DOI 10.1542peds.2012-2757; originally published online Nov.docx

DOI: 10.1542/peds.2012-2757
; originally published online November 26, 2012;
2012;130;e1757Pediatrics
COUNCIL ON ENVIRONMENTAL HEALTH
Pesticide Exposure in Children
http://pediatrics.aappublications.org/content/130/6/e1757.full.ht
ml
located on the World Wide Web at:
The online version of this article, along with updated
information and services, is
of Pediatrics. All rights reserved. Print ISSN: 0031-4005.
Online ISSN: 1098-4275.
Boulevard, Elk Grove Village, Illinois, 60007. Copyright ©
2012 by the American Academy
published, and trademarked by the American Academy of
Pediatrics, 141 Northwest Point
publication, it has been published continuously since 1948.
PEDIATRICS is owned,
PEDIATRICS is the official journal of the American Academy
of Pediatrics. A monthly
by guest on December 12,
2012pediatrics.aappublications.orgDownloaded from

ml
http://pediatrics.aappublications.org/
POLICY STATEMENT
abstract
This statement presents the position of the American Academy
of Pe-
diatrics on pesticides. Pesticides are a collective term for
chemicals
intended to kill unwanted insects, plants, molds, and rodents.
Children
encounter pesticides daily and have unique susceptibilities to
their po-
tential toxicity. Acute poisoning risks are clear, and
understanding of
chronic health implications from both acute and chronic
exposure are
emerging. Epidemiologic evidence demonstrates associations
between
early life exposure to pesticides and pediatric cancers,
decreased cog-
nitive function, and behavioral problems. Related animal
toxicology
studies provide supportive biological plausibility for these
findings.
Recognizing and reducing problematic exposures will require
attention
to current inadequacies in medical training, public health
tracking, and
regulatory action on pesticides. Ongoing research describing
toxico-

logic vulnerabilities and exposure factors across the life span
are
needed to inform regulatory needs and appropriate
interventions. Pol-
icies that promote integrated pest management, comprehensive
pes-
ticide labeling, and marketing practices that incorporate child
health
considerations will enhance safe use. Pediatrics
2012;130:e1757–e1763
INTRODUCTION
Pesticides represent a large group of products designed to kill
or harm
living organisms from insects to rodents to unwanted plants or
ani-
mals (eg, rodents), making them inherently toxic (Table 1).
Beyond
acute poisoning, the influences of low-level exposures on child
health
are of increasing concern. This policy statement presents the
position
of the American Academy of Pediatrics on exposure to these
products.
It was developed in conjunction with a technical report that
provides
a thorough review of topics presented here: steps that
pediatricians
should take to identify pesticide poisoning, evaluate patients for
pesticide-related illness, provide appropriate treatment, and
prevent
unnecessary exposure and poisoning.1 Recommendations for a
regula-
tory agenda are provided as well, recognizing the role of federal
agen-

cies in ensuring the safety of children while balancing the
positive
attributes of pesticides. Repellents reviewed previously (eg,
N,N-diethyl-
meta-toluamide, commonly known as DEET; picaridin) are not
discussed.2
SOURCES AND MECHANISMS OF EXPOSURE
Children encounter pesticides daily in air, food, dust, and soil
and on
surfaces through home and public lawn or garden application,
household insecticide use, application to pets, and agricultural
product
KEY WORDS
pesticides, toxicity, children, pest control, integrated pest
management
ABBREVIATIONS
EPA—Environmental Protection Agency
IPM—integrated pest management
This document is copyrighted and is property of the American
Academy of Pediatrics and its Board of Directors. All authors
have filed conflict of interest statements with the American
Academy of Pediatrics. Any conflicts have been resolved
through
a process approved by the Board of Directors. The American
Academy of Pediatrics has neither solicited nor accepted any
commercial involvement in the development of the content of
this publication.
All policy statements from the American Academy of Pediatrics

automatically expire 5 years after publication unless reaffirmed,
revised, or retired at or before that time.
www.pediatrics.org/cgi/doi/10.1542/peds.2012-2757
doi:10.1542/peds.2012-2757
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-
4275).
Copyright © 2012 by the American Academy of Pediatrics
PEDIATRICS Volume 130, Number 6, December 2012 e1757
FROM THE AMERICAN ACADEMY OF PEDIATRICS
Organizational Principles to Guide and Define the Child
Health Care System and/or Improve the Health of all Children
residues.3–9 For many children, diet
may be the most influential source, as
illustrated by an intervention study
that placed children on an organic
diet (produced without pesticide) and
observed drastic and immediate de-
crease in urinary excretion of pesticide
metabolites.10 In agricultural settings,
pesticide spray drift is important for
residences near treated crops or by
take-home exposure on clothing and

footwear of agricultural workers.9,11,12
Teen workers may have occupational
exposures on the farm or in lawn
care.13–15 Heavy use of pesticides may
also occur in urban pest control.16
Most serious acute poisoning occurs
after unintentional ingestion, although
poisoning may also follow inhalational
exposure (particularly from fumigants)
or significant dermal exposure.17
ACUTE PESTICIDE TOXICITY
Clinical Signs and Symptoms
High-dose pesticide exposure may re-
sult in immediate, devastating, even
lethal consequences. Table 2 summa-
rizes features of clinical toxicity for
the major pesticides classes. It high-
lights the similarities of common clas-
ses of pesticides (eg, organophosphates,
carbamates, and pyrethroids) and
underscores the importance of dis-
criminating among them because treat-
ment modalities differ. Having an index
of suspicion based on familiarity with
toxic mechanisms and taking an envi-
ronmental history provides the oppor-
tunity for discerning a pesticide’s role in
clinical decision-making.18 Pediatric care
providers have a poor track record for
recognition of acute pesticide poison-

ing.19–21 This reflects their self-reported
lack of medical education and self-
efficacy on the topic.22–26 More in-depth
review of acute toxicity and manage-
ment can be found in the accompanying
technical report or recommended
resources in Table 3.
Thelocal or regionalpoisoncontrolcenter
plays an important role as a resource for
any suspected pesticide poisoning.
There is no current reliable way to de-
termine the incidence of pesticide ex-
posure and illness in US children. Existing
data systems, such as the American
Association of Poison Control Centers’
National Poison Data System or the Na-
tional Institute for Occupational Safety
and Health’s Sentinel Event Notifica-
tion System for Occupational Risks,27,28
capture limited information about acute
poisoning and trends over time.
There is also no national systematic
reporting on the use of pesticides by
consumers or licensed professionals. The
last national survey of consumer pesti-
cide use in homes and gardens was in
1993 (Research Triangle Institute study).29
Improved physician education, accessi-
ble and reliable biomarkers, and better
diagnostic testing methods to readily

identify suspected pesticide illness
would significantly improve reporting
and surveillance. Such tools would be
equally important in improving clinical
decision-making and reassuring fami-
lies if pesticides can be eliminated from
the differential diagnosis.
The Pesticide Label
The pesticide label contains informa-
tion for understanding and preventing
acute health consequences: the active
ingredient; signal words identifying
acute toxicity potential; US Environ-
mental Protection Agency (EPA) regis-
tration number; directions for use,
including protective equipment rec-
ommendations, storage, and disposal;
and manufacturer’s contact informa-
tion.30 Basic first aid advice is pro-
vided, and some labels contain a “note
for physicians” with specific relevant
medical information. The label does
not specify the pesticide class or
“other”/“inert” ingredients that may
have significant toxicity and can ac-
count for up to 99% of the product.
Chronic toxicity information is not in-
cluded, and labels are predominantly
available in English. There is significant
use of illegal pesticides (especially in
immigrant communities), off-label use,
and overuse, underscoring the impor-
tance of education, monitoring, and

enforcement.31
TABLE 1 Categories of Pesticides and Major Classes
Pesticide category Major Classes Examples
Insecticides Organophosphates Malathion, methyl parathion,
acephate
Carbamates Aldicarb, carbaryl, methomyl, propoxur
Pyrethroids/pyrethrins Cypermethrin, fenvalerate, permethrin
Organochlorines Lindane
Neonicotinoids Imidacloprid
N-phenylpyrazoles Fipronil
Herbicides Phosphonates Glyphosate
Chlorophenoxy herbicides 2,4-D, mecoprop
Dipyridyl herbicides Diquat, paraquat
Nonselective Sodium chlorate
Rodenticides Anticoagulants Warfarin, brodifacoum
Convulsants Strychnine
Metabolic poison Sodium fluoroacetate
Inorganic compounds Aluminum phosphide
Fungicides Thiocarbamates Metam-sodium
Triazoles Fluconazole, myclobutanil, triadimefon
Strobilurins Pyraclostrobin, picoxystrobin
Fumigants Halogenated organic Methyl bromide, Chloropicrin
Organic Carbon disulfide, Hydrogen cyanide, Naphthalene
Inorganic Phosphine
Miscellaneous Arsenicals Lead arsenate, chromated copper
arsenate,
arsenic trioxide

Pyridine 4-aminopyridine
e1758 FROM THE AMERICAN ACADEMY OF PEDIATRICS
CHRONIC EFFECTS
Dosing experiments in animals clearly
demonstrate the acute and chronic
toxicity potential of multiple pesticides.
Many pesticide chemicals are classi-
fied by the US EPA as carcinogens. The
past decade has seen an expansion
of the epidemiologic evidence base
supporting adverse effects after
acute and chronic pesticide exposure
in children. This includes increasingly
sophisticated studies addressing
combined exposures and genetic
susceptibility.1
Chronic toxicity end points identified in
epidemiologic studies include adverse
birth outcomes including preterm
birth, low birth weight, and congenital

TABLE 2 Common Pesticides: Signs, Symptoms, and
Management Considerationsa
Class Acute Signs and Symptoms Clinical Considerations
Organophosphate and N-methyl carbamate
insecticides
• Headache, nausea, vomiting, abdominal pain, and
dizziness
• Obtain red blood cell and plasma cholinesterase
levels
• Hypersecretion: sweating, salivation, lacrimation,
rhinorrhea, diarrhea, and bronchorrhea
• Atropine is primary antidote
• Muscle fasciculation and weakness, and respiratory
symptoms (bronchospasm, cough, wheezing, and
respiratory depression)
• Pralidoxime is also an antidote for organophosphate
and acts as a cholinesterase reactivator
• Bradycardia, although early on, tachycardia may be
present
• Because carbamates generally produce a reversible
cholinesterase inhibition, pralidoxime is not
indicated in these poisonings
• Miosis
• Central nervous system: respiratory depression,
lethargy, coma, and seizures

Pyrethroid insecticides • Similar findings found in
organophosphates
including the hypersecretion, muscle fasciculation,
respiratory symptoms, and seizures
• At times have been mistaken for acute
organophosphate or carbamate poisoning
• Headache, fatigue, vomiting, diarrhea, and irritability •
Symptomatic treatment
• Dermal: skin irritation and paresthesia • Treatment with high
doses of atropine may yield
significant adverse results
• Vitamin E oil for dermal symptoms
Neonicotinoid insecticides • Disorientation, severe agitation,
drowsiness,
dizziness, weakness, and in some situations,
loss of consciousness
• Supportive care
• Vomiting, sore throat, abdominal pain • Consider sedation for
severe agitation
• Ulcerations in upper gastrointestinal tract • No available
antidote
• No available diagnostic test
Fipronil (N-phenylpyrazole insecticides) • Nausea and vomiting
• Supportive care
• Aphthous ulcers • No available antidote
• Altered mental status and coma • No available diagnostic test
• Seizures

Lindane (organochlorine insecticide) • Central nervous system:
mental status changes
and seizures
• Control acute seizures with lorazepam
• Paresthesia, tremor, ataxia and hyperreflexia • Lindane blood
level available as send out
Glyphosate (phosphonate herbicides) • Nausea and vomiting •
Supportive care
• Aspiration pneumonia type syndrome • Pulmonary effects may
be secondary to organic
solvent
• Hypotension, altered mental status, and oliguria in
severe cases
• Pulmonary effects may in fact be secondary to
organic solvent
Chlorophenoxy herbicides • Skin and mucous membrane
irritation • Consider urine alkalinization with sodium
bicarbonate in IV fluids• Vomiting, diarrhea, headache,
confusion
• Metabolic acidosis is the hallmark
• Renal failure, hyperkalemia, and hypocalcemia
• Probable carcinogen
Rodenticides (long-acting anticoagulants) • Bleeding: gums,
nose, and other mucous
membrane sites
• Consider PT (international normalized ratio)

• Bruising • Observation may be appropriate for some clinical
scenarios in which it is not clear a child even
ingested the agent
• Vitamin K indicated for active bleeding (IV vitamin K)
or for elevated PT (oral vitamin K)
IV, intravenous; PT, prothrombin time.
a Expanded version of this table is available in the
accompanying technical report.1
anomalies, pediatric cancers, neuro-
behavioral and cognitive deficits, and
asthma. These are reviewed in the
accompanying technical report. The
evidence base is most robust for
associations to pediatric cancer and
adverse neurodevelopment. Multiple
case-control studies and evidence re-
views support a role for insecticides in
risk of brain tumors and acute lym-
phocytic leukemia. Prospective con-
temporary birth cohort studies in the
United States link early-life exposure to
organophosphate insecticides with

reductions in IQ and abnormal behav-
iors associated with attention-deficit/
hyperactivity disorder and autism. The
need to better understand the health
implications of ongoing pesticide use
practices on child health has benefited
from these observational epidemiologic
data.32
EXPOSURE PREVENTION
APPROACHES
The concerning and expanding evidence
base of chronic health consequences of
pesticide exposure underscores the
importance of efforts aimed at de-
creasing exposure.
Integrated pest management (IPM) is
an established but undersupported
approach to pest control designed to
minimize and, in some cases, replace
the use of pesticide chemicals while
achieving acceptable control of pest
populations.33 IPM programs and
knowledge have been implemented in
agriculture and to address weeds and
pest control in residential settings
and schools, commercial structures,
lawn and turf, and community gar-
dens. Reliable resources are available
from the US EPA and University of
California—Davis (Table 3). Other local
policy approaches in use are posting
warning signs of pesticide use, restrict-
ing spray zone buffers at schools, or

restricting specific types of pesticide
products in schools. Pediatricians canTA
B
LE
3
Pe
st
ic
id
e
an
d
Ch
ild
H
ea
lt
h
R
es
ou
rc
es
fo
r
th
e
Pe
di
at
ri
ci

an
To
pi
c/
R
es
ou
rc
e
Ad
di
ti
on
al
In
fo
rm
at
io
n
Co
nt
ac
t
In
fo
rm
at
io
n

M
an
ag
em
en
t
of
ac
ut
e
pe
st
ic
id
e
po
is
on
in
g
R
ec
og
ni
ti
on
an
d
M
an
ag

em
en
t
of
Pe
st
ic
id
e
Po
is
on
in
gs
Pr
in
t:
fi
ft
h
(1
99
9)
is
av
ai
la
bl
e
in
Sp
an

is
h,
En
gl
is
h;
6t
h
ed
it
io
n
av
ai
la
bl
e
20
13
ht
tp
:/
/w
w
w
.e
pa
.g
ov
/p
es
ti
ci
de

s/
sa
fe
ty
/h
ea
lt
hc
ar
e/
ha
nd
bo
ok
/
ha
nd
bo
ok
.h
tm
R
eg
io
na
l
Po
is
on
Co
nt
ro
l

Ce
nt
er
s
1
(8
00
)
22
2-
12
22
Ch
ro
ni
c
ex
po
su
re
in
fo
rm
at
io
n
an
d
sp
ec
ia
lt

y
co
ns
ul
ta
ti
on
Th
e
N
at
io
na
l
Pe
st
ic
id
e
M
ed
ic
al
M
on
it
or
in
g
Pr
og
ra
m

(N
PM
M
P)
Co
op
er
at
iv
e
ag
re
em
en
t
be
tw
ee
n
O
re
go
n
St
at
e
U
ni
ve
rs
it
y
an

d
th
e
U
S
EP
A.
N
PM
M
P
pr
ov
id
es
in
fo
rm
at
io
na
l
as
si
st
an
ce
by
E-
m
ai

l
in
th
e
as
se
ss
m
en
t
of
hu
m
an
ex
po
su
re
to
pe
st
ic
id
es
np
m
m
[email protected]
or
eg
on

st
at
e.
ed
u
or
by
fa
x
at
(5
41
)
73
7-
90
47
Pe
di
at
ri
c
En
vi
ro
nm
en
ta
l
H
ea
lt

h
Sp
ec
ia
lt
y
U
ni
ts
(P
EH
SU
s)
Co
or
di
na
te
d
by
th
e
As
so
ci
at
io
n
of
O
cc
up

at
io
na
l
an
d
En
vi
ro
nm
en
ta
l
Cl
in
ic
s
to
pr
ov
id
e
re
gi
on
al
ac
ad
em
ic
al
ly

ba
se
d
fr
ee
co
ns
ul
ta
ti
on
fo
r
he
al
th
ca
re
pr
ov
id
er
s
w
w
w
.a
oe
c.
or
g/

PE
H
SU
.h
tm
;
to
ll-
fr
ee
te
le
ph
on
e
nu
m
be
r
(8
88
)
34
7-
AO
EC
(e
xt
en
si
on

26
32
)
R
es
ou
rc
es
fo
r
sa
fe
r
ap
pr
oa
ch
es
to
pe
st
co
nt
ro
l
U
S
EP
A
Co

ns
um
er
in
fo
rm
at
io
n
do
cu
m
en
ts
w
w
w
.e
pa
.g
ov
/o
pp
fe
ad
1/
Pu
bl
ic
at
io
ns
/C

it
_
G
ui
de
/c
it
gu
id
e.
pd
f
Ci
ti
ze
ns
G
ui
de
to
Pe
st
Co
nt
ro
l
an
d
Pe
st
ic
id

e
Sa
fe
ty
•
H
ou
se
ho
ld
pe
st
co
nt
ro
l
•
Al
te
rn
at
iv
es
to
ch
em
ic
al
pe

st
ic
id
es
•
H
ow
to
ch
oo
se
pe
st
ic
id
es
•
H
ow
to
us
e,
st
or
e,
an
d
di
sp
os
e

of
th
em
sa
fe
ly
•
H
ow
to
pr
ev
en
t
pe
st
ic
id
e
po
is
on
in
g
•
H
ow
to
ch
oo

se
a
pe
st
-c
on
tr
ol
co
m
pa
ny
Co
nt
ro
lli
ng
pe
st
s
R
ec
om
m
en
de
d
sa
fe
st

ap
pr
oa
ch
es
an
d
ex
am
pl
es
of
pr
og
ra
m
s
w
w
w
.e
pa
.g
ov
/p
es
ti
ci
de
s/
co

nt
ro
lli
ng
/i
nd
ex
.h
tm
Th
e
U
ni
ve
rs
it
y
of
Ca
lif
or
ni
a
In
te
gr
at
iv
e
Pe
st
M
an

ag
em
en
t
Pr
og
ra
m
In
fo
rm
at
io
n
on
IP
M
ap
pr
oa
ch
es
fo
r
co
m
m
on

ho
m
e
an
d
ga
rd
en
pe
st
s
w
w
w
.ip
m
.u
cd
av
is
.e
du
O
th
er
re
so
ur
ce
s
N

at
io
na
l
re
se
ar
ch
pr
og
ra
m
s
ad
dr
es
si
ng
ch
ild
re
n’
s
he
al
th
an
d
pe
st
ic
id
es

•
N
IE
H
S/
EP
A
Ce
nt
er
s
fo
r
Ch
ild
re
n’
s
En
vi
ro
nm
en
ta
l
H
ea
lt
h
&
D
is
ea
se

Pr
ev
en
ti
on
R
es
ea
rc
h
w
w
w
.n
ie
hs
.n
ih
.g
ov
/r
es
ea
rc
h/
su
pp
or
te
d/
ce
nt
er

s/
pr
ev
en
ti
on
•
Th
e
N
at
io
na
l
Ch
ild
re
n’
s
St
ud
y
w
w
w
.n
at
io
na
lc
hi
ld
re
ns

st
ud
y.
go
v/
Pa
ge
s/
de
fa
ul
t.a
sp
x
U
S
EP
A
Pe
st
ic
id
e
pr
od
uc
t
la
be
ls
w
w
w

.e
pa
.g
ov
/p
es
ti
ci
de
s/
re
gu
la
ti
ng
/l
ab
el
s/
pr
od
uc
t-
la
be
ls
.
ht
m
#p
ro
je
ct
s

Th
e
N
at
io
na
l
Li
br
ar
y
of
M
ed
ic
in
e
“T
ox
To
w
n”
Se
ct
io
n
on
pe
st
ic
id
es

th
at
in
cl
ud
es
a
co
m
pr
eh
en
si
ve
an
d
w
el
l-o
rg
an
iz
ed
lis
t
of
w
eb
lin

k
re
so
ur
ce
s
on
pe
st
ic
id
es
ht
tp
:/
/t
ox
to
w
n.
nl
m
.n
ih
.g
ov
/t
ex
t_
ve
rs
io
n/
ch

em
ic
al
s.
ph
p?
id
=
23
http://www.epa.gov/pesticides/safety/healthcare/handbook/hand
book.htm
http://www.epa.gov/pesticides/safety/healthcare/handbook/hand
book.htm
www.aoec.org/PEHSU.htm
www.epa.gov/oppfead1/Publications/Cit_Guide/citguide.pdf
www.epa.gov/pesticides/controlling/index.htm
www.ipm.ucdavis.edu
www.niehs.nih.gov/research/supported/centers/prevention
www.nationalchildrensstudy.gov/Pages/default.aspx
www.epa.gov/pesticides/regulating/labels/product-
labels.htm#projects
labels.htm#projects
http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=23
play a role in promotion of develop-
ment of model programs and practices
in the communities and schools of

their patients.
RECOMMENDATIONS
Three overarching principles can be
identified: (1) pesticide exposures are
common and cause both acute and
chronic effects; (2) pediatricians need
to be knowledgeable in pesticide iden-
tification, counseling, and management;
and (3) governmental actions to improve
pesticide safety are needed. Whenever
new public policy is developed or ex-
isting policy is revised, the wide range of
consequences of pesticide use on chil-
dren and their families should be con-
sidered. The American Academy of
Pediatrics, through its chapters, com-
mittees, councils, sections, and staff, can
provide information and support for
public policy advocacy efforts. See http://
www.aap.org/advocacy.html for addi-
tional information or contact chapter
leadership.
Recommendations to Pediatricians
1. Acute exposures: become familiar
with the clinical signs and symp-
toms of acute intoxication from
the major types of pesticides. Be
able to translate clinical knowledge
about pesticide hazards into an
appropriate exposure history for
pesticide poisoning.

2. Chronic exposures: become familiar
with the subclinical effects of chronic
exposures and routes of exposures
from the major types of pesticides.
3. Resource identification: know lo-
cally available resources for acute
toxicity management and chronic
low-dose exposure (see Table 3).
4. Pesticide labeling knowledge: Under-
stand the usefulness and limitations
of pesticide chemical information on
pesticide product labels.
5. Counseling: Ask parents about pes-
ticide use in or around the home to
help determine the need for provid-
ing targeted anticipatory guidance.
Recommend use of minimal-risk
products, safe storage practices,
and application of IPM (least toxic
methods), whenever possible.
6. Advocacy: work with schools and
governmental agencies to advocate
for application of least toxic pesti-
cides by using IPM principles. Pro-
mote community right-to-know
procedures when pesticide spray-
ing occurs in public areas.
Recommendations to Government
1. Marketing: ensure that pesticide

products as marketed are not at-
tractive to children.
2. Labeling: include chemical ingredi-
ent identity on the label and/or the
manufacturer’s Web site for all
product constituents, including inert
ingredients, carriers, and solvents.
Include a label section specific to
“Risks to children,” which informs
users whether there is evidence
that the active or inert ingredients
have any known chronic or develop-
mental health concerns for children.
Enforce labeling practices that en-
sure users have adequate informa-
tion on product contents, acute and
chronic toxicity potential, and emer-
gency information. Consider printing
or making available labels in Span-
ish in addition to English.
3. Exposure reduction: set goal to re-
duce exposure overall. Promote appli-
cation methods and practices that
minimize children’s exposure, such
as using bait stations and gels, advis-
ing against overuse of pediculicides.
Promote education regarding proper
storage of product.
4. Reporting: make pesticide-related
suspected poisoning universally re-
portable and support a systematic
central repository of such inci-
dents to optimize national surveil-

lance.
5. Exportation: aid in identification of
least toxic alternatives to pesticide
use internationally, and unless
safer alternatives are not available
or are impossible to implement,
ban export of products that are
banned or restricted for toxicity
concerns in the United States.
6. Safety: continue to evaluate pesti-
cide safety. Enforce community
right-to-know procedures when pes-
ticide spraying occurs in public
areas. Develop, strengthen, and en-
force standards of removal of con-
cerning products for home or child
product use. Require development
of a human biomarker, such as
a urinary or blood measure, that
can be used to identify exposure
and/or early health implications
with new pesticide chemical regis-
tration or reregistration of existing
products. Developmental toxicity,
including endocrine disruption,
should be a priority when evaluat-
ing new chemicals for licensing or
reregistration of existing products.
7. Advance less toxic pesticide alter-
natives: increase economic incen-
tives for growers who adopt IPM,
including less toxic pesticides. Sup-
port research to expand and im-

prove IPM in agriculture and
nonagricultural pest control.
8. Research: support toxicologic and
epidemiologic research to better
identify and understand health risks
associated with children’s exposure
to pesticides. Consider supporting
another national study of pesticide
use in the home and garden setting
of US households as a targeted ini-
tiative or through cooperation with
existing research opportunities (eg,
National Children’s Study, NHANES).
9. Health provider education and sup-
port: support educational efforts
to increase the capacity of pediatric
health care providers to diag-
nose and manage acute pesticide
http://www.aap.org/advocacy.html
http://www.aap.org/advocacy.html
poisoning and reduce pesticide ex-
posure and potential chronic pesti-
cide effects in children. Provide

support to systems such as Poison
Control Centers to provide timely,
expert advice on exposures. Require
the development of diagnostic tests
to assist providers with diagnosing
(and ruling out) pesticide poisoning.
LEAD AUTHORS
James R. Roberts, MD, MPH
Catherine J. Karr, MD, PhD
EXECUTIVE COMMITTEE, 2012–2013
Jerome A. Paulson, MD, Chairperson
Alice C. Brock-Utne, MD
Heather L. Brumberg, MD, MPH
Carla C. Campbell, MD
Bruce P. Lanphear, MD, MPH
Kevin C. Osterhoudt, MD, MSCE
Megan T. Sandel, MD
Leonardo Trasande, MD, MPP
Robert O. Wright, MD, MPH
FORMER EXECUTIVE COMMITTEE
MEMBERS
Helen J. Binns, MD, MPH
James R. Roberts, MD, MPH
Catherine J. Karr, MD, PhD
Joel A. Forman, MD
James M. Seltzer, MD
LIAISONS
Mary Mortensen, MD – Centers for Disease
Control and Prevention/National Center for
Environmental Health

Walter J. Rogan, MD – National Institute of
Environmental Health Sciences
Sharon Savage, MD – National Cancer Institute
STAFF
Paul Spire
REFERENCES
1. Roberts JR, Karr CK; American Academy of
Pediatrics, Council on Environmental
Health. Technical report—pesticide expo-
sure in children. Pediatrics. 2012:130(6)
2. Katz TM, Miller JH, Hebert AA. Insect
repellents: historical perspectives and new
developments. J Am Acad Dermatol. 2008;
58(5):865–871
3. Lewis RG, Fortune CR, Blanchard FT,
Camann DE. Movement and deposition of
two organophosphorus pesticides within
a residence after interior and exterior
applications. J Air Waste Manag Assoc.
2001;51(3):339–351
4. Hore P, Robson M, Freeman N, et al.
Chlorpyrifos accumulation patterns for
child-accessible surfaces and objects and
urinary metabolite excretion by children
for 2 weeks after crack-and-crevice appli-
cation. Environ Health Perspect. 2005;113
(2):211–219
5. Gurunathan S, Robson M, Freeman N, et al.
Accumulation of chlorpyrifos on residential

surfaces and toys accessible to children.
Environ Health Perspect. 1998;106(1):9–16
6. Fenske RA, Black KG, Elkner KP, Lee CL,
Methner MM, Soto R. Potential exposure
and health risks of infants following indoor
residential pesticide applications. Am J
Public Health. 1990;80(6):689–693
7. Nishioka MG, Lewis RG, Brinkman MC,
Burkholder HM, Hines CE, Menkedick JR.
Distribution of 2,4-D in air and on surfaces
inside residences after lawn applications:
comparing exposure estimates from vari-
ous media for young children. Environ
Health Perspect. 2001;109(11):1185–1191
8. Coronado GD, Vigoren EM, Thompson B,
Griffith WC, Faustman EM. Organophos-
phate pesticide exposure and work in
pome fruit: evidence for the take-home
pesticide pathway. Environ Health Per-
spect. 2006;114(7):999–1006
9. Lu C, Fenske RA, Simcox NJ, Kalman D.
Pesticide exposure of children in an agri-
cultural community: evidence of household
proximity to farmland and take home ex-
posure pathways. Environ Res. 2000;84(3):
290–302
10. Lu C, Toepel K, Irish R, Fenske RA, Barr DB,
Bravo R. Organic diets significantly lower
children’s dietary exposure to organo-
phosphorus pesticides. Environ Health

Perspect. 2006;114(2):260–263
11. Curl CL, Fenske RA, Kissel JC, et al. Evalu-
ation of take-home organophosphorus
pesticide exposure among agricultural
workers and their children. Environ Health
Perspect. 2002;110(12):A787–A792
12. Curwin BD, Hein MJ, Sanderson WT, et al.
Pesticide contamination inside farm and
nonfarm homes. J Occup Environ Hyg. 2005;
2(7):357–367
13. Shipp EM, Cooper SP, del Junco DJ, Bolin
JN, Whitworth RE, Cooper CJ. Pesticide
safety training among adolescent farm-
workers from Starr County, Texas. J Agric
Saf Health. 2007;13(3):311–321
14. Gamlin J, Diaz Romo P, Hesketh T. Exposure
of young children working on Mexican to-
bacco plantations to organophosphorous
and carbamic pesticides, indicated by cho-
linesterase depression. Child Care Health
Dev. 2007;33(3):246–248
15. Eckerman DA, Gimenes LA, de Souza RC,
Lopes Galvão PR, Sarcinelli PN, Chrisman
JR. Age related effects of pesticide expo-
sure on neurobehavioral performance of
adolescent farm workers in Brazil. Neuro-
toxicol Teratol. 2007;29(1):164–175
16. Landrigan PJ, Claudio L, Markowitz SB,
et al. Pesticides and inner-city children:

exposures, risks, and prevention. Environ
Health Perspect. 1999;107(suppl 3):431–437
17. Reigart JR, Roberts JR. Recognition and
Management of Pesticide Poisoning, 5th ed.
Washington, DC: US Environmental Pro-
tection Agency; 1999
18. American Academy of Pediatrics, Commit-
tee on Environmental Health. Taking an
environmental history and giving anticipa-
tory guidance. In: Etzel RA, Balk SJ, eds.
Pediatric Environmental Health. 2nd ed. Elk
Grove Village, IL: American Academy of Pe-
diatrics; 2003:39–56
19. Sofer S, Tal A, Shahak E. Carbamate and
organophosphate poisoning in early child-
hood. Pediatr Emerg Care. 1989;5(4):222–225
20. Zwiener RJ, Ginsburg CM. Organophos-
phate and carbamate poisoning in infants
and children. Pediatrics. 1988;81(1):121–
126
21. Lifshitz M, Shahak E, Sofer S. Carbamate
and organophosphate poisoning in young
children. Pediatr Emerg Care. 1999;15(2):
102–103
22. Balbus JM, Harvey CE, McCurdy LE. Educa-
tional needs assessment for pediatric
health care providers on pesticide toxicity.
J Agromed. 2006;11(1):27–38
23. Kilpatrick N, Frumkin H, Trowbridge J, et al.

The environmental history in pediatric
practice: a study of pediatricians’ attitudes,
beliefs, and practices. Environ Health Per-
spect. 2002;110(8):823–871
24. Trasande L, Schapiro ML, Falk R, et al. Pe-
diatrician attitudes, clinical activities, and
knowledge of environmental health in
Wisconsin. WMJ. 2006;105(2):45–49
25. Karr C, Murphy H, Glew G, Keifer MC, Fenske
RA. Pacific Northwest health professionals
survey on pesticides and children. J
Agromed. 2006;11(3-4):113–120
26. Roberts JR, Balk SJ, Forman J, Shannon M.
Teaching about pediatric environmental
health. Acad Pediatr. 2009;9(2):129–130
27. Bronstein AC, Spyker DA, Cantilena LR Jr,
Green JL, Rumack BH, Dart RC. 2010 Annual
Report of the American Association of
Poison Control Centers’ National Poison
Data System (NPDS): 26th Annual Report.
Clin Toxicol. 2011;49(10):910–941
28. Baker EL. Sentinel Event Notification System
for Occupational Risks (SENSOR): the con-
cept. Am J Public Health. 1989;79(suppl):

18–20
29. Whitmore RW, Kelly JE, Reading PL, et al.
Pesticides in urban environments. ACS
Symp Ser. 1993;522(3):18–36
30. US Environmental Protection Agency. Pes-
ticide product labels. Available at: www.
epa.gov/pesticides/regulating/labels/product-
labels.htm#projects. Accessed October 15, 2012
31. US Environmental Protection Agency. Illegal
pesticide products. Available at: www.epa.gov/
opp00001/health/illegalproducts. Accessed Oc-
tober 15, 2012
32. Kimmel CA, Collman GW, Fields N, Eskenazi
B. Lessons learned for the National Children’s
Study from the National Institute of En-
vironmental Health Sciences/U.S. Envi-
ronmental Protection Agency Centers
for Children’s Environmental Health and
Disease Prevention Research. Environ
Health Perspect. 2005;113(10):1414–
1418
33. US General Accounting Office. Agricultural
pesticides: Management improvements
needed to further promote integrated pest
management. Available at: www.gao.gov/
new.items/d01815.pdf. Accessed October
15, 2012

labels.htm#projects
labels.htm#projects
labels.htm#projects
www.epa.gov/opp00001/health/illegalproducts
www.epa.gov/opp00001/health/illegalproducts
www.gao.gov/new.items/d01815.pdf
www.gao.gov/new.items/d01815.pdf
DOI: 10.1542/peds.2012-2757
; originally published online November 26, 2012;
2012;130;e1757Pediatrics
Services
Updated Information &
html
http://pediatrics.aappublications.org/content/130/6/e1757.full.
including high resolution figures, can be found at:
References
html#ref-list-1

http://pediatrics.aappublications.org/content/130/6/e1757.full.
at:
This article cites 26 articles, 1 of which can be accessed free
Rs)3Peer Reviews (P
Post-Publication
http://pediatrics.aappublications.org/cgi/eletters/130/6/e1757
R has been posted to this article: 3One P
Subspecialty Collections
cs_and_toxicology
http://pediatrics.aappublications.org/cgi/collection/therapeuti
Therapeutics & Toxicology
the following collection(s):
This article, along with others on similar topics, appears in
Permissions & Licensing
tml
http://pediatrics.aappublications.org/site/misc/Permissions.xh
tables) or in its entirety can be found online at:
Information about reproducing this article in parts (figures,
Reprints
http://pediatrics.aappublications.org/site/misc/reprints.xhtml
Information about ordering reprints can be found online:
rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-
4275.
Grove Village, Illinois, 60007. Copyright © 2012 by the
American Academy of Pediatrics. All

and trademarked by the American Academy of Pediatrics, 141
Northwest Point Boulevard, Elk
publication, it has been published continuously since 1948.
PEDIATRICS is owned, published,
PEDIATRICS is the official journal of the American Academy
of Pediatrics. A monthly
ml
ml#ref-list-1
http://pediatrics.aappublications.org/cgi/eletters/130/6/e1757
http://pediatrics.aappublications.org/cgi/collection/therapeutics
_and_toxicology
http://pediatrics.aappublications.org/site/misc/Permissions.xhtm
l
http://pediatrics.aappublications.org/site/misc/reprints.xhtml

567891011121314
371372-373374-375376-377378-379

Pg1.pdfPg2.pdfPg3.pdfPg4.pdfPg5.pdfPg6.pdfPg7.pdfPg8.pdfPg
9.pdfPg10.pdfPg11.pdf
ENVIRONMENTAL RISK AND THE IRON TRIANGLE:
THE CASE OF YUCCA MOUNTAIN
Kristin S. Shrader-Frechette
Abstract: Despite significant scientific uncertainties and strong
public op-
position, there appears to be an "iron triangle" of industry,
government,
and consultants/contractors promoting the siting of the world's
first per-
manent geological repository for high-level nuclear waste and
spent fuel,
proposed for Yucca Mountain, Nevada. Arguing that
representatives of
this iron triangle have ignored important epistemological and
ethical
difficulties with the proposed facility, I conclude that the
business cli-
mate surrounding this triangle appears to leave little room for
considera-
tion of ethical issues related to public safety, environmental
welfare, and
citizen consent to risk. If my analysis of the Yucca Mountain
case is
correct and typical, then some of the most pressing questions of
busi-
ness ethics may concern how to break the iron triangle or, at

least, how
to expand it into a quadrilateral that includes the public.
1. Introduction
IN late 1991 someone leaked a confidential letter written by
Allen Keesler,President of Florida Power and Chair of the
utility industry's American
Committee on Radwaste Disposal. Keesler's letter to other US
utility execu-
tives revealed that nuclear utilities in the US were about to
begin a $9 million
"advertising blitz in Nevada designed to overcome its resistance
to serving as
the dumping ground for other states' nuclear wastes."
Recognizing that the
profits of nuclear utilities are tied to the existence of radwaste
repositories,
Keesler was eager to promote the proposed Nevada repository.
He also re-
vealed, in his letter to the other nuclear-utility executives, that
the federal
waste-disposal program being run by the US Department of
Energy (DOE) is
progressing only "because of the active support, guidance, and
involvement
of our industry" in re-educating the people of Nevada.'
According to Keesler's plan, each utility owning a nuclear unit
in the US
would be assessed $50,000 per year, per unit, for the cost of
Nevada advertising
designed to "convert" the Nevada citizens to favoring the
proposed Yucca
Mountain high-level nuclear waste repository. For the 112
commercial nuclear

reactors in the US, this assessment comes to $5.6 million
annually. Keesler
asked the executives to keep his letter "confidential" because
"all costs for the
utility campaign" are to be charged to utility "customers, not
stockholders."^
Keesler's actions raise a host of ethical questions.^ Central
among them is
whether a particular industry ought to attempt to coerce both
citizens of Nevada
©1995. Business Ethics Quarterly, Volume 5, Issue 4. ISSN
1052-150X. 0753-0777.
754 BUSINESS ETHICS QUARTERLY
and the US DOE to accept a risk (the repository) whose central
benefits accrue
to that industry. Another question is whether such one-sided
"educational" ef-
forts (directed by a regulated monopoly) ought to be funded by
the ratepayers,
without their knowledge, when a subset of these ratepayers are
those likely to
be put at risk because of the repository. A broader question is
whether the
behavior of the nuclear-utility representatives points to the
failure of profit-
based market allocation."^ An equally broad question is whether
Keesler's plan
takes adequate account of public welfare and public consent to
industrial risks.
Or, is the public effectively shut out of the "iron triangle" of

industry, govem-
ment, and contractors/subcontractors—an iron triangle of
cooperation, influ-
ence, persuasion, and money that is "beyond the control of
existing laws"?^
In this essay I argue that there appears to be an "iron triangle"
promoting the
siting of the world's first permanent geological repository for
high-level nuclear
waste and spent fuel, proposed for Yucca Mountain, Nevada.
Government con-
tractors, scientists and consultants, US DOE officials, and
nuclear industry
representatives are all eager to build Yucca Mountain. Noting
that 80 percent of
Nevadans are opposed to the proposed facility, I argue (1) that
scientists cannot
guarantee Yucca Mountain safety; (2) that uncertainty regarding
Yucca Moun-
tain is so great that it is not quantifiable; (3) that no other
country in the world
is moving to permanent geological disposal of radioactive waste
as quickly as
the US; and (4) that ethics requires, in such a situation of
uncertainty, that
industry, government, and scientists attempt to limit false
negatives (type-II
risks), false assurances that Yucca Mountain will cause no
serious harm. More-
over, I conclude that, because the "iron triangle" of industry,
govemment, and
consultants/contractors is heavily promoting Yucca Mountain,
despite significant
scientific uncertainties, the business climate surrounding this
triangle appears to

leave little room for consideration of ethical issues related to
public safety, environ-
mental welfare, and citizen consent to risk. If these speculations
about the "iron
triangle" are correct, then some of the most pressing questions
of business ethics
concem the acceptability of the industry-govemment-contractor
triad.
2. Historical Background
For nearly four decades, virtually all scientists and public
policymakers have
agreed that permanent geological disposal is the preferred
method of dealing
with high-level radioactive waste during the 10,000 years that it
remains a
serious threat to health and safety. Because Yucca Mountain,
Nevada has been
proposed as the location of the first permanent geological
repository for high-
level radioactive waste anywhere in the world, the US is
spending billions of
dollars to study and engineer the site. Indeed, during the last
five years, the
formalities of site study and selection have cost more than $2.5
billion,^ and the
US government is nowhere close to final approval of a single
site. Because of
the scientific and financial preeminence of Yucca Mountain, it
provides a para-
digm case of the ethical, policy, and scientific questions
associated with perma-
nent disposal. Although the US Department of Energy (DOE)
studies of the

ENVIRONMENTAL RISK AND THE IRON TRIANGLE 755
Nevada location are state-of-the-art quantitative risk
assessments, this essay
argues that the optimistic assessment conclusions about site
suitability both
conflict with fundamental scientific uncertainties about Yucca
Mountain and
raise questions about how far the "iron triangle" (of industry,
govemment and
contractors) controls repository siting.
As early as 1955, researchers representing the US National
Academy of Sci-
ences (NAS) recommended permanent isolation of high-level
radioactive wastes
in mined geological repositories, a position the NAS
spokespersons hold today.^
This basic approach to disposal of high-level radioactive wastes
is still being
pursued in virtually every nation in the world. As Don U.
Deere, Chair of the US
Nuclear Waste Technical Review Board of the NAS, expressed
this position in
1990: "There is currently a world-wide scientific consensus that
a deep geologic
repository is the best option for disposal of high-level waste.
The Board believes
that there are no insurmountable technical reasons why an
acceptable deep
geologic repository cannot be developed."^
The most fundamental reason that virtually all govemments and
nuclear-risk

experts have pursued a policy of developing repositories for
permanent geologi-
cal disposal of high-level radioactive wastes is that they wish to
maximize waste
isolation. Other arguments in favor of permanent geological
disposal are that it
minimizes both costs and hazards, especially transport risks to
and from a
storage facility. Still other reasons for permanent disposal are
that we, members
of the present generation, should solve the high-level
radioactive waste problem,
not merely store the waste and thus leave the burden to
members of future
generations.^ The underlying assumption of this rationale for
disposal is that
only a permanent geological repository addresses important
ethical obligations
to future persons. The technical disadvantages of permanent
geological disposal
of high-level radioactive wastes are the lack of experience with
long-term iso-
lation and the difficulty of knowing geological features and
processes at the
great depths and over the long time periods required. Some
persons also oppose
permanent geological disposal because they claim that it is
impossible to assure
isolation of the wastes underground. Other arguments against
permanent dis-
posal focus on technical uncertainties, on political difficulties
associated with
siting the facilities, on ethical problems related to imposing
such a risk on
members of future generations, and on the importance of the
retrievability of the

waste, so as to leave open the options for future storage or
disposal.'"
In 1982, Congress passed the Nuclear Waste Policy (NWPA),
perhaps the
single most important piece of legislation affecting high-level
radioactive-waste
disposal. The act mandated permanent disposal of radwaste, a
policy that had for
years been the conventional wisdom. Containing timetables for
the Department of
Energy (DOE) to accomplish permanent, underground disposal
of high-level waste,
the NWPA govems commercially generated materials but allows
for disposal of
defense wastes, given Presidential approval. The NWPA also
requires an Office of
Civilian Radioactive Waste Management, with its director
reporting to the Sec-
retary of Energy. Perhaps most importantly, the act provides
guidelines for site
selection of possible high-level radioactive-waste repositories."
Under the guidelines of the 1982 NWPA, the DOE selected a
number of sites
as potentially acceptable for the first permanent high-level
radwaste repository
in the US. They were in Washington, Utah, Texas, Mississippi,
Louisiana, Ne-
vada, the Great Lakes area, and the Appalachian range. In 1987,
the choice of
sites was narrowed to Hanford (Washington), Yucca Mountain

(Nevada), and
Deaf Smith (Texas). After much political compromise, the US
Congress passed
the Nuclear Waste Policy Amendments Act of 1987; one of its
main provisions
was to mandate study of only one site. Yucca Mountain,
Nevada. Other special
features in the act are the requirements to create a Nuclear
Waste Review Board
in the National Academy of Sciences; to ship spent fuel in
NRC-approved
packages, with state and local authorities notified of shipments;
and to provide
an analysis, between the years 2007 and 2010, of the need for a
second reposi-
tory.'^ Only if the Nevada site is found unacceptable will other
possible loca-
tions be considered. Currently scientists and engineers are
studying the
hydrogeology, seismicity, volcanism, and climate of the Nevada
location. How-
ever, on January 5, 1990, the Nevada Attorney General filed a
court petition
seeking a "notice of disapproval" of the Yucca Mountain site
under the NWPA.
The petition failed, and Nevada has appealed it to the US
Supreme Court.'^ The
US Supreme Court, however, denied further review. It said that
discussion of
constitutional issues (related to Nevada's support of an absolute
right to veto the
selection of the Yucca Mountain site) was premature. In other
words, Nevada's
alleged right to veto the site can be discussed only after the site
is formally
selected for a repository, after all licensing and permitting

procedures are com-
pleted.'"* Hence, the DOE plans for Yucca Mountain remain in
question.'^ Some
persons have even argued that the DOE may have to abandon its
current plans
and consider other options, such as sub-seabed disposal or
above-ground stor-
age.'^ Evaluation of the Yucca Mountain site continues,
however, despite the
opposition of 80 percent of Nevadans to the repository.'^ Site
studies will cost
several billion more before site evaluation is complete.'^
Part of the controversy driving the opposition of Nevadans to
the proposed
Yucca Mountain facility is not only the possibility of repository
failure and
radioactive contamination but also the questionable way in
which the nuclear
industry, the DOE, and its contractors—the iron triangle—are
performing the
Yucca Mountain environmental risk assessments. At the heart of
this controversy is
disagreement over the assessment methods and the data that are
being used.
3. Assessors Cannot Guarantee Yucca Mountain Safety
The authors of a recent US Geological Survey (USGS) study of
the proposed
Yucca Mountain site warned that site "data are not sufficient to
predict accu-
rately rates of [ground] water movement and travel times."'^
One question
raised by the USGS warning is whether the Yucca Mountain
predictions, al-

though inaccurate, are accurate enough for us to build the
repository. Are the
questionable inferences in the repository risk estimates and
evaluations signifi-
cant? Or, are the quantitative risk assessments (QRAs)
nevertheless accurate
enough to justify permanent geological disposal of high-level
radwaste?
If no scientific result is ever certain or completely objective,
and if no policy
is ever perfectly just, a reasonable person ought fault neither
science nor policy
merely for uncertainty, subjectivity, or incomplete justice. The
real issue is the
significance of the apparent problems in the Yucca Mountain
assessments. How
objective is objective enough? How certain is certain enough?
How just is just
enough? Do the available data and site characteristics lead one
to believe that
QRAs of Yucca Mountain can be done with sensitivity and
precision adequate
to insure credible regulation and long-term safety?
Many risk assessors believe that the data and the site are
adequate to insure
safety. They say that Yucca Mountain would comply with the
regulations.̂ ** This
judgment, however, is quite controversial given all the ways in
which incom-
plete data, inadequate theory, uncertainty, and site

heterogeneity threaten accu-
rate knowledge of Yucca Mountain. Even US DOE assessors use
language that
suggests their largely qualitative and imprecise knowledge of
the site is a prob-
lem. Note, for example, the US DOE's use of the terms
'estimate,' 'likely,' and
'significant' in the following claim:
estimates of groundwater travel time along any path of likely
and significant
radionuclide travel from the disturbed zone to the accessible
environment are
more than 1,000 years. Therefore, the evidence does not support
a finding that
the site is disqualified.̂ *
Presumably, if DOE officials were more certain about Yucca
Mountain safety,
they would speak of "calculations" or definite "probabilities" of
certain ground-
water travel times and not of "estimates." Likewise, if their data
were more
accurate, presumably they would speak of threats posed by "any
path of radionu-
clide travel," rather than of threats "along any path of likely and
significant
radionuclide travel." As the DOE's own works illustrate, its
claims of safety are
laden with methodological judgments about "likely" travel, for
example, and
with language that avoids assigning any probabilities to
regulatory compliance.
The DOE officially admits, for example:
The characteristics of the Yucca Mountain site and the

processes operating
there permit, and probably ensure, compliance with the limits
on radionuclide
release to the accessible environment.
When one is considering a potentially catastrophic threat to
health and safety,
however, one requires a very high probability that the site in
question will
comply with regulations. One of the main reasons why the
methodological
judgment—that site knowledge is adequate for regulation and
for safety—is
questionable is that the various DOE probabilities allegedly
associated with site
characteristics are already very close to the limits of regulatory
acceptability. We
shall argue that, given a variety of questionable inferences,
assumptions, and
value judgments made by assessors,^^ actual site characteristics
might not com-
ply with regulations. Changes of only one order of magnitude in
some of the
parameters dealing with fracture flow, infiltration,
precipitation, or volcanic and
seismic activity could initiate disastrous changes—such as
flooding or unaccept-
ably rapid groundwater transport—in the Yucca Mountain
repository. As Amory
Lovins warned, an error factor of two at each stage of a twenty-
step methodol-

ogy permits a possible millionfold mistake. '̂* For example,
increasing the al-
leged percolation rate by only one order of magnitude could
initiate fracture
flow and speed groundwater-travel time.^^ Such sensitive
numbers, together
with the two to six orders of uncertainty of characterizing many
risk assess-
ments, show that the margin for error at Yucca Mountain may
be too slim to
insure adequate government regulation and safety. Even the US
National Acad-
emy of Science (NAS) noted that the DOE assumes, incorrectly,
"that the prop-
erties and future behavior of a geological repository can be
determined and
specified with a very high degree of certainty. In reality," said
the NAS, "the
inherent variability of the geological environment will
necessitate frequent
changes in the specifications."^^ But if geological variability
necessitates
changes in repository specifications, then there is question
whether a facility
like Yucca Mountain can meet the pre-determined US safety
regulations.
Porous flow alone onsite would mean leachate could reach the
water table at
Yucca Mountain in 10,000 to 20,000 years.^' Fracture fiow,
however, could
enhance transport of water and radioactive leachate, above the
flux at Yucca
Mountain, by as much as 5 orders of magnitude.^^ Assessors
have confirmed that
"fractures do exist of sufficient width to allow significant water

flow in the
unsaturated region."^^ Moreover, with a large fracture-fiow
rate,^'C, ^ ^ ^ , and
237 Np could get through to the water table in less than 10,000
years.3° Hence,
understanding fracture fiow is a crucial determinant of site
safety. Yet, knowl-
edge of fractured zones, particularly for unsaturated regions, is
very limited.
Likewise, the seismicity at Yucca Mountain, prior to 1960, is
virtually unknown
even though seismic failure is possible.3' One wonders how a
possibly seismic,
fractured site, even in an arid climate like Yucca Mountain,
could be acceptable
if volcanism, intruding water, and seismic activity were not
highly improbable
during the life of the repository.^^ At Yucca Mountain, these
conditions do not
appear to be highly improbable.
A person who makes the value judgment that site knowledge is
sufficient for
regulation and for safety is in the questionable position of
knowing that signifi-
cant problems could occur with fracture flow, seismicity, and
volcanism, yet not
being able to predict any of them accurately—because of
numerous difficulties
with modelling, sampling, extrapolation, and so on. Even the
Nuclear Regula-
tory Commission (NRC) officials recognized some of these
problems when they
complained that the Yucca Mountain risk assessments fail to
recognize ade-
quately the uncertainty in the data. Likewise, the US NAS

warned that "uncer-
tainty is treated inappropriately" in the Yucca Mountain
assessments.^^ Indeed,
the NRC said that the environmental assessments of the DOE
for its proposed
radwaste facilities are, in general, "overly optimistic."^'^ Such
optimism often
appears almost gratuitous, because it is not based on precise,
quantitative pre-
dictions. For example, an official DOE document claims that the
site can protect
the safety of ail future generations from radiological hazards:
The quality of the environment during this and future
generations can be
adequately protected. Estimates of radiation releases during
normal operation
and worst-case accident scenarios provide confidence that the
public and the
environment can be adequately protected from the potential
hazards of radio-
active-waste disposal.
Equally gratuitous is the DOE claim that no future groundwater
conditions will
disrupt the site:
Currently available engineering measures are considered more
than adequate
to guarantee that no disruption of constniction and operation
will occur be-
cause of groundwater conditions at Yucca Mountain.''

Such assurances are highly questionable, given DOE assessors'
admissions of
uncertainties about basic hydrological and geological conditions
at the site. For
example, at Yucca Mountain, "in most cases, hydraulic data are
insufficient for
performing geostatistical analyses,"^' and "traditional fiow path
chemical evalu-
ation does not directly apply to tuffaceous volcanic
environments."'^ Likewise,
there is "no known mechanical model that describes nonuniform
corrosion well
enough to use in performance assessment" of the waste
canisters.^' In areas of
hydrology, geology, canister security, climate, volcanism, and
seismicity, no
techniques exist, at the present time, that are adequate for
removing the uncer-
tainties at Yucca Mountain or even for quantifying them.'*''
Basic questions
conceming the reliability of the studies remain unanswered.^^
Indeed, how could
significant uncertainties be removed if one required precise
predictive power
and regulatory guarantees regarding the site for 10,000 years?
The long time period of storage is one reason that Yucca-
Mountain reviewers
have claimed that "compliance with US [radiation-dose] limits
cannot be shown
objectively by PRA [probabilistic risk assessment] methods."^^
One reason for
this problem is that the precise, probabilistic standards of the
Environmental
Protection Agency (EPA) for the management of spent fuel and

high-level and
transuranic radioactive wastes cannot be confirmed with current
data. The stand-
ards set limits for releases when events have more than a 1 in 10
chance of
occurring over the 10,000 years.''^ Such precise probabilistic
standards cannot
be guaranteed for so long a time, however. As one DOE
reviewer put it: "no
assurance can be given that all significant factors have been
examined here.'"*'*
Other reviewers maintain that it is doubtful whether we can
model or predict
long-term behavior at all, given the heterogeneities and
uncertainties at the
site.'*^ Still other evaluators, including those from the utility
industry and the
NAS, have proclaimed that the limits of environmental science
have been ex-
ceeded by the goals set by the nation's radioactive waste
program.^* Perhaps the
most significant analysis of how scientific uncertainties
undercut assurances of
repository safety is that of the DOE team of 14 peer reviewers
who in 1992
analyzed the DOE's Early Site Suitability Evaluation for Yucca
Mountain. The
"consensus position" of the 14 DOE-selected peer reviewers is
telling:
It is the opinion of the panel that many aspects of site
suitability are not well
suited for quantitative risk assessment. In particular are
predictions involv-
ing future geological activity, future value of mineral deposits
and mineral

occurrence models. Any projections of the rates of tectonic
activity and vol-
canism, as well as natural resource occurrence and value, will
be fraught with
substantial uncertainties that cannot be quantified using
standard statistical
methods.
If uncertainties at any proposed site are so severe that they
cannot be quantified,
then it is arguable that they force those who currently favor a
permanent reposi-
tory—some members of the iron triangle—into either begging
the question or
appealing to ignorance in defending site suitability. Indeed,
anyone who main-
tains that there is, at present, a compelling scientific basis for
permanent geo-
logical disposal is unavoidably forced to use incomplete and
short-term data (on
seismicity, volcanism, hydrogeology, and so on) as a basis for
extraordinarily
precise, long-term predictions—tens of thousands of years—
about site suitabil-
ity. We are able to make general predictions about the future, of
course, and
geologists do so all the time. Precise predictions, however, are a
problem. Be-
cause of the imprecision of our hydrogeological and climate
models, we are at
present unable to predict the geological and hydrological

situation at Yucca
Mountain with any degree of reliability and precision, 10,000
years into the
future. As a result, we cannot quantify the claim that we shall
be able to meet
current US repository standards for safety 10,000 years from
now. We cannot be
reasonably assured that a permanent repository might not cause
catastrophe
hundreds or thousands of years into the future. Indeed, to claim
the ability to
predict very precise geological events, 10,000 years into the
future, when one's
precise, site-specific evidential base for doing so covers only
tens of years, has
little scientific justification. Although we can reconstruct
geological histories
spanning millions of years, geology is primarily an explanatory
and not a pre-
dictive science, as we argued earlier. Hence, it seems prima
facie evident that
one ought not base arguments for the safety of a permanent
repository on an
uncertain judgment about our ability to make precise geological
predictions.
Another reason that it is difficult to know the distant future in
great detail is
that we humans and our institutions are not precisely
predictable. Anyone who
argues for permanent geological disposal must discount the
effects (on reposi-
tory safety) of human error and the social amplification of risk
that might occur
in thousands of years. Discounting these effects is problematic,
as the Chair of

the US NAS overview committee (for the WIPP project for
storage of weapons-
related radwaste in New Mexico) noted before Congress:
current feeling is that the WIPP site could probably meet EPA
standards with the
exception of the so-called "human-intrusion" scenario. This is
the idea that some-
time in the future somebody comes and drills directly into a
repository. . .'*
As the NAS committee warned, dismissing the effects of human
activities such
as terrorism, sabotage, or ignorance, tens of thousands of years
into the future,
is highly problematic. Indeed, given the prevalence of fiaws in
humans and their
institutions, it might be more reasonable to assume that
terrorism or ignorance
would be a major problem for a facility storing radiotoxic
materials. Moreover,
whether about climate and hydrogeology, or about human errors
and institutions.
precise predictions about the long-term future are highly
questionable, at least
at present, because our generalizations are built on such a
limited empirical base.
If it is impossible to know the long-term future with great
precision, then any
claims to precision (as US radwaste regulations require) about

the long-term
future must rely in part on ignorance. Yet, from ignorance about
a particular
claim, it is logically invalid to conclude that the claim is either
true or false.
From our ignorance about future, long-term, repository safety, it
is logically
invalid to conclude that a repository would be either safe or
unsafe. Like many
scientific claims, conclusions about the safety of repositories—
tens of thou-
sands of years into the future—are uncertain. Based on data
from the present or
even from several decades, there can be no empirically
compelling argument for
the safety of such repositories in the distant future. The best our
experiments can
do is to confirm that, if permanent repositories meet certain
safety standards in the
future, then our current experiments are likely to exhibit these
same features. Be-
cause affirming the consequent does not invariably lead to valid
conclusions, how-
ever, the reverse is not true. We cannot infer that because of the
success of current,
short-term experiments, therefore repositories will avoid
catastrophic releases of
radionuclides and will meet safety standards thousands of years
from now.
Because of all the uncertainties in the Yucca Mountain data and
methods,
assessors typically are not able to determine the degree of
accuracy in their
models.'*' They are able, for example, merely to say that there
is a "high level of

probability" that groundwater travel time to the water table will
exceed 10,000
years.̂ *^ In other words, the degree of uncertainty regarding
groundwater travel
time is very great. Likewise, the margin of safety necessary to
prevent signifi-
cant problems, such as fracture flow, is quite slim. Yet, despite
this narrow
"window," some persons appear to believe that Yucca Mountain
will be predict-
ably safe or in compliance with govemment regulations
requiring a groundwater
travel time greater than 1,000 years.^' There is also only a
"narrow window," or
slim margin, of safety because groundwater travel time is
extremely sensitive to
fracture flow, and fracture flow is extremely sensitive to
percolation rate. If
either flow or percolation increase by even a small amount, then
the travel time
of leachate from the waste will increase significantly.^^ In the
world of ground-
water flow, where risk assessments "are highly uncertain,"^^ a
factor of 10 as a
window of safety is quite small. Indeed, in some of the
simulated cases, water
travel time from the repository to the water table is less than
1,000 years.5^*
Hence, the methodological judgment that current and near-
future knowledge
about Yucca Mountain can guarantee safety and compliance
with govemment
regulations—for example, requiring groundwater travel time of
more than 1,000
years—may be questionable.

The judgment about travel time is not only factually
questionable but also
inconsistent. One well known group of assessors, for example,
found that, ac-
cording to their models, some calculated groundwater travel
times are less than
10,000 years. They also admitted that hydraulic data were
insufficient, and that
there has not been enough time to estimate cumulative
radioactive releases.^^
Nevertheless, they concluded that the "evidence indicates that
the Yucca Moun-
tain repository site would be in compliance with regulatory
requirements,"^^ and
that "no radioactivity from the repository will migrate even to
the water table
immediately beneath the repository for about 30,000 years."^''
How do some
migration values of less than 10,000 years translate to a
migration time of
"about" 30,000 years? How can the same DOE assessors claim
that the reposi-
tory will be in compliance with govemment regulations^* when
they also assert
that low flux "will probably limit fiow velocities to the extent
that no leachate
will reach the water table for tens to hundreds of thousands of
years"?^^ Such
poorly grounded "probable" knowledge of something that may
occur within tens
to hundreds of thousands of years (a wide range) is hardly

consistent with
precise claims about safety and regulatory compliance!
Likewise, how can the
same DOE assessors conclude, with confidence, that no
radioactivity will mi-
grate to the water table for at least 30,000 years,^° and yet
claim: "Because data
and understanding about water flow and contaminant transport
in deep unsatu-
rated fractured environments are just beginning to emerge,
complete dismissal
of the rapid-release scenarios is not possible at this time"?^'
How is the 30,000-
year claim consistent with the assertion about not dismissing the
rapid-release
scenarios?
Assessors investigating the uncertainties in the Yucca Mountain
hydro-
geological data also have admitted that, for the unsaturated
zone, uncertainties
in groundwater velocities may be as much as 100 percent above
or below the
mean value.̂ -̂ They likewise claim that a change in percolation
of a factor of
only 10 is sufficient to initiate fracture fiow, that groundwater
travel time is
extremely sensitive to fracture flow,̂ ^ and that heat from the
waste could cause
fractures. '̂* Given such admissions, how can the same DOE
assessors consis-
tently claim that fracture fiow is not a credible process,^^ and
that groundwater
flow will be "well within the limits set by the NRC"?^^ Similar
inconsistencies
appear, when the same assessors, after acknowledging (1) that

they have incom-
plete data,^^ (2) that they have had no time to estimate
cumulative radioactive
releases,^^ and (3) that they may "have underestimated the
cumulative releases
of all nuclides during 100,000 years, by an amount that is
unknown,"^^ never-
theless draw a contradictory conclusion. They conclude that
only one ten-mil-
lionth of allowable releases of radionuclides will reach the
water table.™
Likewise, Yucca-Mountain assessors admit that solubility limits
and retarda-
tion factors are site- and (radioactive) species-dependent.'''
They also claim that
they may have underestimated radioactive releases.^^ If the
same DOE assessors
do not know the degree to which they may have underestimated
radioactive
releases,^' how do they know so precisely that only one ten-
millionth of allow-
able releases will be released? Similar inconsistencies and
unsupported extrapo-
lations occur throughout the Yucca Mountain analyses, with
DOE assessors
confidently affirming that there will be "less than one health
effect every 1,400
years." '̂̂ A more precise and consistent appraisal, given the
problems with the
data and models at Yucca Mountain, might be that of the
assessors who con-

eluded: "Even though we have tried to use the best data and
models available at
this time, we make no claims that these results have any value
in the perform-
ance assessment of the Yucca Mountain repository site."'*
Instead of using such precise language, however, the DOE's
final 1992 Early
Site Suitability Evaluation (ESSE) for Yucca Mountain
continues to formulate
site risks in terms of words such as "likely" and "unlikely,"
rather than by using
numerical probabilities.̂ *^ Similarly, when DOE reviewer M.
T. Einaudi com-
plained that the ESSE had vaguely defined the "foreseeable
future" as "the next
few years to 10 years, and occasionally as long as 30 years,"^'
the DOE ESSE
team responded by removing from the document all language
mentioning the
number of years. Next the team noted:
The evaluation and definition of the terms, such as "reasonable
projections"
and "likely future activities" will receive considerable attention
in the future
and is likely to utilize the review of a panel of experts.
This response, however, does not solve the problem with vague
language, both
because the DOE team uses the language to argue for site
suitability, and pre-
sumably such usage must have implications. Indeed, if the
language did not have
certain implications regarding future time periods, then it would

not be part of
an effective argument for site suitability. Hence, if the terms are
used effectively,
they must have some precise, implicit meaning. If they do not
have a precise,
implicit meaning, then it is arguable that they are not effective
in supporting the
site-suitability conclusions and ought not be used. Indeed, by
using indefinable
terms to defend conclusions about site suitability, the ESSE
renders its conclu-
sions nonfalsifiable and therefore ineffective, because vague
claims cannot be
falsified. And if the ESSE site- suitability claims are not
falsifiable, then this
suggests that they are a priori rather than empirical and
scientific.
Another reviewer (of the 1992 ESSE for Yucca Mountain), J. I.
Drever, also
complained about the failure of the ESSE to provide rigorous
definitions of
words such as "likely" and "significant."^^ Again, the final
ESSE document did
not alleviate the difficulty. Instead the ESSE Core Team
responded to Drever's
criticism:
The terms 'likely' and 'significant' should be defined in the
context of the
overall postclosure performance objectives. Because the
evaluations of sys-
tem performance cannot be definitive at this time, the ESSE
Core Team be-
80

lieved it inappropriate to define those terms precisely for this
evaluation.
This response by the DOE team, however, creates more
questions than it an-
swers. For one thing, to say that terms like "likely" should be
defined in terms
of overall postclosure performance is not coherent, because the
term "likely,"
for example, is rarely if ever used in the context of "total
system performance."
Rather, it is used in radically different, but specific contexts,
such as probability
of human interference at the site, or the probability of a route of
radionuclide
transport.*' Hence, terms like "likely" not only do not refer to
"overall perform-
ance," as the DOE team claimed, but, second, they are not
univocal. They clearly
mean different things in different ESSE contexts. Third,
although the ESSE team
says that such terms cannot be defined precisely because the
system evaluations
are incomplete, this response is puzzling because the ESSE team
obviously has
already used the terms to mean something. Fourth, if the
system-performance
evaluations are not definitive enough to allow the ESSE team to
define the very
terms that it uses, then it is unclear why the system-performance
evaluations are

definitive enough to support a lower-level suitability finding,
rather than an
unsuitability finding, for Yucca Mountain. Fifth, contrary to the
response of the
DOE ESSE Core Team, the terms used by the team clearly
presuppose some
precise meanings, because words like "likely" are often used in
precise regula-
tory contexts, such as "not likely to exceed a small fraction of
[radiation dose]
limits."*^ If such terms were not used somewhat precisely, then
it would be
impossible for the claims in which they are imbedded not to be
false. Likewise,
the ESSE Core Team claims, for example, that "although
confidence is substan-
tial, it is not yet sufficient to support the higher-level suitability
finding for this
qualifying condition."^^ Such a claim appears to presuppose
some precise level
or cut-off of confidence or likelihood. It appears to presuppose
that lower-level
findings are justified below this level, and that higher level
findings are justified
above it. For all these reasons, there appears to be a mismatch
between the
science and the regulations discussed in DOE assessments such
as the ESSE.
Because of this mismatch, it is questionable whether the science
discussed in
repository assessments is adequate to the regulatory task.
Previous experiences at the Maxey Flats low-level radwaste
facility show that
similar problems with value judgments about hydrogeological
accuracy—and

the ability of QRA to meet regulatory guidelines—may have
occurred there. Envi-
ronmental Protection Agency (EPA) assessors believed that the
knowledge of the
Maxey Flats site was adequate to insure containment, credible
regulation, and
safety, largely because "the general soil characteristics" at the
facility have been
"very impermeable." '̂* Yet, such general assurances failed to
address the problem
of leachate migration with sufficient precision and accuracy.
Other US EPA geolo-
gists noted that precise determination of hydraulic conductivity
is impossible at a
site, like Maxey Flats, with fractures.̂ ^ US Geological Survey
(USGS) scientists
claimed that the Maxey Flats hydrogeology, because of the
fractures, was "too
complex for accurate quantitative description."^^ Given the
complexity and uncer-
tainty associated with much information about Yucca Mountain,
there is reason to
believe that optimistic judgments, about the accuracy of site
studies, may err just as
they did at Maxey Flats. Because inaccurate knowledge of the
Yucca Mountain
facility prevents scientists from being able to predict precisely
migration rates of
the waste thousands of years into the f̂ uture, it also prevents
them from guarantee-
ing that the proposed repository will comply with very specific,
US radiation-
dose limits. Because compliance with government regulations is
unknown, and
because the consequences of repository failure could be
catastrophic, it is argu-

able that tbe Yucca Mountain facility ought not be built, at least
not until there
is significantly more knowledge about the future risks likely to
be associated
with the installation. The fact that nuclear industry, DOE, and
contractor repre-
sentatives support siting the facility suggests that this "iron
triangle" may be
taking inadequate account of scientific concerns about the site.
4, Nonquantifiable Uncertainty at
Yucca Mountain Argues Against Disposal
US NAS panelists said that perhaps the US should delay any
permanent
radwaste facility until we have more knowledge about long-term
repository
behavior. Likewise, a major US government commission,
studying policy for
dealing with high-level radioactive waste, concluded recently
that Congress
should reconsider the subject of interim [rather than permanent]
high-level rad-
waste storage by the year 2000 so as to "take into account
uncertainties that exist
today and which might be resolved or clarified within 10 years."
Indeed, said
the commission, "despite the considerable time and money
already expended to
site a repository, none has been sited yet, and the date by which
a permanent
repository will be available is uncertain...the most notable

uncertainty" is the
"date of opening a permanent repository" in the US.*''
At least part of the reason for the commission's worries, it
appears, are the
scientific uncertainties associated with the proposed facility at
Yucca Mountain,
some of which have been outlined in the preceding section.
Moreover, to the
degree that this nonquantifiable uncertainty precludes assurance
that precise
radiation-control standards can be met during the thousands of
years of opera-
tion of the proposed Nevada repository, to that extent it is
arguable that we
cannot yet guarantee the safety of permanent waste disposal.
And if we cannot
guarantee the long-term safety of proposed repositories, like
Yucca Mountain,
then the "dig now, pay later" approach of repository supporters
is highly ques-
tionable. Part of the rationale for delay or avoidance of a
permanent US reposi-
tory is a basic legal premise: res inter alios acta alteri nocere
non debet: no one
ought to suffer from what others have done.** Unless we can
guarantee that
many others in the future will not suffer unreasonably from
what we have done
in building a permanent repository, then our scientific
uncertainty may be suffi-
cient to argue against building the Yucca Mountain permanent
repository.
Why does our uncertainty about whether Yucca Mountain will
lead to catas-

trophe in the future argue against the facility? Brian Berry has
provided one of
the simplest rationales for the claim that the possibility of
causing future catas-
trophe is a decisive reason for not acting in the present. He
argues that, (1) in
the case of an individual making a possibly lethal choice that
affects only
himself we should regard anyone who chooses the potentially
fatal action—who
claims that uncertainty makes it premature to decide against the
action—as
crazy. Likewise, says Barry, (2) when we change the case to one
that involves
millions of people and extends over many centuries, the same
reasoning applies
with increased force. Barry's rationale for (1) is that no rational
person gambles
with his own life except to gain a comparable benefit, to save it.
Rock climbers,
sky divers, and other risk enthusiasts, however, might claim that
they are skilled
and well trained and hence not gambling with their lives since
the probability of
death for such a skilled person is low. Risk enthusiasts probably
would also
argue that they gain great benefits from their activities. Both
Barry and these
enthusiasts would likely agree, however, that as the benefits
decreased, and as
the probability of death increased, the risky actions become

more foolish.
Hence, (I) is reasonable. Barry's rationale for (2) is that,
because the numbers
of persons potentially at risk of death are larger, the impetus for
choosing against
the risk is likewise even greater. Despite reasoning such as
Barry's, official US
DOE documents have argued for permanent repositories on
exactly the grounds
that Barry says are most questionable. He claims that anyone in
this position
—who argues that uncertainty makes it premature to decide
against a potentially
catastrophe action—is "crazy." Yet, the US DOE repeatedly has
argued for such
a claim, for example:
A final conclusion on the qualifying condition for climatic
changes cannot be
made based on available data. However, the evidence does not
support a
finding that the reference repository location is not likely to
meet the qualify-
ing condition.
In other words, DOE officials have used uncertainty about
climatic changes as
an argument for the thesis that the repository ought not be
disqualified. Such an
argument, an appeal to ignorance, is problematic on both logical
grounds and for
the ethical reasons outlined by Barry. Moreover, in cases of
future catastrophic
risk, Barry's reasons (1) and (2) likewise are compelling,
because a repository
catastrophe presumably could wipe out an entire culture, not

just many persons,
and destroying a culture may be worse than merely killing many
people. Also,
in the case of our threatening future generations, the repository
risk is imposed
without the consent of the possible victims, and it is not
confined to the benefi-
ciaries—a point that we shall not take time to discuss here. For
all these reasons,
scientific uncertainty raises numerous questions regarding siting
permanent rad-
waste facilities like Yucca Mountain.^°
5. Uncertainty and Permanent Disposal: Other Countries
Despite the uncertainties associated with Yucca Mountain, the
US could have
a permanent geological facility for storage of high-level
radioactive waste there
as early as 2010.^' No other country is moving so quickly to
permanent reposi-
tories. Officials in other nations have openly admitted that they
are proceeding
more slowly with high-level radioactive waste disposal,
precisely because of the
scientific uncertainties involved. As the Board on Radioactive
Waste Manage-
ment of the National Research Council of the US National
Acadethy of Sciences
(NAS) put it:
The US program is unique among those of all nations in its rigid
schedule, in
its insistence on defining in advance the technical requirements
for every part
of the multibarrier system, and in its major emphasis on the

geological com-
ponent of the barrier as detailed in 10 CFR 60. Because one is
predicting the
fate of the HLW into the distant future, the undertaking is
necessarily full of
uncertainties.... It may even tum out to be appropriate to delay
permanent
closure of a waste repository until adequate assurances
concerning its long-
term behavior can be obtained through continued in-situ
geological studies....
There are scientific reasons to think that a satisfactory HLW
repository can be
built and licensed. But for the reasons described earlier, the
current US pro-
gram seems unlikely to achieve that desirable ^̂
What can we learn about the likelihood of success in permanent
geological
disposal, on the basis of activities in the various countries
considering the
repository option?
In eight of the nations with the most radioactive waste,
uncertainties have
forced the countries to postpone permanent geological disposal.
In Canada, for
example, although nuclear reactors supply about 13 percent of
the country's
electricity, there has been no decision about spent reactor fuel,
although Canada
will have approximately 34,000 MTU by the end of the century.

Given no
decision about permanent disposal, the earliest Canadians could
have such a
repository is 2010, even assuming that it wanted one.'^
Similarly, the French plan to use interim storage for a minimum
of 20 years
before moving to permanent disposal. Nuclear reactors currently
supply more
than 70 percent of French electricity. The earliest a permanent
facility could be
ready in France is 2010. The French rationale for delaying
decisions about
permanent storage is that cooling the waste would reduce the
thermal impact on
the host rock where it might be stored. In the Yucca Mountain
studies, many
problems have arisen because of the ability of the high-
temperature wastes to
induce thermal fractures in the host rock, thereby increasing the
probability of
fracture flow of the leachate. Because of such diH'iculties, "the
French believe
that the period [of interim storage] could be extended as long as
needed because
of the safety of monitored storage."'"*
Nuclear reactors supply approximately 40 percent of electricity
in Germany.
Like France, Germany is building interim storage facilities for
high-level radio-
active wastes, although the Germans hope to use deep
geological disposal at the
Gorleben salt dome. Even if the German plans are not delayed,
the earliest a
permanent repository could be ready is 2008. The Gorleben

facility was licensed
in 1983, but litigation conceming safety and scientific
uncertainty has, so far,
prevented its use as repository for spent fuel.̂ ^ In Japan,
approximately 32
percent of the nation's electricity is supplied by nuclear
reactors. Despite this
fact, the Japanese appear to be quite concemed about a
premature leap to an
inadequately tested technology for permanent waste disposal.
They plan to store
their vitrified waste for 30 to 50 years before considering deep
geological em-
placement. In fact, the Japanese do not plan even to try to
develop regulations
for siting a permanent repository until after the year 2000.
Hence, if approved,
the earliest date at which a Japanese repository could operate is
2030.'^
Spain is following a strategy similar to that of its European
neighbors. With
36 percent of its electricity supplied by nuclear reactors, the
Spaniards plan to
store spent fuel at the reactors for 10 years, and then to use
interim storage for
another 40 years. Sometime around the tum of the century, they
plan to consider
possible candidate sites for permanent geological disposal.
Their explicit strat-
egy is to gain more experience dealing with the wastes before
deciding what to
do with them.^'
In Sweden, approximately 50 percent of electricity is supplied
by nuclear

reactors. Because of scientific uncertainties and because they
want to achieve a
tenfold reduction in radiation and heat output from the waste,
the Swedes are
storing their spent fuel for 30 to 40 years in centralized, interim
storage facili-
ties. They do not expect to have a permanent facility available
until some time
after 2020.^* Like the Swedes, the Swiss plan to store their
spent fuel in interim
facilities for 40 years. Approximately 38 percent of electricity
in Switzerland is
supplied by nuclear reactors. The earliest a permanent
repository could be avail-
able in Switzerland is sometime after 2025. Like the Swedes,
the Swiss have
laws and regulations that make it impossible to site a new
commercial nuclear
plant unless operators can demonstrate safe disposal of spent
fuel. As a result,
no new plants have been sited in either country.^^
The United Kingdom (UK), with 17 percent of its electricity
coming from
nuclear reactors, has one of the longest periods of interim
storage of spent fuel,
50 years. Using interim storage at Sellafield has been necessary,
in part, because
of opposition in the UK to permanent disposal and because of
scientific uncer-
tainties associated with deep geological facilities. The earliest

date by which the
British could have a permanent repository ready is 2030,
although the have not
begun the siting process.'*^°
Although all eight countries just surveyed are some of the
world's major users
of nuclear electricity, and even though all of them plan to use
permanent geo-
logical disposal of spent fuel in the future, none of them expects
to do so as
quickly as the United States. Indeed, the preferred altemative is
to reduce uncer-
tainties about behavior of the waste. As the US review
commission put it: "In
general, deferred disposal is viewed as beneficial because it
reduces the heat
output of the wastes." As a result, centralized, monitored,
interim storage facili-
ties have been built or planned in all but one country, Canada,
where plans are
to use at-reactor interim storage."" If the experience of eight
major nuclear
countries is correct, then one powerful argument (for not
pursuing permanent
disposal at present and for postponing a decision about a
geological repository)
is that no nation, except the US, has plans for rapid permanent
disposal of
nuclear waste. If the plans of most countries refiect a scientific
consensus about
our inability, at present, to handle the uncertainties associated
with permanent
disposal of high-level nuclear waste, then these uncertainties
may undercut
arguments for permanent disposal anywhere at present.

6. Uncertainty and Permanent Disposal: An Objection
In response to these arguments about the scientific uncertainty
associated with
the safety of permanent geological disposal, a proponent of the
repositories
could argue that no science is ever certain, and that scientific
certainty is not
always required before one acts. In other words, one could
argue that reasonable
assurance of safety, not scientific certainty, is a precondition
for ethically defen-
sible behavior. On this view, one could argue that certainty is
impossible, and
therefore that one need merely follow the best available
scientific opinion or the
course of action leading to the best estimated results.
The heart of this objection to our analysis is correct. One does
not need
certainty before one acts, because certainty is unattainable. Our
argument, how-
ever, is not that permanent disposal requires certainty. Rather,
the argument is
that permanent disposal requires more certainty than we have
now, and that at
present, the uncertainties associated with permanent disposal
are extreme. For
now, we wish to raise the issue of what behavior is ethically
defensible under

conditions of uncertainty. Following Barry's insights already
mentioned, our
presupposition is that, in cases of extensive scientific and
probabilistic uncer-
tainty—like those concerning precise geological predictions
10,000 years from
now or like those concerning events whose uncertainty cannot
be quanti-
fied—we ought to behave in an ethically conservative way. But
what is ethically
conservative behavior? On one view, ethically conservative
behavior, in a situ-
ation of uncertainty, is behavior that does not reject the null
(no-effect) hypothe-
sis. That is, if we are uncertain about a catastrophic event in the
future, for
example, ethical conservatives do not assume there will be no
effect. In other
words, we ought to minimize type-II statistical errors. Although
we shall not
take the time to provide the arguments in full here,'"^ there are
a number of
reasons for minimizing type-II error in situations of uncertainty,
like those
associated with permanent geological disposal of radioactive
waste.
7. Uncertainty and Permanent Disposal: Type-II Error
In a situation of uncertainty, errors of type I occur when one
rejects a null
hypothesis that is true; errors of type II occur when one fails to
reject a null
hypothesis that is false. (One null hypothesis might be, for
example, "the pro-
posed Yucca Mountain repository will secure high-level

radwastes so that only
one ten-millionth of allowable releases of radionuclides will
reach the water
table over 100,000 years.")i«>3
Given a situation of uncertainty, which is the more serious
error, type I or type
II? An analogous issue arises in law. Is the more serious error
to acquit a guilty
person or to convict an innocent person? Ought one to run the
risk of rejecting
a true null hypothesis, of not using the Yucca Mountain
technology that is really
acceptable and safe? Or, ought one to run the risk of not
rejecting a false null
hypothesis, of employing the Yucca Mountain technology that is
really unac-
ceptable and unsafe? The basic problem is that to decrease type-
I risk might hurt
the public, especially members of future generations, and to
decrease type-II
risk might hurt both present persons and especially those
dependent on the
industries promoting the permanent repository.
In the area of pure science and statistics, most persons believe
that in a
situation of uncertainty one ought to minimize type-I risks, so
as to limit false
positives, assertions of effects where there are none. Pure
scientists often attach
a greater loss to accepting a falsehood than to failing to
acknowledge a truth.'""^
Societal decisionmaking under uncertainty, as in cases
involving siting perma-
nent radwaste facilities, however, is arguably not analogous to

decisionmaking
in pure science. Societal decisionmaking involves rights, duties,
and ethical
consequences that affect the welfare of persons, whereas purely
scientific deci-
sionmaking involves largely epistemological consequences. For
this reason, it
is not clear that in societal cases under uncertainty, one ought to
minimize type-I
risks. Instead, there are a number of prima facie reasons for
minimizing type-II
errors. For one thing, it is arguably more important to protect
the public from
harm (from possible catastrophic radwaste releases) than to
provide, in some
positive sense, for welfare (building permanent repositories),
because protecting
from harm seems to be a necessary condition for enjoying other
freedoms.'^^
Admittedly, it is difficult to draw the line between providing
benefits and pro-
tecting from harm, between positive and negative laws or
duties. Nevertheless,
just as there is a basic distinction between welfare rights and
negative rights,•"^
so there is an analogous distinction between welfare policies
(that provide some
good) and protective policies that prohibit some infringement).
Moral philoso-
phers continue to honor related distinctions, such as that
between letting die and

killing someone. It therefore seems more important to protect
citizens from
public hazards, like a catastrophic leak at a permanent radwaste
facility, than to
attempt to enhance their welfare, over the short term, by
implementing a tech-
nology such as permanent geological disposal of radwaste."'^ A
second reason
for minimizing type-II errors under uncertainty is that the
public typically needs
more risk protection than do the industry or government
proponents of the risky
technology, like Yucca Mountain. The public usually has fewer
financial re-
sources and less information to deal with societal hazards that
affect it, and
laypersons are often faced with bureaucratic denials of public
danger. Certainly
members of future generations are likely to have less
information to deal with a
permanent repository since, by definition (US regulations), it
will not be moni-
tored. Hence, their needs for protection seem larger, and the
importance of
minimizing type-II errors appears greater."*^
Third, it is more important to minimize type-II error, especially
in cases of
great uncertainty, because laypersons ought to be accorded legal
rights to pro-
tection against technological decisions that could threaten their
health and
physical security. These legal rights arise out of the
considerations that everyone
has both due-process rights and rights to bodily security. In
cases where those

responsible or liable cannot redress the harm done to others by
their faulty
decisions—as they cannot in the case of repositories' harming
future genera-
tions—there are strong arguments for minimizing the public
risk. Industrial and
technological decisionmakers cannot adequately compensate or
insure their po-
tential victims from bad consequences in the case of permanent
disposal, be-
cause the risks involve death. Therefore, they are what Judith
Jarvis Thomson
calls "incompensable." Surely incompensable risks ought to be
minimized for
those who fail to give free, informed consent to them. Whenever
risks are
incompensable, (e.g., imposing a significant probability of
death on another),
failure to minimize the risks is typically morally unjustifiable
without the free,
informed consent of the victim. "'̂ A final reason for
minimizing type-II error in
cases of uncertainty is that failure to do so would result in using
members of
future generations as means to the ends of present persons. It
would result in
their bearing a significantly higher risk from radwaste than
members of present
generations, despite the fact that present persons have received
most of the
ENVIRONMENTAL RISK AND THE IRON TRIANGLE ' 771
benefits associated with generating the waste. Such

DOI 10.1542peds.2012-2757; originally published online Nov.docx

DOI 10.1542peds.2012-2757; originally published online Nov.docx

Recommended

Recommended

More Related Content

Similar to DOI 10.1542peds.2012-2757; originally published online Nov.docx

Similar to DOI 10.1542peds.2012-2757; originally published online Nov.docx (20)

More from elinoraudley582231

More from elinoraudley582231 (20)

Recently uploaded

Recently uploaded (20)

DOI 10.1542peds.2012-2757; originally published online Nov.docx