Superfund
Success
Stories

Since 1994, the National Association of County and City Health Officials (NACCHO) has worked with the Agency for Toxic Substances and Disease Registry (ATSDR) to improve the capacity of local health departments (LHDs) to meet the educational needs of communities near hazardous waste sites. ATSDR provides NACCHO with funding for this effort through a cooperative agreement. The LHDs receive small grants, a 2-day training, assistance of a peer advisor, and ongoing technical assistance to implement community environmental health educational needs assessment activities in their communities. Based upon the success of the 10 previous LHD participants in the educational needs assessment process, NACCHO invited them to submit articles highlighting "lessons learned" from their participation. Local health officials in general can use the experience and knowledge gained by the participants to address hazardous waste issues in their own communities. One of these stories, which first appeared in NACCHO News, follows.

- National Association of County and City Health Officials

Community Collaboration and Superfund Education Address Cecil County Residents' Concerns

Chris Barclay, RN, BSN, Cecil County Health Department, Division of Health Promotion

The Site

The Spectron/Galaxy Superfund Site, a former chemical recycling and solvent recovery facility, sits in a valley bordered by Little Elk Creek in northeastern Cecil County, Maryland. Chemical liquids and sludges were dumped in open lagoons and stored in drums, which were later found to be leaking or damaged. Over nearly 30 years of operation, there were 685 odor complaints and several notices of violation, court orders, and settlement agreements from or with the Maryland Department of the Environment (MDE) and the U.S. Environmental Protection Agency (EPA). The local citizens' organization Families Linked Against Chemical Contamination (FLACC) was very active in the closure of the plant by the State of Maryland in 1988. In 1989, EPA initiated an Emergency Removal Action at the site.

At certain times during the 1960s and the early 1970s, levels of airborne contaminants from the site represented a public health hazard for some exposed residents and workers; however, repeated sampling in 1995 found no airborne contaminants capable of causing adverse health affects. Surface and ground water contamination are the current, primary environmental concerns.

The Project

In 1995, the Cecil County Health Department (CCHD) was awarded a grant from NACCHO to conduct a community environmental health educational needs assessment of the community surrounding the site. CCHD formed a multidisciplinary team consisting of an epidemiologist, sanitarian, nurse, and health educator/nurse. Prior to contacting the community to begin the needs assessment, the CCHD team researched site records in CCHD's Division of Environmental Health and located the membership list of FLACC, which was by then disbanded. Of seven former members contacted, four agreed to meet--along with a lay person from a local church, a county environmental activist, and a representative from the office of the local state delegate--to form a community advisory committee.

Committee discussions centered on the frustration and sense of powerlessness the community felt because the site had not been cleaned up because of its complexity in the 6 years since the plant closed. Committee members wanted (1) immediate cleanup of the site; (2) more information for the community on the progress of the clean-up plans; (3) answers to questions about water quality in the area; (4) conduction of follow-up activities based on the 1977 Maryland Department of Health's Cancer Mortality Study; (5) revision into lay terms of the language of ATSDR's draft public health assessment; (6) increased awareness of the site among new residents; and (7) more information concerning long-term health effects from exposure to contaminants.

It was often necessary to refocus the committee on the issue of designing the community environmental health educational needs assessment. In addition to gathering simple demographic information, CCHD staff members conducted a survey of community residents to assess levels of knowledge about the site, concern for possible health problems, and the desire for further information regarding health-related site issues. Community input, with CCHD having the final authority, was used to make decisions. For example, the CCHD team was concerned that inserting community-suggested questions regarding concern for water quality might raise alarm in the community. Because of strong committee support for inclusion of these questions, the CCHD team included them in the survey.

Within 9 months of the project's start, the committee members began to view the CCHD team as their advocate. During this time, two committee members requested that the committee have the right to review and comment on any proposed site-related, clean-up action. Later in the process, the CCHD team worked with MDE, EPA, and ATSDR toxicologists and environmental engineers to form the Public Health Enhancement Site Team to ensure open communication between government agencies and the community at large. Site team members confer twice monthly via telephone conference call to share site-related information.

Community survey results indicated that a community newsletter would be an appropriate educational vehicle for site-related information. The committee decided to divide the information into three newsletters to help the public better understand the Superfund site and its health implications. At a later EPA public meeting, members of the public voiced several positive comments about the newsletters.

The next step was education of professionals. CCHD sent information packets to residents' physicians and placed the citation for the ATSDR Case Studies for Environmental Medicine in the libraries of two nearby hospitals.

Major problems faced early in the project were the lack of trust of government agencies and anger and frustration exhibited by community advisory committee members, which at times impeded the tasks at hand. The CCHD team decided to make the meetings more personal by holding them in the early evening with light refreshments. CCHD team members helped the community advisory committee members feel that their participation was essential to the process by frequently asking for their opinions and using their suggestions in the assessment and education process. To enhance community collaboration, CCHD scheduled a meeting for the committee with the health department's peer advisor from NACCHO's Peer Assistance Network and a second meeting with EPA and MDE to discuss the community's concerns and answer questions prior to the public meeting.

Lessons Learned

CCHD staff members learned several lessons from working with the community on this project. Meeting with the peer advisor gave insight into the basic health education needs of the residents. Understanding EPA's process and where this site fits into that process were the essential first steps in educating residents about the site and related health effects. The CCHD team needed to understand that the public views risk differently than scientists; the public may consider living near a Superfund site more risky because the risk is involuntary, unfamiliar, and uncontrollable. The CCHD staff completed 85% of the needs assessment survey by home visits and telephone interviews. This person-to-person contact increased CCHD's credibility with the public and provided the team with a clearer picture of the community's needs. Yielding to the committee's request to include questions about concern for water quality on the survey showed us that 65% of the community was concerned and led us to publish available residential and surface water testing results in each newsletter.

CCHD would encourage others to participate in a similar project if given the opportunity and not to feel that this undertaking is beyond their expertise. The NACCHO manual for community environmental health educational needs assessments and the Peer Assistance Network are valuable resources.

For more information about the ATSDR/NACCHO Superfund Project and the Peer Assistance Network, contact NACCHO, 440 First Street, NW, Suite 450, Washington, DC 20001; telephone (202) 783-5550; fax (202) 783-1583.

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Environmental and Public Health Internet Resources

Healthy People 2000/2010
http://odphp.osophs.dhhs.gov/pubs/hp2000/

This site contains descriptions of and updates on the national prevention initiatives Healthy People 2000 and 2010. Healthy People 2010 is being developed for release in the year 2000. The section "Developing Objectives for Healthy People 2010" (http://web.health.gov/healthypeople/) describes the who, what, when, and how of the 2010 development process and how you can contribute.

Community Toolbox
http://ctb.lsi.ukans.edu/

The goal of this site is "promoting community health and development by connecting people, ideas, and resources." The site was developed by the University of Kansas' Work Group on Health Promotion and Community Development and the Massachusetts Statewide Area Health Education Center's AHEC/Community Partners group. The site includes information and resources for building core skills for community work; links to other information, people, funding, and resources; and networking opportunities through its Community Forum for connecting those doing similar work.

The Institute for Environmental Toxicology
http://www.iet.msu.edu/

The purpose of the Institute for Environmental Toxicology at Michigan State University and this site is to promote public awareness of environmental issues. The site contains a section on "Environmental Toxicology Concepts and Information About Specific Chemicals," which includes "Toxicology for the Citizen," an introduction to environmental toxicology (http://www.iet.msu.edu/Tox_for_Public/citizen.htm). There are also environmental toxicology resources for journalists and information on risk assessment.

Reporting on Risk
http://www.facsnet.org/tools/ref_tutor/risk/index.php3

This is a handbook designed to help journalists and others communicate environmental risk to the public. It contains the basics of risk, exposure, and toxicology assessment; epidemiology; risk communication; and how to assess a study's validity. The Foundation for American Communications, a nonprofit, educational institution, and the National Sea Grant College Program produced the handbook.

Native American Health and Environment Group

Discussion forums have been created on the Indian Health Service (IHS) web site for the exchange of information on Indian health and environmental issues. Instructions for the use of the discussion forums are available at http://www.ihs.gov/cio/discussionserver/index.asp.

SafetyNets
http://www.ehs.ucdavis.edu/sftynet/

SafetyNets is a service of the University of California, Davis, Office of Environmental Health and Safety. "SafetyNets" are guidelines on how to protect health and safety in relation to the following topic areas: biohazards/biological materials, chemical/lab safety, emergency preparedness/response, ergonomics issues, physical hazards safety, training safety issues, radiological health safety, and a miscellaneous category.

Environmental Health Perspectives Journals
http://ehpnet1.niehs.nih.gov/docs/journals.html

The National Institute of Environmental Health Sciences of the National Institutes of Health is now making available an online version of Environmental Health Perspectives (EHP) and EHP Supplements published by the institute. The site also offers a full text search of the journal and its supplements.

Trail Blazers:
University of Minnesota School of Public Health Is Studying Feasibility of Internet Epi Studies

University of Minnesota School of Public Health researchers are conducting one of the first studies to examine the feasibility of using the Internet to conduct epidemiologic studies.

The researchers are conducting an epidemiologic study of diet and cancer through their World Wide Web (WWW) site at http://www.epi.umn.edu/health_survey. Anyone can register and participate in the survey through the site. Participants are offered a personalized nutrient intake profile and periodic study updates. The public health community, on the other hand, has the opportunity to learn even more from this study: what the future may look like for conducting epidemiologic studies.

The rationale for the study lies primarily in the potential of the Internet to provide inexpensive, highly efficient data collection and followup of large numbers of individuals, said the researchers in their abstract.

The study's background and research proposal are posted on the site. Briefly, the researchers' aims are to develop and implement a survey on the WWW that can serve as a baseline questionnaire for a prospective cohort study of diet and breast cancer. Technical objectives include pretesting and implementing the survey, ensuring confidentiality of responses, and developing methods to follow up respondents with additional WWW surveys. Scientific objectives include describing the demographic and nutrient intake profile of respondents; determining the short-term and long-term reliability of the dietary information that is collected; and determining follow-up rates.

National Institute of Environmental Health Sciences' Kids' Page
http://www.niehs.nih.gov/kids/home.htm

The National Institute of Environmental Health Sciences' Kids' Page has games, puzzles, brain-teasers, and easy-to-understand information and descriptions about environmental health science research.

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The Agency for Toxic Substances and Disease Registry (ATSDR) has implemented a toll-free access system to address issues of community concern; meet the communication, information-sharing, and technical information needs of the public; and to provide all US residents with equal access to ATSDR information. Callers can access the system by calling (800) 447-1544, Monday through Friday from 9 am to 5:30 pm (EST). Information and referrals for information are available for the following: public health assessments; health consultations, studies, and investigations; site-specific activities; applied research; community involvement, health education, and health promotion activities; the National Exposure Registry; ATSDR publications; and emergency response.

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American Public Health Association (APHA) members attending APHA's 1997 annual conference in November voted to establish a health communications subsection under the Public Health Education and Promotion section. The staff of the Centers for Disease Control and Prevention's Office of Communication is coordinating this effort. Staff members are compiling a mailing list of interested health communicators who may be contacted for ideas or feedback regarding establishment of this subsection or with information about the subsection. To join this list, contact Fred Kroger, CDC Office of Communication, 1600 Clifton Rd, NE, MS D42, Atlanta, GA 30333; (404) 639-7276; fax (404) 639-7391; e-mail fck1@cdc.gov.

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Geographic Information Systems (GIS) in Public Health Conference; August 17-20, 1998; San Diego, California. The conference is cosponsored by the Agency for Toxic Substances and Disease Registry (ATSDR) and a number of federal agencies. Abstracts are due on March 15, 1998. For abstract and conference information, contact Bill Henriques, ATSDR, 1600 Clifton Rd, NE, MS E56, Atlanta, GA 30333; telephone (404) 639-6088; fax (404) 639-6076; e-mail wdh2@cdc.gov; or check the conference Web page at /GIS/conference/.

International Conference on Children's Health and Environment; August 11-13, 1998; Amsterdam. Deadline for poster and presentation abstracts is March 15, 1998.This conference will cover a wide range of topics related to the impact of environmental contaminants on children's health and related cross-cutting issues. For more information on the conference and abstract content and submission guidelines, contact Scientific Secretariat, Dutch Association of Environmental Medicine, Peter van den Hazel, MD, Postbox 389, 6800 AJ Arnhem, Netherlands; telephone +31 26 3773915; fax +31 26 3773847; e-mail pvdhazel@inter.nl.net; Internet http://web.inter.NL.net/users/nvmm/.

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A revised priority list of hazardous substances and the new report "Completed Exposure Pathway Site Count Report" (/97cep.html) on hazardous waste sites are now available.

The Agency for Toxic Substances and Disease Registry (ATSDR), in cooperation with the US Environmental Protection Agency, has updated and revised the "Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Priority List of Hazardous Substances" (/97list.html) based on the most recent information available. This list includes substances most commonly found at facilities on the CERCLA National Priorities List (NPL) and which are determined to pose the most significant potential threat to human health. Each substance on the priority list is a candidate to become the subject of a toxicological profile prepared by ATSDR and subsequently a candidate for the identification of priority data needs.

ATSDR has also developed the "Completed Exposure Pathway Site Count Report" (/97cep.html). This report lists the number of sites or events with ATSDR activities where a substance has been found in a completed exposure pathway (CEP). A CEP is an exposure pathway that links a contaminant source to a receptor population. Since the CEP report focuses on documented exposure, it provides an important prioritization based on substances to which people are exposed. There are some substances included in the CEP report that are not on the priority list because they have a very low toxicity.

The priority list is available on the Internet at /97list.html. Requests for a hard copy of the document "1997 CERCLA Priority List of Hazardous Substances That Will Be The Subject of Toxicological Profiles and Support Document," including the CEP report, should bear the docket control number ATSDR-130 and should be submitted to Lydia Wilcox, ATSDR Information Center, Division of Toxicology, MS E29, 1600 Clifton Rd, NE, Atlanta, GA 30333. Requests must be in writing.

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COURSES

• Northwest Center for Occupational Health and Safety

  Evaluating Health and Safety Programs; February 19, 1998; Seattle, WA. This course provides a survey of evaluation methods and illustrates their utility for health and safety assessment. It will supply tools to answer the question: Do our interventions have an impact? The course is intended for risk management and assessment and occupational health and safety professionals. Cost: Unavailable at press time.

  Managing Hazardous Materials Incidents (Tri-Cities); April 22-24, 1998; Seattle, WA. This course covers how to coordinate with other agencies in managing hazardous materials incidents. Emphasis is placed on hazard recognition, response strategies, worker protection, and working with the public and the press. Participants will role-play a simulated incident. The intended audience is federal, state, and local government personnel from agencies involved in responding to hazardous substance releases. Cost: Unavailable at press time.

  For more information, contact the center at 4225 Roosevelt Way, NE, Room 100, Seattle, WA 98105-6099; telephone (206) 543-1069; fax (206) 685-3872; e-mail ce@u.washington.edu.

• North Carolina Occupational Safety and Health Educational Resource Center

  40-Hour Hazardous Waste Training (1988 Refresher); March 26, 1998; Chapel Hill, NC. This course is designed to address the health and safety issues for remediation and Superfund workers outlined in 29 CFR 1910.120. It will cover regulations, measurements, protective clothing, confined space, decontamination, medical surveillance, site safety and health plans, respiratory protection, and more. Demonstrations and hands-on training in respirator fit testing are also offered. Cost: $170.

  For more information, contact The North Carolina Occupational Safety and Health Educational Resource Center, University of North Carolina at 109 Conner Drive, Suite 1101, Chapel Hill, NC 27514; telephone (919) 962-2101; fax (919) 966-7579.

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CALENDAR

January 12, 1998. The Health Care Industry's Impact on the Environment: Strategies for Global Change [teleconference]; 12:30-2 p.m., EST. The conference is meant to alert participants to the toxicity of dioxin and mercury, the volume of pollution generated from the health care delivery system, and the urgency of preventing dioxin formation and dispersion. Contact: Ellen Ceppetelli, MS, RNC, University of Vermont at (800) 639-3188; e-mail eceppete@zoo.uvm.edu; Internet http://uvmce.uvm.edu:443/hlthcare/waste.html.

January 15, 1998. Abstract Due for Health Promotion Futures: Investing for the New Millennium; May 20-22, 1998; San Antonio, Texas. [Joint meeting of the Association of State and Territorial Directors of Health Promotion and Public Health Education (ASTDHPPHE) and the Society for Public Health Educators]. Contact: ASTDHPPHE, 1015 15th St, NW, Suite 410, Washington, DC 20005; telephone (202) 289-6639; fax (202) 408-9815; e-mail dinchols@dpa.tdh.state.tx.us; Internet http://www.astdhpphe.org/general98.html.

March 1-5, 1998. 1998 Society of Toxicology Annual Meeting; Seattle, Washington. Contact: Society of Toxicology, 1767 Business Center Dr, Suite 302, Reston, VA 22090; telephone (703) 438-3115; fax (703) 438-3113; e-mail sothq@toxicology.org; Internet http://www.toxicology.org/.

April 2-5, 1997. PREVENTION 98: Translating Science Into Action; San Francisco, California. Contact: PREVENTION 98, 1660 L St, NW, #206, Washington, DC 20036; telephone (202) 466-2569; fax (202) 466-2662; e-mail prevention@acpm.org; Internet http://www.acpm.org/.

April 5-9, 1998. 14th Annual Hazardous Material Spills Conference; Chicago, Illinois. Contact: Lee Depont, EPA, 401 M St, SW, Mail code 5104, Washington, DC 20460; telephone (202) 260-9499; fax (202) 260-1686; Internet http://www.nrt.org/.

May 27-29, 1998. Partnerships for Networked Consumer Health Information Conference: "Bringing Knowledge to the Point of Use"; Philadelphia, Pennsylvania. Contact: Watch for details at http://odphp.osophs.dhhs.gov/confrnce/partnr98.

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This page last updated on October 24, 2003
Contact Name: Wilma López/ WLópez@cdc.gov