ATSDR in Partnership With Illinois
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. ATSDR provides funding and technical assistance to
states and other partners through cooperative agreements and grants 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. From
fiscal
years 1988 through 2003, ATSDR awarded more than
$15.4 million—more
than
$1.8 million in the last 2 years—in direct funds and
services to
Illinois for comprehensive support of its
environmental health unit. In addition to direct funds and services, ATSDR staff
provides technical and administrative guidance for state-conducted site
activities.
ATSDR Site-Specific Activities
Public Health Assessment-Related Activities
One of the agency'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.
Fifty
sites have been designated to the NPL in
Illinois.
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 current or future impact on public health. ATSDR, in collaboration
with public health and environmental officials from Illinois,
has conducted 107 public health assessments in the state,
including the following recent example.
Hartford Residential Vapor—In June 2003,
ATSDR released a final public health assessment prepared by the
Illinois Department of Public Health (IDPH) that
evaluated residential vapor intrusions in Hartford. In May
2002, volatile organic compounds (VOCs) entered the basements of several
homes, causing acute health effects and forcing evacuations. Air samples
showed very high levels of VOCs, including benzene at six times the acute
health guideline.
The VOC source most likely is a layer of about 2 million gallons of gasoline
atop a shallow aquifer. The source of the gasoline was a pipeline leak about
25 years ago. Interviews and surveys of residents suggest that vapor
intrusions have existed in the northeastern portion of the community since
1966 but were worse in the late 1980s after the pipeline leak. The refinery
installed a vapor extraction system in 1992, but homes affected in 2002 were
outside the treatment area of that system.
The public health assessment concluded that these vapor intrusions do not
pose a chronic health hazard. Acute health hazards associated with these
acute exposure events are not predictable, and the vapor intrusions are
likely to recur. In this public health assessment, recommendations were made
to the agencies responding to the cleanup; no specific recommendations were
made to the public. After a fourth quarterly sampling event is complete this
spring, IDPH will write a health consultation and make additional
recommendations based on the sampling results.
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 is. To date, 171
documented health consultations have been conducted at 144
sites in Illinois, including the following recent example.
W.R. Grace—In September 2003, ATSDR released a health
consultation prepared by
IDPH in cooperation with ATSDR for the
former W.R. Grace & Co. facility in
West Chicago. Until it
closed in the early 1990s, the plant processed more than 273,000 tons of
asbestos-contaminated vermiculite ore mined in Libby, Montana. IDPH concluded
that the site currently poses no health hazard to area residents. However,
former facility employees were exposed to elevated levels of asbestos. Residents
of employees' households also may have been exposed to asbestos fibers brought
home on employees' clothing. As a result, employees and people who lived in
their homes may be at increased risk for asbestos-related diseases.
The West Chicago site is part of ATSDR's National Asbestos Exposure Review
(NAER) being conducted with other federal, state, and local environmental and
public health agencies. NAER is an examination of more than 200 U.S. sites that
received asbestos-contaminated vermiculite ore mined in Libby from the early
1920s until 1990. ATSDR is working closely with the U.S. Environmental
Protection Agency (EPA) and state health partners to determine whether a hazard
to public health exists at any of the sites.
An exposure investigation collects information about
specific human exposures through biologic sampling, personal monitoring, related
environmental assessment, and exposure-dose reconstruction. Following is a
recent example of an exposure investigation conducted in Illinois.
Batavia Groundwater Site—During routine
well water sampling in January 1996, IDPH identified vinyl chloride and
other chlorinated solvents in a well used by the Montessori Academy in
Batavia. No source of vinyl chloride was found at the academy, and
IDPH collected additional water well samples from surrounding properties in
July 1996. Results of those samples showed an area of contamination south of
the Montessori Academy, in association with Batavia Concrete, Inc. IDPH
referred the site to the Illinois EPA in 1996 for possible
remediation.
In December 1996, IDPH began an annual groundwater monitoring program for
homes in a subdivision west of the site across the Fox River. From 1996
through 2001, site-related chemicals were detected in groundwater samples
from only one home. In groundwater samples collected in 2001, elevated
levels of vinyl chloride and cis-1,2-dichloroethylene were found. Because of
these levels, residents in this home were advised to use an alternate
drinking water supply or install a whole-house water filtration system.
In June 2002, IDPH collected additional groundwater samples from residential
water wells in the subdivision west of the site, including the private well
where vinyl chloride was detected in January 2001. Groundwater samples were
collected from 11 homes, but vinyl chloride was found only in the one well
that was previously affected. The homeowners with the affected well use only
bottled water for drinking and cooking.
IDPH concluded that under current conditions, exposure to vinyl chloride in
groundwater poses no apparent public health hazard to residents in the
affected home west of the site across the Fox River. This conclusion was
based on continued use of bottled water by the residents and the absence of
children in the home.
Health Education and Community Activities
Illinois has participated in ATSDR's cooperative agreement
program since 1988. Under this program,
IDPH has received
funding and technical assistance to develop approximately 90 educational tools
related to human health issues associated with hazardous substances in the
environment. Additionally, more than 8,000 citizens have attended 216 public
meetings or training sessions (e.g., public meetings, in-school presentations,
workshops, seminars, grand rounds).
IDPH developed an interactive Web site about mercury using funding provided by
ATSDR. The site (
www.idph.state.il.us/mercury)
,
launched in August 2003, provides information for teachers, parents, and
students about the health effects of mercury, ways to clean up a small mercury
spill, and action to take for a large spill. The site also includes information
about the history and physical properties of mercury, curricula for teachers to
use in the classroom, and a mercury quiz.
Through a cooperative agreement with the National Environmental Health
Association, ATSDR awarded funds to the
Illinois Environmental Health
Association, whose members are from the private sector as well as city,
county, state, and tribal organizations. The cooperative agreement provides for
evaluating, planning, designing, and implementing an environmental health
education program that responds to the significant threat of chemical terrorism.
One of the agreement's five goals is to conduct regional and national training
and education workshops.
Health Studies
Health studies are investigations to determine the relations between
exposures to hazardous substances and adverse health effects. Health studies
also define health problems that require further investigation through, for
example, health surveillance or an epidemiologic study. Following are examples
of health studies or investigations that ATSDR conducted or supported in
Illinois.
La Salle Electrical Utilities—In September
1993, ATSDR awarded funds to IDPH to conduct
polychlorinated biphenyls (PCB) exposure assessment and biologic sampling at
this site. The study was conducted in three phases: a mortality
cause-of-death analysis for 2,880 workers, and two morbidity studies
(various biomarker analyses and survey responses for nervous and
reproductive systems).
The mortality analysis showed that total mortality and all-cancer mortality
were similar to expected in both males and females; however, females with
longer employment had a significantly elevated liver/biliary cancer, and
stomach cancer in males was significantly elevated.
The morbidity I biomarker report of 190 workers was printed in 2002. The
study found significant associations for various lipid and hormone
biomarkers: increased triglycerides, decreased HDL-cholesterol, decreased
sex-hormone binding globulin, and decreased follicle-stimulating hormone in
women, and levels of natural killer cells and thyroid-stimulating hormone in
men. Preliminary findings of the morbidity II study report indicate elevated
breast cancer in former female employees, based on a small number of cases,
and elevated rates of ear infection in workers' children.
National Exposure Registry (NER): Trichloroethylene (TCE) Subregistry—TCE,
a synthetic chemical that does not occur naturally in the environment, was
the first chemical selected for an NER subregistry. Occupational and animal
studies suggest that TCE is associated with liver, kidney, or lung cancer.
Data on nonoccupational exposures, such as environmental exposures and their
potential health effects, are sparse and inconclusive. At selected sites
throughout the nation at which TCE exposures have occurred, initial (i.e.,
baseline) and follow-up interviews have been conducted; 4,986 people from 15
areas associated with hazardous waste sites in five states have been
enrolled in the TCE Subregistry. Health outcomes reported for certain sex
and age groups included speech impairment, hearing impairment, and anemia
and other blood disorders.
The Illinois sites included in the TCE Subregistry are the
SE Rockford Groundwater Contamination, Warner Electric Brake and Clutch
Company, Beloit Corporation, Byron Salvage Yard, Acme Solvent Reclaiming,
and Frinks Industrial Waste sites. Baseline interviews were conducted in
1990; follow-up interviews were conducted in 1991, 1993, 1995, 1997, and
2000.
Determining the Prevalence of Multiple Sclerosis (MS) and Amyotrophic
Lateral Sclerosis (ALS) in Communities Living Around Hazardous Waste Sites—Citizens
in five Illinois communities (DePue, Lewistown,
Morrison, Paw Paw, and Savanna)
expressed concern about the number of people with MS and ALS in their
communities and a possible link to hazardous waste sites. In fiscal year
2002, ATSDR awarded a cooperative agreement to the University of
Illinois to determine the prevalence of these diseases in the five
communities. People suspected of having MS and ALS will have their diagnosis
verified by the project neurologist after a review of their medical records.
Prevalence rates will then be compared with national statistics. This study
will also investigate the proximity of MS and ALS cases to environmental
hazards in the five communities.
Great Lakes Human Health Effects Research Program
In support of the Great Lakes Critical Programs Act, this program's six
objectives are to (1) extend the results from past and ongoing research in the
Great Lakes region; (2) develop information databases or research methodology,
or both, that will provide long-term benefits to the human health effects
research efforts in the Great Lakes basin; (3) provide direction for future
health effects research; (4) provide health information to state and local
health officials, the concerned public, and their medical health care
professionals; (5) increase public awareness about the potential health
implications of toxic pollution in the Great Lakes; and (6) coordinate as
necessary with relevant government research programs and activities to
ameliorate adverse public health impacts of persistent toxic substances in the
Great Lakes basin. Two institutions in Illinois have been
awarded funds through this program: the University of Illinois at
Chicago and the University of Illinois at Urbana-Champaign.
Great Lakes Fish as a Source of Maternal and Fetal
Exposure to Chlorinated Hydrocarbons—The purpose of this study at
the University of Illinois at Chicago is to determine the
effects of consumption of possibly contaminated fish (PCBs, DDT/DDE, and
dieldrin) on pregnant woman of African-American descent and on their
newborns. The subject population will consist of a control and a fish-eating
group identified at the University of Chicago Lying-in Hospital,
the University of Illinois Hospital, Miles Square
Clinic, and Altgeld Gardens Clinic (and possibly
other area clinics). Participants are interviewed, then followed throughout
pregnancy to term. Biologic specimen collections consist of maternal and
fetal cord blood, placenta, breast milk, adipose tissue, and meconium. The
investigators will evaluate meconium as a biologic specimen to predict
infant in utero exposure to toxic chemicals.
Longitudinal Assessment of Neuropsychological and Thyroid Function
in Aging Great Lakes Fish-Eaters and a Prospective Study of Health Outcomes
in Asian Americans-The University of Illinois at Urbana-Champaign
proposes to complete follow-up neuropsychological assessments of aging Lake
Michigan fish-eaters, statistically analyze the data, and prepare
manuscripts for publication, establish a cohort of Asian American (Hmong
people from Laos and Cambodia) men and women of childbearing age who have a
high probability of eating contaminated fish from the Fox River and/or other
local polluted water, describe the reproductive experiences of this
population, determine fish consumption practices of this population,
determine the distribution of serum PCB levels in a subset of the cohort,
examine changes in serum PCB and serum thyroid hormone levels during
pregnancy, and evaluate health outcomes in infants born to the women in this
cohort.
These studies are expected to be completed by 2006.
Association of Occupational and Environmental Clinics
Through a national cooperative agreement with the Association of Occupational
and Environmental Clinics (AOEC), ATSDR supports two occupational and
environmental health programs in
Illinois. This support is
provided to improve education and communication related to surveillance,
diagnosis, treatment, and prevention of illness or injury related to exposure to
hazardous substances. The member institutions in Illinois are the
Occupational Medicine Clinic,
Stroger Hospital of Cook County,
and the
University of Illinois Occupational Medicine Program,
both in
Chicago.
Since 1998, ATSDR has provided funds to AOEC to support a project establishing
Pediatric Environmental Health Specialty Units (PEHSUs) as a national resource
for pediatricians, other health care providers, federal staff, and the public.
The PEHSUs develop materials and present training to health professionals and
public health officials on environmental health issues and their impact on
children's health. The PEHSU for
Illinois,
Indiana,
Michigan,
Minnesota,
Ohio, and
Wisconsin is the
Great Lakes Center for Children's
Environmental Health at
Cook County Hospital. The
center was established in 1999 to promote and protect children's health through
prevention, education, diagnosis and treatment of environmentally related
diseases.
Resource Materials
ATSDR develops materials for public health professionals and medical care
providers to use to assess the public health impacts of chemical exposures.
These resources are available in print, on the ATSDR Web site, and on CD-ROM.
For example, medical management guidelines are available for acute chemical
exposures to more than 50 chemicals. These guidelines were designed to aid
emergency department physicians and other emergency health care professionals,
such as first responders, who manage acute exposures resulting from chemical
incidents. ATSDR's toxicological profiles comprehensively describe health
effects; pathways of human exposure; and the behavior of more than 250 hazardous
substances in air, soil, and water at hazardous waste sites. The toxicological
profiles are primarily used as a comprehensive resource by health professionals
at all levels. In the last 5 years, more than
18,000 of these
profiles have been sent to requesters, including representatives of federal,
state, and local health and environmental departments; academic institutions;
private industries; and nonprofit organizations in
Illinois.
ATSDR also has developed extensive resources for community members.
February 2004