The Agency for Toxic Substances and Disease Registry (ATSDR) is the lead public health agency responsible for implementing the health-related provisions of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). ATSDR is an Atlanta-based federal agency with more than 400 employees and a budget for 2004 of approximately $73 million. ATSDR assesses the presence and nature of health hazards at specific Superfund sites, helps to prevent or reduce further exposure and illnesses resulting from those hazards, and expands the knowledge base about the health effects of exposure to hazardous substances.
ATSDR works closely with state agencies to carry out its mission to serve the
public by using the best science, taking responsive public health actions, and
providing trusted health information to prevent harmful exposures and disease
related to toxic substances. Through cooperative agreements and grants, ATSDR
provides funding and technical assistance to states and other partners to identify
and evaluate environmental health threats to communities. These resources enable
state and local health departments and other grantees to further investigate environmental
health concerns and to educate communities. In fiscal years 1988—2004,
ATSDR awarded more than $10.9 million—more than $1.2 million in
the last 2 years-in direct funds and services to Louisiana for comprehensive
support of its environmental health unit. In addition to direct funds and services,
ATSDR provides technical and administrative guidance for state-conducted site
activities.
ATSDR Site-Specific Activities
Public Health Assessment-Related Activities
One of ATSDR's important mandates is to conduct public health assessments
of all National Priorities List (NPL) sites and of other sites where a significant
threat to public health might exist. A public health assessment is a written,
comprehensive evaluation of available data and information about the release of
hazardous substances into the environment in a specific geographic area. Such
releases are assessed for past, current, or future impact on public health. ATSDR,
in collaboration with public health and environmental officials from Louisiana,
has conducted 33 public health assessments in the state, including the
following recent example.
Louisiana Army Ammunition Plant—In June 2003, ATSDR
released a public health assessment that evaluated the potential for contamination
from the Louisiana Army Ammunition Plant site to cause harm to people working
at or living near the facility. The plant in Doyline is a government-owned,
contractor-operated facility activated in the early 1940s for loading, assembling,
and packing military munitions for the U.S. Army in support of national wartime
efforts. All production and loading of ammunition operations ended in October
1994. Valentec Systems, Inc., oversees and operates the facility under modified
caretaker/partial standby status, and several tenants occupy portions of the
site.
Principal site contaminants are volatile organic compounds (VOCs) and explosive compounds associated with munition production. The U.S. Environmental Protection Agency (EPA) added the site to the NPL in March 1989, primarily because of concerns about groundwater contamination from water lagoons.
After evaluating environmental monitoring data and key potential exposure situations, ATSDR determined that potential exposures associated with groundwater, surface soil, surface water/sediment, and biota at the site do not pose past, current, or future public health hazards.
A health consultation is a written or oral response from ATSDR to a specific
request for information about health risks related to a specific site, chemical
release, or hazardous material. A health consultation is a more limited response
than a public health assessment. In Louisiana, 125 health consultations
have been conducted at 63 sites, including the following recent example.
Pennzoil-Quaker State Refinery—In October 2000, a
community member petitioned ATSDR to evaluate the potential public health impacts
of the Pennzoil-Quaker State Refinery in Shreveport. The petitioner requested
ATSDR involvement at the site because of an explosion at the refinery in January
2000. However, verbal communication with the petitioner and other community
members clarified that ongoing air releases are also a concern. ATSDR accepted
the petition; a final version of the public health consultation was released
in June 2004.
ATSDR's evaluation concluded that an indeterminate public health hazard exists for exposure to VOCs because available VOC data did not sufficiently represent the community's exposure. Levels of hydrogen sulfide and sulfur dioxide detected in the air during routine or permitted releases do not pose a public health hazard. Modeling was performed because no data from unintentional or nonroutine releases were available for review. Modeling showed some exceedances of health-based screening values. Insufficient information was available to determine whether the community's exposure to soil and surface water is of health concern.
Because little data exist to fully evaluate exposure, ATSDR made several recommendations
to conduct further sampling and continue monitoring. Also, because of community
interest, the Louisiana Department of Health and Hospitals (LDHH)
Office of Public Health (OPH) is planning a community health fair
in conjunction with the community. Local and state agencies will participate.
New Orleans Asbestos Exposure Review Site—The Zonolite site in New
Orleans is among 28 Phase 1 sites in ATSDR's National Asbestos Exposure
Review (NAER) being conducted with other federal, state, and local environmental
and public health agencies. NAER examines more than 200 U.S. sites that received
asbestos-contaminated vermiculite ore mined in Libby, Montana, from the 1920s
until 1990. The 28 Phase 1 sites, which received 80% of the vermiculite mined
in Libby in 1964-1980, may have received vermiculite from Libby at any time
during the years the mine operated. All Phase 1 sites ceased processing the
vermiculite by the early 1990s. This site ceased operations in 1990.
ATSDR is working closely with EPA and state health partners to determine whether a hazard to public health exists at any of the NAER sites.
An exposure investigation collects information about specific human exposures
through biologic sampling, personal monitoring, related environmental assessment,
and exposure-dose reconstruction. Following is an example of an exposure investigation
conducted in Louisiana.
Mossville (Calcasieu)-Calcasieu Parish
is the site of a large number of companies that produce petroleum-based chemicals,
chlorinated hydrocarbon solvents, and other organic chemicals. In 1998, EPA
asked ATSDR to review the results of blood tests for several residents of the
parish. Test results indicated elevated levels of dioxin-like substances in
several of the samples. As a follow-up action in support of the exposure investigation
results, ATSDR and the Association of Occupational and Environmental Clinics
(AOEC) conducted individualized education sessions with each community member
who participated in the exposure investigation to address the resulting data
and community-based environmental issues.
In response to the test results and community concerns, ATSDR conducted an exposure
investigation in 1998. Blood samples were collected from 28 residents of Mossville,
a small community in Calcasieu Parish. Samples were analyzed for chlorinated
dibenzodioxins, chlorinated dibenzofurans, and co-planar polychlorinated biphenyls.
Test results indicated unusual levels of dioxin compounds in some of the samples.
As a result of these findings, ATSDR implemented several follow-up activities:
(1) ATSDR is conducting an expanded exposure investigation in the parish to
determine whether residents have been exposed to unusual levels of dioxin or
VOCs. This follow-up study began in January 2002. Results of the dioxin investigation
will be released in 2004. The VOC investigation is ongoing and will continue
through 2005. (2) ATSDR is conducting a follow-up exposure investigation to
address questions on current versus past exposures to dioxins. The environmental
sampling conducted during this exposure investigation will provide results to
address the concerns of current exposure to environmental dioxins in participants'
homes. (3) ATSDR has several ongoing projects to evaluate environmental data
as they become available to address possible pathways and routes of exposure
for the community. (4) ATSDR worked with EPA, LDHH, and the community
to present a symposium on environmental health for Calcasieu Parish physicians
and nurses. (5) ATSDR is working with the Mossville Environmental Health
Services Workgroup and EPA to address other environmental health and environmental
justice issues. ATSDR and EPA have had continuing dialogues and meetings with
community representatives and groups and our community partners to plan and
coordinate further public health actions.
Health Education and Community Activities
Louisiana has participated in ATSDR's cooperative agreement program since
1988. Under this program, LDHH has received funding and technical assistance
to develop more than 20 educational tools that relate to human health issues associated
with toxic substances in the environment. In addition, more than 2,200 Louisiana
residents have attended 41 environmental health education seminars, workshops,
or town meetings. Following are examples of health education and community activities
in Louisiana.
Calcasieu Parish—ATSDR hosted the Calcasieu Parish
Environmental Health Symposium to respond to the Mossville community's concerns
about health care provider training: the community thought its local health
care providers needed training on diagnosing, treating, and preventing environmentally
related illnesses. More than 360 health care professionals attended the February
2002 symposium at McNeese State University. Attendees included representatives
of five federal agencies and numerous regional universities; attendance exceeded
anticipated participation and the physical capacity of the facilities. Sets
of six Case Studies in Environmental Medicine and sets of the complete toxicological
profiles series were left at the university and at local hospitals and major
clinics in the area for future reference.
Building on the need for provider and community education, ATSDR conducted an introductory community stress management program in April 2002 for residents of the Myrtle Grove Trailer Park site affected by vinyl chloride in their drinking water. Follow-up included a needs assessment of the capacity of the local mental health system's ability to respond to community needs. In September 2002, a "train the responder" workshop was conducted to provide tools for service delivery and methods to identify future needs.
Through a national cooperative agreement with the Migrant Clinicians Network,
ATSDR provides assistance to health care providers working with migrant and
seasonal farm workers. The Migrant Clinicians Network, the second-largest clinical
network in the nation, brings together clinicians from various professions to
meet the needs of migrant and seasonal farm workers. The Louisiana Primary
Care Association and the Southwest Primary Care Association are members
of the Migrant Clinicians Network.
Health Studies
Health studies are investigations to determine the relations between exposures
to hazardous substances and adverse health effects. They also define health problems
that require further investigation through, for example, health surveillance or
an epidemiologic study. Following are examples of health studies that ATSDR conducted
or supported in Louisiana.
American Creosote, Winn Parish—A health statistics
review was conducted at this site to evaluate the relationship between cancer
occurrence and site proximity. The review also included an assessment of selected
birth outcomes. Site contaminants included polycyclic aromatic hydrocarbons
(PAHs), benzene, pentachlorophenol, and dioxin. This review included many types
of cancers; therefore, in addition to all cancers combined, specific types were
also assessed. Because of the low geocoding rate, the cancer review could not
be completed. In addition, the study found that any calculations performed on
the subset with latitute and longitude coordinates would be unreliable and would
likely be an underestimate of actual cancer incidence in the 1-mile site proximity
zone.
Bayou Bonfouca, St. Tammany Parish—A health statistics review was conducted
at this site to evaluate the relationship between cancer occurrence and site
proximity. The review also included an assessment of selected birth outcomes.
The site contaminants included PAHs in creosote. This review included many types
of cancers; therefore, in addition to all cancers combined, specific types were
also assessed. Results of this review have been peer reviewed and are being
finalized by ATSDR.
Combustion Inc., Livingston Parish—A health statistics review was conducted
on this site to evaluate the relationship between cancer occurrence and site
proximity. The review also included an assessment of selected birth outcomes.
The site contaminants included arsenic, lead, vanadium, and polychlorinated
biphenyls (PCBs). This review included many types of cancers; therefore, in
addition to all cancers combined, specific types were also assessed. The results
of this review have been peer reviewed and are being finalized by ATSDR.
Louisiana Database Project State-Based Surveillance—This project uses
geographic information system (GIS) technology to create a surveillance system
by joining state health outcome databases in Louisiana with appropriate environmental
databases. The resulting surveillance system will allow identification of specific
areas of exposure and increased disease prevalence throughout the state and,
subsequently, appropriate analytic epidemiologic investigations. Tumor registry
and birth and death data for the Mississippi River parishes are being added
to the system. A pilot project demonstrating the use of GIS as a tool for managing
and analyzing existing demographic, environmental, and health outcome databases
in Ascension Parish has been completed. A demonstration project evaluating blood-lead
data and environmental factors in Orleans Parish and Lafourche Parish
has been completed.
Hazardous Substances Emergency Events Surveillance System (HSEES)—Fifteen
state health departments, including Louisiana, participate in ATSDR's HSEES.
Overall, HSEES captures data on over 8,000 events annually. Of these, 80% occur
at fixed facilities, and 20% are transportation-related events. Most events
occur from 8:00 am to 5:00 pm Monday through Friday. Persons most often injured
are employees.
Exposure to Tremolite Asbestos in Vermiculite Ore—In fiscal year 2001,
ATSDR entered into a cooperative agreement with OPH to conduct health
statistics reviews related to human exposure to contaminated vermiculite ore
at sites in Louisiana that received or processed ore from the W.R. Grace
mine in Libby, Montana.
Minority Health Professions Foundation (MHPF) Research Program
The MHPF program supplements the substance-specific information needs of the public
and the scientific community and supplies necessary information for conducting
comprehensive public health assessments of hazardous waste sites. The program
addresses ATSDR's goals to ascertain the relation between exposure to toxic substances
and disease and to build and enhance effective partnerships. The purpose of the
MHPF program is to initiate research to fill ATSDR-identified data needs for priority
hazardous substances, and to enhance existing disciplinary capacities to conduct
research in environmental health at MHPF member institutions, one of which is
Xavier University of Louisiana, which has been funded since fiscal year
1992. The university is conducting an environmental assessment study to determine
the concentrations and distribution of arsenic, selenium, mercury, and molybdenum
in urban and rural environments of New Orleans.
August 2004
To order copies of ATSDR publications, call 1-888-422-8737
Questions? - Call the ATSDR Information
Center toll free at 1-888-422-8737, or e-mail
This page updated by Thomas Walker September 8, 2004
