ATSDR in Partnership With Texas
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 an annual budget for 2003 of 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
resulting from those hazards, 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 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
$9.2 million—more
than
$1.4 million in the last 2 years-in direct funds and
services to
Texas 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-two
sites have been designated to the NPL in
Texas.
A
public health assessment is 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, in collaboration
with public health and environmental officials from
Texas, has
conducted
67 health assessments in the state, including the
following recent examples.
Patrick Bayou—ATSDR and TDH prepared a
health assessment, released in March 2003, for the Patrick Bayou NPL site.
Patrick Bayou is a small tidal tributary of the Houston Ship Channel (HSC)
that flows through a heavily industrialized area in Deer Park.
The Texas Department of Health (TDH),
under a cooperative agreement with ATSDR, reviewed available environmental
information for the Patrick Bayou site and evaluated the primary pathways
through which people might possibly come into contact with contaminants from
the site. These potential exposure pathways include groundwater, sediment,
surface water, seafood, and air. Available information shows that people are
not coming in contact with site contaminants; therefore, the Patrick Bayou
NPL site does not pose a public health hazard.
Kelly Air Force Base (AFB)—ATSDR was
petitioned to conduct a health assessment of Kelly AFB and the neighborhoods
north and southeast of the base. The request was in response to community
concerns about pollution generated by the base. In addition to releasing an
initial summary document, two health consultations, and a public comment
draft of the health assessment, ATSDR has evaluated several other public
health-related issues for Kelly AFB: on-base drinking water, on-base
exposure to current air emissions, off-base exposure to past air emissions,
potential off-base exposures from East Kelly, two occupational radiation
consultations, and health outcomes in zip codes surrounding the base. The
final health assessment and several final health consultations will be
released after translation into Spanish.
ATSDR is also conducting environmental training for health care providers,
nurses who serve Kelly AFB and the surrounding community, and community
residents.
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 is. To date,
196
documented health consultations have been conducted at
110
sites in
Texas, including the following recent example.
El Paso County Metals Survey—In May
2001, the city of El Paso was concerned about heavy metal
contamination in the soil near Sun Bowl stadium. EPA collected soil samples
near the stadium and at El Paso area elementary schools, area parks, and the
University of Texas at El Paso campus. These samples showed some
elevations of lead and arsenic in the soil. Under a cooperative agreement
with ATSDR, TDH conducted health consultations on each of
these areas and determined that although some of the levels were above
screening levels, no adverse effects would be expected.
In response to recommendations made in previous health consultations, EPA
contracted with the College of Veterinary Medicine at the University of
Missouri Columbia to assess the relative bioavailability of arsenic in soil
from the El Paso remediation area. Using data from this study, scientists
from the Texas Commission on Environmental Quality (TCEQ)
and EPA proposed a residential soil clean-up level of 46 milligrams per
kilogram (mg/kg). EPA asked TDH and ATSDR for an independent assessment to
evaluate whether the proposed soil clean-up level for arsenic would be
protective of public health.
A health consultation released in July 2003 concluded that the proposed
clean-up level of 46 mg/kg arsenic in surface soil is not expected to cause
adverse health effects as a result of short-term or long-term exposure. The
proposed clean-up level for arsenic in surface soil at this site would pose
no apparent public health hazard.
All activities are being coordinated with TCEQ, TDH, the El Paso
City-County Health District, ATSDR, and local city and county
officials. EPA and ATSDR have ensured that all information is shared with
the appropriate Mexican government counterparts.
Health Education and Community Activities
Texas has been a participant in ATSDR's cooperative agreement
program since
1988. Under this program,
TDH
has received funding and technical assistance for the development of community
education and activities associated with human exposure to hazardous substances
in the environment. The state has conducted grand rounds presentations and
contacted physicians by letter about specific health concerns related to
hazardous waste sites in the state, conducted site-specific community education,
and developed and distributed fact sheets or resource guides.
Health Studies
Health studies are investigations conducted to determine the relationships
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 and investigations that ATSDR conducted or supported in the state of
Texas.
Determining the Prevalence of Multiple Sclerosis
and Amyotrophic Lateral Sclerosis in Communities Living Around Hazardous
Waste Sites—ATSDR awarded a cooperative agreement to TDH
to build on the methods and expertise they have developed in the pilot
project by continuing multiple sclerosis (MS) surveillance in the 19-county
Lubbock study area, expanding MS surveillance to El Paso County,
including amyotrophic lateral sclerosis (ALS) as a surveillance condition
and conducting ALS surveillance in the 19-county Lubbock study area, El Paso
County, and Bexar County. TDH has targeted El Paso County because MS has
been the focus of intense public scrutiny since a resident reported a
cluster of this disease among individuals who attended the same elementary
school and TDH conducted a cluster investigation finding a two fold increase
in the disease. However, the cluster investigation focused only on attendees
of the elementary school and residents are concerned about an apparent
excess of the disease in their community that may be linked to exposure to
environmental contaminants. Bexar County was specifically targeted for ALS
surveillance to address community concerns regarding exposures from Kelly
Air Force Base and an apparent excess of ALS.
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. Fifteen state health departments, including Texas,
currently participate in HSEES. HSEES captures data on over 5,000 events
annually. Of these, 80% occur at fixed facilities, and 20% are
transportation-related events. Most events occur between 8:00 AM and 5:00 PM
on Monday through Friday. Persons most often injured are employees.
The HSEES system is used to generate information for use by states to
conduct presentations on planning prevention strategies for industries that
account for a significant number of spills; conduct HazMat training courses,
including information on the risk for injury from methamphetamine labs;
establish and maintain protection areas for municipal water systems; assist
with the proper placement of HazMat teams; develop fact sheets on frequently
spilled chemicals or chemicals that cause a disproportionate number of
injuries (e.g., chlorine and ammonia); develop newsletters for industry,
responders, and environmental groups; and conduct presentations for state
and local emergency planners.
National Exposure Registry: Benzene Subregistry—The
National Exposure Registry comprises chemical-specific subregistries
designed to aid in assessing the long-term health consequences of low-level,
long-term exposures to hazardous chemicals identified at hazardous waste
sites. Benzene is one of the chemicals selected for a subregistry. The only
site for this subregistry in Texas is the Three
Lakes Municipal Utility District in Harris County.
Benzene, which is found in air, groundwater, and soil, and is a known human
carcinogen, causes aplastic anemia. Exposure to benzene has also been linked
to genetic damage. Long-term exposure to benzene in the air can cause cancer
of the tissues that form white blood cells (leukemia). Health outcome rates
for this subregistry were compared with national rates, as determined by the
National Health Interview Survey. Health outcomes reported in significant
excess by these subregistry members during the data collection periods (for
certain age and sex groups) included anemia and other blood disorders;
arthritis, rheumatism, or other joint disorders; cancer; diabetes; kidney
disease; liver problems; other respiratory allergies or problems such as hay
fever; skin rashes, eczema, or other skin allergies; effects of stroke; and
ulcers, gall bladder trouble, or stomach or intestinal problems. Baseline
interviews were conducted in 1991; follow-up interviews were conducted in
1992, 1993, 1995, 1997, and 2000.
Tribal Government Collaboration
In September 2003, an ATSDR staff member met with the Tribal Environmental
Protection Department of the
Kickapoo Traditional Tribe of Texas.
The Kickapoo Traditional Tribe of Texas is about 5 miles south of
Eagle
Pass, Texas, on the Texas/Mexico border. At EPA's request, ATSDR met
with the Kickapoo Tribe to discuss its emergency response capabilities. Funding
for this trip was provided by an interagency agreement with EPA. The Kickapoo
Tribe informed ATSDR that the tribe does not have a police force or a fire
department. The tribe has a small security staff housed in an office at the
entrance to its Reservation, and it has a 40-year-old fire truck parked next to
the security office. All Reservation emergency and police services come from the
city of Eagle Pass or the county of Maverick on an emergency-response-only
service. The tribe hopes to get emergency response training from Texas or from
the federal government for tribal staff, but training has not been secured for
the tribe. The tribe does have a small health clinic funded by the Indian Health
Service, but the clinic does not have medical emergency capability.
Substance-Specific Applied Research Program
In 1997, ATSDR awarded cooperative agreement funds to five universities,
including
Texas A&M Research Foundation, to conduct research to
assess health risk after exposure to mixtures of environmental chemicals.
Results of this research will enable ATSDR staff to conduct toxicity assessments
of chemical mixtures that affect public health; study the behavior of chemical
mixtures; identify various end points that would be affected; evaluate target
organs that could be affected; study the mechanisms of action, initiation,
progression, and repair of injury; identify biomarkers to determine the health
of an organism; and develop qualitative and quantitative methods to assess
multiple health effects. The overall objectives of this project are to develop a
protocol to investigate the toxicity of several classes of environmentally
important chemical mixtures. Some of the most common mixtures present in the
environment include the polycyclic aromatic hydrocarbons (PAHs) that are present
in air particulates, cigarette smoke, petroleum products, and wood-preserving
waste. These analytical methods would be valuable for assessing risk of complex
mixtures found in the environment or associated with lifestyle and occupational
exposures. Individual chemicals and component mixtures can be tested and the
data analyzed to investigate potential chemical interactions.
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
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 the
College of Pharmacy and Health
Sciences,
Texas Southern University (
TSU)
in
Houston.
Funded studies at TSU include an investigation to determine the molecular events
or mechanisms involved in lead-induced neurotoxicity. Investigators at TSU
developed an animal model for studying the molecular events that occur at blood
lead levels that are associated with behavioral effects in children. Findings
from this investigation at TSU have been published in the scientific literature.
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
Texas. 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 Texas are the
Texas
Institute of Occupational Safety and Health (
Tyler)
and the
University of Texas Health Services (
Houston).
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 Arkansas, Louisiana, New Mexico, Oklahoma, and
Texas is the
University of Texas Health Center at Tyler.
The unit began operations in September 2000 and offers multidisciplinary
evaluation and management of children with known or suspected exposure to a wide
range of environmental toxicants.
November 2003