ATSDR in Partnership With Louisiana
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