to work and live around the potentially contaminating sites.
“Our communities are very well informed about their own issues,” Benally said, “especially when it comes to the health of their children, their animals, and clean water and windmills associated with wells that are needed for basic necessities at home.”
In a sense, the people are self-educated by their own family experiences. Many people suspect that scientific numbers and a trail of evidence will validate their often-painful stories about uranium.
Who can enroll?
The project has room for 1,500 pregnant women between the ages of 14 and 45 who have lived on the reservation for a minimum of 5 years. They must have a confirmed pregnancy, and plan to deliver at one of the five Indian Health Services facilities. Current residence and uranium exposure are not criteria. The study is also ethnically and tribally inclusive – any woman fitting the criteria is eligible.
Participants will be followed through pregnancy and the child’s first year of life through surveys, developmental, clinical and home assessments, and analysis of biological samples. Should any evidence of environmental risks or developmental delays be identified, families will be referred to early intervention or remediation programs.
Questions are asked that fit the traditional Navajo lifestyle in order to determine possible exposing environments such as those found while herding sheep and cattle, or hauling water and firewood. The study will explore the woman’s everyday patterns and relationship to traditional Navajo activities and place, such as how they use the land and water around them.
Johnnye Lewis, Ph.D., is the director of the Community Environmental Health Program, Health Sciences Center, at the University of New Mexico. As principal investigator in the project, she coordinates the professional research team drawn from the five agencies responsible for implementing the project.
The heart of the project is the well-being of the mothers and children, and by extension, future generations. The fact that more than 500 abandoned uranium mines with their impacts on Navajo people sat unnoticed for more than 50 years leads Lewis to think that “moms have wanted to study the effects.”
But studying exposure can be tricky. It, like a clear, moving vapor, seems invisible until a study puts parameters and structure to the work.
This study will include “women from both exposed and unexposed communities, so we have a full spectrum of exposures to inform the results, including those with no exposures,” Lewis said.
Information on the location of each mine and waste site, soil contamination and water quality in livestock wells will be included, because those wells have often been used for drinking water by humans.
“We will be conducting surveys [with the client] as a first level of information, including lab sampling, on potential exposures, and logging the actual geospatial residences of the moms during the pregnancy,” Lewis said.
“Exposure assessment is very challenging, and overall their approach is good,” commented Brugge. “They will have actual measures of uranium in blood and urine, for example, rather than simply self-report or distance from home, which may be less reliable.”
But not all of the potential exposures are exterior. Many happen in the home, writes Lewis. “We will make assessments there … in dust-wipe samples. We’ll do scans to determine whether or not radioactive materials were used in home construction, and do visual observation of any potential exposure sources within that home that may present known risks for the babies.”
A reservation-wide marketing and public awareness campaign is bringing the details to the people in various formats — videos, brochures and forms written in English and Navajo. The information explains expectations of participants, all rights, medical terms, contractual agreements and future benefits to the client. The intent is to be as clear and as culturally sensitive as possible.
“Finding language for quality translations that describe concepts in the best way we can is a major thrust of our language team,” explained Benally. “It’s a beautiful component that directly benefits the participants, the children, the study and the future implications of the results. Words such as ‘arsenic levels,’ or potential sources of exposure such as ‘water or dust with lead in it,’ never get explained accurately.”
The phrase “Navajo Birth Cohort” is a linguistic concept best described in Navajo as, “walking in the birth of new generations.”
The dictionary reveals that the term ‘cohort,’ in English, implies “the sense of a group; emphasizing companionship and association. “Together we are the ‘cohorts’ of the study,” Benally said.
In the preliminary stages of the study proposal the research team worked with community members and Navajo institutions to design the project and assure the Navajo Nation Institutional Review Board that the study will not endanger the physical or cultural well-being of the Diné.
That stringent process, the Navajo moratorium on all genetic research and the requirement that conclusions be reviewed by the tribe before publication assure tight control over potential discrimination that can occur in tribal research studies. But it also requires tangible benefits to the client and the nation.
In this case, participants will receive early assessment and education on environmental, prenatal risks. If indications of any serious levels of contamination are present the family will be referred to the appropriate agency for further environmental testing.
If developmental indicators are present, the family is given access to community based infant services, such as Growing In Beauty and the Navajo Nation Early Intervention Program.
It’s been decades since the story of uranium- mining and Navajo exposure began. This first prenatal research project will inform the health providers with a more thorough and concise understanding of the impacts of environmental exposures.
“A young woman who takes the step to join the study is participating in the reality of how environmental contamination can affect children, but the mom and her child are also contributing to the improvement of early-detection programs and, hopefully, to prevention and developmental and health programs that can help,” said Benally.
In October, the Navajo Birth Cohort Study will begin releasing short educational videos on YouTube. The first two include an introduction to the study and a young woman’s eligibility interview with a clinical liaison. There will be other videos about uranium, environmental contaminants, and the study’s progress.
“Young people and communities are coming together to support this study by telling their stories or by helping out the best way they can,” said Benally, who directed the documentaries.
For more information on the Navajo Baby Cohort Study, call toll-free 1-877-545-6775 or contact Clinical Liaisons at the nearest Indian Health Service: Chinle Comprehensive Health Care Facility, Tséhootsooí Medical Center, Gallup Indian Medical Center, Shiprock- Northern Navajo Medical Center and Tuba City Regional Health Care Corporation Health care providers.