1. What is ATSDR?
2. What is a Health Consultation?
3. What Happens After the Health Consultation?

What is ATSDR?

ATSDR is the Agency for Toxic Substances and Disease Registry, a federal public health agency. ATSDR is part of the Public Health Service in the U.S. Department of Health and Human Services. ATSDR is not a regulatory agency like the U.S. Environmental Protection Agency. Created by Superfund legislation in 1980, ATSDR's mission is to prevent exposure and adverse human health effects and diminished quality of life associated with exposure to hazardous substances from waste sites, unplanned releases, and other sources of pollution present in the environment. Through its programs-including surveillance, registries, health studies, environmental health education, and applied substance-specific research-and by working with other federal, state, and local government agencies, ATSDR acts to protect public health.

What is a Health Consultation?

An ATSDR Health Consultation is not the same thing as a medical exam, a community health study, or a Public Health Assessment. It can sometimes lead to those things, as well as to other public health activities.

A Health Consultation provides advice on a specific public health issue related to real or possible human exposure to toxic material. Anyone can request a Health Consultation. ATSDR receives the most requests from EPA and state and local health and environmental departments, and provides about 1,000 Health Consultations per year.

A Health Consultation is a way for ATSDR to respond quickly to a need for health information on toxic substances and to make recommendations for actions to protect the public's health. ATSDR staff evaluate information available about toxic material at the site, determine whether people might be exposed to it, and report what harm exposure might cause. Health Consultations may consider-

• what the levels (or "concentrations") of hazardous substances are
• whether people might be exposed to contamination and how (through "exposure pathways" such as breathing air, drinking or contacting water, contacting or eating soil, or eating food)
• what harm the substances might cause to people (or the contaminants' "toxicity")
• whether working or living nearby might affect people's health
• other dangers to people, such as unsafe buildings, abandoned mine shafts, or other physical hazards

What Happens After the Health Consultation?

Every Health Consultation includes ATSDR's conclusions about public health hazards and recommendations for actions to protect the public's health. ATSDR's recommendations cover many activities by EPA, state environmental and health agencies, and ATSDR.

For example, ATSDR recommendations can contribute to-

• site cleanup
• keeping people away from contamination and physical dangers-for example, by fencing the site
• giving residents acceptable drinking water
• relocating exposed people
• community environmental health education for residents and health care providers to inform them about site contaminants, harmful health effects, and ways to reduce or prevent health effects
• an ATSDR or state health study

In addition, a Health Consultation can lead to other ATSDR activities-specifically, a Public Health Assessment or Public Health Advisory.

ATSDR Public Health Assessments report on sites but in more detail. They rely on three main types of information-

• environmental data, such as information available on contaminants and how people could come in contact with them
• health data, including available information on communitywide rates of illness, disease, and death compared with national and state rates
• community concerns, such as reports from the public about how the site affects their health or quality of life 

Public Health Advisories are notices from ATSDR's administrator to EPA's administrator. They are used when sites pose an immediate and significant threat to people.

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