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International Health Studies and Activities


The purpose of international health studies and activities is to support the health and safety mission of DOE by providing new knowledge and information about the human response to ionizing radiation and other industrial exposures encountered in the workplace or within nearby communities; and as a result of nuclear weapons testing, use and accidents. The activities mandated by congress or required by international agreement include studies of human health, environmental impacts, and provision of medical services. Activities are underway in Japan, Marshall Islands, Russian Federation, and Spain. The studies and activities represent unique opportunities to enhance our knowledge and to establish science-based worker and public protection standards and to fulfill humanitarian purposes.


Japan Program

Assess the risk of exposure to ionizing radiation on humans as a result of the Atomic-bomb through support of the Radiation Effects Research Foundation (RERF) in Hiroshima and Nagasaki, Japan. The objective of the RERF is to conduct research and studies for peaceful purposes, on medical effects of radiation and associated diseases in humans, with a view to contributing to maintenance of the health and welfare of the atomic-bomb survivors and for other peaceful purposes. Results of RERF studies of atomic-bomb survivors are the primary basis for international radiation protection standards. RERF was chartered by the U.S. DOE and Japanese Ministry of Labour and Welfare in 1975 and rechartered in 2012 as a public interest incorporated foundation.For information on this program please contact Isaf Al-Nabulsi

Marshall Islands Program

The Marshall Islands Program was established in 1977 by the Energy Research and Development Administration, the predecessor Agency to the Department of Energy (DOE).  The program is the U.S. response to the legacy of nuclear testing in the Marshall Islands from 1946 to 1958.  There are four (4) northern “nuclear affected atolls” included in the program — Bikini, Enewetak, Rongelap, and Utrik.  All are part of the DOE Radiological and Environmental Monitoring Program to characterize the radioactive materials remaining in the environment and in naturally occurring food plants growing on the islands of the four atolls. Inhabitants of Bikini and Enewetak atolls, the locations for most of the nuclear testing, had been relocated before testing began and had no exposure to local fallout; inhabitants of Rongelap and Utrik atolls remained and were exposed to local fallout from the weapons test code-named Castle BRAVO in 1954. The exposed individuals on Rongelap and Utrik make up the Special Medical Care Program that provides annual comprehensive medical screenings to detect and treat cancer.

The mandate to provide annual medical surveillance and care, environmental monitoring and characterization, and dose assessment for the peoples of the nuclear affected atolls is memorialized in U.S. statutes (Public Laws 95-134, section 104; 96-205, section 106; 99-239, section 103; 108-188, section 103; and 112-148, section 2).  Since 1977, DOE and its predecessor Agencies have afforded the exposed people access to state-of-the-art diagnosis and treatment of cancer and technical assistance to aid the four affected atolls in their efforts to remain resettled in a safe environment and to assist others in resettling safely.  Enewetak Island and Utrik Island are resettled; Rongelap Island is on the path to resettling, and Bikini Island has made public their resettlement plans, although no progress has occurred as of 2014. Two major issues of the journal “Health Physics” — Volume 73 (Issue 1) July 1997 and Volume 99 (Issue 2) August 2010 — present the major research findings from decades of environmental surveys and analyses.  Other major environmental reports prepared by the DOE Lawrence Livermore National Laboratory are available on their web page at  The first technical report on Runit Island (Cactus Crater) radioactive waste containment structure engineering survey and groundwater monitoring program required under Pub. L. 112-149 is available at

DOE actively promotes efforts to locate; declassify, when necessary, and make available to the government of the Republic of the Marshall Islands (GRMI) and the general public, documents on environmental monitoring activities a chronology of important events during the testing period. Operations documents from the weapons test era were located in U.S. government archives, and by 2005 all known classified documents were declassified to the extent permitted by national security policy; electronic copies are located in the Marshall Islands at the Ministry of Foreign Affairs and in their embassy in Washington, DC. These documents are used by GRMI and others to independently assess the magnitude of the impacts of testing and for pursuing remedies according to terms of the Compact of Free Association Act of 1986 related to human health impacts, environmental damage, and loss of use of property. 

A note to longtime users of the historical collection of declassified documents for the Marshall Islands Program.

The collection is not available on The E-Government Act of 2002 required a privacy impact assessment of the collection. The assessment of a sample of declassified documents for the Pacific nuclear tests made publicly available on the Marshall Islands Program web site revealed a significant number of documents that contained information that could uniquely identify individuals – Personally Identifying Information (PII).

The U.S. Office of Management and Budget has issued strict policies concerning release of PII. This finding of a large number of individuals identified in the collection required the temporary removal of the document collection until all PII could be removed or obscured. The extent of the PII problem was so great that the remedy, removing or obscuring all the personally identifying information, was judged as not feasible. DOE will no longer offer access to the collection on its web sites.

For additional information contact: William Jackson

Spain Program

Also known as Project Indalo

In 1966, two U.S. Air Force planes collided during a midair refueling near the coast of Palomares, Spain with the release of four (4) unarmed nuclear weapons. Two (2) weapons landed intact and two (2) weapons burned and dispersed plutonium across steep and rugged agricultural areas. The U.S. Department of Defense remediated the site within weeks of the accident. The detailed history of the response to the accident is available on the Internet at security_affairs/spain/844.pdf (accessed on 3/19/14). The contaminated soil was placed in barrels and shipped to the DOE Savannah River Site where it was initially burried. A description is available on the Internet at: (accessed on 3/19/14).

In the immediate aftermath of the accident, a formal cooperative research program was initiated on February 25th between the U.S. Atomic Energy Agency, signed by John A. Hall, Assistant General Manager for International Activities, and the President of Spain’s Junta de Energía Nuclear (JEN), José Maria Otero Navascues. This is called the Hall-Otero Agreement of 1966. The major goals of the Agreement are to: (1) evaluate the associated radiological impact on the community and its livelihood; (2) update radiological inventories for further land recovery; and (3) improve knowledge on the environmental behavior of transuranic elements in an arid rural environment.

The Agreement acknowledges that CIEMAT is the “principal investigator” and DOE is the “secondary investigator” providing technical advice and partial funding of the research activities. The Palomares scientific program is ambitious and many of the research reports are published in the open scientific literature. There are also many videos of various aspects of the Palomares accident available on the Internet on

In 1997, DOE and Spain’s Centro de Investigaciones Energéticas, Medioambientales y Technológicas (CIEMAT) signed a new agreement to continue the work begun under Hall-Otero. The CIEMAT Palomares program can be accessed on the Internet at (accessed on 3/19/14).

In 2005, CIEMAT informed DOE that they would begin the work necessary to release the land for use and that it was necessary to conduct a three-dimensional radiation survey of Palomares' residual contaminated zones and to prepare a final radiological management plan for these zones. In 2007, the two parties formally agreed to share the cost of the three-dimensional radiation survey for completion by the end of 2008. The cost-sharing arrangement required DOE to forgo future cost sharing and instead provide a one time lump sum payment to offset the full cost of the survey.

The survey was completed in 2009 and received a positive “International Peer Review” sponsored by the International Atomic Energy Agency. CIEMAT plans for the final Palomares rehabilitation are in preparation following a U.S. technical delegation visit in 2011 and ongoing US and Spain discussions. The technical aspects of the CIEMAT plan can be accessed on the Internet at: (accessed on 3/19/14).

Since 1966, approximately 150 residents of Palomares went to CIEMAT in Madrid for a complete annual physical examination and measurement of plutonium deposited internally. The list of people receiving examinations is dynamic with new people being added to the list each year. Through 2011, 1,029 people had received more than 4,000 medical and/or radiometric examinations. Preliminary data for 2014 indicate there have been an additional 1,000 examinations. The 2011 “Palomares Medical Surveillance” report prepared by the CIEMAT Occupational Medical Unit describes the medical follow-up of Palomares individuals seen at CIEMAT through 2011. The examiners stated that: (1) the periodic clinical examinations have not revealed findings that are unusual or unexpected for persons in their age group; (2) offered their professional opinion that none of the findings from medical examinations of these individuals can be attributed to Plutonium depositions; and (3) specific changes which are attributable to radiation effects were not seen.

Under the terms of the Hall-Otero Agreement, unpublished reports can not be released to the public without the concurrence of the two agencies. DOE relinquished this role to CIEMAT and public requests for unpublished reports and other program documents are at the discretion of CIEMAT and requests should be addressed to CIEMAT for consideration.

CIEMAT contact: Ms. Isabel Redondo
Director, Unity of Communication and Public Relations
Avenida Complutense, 22 28040, Madrid, Spain
Phone: +34 913466355
Fax: + 34 913466740

For additional information contact Gerald Petersen.

Russian Program

The Russian Health Studies Program assesses worker and public health risk from exposure to ionizing radiation among workers and populations living near Russian former nuclear weapons production sites. The effort is expected to answer critical questions on the health impacts associated with long-term, low dose-rate radiation exposures. Studies are performed jointly by U.S. and Russian scientists, managed by DOE, and with independent scientific oversight under the aegis of U.S.-Russian Federation Joint Coordinating Committee for Radiation Effects Research. The Joint Coordinating Committee is a bilateral U.S.-Russian commitment to support research and exchange information on radiation health effects; it started in 1994. For information on this program please contact Barrett Fountos.