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Chapter 20: Health and Safety

The health and safety of Manhattan Project personnel were essential to the success of the atomic bomb program. But in ensuring the workers’ health and safety, the Army faced one of its most challenging administrative tasks because of the many unique and little understood hazards inherent in bomb development. Among these were the potentially deadly rays emitted by radioactive elements, the toxicity of a variety of chemical compounds and agents, the danger of high-voltage electricity employed in novel ways, the possibility of explosions in experimental work that involved the use of gas and liquids under great pressure and of high explosives as propellants, or even the likelihood of serious injury from metal objects cast about by tremendous magnetic forces.1

The Army knew that these unusual hazards must be properly controlled, for the lives of thousands of atomic workers were at stake. Although the Army had a long and outstanding record of carrying out public construction projects under extremely adverse and hazardous conditions, two factors peculiar to Manhattan made its task of devising and administering appropriate health and safety measures unsually complicated. One was the unrelenting urgency that prevailed in almost every aspect of the nuclear steeplechase to produce an atomic weapon before the enemy could do so, with the unfortunate result that project managers often were tempted to resort to shortcuts and speedy solutions that imposed greater health and safety risks. The other was the strict policy of compartmentalization, which prevented any widespread sharing of information and experience gained in dealing with special hazards. Fortunately, however, the Army was able to rely on its past experience on other projects and to build on the early measures of its predecessor, the Office of Scientific Research and Development (OSRD), to establish highly effective health and safety programs.2

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The Health Program

Manhattan’s health program developed slowly but steadily during the first months of District operation. Health matters originally were the sole responsibility of a single medical officer, Capt. Hymer L. Friedell, who devoted most of his time to urgent pile process health problems at the Metallurgical Laboratory. But in early 1943, when the Army implemented measures to take over most OSRD contracts, Manhattan’s modest administrative arrangements for health matters came under close review. As a consequence, pressed by a lack of adequately trained medical personnel, the District began its quest for expert assistance to monitor not only the existing OSRD programs but also those to be established by the Army in the future.3

Aware that few American medical scientists had the special knowledge needed to understand and solve the unique problems of the atomic program, General Groves launched a nationwide search for qualified medical personnel. The search revealed that a professor in the department of radiology at the University of Rochester, Stafford L. Warren, was mentioned most frequently as the best in his field. Professor Warren, Groves decided in February, was the medical scientist who, with the aid of the District staff, should coordinate the activities of all the individual health groups established and to be established by project contractors. Under the guise of discussing the radiological aspects of work to be done for the government by the Eastman Kodak Company of Rochester, Groves and the district engineer met with Warren at company headquarters. During the meeting they asked him to direct an important University of Rochester research program presumably related to the Eastman project, and also to serve part time as a medical consultant. When he indicated he was already fully involved in other wartime projects, including one for the OSRD, they asked him to take some time to think over the proposal.4

Meanwhile, Groves weighed the possibility of appointing either Major Friedell or medical scientist Robert S. Stone, who was working at the Metallurgical Laboratory on pile radiation hazards, but concluded that neither had the outstanding qualifications of Professor Warren. By giving Warren more specific information, the Manhattan commander reasoned, he might be persuaded. Groves immediately arranged for Warren to confer with other District officials concerning contractual provisions for the proposed research program at the University of Rochester and to go on an

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inspection trip to some of the other atomic installations, including a visit to Oak Ridge to view a site for a hospital. Impressed greatly with what he saw, and now convinced of the crucial importance of the project, Warren agreed in March 1943 to become a full-time consultant to Groves with a view to eventual assignment as chief of the District’s health program.5

Program Organization

At the end of June, Professor Warren became chief of a provisional medical section at District headquarters, with Major Friedell assigned as his executive officer and another Army doctor as his assistant. During the summer, as the section found itself overwhelmed with new health problems, Warren repeatedly asked for more personnel but his requests proved to be of little avail, resulting in employment of only two civilian physicians for the Clinton Engineer Works. Furthermore, the district engineer’s announcement of the Medical Section’s formal organization in August failed to include any provision for the much-needed additional personnel.6

Adequate staffing for the Medical Section awaited solution of the problem of how to recruit and hold medical personnel for at least as long as security and program continuity required. Medical personnel brought in to staff project medical facilities had to be privy to considerable secret data in order to perform their jobs properly. Manhattan’s proposed solution was to. militarize the medical staff, a step that would require collaboration with the Office of the Surgeon General (OSG).7

Following extended negotiations, Manhattan completed details of a working agreement with the OSG in September 1943. This agreement provided that the OSG, giving full cognizance to both the continuity and security required for the District health program, would furnish a broad range of medical assistance – for example, commission key District civilian medical personnel, provide additional trained personnel from the Army Medical Department, supply funds for the medical and dental care of District military personnel, and furnish medical supplies through Medical Department facilities for District use. To ensure that project security would not be compromised, the OSG appointed Col. Arthur B. Welsh as a liaison officer on its staff, giving him authority to approve all incoming requests from the District. The OSG also granted permission to the District’s Medical Section to retain in its own files all reports that might reveal the nature, scope, or military significance of the project and agreed to secure approval from the district engineer for all transfers of Medical Department personnel from the project.

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These unusual arrangements with respect to security were consistent with the Manhattan-OSG agreement that responsibility for project health matters resided with the district engineer. The OSG had protested this provision, but the District had secured an order from General Somervell that upheld it, and it remained in effect for the duration of the Manhattan Project.8

On 2 November, shortly after the agreement became effective, Warren received his commission as a colonel in the Medical Corps and official appointment as chief of the Medical Section. One of his first actions was a reorganization of the section, to reflect the major areas of activity in the District’s health program. He divided the unit into three branches: medical research, industrial medicine, and clinical medicine services; a fourth branch to oversee the Hanford health program never materialized, because Du Pont, the prime contractor, took over almost all responsibility for this activity. Another of Warren’s concerns was to expand his staff by recruiting civilian physicians to serve in clinical assignments as commissioned officers. Warren’s basic organization continued with little change up until July 1945 (except for the clinical branch, which then achieved the status of a separate division); however, in order to keep pace with the rapid growth of the project, he had to greatly expand its size – the original three-man staff eventually numbering eighty medical personnel.9

Active and continuing support not only from the OSG but also from a number of civilian medical organizations made possible the District’s rather remarkable success in recruiting a relatively large and specialized medical staff in a period of the war when medically trained personnel were in extremely short supply. Especially valuable was the assistance provided by the national office and some local branches of the Procurement and Assignment Service.10 State boards of medical and dental examiners, particularly those in Tennessee and Washington, granted concessions on licensing requirements. Numerous universities, medical schools, and biological institutes agreed to provide on a continuing basis medical specialists and technicians for District research laboratories and industrial hygiene teams.11

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Col

Col. Stafford L. Warren briefing the Oak Ridge hospital staff

The unique opportunities presented by the District’s health program also facilitated procurement of medical personnel. Medical scientists were quick to recognize that research in radiation had significant applications in the investigation of cancer, metabolism, and many other aspects of medicine. Fortunately, too, many had not been recruited for military service because their specialty did not relate directly to military medical requirements; Colonel Warren and a number of members of his staff were in this category. Others came from the field of internal medicine and from the basic biological sciences. Colonel Warren noted in retrospect that what these men all had in common, without reference to their specialty, was an interest “in using radiation or isotopes as tools to explore basic mechanisms in biologic systems.”12 The atomic bomb program promised an unexcelled chance to pursue this interest.

Medical Research

The basic objective of Manhattan’s medical research program was collection of data on potentially damaging effects of radioactive and highly toxic materials so that measures and instrumentation could be incorporated into plant design and operations for the protection of atomic workers. An important corollary objective was to

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learn more about how to treat cases of overexposure to radiation and poisoning from toxic substances. Responsibility for the medical research projects at Manhattan laboratories and a number of universities and biological institutes under contract rested with the District’s Medical Research Branch, headed by Major Friedell. Colonel Warren, too, with broad expertise in the areas under investigation, gave a great deal of attention to the various research projects.13

Collection of medical hazards data was a direct outgrowth of expanding scientific investigations into the pile and electromagnetic methods of producing fissionable materials. More adequate data became essential as the number of workers involved in research activities increased and as planning began for large-scale production. For example, with the goal of establishing safety and health protection standards and developing safe operating procedures for the pile process, the Metallurgical Laboratory at the University of Chicago formed a health physics research group. Under direction of medical scientist Robert Stone, this group (numbering more than two hundred by mid-1945) conducted extensive investigations into the toxicity of radioactive materials, giving particular attention to their chemistry and pathology; designed monitoring instruments and pile shielding; and developed treatment programs for clinical medicine problems related to pile hazards.14

The University of Chicago-operated Clinton Laboratories in Tennessee had a similar research program. Although Stone had administrative responsibility for the Clinton program, he left actual direction to radiologist Simeon T. Cantril, who had worked under Stone at the Metallurgical Laboratory for more than a year. Using the pile semiworks, the Clinton team of scientists, physicians, and technicians tested the effects of radiation on animals and developed monitoring instruments for the Hanford production piles. Further investigations into the toxicity of radiation were carried out by other institutions under subcontract. For example, researchers at Columbia University in New York investigated the effects of fast-neutron dosages on mice, those at the Franklin Institute in Newark (Delaware) conducted similar tests on dogs, and those at the University of Washington in Seattle studied the exposure of X-rays and fission products on fish and fish eggs.15

Investigations at the Metallurgical Laboratory and Clinton Laboratories were supported and supplemented by the large University of Rochester medical research program. Under direction of Stafford Warren, scientists at Rochester pursued research in radiology, pharmacology, and instrumentation. The radiology section experimented with exposing animals to high-voltage X-rays and conducted beta radiation studies and genetic experiments relative to the effects of radiation on mice and fruit flies. The pharmacology group tested radioactive

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and potentially toxic chemical substances. Two groups concentrated on instrumentation problems, including the design of standard meters for measuring alpha and beta particles and gamma rays and the development of film and instrument monitoring methods and protective devices. To ascertain under actual operating conditions the validity of measuring instruments and protective devices, Rochester scientists tested them in the plants at Clinton, Hanford, and elsewhere in the project.16

The Army believed these various research efforts would furnish all the data and instrumentation the Los Alamos Laboratory would need for its health program. But unique requirements of the bomb development program forced laboratory groups to launch separate medical research projects. In the spring of 1944, for example, essential monitoring apparatus was still not available, so members of the health and electronics groups combined their talents to develop the necessary instruments. Similarly, the industrial medicine group, faced with handling large quantities of fissionable plutonium, were dissatisfied with the available data on detecting overdoses, so they established their own research project, employing scientists from the health group and the metallurgical and chemistry division. These ad hoc research activities, born of necessity, contributed much to the success of other health and safety programs at the laboratory.17

Industrial Medicine

The major objective of Manhattan’s industrial medicine research program was to identify and control the industrial hazards associated with the atomic processes. Effective application of the knowledge and techniques developed from this research was the responsibility of the District’s Industrial Medicine Branch, headed by Capt. John L. Ferry. To monitor the project’s various industrial hygiene activities, Ferry organized his staff from officers drawn from the Corps of Engineers and the Medical Corps.

Beginning with one specialized group to monitor the University of Rochester’s industrial medicine research program, Ferry subsequently formed other groups to oversee the hazards program in materials procurement at the Madison Square Area Engineers Office, to deal with special problems wherever they might arise, to provide consultation on first aid and other aspects of operations medicine as needed, and to carry on liaison with the programs at the electromagnetic and diffusion production plants. Because of the special expertise of the Metallurgical Laboratory’s health physics research group in dealing with pile process hazards, that group was given broad authority to monitor the industrial hygiene programs at the Clinton Laboratories, Hanford Engineer Works, and Monsanto Chemical Company plant in Dayton, Ohio. Ferry’s branch did not have responsibility for the Los Alamos Laboratory’s industrial hygiene program, which was under the direction of Washington University internal medicine specialist Louis H. Hempelman,

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for the Army maintained oversight of the bomb development program through General Groves’ Washington headquarters.18

Because of the shifting and unpredictable character of plant design, construction, and operational requirements, the Industrial Medicine Branch adopted a broad and flexible approach to its difficult task of monitoring the development of effective industrial hygiene measures. To ascertain the precise nature of industrial hazards, the branch had medical research scientists supplement their laboratory experiments with extensive observations in the field. The scientists gave medical examinations to plant employees to determine the potentially dangerous effects of handling large quantities of uranium and fluorine; they took dust counts in production plants to ascertain the amount of radioactive dust present in the different processes; and they detected areas where exposure to radiation was likely by having production workers wear X-ray film badges.19

As soon as sufficient information was in hand, the Industrial Medicine Branch drew up industrial hygiene standards and procedures that became the basis for recommendations to project contractors, who were responsible for their implementation. These recommendations generally took the form of bulletins or instructional materials. Typical were bulletins originally prepared by Kellex engineers and Ferry’s staff for the firm’s employees. They outlined approved methods for working with fluorine, uranium hexafluoride, hydrofluoric acid, and similar hazardous compounds, and included first aid procedures. The branch eventually gave these bulletins wide circulation wherever these substances were being employed. On occasion, when the Los Alamos health group requested supplemental training data for its educational program on plutonium-related hazards, the branch furnished the technical information.20

Through periodic inspections, the Industrial Medicine Branch maintained a check on contractors’ compliance with its recommendations. Often the local area engineer would accompany branch inspectors on their rounds, exercising his authority to institute immediate changes when necessary. Frequency and thoroughness of inspections varied. Where the War Department had complete financial responsibility for all costs, as in cost-plus-fixed-fee contracts, the operating practices of the contractor – regardless of his industrial expertise or lack thereof – were likely to receive very close scrutiny. Where the industrial firm had primary liability, as under other types of contracts, inspections

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were more infrequent and less rigorous because of the firm’s already proven record for controlling hazards. Branch inspection teams rated hazards control primarily upon results from more or less continuous checks upon employee health and from monitoring hazardous work areas, comparing the collected data with established standards.21

Chronologically speaking, among the District’s first industrial hygiene problems were those in procurement and processing of uranium ore and in production of special chemicals (fluorine, fluorocarbons, and boron) required to manufacture fissionable materials. As industrial hygiene measures, the Industrial Medicine Branch recommended periodic physical examinations for workers exposed to hazardous conditions, use of protective clothing and masks, and installation of more effective ventilation systems.22

The principal hazard in the diffusion processes arose from the employment of highly toxic substances, including uranium in its oxide and hexafluoride forms, radium, and several fluorocarbons. While their use in small quantities for pilot plant testing presented little danger, their employment in enormously increased amounts in the production plants posed much greater hazards. To protect diffusion workers from these hazards, such as burns, lung irritation, or even kidney failure, the Industrial Medicine Branch collaborated with construction and operating contractors to install closed ventilation systems and to develop special handling techniques. The Carbide and Carbon Chemicals Corporation, for example, had its gaseous diffusion plant workers use protective clothing and Army-type gas masks when they repaired the hundreds of pumps that were cooled and lubricated with toxic fluorinated hydrocarbons. Similarly, the Fercleve Corporation had its thermal diffusion plant workers apply dry ice to solidify the highly volatile uranium hexafluoride gas before transferring it in or out of the system.23

The considerable hazards present in the research and development phases of the electromagnetic process were magnified during the production phase, thus proportionately increasing the control problem. Ironically, the most serious hazard, phosgene gas, was a deadly by-product of the most effective method of preparing charge materials for the production racetracks; other hazards included toxic dusts, radiation, carbon dusts, and toxic chemicals (principally carbon tetrachloride and trichloroethylene), and the use of high-voltage sources of electricity to operate the racetrack calutrons. As the operating contractor, the Tennessee Eastman Corporation collaborated with the District’s Industrial Medicine Branch to institute a hazards control program. Protective measures developed included devices

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for detecting phosgene gas and monitoring dust concentration and toxic chemicals, as well as the requirement for physical examination of employees – particularly those who would have an above-average exposure to radiation emanations, uranium compounds, and other hazardous conditions.24

Of all the processes, hazards in the pile process were potentially the most dangerous, for there was little previous industrial experience on which to draw to devise adequate protective measures for atomic workers. Perils existed in each step of the process. In preparing uranium metal as fuel for the pile, there was radioactivity, uranium dust, and employment of highly acid cleaning substances; in pile operations, radiation and poisonous radioactive fission products; and in extraction and concentration of the end products, radioactive uranium slugs and very poisonous plutonium. To counter these hazards, project scientists and technicians worked with the Industrial Medicine Branch to develop a variety of control measures.

One of the most effective measures was the heavy shielding built into the production piles. Others included radiation-monitoring instruments with automatic alarms, which were placed in all exposed areas; periodic fingerprinting and physical examinations for workers; portable detection equipment, such as pocket ionization meters, film badges, and ring-type film meters; and protective clothing, respirators, and goggles. In those plant areas known to have radioactive beta or gamma emissions above the established tolerance level of 0.1 roentgen per 24-hour day,25 plant health teams maintained a constant check of clothing and equipment for contamination. And in those situations where every possible protective measure still did not prevent exposure above the tolerance level, employees rotated in and out of the dangerous zones.26

Of the dangers facing employees at Los Alamos in bomb development operations, including exposure to radiation, work with high-voltage current, testing with high explosives, and handling of toxic materials and volatile gases, the single most serious hazard was work with fissionable plutonium. When the first shipments of plutonium began arriving in the spring of 1944, the Los Alamos health group exploited resources within the laboratory’s own organization and formed special committees

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to devise and enforce the necessary controls for handling plutonium. While the committees concentrated on developing monitoring, decontamination, and other technical controls, the health group compiled and circulated appropriate health standards; established requirements for preemployment and job-termination physical examinations; instituted tests for detecting overexposure of workers; improved the statistical records it maintained on individual employees; and carried out an educational program to instruct workers in the particular problems of plutonium. These efforts notwithstanding, laboratory operations with plutonium were plagued with a series of accidents.27

Clinical Medicine Services

The primary objective of Manhattan’s clinical medicine services program was to provide the thousands of project workers living on the closed and isolated atomic reservations with comprehensive on-site medical facilities. Providing full medical services, the Army felt, would enhance not only manpower recruitment but also work force retention. Another important benefit would be increased project security, for attending to the resident employees’ personal medical needs on the reservation would obviate their having to seek treatment in the surrounding communities where services were often inadequate and limited. Accordingly, overseeing the establishment and operation of adequate on-site medical facilities – first aid stations, field dispensaries, outpatient and dental clinics, and full-service hospitals – became an important feature of the District’s medical activities.

Unlike the medical research and industrial medicine programs, the clinical medicine program at each of the major atomic sites functioned with a minimum of external supervision. At Clinton, the Medical Section’s Clinical Medicine Services Branch, headed by Lt. Col. Charles E. Rea, administered medical facilities provided by construction and operating contractors and the District. At Hanford, Du Pont established and monitored its own clinical medicine program, with the Medical Section exercising only a general supervisory role through a small liaison unit in the area engineer’s office. And at Los Alamos, the post surgeon, Capt. James F. Nolan, a specialist in radiology and obstetrics and gynecology, administered the community medical services program under supervision of the post commander, who reported any medical problems directly to General Groves. The Manhattan commander, in turn,

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Hazardous materials storage 
area at Los Alamos

Hazardous materials storage area at Los Alamos. Technicians are removing lead-lined container

consulted with Colonel Warren, who, in addition to being the Medical Section chief, also served as Groves’ personal adviser on medical matters.28

Planning for the medical resources of the Oak Ridge community began in the spring of 1943, when Professor Warren and his University of Rochester staff developed a broadly conceived clinical medicine program. They recommended that the residents of Oak Ridge have access to a full range of medical services, to include surgery, medicine, pediatrics, obstetrics and gynecology, eye, ear, nose, and throat, psychiatry, proctology, neurology, urology, orthopedics, and dermatology. They also suggested the need for supporting X-ray and laboratory facilities.

Responding to these recommendations, District medical officials, working closely with both construction and operating contractors, took steps to provide for adequate medical facilities in the town of Oak Ridge. For workers requiring hospitalization they initially had planned to use off-site hospitals, but a survey of the surrounding communities, including Knoxville, revealed that the number of hospital beds available was well below the national

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average of 3.4 per thousand population. Because of the survey findings, the Medical Section decided to build a hospital in Oak Ridge that was substantially larger than required by the national average. A confluence of other factors also had entered into this decision. Of particular concern was the fact that more than an average number of workers were likely to require hospitalization in cases of serious illness or contagious disease, because they resided in dormitory-style dwellings or were members of families where everyone was employed. Compounding this concern was the consensus that there would not be enough physicians available to make home visits.29

Construction began on a fifty-bed hospital, as well as a medical service building, in late 1943. But before either was ready for service, rapid population expansion had made both inadequate. With population figures revised from as many as ten thousand to fifty thousand in early 1944, the Medical Section authorized two additional wings, each with one hundred beds, and a fully equipped outpatient clinic. Again, however, community growth outstripped estimates, reaching seventy-two thousand in early 1945, and made necessary an additional sixty-bed wing. Even with the completion of this latter unit the hospital resources of the community were greatly strained in the spring of 1945, when there was an epidemic of severe upper respiratory infections among Oak Ridge residents.30

The pool of doctors, nurses, dentists, and other specialists to staff the Oak Ridge medical facilities burgeoned with the mushrooming population. To maintain the national wartime ratio of 1 physician to each 1,500 persons, the Clinical Medicine Services Branch procured Army Medical Corps personnel from the OSG and some civilians. From 8 doctors and 4 nurses in July 1943, the staff was increased to 25 doctors and 72 nurses in July 1944 and to 52 doctors and 144 nurses a year later, with analogous increases in outpatient treatments totaling 1,890 in July 1943, 10,403 a year later, and 19,599 in July 1945. Similarly, the branch enlarged the dental staff at Oak Ridge. From 2 dentists and 1 assistant in September 1943, the staff was increased to 29 full-time dentists and 23 assistants by March 1945. Most of the dentists were civilians, because their work did not require them to have access to classified information.31

The Oak Ridge clinical medicine services program also provided for the public health needs of the community. In the early months of community development, Army veterinarians cared for government-owned animals of various kinds – horses, sentry dogs, test animals – in use on the reservation and assisted community officials in meat and milk inspections.

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Oak Ridge Hospital 
(multiwinged structure in foreground)

Oak Ridge Hospital (multiwinged structure in foreground)

With the establishment of a formal public health service in January 1944, they also oversaw rabies inoculation of pets and maintained the dog pound and an animal hospital. The public health service, which functioned very much as did that in a private civilian community of comparable size to Oak Ridge, devoted detailed attention to food production and handling, inspection of water and sewage facilities, and control of communicable diseases. And with films, newspaper articles, and special schools, it kept community residents and plant workers informed concerning the latest developments and most effective means for maintaining suitable public health conditions.32

Two aspects of the Oak Ridge clinical medicine program were unusual for the times: a psychiatric and social welfare consultation service, available to both civilian and military residents; and a low-cost medical and dental insurance plan (the Oak Ridge Health Association), which was patterned after the California Physicians Service. Both contributed significantly to reducing the turnover of trained workers, a persistent problem throughout the war. Dental coverage subsequently proved financially unworkable and was abandoned, but comprehensive

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medical care continued as a permanent feature.33

The Hanford clinical medicine services program was essentially civilian in character. Du Pont, not the Army, had primary responsibility for its direction, which was consistent with Manhattan’s larger policy of granting the company the maximum autonomy possible with efficient operation. Few Army personnel were directly involved, and there was no effort to militarize the civilian medical staff. Also, as at Clinton and Los Alamos, the District did not maintain special medical facilities at Hanford for military personnel. Instead, the relatively small military contingent depended upon the contractor-administered services for its medical and dental needs.34

In early 1943, Army leaders had few precedents for entrusting medical care of tens of thousands of atomic workers to a private industrial firm. From 1943 through 1945, Du Pont had to cope with problems similar to those in Tennessee, including a rapidly expanding population, the necessity for maximum secrecy, and a remote location. In certain respects, however, its problems were more difficult because of the greater isolation of the site and the much larger proportion of workers living on it. Nevertheless, the Hanford clinical medicine program – including regular medical services, emergency dental care, and public health – was a success. A close observer of the program, the director of health of the state of Washington, commented in 1944 that he knew of “no industry in this state doing a more adequate and as thorough a job as is being done at the Hanford Engineer Works.”35

Residents of Los Alamos, as did residents of Manhattan’s other atomic reservations, had access to complete medical services. Provision of these services was perhaps even more essential at the bomb laboratory than at Clinton and Hanford. The location of the New Mexico site was more than 50 miles via a tortuous mountain road to the nearest hospital. The highly secret nature of the work made it imperative, from the security standpoint, that all travel away from the post – including that for medical purposes – be limited to an absolute minimum. A final factor, and one of central importance, was maintenance of high employee morale, for so many members of the scientific and technical staffs who had to work at a forced-draft pace would find little opportunity for relief from the unremitting pressure of trying to solve extremely difficult problems.36

In the first year of Los Alamos operations, medical facilities were extremely limited. For civilian patients there was only a five-bed industrial infirmary (eventually, through

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severe overcrowding, it accommodated twenty-four bed cases), staffed by two physicians and three civilian nurses. For military personnel the Army provided a separate three-bed infirmary, staffed by a Medical Corps officer and seven enlisted men. With the Army’s Bruns General Hospital in Santa Fe available for civilian residents requiring lengthy hospitalization or special treatment, these modest facilities sufficed as long as the population of the site remained relatively small. Dependence upon Bruns Hospital, however, presented some serious drawbacks. The time-consuming trip to Santa Fe resulted in a loss of man-hours, which the project could ill afford. There also was the inherent risk to security in having personnel leave the reservation, even though the trips were carried out under military supervision.

A reassessment of the post’s limited medical facilities occurred in late 1943 in order to meet the increased health needs of a rapidly expanding population, which had not only more than doubled in size but also had changed in composition. Beginning in January with only fifteen hundred construction workers, the population by the end of the year had expanded to over thirty-five hundred and now included scientists, technicians, University of California and civil service employees, military personnel, and dependents. Providing them with proper medical care was essential, especially for the larger proportion of individuals who were likely to require hospitalization. Several factors occasioned this situation: An increasing number of workers had been rejected for military service for medical reasons; a higher percentage of young married couples were likely to need obstetrical services and medical care for small children; and a sizable element of the civilian population lived in barracks or dormitories. Hence, Captain Nolan recommended to Lt. Col. Whitney Ashbridge, commanding officer of the post, that the industrial infirmary be expanded into a 60-bed hospital, to include a 30-bed convalescent ward for use by both civilian and military patients. Nolan did not get all that he requested, but with Colonel Warren’s support he secured authorization for expansion of the infirmary into a 54-bed unit. Because civilian medical personnel were virtually unobtainable by mid-1944, most of the additional staff had to come from the Army Medical Corps.37

By late 1944, the New Mexico community had reasonably complete clinical medicine facilities. Most services were available to permanent residents at little or no cost, the only exceptions being that civilian in-patients at the hospital paid a subsistence fee of $1 a day and construction contractors paid at established rates for emergency treatment of their personnel. Until early 1944, periodic visits by dentists from Bruns General Hospital provided the only on-site dental care, but in March a full-time dentist became available at the Los Alamos hospital. Veterinary services had come much earlier, when the military police detachment at the post brought in a

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medical officer in April 1943 to look after the horses and war dogs used on security patrols. Under direction of Captain Nolan, the post veterinarian and his staff cooperated with the clinical medicine staff to establish and maintain public health services for the community.38

As a major factor in maintaining community morale, the clinical medicine services program was perhaps more significant at Los Alamos than at any of the other atomic sites. This was particularly the case during the hectic months of bomb development and testing in late 1944 and early 1945. In this period, the strain of working long hours on extremely difficult technical problems in the face of pressing deadlines combined with the stress of other factors – geographic isolation of the site, limited recreational opportunities, strict security requirements including censorship of mail, and not always adequate living conditions – to place a severe burden on both individual and community morale.

In August 1944, Colonel Warren sent a psychiatrist to the New Mexico site to survey the situation. The psychiatrist found that “dissatisfactions were expressed by every category of resident interviewed.” He recommended that a psychiatric social worker would help ease tensions and remove frictions in the civilian population and more intensive efforts by the post chaplain and the WAC commanding officer would improve relationships among the diverse military groups. Warren acted promptly to put these recommendations into effect. In the follow-up survey made in April 1945, the psychiatrist found community morale greatly improved. And in the final hectic weeks of bomb assembly and testing in the summer of 1945, no key scientists or technicians were lost to the effort because of illness or mental breakdown.39

The Safety Program

Start of large-scale project construction activities in the spring of 1943 brought the first big upsurge in safety problems for the Manhattan District. Anticipating this increase, Colonel Marshall had transferred the only safety engineer on his headquarters staff to the Clinton Engineer Works. Consequently, in early 1943, he began to look for a replacement, this time seeking an engineer with the ability and experience to organize and direct a project-wide safety program. Not until June did he find the man he wanted. James R. Maddy was a veteran in the safety field, with broad experience and an outstanding record of achievement on other government projects. Marshall’s instructions to his new safety engineer were to form from the District’s existing safety staff a separate section with sufficient personnel and expertise to oversee all Manhattan safety activities.40

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Program Organization

Maddy’s program organization coincided with the move of District headquarters from New York to Oak Ridge. The newly established Safety-Accident Prevention Section (in late 1944 it became a branch) henceforth became responsible not only for the project-wide safety program but also for the Clinton program. At the same time, however, the policy of granting Hanford greater administrative autonomy relieved the section of all but very general supervision of its safety program.41

By the end of 1943, Maddy had a staff of fifty full-time employees assigned to five subsections (construction, industrial, training, traffic, and community safety). In subsequent reorganizations he consolidated the construction and industrial units to form an Occupational Safety Section and the traffic and community units to create a Public Safety Section. Maddy’s headquarters section supervised the program through resident safety engineers, one of whom was assigned to each field activity where exposure to hazards amounted to at least eighty thousand man-hours per month and, beginning in May 1945, one to the staff of each officer in charge of a major operating division at Clinton. The resident engineer was usually a member of the area engineer’s staff, performing the dual function of advising the area engineer on safety matters and maintaining liaison between his area and the safety office in Oak Ridge.42

Maddy managed the District’s safety program with only modest additions to the personnel of the Safety-Accident Prevention Section. This he was able to do by close adherence to General Groves’ basic policy of making maximum use of available assistance from existing outside organizations operating in the safety field. Thus, wherever feasible, he relied upon the existing safety organizations of the prime contractors, such as Du Pont and Kellex, who employed full-time safety engineers. Similarly, in community safety matters he encouraged voluntary safety committees, although these were not always as effective as relying on professional safety engineers. This was the case in Oak Ridge, for example, where the collaborative efforts of Roane-Anderson and a volunteer committee for a community safety program proved less efficient than the expertise of Maddy’s office.43

The safety program , also received indispensable assistance from the Office of the Chief of Engineers (OCE). Groves had established an effective liaison with the OCE’s Safety and Accident Prevention Division, enabling Manhattan safety personnel to secure materials on standards and requirements, special studies, and even personnel. Similar liaison arrangements with the Department of Labor and the Bureau of Mines provided a source of training materials and, from the Bureau only, safety instructors.

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Also many nongovernmental organizations – most notably the National Safety Council, American Red Cross, and International Association of Chiefs of Police – supplied technical data and special training. With this extensive outside assistance, District safety employees could devote most of their time to solving urgent current problems.44

Occupational and Community Aspects

At the Tennessee and Washington sites, separate staffs administered occupational safety for the worker on the job and community safety for residents of the atomic communities. In each production plant at Clinton, a resident engineer coordinated safety measures with the appropriate construction and operating contractors. At Hanford, Du Pont’s own safety department, assisted by a central safety committee comprised of all department heads and with advice from the area engineer’s safety office, administered occupational safety. Community safety at Oak Ridge was the responsibility of a full-time safety director functioning under supervision of the resident engineer for the central facilities and at Richland, of the area engineer’s safety office. At the New Mexico site, where the production organization and community were much more closely integrated, a safety committee oversaw both occupational and community safety until early 1945. That year the Los Alamos administrative board employed a full-time professional safety director, who later divided safety activities between a community program and a technical area program.45

Manhattan’s occupational safety program came to resemble that found in many large-scale wartime industrial enterprises. The District safety staff promulgated a great variety of regulations intended to minimize job-related injuries and illnesses. These required contractors to provide workers with safe drinking water, goggles, hard hats, safety shoes, and similar items; to submit monthly reports on all accidents; and to incorporate thousands of safety features in plant buildings and equipment. Compliance with established safety codes and standards was verified through on-the-spot inspections. To support the efforts of resident safety engineers and contractors, the safety staff developed a program of safety indoctrination for all employees, provided materials for special courses, issued safety rule books, and carried out a continuing program to publicize safety matters in community and plant newspapers, in films shown in local theaters, and in widely displayed posters.46

On the whole, the community safety program was more conventional. Oak Ridge, Richland, and Los

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Alamos required essentially the same provisions for the safety of their residents as most normal American towns of comparable size and population, but with certain significant differences. One was their unusually great dependence upon automobile transportation, creating special traffic problems. Another was security, making it necessary for the military to perform certain safety functions usually assigned to civilian agencies, as, for example, fire safety and the enforcement of traffic regulations. On the other hand, the programs for safety in public places (theaters, recreation centers, playgrounds), in schools, and in the home were not unlike those in effect in most American communities.

District traffic engineers carefully studied various statistical reports on road congestion and accidents and devised corrective measures, including institution of such advanced concepts as radio control of traffic flow, unbalanced lanes for inbound and outbound rush-hour traffic, and ingenious layouts to expedite turns. They also drew up traffic regulations based on the Uniform Vehicle Code in force in many states, and therefore familiar to most of the residents in the atomic communities, and distributed copies of these regulations widely among District drivers.47

As a check on the public safety standards and as an additional source of professional expertise, the Army requested National Safety Council experts on home, school, and traffic safety to make periodic surveys. After each survey the council issued recommendations, most of which the district adopted. Thus, in early 1944, Maddy reported to the district engineer that of the sixty-nine recommendations the council had made in a survey of Oak Ridge, the District had adopted thirty-two and was in the process of adopting twenty-one others, more than a third of them relating to traffic problems.

A continuing problem for the District safety staff was how to maintain a high level of adherence to project safety regulations. Among the factors that tended to reduce attention to safety requirements below an optimum level were inadequate knowledge of current regulations or a general decline in morale, which occurred among atomic workers in 1944 and early 1945. One effective means was to hold a safety exposition, presenting a combination of entertainment and exhibits designed to build up morale and at the same time teach safety measures. In the hectic last months of the war, thousands of project employees at Clinton and Hanford viewed highly successful safety expositions on industrial, off-the-job, and home safety.48

A precise assessment of the Manhattan District’s relative success in its public safety program is difficult because of a lack of detailed statistical

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records. Nevertheless, there is some evidence that by 1944 the atomic communities were achieving a public safety record at least equal to that in long-established civilian towns of comparable size. Traffic safety was a specific case. Workers commuting from Oak Ridge and Richland to the atomic plants were abnormally dependent upon motor vehicles driven unusually long distances over roads often poorly built and maintained. Yet their record of traffic safety was as good as that of war workers in comparable civilian communities commuting under far less hazardous conditions. And in fact during one specific period in 1944, Oak Ridge drivers had fewer fatalities per 10,000 vehicles in operation than towns of similar size in other parts of the country.49

In December 1945, the National Safety Council presented the Manhattan Project with the Award of Honor for Distinguished Service to Safety in recognition of its unusually low incidence of occupational accidents from January 1943 through June 1945, resulting in 62 fatalities and 3,879 disabling injuries during 548 million man-hours. This record, statistically speaking, gave the District an occupational injury rate 62 percent below that for equivalent private industry. Viewed in another way, District safety programs, compared with the national average, could be credited with having saved 94 lives, prevented 9,200 disabling injuries, and contributed an additional 814,000 employee-days-of-work to the project. In some respects, a more important achievement was that effectiveness increased during the thirty-month period, as demonstrated by the steady decline of the frequency, fatality, and severity rates of injury among District workers .50

Insurance Plans

Acquisition of normal insurance coverage for the atomic project was virtually impossible. Even if complete disclosure to a group of insurance companies had been possible, they would have been unable to write coverage because of the lack of knowledge and understanding of the hazards involved, the extent and duration of the effects these hazards might cause, and the ramifications of any large-scale nuclear-related accident that might occur. Consequently, where normal insurance was not possible, the government had to assume full responsibility for any claims that might result.

Consistent with provisions relating to insurance in the First War Powers Act of 1941 and to procurement of coverages in War Department Regulation 4, Manhattan developed an insurance plan to protect the interests of the government and project contractors and employees. The number of insurance carriers was limited deliberately to prevent knowledge of the

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project from becoming too widely known in the insurance industry, and District officials often had to perform investigations, determine merits of claims, conduct inspections, and examine contractors hooks on behalf of the insuring companies. The District’s Insurance Section, organized in August 1942, supervised these activities and helped administer a variety of insurance rating plans and types of insurance for project contractors, including guaranteed costs, industrial accident and health, employees benefits, and group insurance.51