Energy alternatives: what are their possible health effects

Energy alternatives What are their possible health effects? Here is an overview of actual and potential medical and environmental problems that present and future technologies may pose

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William N. Rom Jeffrey Lee Rocky Mountain Center for Occupational and Environmental Health Uniuersity of Utah School of Medicine Sal1 Lake City, Utah 841 12

Exciting new energy technologies are being developed to solve America's long-term energy problem. They include the mining and retorting of oil shale; extracting hydrocarbons from bitumen in tar sands; tapping geothermal resources; exploiting solar power; exploring fusion; developing new methods for gasifying, liquefying, or burning coal; and extracting gaseous fuels such as hydrogen or methane from water and plant material, respectively. However, these technologies may pose occupational and environmental health risks that need to be addressed early in the developmental stage to reduce or prevent potential exposures. By focusing on prevention of occupational diseases and exposures, health professionals and engineers can reduce significantly the long-term costs of an energy alternative. And lessons learned from the past (e.g., from the incidence of lung cancer among uranium miners and pneumoconiosis in coal miners) might be applied to the emerging oil shale and coal conversion processes. Sociopolitical and economic factors may be more important in making energy choices than health, safety, or environmental considerations (for example, cancellation of one major oil shale project for economic reasons, government-sponsored research and development or price guarantees, .consumer choice of wood-burning stoves in New England, and the like). As oil and natural gas sources are depleted in the decades ahead, there will be a transitional or interim period for research and demonstration of the new, emerging technologies. Data generated should allow government officials, industry representatives, and the public to assess the alternatives in terms of health risk and risk management strategies, as well as economic viability. Many articles, reports, books, and proceedings deal with various aspects of energy, health, or the environment (1-19). Documents from the Environmental Protection Agency (EPA) and the Department of Energy (DOE) and reports of the Electric Power Research Institute (EPRI, Palo Alto, 0013-936X/83/0916-0132A$01.50/0

Calif.) are pertinent to these topics ( 1 , 16, 17, 19-24). Attempts at quantitative risk assessment of various energy alternatives and technologies also have been reported ( 2 2 , 2 3 ) . The nuclear cycle The nuclear fission cycle includes uranium mining and milling, uranium processing, power production, spent fuel recycling, and radioactive waste disposal. Underground uranium mining presents a well-documented health hazard of lung cancer from inhaled radon daughters (decay products) ( 2 5 ) .Radon-222 is a chemically inert, radioactive gas formed by the radioactive decay of radium-226, a longlived member of the uranium-238

decay chain. Radon itself decays with a half-life of 3.6 d, releasing alpha, beta, and gamma energy through four short-lived daughters [polonium 218, lead 214, bismuth 214, and polonium 214 ( 2 6 ) j . The radon daughters are adsorbed onto dust particles in the mine air and inhaled by the miner. Depending on their size, the particles attach themselves to the respiratory epithelium, particularly at airway bifurcations. High-energy alpha particles are released during the decay process, resulting in exposure of respiratory basal epithelial cells of the bronchi to intense radiation. The unit of measurement quantifying the amount of radon daughters in air is the working level (WL), defined as any mixture of the short-lived daughters in a liter of air that has a potential alpha energy of 1.3 X los

@ 1983 American Chemical Society

MeV (2.8 X J). The working level month (WLM) is defined as an exposure to 1 WL for one month (1 70 h), and the current Mine Safety and Health Administration standard for a uranium miner is 4 WLM/y. Radon daughter exposure is controlled by mine ventilation and by blocking off old working areas. The average concentrations of radon daughters in working levels to which U S . underground uranium miners are exposed havedropped from 15 in 1943 100.15 in 1979 ( 2 7 ) . Lung cancers

The epidemiology linking uranium mining and radon daughter exposure to lung cancer is compelling and spans many decades (25).As early as 1879, Haerting and Hesse indicated that the majority of deaths among Schneeberg (East Germany) miners were attributable to lung cancer and that the disease occurred 20-30 y after they began their work (this was before cigarette smoking became epidemic) ( 2 8 ) . In 1924 Ludewig and Lorenser reported high concentrations of radon in the air in the Schneeberg mines and linked this to the high rate of lung cancer among the miners (29). In 1945, Mitchell identified the shortlived daughters in radon as the likely cause of the increased cancers in the Schneeberg and Joachimsthal (Czechoslovakia) miners (30). In the US.,extensive mining of uranium ores began on the Colorado plateau in the late 1940s, with many initial mine measurements for radon daughters as high as those in the Schneeberg-Joachirnsthal mines decades earlier (26). In 1962 Archer et al. reported an increased incidence of lung cancers among the Colorado plateau miners (31). Subsequently, a dose-response with radon exposure and synergism with cigarette smoking were described (32, 33). Later studies revealed the initial increase to be primarily among cigarette smokers, confirming a shorter dose-induction period among this group. However, studies of Navajo uranium miners (who seldom smoke) revealed increased risk even among light smokers and nonsmokers (33-35). Further analysis of the data showed that the average time between exposure and development of lung cancer (the induction period) is shorter for older miners than for younger miners (25).Years of life expectancy lost are higher in smokers than nonsmokers. The metaplasia (atypia, or bizarre shape or size of the cell, and abnormal nuclei) caused by cigarette smoke may Envimn. Sci. Technal.. Vol. 17. NO.3. 1983

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reduce protection of the basal cells by the ciliated respiratory tracheobronchial epithelium. The major U S . uranium miner epidemiologic studies have focused on a cohort of 3362 white and approximately 780 nonwhite males examined by the U S . Public Health Service in the decade 1950-60. They had worked underground in Colorado plateau uranium mines for at least one month by Jan. 1, 1964 (35). Their mortality has been determined thEough Dec. 31, 1977, and compared to U S . white males (standardized for age, calendar period, and cause of death) not working in uranium mines. Overall, 950 deaths were observed with a standardized mortality ratio (SMR) of 158 (Table 1). A fivefold excess was noted for cancer of the trachea, bronchus, and lung, and the attributable risk calculation determined that 80% of the deaths ascribable to lung cancer in this group could be attributed to uranium mining. There were also elevated risks for stomach, pancreas, prostate, and skin cancers, but none were statistically significant. Moreover, the excesses of nonmalignant respiratory disease consisted of bronchitis, emphysema, silicosis, and pulmonary fibrosis. Miners under the age of 50 had a twofold excess of mortality, primarily from lung cancer and accidents. The latter could be attributed to industrial, mining, and transportation causes. In 1964 Saccomanno et al. published results indicating an increase in the small-cell undifferentiated (oatcell) type of lung cancer (Figure lb; Figure l a shows a normal lung) among uranium miner patients (36). However, epidermoid (bronchogenic) and adenocarcinoma are also increased (37). Recently, these authors have

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biomedical concerns Public health concerns consider-" to be most urgent are: the probability of large radio:

tive releases through accident sabotage. "Areas where serious I certainty exists include the futi consequences of deterioration of pa of nuclear plants through aging. events such as earthquakes that i difficult to predict, or of deliber; sabotage of the generating plant other segments of the nuclear f i cycle by terrorist or criminal elemer whose technical knowledge and Lphistication, with time, will surely increase" ( 15, 54): storage of high-level radioact wastes; and somatic and genetic effectsof low-level radiation. ..

show.. .;.-.small ___. indiff _._... :ated carcinoma is associated with young age and a short dose-induction period, that adenocarcinoma was associated with a high WLM and smoking history, and that epidermoid carcinoma was associated with older age and a longer latent period (38).These associations were also consistent with a trend toward fewer small-cell carcinomas, since the high-exposed uranium miner cohort was aging, and younger miners worked under improved hygienic conditions (38). Since 1957, sputum studies of several thousand uranium miners on the Colorado plateau have been conducted. Saccomanno has demonstrated that there is a progression from mild metaplasia of squamous cells (cells originating from the respiratory epithelium) through moderate and

marked atypia over approximately eight years to carcinoma in situ (not yet metastasized) lasting approximately three years before invasive carcinoma is identified (39). The use of sputum cytology to justify transfer of a miner to another job or out of the mines remains premature, because of the heterogeneity in the method and lack of sufficient follow-up data on those currently under surveillance (40). Furthermore, sputum cytology itself is currently under study to assess whether early diagnosis may aid in tumor localization and treatment by fiber-optic bronchoscopy and laser eradication. Relative risks Table 2 illustrates the relative impact, expressed in man-rems (number of men exposed times average exposure in rems), of various components of the nuclear fuel cycle (41). Nuclear fuel reprocessing, once under way, may lead to three times as much exposure as uranium mining. On the.other hand, uranium milling has not been found to pose an occupational lung cancer risk, although one study did find an excess of lymphoma that was postulated to be related to thorium-230 (42). Uranium mill tailings also release radon gas and potentially may create a health risk when used as a filler for cement foundations. However, a recent study of an increased leukemia mortality rate in Mesa County, Colorado, where tailings were used extensively in house construction, found no association in a follow-up case-control study assessing leukemia patients resident in these houses (43). Even though uranium mill tailings are no longer used in residential or commercial construction, exposures to accumulated radon gas from tailings at other locations may occur unless remedial action is taken. The EPA and DOE recently received congressional authority to initiate a uranium mill tailing cleanup and disposal program. The Nuclear Regulatory Commission (NRC) provides standards for nuclear power plants; currently, the radiation dose limit is 3 rems quarterly for any worker, with an annual limit of 5 rems. In 1977, NRC licensee data listed 71 904 nuclear power plant workers, with 44 233 exposed (0.74 rem being the mean whole-body dose for those exposed) (44). Only 1.6% had an annual exposure >4 rems. Over 70% of those exposed were maintenance employees; however, many more potentially exposed maintenance workers may be employed by outside contractors.

FIGURE 1

Lung X-rays

( a J Nnrmal lungs.

(bJ Oat-cell carcinoma. Found in uranium miner who sustained

3200 WLM o/exposure ouerfiue years and who was a cigarette smoker. Note hilar and mediastinal enlargement with obstrucrioe pneumonia.

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((.) Pneumoconiosis. Discocered in coal miner who norhed underground for 30 years.

( d J Mixeddust pneunwconiiosis.Patient worked in oil shale mine /or one year, 23 years earlier, lhen laid railrond tracks i n a cool mine /or six months. Note hilar node colcijcation and lower lobe omcities.

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Man-rems (x Potential health effects p r 80MWe plant per year F s a l i Synpoolun an Ewgf

Ishlngan, D C ,198

The health risk of occupational exposures to low-level ionizing radiation must be obtained by extrapolation from higher levels (45, 46). This extrapolation is usually based on a linear dose-response relationship. Animal studies indicate that there is a linear relationship between low-dose exposures and health effects for X-ray, beta, and gamma radiation, but not for neutrons or alpha particles (47). Health effects include genetic effects (risk of malformation or disease in the unborn, which has received less research attention) and somatic effects, which involve cancer of a variety of organs. Ionizing radiation has been associated with myeloid leukemia, and lung, breast, thyroid, skin, liver, and bone cancer in particular. Two recent studies have assessed cancer risk from low-dose ionizing radiation. Lyon et al. have identified an increase (by a factor greater than two) in childhood leukemia mortality during 1959-67 in high-fallout counties of Utah downwind from nuclear tests in Nevada during the 1950s. Lyon subsequently confirmed the leukemia deaths by analysis of pathological specimens. He extended his observations through 1980 and found that following the 1959-67 increase seen shortly after the onset of atmospheric nuclear weapons testing, childhood leukemia mortality returned to lower levels. The attribution of this temporary excess leukemia to low-level radiation exposure has been challenged (48). Further studies will attempt to reconstruct the dosage received, examine the thyroids of children studied 1361

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for thyroid abnormalities in 1965, and ascertain the mortality patterns of amroximatelv one million Mormons poientially exposed and a similar number of those unexposed (49). Mancuso et al. and others studied radiation workers in Hanford, Wash., observing excess deaths caused by multiple myeloma and cancer of the pancreas and lung (50,51). However, no increase in myeloid leukemia (the most radiosensitive) was observed the diagnosis of cancer of the pancreas is often inaccurate on a death certificate; and the excess in lung cancer was not observed when controlling for calendar year, since between 1950 and 1975 general lung cancer death rates for

U S . white males more than doubled (51-53). A permanent high-level radioactive waste storage site has yet to be identified, and potential sites face political vetoes by states reasserting their power under the “new federalism.” For instance, one site in eastern Utah is adjacent to Canyonlands National Park in an area proposed for park expansion. Also, the decomissioningof spent nuclear power plants has yet to begin; recent discoveries of long-lived radioisotopes (nickel-59 and niobium-94) in nuclear power plant steel and concrete casings suggest that the amount of nuclear power plant waste needing storage may be much larger than originally believed (55).

The coal cycle The coal cycle includes the mining and transportation of coal and combustion in a coal-fired electrical or heating plant with attendant air pollution and fly ash disposal problems. In addition, it includes coal conversion technologies, such as coal gasification and liauefaction. Coal is also directlv burned in some small industries, a’s well as in homes for the purpose of space heating. The US. produces 20% of the world‘s coal and has extensive reserves. Half of the coal is mined from underground mines and half from surface mines; more than 20 states have coal mines. The maioritv . . of the coal mined is bituminous and subbituminous, with a few anthracite mines in Pennsylvania and lignite strip mines in Texas and North Dakota. Hazards to the nation’s almost 200 000 coal miners include coal mine dust, diesel exhaust emis-

sions, asphyxiant gases (CO, C02, hydrogen sulfide, and methane), explosions, and accidents. The mortality of coal miners, U S . coal miners in particular, was recently reviewed by Rockette (56).Hedetermined the vital status and cause of death of a random sample (23 233 miners) eligible for United Mineworkers of America health and retirement funds as of Jan. 1,1959. He achieved a 99% follow-up (22 998 miners) of this cohort through Dec. 3 1,197 I. Significant increases in the standardized mortality ratios for stomach cancer, respiratory disease (influenza, emphysema, asthma, and tuberculosis), and accidents were found (Table 3). There were 187 deaths directly attributable to coal workers’ pneumoconiosis (CWP), and CWP was men-

Respirable coal particles are deposited in the terminal respiratory bronchioles and alveoli where they are engulfed by alveolar macrophages. Collections of macrophages and particles form coal macules, a characteristic lesion that is nonpalpable. The macules are nonspecific, but sharp, angular particles are characteristic of coal, whereas rounded particles are more commonly seen in smokers’ macules (61).Next, focal emphysema, a dilation of the respiratory bronchioles caused by the stresses and strains placed on the tissue from accumulated dust, macrophages, and reticulin, develops, and actual tissue destruction and smooth muscle atrophy may be observed (61, 62). Small pulmonary arterioles may be obliterated in the nodular stage, - . and cor pulmonale

coal UI..

The . greatest . . risk is to the respiratory system,

tioned as a contributory cause in 393 deaths. The overall SMR was 101.6, which is comparable to the general population, although some investigators consider this figure high compared to that for other working groups

Pneumoconiosis Coal workers’ respiratory disease consists primarily of CWP (Figure IC) and industrial bronchitis, but exposures to cigarette smoke, silica, and air pollution may alter the spectrum of responses to include emphysema, silicosis, tuberculosis, and other respiratory diseases (57, 58). Coal dust has been shown to cause pneumoconiosis in the absence of silica, for example, among coal trimmers working with washed coal in the holds of ships decades ago and among electrotypists workl’ng with pure carbon (59,60).

(heart failure secondary to lung disease) has been described. Coal workers’ pneumoconiosis may be simple or complicated; radiographically, these two diseases are defined by the size of the pulmonary nodules, with > I cm characterized as complicated. Pathologically, a 2-cm nodule is considered evidence for complicated CWP (61).Simple CWP usually is not associated with pulmonary function impairment, whereas complicated CWP more often is, and categories Band C have been shown to result in decreased longevity (57). (Categories A, B, and C refer to the increasing volume of the large opacities in complicated CWP). Simple CWP is divided into categories 1, 2, and 3, according to the profusion of opacities in a chest radiograph. Physiologic changes in categories 2 and 3

are minimal: They consist of alterations in the distribution of inspired gas, increased closing volume and capacity, increased residual volume, increased alveolar-arterial oxygen gradient, and, in the p-type (rounded opacities less than 1 mm), a reduced diffusing capacity (63). Complicated CWP or progressive massive fibrosis (PMF) usually involves physiological abnormalities and may result in respiratory impairment. Coal dust exposure or other fibrogenic dust (usually siliceous) plus an unknown factor-probably immunologic-may lead to PMF (57). Although most cases of PMF appear to arise in persons with categories 2 and 3 simple CWP, recent British studies indicate that almost half may arise directlv in Dersons whose chest films showed cacegory 1, or even normal (64).Thus, preventing or reducing the chances of the development of category 2 pneumoconiosis by dust control may not entirely eliminate the risk for developing PMF. Longitudinal studies (prospective epidemiological investigations) in the United Kingdom, sponsored by the National Coal Board, have developed estimates of the probability of developing category 2 simple CWP after 35 y a t the coal face at different mean dust concentrations (65).Their recent data suggest a risk of approximately 5% or less at the current U S . dust standard of 2 mg/m3. PMF.lesions tend to occur in the upper and posterior regions of the lungs bilaterally and destroy blood vessels and airways, greatly distorting the lung architecture. These lesions are composed of collagen, calcium phosphates, and various proteins, including hydroxyproline, and glycosoamin6 glycans (66). Caplan described a syndrome of bilateral, peripheral, 1-5-cm rounded lesions associated with simple CWP and with rheumatoid arthritis and high titers of rheumatoid factor in the serum (67). Coal workers have been described as having a variety of circulating immune responses, but their relationship to the etiology of CWP remains uncertain (68). Epidemiologic studies have been performed by the National Institute for Occupational Safety and Health (NIOSH) under the Federal Coal Mine Safety and Health Act of 1969 (69). Round two (1974-77) of the NIOSH National Coal Workers’ Health Surveillance Program of more than 114 000 miners found 5.7% to have CWP and 0.2% to have PMF (70). Pulmonary function studies have shown that the obstructive impairment Environ. Sci. Technol.. VoI. 17. NO. 3, 1983

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in simple CWP or among coal miners with normal chest radiographs is probably related to cigarette smoking (71 ). National studies have also demonstrated a geographic difference, with CWP more prevalent in Appalachia than in the Midwest or West ( 5 7 ) . These differences were explained on the basis of coal rank (higher rank referring to a higher Btu coal with less volatile mqtter), with the East having higher-ranked coal. British studies also have found an effect of coal rank on pneumoconiosis risk and have shown that silica exposure correlated with CWP in low-rank coal mines, while mean mass of coal particles correlated with CWP in high-rank mines (70,72, 7 3 ) .Toxicity and size of the coal dust particles may also influence pneumoconiosis risk (74). Bronchitis and emphysema Coal miners have excess industrial bronchitis (cough and phlegm production) related to larger coal particles (>5 pm) depositing on the larger airways (75). This does not generally result in any changes in pulmonary function tests ( 7 6 ) . Considerable controversy exists, however, on emphysema in coal miners. Nonsmoking coal miners have been found to have similar type (centrilobular) and extent of emphysema at autopsy as do smoking coal miners (77). Centrilobular emphysema has correlated with both age and coal mine dust exposure among British coal miners autopsied by scientists at the Institute of Occupational Medicine in Edinburgh, Scotland (A. Seaton, personal communication). Surface coal mining poses far less risk of CWP, since exposures are generally much lower, although accelerated silicosis has been reported among surface drillers by NIOSH ( 7 8 , 7 9 ) . In 1976, NIOSH estimated that there were 65 new cases of CWP per million tons of coal mined underground. NIOSH also estimated the accident rate per million tons of coal: 0.10 accidental deaths and 5.2 accidental injuries for surface mining, and 0.35 accidental deaths and 2 injuries for underground mining (23). Power plants Following mining, coal is transported, crushed, and burned in power plants. NIOSH has estimated that there are 0.084 occupational accidental deaths per million tons of coal transported, and 9.8 general-public and 1.08 occupational injuries per million tons of coal transported ( 2 3 ) . 138A

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The occupational environment in power plants is complex, with many paths of potential exposure including coal dust, chemical solvents, PCBs, noise, mercury in switches, electromagnetic radiation, asbestos, fly ash, sulfur dioxide, and others (80). Unfortunately, epidemiologic research on occupational health in this industry is sparse. Asbestos-related disease has been reported among pipe coverers in power plants in France; also, one of our colleagues recently observed a patient with hypersensitivity pneumonitis from being exposed to fungi while cleaning a power plant baghouse (81). New technologies might, in the future, play a role in curtailing health risks from coal. For instance, the hot gases from coal combustion can be used directly to generate electricity, a process termed magnetohydrodynamics (MHD) (19,82).Fluidized-bed combustion is an additional technology that may achieve reductions in SO, and NO, emissions when high-sulfur coal is burned ( I 9 ) . Other issues related to the coal cycle include sulfur oxide(s) and particulates from exhaust stacks, which contribute to general air pollution, and acid rain ( 1 0 , 8 3 , 8 4 ) Radioactive . isotopes and toxic metal and halogen compounds also are generated and released by coal combustion (85, 86). The release of carbon dioxide contributes to the global increase in COz levels (11). The reclamation of strip mined lands, acid seepage from mined-out areas, uncontrolled fires in closed underground mines, and disposal of fly ash with arsenic, beryllium, lead, cadmium, mercury, nickel, and other hazardous metals present additional environmental concerns related to the coal cycle. Land reclamation, restoration of lands disturbed by both surface and underground mining, is required by the 1977 Federal Surface Mining Act. Gasification Coal conversion technologies include coal gasification and liquefaction. These synthetic fuel routes provide clean-burning gas and liquid fuels for multiple uses: power production, transportation, and chemical feedstocks. In the western U.S., coal conversion plants are likely to utilize strip mining, which has a lower occupational health and safety impact than does underground coal mining. Coal gasification involves cracking heavy hydrocarbons into lighter ones and enriching the resultant molecules with hydrogen. Three types of coal gas can be produced by coal gasification: low (100-200 Btu/ft3), medium

(300-650 Btu/ft3), and high (9501000 Btu/ft3) Btu gas. Low-Btu gas is produced by reacting coal with steam and air; medium-Btu gas is produced similarly, except that oxygen is substituted for air; and high-Btu gas is made from medium-Btu gases by a methanation reaction and is equivalent to natural gas. Low-Btu gas has been produced from coal since the 19th century; currently the Lurgi, Koppers-Totzek, and other technologies are being evaluated (19). A gasification scheme begins when pulverized coal is injected into a reactor where it is gasified with heat (hot steam), oxygen, and elevated pressure. Next come gas cleanup, which removes solids, tars, and oils; gas cooling; and shift conversion, whereby CO and steam are converted to Hz and carbon dioxide so that increased hydrogen is reacted with residual C O . to form methane. The next steps in the gasification process are acid gas removal, which consists of using methanol to absorb gases such as carbon dioxide, hydrogen sulfide, and carbonyl sulfide; sulfur recovery, usually employing the Claus process, which uses bauxite to burn hydrogen sulfide to sulfur and water; and catalytic methanation, usually using a nickel catalyst to hydrogenate various carbon oxides to methane. Finally, compression and dehydration prepare gas for the pipeline in the case of a high-Btu gas or deliver it to a boiler to produce heat or steam in the case of low- or mediumBtu gas (87). Coal gasification also may be accomplished underground, producing a low-Btu gas that makes possible the use of coal seams not amenable to mining, and avoids the expensive and risky step of coal mining (88). Coal gasification processes may be used to produce a clean gas for power plant combustion by removing sulfur and nitrogen as hydrogen sulfide and ammonia in the gas cleanup phase. This process completely gasifies the coal, leaving neither a tarry residue nor the calcium sulfate sludge resulting from flue gas desulfurization in standard power plants (89). Gasification health hazards The major occupational hazards of gasification are to maintenance workers who may be exposed to process streams and fugitive emissions containing a variety of possible toxicants. These include: trace metals that may be adsorbed on particulate matter or included in by-products, final products, or other gases as fugitive pollutants;

polynuclear aromatic hydrocarbons (PAHs), suspected of being mutagenic and carcinogenic; sulfur compounds in the form of hydrogen sulfide and lesser amounts of carbonyl sulfide and carbon disulfide found in the gas stream; nitrogen, which in coal is chemically bound as amines and in ring structures. Under heat and pressure, organic nitrogen compounds are released and react to form ammonia primarily but also lesser amounts of amines, hydrogen cyanide, and heterocyclic nitrogen compounds-severa1 of which are mutagenic; and carbon monoxide. Liquefaction Coal liquefaction, particularly solvent refining, has been shown to produce many mutagenic substances, but it has one advantage over gasification in that a range of liquid products (heavy boiler fuel, distillate fuel oil, gasoline, jet fuel, and diesel oil) can be produced by varying the type of process and operating conditions. There are several major technologies: Solvent extraction. In this method, crushed coal is dissolved in a process-derived solvent through an indirect transfer of the hydrogen to the coal. Direct hydrogenation. A catalytic reactor adds hydrogen under pressure to slurried coal with recvcled oil. Pyrolysis. Thermal decompositionofcoal is brought about by heating it in the absence of oxygen, producing a liquid product as well as a by-product of gas and char. Indirect liquefaction. This method (Fischer-Tropsch process) involves the initial gasification of coal to produce a mixture of carbon monoxide and hydrogen (synthesis gas), which is purified and converted to a liquid fuel via a catalytic reaction (90). The Fischer-Tropsch process is in operation in Sasolburg, South Africa. In both coal conversion processes, closed systems are the design objective to Drevent anv significant occuoational exposure. a i d considerable kffort in d o t studies has been exwnded to ,revent any breaching of the system. Conversion plants will have water effluents, gaseous emissions, and solid wastes similar to those of oil refineries and chemical plants. However, coal liquefaction produces numerous carcinogenic and mutagenic toxicants, thereby providing a challenge to industrial engineers and hvnienists to reduce or Aminate occup&onal exposures to these substances (91-97). The heavy distillates appear to be a

major source of PAHs and the primary amines of PAHs that have both mutagenic and carcinogenic properties. Catalytic hydrogenation within liquefaction processes is quite effective in converting these substances to nontoxic species, and current wastewater treatment systems are effective in removing many of the toxic hydrocarbons. In 1952, Union Carbide developed a commercial coal liquefaction process with a medical surveillance program. Between 1955 and 1960, R. J. Sexton, the plant medical director, found one worker with two cutaneous (skin) cancers, nine workers with one cuta-

coal (higher hydrogen:carbon ratio) and it can be converted into liquid fuels more economically. The oil in oil shale is contained in an organic substance known as kerogen, a waxy, solid, and largely insoluble complex organic material composed mainly of carbon, hydrogen, oxygen, sulfur, and nitrogen. The shales of the Green River formation on the Utah-Colorado border contain an estimated 1.8 trillion barrels of oil; 600 billion barrels of oil are recoverable from these deposits with current technology. Oil shale can be mined by open pit methods or underground room-andpillar methods, or retorted in situ.

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Occupational health r neous cancer each, and 40 workers with one cutaneous precancerous lesion each, out of an exposed work force of 359 (98). A follow-up of the cohort of 50 workers with skin lesions through 1977 confirmed five deaths. none from cancer (99). The National Institute for Occupational Safety and Health is developing a literature and data bank on the coal conversion processes, primarily consisting of industrial hygiene information from pilot plants (12). The oil shale cyele Oil shale is very attractive in the synthetic fuels industry because its molecular chemistry is simpler than

Retorting requires heating of the oil shale to between 350 and 500 'C, at which it decomposes and yields an oil vapor which, in turn, condenses at a lower temperature into liquid oil. True in situ techniaues involve the explosive, undergrouid fracturing of the shale, and retorting in place. A horizontal in situ retort has been developed in Utah; a thin, 30-ft layer of oil shale is retorted with the flame front on one end, while pumps remove the shale oil on the far end. Modified in situ processes involve mining 20-40% of the oil shale and then b'iasting the remainder to rubble, which fills the void spaces. The mined portion can be transported to the surEnviron. Sci. Technol.. Vol. 17, No. 3, 1983

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face and retorted. The unmined portion is retorted in place, generally vertically by igniting the upper layer and pumping the shale oil from the bottom of the mined area. Oil shale may be retorted above ground by two methods: direct and indirect. In the direct method, oil shale is crushed into particles of suitable sizes and charged in a retort. One end is ignited, and air and recycled gas are pumped into the retort. An oil mist is collected and condenses into shale oil. In the indirect method, another medium (such as porcelain balls) is heated and introduced into the retort, or the oil shale is retorted by recycled gas heated outside the retort. Because the kerogen molecule (C215H330012N5S) is too large to be refined conventionally, it must be hydrogenated before refining to various petroleum products (100). Hydrotreating shale oil reduces the nitrogen content from 2 to 0.3% and the sulfur content to negligible levels, and significantly reduces the levels of various metals, such as arsenic, nickel, iron, and vanadium (101). In addition to refining, oil shale may be burned in the pulverized powder form in electric power plants; however, in Estonia, U.S.S.R., where this is done, large amounts of noncombustible wastes are generated.

Oil shale pollution problems Oil shale development will create pollution problems involving air, water, and solid waste. Particulate emissions will be produced by mining, crushing, and retorting, with higher pollutant levels produced by those processes requiring a fine oil shale feed. For example, an industrial hygiene survey of the pilot operations at the Anvil Points, Colo., facility has demonstrated increased levels of silica-containing dust (102). The major source of SO2 will be from the ammonia and sulfur recovery processes (203). Nitrogen oxides will be emitted when low-Btu shale offgases are burned in steam and power production. Hydrocarbons and carbon monoxide appear to be less of a problem, but they may be emitted in the aboveground retorting operations. Carbon monoxide may be a hazard near the in situ or modified in situ retorts because of ongoing combustion, while fugitive emissions through fissures following the rubbling process may be a particular hazard for workers. Oil shale wastewater may contain many toxic constituents, including trace metals, phenols and other organic chemicals, and carcinogens 140A

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(such as PAHs). Mine drainage waters may contain inorganic salts, chloride and fluoride ions, and boron. Leachates from spent shale piles may contain many inorganic salts, trace elements, and organic compounds. Their alkalinity (pH 8-1 3) could result in significant water quality changes. A potentially major concern is the unknown contamination of aquifers from in situ or modified in situ retorts, resulting from contaminated water that would be difficult to treat. Several potential occupational health problems are associated with the oil shale industry. These include oil shale mine dust, PAHs, irritant and asphyxiant gases, toxic metals and catalysts, physical factors such as heat and noise, and the threat of accidents related to the hazardous nature and large scale of many of the proposed operations (104). A commercial oil shale industry existed in Scotland from the mid-19th century until 1963. Oil shale from the underground mines was retorted to shale oil and used for a variety of commercial purposes, including lubrication for spindles in the English textile mills. In 1876, Bell reported the first oil shale cancer in the scrotum of a Scottish oil shale worker at the Royal Infirmary of Edinburgh (105). Alexander Scott observed oil shale workers, and reported 65 cases of epithelioma from 1900 to 1921 (106). There were over 5000 Scottish shale oil workers; thus the total incidence rate was 1.5%, or less than O.l%/y. In 1922, Leitch documented the carcinogenicity of Scottish shale oil by producipg skin papillomas in animals through skin-painting experiments (107). Berenblum and Schoental identified 0.01 % 3,4-benzo[a] pyrene (B[a]P) in blue shale oil, which is carcinogenic in animals (108), Seaton et al. recently described complicated pneumoconiosis in four patients diagnosed toward the end of a lifetime’s work in underground oil shale mines (109). They reported that the clinical and histological features resembled the pneumoconioses of coal miners and kaolin workers and that the lungs of three of the patients were shown to contain dust composed predominantly of kaolinite, mica, and silica. Two of the patients were found at necropsy to have peripheral squamous-cell carcinoma of the lung (Figure 1d). Estonia has had an oil shale industry for several decades, with about 25 million tons mined annually for use in power plants, as a chemical feedstock, and as a lubricant, as well as for other

purposes. Bogovskiy has shown that B [a ] P-containing and B [a]P-free fractions of shale oil may be carcinogenic to mice when administered by skin painting or intratracheal injection (110, 111). He concluded that carcinogenicity was highest for the fractions retorted at the highest temperatures, that there was no parallelism among local irritant, general toxic, and carcinogenic effects, that blending carcinogenic oils with noncarcinogenic ones was relatively ineffective in lowering carcinogenic potency, and that determining B[a]P quantity did not provide a reliable index of potency. Bogovskiy stated that many fractions contained promoters and co-carcinogens in the complex mixtures.

PAHs from coal and oil shale Both the coal conversion and oil shale cycles produce PAHs that have three or more fused aromatic rings and include several that are carcinogens (13,14,95-97). The biologic activity of these compounds is complex; depending upon the site of methylation of benzanthracene, for example, the resulting compound may be carcinogenic or noncarcinogenic. PAHs are activated by the hepatic microsomal enzyme system to carcinogenic forms that may bind covalently to DNA (112). The PAH forms are metabolized by aryl hydrocarbon hydroxylase, an enzyme located in the endoplasmic reticulum or microsomes of a variety of tissues. Most PAHs are hydroxylated in tissue; the resulting phenolic compounds are then conjugated, usually with glucuronic or sulfuric acid, and excreted via the urine or the bile. The carcinogenic property of soot (containing certain PAHs) was recognized as early as 1775 when Sir Percival Pott associated the soot that contaminated the chimney sweeps’ pants with cancer of the scrotum (112). Even after two centuries, the chimney sweep trade still exists, and a recent Swedish study found that there is still an excess risk for occupational cancer (113). Kawai has reported a 33-fold increase in lung cancer risk among male workers exposed to tar fumes while employed at the gas generation facility of a Japanese steel mill (114).The risk was greatest among those with greater than 20 years’ employment and could not be explained by cigarette smoking. Sir Richard Doll studied 2071 male pensioners of a London gas company and found that lung cancer deaths were double those of male inhabitants of London of the same age but without

exposure and that bladder cancer was increased fourfold (115). Cancers of the skin and scrotum were also detected. Cokeoven workers have been found to have a lung cancer mortality rate greater than twice that predicted by the experience of all steelworkers; excess cancer of the kidney also has been identified (116, 117). Risk increased with increasing duration of exposure, and those exposed to higher PAH concentrations topside had a greater risk than those working along the sides of the ovens (117).Oil shale coke has been found to be a potent carcinogen in animal experiments (118). Hueper of the National Cancer Institute, who conducted extensive bioassay testing of hydrocarbon products from synthetic fuel processes, stated in 1953: “It

following low-temperature (100 “C) alkaline separation (121). Based on petroleum refinery experience, the upgrading of 10 000 barrels per day of bitumen could yield approximately 360 Ib of carbon monoxide, I 1 600 Ib of hydrocarbons, 6500 Ib of nitrogen, and 8800 Ib of particulates (122). No PAHs have been detected in the lowtemperature pilot plant tar sands operation conducted by the University of Utah. Geothermal power plants are in operation in California, Mexico, New Zealand, and Italy, with lower temperature geothermal energy being used for space heating in a variety of other places as diverse as Salt Lake City, Utah; Reykjavik, Iceland; and Boise, Idaho (20). Water temperatures of 100-150 “ C may be used for space

odor (123). Processes to abate hydrogen sulfide emissions have concentrated on removing it from the condensate and producing a sulfur sludge, which presents disposal problem and has resulted in several cases of occupational dermatitis (123). A design change that mitigates ths situation employs a tube-and-shell condenser that forces more of the hydrogen sulfide into the noncondensable gas stream; the stream is then treated in a Stretford unit to convert hydrogen sulfide to commercial-quality sulfur. Other occupational and environmental problems include noise [I20 dB(A) has been measured during the venting of wells], explosive gases such as isobutane in binary systems, carbon dioxide in enclosed spaces, ammonia near the cooling towers, arsenic in the wastewater, and very small amounts of mercury, boron, and radon gas (123).

Fusion and solar Both nuclear fusion and solar energy schemes envisage bountiful energy harvests with minimal environmental or social disruption. Critics argue that these are “pie-in-the-sky” solutions, but solar at least may make a substantial contribution even in the near term. Advocates of centralized thermonuclear fusion power state that their fuel supply is accessible,abundant, and cheap, and that this cycle would achieve a high degree of safety with low levels of social and environmental impact (124). However, fusion power I in a reactor in the laboratory leading to net power production has not yet solar eiectrlcily. The production process could inuolue several toxicants. been accomplished. Major environmental liabilities would include tritium leakage and activation of structural can be expected, therefore, that both heating. Temperatures of 150-210 OC materials by neutron bombardment. producers and consumers of these coal are required for a binary system that Specific concerns include: hydrogenates may run a definite can- uses the geothermal fluid to heat a extraction and processing of the cer hazard, if they are not properly high-vapor-pressure gas such as isobasic fuels, protected against contact to the skin or butane in a heat exchanger that then routine emissions of radioactivity [against] inhalation of these products drives a turbine. With temperatures from fusion reactors, in the form of pastes, greases, liquids, above 210 OC, the geothermal fluid production and handling of rafumes, or mist:” (119). may be used to drive the turbine di- dioactive wastes, rectly. nonroutine releases of radioacTar sands and geothermal cycles Because processes at the various tivity (through accidents or hostile The tar sands and geothermal en- geothermal plants and environments acts), ergy cycles are less important than differ, their impacts are also different. demands on nonfuel materials, other alternatives at present because The geothermal cycle is rather short, thermal discharges, and their potential energy is less than that since steam is flashed from hot water; the use of nuclear materials for of nuclear fission, coal, or oil shale. Tar the condensate can be used in cooling weapons (124). sands are found mainly in Utah (30 towers or reinjected into the reservoir. A nuclear fusion reactor would inibillion barrels of oil) and New Mexico This obviates the need for combustion, tially utilize the deuterium-tritium (20 billion barrels) (120). These de- mining, retorting, and refining. The reaction and “breed” tritium by bomposits differ from the Athabasca tar major environmental and occupational barding a lithium blanket with neusands in Canada in that there is less exposure involves hydrogen sulfide, trons. Very high energies could be water interposed between the sand and which has annoyed inhabitants near generated, and the fuel elements tar. The tar is removed as a bitumen The Geysers, Calif., with its pungent (lithium) are abundant and easy to

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extract. Furthermore, compared to fission reactors. fusion has the potential for a less hazardous radioactive material inventory, less long-lived waste, less vulnerability to loss-ofcmlant accidents, no fissionable materials to steal, and production of less waste heat because of higher efficiency (124).

Solar energy includes a wide variety of technological approaches that could be considered under two headings: solar heating and cooling systems and central electric generation (24, 125). A typical solar heating system includes a flat-plate collector on the roof of a building plus a storage device varying from cement walls to a water tank in the basement (126). Other designs include various passive concepts in housing design and orientation, such as southerly oriented greenhouses that can vent warm air into the house during cold winter months ( 2 4 ) . Central electric generation encompasses a variety of concepts. These include: using temperature differentials in oceans; collecting and focusing the rays of the sun with giant mirrors or heliostats that move with the sun; concentrating the sun’s rays upon a point to elevate temperatures sufficiently to produce steam; solar-powered satellites that can transmit energy to the earth’s surface via microwaves; and solar or photovoltaic cells that convert the sun’s energy directly into electricity (127). Windmills can produce electrical energy, and they have been used for centuries to pump water. When supplemented with central power for windless days, windmills can provide electricity for private homes. However, inconsistent wind requires electrical storage that usually makes wind energy uneconomical. Now enjoying renewed interest, wood or biomass is the oldest known form of solar energy, but the increase in winter particulate loads from wood-burning stoves may lead to, or exacerbate, chronic bronchitis and asthma ( 2 1 ) . Photovoltaic solar cells, which convert sunlight directly into electricity, consist of three types: silicon, cadmium sulfide, and gallium arsenide (19). The three cells work on the same principle, that is, by driving electrons from an electron-rich layer (n-type semiconductor) to an electron-poor layer (ptype semiconductor) using light energy. Silicon is the more common type of photovoltaic cell. Its production process involves exposures to a variety of toxicants. The process entails mining 142A

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quartz-bearing rock; reducing the quartz with coke in an electric arc furnace at 1000 OC to produce silicon; and purifying the silicon through the fluidization of a bed of finely pulverized, metallurgical-grade silicon with hydrogen chloride (little is known about the human health effects of the resulting chlorosilanes). Additional steps entail heat conversion of chlorosilane to polycrystalline silica; single-crystal production via the Czochralski process of zone refining and addition of boron to form the p-type semiconductor (exposures to diborane or silicon monoxide may occur); and creating the wafers and adding phosphorus to form the n-type semiconductor (exposures to phosphorous compounds, including phosphine, may occur) (128). Thus, manufacturing solar cells involves resource extraction procedures similar to those for other fuel cycles, use of numerous exotic compounds in the production process, and eventual disposal of hazardous waste. Advances in photovoltaic materials technology and automation in processing are necessary before solar cells can be cost-competitive ( 1 2 9 ) . No innocuous system The health, safety, and environmental effects of the various energy alternatives are complex. Nevertheless, several sources of exposure are common to all of them: resource extraction, milling and processing; construction and operation of the energy-producing unit; and environmental pollution of air, land, and water. No system is environmentally innocuous; moreover, social, political, and economic dictates may affect the priority of the options. The consuming public has a role in shaping the governmental function, since the federal government sponsors research and development in energy cycles, for example, through DOE, the Tennessee Valley Authority, the Synthetic Fuels Corporation, and the Solar Energy Research Institute. The federal government itself is such a large purchaser of energy that economies of scale become possible. An example is found in the use of photovoltaic cells at remote military stations or for highway lights. We encourage government research and development funding for solar and nuclear fusion projects, which appear to have less potential for adverse environmental and health impacts, rather than for nuclear fission or synthetic fuels where the private sector is already active. We also suggest that

impacts on health, safety, and the environment from synthetic fuel cycles are potentially significant and that nuclear fission has adverse impacts more difficult to measure precisely (accidents, risk of sabotage, and the disposal of radioactive waste). Other energy ideas, such as genetic engineering to produce methanol from biomass cheaply to fuel transportation systems; using solar energy to produce hydrogen fuel from water; and cogeneration to produce both heat and electricity from methane or natural gas, using municipal and industrial waste or coal gasification, should offer opportunities for federal and private research. A transitional period from the use of oil, gas, and coal to renewable or long-term energy resources is necessary, but it is unclear whether this period should be dominated by synthetic fuels or extended oil and gas development. Expanded oil and gas exploration may have adverse impacts on sensitive ecosystems, including wilderness areas, coastal estuaries, Arctic wilderness, or the Arctic Ocean itself. Finally, it seems reasonable to apply the “ A L A R A concept from the ionizing radiation field to the synthetic fuels cycles and to emerging new technologies in solar, geothermal. and tar sands, that is, to keep hazardous emissions “US low as reasonably achievable” to protect health, safety, and the environment. Acknowledgment The authors thank Victor Archer, M.D.. for reviewing this manuscript. Prior to publication, this article was read and commented on for suitability as an ES&T feature by Dr. Philip Landrigan. Robert A. Taft Laboratories, National Institute for Occupational Safety and Health. Cincinnati, Ohio 45226, and Dr. L. D. Hamilton, Department of Energy and Environment, Brookhaven National Laboratory. Upton, N.Y. 11973.

IIillinrn .\. Kom. M.D.. ( I . ) gradiiar~d /rim8 !he 1 niwrsiry of Minnerora Medical Sc11o~11 i n IY71 and complcred a residency i n inrurnal niedrcine at rhe Uniuersiry of Calr/umia, Dacis. tie receiued a Master’s of Public Healrh in enoironmenral and occupational healrh from Haruard in 1973. t i e was a fe11ow in enuironmenial and pulmonary medicine at M t . Sinai in

New York. Currently, he is an associate professor of medicine at the University of Utah School of Medicine and director of the Rocky Mountain Center for Occupational and Environmental Health. He is editor-in-chief of Environmental and Occupational Medicine, published by Little, Brown and Company. Jeffrey Lee obtained M.P.H. and Ph.D. degrees in industrial hygiene from the University of California, Berkeley. He had extensive experience with government occupational health agencies (Le., OSHA and NIOSH) prior to joining the Universitv of Utah faculty in 1978. He is an assistant professor in the De artment of Family and Community M e d i n e , School of Medicine, and is the director of the Industrial Hygiene Program at the Rocky Mountain Center for Occupational and Environmental Health. He is board certifed in the comprehensive practice of industrial hygiene and is a registered professional engineer in safety.

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