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 400 employees. ATSDR's annual budget for 2003 is approximately $82 million. ATSDR is responsible for assessing the presence and nature of health hazards at specific Superfund sites, helping to prevent or reduce further exposure and illnesses that result, and expanding the knowledge base about the health effects of exposure to hazardous substances.
ATSDR works closely with state agencies to carry out its mission of preventing exposure to contaminants at hazardous waste sites and preventing adverse health effects. ATSDR provides funding and technical assistance for states to identify and evaluate environmental health threats to communities. These resources enable state and local health departments to further investigate environmental health concerns and educate communities. This is accomplished through cooperative agreements and grants. At this time, ATSDR has cooperative agreements or grants with 31 states, 1 American Indian nation (Gila River Indian Community), and 1 commonwealth (Puerto Rico Department of Health). From 1992 through 2002, ATSDR awarded more than $2,289,034 in direct funds and services to the state of Oregon (see chart for breakdown of funds). 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 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 the public health might exist. Oregon now has 16 NPL sites.
A public health assessment provides a written, comprehensive evaluation of available data and information on 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 staff, in conjunction with public health and environmental officials from Oregon, has conducted 15 health assessments in the state. The following text describes a public health assessment ATSDR is conducting in the state.
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. It is a more limited response than a public health assessment. To date, 13 documented health consultations have been conducted at 10 sites in Oregon.
Brownfields Initiative
In 1997 the Brownfields National Partnership, a collaboration of 17 federal agencies, was formed to assist local remediation and redevelopment in a coordinated manner. ATSDR is among the participating agencies. Brownfields are abandoned, idled, or underused industrial and commercial properties where expansion or redevelopment is complicated by real or perceived contamination. The federal agencies participating in the Brownfields National Partnership will offer special technical, financial, and other assistance to selected communities—Brownfields Showcase Communities—to demonstrate the benefits of focused, coordinated attention on brownfields. The Brownfields National Partnership selected Portland, Oregon, as a Brownfields Showcase Community.
In 1998 ATSDR entered into cooperative agreements with local health departments in six Brownfields Showcase Communities. In addition, ATSDR awarded the Multnomah County Health Department a grant to enhance its participation in brownfields decisions and actions. The grant funded the development of a low-barrier, community-focused educational tool to provide information on brownfields and opportunities for community involvement in the process. This information was printed, posted on the Internet, and served as the basis for several brownfields community training sessions. The purpose of these programs is to help the local health departments develop and implement strategies that ensure remediation and redevelopment efforts will not present environmental public health hazards to the communities.
Health Education and Community Activities
Another aspect of the cooperative agreement program includes the support of educational activities for physicians, other health professionals, and communities about human exposure to hazardous substances in the environment. The Oregon Department of Human Services became a partner in the program in 2001. Under the cooperative agreement, more than 30 educational tools have been developed for use with community assistance groups, neighborhood associations, grand rounds, and professional groups during 2002.
Community involvement and health education have an important role in the ATSDR programs. After fish consumption was identified as the primary exposure pathway that could adversely affect human health at the Portland Harbor Superfund site, the Oregon Department of Human Services assessed health education needs in the community. Current health education efforts are based on the following goals:
Public Health Conference Support
ATSDR awards grants to state and local agencies to support public health conferences to encourage information sharing, technical discussion, and other training activities related to acute illness and chronic disease resulting from exposures to hazardous substances. Following is an example of a conference funded in the state of Oregon.
Public Health Conference Program, Oregon Health Sciences University—The primary goals of the conference were to provide information to nurses enabling them to identify potentially toxic substances, to make informed decisions when confronted with clinical situations involving toxic substances, and to educate the public on the realistic consequences of toxic exposure. The conference was planned by an eight-member planning and advisory committee from the sponsoring organizations, with expert speakers and faculty selected primarily from Oregon. The conference was an outstanding success, and the conference proceedings were printed and mailed to all attendees.
Tribal Government Collaboration
Through a cooperative agreement, ATSDR assists and collaborates with nine American Indian tribal governments in capacity-building activities to address human health issues related to exposures from hazardous substance releases from the Hanford Nuclear Reservation in Washington state. This assistance includes site-specific public health assessments, health consultations, community involvement, preventive health education, and follow-up health studies. In Oregon, the Confederated Tribes of the Umatilla Indians and the Confederated Tribes of Warm Springs are currently participating in this agreement.
The initial issues related to Hanford the tribes addressed were (1) identifying tribal liaisons to work with ATSDR on environmental health activities, and (2) determining tribal capability (through a needs assessment) to address the environmental health issues resulting from hazardous substance releases. Subsequently, the tribes developed a work plan and are building capability to address the issues identified in the needs assessment.
Health Studies
Health studies are conducted to determine the relationships between exposure 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 site-specific health surveillance that ATSDR has supported in Oregon.
View-Master Worker Health Study—Under a cooperative
agreement with ATSDR, the Oregon Department of Human Services
(ODHS) is investigating the feasibility of conducting a
health study of former factory workers who were orally exposed to
trichloroethylene (TCE) in drinking water. The objectives of the feasibility
investigation are to review existing health outcome data, identify and
locate former workers, and develop methods for evaluating TCE exposure and
adverse health and reproductive effects among the former workers.
The factory used TCE to clean manufacturing equipment and to degrease
metal parts for the production of View-Master stereoscopic slide viewers.
Drums of degreaser waste were dumped on-site from the 1950s to the 1970s, at
which time the factory began recycling the spent solvent. In 1980, the
factory phased out the manufacture of products that required metal parts for
assembly and discontinued the use of TCE. In March 1998, chemical analysis
of the View-Master factory supply well revealed the presence of the TCE at
concentrations as high as 1,670 parts per billion. The Oregon
Department of Environmental Quality (ODEQ)
estimates that TCE had contaminated the drinking water at the View-Master
plant for more than 20 years.
ODHS developed a public health consultation report on the View-Master
factory supply well, and ATSDR has released the report for public comment.
The report describes the preliminary findings of a review of the mortality
among former View-Master workers. It proposed follow-up activities that
would include both (1) an environmental exposure assessment to confirm
ODEQ's estimate of how long TCE was in the supply well and to provide a
historical understanding of the concentration of TCE in the well, and (2) an
epidemiologic study to determine whether former workers have experienced
adverse health and reproductive outcomes as a result of TCE exposure.
Hazardous Substances Emergency Events Surveillance System
(HSEES)—HSEES was established by ATSDR in
1990 to collect and analyze information about releases of hazardous
substances that need to be cleaned up or neutralized according to federal,
state, or local law, as well as threatened releases that result in a public
health action, such as an evacuation. The goal of HSEES is to reduce the
morbidity and mortality of first responders, employees, and the general
public resulting from hazardous substances emergencies. Sixteen state health
departments were awarded cooperative agreements, including Oregon,
which has participated in HSEES since 1992.
The HSEES system is used to generate information for use by states to
1. conduct presentations on planning prevention strategies for industries
that account for a significant number of spills;
2. conduct HazMat training courses, including information on the risk for
injury from methamphetamine
labs;
3. establish and maintain protection areas for municipal water systems;
4. assist with the proper placement of HazMat teams;
5. develop fact sheets on frequently spilled chemicals or chemicals that
cause a disproportionate number
of injuries (e.g., chlorine and ammonia);
6. develop newsletters for industry, responders, and environmental groups; and
7. conduct presentations for state and local emergency planners.
Emergency Response Training
In September 1992, ATSDR staff collaborated with the design team and were part of the control team for a Coast Guard community-wide tabletop drill for the Portland Marine Safety Zone. Forty to 60 persons participated in the drill, and 300-400 persons watched it on closed circuit television. Key to the success of this drill was the interaction between the federal on-scene coordinator and the regional response team. This exercise also provided an opportunity to test the local community's ability to deal with a chemical release.
Toxicological Profiles
ATSDR develops toxicological profiles that describe health effects, environmental characteristics, and other information, for substances found at NPL sites. These profiles describe pathways of human exposure and the behavior of toxic substances in environmental media such as air, soil, and water. In the past five years, more than 800 of these profiles have been supplied directly by ATSDR to requesters, including representatives of federal, state, and local health and environmental departments; academic institutions; private industries; and nonprofit organizations inOregon.
May 2003