<DOC>
[110th Congress House Hearings]
[From the U.S. Government Printing Office via GPO Access]
[DOCID: f:40941.wais]
TOXIC TRAILERS: HAVE THE CENTERS
FOR DISEASE CONTROL FAILED TO
PROTECT PUBLIC HEALTH?
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON INVESTIGATIONS AND
OVERSIGHT
COMMITTEE ON SCIENCE AND TECHNOLOGY
HOUSE OF REPRESENTATIVES
ONE HUNDRED TENTH CONGRESS
SECOND SESSION
__________
APRIL 1, 2008
__________
Serial No. 110-88
__________
Printed for the use of the Committee on Science and Technology
Available via the World Wide Web: http://www.science.house.gov
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______
COMMITTEE ON SCIENCE AND TECHNOLOGY
HON. BART GORDON, Tennessee, Chairman
JERRY F. COSTELLO, Illinois RALPH M. HALL, Texas
EDDIE BERNICE JOHNSON, Texas F. JAMES SENSENBRENNER JR.,
LYNN C. WOOLSEY, California Wisconsin
MARK UDALL, Colorado LAMAR S. SMITH, Texas
DAVID WU, Oregon DANA ROHRABACHER, California
BRIAN BAIRD, Washington ROSCOE G. BARTLETT, Maryland
BRAD MILLER, North Carolina VERNON J. EHLERS, Michigan
DANIEL LIPINSKI, Illinois FRANK D. LUCAS, Oklahoma
NICK LAMPSON, Texas JUDY BIGGERT, Illinois
GABRIELLE GIFFORDS, Arizona W. TODD AKIN, Missouri
JERRY MCNERNEY, California JO BONNER, Alabama
LAURA RICHARDSON, California TOM FEENEY, Florida
PAUL KANJORSKI, Pennsylvania RANDY NEUGEBAUER, Texas
DARLENE HOOLEY, Oregon BOB INGLIS, South Carolina
STEVEN R. ROTHMAN, New Jersey DAVID G. REICHERT, Washington
JIM MATHESON, Utah MICHAEL T. MCCAUL, Texas
MIKE ROSS, Arkansas MARIO DIAZ-BALART, Florida
BEN CHANDLER, Kentucky PHIL GINGREY, Georgia
RUSS CARNAHAN, Missouri BRIAN P. BILBRAY, California
CHARLIE MELANCON, Louisiana ADRIAN SMITH, Nebraska
BARON P. HILL, Indiana PAUL C. BROUN, Georgia
HARRY E. MITCHELL, Arizona
CHARLES A. WILSON, Ohio
------
Subcommittee on Investigations and Oversight
HON. BRAD MILLER, North Carolina, Chairman
JERRY F. COSTELLO, Illinois F. JAMES SENSENBRENNER JR.,
EDDIE BERNICE JOHNSON, Texas Wisconsin
DARLENE HOOLEY, Oregon DANA ROHRABACHER, California
STEVEN R. ROTHMAN, New Jersey DAVID G. REICHERT, Washington
BRIAN BAIRD, Washington PAUL C. BROUN, Georgia
BART GORDON, Tennessee
RALPH M. HALL, Texas
DAN PEARSON Subcommittee Staff Director
EDITH HOLLEMAN Subcommittee Counsel
JAMES PAUL Democratic Professional Staff Member
DOUGLAS S. PASTERNAK Democratic Professional Staff Member
KEN JACOBSON Democratic Professional Staff Member
BART FORSYTH Republican Counsel
TOM HAMMOND Republican Professional Staff Member
STACEY STEEP Research Assistant
C O N T E N T S
April 1, 2008
Page
Witness List..................................................... 2
Hearing Charter.................................................. 3
Opening Statements
Prepared Statement by Representative Bart Gordon, Chairman,
Committee on Science and Technology, U.S. House of
Representatives................................................ 17
Statement by Representative Brad Miller, Chairman, Subcommittee
on Investigations and Oversight, Committee on Science and
Technology, U.S. House of Representatives...................... 9
Written Statement............................................ 11
Statement by Representative F. James Sensenbrenner Jr., Ranking
Minority Member, Subcommittee on Investigations and Oversight,
Committee on Science and Technology, U.S. House of
Representatives................................................ 13
Written Statement............................................ 15
Prepared Statement by Representative Nick Lampson, Chairman,
Subcommittee on Energy and Environment, Committee on Science
and Technology, U.S. House of Representatives.................. 18
Panel I:
Dr. Heidi Sinclair, Medical Director, Baton Rouge Children's
Health Project; Assistant Professor, Department of Pediatrics,
Louisiana State University Health Sciences Center
Oral Statement............................................... 19
Written Statement............................................ 21
Biography.................................................... 25
Mrs. Lindsay Huckabee, Resident of FEMA-provided mobile home in
Kiln, Mississippi, from October, 2005 to March, 2008
Oral Statement............................................... 28
Written Statement............................................ 29
Ms. Becky Gillette, Formaldehyde Campaign Director, Sierra Club
Gulf Coast Environmental Restoration Task Force
Oral Statement............................................... 32
Written Statement............................................ 34
Biography.................................................... 38
Discussion
ATSDR Response to Sierra Club Tests............................ 38
Health Effects From Formaldehyde............................... 39
Tracking Trailer Residents' Long-term Health................... 40
Failings of ATSDR.............................................. 40
Dr. Sinclair's Experience in Her Trailer....................... 46
Obstacles to Safe Housing...................................... 47
More on Tracking Residents..................................... 48
Trivializing Health Concerns................................... 48
Health Care Costs.............................................. 49
Formaldehyde's Effects on Reproductive Health.................. 50
Population Size................................................ 50
Panel II:
Dr. Meryl H. Karol, Professor Emerita, University of Pittsburgh
Oral Statement............................................... 51
Written Statement............................................ 53
Dr. Christopher T. De Rosa, Assistant Director for Toxicology and
Risk Assessment, National Center for Environmental Health/
Agency for Toxic Substances and Disease Registry, Centers for
Disease Control and Prevention, U.S. Department of Health and
Human Services
Oral Statement............................................... 56
Written Statement............................................ 58
Biography.................................................... 63
Discussion
Safe Formaldehyde Exposure Levels.............................. 66
ATSDR Review Process........................................... 67
Dr. De Rosa's Performance Reviews.............................. 68
Consequences of Inaction: Health Effects of Additional Exposure 68
Protecting the Public.......................................... 69
More on Long-term Health Tracking.............................. 69
Dr. De Rosa Excluded From Past Reviews?........................ 70
ATSDR Emergency Health Evaluations............................. 70
More on Reproductive Health.................................... 71
Deficiencies in the February 2007 Health Consultation.......... 72
Panel III:
Dr. Howard Frumkin, Director, and Dr. Thomas Sinks, Deputy
Director, Agency for Toxic Substances and Disease Registry, and
National Center for Environmental Health, Centers for Disease
Control and Prevention, U.S. Department of Health and Human
Services
Oral Statement............................................... 73
Written Statement............................................ 75
Biography.................................................... 83
Vice Admiral Harvey E. Johnson, Jr. (Ret.), Acting Deputy
Administrator and Chief Operating Officer, Federal Emergency
Management Agency, Department of Homeland Security
Oral Statement............................................... 83
Written Statement............................................ 85
Biography.................................................... 91
Discussion
Warning FEMA Employees About Formaldehyde...................... 92
February 2007 Health Assessment................................ 93
Dr. De Rosa's Concerns Over the Health Consultation............ 97
2005 Formaldehyde Testing...................................... 98
FEMA's Emergency Housing....................................... 98
Acute Formaldehyde Exposure Levels............................. 98
Tracking Former Trailer Occupants.............................. 99
Trailer Costs, Inventory, and Sales............................ 99
FEMA Outreach on Formaldehyde Health Effects................... 100
Drs. Frumkin and Sinks Health Consultation Review.............. 100
FEMA's Office of General Council's Involvement With the Health
Consultation................................................. 103
Trailers at Maxwell Air Force Base............................. 104
Emergency Housing Alternatives................................. 104
How Will ATSDR Prevent Future Problems?........................ 105
More on Dr. De Rosa's Performance.............................. 106
Review of the Events Surrounding the Health Consultation....... 108
More on Obstacles to Safe Housing.............................. 109
Health Care Costs.............................................. 111
CDC Actions: May-July, 2007.................................... 111
Were Discussions Being Made By FEMA's Lawyers?................. 112
Appendix: Additional Material for the Record
#1. ATSDR Health Consultations. 2/1/07-1/29/07................... 116
#2. Interim Findings on Formaldehyde Levels in FEMA-supplied
Travel Trailers, Park Models, and Mobile Homes (CDC). 2/29/08.. 190
#3. Handwritten notes by Joseph D. Little, one of two authors on
the February 2007 ATSDR Health Consultation--Formaldehyde
Sampling of FEMA Temporary-Housing Trailers. 6/28/06-8/30/07... 211
#4. ATSDR Chronology. 2008....................................... 234
#5. OSHA fact sheet on ``Occupational Exposure to Formaldehyde.''
1/1/95......................................................... 241
#6. E-mail from Bryan McCrear, Contracting Officer, FEMA to Guy
Morgan, Morgan USA. Re: FEMA orders 10,000 handicapped travel
trailers from Morgan USA. 9/2/95............................... 243
#7. News article: ``Couple Discovers High Levels of Formaldehyde
in FEMA Trailer,'' WLOX-TV, Biloxi, MS. 3/17/06................ 244
#8. E-mail from Adrian Server to Mary Martinet, David Trissell,
Edward Broyles, Jordan Fried, Cc: Martin Matzen. Re: Server to
FEMA attorneys involved, ``Whatever testing we do, we better do
it very quietly.'' 3/18/06..................................... 246
#9. E-mail from Bronson Brown to FEMA staff. Re: FEMA staff
should not enter new trailers until they are ``off-gassed.'' 3/
22/06.......................................................... 247
#10. E-mail from Stewart (ESF-8 1603 AFO NOLA) to Stephen De
Blasio (FEMA), Barbara Russell (Fluor), Guy Bonomo (FEMA), and
Larry Woodruff. Re: Warning on trailers: Health concerns. FEMA
says to tell residents to air out trailers and keep temperature
and humidity low. 4/5/06....................................... 248
#11. Evaluation of Formaldehyde Concentration in the Carlton and
Dawn Sistrunk FEMA Trailer by Bonner Analytical Testing
Company. Sistrunk trailer results from 0.9-2.4 ppm. 4/6/06..... 253
#12. E-mail from Frank Alamia, Office of General Counsel, the
Department of Homeland Security, to Adrian Server. Re: Use
NIOSH, not OSHA standard, for testing. 5/17/06................. 256
#13. E-mail chain with FEMA staff. Re: FEMA headquarters decides
to only air out trailers residents are complaining about. 5/30/
06............................................................. 258
#14. MEMO from Dr. William Ringo, FEMA Occupational Safety and
Health Officer, stating that occupational exposure levels are
too high as a reference. 6/2/06................................ 260
#15. E-mail chain with FEMA field staff. Re: FEMA's field staff
was told if a TT has been cleared, FEMA is under ``no further
obligation'' to put complainant in a hotel. 6/13/06............ 262
#16. E-mail chain with FEMA field staff. Re: FEMA continues to
deny health claims from residents and resident manager for
hotel programs says applicants have reported serious medical
problems from formaldehyde, but has been told to deny hotel
stays. 6/14/06................................................. 264
#17. E-mail from Peggy Phillips, FEMA Logistical Management
Specialist. Re: ``OGC has advised that we do not do testing,
which would imply FEMA's ownership of this issue.'' 6/16/06.... 266
#18. E-mail chain with message from Martin McNeese, FEMA Region
VIII Emergency Management Program Specialist, to Patrick
Preston, cc to David Chawaga and Kevin Souza. Re: McNeese, ``I
think the [ATSDR] report gave us what we were looking for.'' 2/
12/07.......................................................... 268
#19. E-mail from Patrick Preston to Margaret Ramos. Re: Preston
tells another FEMA lawyer that FEMA ``has not identified any
independent evidence of dangerous formaldehyde conditions in
trailers.'' 2/27/07............................................ 270
#20. Letter to Patrick Preston from Mark Keim stating that the
ATSDR Health Consultation has been ``completed without a policy
review by our senior technical staff. I am concerned that this
health consultation is incomplete and perhaps misleading.''
Notes there is no ``safe'' level of exposure. 3/17/07.......... 274
#21. E-mail from MHOPS Maintenance Coordinator to MHOPS Field
Staff. Re: FEMA tells Mississippi housing office that ATSDR
results indicate that formaldehyde levels in travel trailers
would not cause ``physical discomfort to most people.'' FEMA is
using ATSDR ``level of concern'' as a guide to our housing
program. 3/22/07............................................... 276
#22. E-mail from Martin McNeese to Stephen Miller. Re: In
response to concerns from GSA, FEMA says travel trailers are
not being sold for housing but as recreational vehicles. 4/08/
07............................................................. 278
#23. E-mail from David Chawaga to FEMA staff. Re: FEMA asks who
determined 0.3 ppm was the ``level of health concern for
sensitive individuals'' as there is not website providing that
number. Refers to several sites listing 0.1 ppm or less as the
level. 5/1/07.................................................. 282
#24. McNeese response to 5/1/07 e-mail from David Chawaga. Re:
``The .3 ppm reference is also out of the ATSDR report.'' 5/1/
07............................................................. 284
#25. E-mail chain with message from Jeff Runge (FEMA) to Jerry
Thomas (CDC). Re: After CBS report, Runge says ATSDR did study
that showed ``conclusively'' that ventilating a new trailer
obviated problems with formaldehyde. 5/17/07................... 288
#26. E-mail chain with message from Harvey Johnson to Jeff Runge.
Re: Johnson tells Dr. Runge he wants a ``fresh look.'' 5/17/07. 293
#27. E-mail chain with message from Merritt Lake to William Lang.
Re: Merritt Lake, DHS's expert on formaldehyde, tells Dr. Lang
that 0.3 ppm is the exposure level for adults, but children are
more sensitive. 5/17/07........................................ 295
#28. E-mail chain with message from Price Roe to FEMA staff. Re:
DHS deputy secretary tells Runge to take the lead on medical
issues. Runge reviews various standards; says none are
``germaine to 24-hr x 7 days/week exposure in a mobile home or
trailer that child or stay-home parent may experience.'' 5/18/
07............................................................. 298
#29. E-mail from Stephen Orsino to Jordan Fried. Orsino, FEMA
attorney, notes that ACGIH level of 0.3 ppm used by ATSDR has a
caveat attached that it should not be applied to non-
occupational applications. 5/23/07............................. 306
#30. Formaldehyde Event DHS/OHA SITREP Draft #002. Re: FEMA draft
statement: ATSDR said 0.3 ppm was level of concern, but
Mississippi doctor is seeing upper respiratory illnesses in
children living in trailers; need to re-look at the issue. 5/
25/07.......................................................... 308
#31. E-mail chain with message from Mike McGeehin to William
Lang, Paul Garbe, Gary Noonan. Re: McGeehin doubts that any
study would allow CDC to ``define a level below which adverse
effects do not occur.'' 5/29/07................................ 321
#32. E-mail chain with message from Lang to Garratt. Re: CDC
ought to be able to say that 0.1 ppm is a reasonable short-term
mitigation goal. 5/29/07....................................... 323
#33. E-mail from Jill Igert, Senior Counsel, Office of Chief
Counsel, Louisiana Transitional Recovery Office. Re: FEMA
conference call on formaldehyde. Decision made with CDC last
year to ventilate isn't sufficient. ``It doesn't work in
Louisiana or Mississippi during the summer time.'' 5/31/07..... 326
#34. E-mail chain with message from Vice Adm. Johnson. Re:
Johnson says ``slow to roll any sales and/or provisions as
opposed to a notice to suspend'' in response to question about
whether FEMA should immediately suspend provision of travel
trailers for disasters and sale to occupants. 6/1/07........... 330
#35. News article: ``Formaldehyde High In Trailers.'' Jackson
Clarion Ledger. 6/4/07......................................... 332
#36. E-mail from Lang to Kevin Souza. Re: Current question is
whether these trailers, under real-life conditions, provide
safe and healthful environment. 6/4/07......................... 334
#37. E-mail from Lang to Garratt. Re: Who put out Gerberding
letter without consulting FEMA? FEMA wants ``rapid answers.''
6/5/07......................................................... 336
#38. Information Paper: Formaldehyde in FEMA Provided Temporary-
use Travel Trailers. 7/16/07................................... 338
#39. E-mail chain with FEMA staff. Re: GSA makes DHS aware of
health complaint about trailer surplused to military. 7/17/07.. 345
#40. FEMA Disaster Assistance Directorate. Discussions, Issues
and Questions Paper: Formaldehyde Testing. Re: DHS OHA has
recommended 0.1 ppm as ``interim formaldehyde baseline safety
level.'' FEMA/CDC site visit to LA. 7/22/07.................... 348
#41. E-mail chain. Re: No study protocol and sampling plan for
new testing. Lang reports on field trip to Louisiana. Cites
``major problem'' with HVAC systems in the trailers. ``There is
not ventilation in the units. . . In addition, most of the
units have gas stoves. . . Gas cooking is a potent source of
formaldehyde.'' 7/24/07........................................ 354
#42. CDC Health Advisory on formaldehyde: admits that people can
manifest symptoms at very low levels. ``Symptoms should lessen
if the affected individual is removed from the area of
exposure.'' 7/26/07............................................ 360
#43. E-mail chain with message from Gil Jamieson to FEMA staff.
Re: Moratorium on sales is in place because TT are not built to
HUD standards. 8/18/07......................................... 363
#44. E-mail from Michael Lapinski to Vice Admiral Johnson. Re:
FEMA refers to ``long delay'' in getting signature from CDC on
IAA. 9/23/07................................................... 366
#45. E-mail from Lapinski to Vice Admiral Johnson. Re: Johnson is
told numbers ``out there'' are 0.1 ppm, which is the NASA,
ASHRAE and California Air Resources Board standard. 0.1 ppm
``likely to become the defacto standard.'' Johnson wants to
approve sampling plan. 10/22/07................................ 369
#46. E-mail from Heather Smith to FEMA staff. Re: Johnson does
not want testing until there is an action plan. 10/31/07....... 372
#47. E-mail from Lang to Lapinski and Garratt. Re: New health
consultation recommends level unachievable in almost any
residential situation. Wants to scrap the Phase I study; move
to Phase III; get people out of trailers. Only other
alternative is to accept higher levels for disaster relief. 11/
2/07........................................................... 373
#48. E-mail from Jeff Runge to Johnson, Paulison, David,
Schneider. Re: ``I'd be ok with `higher levels (over 0.1)' or
`relatively higher levels (0.1).' '' 11/15/07.................. 375
#49. Statement of Administrator Paulison. Re: Background document
for FEMA Administrator Paulison's announcement of new testing
states that testing was delayed because no agency was willing
to ``establish guidance for residential indoor levels of
formaldehyde.'' 12/07.......................................... 376
#50. E-mail from Sam Coleman to Donald Benken with Tom Sinks
CC'd. RE: FEMA wants the CDC to help with trailer testing. 7/5/
06............................................................. 379
#51. Letter from Patrick Preston to Scott Wright. RE: Test
results and data from the FEMA trailer Formaldehyde testing
conducted by EPA. 11/30/06..................................... 380
#52. E-mail from Sam Coleman to Joseph Little and Scott Wright
with Howard Frumkin CC'd. RE: EPA Concerns that FEMA may not be
properly interpreting the data from EPA testing. 12/1/06....... 381
#53. E-mail from Howard Frumkin to Joseph Little, Scott Wright,
Sven Rodenbeck, and Phillip Allred with Tom Sinks CC'd. RE:
Howard Frumkin asking for details on the ATSDR analysis of
Formaldehyde in FEMA trailers. 12/4/06......................... 384
#54. E-mail from Joseph Little to Howard Frumkin with Tom Sinks,
Scott Wright, and Chris De Rosa CC'd. RE: Summary of ATSDR
involvement in the analysis of Formaldehyde in FEMA trailers
and of conference calls with FEMA OGC and EPA. 12/4/06......... 385
#55. E-mail from Howard Frumkin to Chris De Rosa with Tom Sinks
CC'd. RE: Howard Frumkin asking Chris De Rosa to keep him up-
to-date on potentially controversial activities such as the
ATSDR analysis of Formaldehyde in trailers. 12/5/06............ 387
#56. E-mail from Scott Wright to Richard Nickle and Gregory Zarus
with John Florence and Joseph Little CC'd. RE: Joe and Scott
instructed not to discuss or release any data outside of
themselves and FEMA's Office of Chief Counsel 12/7/06.......... 388
#57. E-mail from Richard Nickle to James Holler with Gregory
Zarus CC'd. RE: FEMA Trailers issue could warrant inquiry from
outside the division. 12/26/06................................. 389
#58. E-mail from Mark Keim to Phillip Allred. RE: Formaldehyde
health consultation to be presented to Howard Frumkin January
8th, 2007. 1/6/07.............................................. 391
#59. E-mail from Phillip Allred to Joseph Little and Scott
Wright. RE: Formaldehyde health consultation to be presented to
Howard Frumkin January 8th, 2007. 1/8/07....................... 392
#60. E-mail from Phillip Allred to Joseph Little and Scott
Wright. RE: Howard Frumkin's reaction to the Formaldehyde
health consult. 1/8/07......................................... 393
#61. Formaldehyde Sampling at FEMA Temporary Housing Units. Baton
Rouge, Louisiana: Executive Summary. 1/16/07................... 394
#62. E-mail from Phillip Allred to Louise Williams. RE: Setting
up a meeting to brief Tom on the Formaldehyde Consultation. 1/
18/07.......................................................... 395
#63. E-mail from Louise Williams to Phillip Allred. RE: Time set
up to brief Tom on the Formaldehyde Consultation. 1/19/07...... 396
#64. Letter from Mark Keim to Patrick Preston with Michael
Allred, Joseph Little, and Scott Wright CC'd. RE: Delivery of
ATSDR Health Consultation to FEMA. 2/1/07...................... 397
#65. E-mail from Phillip Allred to Phillip Allred. RE: Phillip
spoke to Patrick Preston about the temporary housing issues. 2/
15/07.......................................................... 399
#66. E-mail from Richard Nickle to (only key people listed) Chris
De Rosa, Howard Frumkin, Joseph Little, Tom Sinks, and Scott
Wright. RE: Health Consultation finalized and sent to FEMA--
Summary of findings are detailed in this e-mail. 2/2/07........ 400
#67. E-mail from Mark Keim and Phillip Allred. RE: Formaldehyde
update to be presented at the Issues Management Meeting to Tom
Sinks and Howard Frumkin. 3/2/07............................... 402
#68. E-mail from Chris De Rosa to Howard Frumkin and Tom Sinks.
RE: Concerns regarding the Formaldehyde health consultation
done for FEMA (Letter to Patrick Preston detailing concerns is
attached). 3/8/07.............................................. 403
#69. E-mail from Chris De Rosa to Mark Keim and James Holler. RE:
Concerns regarding the Formaldehyde health consultation done
for FEMA (Letter to Patrick Preston detailing concerns is
attached). 3/9/07.............................................. 405
#70. E-mail from Howard Frumkin to Mark Keim with Chris De Rosa
and Tom Sinks CC'd. RE: Howard Frumkin acknowledges that the
report should be corrected to include both acute and chronic
toxicity. 3/9/07............................................... 408
#71. E-mail from Mark Keim to Howard Frumkin with Chris De Rosa
and Tom Sinks CC'd. RE: Mark Keim acknowledges that he will
make changes to the health consult. 3/9/07..................... 409
#72. E-mail from Chris De Rosa to Howard Frumkin and Tom Sinks.
RE: History of FEMA not including cancer risks and asking ATSDR
to not include long-term health effects of Formaldehyde and on
amending the original Formaldehyde health assessment. 3/9/07... 410
#73. E-mail from Chris De Rosa to Howard Frumkin and Tom Sinks.
RE: Concerns regarding the Formaldehyde health consultation
done for FEMA (letter to Patrick Preston detailing concerns is
attached). 2/27/07............................................. 412
#74. Letter from Mark Keim to Patrick Preston with Chris De Rosa
and Howard Frumkin CC'd. RE: Concerns that the Formaldehyde
Health Consultation didn't address long-term health effects
including cancer. 3/17/07...................................... 414
#75. E-mail from Becky Gillette to James Durant. 2/27/07......... 416
#76. E-mail from Susan Metcalf to James Holler and Mary Jean
Brown with James Durant CC'd. RE: Determining CDC's Response to
the Sierra Club. 3/5/07........................................ 417
#77. E-mail from Becky Gillette to James Durant. RE: Second
request for an ATSDR contact to investigate Formaldehyde in
FEMA trailers. 5/7/07.......................................... 418
#78. E-mail from Sascha Fielding to Chris De Rosa. RE: Requesting
Chris to look over the responses to Congress regarding FEMA
trailers. 3/23/07.............................................. 419
#79. E-mail from Chris De Rosa to Sascha Fielding. RE: Concerns
from the response to Congress regarding FEMA trailers. 3/27/07. 420
#80. E-mail from Angela Davis to Barbara Rogers and Sascha
Fielding. RE: Non-disclosure request by FEMA Office of General
Counsel of ATSDR Formaldehyde data discussed in Issue
Management Meeting (typically for Dr. Frumkin and Dr. Sinks).
3/21/07........................................................ 421
#81. E-mail from Howard Frumkin to CDC All--NCHE/ATSDR. RE:
Newsletter--Important point was CDC's response to Congressman
Gene Taylor detailing that the CDC would not provide a health
assessment of Formaldehyde exposure in FEMA trailers. 4/6/07... 422
#82. E-mail from Joseph Little to Dagny Olivares, Richard Nickle,
Larry Cseh, and Phillip Allred with Mark Keim CC'd. RE: Joseph
Little concurs with the content of a FEMA news release which
does not include any long-term health effects (i.e., cancer).
5/3/07......................................................... 424
#83. E-mail from Dagny Olivares to Mark Keim and Phillip Allred.
RE: CDC not undertaking a health assessment as no one has
requested them to do so with regards to media requests on the
CDC's response to people living in trailers. 5/17/07........... 432
#84. E-mail from Stanley Meiburg to Sascha Fielding, Jane Telfer,
and Kenneth Rose. RE: Continued Formaldehyde discussions in
Issues Management Meetings with regards to CBS News report. 5/
21/07.......................................................... 433
#85. E-mail from Jane Telfer to William Cibulas, Stanley Meiburg,
Sascha Fielding, and Kenneth Rose with Howard Frumkin CC'd. RE:
Details on FEMA releasing the February Health Consultation
without long-term health risks. 5/21/07........................ 434
#86. Letter from Congressman Gene Taylor to Julie Gerberding. RE:
Asking CDC to Investigate the Formaldehyde in trailers. 2/22/07 436
#87. Letter from Julie Gerberding to Congressman Gene Taylor. RE:
Information on Formaldehyde and CDC recommends ventilation of
the units. 5/30/07............................................. 437
#88. E-mail from Howard Frumkin to Chris De Rosa and Tom Sinks.
RE: Forwarding news article about Formaldehyde and Kids. 5/30/
07............................................................. 443
#89. E-mail from Chris De Rosa to Howard Frumkin and Tom Sinks.
RE: CDC should be cautious about the word ``safe'' in reference
to formaldehyde since it is a carcinogen. 6/1/07............... 445
#90. E-mail from Scott Wright to Sascha Fielding with Joseph
Little CC'd. RE: Basis of the 0.3 ppm level of concern used by
ATSDR. 7/20/07................................................. 447
#91. E-mail from Howard Frumkin to Sascha Fielding, Mike
McGeehin, William Cibulas, and Henry Falk. RE: 0.3 ppm level of
concern has little or no operational meaning. 7/20/07.......... 448
#92. E-mail from Henry Falk to Howard Frumkin, Scott Wright, and
others. RE: FEMA talking points on the ATSDR report and
discussion of the 0.3 level of concern. 7/20/07................ 449
#93. E-mail from Howard Frumkin to Henry Falk, Scott Wright, and
others. RE: Discussion of FEMA Talking Points. 7/20/07......... 450
#94. E-mail from Howard Frumkin to Scott Wright, Joseph Little,
Henry Falk, and others. RE: Formaldehyde Exposure Levels. 7/21/
07............................................................. 451
#95. E-mail from Scott Wright to Richard Nickle. RE: Scott helped
draft Director Paulison with his Congressional testimony and
helped with the new FEMA fact sheet. 7/24/07................... 453
#96. E-mail from William Cibulas to Howard Frumkin, Scott Wright,
Henry Falk, Joseph Little, and others. RE: Mentions concern
that they don't mention cancer with regards to Formaldehyde
Exposure Levels. 7/24/07....................................... 454
#97. E-mail from Dagny Olivares to Howard Frumkin. RE: HAN
Feedback from the Emergency Communications System. NOTE: Still
no mention of cancer concerns in the attached document. 7/25/07 456
#98. E-mail from Chris De Rosa to Mike McGeehin, Henry Falk,
Howard Frumkin, and Tom Sinks. RE: Discussions regarding
ATSDR's approaches to the health consultations. 7/25/07........ 459
#99. E-mail from Chris De Rosa to Richard Weston. RE: No mention
of long-term health effects and developmental toxicity in the
Health Advisory. 7/26/07....................................... 463
#100. E-mail from Mike McGeehin to Howard Frumkin and others. RE:
Discussion on language in the report prepared by ATSDR for the
CDC website. 7/28/07........................................... 465
#101. E-mail from Dagny Olivares to Howard Frumkin and others.
RE: Posting the report prepared by ATSDR for the CDC website.
7/30/07........................................................ 466
#102. E-mail from Sascha Fielding to Howard Frumkin and others.
RE: Meeting to identify and review health issues related to
living in the trailers. 7/30/07................................ 468
#103. E-mail from Anne Sowell to Mark Bashor with Tom Sinks CC'd.
RE: Concerns regarding the ATSDR Formaldehyde consult. 8/8/07.. 470
#104. E-mail from Howard Frumkin to Henry Falk, Tom Sinks, and
Mike McGeehin. RE: Reduced pressure on CDC if FEMA is moving
people out of the trailers. 8/9/07............................. 472
#105. E-mail from Julie Gerberding to Henry Falk, Howard Frumkin,
William Gimson, and Tom Sinks. RE: Speeding up the timeline for
the study to relieve pressure. 8/10/07......................... 474
#106. E-mail from Chris De Rosa to Mike Groutt with Scott Wright
and Joseph Little CC'd. RE: Comments on Chronology of FEMA
Trailers to include details on senior policy and technical
reviews. 8/10/07............................................... 476
#107. E-mail from Tom Sinks to Howard Frumkin, Henry Falk, and
Louise Galaska. RE: Tom Sinks states that ATSDR leadership was
unaware that this consult was done through the Council's
office. 9/11/07................................................ 478
#108. E-mail from Alan Crawford to Tom Sinks. RE: Initial meeting
between ATSDR, EPA, and FEMA and a request to Dr. Frumkin
regarding Formaldehyde testing in June 2006. 9/13/07........... 479
#109. Letter to Howard Frumkin from Chris De Rosa. RE: Concerns
regarding several critical public health issues and objections
to limitation on Chris's ability to perform the duties
contained in his position description. 9/21/07................. 480
#110. E-mail from Chris De Rosa to Tom Sinks, Howard Frumkin,
Kenneth Rose, Jana Telfer, and Mark Basher with Henry Falk and
Mark Kashdan CC'd. RE: Health alert regarding formaldehyde
levels. 10/6/07................................................ 487
#111. E-mail from Tom Sinks to Chris De Rosa, Howard Frumkin,
Kenneth Rose, Jana Telfer, and Mark Basher with Henry Falk and
Mark Kashdan CC'd. RE: Health alert regarding formaldehyde
levels. 10/7/07................................................ 488
#112. E-mail from Tom Sinks to Henry Falk, Tom Sinks, and others.
RE: ATSDR leadership was unaware that their staff was working
directly with FEMA lawyers. 10/12/07........................... 489
#113. Flyer: Formaldehyde Levels in FEMA-Supplied Trailers--Early
Findings from the Centers for Disease Control and Prevention... 492
#114. Memo from NCEH/ATSDR--Howard Frumkin to Chris De Rosa. RE:
2007 Performance Assessment and Detail. 10/25/07............... 493
#115. Letter from Edward Murray. RE: Management Notification of
Highly Sensitive Issues--Failure to notify OGC/CDC. 11/8/07.... 494
TOXIC TRAILERS: HAVE THE CENTERS FOR DISEASE CONTROL FAILED TO PROTECT
PUBLIC HEALTH?
----------
TUESDAY, APRIL 1, 2008
House of Representatives,
Subcommittee on Investigations and Oversight,
Committee on Science and Technology,
Washington, DC.
The Subcommittee met, pursuant to call, at 9:37 a.m., in
Room 2318 of the Rayburn House Office Building, Hon. Brad
Miller [Chairman of the Subcommittee] presiding.
<GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT>
hearing charter
SUBCOMMITTEE ON INVESTIGATIONS AND OVERSIGHT
COMMITTEE ON SCIENCE AND TECHNOLOGY
U.S. HOUSE OF REPRESENTATIVES
Toxic Trailers: Have the Centers
for Disease Control Failed to
Protect Public Health?
tuesday, april 1, 2008
9:30 a.m.-1:00 p.m.
2318 rayburn house office building
Overview
The mission of the Agency for Toxic Substances and Disease Registry
(ATSDR), a sister agency of the Centers for Disease Control and
Prevention (CDC), ``is 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.'' Unfortunately, the agency failed to meet any of those
objectives when it produced a Health Consultation on Formaldehyde
Sampling of FEMA Temporary-Housing Trailers in February 2007. In almost
every respect ATSDR failed to fulfill its mission to protect the public
from exposure to formaldehyde at levels known to cause ill-health
effects. The agency's handling of this issue and their inability to
quickly and effectively correct it was the direct result of a collapse
of senior management and leadership at the very top of the agency. The
agency failed to translate scientific findings and facts into
appropriate public health actions which would have resulted in properly
informing and warning tens of thousands of Hurricanes Katrina and Rita
survivors living in FEMA-provided trailers and mobile homes of the
potential health risks they faced. The agency should have pushed to
remove them from this circumstance as early as possible. Instead, they
did virtually nothing.
The Health Consultation, which was conducted at the request of the
Federal Emergency Management Agency's (FEMA) Office of General Counsel
was scientifically flawed and omitted critical health information. The
report provided an illusion of safety that was used to drive FEMA
policy of maintaining tens of thousands of Hurricanes Katrina and Rita
families in FEMA-provided travel trailers. Rather than clearly warning
occupants of the full-extent of potential health effects they could be
exposed to the report determined that opening windows and vents would
reduce the concentrations of formaldehyde in the trailers below levels
of health concern.
Opening windows and vents did substantially reduce the level of
formaldehyde in the trailers, but the Health Consultation
inappropriately relied on a ``level of concern'' regarding the health
risks of formaldehyde of 0.3 parts per million (ppm), ten times higher
than ATSDR's own Minimal Risk Level of up to one year of exposure (0.03
ppm) and three times higher than the level of exposure widely accepted
by other federal agencies to cause health effects (0.1 ppm). It also
neglected to mention the potential long-term effects of exposure to
formaldehyde and possible cancer risks.
Purpose
The Subcommittee hearing will review how and why the Nation's
public health agency failed to protect the public's health. The hearing
will examine the direct involvement of the Director and Deputy Director
of ATSDR in reviewing, vetting and approving the release of the
agency's February 2007 Health Consultation on formaldehyde which was
scientifically unsound and quickly dismissed by the agency's chief
toxicologist after it had been forwarded to FEMA. Dr. Christopher De
Rosa, ATSDR's chief toxicologist and then-Director of the Division of
Toxicology and Environmental Medicine, immediately drafted a swift,
sharp letter to FEMA pointing out many of the scientific faults with
the report and said to release it as it was would be ``perhaps
misleading.'' The Director of ATSDR finally had the letter sent to Mr.
Rick Preston from FEMA's Office of General Counsel, who had requested
the report in the first place, from a separate ATSDR office on March
17, 2007. Amazingly, Mr. Preston acknowledged in interviews with
Subcommittee staff that he simply placed the letter in a file drawer
and never shared it with anyone else.
Without knowledge of the March letter, the February Health
Consultation by itself led senior FEMA officials to believe that
concentrations of formaldehyde in FEMA-provided temporary housing units
did not present a public health hazard. That interpretation of ATSDR's
Health Consultation and the astonishingly lackluster effort by ATSDR
officials to correct public mis-statements by FEMA officials or to
immediately revise their own flawed report in the Spring of 2007 led
FEMA to maintain the status quo and keep tens of thousands of Hurricane
Katrina and Rita survivors living in potentially formaldehyde-laden
toxic trailers for at least one year longer than necessary or
warranted. Apart from the March 17th letter ATSDR had no response at
all. If they had, perhaps more than 30,000 families would not remain in
these temporary housing units today.
Among the key questions:
<bullet> Why did the leadership of ATSDR take such halfhearted
actions after the flawed report was issued and after they were
informed--and agreed--that the report was fundamentally flawed
and would be misleading if it was released?
<bullet> Why did top officials of ATSDR fail to either
publicly or privately correct mis-statements by the FEMA
Administrator that formaldehyde in the trailers did not pose a
threat to the inhabitants?
<bullet> The preparation and dissemination of the February
Health Consultation to FEMA was managed by the Office of the
Director. The Director of ATSDR, Dr. Howard Frumkin, reviewed
and commented on the report and his Deputy, Dr. Tom Sinks,
reviewed, edited and approved the release of the report. Given
their intimate involvement in the preparation of this report,
why did Drs. Frumkin and Sinks both take concerted actions in
the fall of 2007 to publicly scold the two authors of the
report, reprimand their branch chief who was unaware of the
report and demote and retaliate against Dr. Chris De Rosa, the
agency's chief toxicologist, who appeared to be the one
individual who repeatedly pushed the agency to do more and be
more assertive in its response to the formaldehyde issue?
<bullet> How can the public and Congress trust an agency to
protect the public's health that treated one of the most
important public health issues of the agency's recent past so
wantonly, with so little urgency, insight, sound scientific
advise or concern?
Background
Formaldehyde is a colorless, strong-smelling gas that is widely
used in the building industry, as an adhesive in many consumer
products, including plywood, particle board, carpet and upholstery.
Travel trailers are widely composed of these products. Because of the
materials used in their construction, mobile homes and travel trailers
have long been known to contain higher levels of formaldehyde,
particularly when they are new, and there is a lot of ``off-gassing''
of formaldehyde. Over time the levels of formaldehyde in these products
normally decrease as ``off-gassing'' occurs. Still, some trailers have
shown elevated levels of formaldehyde even after years of ``off-
gassing.''
Hurricane Katrina made landfall on August 29, 2005. Less than one
month later on September 24, 2005 Hurricane Rita struck the Gulf Coast.
These hurricanes left tens of thousands of individuals and families
homeless. In response, FEMA provided more than 140,000 mobile homes and
travel trailers known as temporary housing units, to individuals and
families across the Gulf Coast, but the potential threat of exposure to
high levels of formaldehyde from this housing was soon recognized by at
least some federal agencies. High levels of formaldehyde in the
manufactured homes industry was no secret. Several health studies in
the 1980s documented adverse health effects from individuals living in
travel trailers and mobile homes. By October 2005, concerned about the
health consequences of formaldehyde exposures to FEMA workers, the
Occupational Safety and Health Administration (OSHA) began testing for
formaldehyde in FEMA temporary housing staging areas and discovered
high levels of formaldehyde. But no agencies conducted testing on the
actual trailers families and individuals would be living in for
extended periods of time.
In November 2005, Dr. Howard Frumkin, who took over as Director of
the Agency for Toxic Substances and Disease Registry (ATSDR) two months
earlier, seemingly recognized the health risks from the toxic chemicals
being unleashed into the environment in the wake of Hurricane Katrina,
including formaldehyde. But Dr. Frumkin did not link the formaldehyde
to trailers at the time, but said as a result of Hurricane Katrina
people faced a number of environmental health risk factors. ``In many
ways,'' Dr. Frumkin told the Knight Ridder Newspapers, ``this is the
major environmental health disaster of our lifetime.'' \1\ Yet, the
issue of formaldehyde exposure in travel trailers never seemed to
galvanize or sustain Dr. Frumkin's attention or interest.
---------------------------------------------------------------------------
\1\ Seth Borenstein and Chris Adams, ``Health problems abound
months after Katrina roared ashore,'' Knight Ridder Washington Bureau,
30 November 2005.
---------------------------------------------------------------------------
In April 2006, after hearing of a high level of formaldehyde in one
trailer, the Sierra Club began testing other FEMA trailers. It
conducted 52 tests between April and August, 2006 and found that 45 of
the trailers it tested had levels of formaldehyde above 0.1 parts per
million, the level at which potential health effects may begin to
occur. In June 2006, a Louisiana man living in a trailer who had
complained of formaldehyde died. This, in combination with the Sierra
Club tests and the fact that FEMA was concerned about litigation
regarding the presence of elevated levels of formaldehyde in these
trailers, spurred FEMA to initiate environmental testing of the
trailers for formaldehyde.
In June 2006, FEMA and the Environmental Protection Agency (EPA)
began developing protocols for the testing of trailers. Since the
immediate aftermath of Hurricane Katrina the EPA had been working with
ATSDR on emergency public health incidents, including oil fires and
potentially contaminated sediment. Dr. Frumkin had implemented a
streamlined procedure to respond to these sorts of emergency public
health calls. Federal or State agencies would contact ATSDR's Office of
Terrorism Preparedness and Emergency Response (OTPER) within the Office
of the Director who would assign the specific tasks to subject matter
experts within ATSDR or very often to the Emergency Response Team
within the Division of Toxicology and Environmental Medicine (DTEM). In
this instance, Sam Coleman, Director of EPA's Region 6 Superfund
Division, who had worked in the past with the Emergency Response Team
contacted Scott Wright, a member of the team about assisting FEMA in
testing travel trailers for formaldehyde.
Scott Wright, following the normal procedure established by Dr.
Frumkin, contacted Don Benken who was then Acting Director of OTPER.
The first of a long series of conference calls took place in late June
between FEMA, EPA and ATSDR regarding the testing of FEMA trailers. Don
Benken was present on the call as well as Scott Wright and Joseph
Little, from the Emergency Response Team. The calls were normally
directed by Rick Preston, a trial attorney from FEMA's Office of
General Counsel who was handling FEMA's litigation on the formaldehyde
issue.
After this first call Don Benken says that he physically walked
into Dr. Tom Sinks' office and informed him that FEMA arranged the call
partly because they were concerned about litigation. Dr. Sinks said
that they should offer assistance in any way that they could. In the
end, the test protocols called for testing 96 ``unoccupied'' trailers
for levels of formaldehyde. Testing ``occupied trailers'' was deemed
too difficult because of confounding lifestyle issues, such as smoking.
Tobacco contains formaldehyde and could have skewed the test results,
some of the participants argued.
In the tests, the EPA collected environmental samples in 96 new
unoccupied travel trailers in order to access the levels of
formaldehyde in closed trailers and under two ventilation methods: by
running the air conditioning with the bathroom vents open and by
opening the windows and vents. The tests were conducted in October 2006
and the data was provided to FEMA attorney Rick Preston, who provided a
CD of the test results to Scott Wright at ATSDR in November.
In the letter, received by Wright in early December, Preston said:
``Please review the data and provide to us a written report of your
analysis of the results of these tests and any conclusions or
recommendations that can be derived therefrom.'' Preston also asked
that the information and their analysis be kept confidential. The role
of ATSDR was to interpret and analyze the data, make recommendations
regarding the best methods to reduce formaldehyde in the trailers and
determine potential health implications.
February 2007 Health Consultation
On December 1, 2006, Sam Coleman from the EPA sent an e-mail to
Joseph Little and Scott Wright at ATSDR and cc'd Dr. Frumkin and others
at EPA on the e-mail. The e-mail thanked Joe and Scott for all of their
help, but then warned: ``We at EPA are concerned that FEMA might not be
properly interpreting the data. We urge CDC to complete its review as
soon as possible to provide appropriate advice to FEMA.''
Dr. Frumkin sent an e-mail to Joe and Scott the following day
saying ``I didn't know this was happening'' and asked who at ATSDR was
handling this issue. Dr. Frumkin appeared so concerned about this issue
at the time that he telephoned Scott Wright on his cell phone on
Wright's day off. On December 4th, Joe Little sent an e-mail to Dr.
Frumkin, Dr. Sinks, and others, including Dr. De Rosa, that clearly
mentions they are working with Rick Preston from FEMA's Office of
General Council.
Scott and Joe's evaluation looked simply at ventilation methods to
reduce formaldehyde in the trailers. Opening windows and vents did
substantially reduce the level of formaldehyde in the trailers, but the
Health Consultation also relied on a ``level of concern'' regarding the
health risks of formaldehyde of 0.3 parts per million (ppm), ten times
higher than ATSDR's own Minimal Risk Level of up to one year of
exposure (0.03 ppm) and three times higher than the level of exposure
widely accepted by other federal agencies, including EPA, OSHA and the
Consumer Products Safety Commission and international organizations to
cause health effects (0.1 ppm). These health effects can include
irritation of the respiratory tract, watery eyes, burning sensations in
the eyes, nose and throat, nausea, coughing, chest tightness, wheezing,
skin rashes, and allergic reactions. Over the long-term exposure to
elevated levels of formaldehyde may be linked to cancers of the nasal
sinuses, brain and leukemia.
On January 8, 2007, Mike Allred, Associate Director of the OTPER
presented the ``draft'' Health Consultation at Director Frumkin's
normal weekly Issues Management Meeting. Dr. Frumkin told Allred that
he wanted an executive summary and some conclusions. Dr. Sinks recalls
seeing and editing the document at least once, although Scott and Joe
say the document went through four revisions with the Director's
office. Mike Allred physically carried the document from Joe and Scott
to Dr. Sinks for edits. Dr. Sinks does not recall making any
significant changes or corrections to the document. On February 1,
2007, the Health Consultation was completed and sent to Rick Preston,
the FEMA trial attorney. The transmittal letter to the Health
Consultation said: ``In summary, the opening of windows and vents was
effective in reducing formaldehyde concentrations below levels of
health concern.''
On February 27, 2007, the Director of ATSDR's Division of
Toxicology and Environmental Medicine, Dr. Chris De Rosa became aware
of the report for the first time. He immediately informed the director
of ATSDR and his deputy that the report was fundamentally flawed and he
drafted--on his own volition--a letter to FEMA's Rick Preston that said
the February Health Consultation failed to undergo ``a policy review by
our senior technical staff'' and neglected to mention that formaldehyde
was a ``probable'' carcinogen, that there was no safe levels of
exposure and it omitted any reference to long-term exposure or cancer
risks. It concluded: ``Failure to communicate this issue is possibly
misleading, and a threat to public health.''
On Monday, March 5, 2007, ``Formaldehyde in FEMA trailers'' was one
of the topics of discussion at the Director's Issues Management
Meeting. These meetings are not attended by Division Directors, such as
Dr. De Rosa.
On March 8th, Dr. De Rosa sent a second e-mail to Dr. Sinks and Dr.
Frumkin, since he had not heard anything from them on his Feb. 27th e-
mail, and told them that he planned to send the letter to FEMA the
following day if he received no objections from them. On Friday, March
9th, Dr. Frumkin did respond to Dr. De Rosa and said he agreed with his
concerns but wanted the response to FEMA coming from the same ATSDR
office that originated the initial health consultation to respond. On
March 17, 2007, ATSDR finally sent a letter drafted by Dr. De Rosa, but
signed by the new Associate Director of the OTPER, Dr. Mark Keim, to
Rick Preston at FEMA. Rick Preston told Subcommittee staff that he
simply took the letter and filed it away because he believed everyone
at FEMA was well aware of the risks noted in the March letter. The
letter, according to Preston, was never shared with anyone else.
From March onward, Dr. De Rosa continued to raise the formaldehyde
issue internally. He repeatedly pushed and prodded the agency to do
more and to alert the residents of the trailers, the public and
Congress to the true risks of formaldehyde exposure. At the same time,
FEMA was publicly using the February Health Consultation to justify
maintaining the status quo and keeping people in trailers. At a
Congressional hearing in mid-May 2007, FEMA Administrator David
Paulison said, referring to the February Health Consultation, ``We've
been told that the formaldehyde does not present a health hazard.''
During the same time-frame the media was reporting on formaldehyde
linked health problems in children and others living in trailers on the
Gulf Coast.
Yet, the leadership of ATSDR remained silent. They did not publicly
or privately correct the record, seek a ``revised'' Health Consultation
or take other appropriate actions. Both Dr. Frumkin and Dr. Sinks told
Subcommittee staff that they were simply unaware of media,
congressional or other attention to this issue between March and the
summer of 2007. They say that they wish they had done more sooner. Yet,
documents obtained by the Subcommittee show that the formaldehyde issue
was brought up at the Director's Issues Management Meetings at least
two other times after the March 17th letter was mailed. Once on March
21st and again on May 21st in response to a CBS News report on the
formaldehyde issue in FEMA trailers.
Meanwhile Dr. Chris De Rosa, continued to push the agency to become
more engaged on the formaldehyde issue. On June 1, 2007, Dr. De Rosa
again sends an e-mail to Director Frumkin, Deputy Director Sinks and
others regarding the formaldehyde issue, warning them that there is no
``safe'' level of exposure to formaldehyde. Only after a second
Congressional hearing on this topic in July 2007 and a severe public
critique of ATSDR's February Health Consultation did ATSDR begin to
respond. Even as the agency began to respond, Chris De Rosa kept
pushing to do more.
In August, Dr. Frumkin placed Dr. De Rosa in charge of re-writing
the February Health Consultation. He was removed from this role in
September. On September 21, 2007, Dr. De Rosa wrote a blistering letter
to ATSDR Director Dr. Frumkin raising his concerns that ATSDR was
failing to protect the public's health on the formaldehyde and other
issues. The following month, as part of his annual review, Dr. De Rosa
received an ``unsatisfactory'' performance evaluation and was removed
as Director of the Division of Toxicology, a post he had held with
distinction for the previous 16 years. The Subcommittee considers Dr.
De Rosa a whistleblower.
The agency did finally publish a ``revised'' (much more complete)
Health Consultation in October 2007. But the fundamental failings of
the agency revealed as a result of their work on the formaldehyde issue
remains a serious issue of concern. Rather than articulating a clear,
concise and scientifically sound response to the formaldehyde issue
from the beginning ATSDR seems to be an agency marred by confusion,
lack of clear guidance and poor science from the very top of the
leadership pyramid to the bottom. In February 2007, an internal ATSDR
summary of the February Health Consultation said: ``In summary, the
opening of windows and vents was effective in reducing formaldehyde
concentrations below levels of health concern.'' In April 2007, the
Director of ATSDR, Dr. Howard Frumkin sent out a personal newsletter to
all staff that mentioned ATSDR's role in accessing environmental
samples of formaldehyde levels in trailers that resulted in the
February report. ``These data indicate that in trailers with closed
windows, formaldehyde levels are similar to those found in new
conventional housing,'' he wrote. The day after Congressional hearings
in July 2007 on this issue, one of the two primary authors of the
February report wrote: ``ATSDR emphatically stated in the conclusions
that the levels of formaldehyde seen in trailers was of a Health
Concern!'' It appears clear that the agency's overall ``conclusions''
were not based in scientific fact, but seemed to wax and wane with the
public and congressional interest in this matter.
In February 2008, a full year after ATSDR completed its initial
Health Consultation on formaldehyde, Dr. Julie Gerberding, the Director
of the CDC held a press conference to announce the results of new
formaldehyde tests on occupied trailers. Dr. Gerberding said the tests
provided a snapshot of formaldehyde levels in FEMA trailers that helped
the CDC ``understand and confirm what we suspected all along,'' she
said, ``that in some of these situations the formaldehyde levels are
high enough where there could be a health hazard to the people who are
living there.'' Because formaldehyde levels are likely to rise in the
summer as the heat and humidity increase the CDC made that those in
trailers ``be relocated to safer, permanent housing as quickly as
possible, and certainly before the warm summer months arrive, because
we want people to be as safe as they can possibly be.'' At the same
news conference, FEMA administrator David Paulison said, ``The real
issue is not what it will cost but how fast we can move people out.''
Remarkably, seven months earlier, on July 24, 1007, Dr. De Rosa
sent an e-mail addressed to ``colleagues'' at ATSDR, including Drs.
Frumkin and Sinks and 15 other employees regarding FEMA's announcement
that it intended to conduct formaldehyde testing in trailers.
``Colleagues,'' wrote De Rosa, ``While testing may be warranted, what
immediate interventions are being pursued thru appropriate channels to
interdict exposures? Or to mitigate health impacts? I am concerned that
the reported clinical signs are the harbinger of a[n] impending public
health disaster.'' But no one seemed to listen.
Witnesses
Panel I:
<bullet> Dr. Heidi Sinclair, Assistant Professor of
Pediatrics, Louisiana State University, Medical Director, Baton
Rouge Children's Health Program
<bullet> Mrs. Lindsay Huckabee, Resident of FEMA-provided
mobile home in Kiln, Mississippi from October 2005-to-present,
along with her husband and five children.
<bullet> Ms. Becky Gillette, Formaldehyde Campaign Director,
Sierra Club Gulf Coast Environmental Restoration Task Force
Panel II:
<bullet> Dr. Christopher De Rosa, Former Director, Division of
Toxicology and Environment Medicine, Agency for Toxic
Substances and Disease Registry (ATSDR)
<bullet> Dr. Meryl Karol, Professor Emerita, University of
Pittsburgh, Department of Environmental & Occupational Health
Panel III:
<bullet> Dr. Howard Frumkin, Director, Agency for Toxic
Substances and Disease Registry (ATSDR) and National Center for
Environmental Health, (NCEH)
<bullet> Dr. Tom Sinks, Deputy Director, Agency for Toxic
Substances and Disease Registry (ATSDR) and National Center for
Environmental Health, (NCEH)
<bullet> Vice Admiral (ret.) Harvey E. Johnson, Jr., Deputy
Administrator, Federal Emergency Management Agency (FEMA)
Chairman Miller. Good morning. This hearing will come to
order. Today's hearing is Toxic Trailers: Have the Centers for
Disease Control Failed to Protect Public Health? The Agency for
Toxic Substances and Disease Registry, ATSDR, is a constituent
agency of the Centers for Disease Control and Prevention, the
CDC, it is 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.
The staff of this subcommittee has engaged in more than 100
hours of interviews and read thousands of pages of documents in
preparing this morning's hearing on this matter. The ATSDR
failed in its mission in producing a health consultation for
the Federal Emergency Management Agency, FEMA, on the possible
health consequences of formaldehyde exposure in trailers
provided by FEMA to survivors of Hurricanes Katrina and Rita.
ATSDR failed in what it produced in the consultation, but
ATSDR's greatest failings were in what it left undone.
ATSDR's failings were not just in scholarship, in academic
disputation in obscure learned journals. Tens of thousands of
Katrina and Rita survivors economically and politically
powerless, vulnerable people, were living in the FEMA trailers.
ATSDR released the consultation to FEMA on February 1 last
year. The consultation concluded that formaldehyde levels in
the trailers would be ``below levels of concern'' so long as
the doors and windows were left open to air out the trailers.
The level of concern was established at 0.3 parts per million.
We will hear this morning that is a level well above the level
of exposure that would likely cause adverse health consequences
in sensitive people. And the report was entirely silent on the
risks associated with continuous, long-term exposure to
formaldehyde.
In short, ATSDR issued a scientifically flawed report and
failed to correct the record when they knew that the report was
significantly flawed. And the result of that failure was that
thousands of Americans were exposed to unsafe levels of
formaldehyde fumes for a full year after the ATSDR and FEMA
knew or should have known the real health risks of the
formaldehyde exposure. It was not until February 13 of this
year that the head of CDC, Julie Gerberding, announced that CDC
was encouraging people to be moved out of the trailers as
rapidly as possible.
This is not an instance of lower level employees acting
without the knowledge of the leadership of ATSDR or CDC. The
facts are these:
The analysts who did this report were approved for this
task by the Deputy Director of the Agency, Dr. Tom Sinks, in
July of 2006.
The analysts produced a report that was then sent directly
to the emergency response officials in the Directors Office.
On January 8, 2007, the draft report was briefed to the
Director, the Deputy Director, and the senior staff of the
Director, and the briefing did not include the Division
Directors that possess the technical expertise to evaluate
toxicological or epidemiological studies.
The Director of ATSDR was given a copy of the draft report
and told Committee staff that he cannot remember whether he
ever read it in January of 2007.
The Deputy Director was given a copy of the draft report
and remembers reviewing it at least one time. The analysts
believe that review processes went through four rounds,
providing comments back to the analysts on what they needed to
do to improve the report.
There was no process in place to guarantee that anyone else
between the two analysts and the Director and Deputy Director
had a chance to review the report.
There was no control sheet to indicate to the Director who
else had reviewed it. In most agencies this is a standard form
to guarantee that a document has received the proper
clearances.
This whole process for moving Katrina-related consultations
was established at the personal direction of the Dr. Howard
Frumkin, the Director of ATSDR.
In sum, there was a failure of leadership to establish
effective systems to guarantee that important health, public
health documents were reviewed properly and based on the best
science. There was also a stunning lack of concern for how
important this consultation was to thousands of American
families. It appears that this consultation was, received only
a cursory review by the Director's office, by the Director
himself, and the Deputy Director claims only the vaguest
memories of any concerns regarding the report.
Another director, another official at ATSDR had a very
different reaction to the formaldehyde consultation when he saw
it. After the report was reviewed and approved by the Director,
ATSDR sent the report to FEMA. When it was then distributed
within ATSDR and landed on the desk of Dr. Chris De Rosa, the
head of the Department of Toxicology and Environmental
Medicine, he was appalled. He immediately e-mailed Dr. Frumkin
to urge that they send a letter, ATSDR send a letter to FEMA,
effectively withdrawing the report.
Now, when he didn't receive a response, Dr. De Rosa sent
his letter again, sent a letter draft to Dr. Frumkin and said
that he would assume that unless Dr. Frumkin got back to him by
the end of the next day that Dr. Frumkin intended to do
nothing, and Dr. De Rosa would send the letter himself. Dr.
Frumkin then agreed to have ATSDR send the letter over the
signature of an official from the responsible office, in this
case an official in the Director's office.
ATSDR finally sent that letter on March 17, 2007. That
letter read, in relevant part, ``The health consultation has
been completed without a policy review by our senior technical
staff. I am concerned that this health consultation is
incomplete and perhaps misleading.'' This letter, like the
prior consultation, was sent to the Office of Chief Counsel at
FEMA, to Mr. Rick Preston, an attorney there. Mr. Preston told
our staff that he simply put the letter in his file and did not
mention it to anyone else at FEMA.
But with that letter of repudiation, the leadership of
ATSDR washed their hands of the report until awkward questions
came up at a hearing by Chairman Waxman last July. In the wake
of that hearing, Dr. Frumkin ordered a revised consultation
posted in October, 2007, and shifted the blame for the
consultation, the failings of the consultation, arguing that
Dr. De Rosa, who was the one who asked the questions, the
awkward questions about the report, should be removed from his
position because of the poor quality of the formaldehyde health
consultation.
I want to make it very clear to the management of CDC and
ATSDR that this committee considers Dr. De Rosa to be a
whistleblower. Much of our information about this came from Dr.
De Rosa originally. I have joined Chairman Gordon and Chairman
Lampson in signing a letter to Dr. Gerberding expressing that
position very forcefully. I think I have made it very clear
that there are officials at ATSDR who should be on a
professional improvement plan, a PIP in the jargon of federal
employees. It isn't Dr. De Rosa, and I want to emphasize that
nothing should happen to Dr. De Rosa except that he be restored
to his previous position.
Think back to when you were a child and you were sick. The
safest place was to be at home in bed. Here we have government
providing families with homes that were making children sick.
Where do those children go to be safe? Where do families turn
for help?
The ATSDR is mandated to intervene to protect the public
health, public from adverse health consequences of toxic
chemicals, but in this case we find the leadership at the very
top level of the agency with little interest in the actual work
that was required to do that. Take a look at the testimony, the
testimony from ATSDR is inspiring. It is aspirational. They say
all the right words of concern and commitment, but their
actions and their inactions speak much louder than their words.
The Nation needs much better leadership from ATSDR and the CDC.
[The prepared statement of Chairman Miller follows:]
Prepared Statement of Chairman Brad Miller
The Agency for Toxic Substances and Disease Registry--ATSDR--is a
constituent agency of the Centers for Disease Control and Prevention
(CDC). Its mission is 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.''
The staff of this subcommittee has engaged in more than a hundred
hours of interviews and read thousands of pages of documents in
preparing this morning's hearing on this matter. The ATSDR failed in
its mission in producing a health consultation for the Federal
Emergency Management Agency--FEMA--on the possible health consequences
of formaldehyde exposure in trailers provided by FEMA to survivors of
Hurricanes Katrina and Rita. ATSDR failed in what it did in producing
the consultation, but ATSDR's greatest failings were in what it left
undone.
ATSDR's failures were not just in scholarship, in academic
disputation in obscure learned journals. Tens of thousands of Katrina
and Rita survivors were living in the trailers. ATSDR released the
consultation to FEMA on February 1, 2007. The consultation concluded
that formaldehyde levels in the trailers would be ``below levels of
concern'' so long as the doors and windows were left open to air out
the trailers. The ``level of concern'' was established at 0.3 parts per
million. We will hear this morning that is a level well above the level
of exposure that would likely cause adverse health reactions in
sensitive people. And the report was entirely silent on risks
associated with continuous, long-term exposure to formaldehyde.
In short, ATSDR issued a scientifically flawed report and failed to
correct the record when they knew that the report was significantly
flawed. And the result of that failure was that thousands of Americans
were exposed to unsafe levels of formaldehyde fumes for a full year
after ATSDR and FEMA knew or should have known the real health risks.
It was not until February 13, 2008 that Julie Gerberding announced that
CDC encouraged people to be moved out of trailers as rapidly as
possible.
This was not an instance of lower level employees acting without
the knowledge of the leadership of ATSDR or CDR. The facts are these:
<bullet> The analysts who did this job were approved for this
task by the Deputy Director of the agency, Dr. Tom Sinks, in
July of 2006;
<bullet> The analysts produced a report that was then sent
directly to the emergency response officials in the Director's
Office;
<bullet> On January 8, 2007, the draft report was briefed to
the Director, the Deputy Director and the senior staff of the
Director--this briefing did not include the Division Directors
that possess the technical expertise to evaluate toxicological
or epidemiological studies;
<bullet> The Director of ATSDR was given a copy of the draft
report and told Committee staff that he cannot remember whether
he ever read it or not in January of 2007;
<bullet> The Deputy Director was given a copy of the draft
report and remembers reviewing it at least one time--the
analysts believe that review process went through four rounds
providing comments back to the analysts on what they needed to
do to improve the report;
<bullet> There was no process in place to guarantee that
anyone else between the two analysts and the Director and
Deputy Director had a chance to review the report; There was no
control sheet to indicate to the Director who else had reviewed
it in most agency's this is a standard form to guarantee that a
document has received the proper clearances;
<bullet> This whole process for moving Katrina-related
consultations was established at the personal direction of the
Director of ATSDR, Dr. Howard Frumkin.
In sum, there was a complete failure by leadership to establish
effective systems to guarantee that important public health documents
were properly reviewed and based on the best science. There was also a
stunning lack of concern for how important this consultation was to
thousands of American families. It appears that this consultation
received only a cursory review in the Director's office by the Director
himself and the Deputy Director claims only the vaguest memories of any
concerns regarding the report.
Another official at ATSDR had a very different reaction to this
formaldehyde consultation when he saw it. After the report was reviewed
and approved by the Director, ATSDR sent the report to FEMA. Then it
was distributed to some within ATSDR. When it landed on the desk of Dr.
Chris De Rosa, the head of the Division of Toxicology and Environmental
Medicine, he was appalled. He immediately e-mailed Dr. Frumkin to urge
that they send a letter to FEMA to effectively withdraw the report.
When he didn't receive a response, De Rosa resent his letter draft
and said that Dr. Frumkin would have to get back to him by close of
business the next day or would assume Frumkin's silence implied support
and Dr. De Rosa would send the letter to FEMA himself. Frumkin then
agreed to have ATSDR send the letter over the signature of an official
from the responsible office--in this case an official in the Director's
office.
ATSDR finally sent that letter on March 17, 2007. That letter read,
in relevant part, ``the Health Consultation . . . has been completed
without a policy review by our senior technical staff. I am concerned
that this health consultation is incomplete and perhaps misleading.''
This letter--like the prior consultation--was sent to an attorney in
the Office of Chief Counsel at FEMA, Mr. Rick Preston. Mr. Preston told
our staff that he simply filed the letter and did not send it to anyone
else at FEMA.
With that letter of repudiation, the leadership of ATSDR washed
their hands of the report until awkward questions were raised at a
hearing by Chairman Waxman last July. In the wake of that hearing, Dr.
Frumkin ordered a revised consultation--posted in October 2007, and
shifted the blame for the consultation. Dr. Frumkin argued that Dr. De
Rosa--who first questioned that report--should be removed due to the
poor quality of the formaldehyde health consultation.
I want to make it very clear to the management at CDC that the
Committee considers Dr. De Rosa to be a whistleblower. I have joined
Chairmen Gordon and Lampson in signing a letter to Dr. Gerberding
expressing this position very forcefully. I think I have made it clear
who at ATSDR I believe would most benefit from Professional Improvement
Plan and it isn't Dr. De Rosa--who has been put on one by Drs. Frumkin
and Sinks. I want to emphasize that we believe that nothing is to
happen to Dr. De Rosa short of restoring him to his post.
Think back to when you were a child and sick. The safest place to
be was at home in bed. But here we have a situation where the
government has provided families with homes that are making children
sick. Where do those children go to be safe? Who do their families turn
to for help? ATSDR is mandated to intervene to protect the public from
the adverse health consequences of toxic chemicals. But in this case we
find the leadership at the very top of that agency with no interest in
the actual work it would take to carry out that role. Take a look at
their testimony. In inspiring tones, they utter the right words of
concern and commitment, but their actions and inactions speak much
louder than their words. The Nation needs better leadership from ATSDR
and the CDC.
Chairman Miller. Now, I would like to recognize--I will
recognize Mr. Sensenbrenner of Wisconsin.
Mr. Sensenbrenner. Thank you, Mr. Chairman. Today's hearing
touches on some of the core issues lawmakers face in
implementing policy based on science. As the former Chairman of
this Full Committee and the Ranking Member of the Subcommittee,
as well as being the Ranking Member of the Select Committee on
Global Warming, I probably have had more experience with this
intersection than most of my colleagues.
How do you rely on good science to make informed decisions
in the public interest? First and foremost, good decisions
require good science and good scientific recommendations. The
Agency for Toxic Substances and Disease Registry, which I will
refer to as the ATSDR as the Chairman has, has failed us on
this count.
ATSDR's mission is, ``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 toxic substances.'' This mission is intended to
serve not only lawmakers and other federal agencies but also
individuals like today's witnesses.
Lindsay Huckabee. Ms. Huckabee's family experienced various
health problems since moving into trailers provided by the
Federal Emergency Management Agency. To date, too little has
been communicated about what affect the formaldehyde levels on
her FEMA-provided trailer have had on her family's health.
After an extensive Subcommittee investigation it appears
that one of the principle failings within ATSDR is its review
process. I hope to hear testimony from agency officials about
that review process and how it can be strengthened in the
future to prevent situations like this from occurring.
Regardless of the merits of an individual scientist, good
scientists requires review and contribution from various
perspectives.
On at least two recent instances ATSDR has proven itself
incapable of sufficient review. ATSDR recently released a
report entitled, ``Public Health Implications of Hazard
Subjects in the 26 U.S. Great Lakes Areas of Concern.'' ATSDR
began work on that report in 2002, and largely completed it by
2004. The study was reviewed by external peer reviewers and
cleared for release by ATSDR in July, 2007. Days before its
slated release, ATSDR's leadership withheld the report's
release because, according to the agency, significant
scientific concerns had come to their attention. I am convinced
that those concerns are legitimate.
I am, therefore, confused as to how the report cleared
ATSDR's review process. Watchdog agencies and Congressional
committees are justifiably concerned when a report on public
health is pulled with minimal explanation days before its
release. If this report was fatally flawed, why were problems
not uncovered during ATSDR's two years of review before the
report was cleared for release? ATSDR's initial health
consultation on formaldehyde levels in FEMA trailers similarly
failed the public. That consultation titled, ``Formaldehyde
Sampling at FEMA Temporary Housing Units,'' dated February 1,
2007, concluded that the average concentration of formaldehyde
per day in ventilated trailers after the fourth day of sampling
and for the remainder of the study was below the level of
concern for sensitive individuals of 0.3 parts per million.
That conclusion led FEMA to believe that concentrations of
formaldehyde in FEMA-provided housing units did not present a
public health hazard. That was not the message the report's
authors intended to convey. A competent internal review process
could have determined that the consultation was potentially
misleading before it was ever transmitted to FEMA.
First, competent review could have determined that there
were potential problems with the report's stated level of
concern. The consultation does not discuss why it chose this
level, nor does it discuss the problems could occur at much
lower levels. The stated level was three times higher than the
level used by several other government agencies and, according
to many experts, above the level where many individuals will
experience negative health affects.
While the consultation's authors had a strong argument for
choosing this level, the level should have been subject to at
least some degree of internal review. The health consultation
also focused exclusively on the short-term effects and failed
to mention the potential long-term effects of exposure to
formaldehyde and the possible risk of cancer.
Dr. Christopher De Rosa, then the ATSDR's Director of the
Division of Toxicology and Environmental Medicine, first read
the release nearly a month after it was transmitted to FEMA. He
pointed out some of the consultation's flaws and argued that as
written it was perhaps misleading.
On March 17, 2007, ATSDR wrote to Rick Preston in FEMA's
Office of General Counsel, who had originally requested the
consultation and raised these concerns. Mr. Preston, however,
did not share these concerns with other officials at FEMA. For
its part ATSDR took no action to immediately revise its report,
nor did it raise any protests as FEMA continued to rely on the
health consultation as evidence of the trailers' acceptability.
A month and a half after the report was transmitted to
FEMA, the report was still flawed, and the public was still
uninformed. As today's hearing will make clear, far too little
is known about the effects of formaldehyde and about what level
should be considered problematic. Clearly, risk managers have
to accept exposure to some level of formaldehyde. Suggestions
that there is, ``no safe level of formaldehyde'' are simply not
helpful because formaldehyde is ubiquitous.
Sitting in this hearing room today we are breathing in
formaldehyde. It has long been know that these levels are
higher in trailers and mobile homes, both because of the
material that's used and the relatively poor air exchange. But
exactly what level is unacceptable is not clear.
A report dated February 29, 2008, from the Centers for
Disease Control titled, ``Interim Findings on Formaldehyde
Levels in FEMA-Supplied Travel Trailers, Park Models, and
Mobile Homes,'' provided information about formaldehyde levels
in FEMA-supplied, occupied travel trailers, park models, and
mobile homes that were still being used as of January of this
year. This report found that the average formaldehyde
concentration of these units was 77 parts per billion, well
above what it termed the typical U.S. background levels of ten
to 30 parts per billion. The range of concentration in tested
trailers was, however, extremely broad. The lowest tested
trailer registered on 3 parts per billion, well below the U.S.
average, while the highest concentration measured 590 parts per
billion.
The interim report recommended fast action, finding that
its condition supported the need to move quickly before the
weather in the region warms up, to relocate residents of the
U.S. Gulf Coast Region displaced by Hurricanes Katrina and Rita
who still live in travel trailers, park models, and mobile
homes. This recommendation is broad, sweeping, and
authoritative, but it raises as many questions as it provides
answers.
Does the CDC recommend relocating everyone in FEMA-provided
trailers, even in those trailers with formaldehyde
concentrations below the typical background norms in U.S.
homes? If not, what level is the appropriate level of concern?
Should Americans living in trailers and mobile homes not
provided by FEMA be concerned about formaldehyde levels? Do we
need wide-scale testing for formaldehyde concentrations?
The public will not be served by drastic action based upon
limited science. Relocating individuals who are experiencing
health affects is an urgent priority, but causing a panic among
individuals who are perfectly safe will only result in
unnecessary expense and neglect those who are actually in need.
We need a clearer understanding of formaldehyde and its effects
on human health before we act more broadly.
As the Ranking Member of the Global Warming Committee, I
know too well how science intensified under constant media
exposure can lead to paranoia that seems to require immediate,
wide-scale, and admittedly well-intentioned action. As policy-
makers we depend on agencies to product high-quality,
thoroughly-reviewed science and to provide prudent objective
advice. We haven't gotten it from ATSDR and as a result we are
really operating in the blind in terms of what our response
should be to this problem.
And I thank the Chair for indulging me to speak for more
than five minutes.
[The prepared statement of Mr. Sensenbrenner follows:]
Prepared Statement of Representative F. James Sensenbrenner Jr.
Today's hearing touches some of the core issues lawmakers face in
implementing policy based on science. As the former Chairman of the
Science Committee, the Ranking Member on this subcommittee, and the
Ranking Member on the Select Committee on Global Warming, I have had
more experience with this intersection than most. How do you rely on
good science to make informed decisions in the public's interest?
First and foremost, good decisions require good science and good
scientific recommendations. The Agency for Toxic Substances and Disease
Registry (ATSDR) has failed us on this count. ATSDR's mission is ``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.''
This mission is intended to serve not only lawmakers and other
Federal agencies, but also individuals like today's witness, Lindsay
Huckabee. Ms. Huckabee's family has experienced various health problems
since moving into trailers provided by the Federal Emergency Management
Agency's (FEMA). To date, too little has been communicated about what
affect the formaldehyde levels in her FEMA-provided trailer have had on
her family's health.
After an extensive Subcommittee investigation, it seems clear that
one of the principle failings within ATSDR is its review process. I
hope to hear testimony from agency officials about that review process
and how it can be strengthened in the future. Regardless of the merits
of an individual scientist, good science requires review and
contribution from various perspectives. On at least two recent
instances, ATSDR has proven incapable of sufficient review.
ATSDR recently released a report titled, Public Health Implications
of Hazardous Substances in the Twenty-Six U.S. Great Lakes Areas of
Concern. ATSDR began work on that report in 2002 and largely completed
it by 2004. The study was reviewed by external peer reviewers and
cleared for release by ATSDR in July, 2007. Days before its slated
release, ATSDR's leadership withheld the report's release because,
according to the agency, significant scientific concerns had come to
their attention.
I am convinced that these concerns are legitimate. I am therefore
confused as to how the report cleared ATSDR's review process. Watchdog
agencies and Congressional Committees are justifiably concerned when a
report on public health is pulled with minimal explanation days before
its release. If this report was so fatally flawed, why were problems
not uncovered during ATSDR's two years of review before the report was
cleared for release?
ATSDR's initial health consultation on formaldehyde levels in FEMA
trailers similarly failed the public. That consultation titled,
Formaldehyde Sampling at FEMA Temporary Housing Units, dated February
1, 2007, concluded that:
The average concentration of formaldehyde per day in
[ventilated trailers], after the fourth day of sampling and for
the remainder of the study, was below the level of concern for
sensitive individuals of 0.3 parts per million.
That conclusion led FEMA to believe that concentrations of
formaldehyde in FEMA-provided housing units did not present a public
health hazard. This was not the message the report's authors intended
to convey. A competent internal review process should have determined
that the consultation was potentially misleading before it was ever
transmitted to FEMA.
First, competent review could have determined that there were
potential problems with the report's stated ``level of concern.'' The
consultation does not discuss why it chose this level, nor does it
suggest that problems could occur at much lower levels. The stated
level was three times higher than the level used by several other
government agencies and, according to many experts, above the level
where many individuals will experience negative health effects. While
the consultation's authors had a strong argument for choosing this
level, the level should have been subject to some degree of internal
review.
The health consultation also focused exclusively on short-term
effects and failed to mention the potential long-term effects of
exposure to formaldehyde and the possible risk of cancer. Dr.
Christopher De Rosa, then ATSDR's Director of the Division of
Toxicology and Environmental Medicine, first read the release nearly a
month after it was transmitted to FEMA. He pointed out some of the
consultation's flaws and argued that, as written, it was ``perhaps
misleading.''
On March 17, 2007, ATSDR wrote to Rick Preston in FEMA's Office of
the General Counsel, who had originally requested the consultation, and
raised these concerns. Mr. Preston did not, however, share these
concerns with other officials at FEMA. For its part, ATSDR took no
action to immediately revise its report nor did it raise any protests
as FEMA continued to rely on the Health Consultation as evidence of the
trailer's acceptability. A month and half after the report was
transmitted to FEMA, the report was still flawed and the public was
still uninformed.
As today's hearing will make clear, far too little is known about
the effects of formaldehyde and about what levels should be considered
problematic. Clearly, risk managers have to accept exposure to some
level of formaldehyde. Suggestions that there is ``no safe level'' of
formaldehyde are simply not helpful because formaldehyde is ubiquitous.
Sitting in this hearing room today, we are breathing in formaldehyde.
It has long been known that these levels are higher in trailers and
mobile homes both because of the materials used and the relatively poor
air exchange. But exactly what level is unacceptable is unclear.
A report dated February 29, 2008 from the Centers for Disease
Control (CDC), titled Interim Findings on Formaldehyde Levels in FEMA-
Supplied Travel Trailers, Park Models, and Mobile Homes, provided
information about formaldehyde levels in FEMA-supplied occupied travel
trailers, park models, and mobile homes that were still being used as
of January 2008. This report found that the average formaldehyde
concentration of these units was 77 parts per billion, well above what
it termed the typical U.S. background levels of 10-30 parts per
billion. The range of concentrations in tested trailers was, however,
extremely broad. The lowest tested trailer registering only three parts
per billion, well below the U.S. average, and the highest concentration
measured 590 parts per billion.
The Interim Report recommended fast action. Finding that its
conclusions ``support[ed] the need to move quickly, before weather in
the region warms up, to relocate residents of the U.S. Gulf Coast
region displaced by Hurricanes Katrina and Rita who still live in
travel trailers, park models, and mobile homes.''
This recommendation is broad, sweeping, and authoritative, but it
raises as many questions as it provides answers. Does CDC recommend
relocating everyone in FEMA-provided trailers, even those in trailers
with formaldehyde concentrations below the typical background norms in
U.S. homes? If not, what level is the appropriate level of concern?
Should Americans living in trailers and mobile homes not provided by
FEMA be concerned about formaldehyde levels? Do we need wide-scale
testing for formaldehyde concentrations?
The public will not be served by drastic action based on limited
science. Relocating individuals who are experiencing health effects is
an urgent priority, but causing a panic among individuals who are
perfectly safe will only result in unnecessary expense and neglect of
those actually in need. We need a clearer understanding of formaldehyde
and its effects on human health before we act more broadly. As Ranking
Member on the Global Warming Committee, I know too well how science,
intensified under constant media exposure, can lead to paranoia that
seems to require immediate, wide-scale action. As policy-makers we
depend on agencies to produce high quality, thoroughly reviewed science
and to provide prudent, objective advice.
Chairman Miller. I thank you, Mr. Sensenbrenner, and I
appreciate your going more over your time than I went over my
time, making me look better by comparison.
I now ask unanimous consent that all the additional opening
statements or any additional opening statements be included in
the record. Without objection, it is so ordered.
[The prepared statement of Chairman Gordon follows:]
Prepared Statement of Chairman Bart Gordon
The country depends on the Agency for Toxic Substances and Disease
Registry to warn of health dangers that come with exposure to
chemicals. In the wake of Hurricanes Katrina and Rita, hundreds of
thousands of Americans found themselves placed in mobile homes and
travel trailers as semi-permanent housing. Formaldehyde has
historically been found at higher levels in this kind of manufactured
housing than in traditional construction. It should come as no surprise
then that within months of families being placed in these trailers,
some complaints about sicknesses--nose bleeds and asthma-like symptoms
most prominently--began to filter back to FEMA.
The people in these trailers include the most vulnerable among us--
children, the elderly, the handicapped. Many of these are people who
were really stuck in the trailers twenty-four hours a day, seven days a
week. Children and babies breath faster than adults and are less able
to process formaldehyde so it builds up in their bodies faster than in
adults. These are the same populations that you might expect to be most
sensitive to formaldehyde--lower levels of exposure triggering stronger
health reactions. These are the very segments of the public that we
most expect the government to act to protect.
In the summer of 2006, ATSDR began working with the Environmental
Protection Agency and FEMA to develop a test protocol to examine
formaldehyde in trailers. The ATSDR leadership was aware of this
effort. They did not assign their top formaldehyde or toxicology people
to this task. Rather, they left it to two emergency response staff with
no special training on formaldehyde. Those staffers then analyzed the
data that came back from the EPA testing, and they produced a report
that went directly to the Director and Deputy Director for review
through the Director's Office of Terrorism Preparedness and Emergency
Response. Apparently neither the Director nor Deputy Director asked any
questions about how the report was produced or who else had seen it.
Their memories of dealing with that report are vague on what they knew,
what they saw, what they said or what they did.
However, they must have approved the report because it went to FEMA
on February 1, 2007. The report suggests that if people just open
windows and doors of their trailers, they can keep formaldehyde levels
below ``levels of concern'' regarding health effects. But as we know,
another round of testing and more careful analysis by another office at
the CDC, led to a very different conclusion from the same agency. In
February of 2008 the CDC announced that people should be moved out of
these trailers as quickly as possible. Getting it wrong in February of
2007 consigned tens of thousands of Americans to a year in unhealthful
housing. That hardly sounds like the public health was well served.
Our review of the way the original formaldehyde Health Consultation
was handled demonstrates a complete managerial collapse at ATSDR. The
wrong people were assigned to write it under the Katrina emergency
consultation process set up by the Director. Then the wrong people
reviewed the report--in this case those people consist solely of the
Director and Deputy Director of the agency. When the mess is made
apparent to the Director, he does virtually nothing to correct the
situation. Only when the mess becomes more public do the leaders of the
agency swing into action to issue a corrected consultation and shift
blame to others.
Among those blamed for the poor original consultation was Dr. Chris
De Rosa. Ironically, it was Dr. De Rosa that first brought problems
with the report to the attention of the Director of ATSDR, Dr. Frumkin.
He continued to push on the health conditions in trailers and other
matters throughout 2007. His reward for these efforts was to be blamed
for the failed health consultation and removed from his post as
director of the Division of Toxicology and Environmental Medicine--a
job he had held for 16 years.
The Science and Technology Committee consider Dr. De Rosa a
whistleblower. He sought to repeatedly raise the alarm within the
corridors of the CDC that a public health disaster was unraveling
before them. I strongly believe that raising the alarm on a critical
public health issue that has impacted thousands of individuals should
be rewarded not punished.
I trust that we will receive assurances today from Dr. Frumkin that
retaliation against Dr. De Rosa will cease, and that he will be
recognized for his efforts to fulfill the mission of ATSDR ``to serve
the public'' by ``taking responsive public health actions [in order] to
prevent harmful exposures and disease related to toxic substances.''
[The prepared statement of Mr. Lampson follows:]
Prepared Statement of Representative Nick Lampson
Science is not supposed to take politics or ``broad implications''
into account. It is supposed to provide us with reliable facts--
truths--about our environment. It is a sad day in this country when our
government and its agencies and scientists let politics determine
``scientific'' results and guidelines. And it is a shame that our
nation's scientists whom we entrust with public health and safety are
more worried about politics more than science and the health of the
people we are all sworn to protect. The victims of Hurricane Katrina
suffered one tragedy at the mercy of mother nature and another at the
mercy of their own government and of science--the one thing that should
never provide tainted results or harm. The leaders of these agencies
should swear allegiance first to the scientific process and secondly to
whomever their bosses may be. Unfortunately only Dr. De Rosa upheld
that standard in this situation, and we thank him for his unwavering
commitment to the truth and honesty. Despite mounting evidence it seems
that the agencies involved are still unwilling to accept the broader
implications of their actions. The men and women and children that were
in FEMA's care will suffer the rest of their lives, and maybe even
their children and grandchildren will bear the burden of FEMA and the
CDC's inaction and willingness to throw scientific fact out of the
window. The way we are told societies should be judged is based on how
they treat their most vulnerable. I for one am ashamed of how we have
treated our fellow Americans in their greatest time of need.
Chairman Miller. I also ask unanimous consent to enter into
the record documents that have been collected by the
Subcommittee during the course of work on this matter, and
those documents have already been provided to the Minority.
Without objection, so ordered. [The information appears in
Appendix: Additional Material for the Record.]
I now would like to introduce our witnesses, our first
panel today. Our first witness is Dr. Heidi Sinclair. Dr.
Sinclair is Assistant Professor of Pediatrics at Louisiana
State University and is the Medical Director of the Baton Rouge
Children's Health Program. Ms. Lindsay Huckabee lived with her
husband and five children in a FEMA-provided mobile home in
Kiln, Mississippi, from October, 2005, until just last month.
Mr. Sensenbrenner. Will the gentleman yield?
Chairman Miller. Yes.
Mr. Sensenbrenner. We know all about Kiln, Mississippi,
because of your favorite son. You tell him he ought to go back
to work. That is Brett Farve.
Chairman Miller. The Ranking Member agreed earlier that all
sports analogies would be college basketball, but I think the
early exit of the University of Wisconsin has changed his view.
Our last witness is Ms. Becky Gillette, the Formaldehyde
Campaign Manager for the Sierra Club Gulf Coast Environmental
Restoration Task Force.
Welcome to all of our witnesses. You will have five minutes
for your spoken testimony. Your written testimony will be
included in the record for the hearing. When you all complete
your testimony, we will begin with questions, and each Member
will have five minutes to question the panel.
It is the practice of this subcommittee to take testimony
under oath. Do any of you have any objection to being sworn in?
If not, oh, you may also be represented by counsel. Is
anyone here represented by counsel? Now, would you please stand
and raise your right hand?
[Witnesses sworn]
Chairman Miller. All the witnesses affirmed that they would
tell the truth.
Dr. Sinclair, please begin.
Panel I:
STATEMENT OF DR. HEIDI SINCLAIR, MEDICAL DIRECTOR, BATON ROUGE
CHILDREN'S HEALTH PROJECT; ASSISTANT PROFESSOR, DEPARTMENT OF
PEDIATRICS, LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Dr. Sinclair. Good morning. Thank you, Chairman Miller and
Congressman Sensenbrenner, for inviting me to testify today. My
name is Dr. Heidi Sinclair with the Louisiana State University
Health Science Center (LSUHSC). The views expressed herein do
not reflect the views and opinions of LSUHSC. I am here today
as a community pediatrician and advocate for vulnerable
children.
I, too, was displaced by Hurricane Katrina. I relocated to
Baton Rouge in June of 2006, to accept the position of Medical
Director of the Baton Rouge Children's Health Project,
established post-Katrina by the Children's Health Fund in
collaboration with LSU pediatrics in Baton Rouge. Our project's
mobile medical units have provided comprehensive medical and
mental health care to over 400 children and families displaced
to the Baton Rouge area.
As FEMA trailer group sites were being established, a
number of concerns were expressed regarding the safety and
suitability of both the travel trailers and the group sites
themselves. We were concerned then as we are now that people
living in these trailers are continually being exposed to
formaldehyde, which is most readily absorbed through the
respiratory tract by breathing.
Symptoms associated with formaldehyde exposure include
sinus irritation, respiratory problems, skin rashes, eye
irritation, nausea and stomach aches, as well as neurological
problems such as headaches, fatigue, depression, insomnia, and
difficulty concentrating.
Since we began seeing patients at the FEMA trailer
villages, presenting problems have included many symptoms
consistent with formaldehyde exposure. While ATSDR lists 0.008
parts per million or eight parts per billion as minimal risk
level for long-term formaldehyde exposure, it is important to
emphasize that much remains unclear about formaldehyde. Most
human studies have been limited to adult occupational exposure.
Children, however, are more likely to be affected by even low-
level exposure to formaldehyde in their living environment
because they generally spend more time at home, have a higher
respiratory rate, have a greater surface to mass ratio, are
closer to the ground and formaldehyde concentrations are higher
closer to the ground, and have immature metabolic systems that
may not enable them to clear absorbed formaldehyde as quickly
as adults.
There are also concerns about possible long-term
consequences of formaldehyde exposure, which include changes to
the immune system that can increase allergic responsiveness in
general, possible reproductive or developmental toxicity, an
increased risk of nasal and nasal-pharyngeal carcinomas and
possibly lung cancer, throat cancer, or blood disorders.
Following reports in 2006 of elevated formaldehyde in the
Mississippi Gulf Coast area travel trailers, I discussed
concerns regarding formaldehyde in travel trailers in our area
with colleagues at the Office of Public Health, the Children's
Health Fund, and elsewhere.
The Health Consultation, ``Formaldehyde Sampling at FEMA
Temporary Housing Units, released by ATSDR in February of 2007,
added confusion regarding what might be considered safe levels
of formaldehyde. In this report, 0.3 parts per million or 300
parts per billion was chosen as the level of concern. This
level, however, is nearly 40 times higher than what is
established by the ATSDR as minimal risk level for long-term
exposure. Misinterpretations of this study and other
misconceptions may have served to minimize understanding of the
possible exposure risks to those living in travel trailers in
our area.
In July, 2007, FEMA announced that they would work with CDC
to test occupied travel trailers. I contacted the CDC and
learned that the testing would be random, residents would not
be able to request to have their trailer tested, it was unclear
if individual results were going to be given to residents, and
the actual study start date was unknown. The Sierra Club
provided our project with a few test kits. All of the tests
were elevated with seven of the eight trailers testing between
100 and 300 parts per billion, ten to 25 times above ATSDR's
minimal risk level for long-term exposure and at least five
times above levels often present in conventional homes. A
summary of this testing sample was shared with persons with the
Office of Public Health, the Children's Health Fund, and
others.
I was contacted in the summer and fall of 2007, by CDC
representatives and participated in a phone conference with CDC
representatives regarding their upcoming study on occupied
travel trailers.
ATSDR's October, 2007, update and revision seems to be an
effort to clarify that their February FEMA consultation was not
meant to imply that formaldehyde levels in the travel trailers
were safe for long-term occupancy. This update also mentions
concerns of CDC, NCEH, ATSDR, and EPA representatives as early
as July, 2006, that the study requested by FEMA, ``could not be
generalized and applied to occupied trailers in the Gulf
Region.''
In summary, I would like to share my conclusions and
recommendations. First, I am glad that FEMA acknowledged that
travel trailers are designed for short-term recreational use
and are not intended for housing. I recommend that FEMA more
actively involve local government, non-profits, and family and
child advocates in planning safe and appropriate housing
options for displaced families.
Second, I am surprised that the CDC did wait so long to
initiate formaldehyde testing of occupied travel trailers given
the stated concerns of some of their own representatives as
early as July 2006, and given reports by ATSDR in February of
2007, that cited formaldehyde levels so greatly above their own
defined minimal risk level for long-term exposure.
Third, formaldehyde exposure is just one of many problems
being faced by families displaced by Hurricanes Katrina and
Rita. It is unacceptable that so many families must endure
uncertainty and concerns regarding their exposure to elevated
levels of formaldehyde in addition to daily anxieties and
stresses of displacement.
Fourth, as FEMA works with local agencies to find more
appropriate and safe housing solutions for families, we
recommend that coordinated efforts be made to prevent any
further disruption and endangerment.
Finally, I recommend that the CDC consider expanding their
proposed child health study to a wider sample of children
displaced, affected by Hurricane Katrina. I look forward to
contributing to such a study in any way I might be able.
Thank you.
[The prepared statement of Dr. Sinclair follows:]
Prepared Statement of Heidi Sinclair
Good morning. Thank you for this opportunity to testify today
before the Committee on Science and Technology. My name is Dr. Heidi
Sinclair, Assistant Professor of Pediatrics with the Louisiana State
University Health Sciences Center (LSUHSC) and Medical Director of the
Baton Rouge Children's Health Project. I am here today at the request
of the Committee on Science and Technology as a health care provider,
community pediatrician, and advocate for vulnerable children. The views
expressed herein do not reflect the views and opinions of LSUHSC.
Background
I was living in New Orleans at the time of Hurricane Katrina and
relocated to Baton Rouge in June of 2006 to accept the position of
Medical Director of the Baton Rouge Children's Health Project, a unique
and innovative partnership of LSU Pediatrics in Baton Rouge and The
Children's Health Fund. The Children's Health Fund is committed to
providing health care to the Nation's most medically under-served
children and their families through the development and support of
primary care medical programs such as the Baton Rouge Children's Health
Project.
Our project, established the fall of 2006, has two professionally
staffed mobile medical units, ``doctors' offices on wheels,'' providing
comprehensive primary pediatric medical and mental health care through
4,968 encounters to over 400 children and families displaced to the
Baton Rouge area. Services are provided weekly or bimonthly at a number
of FEMA group sites. Prominent among these is Renaissance Village, the
largest FEMA trailer village in Louisiana with nearly 600 travel
trailers and estimates of 1,500 to 2,100 residents at peak.
Formaldehyde Exposure and FEMA Trailer Sites
As FEMA trailer group sites were established and families were
moved into these travel trailers, a number of concerns were expressed
regarding the safety and suitability of both the travel trailers and
the group sites themselves. Regarding formaldehyde, a colleague
initially raised concerns to the Children's Health Fund and to
Louisiana congressional staff during a legislative visit in May of
2006.
We were concerned then as we are now that people living in these
trailers are continually being exposed to formaldehyde, which is most
readily absorbed through the respiratory tract (by breathing), with
most exposures occurring through inhalation, and skin or eye contact.
Indoors, a major source of formaldehyde is off-gassing from particle
board and urea-foam insulation.
Symptoms
The most common associated symptoms of formaldehyde exposure
include neurological problems, such as headaches, depression, and
insomnia as well as skin rashes, eye irritation, sinus problems,
recurrent colds and nose-bleeds. Long-term consequences can include
changes to the immune system and development of certain cancers.
Since we began seeing patients at the FEMA trailer villages, the
most common presenting problems have, in fact, included: skin rashes,
sinus problems and recurrent colds, headaches, fatigue, depression,
insomnia and attention deficits. Some patients also have recurrent
nose-bleeds, stomach aches, nausea, eye irritation and respiratory
problems. All of these symptoms are consistent with formaldehyde
exposure. These symptoms admittedly are non-specific and not uncommonly
encountered in a general pediatric population. However, formaldehyde
cannot be ruled out as a contributing factor, even when considering the
FEMA trailer park population's association with stress, poor nutrition,
and exposure to other allergens such as mold or irritants.
Exposure Levels
While the Agency for Toxic Substances and Disease Registry (ATSDR)
lists 0.008 ppm (8 ppb) as minimal risk level for long-term (>365 day)
formaldehyde exposure, it is important to emphasize that much remains
unclear about formaldehyde. Some persons, for example, will experience
symptoms at levels as low as 0.05 ppm while others will have no
symptoms even at much higher levels. Most studies of human exposure to
formaldehyde have reviewed adult, acute high level or 8-10 hour
occupational exposure--there have been fewer studies on health effects
of elevated indoor air levels of formaldehyde in homes, and almost no
studies of its effects on children.
Formaldehyde and Children
Nonetheless, children, particularly the youngest, are more likely
to be affected by even low-level exposure to formaldehyde because they:
<bullet> Spend more time at home;
<bullet> Have a higher respiratory rate;
<bullet> Have a greater surface to mass ratio (thus would be
expected to absorb more formaldehyde);
<bullet> Are closer to the ground (formaldehyde gas is heavier
than air and thus at higher concentrations closer to the
ground); and
<bullet> Have an immature metabolic system that may not enable
them to metabolize and clear absorbed formaldehyde as quickly
as in adults.
Therefore, when approaching these issues, it is probably best to
say that there is NO acceptable level of formaldehyde exposure that is
safe for children.
Long-Term Exposure
Beyond the immediate symptoms, there are concerns about possible
long-term consequences of formaldehyde exposure.
<bullet> Formaldehyde sensitization has been associated with
changes to the immune system (increased IgE, altered T-cell
cytokine secretion) that can increase allergic responsiveness
in general;
<bullet> Formaldehyde is genotoxic--causing rearrangement of
chromosomes and breakage of sister chromatids;
<bullet> Formaldehyde is listed as a carcinogen or probable
carcinogen by a number of national and international
organizations; and
<bullet> Formaldehyde has most closely been correlated with
increased risk of nasal and nasal-pharyngeal carcinomas but may
also be associated with lung cancer or blood disorders.
Homeland Security cites a study of mobile home residents exposed to
formaldehyde above 0.10 ppm (100 ppb) for 10 years indicating a
statistically significant increase in the risk of throat cancer.
Timeline of Concern and Agency Contact
In the summer and fall of 2006, I followed reports coming from the
Mississippi Gulf Coast of families living in FEMA travel trailers who
were experiencing more alarming adverse events such as daily profuse
nose-bleeds, severe respiratory problems, and pet illnesses. In May
2006, the Sierra Club released a report of elevated levels of
formaldehyde in 30 of 32 travel trailers they tested in the Gulf Coast.
I felt it would be worthwhile to check the formaldehyde levels in some
of the travel trailers in our area.
I discussed my concerns informally with colleagues at the Office of
Public Health and elsewhere. The general consensus was that
formaldehyde off-gassing should only be a problem in new travel
trailers. As our families had been occupying these travel trailers for
over a year, it was assumed formaldehyde off-gassing should no longer
be a problem. Secondly, the travel trailers at Renaissance Village were
manufactured before Katrina. It was felt that they should not have the
same problems with elevated levels of formaldehyde as those in the
Mississippi Gulf Coast which were put together quickly after Katrina.
The Health Consultation of Formaldehyde Sampling at FEMA Temporary
Housing Units released by the ATSDR in February of 2007 only added to
the confusion regarding what might be considered ``safe'' levels of
formaldehyde in occupied travel trailers. In this report, 0.3 ppm (300
ppb) was chosen as the ``level of concern.'' This level (0.3 ppm) was
reportedly selected as it is an effect level associated with acute
narrowing of the bronchi in sensitive individuals. However, this level
is nearly forty times higher than what is established by ATSDR as
``minimal risk level'' (0.008 ppm or 8 ppb) for long-term (> 365 days)
exposure.
At this time, community members felt that this was an issue for
FEMA to investigate and accept accountability for. Every few months,
when the formaldehyde issue reappeared in the media, rumors would
circulate that FEMA would be testing the travel trailers. On these
occasions, I contacted Mr. Manuel Broussard, FEMA Public Relations in
Baton Rouge, who would clarify that FEMA was not planning to test
occupied travel trailers. Mr. Broussard also put me in touch with Ms.
Gail Tate, FEMA Interagency Coordinator, who affirmed that FEMA's plan
was to continue working towards relocating trailer residents rather
than to offer testing.
After last year's Congressional hearings and FEMA's announcement in
July of 2007 that it would work with the CDC to test occupied travel
trailers, many trailer residents believed that this testing was
imminent and they would be able to request to have their trailer
tested. In fact, FEMA released a press statement in July 2007 that
testing would begin on Tuesday, July 24, 2007. In order to better
inform concerned patients, I contacted the CDC for clarification and
learned that the CDC needed time to design a study and that the testing
of the travel trailers would be random: residents would not be able to
request to have their trailer tested; it was unclear if individual
results were going to be given to those residents whose trailers were
tested; and the study start date was unknown.
There was a fear, warranted or not, among both residents and
service providers, of possible reprisals from FEMA if people complained
about formaldehyde or initiated testing of travel trailers
independently. On my request, the Sierra Club provided our project with
a few test kits and assisted me with installing and collecting these
testers, following up with the families to review test results, and in
advising families on measures they might take to reduce their exposure
to formaldehyde. This sample of trailers tested approximately ten to
twenty-five times above ATSDR's ``minimal risk level'' for long-term
exposure and at least five times above levels often present in
conventional homes.\1\ Only one of the eight measured less than 0.1
ppm--the other seven tested between 0.1-0.3 ppm (100-300 ppb).
---------------------------------------------------------------------------
\1\ It is not unusual for conventional homes to have indoor
formaldehyde concentration levels of 0.01 to 0.02 ppm (10-20 ppb).
---------------------------------------------------------------------------
While maintaining confidentiality on the request of the families
involved, the summary of this testing sample was shared with persons
with the Office of Public Health, the Children's Health Fund and
others. The Children's Health Fund has provided us with additional
testers and we have recently been offering this testing to concerned
families who have not yet had their trailers tested by the CDC or
others.
I was contacted first in late summer/early fall of 2007 by
representatives from the CDC. One gentleman called me to give me the
contact information for Allison Stock, Ph.D., MPH, Team Leader, Air
Pollution Team, CDC/NCEH. I also spoke on a number of occasions with La
Freta Dalton, Senior Health Communication Specialist, CDC/ATSDR, and
participated in a phone conference with CDC representatives regarding
their upcoming study. In the fall of 2007, Allison Stock and I
exchanged a number of e-mails and attempted to arrange a phone
conference regarding CDC's contract with FEMA to test occupied travel
trailers but I do not believe we ever actually spoke in person.
ATSDR's October 2007 Update and Revision of the February report on
Formaldehyde Sampling of FEMA Temporary-Housing Trailers clarified that
``the exposure scenarios examined by the sampling were not intended to
represent those that people living in trailers would experience,'' and
concludes that ``long-term exposures, even at lower level increase the
possibility of cancer or reproductive or developmental toxicity'' and
removed language defining any set ``level of concern.'' This update
also mentions concerns of CDC/NCEH, ATSDR and EPA representatives as
early as July 2006 that the study requested by FEMA ``could not be
generalized and applied to occupied trailers in the Gulf region.''
Conclusions
The Committee asked me to address, ``what do (I) believe the
Federal Government, particularly the ATSDR, could have or should have
done regarding the formaldehyde issue.''
First, I am glad that FEMA acknowledged that recreational vehicles,
such as the travel trailers used so extensively post-Katrina, are not
regulated by HUD and are designed for short-term recreational use and
are not intended for housing. FEMA has accordingly announced that it
will no longer offer recreational vehicles as a temporary housing
option after future disasters. I recommend that in the aftermath of
future disasters, FEMA will more actively involve local government,
non-profits, and family and child advocates in planning safe and
appropriate housing options for displaced families.
Second, I am surprised that the CDC waited so long to initiate
formaldehyde testing of occupied travel trailers given the stated
concerns of some of their own representatives as early as July 2006 and
given the reports by ATSDR in February of 2007 that cited formaldehyde
levels greatly above their own defined ``minimal risk level'' for long-
term exposure. At the recent public forum in Baker, Louisiana, on CDC's
recently released study, I was shocked by the statement of the
representative present that the CDC was not aware there was a potential
problem with elevated levels of formaldehyde in the travel trailers
until July of 2007.
Third, formaldehyde exposure is just one of the many problems being
faced by families displaced by Hurricanes Katrina and Rita. People are
still struggling with fractured support systems, loss of property,
sense of self, income, community and loved ones, stigma, unstable
living situations, transportation problems, and difficulty accessing
quality health care and child care. It is unacceptable that many
families must endure uncertainty and concerns regarding possible short
and long-term effects of on-going exposure to elevated levels of
formaldehyde in addition to the daily anxieties and stresses of
displacement.
Fourth, as FEMA works with local agencies to find more appropriate
and safe housing solutions for families, we recommend that coordinated
efforts be made to prevent any further disruption and endangerment of
families. While priority is being placed on removing families from
their potentially toxic living environment, consideration must also be
given to families' very real educational, employment, child care,
health care and transportation needs. Children and families must not be
forced to move from one difficult environment to another.
Finally, I recommend that the CDC consider expanding their proposed
child health study to a wider sample of children displaced/affected by
Hurricane Katrina and look forward to contributing to such a study in
anyway I might be able. Thank you.
References
Agency for Toxic Substances and Disease Registry, Formaldehyde (HCHO)
CAS 50-00-0; UN 1198, UN 2209 (formalin).
Agency for Toxic Substances and Disease Registry, Health Consultation,
Formaldehyde Sampling at FEMA Temporary Housing Units, Baton
Rouge, LA, February 1, 2007.
FEMA: Statement of Administrator R. David Paulison, HQ-No: 07-143, July
20, 2007.
FEMA: Interim Direction on use of Temporary Housing Units, July 31,
2007.
FEMA: CDC Releases Results of Formaldehyde Level Tests, Release Number:
HQ-08-021, February 14, 2008.
Flynn, Elizabeth, MD; Matz, Paul, MD; Woolf, Alan, MD; Wright, Robert,
MD, MPH; Indoor Air Pollutants Affecting Child Health, American
College of Medical Toxicology, November 2000.
Homeland Security: Background Health Information on Formaldehyde, July
23, 2007.
Mendell, M.J., Indoor residential chemical emissions as risk factors
for respiratory and allergic effects in children: a review,
Indoor Air 2007:17:259-277.
Sierra Club: Testing By Sierra Club Shows Abnormal Levels of
Formaldehyde in FEMA Trailers, May 16, 2006.
U.S. Department of Health and Human Services, Public Health Service,
Agency for Toxic Substances and Disease Registry, An Update and
Revision of ATSDR's February 2007 Health Consultation:
Formaldehyde Sampling of FEMA Temporary-Housing Trailers, Baton
Rouge, LA, September-October, 2006, October 2007.
Biography for Heidi Sinclair
Post Graduate Medical Training
Louisiana State University--July 2000-July 2004
New Orleans, LA
Residency, Internal Medicine/Pediatrics
Medical Education
Tulane University School of Medicine--Aug. 1996-May 2000
New Orleans, LA
MD
Post Graduate Education
Tulane University School of Public Health--June 1997-May 2000
and Tropical Medicine
New Orleans, LA
MPH, Tropical Medicine
Undergraduate Education
University of Pittsburgh--May 1993-May 1995
Pittsburgh, PA
Post-Baccalaureate
University of California, Berkeley--Aug. 1987-May 1990
Berkeley, CA
BA, South Asian Studies
Medical Licensure
Louisiana State Board of Medical Examiners
Medicine and Surgery L#025106
DEA #BS8964505
Board Certification Pediatrics--Oct. 2004
Board Certification Internal Medicine--Dec. 2006
Work Experience
Louisiana State University--June 2006-present
Health Sciences Center
Baton Rouge, LA
Department of Pediatrics
Assistant Professor
As Medical Director of the Baton Rouge Children's Health Project,
responsible for direct clinical care of children and families served by
the medical mobile unit as well as supervision of staff and
coordinating mobile medical and mental health services as part of
LSUHSC Department of Pediatrics and the Children's Health Fund's
national network of mobile pediatric care providers.
Louisiana State University--Aug. 2004-June 2006
Health Sciences Center
New Orleans, LA
Department of Pediatrics, Ambulatory Division
Assistant Professor
As Medical Director of Bridge City Center Youth, responsible for
clinical care of youth in custody of Bridge City Center for Youth,
supervision of 24 hour on-site clinical nursing services, supervision
of on-site pharmaceutical and dental service and coordinating youth
care with Office of Youth Development. Other clinical responsibilities
have included providing clinical services and Pediatric resident and
student supervision at UNO Student Health Clinic, New Orleans
Adolescent Hospital and Level 1 Well-Baby Nursery at University
Hospital, LSUHSC-New Orleans. Other administrative responsibilities
have included assisting in developing lectures and rotations in
conjunction with the Adolescent Medicine division.
Louisiana State University School of Public Health--Oct. 2004-June 2006
New Orleans, LA
Adjunct Assistant Professor
Juvenile Justice Program
Medical Director, Bridge City Center for Youth
Participation in on-going program evaluation and monitoring,
education and program development in conjunction with LSU Juvenile
Justice Program.
Americorps/VISTA--Aug. 1995-Aug. 1996
Beaumont, Texas
Project Supervisor, Henry's Place
Implemented community project to set-up drop-in day center for
mentally-ill homeless, recruited, trained and managed volunteers,
counseled and provided referrals to center guests, supervised daily
activities of Henry's Place.
University of Pittsburgh--1993-1994
Athletic Support Services
Pittsburgh, PA
Math and Science Tutor
Caring Teachers, English Arts--1992-1993
Makuhari, Japan
Developed curriculum, taught conversational English to children and
adults using creative and interactive methods.
Transworld Teachers--1991
San Francisco, CA
Trainee, Student Teacher
Volunteer Experience
Common Ground Clinic--Oct. 2005-May 2006
Clinical Care Provider
After hours clinical service and supervision of volunteer medical
service providers: nurses, medical students and nurse practitioners.
Covenant House Student Clinic--Aug. 2004-June 2005
Staff MD
Oversight of LSU medical student volunteer adolescent medicine
clinic in rotation with fellow LSUHSC Pediatric faculty.
Community Medicine Interest Group--1997-2000
Co-Founder, Treasurer
New Orleans, LA
Sponsored talks by representatives from Department of Health and
Human Services, Medicaid/Medicare, Health Care for the Homeless, St.
Thomas Clinic, Adolescent Drop-in Center and on loan repayment,
alternative medicine, midwifery, HIV, prison health care, and
international medicine.
Sierra Club, Inner City Outings--1996-1999
Trip Leader, Volunteer Recruitment
New Orleans, LA
Organized and led outdoor trips for urban youth in association with
Gert-Town Resource Center and the Pediatric AIDS Program. Fundraising.
New Orleans Center for Science and Math--1996-1997
Math and Science Tutor
New Orleans, LA
Participated in Saturday morning tutoring program for high school
students from New Orleans Center for Science and Math.
Western Psychiatric Institute and Clinic--1993-1994
Remedial Math Tutor
Pittsburgh, PA
Taught basic money management and math skills to clinic
outpatients.
Calcutta Rescue--1993/1988
Clinic Volunteer
Calcutta, India
General medical assistance.
Research Experience
Tulane Infectious Diseases Section--1997-1999
Student Researcher
New Orleans, LA
In association with Health Care for the Homeless: to document the
prevalence of tuberculosis infection and active disease, the
effectiveness of a centralized directly observed preventative treatment
(DOPT) program and factors related to adherence to DOPT.
University of Pittsburgh, Department of Biology--1994-1995
Student Researcher
Pittsburgh, PA
Research to identify genes involved in growth of Mycobacterium in
order to provide new targets for anti-mycobacterial drug design.
Publications
Building Integrated Mental Health and Medical Programs for Vulnerable
Populations Post-Disasters: Connecting Children and Families to
a Medical Home, Pre Hospital Disaster Management, Jan. 2008.
Directly observed preventative therapy at a TB clinic for the homeless
(abstract). H. Sinclair; R.W. Little, MD; N.E. Hyslop, MD; R.
Mera, Ph.D. Journal of Investigative Medicine 47, 111A, 1999.
Honors/Awards
Adopt-A Student Scholarship--1996-2000
MD/MPH Combined Degree Fellowship--1996-2000
Dean's Award for Excellence in Research and Presentation by a Medical
Student--1998
Novartis Community Service Award--1997
Recent Training
Center for Mind-Body Medicine--Jan. 2007
Language Fluency
French, Spanish, Hindi, Japanese, American Sign Language
Introductory level proficiency
Chairman Miller. Thank you. Neither the Chair nor the
Ranking Member set a good example in staying within the five
minutes, and we will be somewhat indulgent, but we want to bear
in mind that there is at least a five-minute suggestion of the
limit of the oral testimony.
Mrs. Huckabee.
STATEMENT OF MRS. LINDSAY HUCKABEE, RESIDENT OF FEMA-PROVIDED
MOBILE HOME IN KILN, MISSISSIPPI, FROM OCTOBER, 2005 TO MARCH,
2008
Mrs. Huckabee. I would first like to thank the Committee
for bringing this up and Congress and holding somebody
accountable for what has been going on.
My name is Lindsay Huckabee. I am not an expert on
formaldehyde. I am not a scientist. I am a woman, a wife, and a
mother, who spent countless hours dealing firsthand with the
effects of formaldehyde.
On August 29 of 2005, our apartment was destroyed along
with all its belongings. We contacted FEMA and were told that
we qualified for their housing, temporary housing program. We
received a trailer in December of 2005. It was a single-wide
mobile home, not a travel trailer like many people believe.
Whenever we first entered it, we noticed that there was a
real strong, offensive smell. We had sinus issues going on. My
six-year-old immediately started having nosebleeds, along with
my four-year-old. In the 29 months since we received our first
FEMA trailer, our family has suffered many health issues. Four
of my five children have been treated for asthma. Four of them
are currently on prescriptions for breathing treatments, none
of which were asthmatic before we moved into the trailer. My
husband and I have allergy symptoms, sinus symptoms, and we
have been tested for allergies and nothing shows up on a test.
My husband had a tumor in his soft pallet that was removed.
It was considered non-cancerous but still malignant because of
its rate of growth. Our ear, nose, throat doctor feels that
formaldehyde could have been a contributing factor to this.
While it cannot be proven, he said that he will make a note of
it for further study.
My daughter, Lelah, was four when we moved into the
trailer. She is now six. She developed moderate asthma. She has
had sinus infections severe enough to require two surgeries.
Whenever I ask the ENT if these surgeries were really necessary
because they were very invasive, he asked me if I could be out
of that trailer in 30 days or less. I told him that, no, I had
nowhere to go. He said, then she must be put through this
because he fears that her nasal passages would not be wide
enough to exchange air.
We had formaldehyde tests done on our trailer in April of
2007. Our first trailer was a Fleetwood home built in November
of 2005. The test came back at 0.18 parts per million, which is
above the 0.1 believed to be harmful to humans. There is no way
to know how high it was in the 16 months we lived there before
having it tested. Since FEMA and the CDC suggests that opening
windows will out-gas the fumes and lower the level, I have to
believe it was much higher, since we did this repeatedly.
We reported our findings to FEMA. We were told that we
would be provided with a replacement unit that would be
formaldehyde free. The second trailer was a 2005 model built by
Destiny Homes. We had a formaldehyde test done on it before we
moved into it, found that its levels were 0.018 parts per
million. It was lower than the ones that we had received but in
researching I found that 0.008 is what is considered safe for
long-term use. This was still above that. Whenever I informed
FEMA of our new findings, they said it is lower than the one
you had before so we are good, right?
I testified in a hearing in Washington, D.C. in July of
2007, regarding the FEMA and the formaldehyde issue. Whenever I
got back, we received a pamphlet saying that they were working
with the CDC to find safe levels. When I called FEMA to the
help number they gave us, she told me I needed to call the CDC
to find out what was a safe level of formaldehyde. We called
the CDC number that was provided by FEMA. First we were told to
call FEMA back, the CDC wasn't handling that. After insisting
that I had already called FEMA and were told to call the CDC
number, I was transferred to six different people, none of
which were willing to give me a name or an employee ID number.
Each one told us they knew nothing about formaldehyde, that
they didn't know anything about any levels, and one of them
even told us she didn't know anything about working with FEMA
on this. So whenever we got off the phone we were just as
confused as we were in the beginning.
I was able to meet with some of the CDC directors or some
of the CDC employees at a town meeting held. I was told by one
of them they knew nothing about the formaldehyde until after
the July, 2007, hearing. I find this really hard to believe
considering my own pediatrician had spoken with the CDC about
doing a child health study.
We went back and forth with the CDC trying to get a safe
number to find out, you know, we were running air purifiers,
trying to find out if our trailer was, indeed, safe. We saw a
decrease of symptoms once we had the air purifiers running. We
were told that there is no safe level of formaldehyde for
living in 24 hours a day.
I feel like since the CDC and FEMA and the ATSDR all knew a
year in advance from today about the formaldehyde in the
trailers, I feel like essentially we were lab rats. We were put
in this situation, we were exposed to this, and seeing as this
large group of scientists knew about it, it seems like they
should have at least been doing studies to find out what the
effects were. This is not a new chemical. It has been around,
used in everything for decades, if not longer. I think that it
is a shame that this high-tech agency has no more information
on this than they do have.
[The prepared statement of Mrs. Huckabee follows:]
Prepared Statement of Lindsay Huckabee
I would like to start by thanking the Members of this Congressional
Committee for taking the time to address this issue and for allowing me
the honor of coming before you to speak. My name is Lindsay Huckabee
and I currently am currently living in Diamondhead, Mississippi in a
hotel with my husband and our five children.
On August 29, 2005, our apartment and all of its contents were
destroyed by Hurricane Katrina. We contacted the Federal Emergency
Management Agency (FEMA) and were granted immediate assistance. In
early October, we received a travel trailer to use as a temporary
shelter. We were unable to stay in the travel trailer because of the
many maintenance problems it had. After six weeks of no response from
the maintenance department, we contacted FEMA about a replacement unit.
We were told that we qualified for a single-wide mobile home because of
our family size so we cleared a site and provided septic, water and
power to the site at our expense. We met all of the requirements and
the trailer was delivered December 14, 2005. We could smell something
in the trailer as soon as we entered and it made our noses, eyes and
throats burn, but we thought it was normal for a new trailer to smell
this way. We had no idea that we were moving into a home that would be
making our family sick. We aired out the trailer and, eventually we
became accustomed to the smell and did not notice it unless we were
gone for a day or more.
In the twenty-nine months since we received our first FEMA trailer,
our family has suffered many health issues. Four of my five children
have been treated for asthma and all four of them have current
prescriptions for breathing treatments. All five children, my husband
and I have allergy and sinus symptoms with no positive allergen that
shows up on a test. We all keep the ``allergic black eyes;'' that is
what doctors call the purple circles under our eyes that give us a
constant tired and sick look.
My husband has been on a daily sinus and allergy medication, had a
tumor removed from the soft pallet of his mouth, and been on
antibiotics about every other month. Our Ear, Nose and Throat doctor
(ENT) said that while he could not be sure that the formaldehyde caused
the tumor, it was in a location he had never personally seen before and
he would not rule it out as it is known to cause cancer of the nasal
passages and lungs.
My daughter Vicki is 13 years old and has had a sore throat off and
on since moving into the first FEMA trailer. Vicki keeps mild
congestion in her sinuses and has been on antibiotics several times,
but has never been hospitalized.
My daughter Caitlin will be nine this month, she has had sinus
infections, pneumonia, asthmatic bronchitis, sore throat, nosebleeds,
headaches and asthmatic symptoms. Caitlin is currently on a daily
allergy medication and inhaled asthma medication as needed. Prior to
living in the trailers Caitlin had never been treated for any breathing
problems. Caitlin has had many x-rays and been on antibiotics again and
again, but she has only been hospitalized once.
Lelah is six years old and since moving in to our first FEMA
trailer she has developed moderate asthma and has also had sinus
infections severe enough to need an operation to widen her sinus
passages. Lelah's doctor said that with the sinus tissue staying
inflamed from the constant irritation, there was nowhere for the sinus
fluid to drain. Lelah has had pneumonia, ear infections, throat
infections, asthmatic bronchitis, nosebleeds, headaches, two MRIs and
has been put under for surgery four times. Lelah is currently on three
daily medications with two more as needed. In the past Lelah has been
on as many as eight daily medications at one time and she has been
hospitalized three times.
Steven is four years old and has been pretty fortunate health-wise.
Steven is on a daily allergy medication and he has had asthmatic
bronchitis, pneumonia, sinus infections and nosebleeds. Steven has also
been treated with breathing treatments for asthma. Prior to living in
the FEMA trailers Steven had never had breathing problems of any kind.
Steven has only been hospitalized once.
Michael is two years old and he was born prematurely after we moved
into our FEMA trailer. Michael has had sinus infections off and on
since he was six days old; he has also had asthmatic bronchitis,
pneumonia, laryngitis, only a few nosebleeds and undergone cardiac
testing because he occasionally turns blue for an unknown reason.
Michael is currently on two daily allergy medications, a nasal steroid,
and antibiotics for the sixth strait week. Michael has been
hospitalized three times.
I have had migraine headaches, sinus infections, throat infections,
bronchitis, and sleep deprived. My doctor has given me sleeping
medication; muscle relaxers and we have spoken about anti depressants
to handle the stress of taking care of sick children while I myself am
sick too. I decided against the anti depressants because while I am
stressed, I don't feel like I am depressed and I don't need anything
that would alter my thinking.
Were all these caused by formaldehyde? I believe that they were
either caused by it or made worse by it. Everywhere I look for an
answer I come up empty. No one seems to know enough about it to say for
sure. We know that it CAN cause all these and many more health effects.
I don't think that it is just by chance all my children were healthy in
the years before the hurricane and once getting into trailers changed.
We have no way of knowing what Michael's health would have been like
were he not born into a FEMA trailer.
I was told by our E.N.T. that we needed to get out of the trailer
as soon as we could. He had many repeat patients with the same symptoms
all living in FEMA trailers. He said that there were chemicals that
could be making my children sick. Both Lelah and Michael have been to
an Allergy and Asthma specialist. He has done allergy test and found
nothing. He said that there must be exposure to some sort of irritant
rather than an actual allergy to something. Then he asked if we were in
a FEMA trailer. He too had seen an increase of patients with inactive
or mild asthma having more severe problems upon moving into these
trailers. .
After months and months of office visits and phone calls, I was
frustrated and upset. Before moving into the FEMA trailer, I can't
remember going to the doctor other than for well-child checks and a few
times with Lelah when she was very young. To date I am still at the
doctor's office or calling just about every week. Our pediatrician, Dr.
Needle, told me that there seemed to be a trend among patients in FEMA
trailers and increased office visits with allergy-like symptoms. He had
been doing some research and thought that formaldehyde may be our
problem. It was through him that a Sierra Club member contacted me
about a formaldehyde test to see if we were living in levels that
could be dangerous. I really did not want this to be the answer,
since we had nowhere else to go.
We had a formaldehyde test done on our trailer in April of 2007.
Our first trailer was a Fleetwood home built in November of 2005. The
test came back as 0.18 ppm, which is well above the 0.10 ppm believed
to be harmful to humans according to one agency. There is no way to
know how high it was in the 16 months we lived in the trailer prior to
having it tested. Since FEMA suggested that ``opening windows would
out-gas the fumes and lower the level,'' I have to believe that the
level was much higher when we moved in. When we told FEMA about the
test, we met much opposition. FEMA representatives were rude when I
called them. I was forced to call more than five different
representatives, and my request for a new mobile home was lost twice
before anything was done to help solve my problem. Finally, FEMA agreed
to replace our mobile home. We were told that the new trailer would be
``formaldehyde free.'' It was supposed to be a used FEMA trailer built
in 2005 by Destiny. We had a formaldehyde test done on the new FEMA
trailer before we started to move anything into it. An inspector from
FEMA saw the tester hanging and asked what it was. When I told him it
was used to test for formaldehyde, he said that people were claiming to
have high formaldehyde levels so they could get bigger and better
trailers. When I asked if FEMA had done test to find this out, he said
NO. The test on the new trailer came back at 0.108 ppm, which is still
above the level believed to be harmful, but lower than the last
trailer. When we called FEMA to tell them what the results were, the
lady said, ``it is lower than the other trailer, so we are good,
right?''
After returning from Washington DC in July of 2007, we received
information from FEMA on formaldehyde. The information sheet gave a
number for FEMA to call for more details on what levels were acceptable
and what the long-term health effects would be. The number proved to be
useless. After talking to the woman at FEMA about our symptoms and our
concerns we were told that it did not sound like we had a problem with
formaldehyde. We had already had a test done on our trailer so we knew
what our problem was. We were told that we did not qualify for the
formaldehyde-testing program. We then asked what level was considered
safe for us to live in and her response was ``I don't know you have to
call the CDC for that information.'' We called the CDC number we were
given and it proved to be as useless as the FEMA number. First we were
told to call FEMA. After insisting that we had already called them and
been told to call the CDC number, we were transferred to six different
desks of people in different departments and levels of management where
the final answer we received was that we needed to talk to FEMA about
our concerns. The CDC representatives said that they did not have
information on levels of formaldehyde and what was safe and what was
not. We were told that the employees could not give us their names or
even an employee number therefore there was no way for us to follow up
on the conversations or have anyone to hold accountable for the lack of
information.
I was able to meet with several CDC officers at a meeting held in
Bay St. Louis, Mississippi on March 6th 2008. I found them very willing
to answer our questions about the formaldehyde and possible effects on
people. I was surprised to learn how little is known about formaldehyde
and long-term effects. While searching for the magic ``safe'' level of
formaldehyde, we found several different numbers through the Internet.
The level of 0.1 ppm, the most commonly accepted safe limit, was not
intended to gage how safe exposure was for children, people with
breathing problems, or even healthy adults for longer than the average
workday. According to the CDC representative I spoke with at the
community meeting that was held to answer questions about formaldehyde,
there is ``No safe level for exposure in a residence.'' I was told at
the meeting that CDC was not aware of the issue until after the July
17th hearing last year. I personally find this hard to believe. It is
my understanding that the ATSDR did the original testing for FEMA and
OSHA when they wanted to know what the levels were for employees and
how to bring them down. They reported the levels to FEMA and agreed to
not share the information. They even sent a revised letter making sure
the FEMA knew that there was no known SAFE level for people to live in
since formaldehyde is a know carcinogen. ATSDR is a part of CDC.
According to everything I can find on the CDC and ATSDR, both claim to
exist to protect us from toxic substances--like formaldehyde. What I
can't understand is, how an agency set in place to protect the people,
failed to let the people know about this problem. I did not think it
was there to help the government find out how much it messed up and
then help them keep quiet about it. I know that at least one
pediatrician contacted the CDC to find out about starting a study and
researching what was going on down here with the kids in the FEMA
travel trailers and mobile homes.
There is now evidence that FEMA knew about the formaldehyde as
early as December of 2005, which is the same time that I get my first
mobile home. They covered up the problem, hid behind lawyers and made
sure they could not be held responsible. FEMA made people feel like
they were being picky, and ungrateful for mentioning the illnesses and
requesting assistance. While FEMA was covering their behinds, my
children were staying sick. I blamed myself for not doing enough to
keep them well, but when FEMA took on the role of landlord for the
thousands of people, they took on the responsibility to provide a safe
and healthy living environment for these people.
While no one should have been exposed to a toxin for over two
years, I think that the CDC should take advantage of this disaster and
learn everything they can about formaldehyde. It is bad enough that was
question every symptom and the length of every illness wondering if we
would have gotten sick in the first place, or why all the other kids
that caught this cold at the same time have been done with it for
weeks, but the fact that NO ONE can tell us how long the effects of
formaldehyde will stay with us, is horrifying. This is not a new
chemical. There should be more information on it. When the CDC and
ATSDR first knew that people were living in these levels and there was
even a possibility that they were getting sick, they should have
stepped in and found out what was going on. Two years later, after so
many people have moved on, some even died in these trailers, it may be
too late to know the full extent of what effect formaldehyde has on
people. There were people of every age, race, and economic status in
these trailers. I fell like after it was fist known that the
formaldehyde was a problem, we were lab rats subjected to the toxin,
but no one wanted to record the results.
Chairman Miller. Thank you, Mrs. Huckabee.
Ms. Gillette.
STATEMENT OF MS. BECKY GILLETTE, FORMALDEHYDE CAMPAIGN
DIRECTOR, SIERRA CLUB GULF COAST ENVIRONMENTAL RESTORATION TASK
FORCE
Ms. Gillette. My name is Becky Gillette, and I am
Formaldehyde Campaign Director for Sierra Club.
After Katrina it became common knowledge that the FEMA
trailers had serious air quality problems; people complained
about burning eyes, respiratory problems, rashes, headaches,
even bloody noses. Sierra Club began formaldehyde testing in
April of 2004, and continued through 2007. What we found was
that 61 out of our 69 tests, 88 percent, were over the 0.1 ppm
limit that EPA had set. And when you use the much lower levels
recommended by the ATSDR recommendations, not a single trailer
was safe.
We tested 17 different brands of trailers and all had at
least one high test, and there were three deaths of people in
the trailers that we tested that we believe could have been
caused by the formaldehyde.
Finally, in October of 2006, over a year after Katrina,
many people had been in the trailers for over a year, EPA
tested the trailers, but there was delay after delay in
releasing the results of those. FEMA has asked ATSDR to
reevaluate those test results. I also contacted ATSDR several
times, and no one ever got back to me.
When it was finally released, the ATSDR health consultation
was a huge disappointment. The report said that formaldehyde
averaged 1.2 parts per million at the beginning of the test and
dropped to 0.3 ppm after four days of constant ventilation.
This was shocking because 1.2 parts per million is extremely
high, and I found it incredible that ATSDR could say 0.3 parts
per million was below the level of health concern. At that
level most people that walk into a trailer will experience
immediate distress, and ATSDR's own standards were many
magnitudes lower. ATSDR gave completely erroneous advice,
covering up this problem with the health of tens of thousands
of families at stake.
Finally, in October of 2007, over two years after Katrina,
a year after the EPA testing, ATSDR revised its health
consultation to more accurately report the problem, but that
was two years that women were living in these trailers, getting
pregnant, having miscarriages, having still births, and losing
babies to SIDS. Adults and children were getting cancer. People
with asthma were literally finding it difficult to breathe, and
mothers were getting up in the middle of the night to give
breathing treatments to their children.
I recall calling Earl Shorty to give him the results of
their FEMA trailer testing. His wife, Desiree Collins, was
coughing so bad in the background that it was painful to hear
her. A few days later she passed away. One woman I tested,
Theresa Coggins, a diabetic, went into a coma for eight days,
running up a $100,000 hospital bill. Another woman, Christine
Lawrence, told me that her head felt like a balloon that was
about to burst. But did FEMA and ATSDR care? No. There was a
callous disregard for the health of the trailer residents, and
there was an appalling lack of urgency.
But this negligence is only the tip of the iceberg.
Contaminated communities often feel let down by ATSDR. Attorney
Monique Harden, coauthor of a report that details the
injustices of ATSDR in Mossville, Louisiana, says, ``Any help
that you can provide in getting the Science and Technology
Committee to connect the dots between ATSDR's role in the toxic
FEMA trailers with its ``public health'' work in communities
plagued by pollution would be greatly appreciated. The problem
that we have is that ATSDR's conduct in the FEMA trailer crisis
is not an aberration but is consistent with the way it has
always worked.''
Sal Mier, who retired from the CDC as Director of the
Division of Prevention in the Dallas Regional Office wrote,
``We strongly believe there is a national pattern in the manner
in which ATSDR conducts their consultations and assessments and
that this pattern could result in great risks to the public
health of many communities. It is our perception that ATSDR
embodies a philosophy and consequently a methodology and
guidance this is designed towards the non-identification or
trivialization of public health problems.''
Our tax dollars are being used to lie to us about the
impact of toxic pollution. The harmful and inaccurate advice
regarding formaldehyde in FEMA trailers is just the latest
example. Congress could help by calling for an independent
National Academies of Science investigation into the process by
which health consultations are developed and communicated.
Katrina was ``the perfect storm'' to expose formaldehyde
poisoning that has been allowed in our buildings now for
decades. FEMA just purchased what was available to sell for the
general public. There are many other people other than disaster
victims who are at risk here. The CDC needs to take immediate
steps to do a nationwide health survey and consultation
regarding formaldehyde and building materials. If there is one
benefit that can come out of all the misery and death that has
resulted from formaldehyde and FEMA trailers, let it be that
the citizens of the U.S. are finally afforded the same
protections that are provided under law in Europe, Japan, and
even China.
Thank you.
[The prepared statement of Ms. Gillette follows:]
Prepared Statement of Becky Gillette
My name is Becky Gillette, Formaldehyde Campaign Director for
Sierra Club. After Katrina, it soon became common knowledge that the
FEMA trailers being used to house people who had lost their homes had
serious air quality problems. People reported that being in the
trailers caused burning eyes, respiratory problems, coughing,
headaches, rashes and even bloody noses. Many people had what came to
be known as ``trailer cough,'' a cough that wouldn't go away.
After Paul and Melody Stewart of Bay St. Louis, MS, found high
levels of formaldehyde in their FEMA trailer in early March 2006,
Sierra Club funded work to test FEMA trailers to see how widespread the
problem was. We began those tests in April of 2006 and continued
testing later that year and again in 2007 because FEMA kept saying that
all people had to do was ventilate the trailers and the problem would
go away.
What we found was very alarming. Overall, 61 out of 69 tests--or 88
percent--were over 0.1 ppm.\1\ OSHA, EPA and other agencies all agree
that health effects from exposure to formaldehyde may begin at 0.1
ppm.\2\ When you use the lower limits recommended by the Agency for
Toxic Substances & Disease Registry (ATSDR) for long-term exposure, not
a single one of the trailers tested was in the safe range. The ATSDR
Minimal Risk Levels is 0.04 ppm for 1-14 days exposure, 0.03 ppm for
14-364 days exposure and 0.008 ppm for 365 or more days exposure.
---------------------------------------------------------------------------
\1\ Sierra Club Fact Sheet ``Toxic Trailers? Tests reveal high
formaldehyde levels in FEMA trailers.''
\2\ National Cancer Institute Fact Sheet ``Formaldehyde and Cancer:
Questions and Answers, http://www.cancer.gov/cancertopics/factsheet/
Risk/formaldehyde
---------------------------------------------------------------------------
When we initiated testing, we suspected just a couple trailer
brands had the problem. But out of 17 brands of trailers tested, all
had at least one high test. And it was also alarming to us that there
were three deaths of people in the trailers that we tested that we
believe could have been caused by the formaldehyde. That is just the
deaths we know of because it wasn't possible to keep up with all 69
families tested because FEMA trailer residents are very migratory.
Sierra Club did everything possible to publicize the high
formaldehyde levels in the trailers that were being used at one point
to house more than 100,000 families. There were numerous articles and
television news programs on the issue, but FEMA continued to deny there
was a problem and said people just needed to open their windows and let
the campers' air out. At the same time people were moving out of their
FEMA trailers to live in tents, storage sheds and even their vehicles
because the formaldehyde was so bad. People were experiencing numerous
health problems such as repeated respiratory infections, migraine
headaches and cancer.
Finally in September to October 7, 2006--more than a year after
Katrina--EPA undertook testing of the trailers for FEMA. We were very
glad that more expensive, extensive testing was being done to evaluate
the problem since FEMA had discounted the Sierra Club testing. But we
were extremely disappointed when there was delay after delay in
releasing the results of the EPA testing. When we asked why, FEMA said
the results were sent to the Agency for Toxic Substances and Disease
Registry (ATSDR) for evaluation. I knew the test results had to be bad
or FEMA would have announced them immediately. Four months after EPA
did that testing, I sent a Freedom of Information Act request to get
the EPA testing results, and started sending e-mails to a contact at
ATSDR.\3\
---------------------------------------------------------------------------
\3\ ATSDR e-mails between Becky Gillette and James Durant,
February-May 2007.
---------------------------------------------------------------------------
In an e-mail to James Durant, an environmental health scientist for
the ATSDR, Feb. 27, 2007, I wrote: ``We have been very frustrated with
the widespread poisoning of tens of thousands of people in FEMA
trailers due to high levels of formaldehyde. FEMA and the (Mississippi)
Health Dept. refuse to do anything about it. Would this be something we
could request investigated by ATSDR? Any tips for us on how to do
that?''
Mr. Durant responded: ``I am sorry that it has taken a while to get
back to you. My supervisor and I have been trying to track down who in
CDC/ATSDR has been heading up this issue. This was not as straight
forward as we thought it would be. We have found the person heading
this up, but she is out of the office. Hopefully, we will be able to
get an answer to you on what is going on with the formaldehyde soon.''
I never heard anything back, and on May 7--seven months after the
EPA testing was concluded--I once again wrote Mr. Durant and asked:
``Did you ever find out who is handling the FEMA request for
information from ATSDR regarding formaldehyde in FEMA trailers? FEMA
just put out a release showing their testing showed very high levels of
formaldehyde even after ventilation. But FEMA says that is below the
ATSDR threshold, which is several times higher than the EPA and
American Lung (Association) guidelines.
``I just tested a family with .32 ppm . . . they have spent over
$700 on medical bills related to the toxic exposure. It is very wrong
to suggest these levels--so strong they make your eyes burn--are
acceptable.
``Do you have a contact at ATSDR on this?''
Mr. Durant responded: ``So you are telling me that no one has
contacted you regarding formaldehyde at all? When you contacted me, we
attempted to have the person who is heading this up contact you. It was
my understanding that you would be contacted. I will flag this issue
and try to get someone to contact you that knows what is happening.''
My response was: ``No, I never heard from anyone. ATSDR, we have
been told, has been asked to give recommendations to FEMA. Ventilation
simply doesn't work here in the summer as it is too hot and humid. If
you do ventilate, the humidity can actually make out-gassing worse.''
In early 2007 when I first contacted the ATSDR, the agency had
already produced a Health Consultation. It was dated Feb. 1, 2007. But
that information was not released to the public until months later and
then the report went counter to the agency's own formaldehyde
standards.
When it was finally released, the ATSDR's Health Consultation was a
huge disappointment. I'm quoting excerpts from a FEMA press release May
4, 2007 titled FEMA Study: Ventilating Travel Trailers Can
Significantly Reduce Formaldehyde Emission Levels:\4\
---------------------------------------------------------------------------
\4\ http://www.fema.gov/news/newsrelease.fema?id=36010
``FEMA said today that its study of air samples collected from
travel trailers in the Gulf shows that formaldehyde emission
levels in the units can be significantly reduced through
adequate ventilation. The study involved collecting air samples
from 96 new, unused travel trailers from Sept. 19 to Oct. 7,
---------------------------------------------------------------------------
2006, at a staging area in Baton Rouge, La.
``The baseline for concentrations of formaldehyde in the units
averaged 1.2 ppm (parts per million) at the beginning of the
test. . . .According to the evaluation report provided to FEMA
by ATSDR, the average concentration of formaldehyde per day in
the units using open window ventilation dropped below 0.3 ppm
after four days of ventilation and remained low for the rest of
the test period. The level for health concerns for sensitive
individuals was referenced by ATSDR at 0.3 ppm and above.''
This is shocking because 1.2 ppm is extremely high. I found it
incredible that ATSDR could say that 0.3 ppm was below the level of
health concerns. At that level, most people experience extreme
distress. It was far, far too high. ATSDR's own standards are many
magnitudes lower at 0.04 ppm for 1-14 days exposure and far lower than
that for long-term exposure.
In a nutshell, the formaldehyde levels with ventilation went from
astronomical to extremely toxic and the ADSDR told the public: No
problem! ATSDR gave completely erroneous advice. What ATSDR did was
criminal negligence covering up this problem when the health and lives
of tens of thousands of Americans were at stake.
Finally in October of 2007 the ATSDR revised the February Health
Consultation to more accurately reflect the scope of the problem. But
that means it was one year between the time ATSDR was asked to evaluate
the EPA test results and when the agency delivered the second Health
Consultation that more accurately described the risks. That was one
year of time where tens of thousands of families were exposed to this
toxic gas. It was one entire year when women were getting pregnant and
sometimes having miscarriages, stillbirths or losing their children to
Sudden Infant Death Syndrome (SIDS). Children and adults were getting
cancer. And people with pre-existing conditions like asthma were
finding it literally hard to catch a breath. Mothers were getting up in
the middle of the night to give breathing treatments to children.
I had no sense that there was any bureaucrat in Atlanta or
Washington who even had a clue the amount of suffering and illness that
was resulting from this long-term exposure to a toxic gas. I recall
calling to give the bad news to Earl Shorty in Baker, La. about their
trailer's high formaldehyde levels. His wife Desiree Collins was
coughing so bad in the background it was painful to hear her. A short
time later she passed away.
One woman I tested, Theresa Coggins, a diabetic, had gone into a
coma for eight days, running up a $100,000 hospital bill. Another woman
whose trailer tested high, Christine Lawrence, told me her head felt
like a balloon that was about to bust.
FEMA and ATSDR showed an appalling lack of urgency. There was a
callous disregard for the health of FEMA trailer residents. I didn't
get the sense there was anyone in FEMA or ATSDR waking up in the middle
of the night worrying about families being poisoned. Instead, all we
got was a cover-up and denial of the problem.
If it was possible to file a malpractice lawsuit against a federal
agency, the ATSDR would not only end up owing millions of dollars for
harming the health of people, but it would lose its license to practice
medicine.
Other concerns about ATSDR
But the thousands of people who have suffered from this agency's
negligence on formaldehyde are only the tip of the iceberg. For many
years now the ATSDR has been called in when communities are concerned
about health impacts from massive amounts of toxic pollution.
Contaminated communities often feel let down by how little ATSDR
studies can tell them about associations between millions of pounds of
toxic releases and rampant illness and early death nearby. And they are
frustrated by the long amount of time it takes for ATSDR to complete
studies.
I would like to introduce into the record a report that details the
injustices of ATSDR in Mossville, LA.\5\ One of the authors of that
report, attorney Monique Harden, wrote the following:
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\5\ ATSDR's Misinformation Campaign on Dioxin Exposures in
Mossville, Louisiana, August 2007.
``Any help that you can provide in getting the Science &
Technology Committee to connect the dots between ATSDR's role
in the toxic FEMA trailers with its ``public health'' work in
communities plagued by pollution would be greatly appreciated.
The problem that we have is that ATSDR's conduct in the FEMA
trailer crisis is not an aberration but is consistent with the
---------------------------------------------------------------------------
way it has always worked.''
The ATSDR has also suppressed a report on Great Lakes health risks
showing people living in polluted areas around the Great Lakes face
higher rates of lung, breast and colon cancer.
Sal Mier, a concerned grandparent in Midlothian, Texas, who retired
from the CDC as Director of the Division of Prevention in the Dallas
Regional Office, says:
``We strongly believe there is a national pattern in the
manner in which ATSDR conducts their Consultations and
Assessments and that this pattern could result in great risks
to the public health of many U.S. communities. It is our
perception that ATSDR embodies a philosophy and consequently a
methodology and guidance that is designed toward the non-
identification and/or trivialization of public health
problems.'' \6\
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\6\ Letter from Sal Mier to House Science and Technology Committee:
ATSDR's Conduct with Public Health Consultations/Assessments, A
Possible Systemic Nationwide Problem, Feb. 20, 2008.
Mr. Mier says the most people who request Health Consultations end
up wishing they hadn't. That is because ATSDR issues a report
whitewashing any health impacts form the pollution, and it removes any
leverage local communities had with the polluters. Mr. Mier says: ``It
puts last nail in the coffin because it exonerates the polluter. I
think there is a pattern nationally.''
The Olympic Environment Council (OEC) is another environmental
group that regretted ever petitioning for the help of ATSDR to assess
the link between 67 years of releases of dioxin, PCBs, phthalates,
heavy metals, and other contaminants released from a local chlorine
dependent pulp mill in Port Angeles, Washington, and high incidences of
illness in the community. In a letter to the ATSDR, Darlene Schanfald,
Ph.D., OEC Project Coordinator, Rayonier Hazardous Waste Site Cleanup,
said:
``There are so many flaws in this report that rather than
enumerating/citing each, the report can be summed up as a
corruption of science. Maybe even a corporate corruption of
science since it is evident the staff did not want to rule
against the polluter when there was substantial evidence to do
so.'' \7\
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\7\ Letter to Julie L. Gerberding, ATSDR Administrator, RE: FINAL
PUBLIC HEALTH ASSESSMENT FOR RAYONIER, INC. MILL, PORT ANGELES WA--EPA
FACILITY ID WAD000-490169, from Darlene Schanfald, Ph.D., OEC Project
Coordinator, Rayonier Hazardous Waste Site Cleanup, Oct. 22, 2004.
Numerous flaws in the ATSDR consultation were detailed in a report
prepared by Dr. Peter deFur.\8\
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\8\ Comments of Dr. Peter L. deFur on behalf of the Olympic
Environmental Council (OEC) on the Public Health Assessment for
Rayonier Mill; Port Angeles, Clallam County, Washington; CERCLIS No.
WAD000-490169, September 6, 2000.
---------------------------------------------------------------------------
Even when the agency does find a link between pollution and health
problems, it tries to shield industry. At case in point was an ATSDR
investigation of DuPont Delisle on the Mississippi Gulf Coast, one of
the largest sources of dioxin emissions in the country. After Katrina
ATSDR did find dioxin levels in crabs can make them unsafe for
consumption by girls and women of childbearing age. But ATSDR denied
there was any link between the dioxin found in the crabs and DuPont,
which is the only large industry on the Bay of St. Louis.
Conclusions and Recommendations
These cases are all clear evidence of a pattern of ATSDR betraying
the public's trust when doing public Health Consultations. Our tax
dollars are being used to lie about the impact of toxic pollution. The
harmful and inaccurate advice regarding formaldehyde in FEMA trailers
is just the latest egregious example. At the end of the press release
for the first formaldehyde Health Consultation, it says: ``ATSDR serves
the public by using the best science, taking responsive public health
actions, and providing trusted health information to prevent harmful
exposures and diseases related to toxic substances.'' This mission
statement is contradictory to the advice given in the first
formaldehyde Health Consultation. Congress could help address this
problem by calling for an independent federal National Academy of
Sciences investigation of the process by which Health Consultations are
developed and communicated.
Now that the scope of the formaldehyde problem is apparent,
immediate steps need to be taken to provide health care to the many
thousands of families who have been sickened. Many of these families
lost everything in the storms, and don't have health insurance. The
government needs to set up free health clinics and work diligently to
help physicians and other health professionals determine the best
methods to treat the wide variety of health problems that have
resulted. The Children's Health Care Fund has studied the health of
residents of the FEMA trailers and determined there is an urgent need
for a health care ``Marshall Plan'' to respond to an emerging
humanitarian crisis in Louisiana and Mississippi.\9\ Sierra Club
endorses this recommendation.
---------------------------------------------------------------------------
\9\ The Recovery Divide: Poverty and the Widening Gap among
Mississippi Children and Families Affected by Hurricane Katrina, http:/
/www.childrenshealthfund.org/whatwedo/operation-assist/pdfs/
TheRecoveryDivide<INF>-</INF>Full%20Report.pdf, February 2007.
---------------------------------------------------------------------------
The CDC has already announced a study monitoring the health of
children who lived in the FEMA trailers that will eventually be
expanded to a study of the health of adults. This is badly needed and
these studies can't end in a few months because the health effects of
this exposure can be expected for the lifetimes of those people
exposed. The CDC also needs to study mental heath as some professionals
suspect the high rates of depression and suicide on the Gulf Coast
could be linked to the toxic exposure.\10\
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\10\ Statement from Ph.D. Psychologist Dr. Lou Finkle of Gulfport,
MS, March 24, 2007.
---------------------------------------------------------------------------
Katrina was the largest natural disaster in our nation's history,
and the formaldehyde in FEMA trailers was the second disaster that
harmed the health of people far more than the original disaster. I
strongly urge you to realize that the storm is not over. Katrina merely
was a ``perfect storm'' to expose the formaldehyde poisoning that has
been allowed in our buildings now for decades.
ATSDR, FEMA and HUD are still not responding adequately to results
that showed high levels of formaldehyde in RVs, trailers and other
products that are sold to the general public. FEMA just purchased what
was available for sale to the public. Manufacturers have said they
didn't do anything different in manufacturing trailers for sale to FEMA
than to the general public.
The fact is that formaldehyde has been a big problem for many, many
years. The CDC needs to take immediate steps to do a nationwide survey
of how big the problem is not only in RVs and manufactured housing, but
also in temporary classrooms that have tested high. We have even seen
high formaldehyde levels in government office buildings such as one
occupied by U.S. Rep. Diane Watson.\11\
---------------------------------------------------------------------------
\11\ U.S. Rep. Diane Watson statement at formaldehyde hearing
before U.S. House Committee on Government Oversight and Reform, July
19, 2007.
---------------------------------------------------------------------------
Many millions of Americans live in manufactured housing. A lot of
people retire to live in a RV at least part of the year. With the
declining economy, many people who are losing their homes are moving
into trailers. At my blogsite www.toxictrailers.com many people have
written about high formaldehyde levels in RVs, trailers, regular homes
and offices. It isn't just victims of disaster who are at risk here.
The CDC needs to immediately launch a nationwide investigation into
formaldehyde levels in RVs, mobile homes, temporary classrooms and
other housing that may be contaminated. It there is one benefit that
can come from all the suffering resulting from formaldehyde in FEMA
trailers, let it be that we finally get this toxic gas out of building
materials providing the citizens of the U.S. the same protections
provided under the law in Europe, Japan and even China.
Biography for Becky Gillette
Becky Gillette is a free-lance writer/photographer and an
environmental activist currently living in Eureka Springs, AR. She was
living on the Mississippi Gulf Coast when Hurricane Katrina hit. After
repairing flood damages to her home, she became aware of problems with
formaldehyde levels in FEMA trailers. She received a grant from Sierra
Club to organize a testing program for the trailers and publicized the
results which showed about 90 percent of FEMA trailers have excessive
formaldehyde levels.
She launched the web site www.toxictrailers.com to publicize the
problems, and helped organize a Congressional hearing on the subject
that led to FEMA halting the use of the travel trailers. In 2007 she
received an Environmental Hero Award from Louisiana Environmental
Action Network recognizing her formaldehyde work. She is currently
Formaldehyde Campaign Director for Sierra Club's Gulf Coast
Environmental Restoration Task Force.
Gillette's writing and photography have been published in about 50
magazines and newspapers nationwide. Her article have appeared in
Ladies Home Journal, Organic Gardening, Utne Reader, E, The
Environmental Magazine, Builder, BioScience, In Business, Mississippi
Business Journal, In Business and Furrow.
Gillette was Chair of the Mississippi Chapter Sierra Club for five
years, and in 2002 she received the National Conservation Achievement
Award from National Wildlife Federation for communications. She has
been named Mississippi 2008 Small Business Journalist of the Year by
the Small Business Administration. She is currently Formaldehyde
Campaign Chair for the Sierra Club Gulf Coast Environmental Restoration
Task Force.
Discussion
ATSDR Response to Sierra Club Tests
Chairman Miller. Thank you. We will now have our first
round of questioning, and my hope is that this panel will be
limited to one round of questioning because we have more to go.
I can tell that none of you appear disappointed that there will
only be one round of questioning from each of us.
Ms. Gillette, you just testified about the Sierra Club's
initial testing as early as April of 2006. You released those
publicly, they were in the press. Did you get contacted by
anyone at ATSDR, CDC, FEMA about the results of your test,
about your test, and what they showed?
Ms. Gillette. No. ATSDR, I just got the runaround from
them. They kept saying on e-mail they would get back with me,
and they never did. Finally over July, last July someone with
NIOSH wrote and asked for the results of our testing, but we
were never, you know, given the opportunity to tell them about
the scope of the problem.
And the thing that really bothered me is that I didn't feel
like there was any bureaucrat that was actually coming and
spending even 15 minutes in these trailers, let alone stay
overnight in them and find out what it is really like to have
to live with those kind of high formaldehyde levels.
Health Effects From Formaldehyde
Chairman Miller. Okay. Mrs. Huckabee, I think that Ms.
Gillette just said that she thought that there was a
trivialization of health consequences. The ATSDR health
consultation in February of 2007, described that results below
the 0.3 level, parts per million, as being a nuisance affect.
Would you describe the effect on your family?
Mrs. Huckabee. If you consider nosebleeds, sinus
infections, asthma attacks, repeat hospitalizations for
pneumonia, asthmatic bronchitis, tumors, if you consider all of
these minor nuisances, then I guess you could agree with it. I
mean, after all, it could be worse, I suppose.
Chairman Miller. And advised by our able staff that that
was not actually in the written report, but that is based upon,
the nuisance effect is based upon interviews with staff.
Dr. Sinclair, I know if you have tens of thousands of
Americans over the course of a couple of years they are going
to have bad things happen to them. You heard Ms. Gillette
describe deaths in the trailers. Do you concur that the
formaldehyde exposure may very well have been a contributing
factor in some of those deaths?
Dr. Sinclair. I would say it very well may have been a
contributing factor. You cannot prove cause and effects, but
many of the symptoms that our family's children exhibited while
common in a general pediatric population, are also associated
with formaldehyde exposure.
Chairman Miller. You described in your testimony the
affects that, the health affects that may come from
formaldehyde exposure. What did you observe personally in your
treatment in seeing families that lived in those trailers?
Dr. Sinclair. The travel trailers in our area may not have
had as high levels of formaldehyde as those in the Mississippi
Gulf Coast because most of them were put together before
Katrina and not put together as quickly after Katrina as those
in the Mississippi Gulf Coast. The symptoms that many of my
patients were exhibiting were not as dramatic as many of those
reported by pediatricians and families in the Mississippi Gulf
Coast area, however, they were persistent and difficult to
treat.
What I am more concerned about are the possible long-term
health affects of these families' exposure to formaldehyde over
the past two and one-half years.
Tracking Trailer Residents' Long-term Health
Chairman Miller. And what do you think should be the--what
should we do to track the health of those folks who have been
in the trailers for health consequences? Should there be a
continuing effort to pay attention to their--what happens to
them medically?
Dr. Sinclair. I believe so. First of all, families should
never have been put in these travel trailers to begin with.
They are not meant for living. They are not up to electrical
standards. They have stoves that would explode. They are not up
to storm standards. They are very small, 200 square feet.
That being said, now that people have lived in these travel
trailers for a year, two years, two and one-half years, I think
it would be very beneficial to create a data bank to track
families and children and to follow their long-term health and
so if there is certain concerning symptoms, that future health
care providers could be alerted to the fact that they had lived
in the travel trailers and maybe have a little bit higher level
of concern that some of the symptoms might not just be your
general cold, asthma, allergies but maybe a symptom of
something more concerning.
Chairman Miller. Ms. Gillette, what effort do you think
there should be to follow the longer-term health of the people
in the trailers?
Ms. Gillette. Well, I actually think it is not enough to
follow their health, but you need to provide free health care
to people that have been poisoned by their own government, and
the problem is that many of these people are still struggling
to get their lives back together. They lost everything in the
storm. There is no affordable housing that you can get into.
Rental rates have doubled. The government needs to get some
sort of formaldehyde swat team together that really bones up on
how do you treat people that are exhibiting the symptoms of
formaldehyde poisoning. Because a lot of the health care
providers don't know, and they are actually in some cases
giving treatment that we think may be doing more harm than
good.
So we really need this concerted effort on training people
that are specialists in treating families that have been
exposed to formaldehyde this long. After people have been
exposed to high levels of it, they become more sensitive. Many
of them make get multiple chemical sensitivity. So there really
needs to be some free clinics provided for these people, and,
again, as far as tracking, I will just say one thing. Some of
these people have moved all over the U.S., and it is going to
be difficult to track them. But definitely it needs to be done
and not just for children but also for adults.
Chairman Miller. Thank you. As an example to the other
Members of the Committee, I will limit my five minutes of
questioning to six and one-half minutes.
Mr. Sensenbrenner. For five minutes more or less.
Failings of ATSDR
Mr. Sensenbrenner. It will be less. There are two aspects
to this issue. One is the aspect of the fact that there have
been people who have been exposed to unacceptably high levels
of formaldehyde because the ATSDR did not do its job properly.
The other issue to make sure that a catastrophe like this never
happens again.
And I think that this committee could probably be the most
constructive in getting on the back of ATSDR to make sure that
their medical and scientific review process passes the smell
test. And this obviously did not pass that test because it
certainly was not acceptable science and what is more
problematical in my opinion is that the deficiencies in the
ATSDR report should have been caught earlier on and were not.
Now, this is not the only case where the ATSDR has not only
dropped the ball but fumbled it in the end zone. And in my
opening remarks I did refer to the issue of the public health
implications of hazardous substances in 26 U.S. areas of
concern in the Great Lakes. Let me say that there was a
premature release of that report. The public health officials
both in Wisconsin and Minnesota reviewed the prematurely-
released report and have sent letters to Dr. Howard Frumkin,
who is the director of the ATSDR, stating that his report
failed. And this is a little bit closer to home for me than the
Gulf Coast is, but it shows that the problems of inadequate and
erroneous scientific review in the ATSDR are not limited to the
issue of formaldehyde in the trailers that FEMA provided to
people who were displaced by the two storms.
In analyzing toxic substances and what I think is probably
the greatest natural resource in the United States, and that is
the Great Lakes, which are the largest body of fresh water in
the world, I ask unanimous consent to include the letter from
the State of Wisconsin, Division of Public Health, signed by
the Chief Medical Officer, Henry Anderson, M.D., as well as a
letter that was sent to Dr. Frumkin by the Minnesota Department
of Public Health and specifically by John Link Stein, who is
the Director of the Environmental Health Division in Minnesota.
And I want to have the record be as complete in its indictment
of how bad the ATSDR has been and how much they have opened up
the population of this country to disease and serious medical
conditions because they haven't done their job properly.
And I would hope that this hearing at minimum would be a
lesson to them that this should never happen again, and if it
does happen again, if folks here from the ATSDR, the CDC think
that today's price to pay is pretty high, to quote Ronald
Reagan, ``You ain't seen nothing yet.''
I yield back the balance of my time to the Chairman.
Chairman Miller. Thank you. Without objection the documents
that Mr. Sensenbrenner has moved be entered into the record are
so admitted.
[The information follows:]
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Chairman Miller. The Chair recognizes Ms. Hooley for five
minutes of questioning.
Dr. Sinclair's Experience in Her Trailer
Ms. Hooley. Thank you, Mr. Chair. I will be rather brief. I
have a couple of questions for Dr. Sinclair.
First of all, I understand that your own mobile unit had
high levels of formaldehyde in it. Did you experience any
symptoms firsthand?
Dr. Sinclair. First of all, as a displaced person I was
actually living in a FEMA trailer in New Orleans for half the
week while I was commuting back and forth the first year before
I relocated to Baton Rouge, and I had headaches the whole time
I was there. I had difficulty sleeping. This was before I knew
anything about formaldehyde. I always kept my windows open and
the doors open, and I assumed that my headaches were because I
wasn't sleeping well.
As far as our own medical mobile unit, when we come on in
the mornings, especially in the hot weather, you do have--you
notice the smell, and you do have burning eyes, and we run the
air, we open the windows and vents, and by the time we start
clinic, we are, you know, we are not noticing the effects of
formaldehyde.
One thing I would like to point out is that we retested the
trailers, that, our medical mobile unit, for just eight hours,
which is our workday.
Ms. Hooley. Uh-huh.
Dr. Sinclair. And it tested lower. It was still above what
EPA recommends for an eight-hour workday exposure, which is 100
parts per billion but was less than what OSHA recommends for an
eight-hour workday exposure, which is the 300 parts per
billion. So this is where some of this confusion has come up is
that the 0.3 parts per million or 300 parts per billion is
considered an acceptable level by OSHA for an eight-hour
workday exposure but not an acceptable level for long-term
exposure in a living environment.
Obstacles to Safe Housing
Ms. Hooley. And when you found that you were having
headaches and not sleeping well and all of that, and as you
understood better what was going on, what did you do about
getting people out of these mobile homes that had such high
levels of formaldehyde?
Dr. Sinclair. This is the real challenge because the cure
is really to get out of the mobile, of the travel trailers. And
Mayor Nagin's request that families be sent to their doctors
and doctors give them advice about what to do about their
formaldehyde exposure is frustrating for me as a health care
provider because my advice is to get out of the travel
trailers.
So that is basically what we have been doing, is just
advising people until you can get out, run the air
conditioners, don't smoke inside, don't use----
Ms. Hooley. Did you work with other agencies, though, to
find them other housing? I mean, if this was a high exposure,
and how successful were you in getting them out of these travel
trailers?
Dr. Sinclair. The rental market in Baton Rouge is extremely
tight right now, as is the rental market in New Orleans, and
the list of housing that our case manager was able to find in
the Baton Rouge area, we managed to find three apartments for
about 300 families. We talked, she also talked with a FEMA case
manager. They weren't much more successful. They had about five
apartments. Catholic Charities has been very helpful in
assisting families. They managed to place 367 families last
fall, but it has been a real challenge. And so the other real
issue here is the fact of the housing shortage.
More on Tracking Residents
Ms. Hooley. The question is that I am concerned about, two
things, is one, that this never happen again, and two, what are
you going to do to track all of those people that were living
in these travel trailers that had the high level of
formaldehyde?
Dr. Sinclair. This has also been a great area of
frustration for me because we want to keep track of our
families as they move out so that we can continue providing
care to them. What we do is we basically just let them know
where we are, they have our phone numbers, but there has not
been a data bank to keep track of families that have been in
the travel trailers.
Ms. Hooley. Don't you think that would be a good idea?
Dr. Sinclair. I definitely think that would be a good idea.
Ms. Hooley. What is it, what do you need to do to make that
happen?
Dr. Sinclair. FEMA, I talked to FEMA, and they said that
they have only kept track of those families that they are still
providing rental assistance to. Louisiana Family Recovery Corps
is not keeping a list of families that have lived in the travel
trailers.
Ms. Hooley. Well, maybe all of you--excuse me for
interrupting you.
Dr. Sinclair. Yeah.
Ms. Hooley. But it seems to me that you have got several
agencies involved and that you might sit down and talk to one
another and say, this is something that we really need to do
and begin that process and who is in charge and who is going to
do it, how are you going to do that in a concerted effort,
because it is not okay to say, well, you know, this agency is
doing this, this agency is doing that, and then when you end up
nobody is really doing it.
Dr. Sinclair. I agree.
Ms. Hooley. Okay. I hope that happens.
Do I have any time left? No.
Dr. Sinclair. I agree, because it has been really difficult
to find out where people are going and follow their health.
Trivializing Health Concerns
Ms. Hooley. Okay. But I think it is incumbent upon all the
agencies that are involved to, in fact, do that.
I just have a quick question for Ms. Gillette. Why do you
think they have trivialized the health problems? I mean, that,
you brought that up in your testimony.
Ms. Gillette. I think there are a couple of things. One is
I don't think that, I think it was hard for people to believe
that this housing was as toxic as it was because it is stuff
that is sold to the general public. And so then there was the
issue, well, what do we do about it, and there aren't
affordable housing out there. I know people who have loved ones
who have died in the trailers they think were killed by the
formaldehyde. They are still living in the trailers. They don't
have anywhere else to go.
Ms. Hooley. So what do you see the solution?
Ms. Gillette. Well, the big--the one bigger solution is
that you have to reform how the CDC works and so that it stops,
you know, covering for big polluters. It is more interested
really in corporate America than it is the health of the
people. And that is a big problem. These health consultations
that are done across the country almost never find any
connection between huge amounts of pollution and people being
sick and dying all around there.
And so until you change that mindset that, oh, we really
just can't prove that all that toxic pollution is causing these
people to die, you know, it harms all of us. Because if you
have pollution on the Gulf Coast that is not controlled because
the ATSDR says there is no connection between the pollution and
the health affects, well, guess where you get a lot of seafood
from? People all over the U.S. are eating seafood that is
contaminated by dioxin and other pollutants.
Ms. Hooley. So I shouldn't eat seafood from the South?
Ms. Gillette. Well, they don't want, you know, the South is
not going to want you to say that, but especially the bigger
fish you don't want, you know, that magnify the pollution. But
my point is like when dioxin goes up in the air and it, you
know, the whole population of the U.S. is overexposed to dioxin
now. We are getting it in our food, we are getting it in our
air, and we need to reduce our pollution, and we can't do that
as long as we have a federal agency that keeps telling people
that pollution doesn't matter, that it is not really harmful.
Ms. Hooley. Mrs. Huckabee, I just have one thing. It is not
really a question. I am so sorry this happened to your family
and hopefully this won't happen in the future.
Chairman Miller. Thank you, Ms. Hooley. The fact that
things happen in the South doesn't mean that it wasn't
Northerners doing it.
Mr. Lampson for five minutes.
Health Care Costs
Mr. Lampson. Thank you, Mr. Chairman. I particularly want
to thank you for letting me sit in on your committee, and I
want to commend you and Ranking Member Sensenbrenner for the
work that you have both done in bringing out these atrocities,
and they are atrocities. It is hard to believe that something
like this could happen in our country, particularly following a
time when so many people have had trauma already.
But I just, a couple of questions because most of what I
wanted to ask has been put into the record, but let me start
with Mrs. Huckabee.
Many families have to bear the brunt of thousands of
dollars of health care costs. I know that FEMA established a
program to reimburse for many of the medical bills. Do you know
about how much you have spent? Have you asked for that money
back? Have you asked for a reimbursement, and have you received
any reimbursement from FEMA at this point?
Mrs. Huckabee. No. Absolutely no reimbursement. In fact, I
heard a rumor that there was--that they were doing that. We
faxed in all of our medical information, notes from our
doctors, and heard absolutely nothing back from FEMA. So if
they are, in fact, reimbursing people, that is brand new news
to me.
Mr. Lampson. Thank you. Do you think they should?
Mrs. Huckabee. I believe so. I mean, if it is, you know, if
you have got, you know, several doctors saying, look. This was
if not 100 percent caused, it was definitely made worse, but I
think FEMA is having enough problems coming up with the things
that they have already said they are going to do as far as food
vouchers and things like that. They haven't got a grasp on that
yet either.
Formaldehyde's Effects on Reproductive Health
Mr. Lampson. Dr. Sinclair, do we know the long-term health
affects of chronic formaldehyde exposure, and can the toxicity
be passed on to future children and grandchildren of these
residents?
Dr. Sinclair. We do not know. There have been fairly
convincing links to formaldehyde exposure to nasal-pharyngeal
cancer and nasal cancers and probably throat cancer, lung
cancer, and possibly blood disorders such as leukemias. There
is conflicting evidence about affects on reproductive health.
There are possible correlations from occupational studies that
may have, may link formaldehyde to premature births and
miscarriages, but, again, there haven't been long-term studies
of exposure in living environments. There have been cell
studies that show that formaldehyde at fairly low levels can be
genotoxic and cause changes to chromosomes and breakage of
sister chromatids and may be related to birth defects. But this
isn't clear.
Population Size
Mr. Lampson. Do you know how many people have been involved
with these trailers? Do we know that number?
Dr. Sinclair. Tens of thousands have lived in the travel
trailers.
Mr. Lampson. We have got an approximate number. We don't
know the number.
Dr. Sinclair. FEMA has an exact number of families that
have lived in the travel trailers.
Voice. One hundred and forty thousand.
Dr. Sinclair. Yeah. One hundred and forty thousand.
Mr. Lampson. One hundred and forty thousand trailers.
Dr. Sinclair. Families.
Mr. Lampson. Families.
Dr. Sinclair. Yeah. At Renaissance Village, which is the
largest FEMA trailer village in Louisiana, there have been over
800 families that have moved in and out of Renaissance Village,
and the peak population there, estimates range from 1,400, the
official number, to about 2,500, the unofficial number,
including friends and families that were living with others in
the travel trailers.
Mr. Lampson. I thank you very much, and I will yield back
my time, Mr. Chairman.
Chairman Miller. Thank you. And I thank this first panel.
We will now take just a two-minute break and have our second
panel.
[Recess.]
Panel II:
Chairman Miller. I would now like to introduce our second
panel. Dr. Meryl Karol is a Professor Emerita of Environmental
and Occupational Health Sciences at the University of
Pittsburgh. She is a former President of the Society of
Toxicology and the former Secretary General of the
International Union of Toxicologists. Dr. Christopher De Rosa
is the former Director of the Division of Toxicology and
Environmental Medicine at ATSDR, the former and his title is
now a matter of dispute.
As our witnesses should know, the, from having observed the
previous panel and from what we have already told them, the
oral testimony, the spoken testimony should be limited to five
minutes each with some indulgence, after which the Members of
the Committee will ask five minutes of questions each. It is,
again, the practice of the Subcommittee to take testimony under
oath. Do either of you have any objection to being sworn in, to
be, swearing an oath?
Okay. You also may be represented by counsel. Is, are
either of you represented by counsel at this hearing today? If
you would now please stand and raise your right hand.
[Witnesses sworn]
Chairman Miller. Both the witnesses have taken the oath.
Dr. Karol, you may begin.
STATEMENT OF DR. MERYL H. KAROL, PROFESSOR EMERITA, UNIVERSITY
OF PITTSBURGH
Dr. Karol. Chairman Miller, Mr. Sensenbrenner, Members of
the Subcommittee, thank you for inviting me to testify today.
In describing my background I am a former President of the
Society of Toxicology. I was also the Secretary General of the
International Union of Toxicologists. This is an association of
toxicologists from all six continents.
Academically I was Associate Dean for Research and Academic
Affairs at the Graduate School of Public Health at the
University of Pittsburgh, and currently I am Professor Emerita
of Environmental and Occupational Health Sciences at the
University. I wish to stress that my testimony today reflects
only my opinions.
As a toxicologist I have conducted research for 34 years on
mechanism of chemically-induced lung and skin diseases. I have
conducted research on formaldehyde, focusing on allergic
sensitization following both skin and lung exposure. This
research was supported by both the NIEHS and by NIOSH.
I have published nearly 200 scientific articles, books,
book chapters, and monographs. Particularly relevant is a 2007,
monograph entitled, Improving Indoor Environmental Quality for
Public Health, and that discusses effects of indoor
environments on human health.
In the brief time that I have available today, and it will
be five minutes, I would like to comment on one of the major
recommendations of the ATSDR February, 2007, health advisory.
Specifically, that 0.3 ppm concentration of formaldehyde be
designated a level of concern for sensitive individuals. The
level of concern being defined as a level above which
individuals with hypersensitivity to formaldehyde would suffer
adverse health affects. In my opinion this level has to be
lowered.
In outdoor air formaldehyde is normally present in
concentrations around 0.002 parts per million. Indoors the
concentration is typically ten to 20 times higher, depending on
various factors such as construction materials, furnishings,
the age of the housing. With newer homes typically releasing
more formaldehyde by off-gassing. Heat and ventilation also
affect the formaldehyde concentration.
Most people can detect the presence of 0.5 ppm formaldehyde
by its odor. This and higher concentrations typically causes
eye, nose, and throat irritation with symptoms of eye tearing
or perhaps eye, nose, and throat burning, hoarseness, cough,
difficulty in breathing.
However, formaldehyde can be irritating at a concentration
that is even lower. A percentage of the population develops eye
irritation when exposed to a concentration below the odor
threshold and around the 0.3 stated level of concern.
Sensitive individuals may have adverse affects when exposed
to yet lower concentrations. Such individuals would include
those with hyperactive or twitchy airways, those with
underlying disease or with a viral infection of the lungs,
among other concerns. Infants and the elderly would reasonably
be expected to be more responsive to irritants such as
formaldehyde. Their narrower airways make children more
susceptible than adults to agents such as irritants that cause
airway constriction.
The ATSDR proposal of February, 2007, suggests 0.3 ppm
formaldehyde as a level of concern for sensitive individuals.
The basis for this proposal was the OSHA guideline for
acceptable workplace exposures, with a maximum of 0.7 ppm
formaldehyde averaged over an eight-hour work shift. It must be
emphasized that the OSHA permissible exposure is an
occupational standard established for healthy adults expected
to have only an eight-hour exposure.
In order to apply this guideline to indoor environments
that would be safe for the general population, one must lower
their permissible concentration because the population is
diverse, not only with respect to age but with respect to
underlying health status and concurrent environmental
exposures. And they may be exposed for 24 hours a day.
Ten years ago a review was published that critically looked
at 150 scientific articles on formaldehyde and concluded that
eye irritation occurred at 0.24 ppm in about 20 percent of the
population, and these are non-sensitive subjects. The authors
of that article concluded that an indoor environment where
exposures might occur 24 hours a day could maintain a
concentration of formaldehyde below 0.1 ppm, and that would
protect virtually all persons.
In summary, to protect residents against adverse affects
from formaldehyde inside their trailers, guidelines must take
into consideration the diversity of the exposed population, as
well as the diversity of the indoor environment, including the
temperature, ventilation, furnishings, and other chemicals.
Suggestion that 0.3 ppm be designated a level of concern for
formaldehyde might protect non-sensitive individuals, but it
would not protect those that are sensitive. The level of
concern should be lowered and should not exceed 0.1 ppm.
Uncertainty remains regarding the likelihood of chronic
health affects resulting from continued formaldehyde exposure
in trailers. And for this reason the level of concern have to
be revisited periodically.
[The prepared statement of Dr. Karol follows:]
Prepared Statement of Meryl H. Karol
Chairman Miller, Mr. Sensenbrenner, Members of the Subcommittee.
Thank you for inviting me to testify today. In describing my
background, I am a former President of the Society of Toxicology, USA,
a professional organization of approximately 6,000 scientists from
academia, government, and industry. I am also a former Secretary-
General of the International Union of Toxicologists, an association
comprised of 51 national societies of toxicology from all six
continents. The goal of the International Union is to increase the
knowledge base of toxicology and to extend this knowledge to other
nations and societies. Academically, I am the former Associate Dean for
Research and Academic Affairs at the Graduate School of Public Health
at the University of Pittsburgh, in Pennsylvania. Currently, I am
Professor Emerita of Environmental and Occupational Health Sciences at
the University. I wish to stress that my testimony today reflects only
my opinions.
As a toxicologist, I have conducted research for 34 years on
mechanisms of chemically-induced lung and skin diseases. This research
has been supported by the NIEHS, NIOSH, USDA, and grants from
industrial corporations and professional associations. I have published
more than 170 refereed scientific articles that are focused on chemical
toxicity and have authored and edited several books, book chapters and
monographs. Particularly relevant is a monograph (of which I was an
editor) entitled, Improving Indoor Environmental Quality for Public
Health. The monograph (1), published in the June 2007 issue of
Environmental Health Perspectives, is comprised of six articles by
international experts in indoor air quality. It contains discussion of
the effects of indoor environments on human health.
I have lectured extensively, both nationally and internationally on
indoor environmental quality, including meetings organized by the World
Health Organization. I have taught graduate classes in environmental
and occupational health, principals of toxicology, and methods in
toxicology. I currently serve on the Scientific Advisory Board of the
EPA, and on the National Research Council's (NRC) Committee on
Toxicology. I chair the NRC Committee on Toxicologic and Radiologic
Effects from Exposures to Depleted Uranium During and After Combat.
Regarding my work with formaldehyde, I have conducted research that
focused on the potential allergic sensitization from skin and pulmonary
exposure to formaldehyde. This research, supported by both NIEHS and
NIOSH, resulted in the development of an animal model of formaldehyde
sensitization, and also led to the development an immunologic assay to
detect the presence in serum of antibodies directed to formaldehyde
(2).
In the brief time I have available today, I would like to comment
on the ATSDR's health advisory (issued February 2007) on formaldehyde
levels in FEMA-provided trailers, and to specifically address one of
its major recommendations, i.e., that a 0.3 ppm concentration of
formaldehyde be designated a ``level of concern'' for sensitive
individuals. A level of concern has been defined as the level above
which individuals with hypersensitivity to formaldehyde would suffer
adverse health effects.
What is Formaldehyde Hypersensitivity?
Formaldehyde is normally present in low concentrations, around 3mg/
m<SUP>3</SUP> (2.5 ppb), in the outdoor air. Indoor, the concentration
is usually higher and may reach 25-50 ppb depending on numerous factors
that include: the construction materials used, furnishings, the age of
the housing (newer homes would be expected to release formaldehyde by
off-gassing from materials). Other factors that also contribute to
formaldehyde concentrations within homes include the heating and
ventilation systems.
Most people can detect the presence of 500 ppb (0.5 ppm)
formaldehyde in the atmosphere by its characteristic odor. At this and
higher concentrations, it typically causes eyes, nose and throat
irritation with symptoms of eye tearing or perhaps eye, nose and throat
burning, hoarseness, cough, or difficulty breathing. However,
formaldehyde can be irritating, especially to the eyes when present in
a concentration that is lower than this odor threshold. As I will
discuss later, it is known that a considerable percentage of the
population develops eye irritation when exposed to 0.24 ppm
formaldehyde, a concentration considerably below its odor threshold (3)
and the ``level of concern.''
There exist sensitive individuals, people who may have an adverse
response when exposed to still lower concentrations of formaldehyde,
i.e., concentrations that are below the level that causes health
effects in the majority of people. Such individuals would include those
with hyperreactive ``twitchy'' airways, those with underlying
respiratory disease, with a viral infection of the lungs, among others.
Infants and the elderly would reasonably be expected to be more
responsive to irritants such as formaldehyde. Their narrower airways
make children more susceptible than adults to agents such as irritants
that cause airway constriction.
The Formaldehyde ``Level of Concern''
The ATSDR Health Consultation of February 1, 2007 offers 0.3 ppm
(369mg/m<SUP>3</SUP>) formaldehyde as a concentration associated with
the narrowing of the lung bronchi in sensitive individuals (4). This
statement implies that most individuals (i.e., those without
sensitivity) would not be adversely affected upon exposure to 0.3 ppm
formaldehyde. Unfortunately, the Consultation statement is contrary to
published reports that provide evidence that 0.3 ppm is not a
protective concentration even for the general population. It certainly
would not be protective for the more susceptible persons, i.e., those
described above.
The basis for establishment of the 0.3 ppm level of concern is a
2001 ATSDR document (5) that lists OSHA permissible exposure limit
(PEL) of 0.75 ppm formaldehyde (averaged over an eight-hour workshift)
as a guideline for an acceptable exposure level. However, it must be
emphasized that the PEL is an occupational standard, established for
healthy adults, individuals expected to have only an eight-hour
(workday) exposure. In order to use this guideline to set indoor
environmental exposures that are safe for the general population, one
must consider applying safety factors that would lower the permissible
concentration of formaldehyde to make it appropriate for a population
that is diverse with regard to age, underlying health status,
concurrent environmental exposures, and may be exposed for 24 hr/day.
October 2007 Revision of the Feb. 2007 ATSDR Health Consultation
The October 2007 revision sought to address, among other items, the
deficiency in the Feb. 2007 report regarding the insufficient
discussion of the health implications resulting from formaldehyde
exposure. It addressed the question, ``Are air formaldehyde levels in
closed, unventilated trailers high enough to be associated with health
effects in humans?''
When corrected, the air samples taken in closed trailers yielded an
average value of 1.04 ppm formaldehyde (with some values extending to
3.5 ppm). Concentrations in air-conditioned trailers averaged 0.39 ppm,
whereas concentrations in trailers with open windows were 0.09 ppm. The
advisory correctly concluded that the levels in the air-conditioned
trailers exceeded federal exposure guidelines. OSHA warns that
``Airborne concentrations of formaldehyde above 0.1 ppm can cause
irritation of the respiratory tract'' (6).
Guidelines for safe formaldehyde exposure
What are the known effects of formaldehyde on humans? Which are the
susceptible populations? What guidelines are appropriate to protect the
health of human sub-populations?
Irritation
Formaldehyde is known to cause irritation of the eyes, nose, throat
and respiratory tract. During the past 60 years, the Occupational
Exposure Guideline for formaldehyde (to prevent irritation reactions in
workers) has been revised downward from 10 ppm in 1947 to 0.3 ppm (as a
ceiling value) in 1992. In 1997, a panel of experts critically reviewed
150 scientific articles related to formaldehyde to derive an
occupational exposure limit that would prevent irritation (3). The
panel found that eye irritation occurred at concentrations lower than
those that caused nose/throat irritation and concluded that it was the
most sensitive irritative effect. They found reports of eye irritation
at 0.24 ppm (19 percent of 16 subjects) clearly indicating the
variation that exists among humans with regard to this endpoint. The
panel concluded that maintaining a formaldehyde concentration below 0.1
ppm in the indoor environment where exposures might occur 24 hour/day
might avoid irritation in virtually all persons. In agreement, the
current OSHA guideline states that between 0.1-0.5 ppm, irritation may
occur in some individuals.
Chronic airway disease
Formaldehyde does not appear to pose a hazard for pulmonary
emphysema or chronic obstructive pulmonary disease (COPD).
Allergic sensitivity
Formaldehyde has been associated with allergic skin sensitivity in
humans and animals (2). It remains uncertain whether inhaled
formaldehyde will or will not induce lung sensitization in humans (7)
although controlled animal studies have failed to detect this response
(2).
Cancer
Based on the reported concentration-dependent carcinogenic effect
of formaldehyde in rats and mice, and on inadequate epidemiologic data
on the cancer risk in humans, ACGIH (1989) recommended that workplace
formaldehyde exposures be reduced to the ``lowest possible level.''
ACGIH has adopted the 0.3 ppm TLV-CV (ceiling value) for formaldehyde
and lists it as an A2 suspected human carcinogen.
There is considerable controversy regarding the conclusion that
formaldehyde causes cancer in humans. In 2004, the International Agency
for Research on Cancer (IARC) reclassified formaldehyde as a Group 1
carcinogen based largely on the results of the National Cancer
Institute (NCI) study on nasopharyngeal cancer (NPC). However, the NPC
findings in the NCI study were driven by a large excess in one plant (6
or 10 cases from that one plant). Nine other plants collectively had no
NPC excess, nor was an NPC excess observed in two other cohort studies,
one by NIOSH and one in the UK.
The NCI nasal pharyngeal excess driven by one plant was the subject
of several papers by the Marsh group. In a recent update (8), the
investigators found that the large NPC excess in this plant appears to
be due to prior employment in the metal working industries of the local
area, where exposures to many agents known or suspected to cause upper
respiratory cancers (e.g., sulfuric acid mists, mineral acid, metal
dusts and heat) have occurred.
The causal association of formaldehyde with leukemia has also been
questioned. A reanalysis (9) of the data provided little evidence to
support a causal association between formaldehyde exposure and
mortality from leukemia.
Summary and Recommendations
The literature regarding the adverse effects from formaldehyde
indicates the potential for both acute and chronic health effects.
Guidelines for safe exposure to formaldehyde to protect against these
effects have been established for the workplace. To protect residents
against adverse effects from formaldehyde inside their trailers,
guidelines must take into consideration the diversity of the exposed
population (including age and underlying health conditions) as well the
diversity of the indoor environment (including the temperature,
ventilation, furnishings, other airborne chemicals). The suggestion
that 0.3 ppm be designated a ``level of concern'' for formaldehyde
would not protect sensitive or nonsensitive individuals from irritation
reactions. The level of concern should be lowered and not exceed 0.1
ppm. Uncertainty remains regarding the likelihood of chronic adverse
health effects resulting from continued formaldehyde exposure in
trailer residences.
References
1. Wu F., Jacobs D., Mitchell C., Miller D., Karol M.H. Improving
indoor environmental quality for public health: impediments and policy
recommendations. Environ Health Perspect 115:953-957, 2007.
2. Lee, H.K., Alarie, Y. and Karol, M.H. Induction of formaldehyde
sensitivity in guinea pigs. Toxicol App Pharmacol 75:147-155, 1984.
3. Paustenbach D., Alarie Y., Kulle T., Schachter N., Smith R.,
Swenberg J., Witschi H., and Horowitz S. A recommended occupational
exposure limit for formaldehyde based on irritation. J Toxicol Environ
Health 50:217-263, 1997.
4. Agency for Toxic Substances and Disease Registry, Health
Consultation, Formaldehyde sampling at FEMA temporary housing units,
February 1, 2007.
5. Agency for Toxic Substances and Disease Registry, Managing
Hazardous Materials Incidents, Medical Management Guidelines for Acute
Chemical Exposures, Formaldehyde. Atlanta, ATSDR, 2001.
6. OSHA Fact Sheet 2002.
7. Kranke B. and Aberer W. Indoor exposure to formaldehyde and risk of
allergy. Allergy 55:402-404, 2000.
8. Marsh G., Youk A.O., and Morfeld B. Mis-specified and non-robust
mortality risk models for nasopharyngeal cancer in the National Cancer
Institute formaldehyde worker cohort study. Regulatory Toxicol and
Pharmacol 47:59-67, 2007.
9. Marsh G. and Youk A.O. Reevaluation of mortality risks from
leukemia in the formaldehyde cohort study of the National Cancer
Institute. Regulatory Toxicol and Pharmacol 40:113-124, 2004.
Chairman Miller. Thank you, Dr. Karol.
Dr. De Rosa.
STATEMENT OF DR. CHRISTOPHER T. DE ROSA, ASSISTANT DIRECTOR FOR
TOXICOLOGY AND RISK ASSESSMENT, NATIONAL CENTER FOR
ENVIRONMENTAL HEALTH/AGENCY FOR TOXIC SUBSTANCES AND DISEASE
REGISTRY, CENTERS FOR DISEASE CONTROL AND PREVENTION, U.S.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Dr. De Rosa. Good morning, Chairman Miller and Ranking
Member, Mr. Sensenbrenner, and other distinguished Members of
the Subcommittee. I am Chris De Rosa, and I have been working
for the Federal Government for 28 years. Today I will respond
to the issues posed in your letter of invitation dated February
27, 2008. I would like to note for the record that I am not
here as a representative of ATSDR, but rather as an individual.
I would also like to emphasize that my remarks today and other
stated concerns should no way be construed as a reflection on
many of the highly-talented and motivated, well-intentioned
staff of my agency.
I served as the Director for the Division of Toxicology and
Environmental Medicine at ATSDR from 1991, until 2007. I have a
degree in ecology, Master's degree, and a Ph.D. in biology from
Miami University of Ohio and have held academic appointments at
the Universities of Virginia and Maine over a period of 10
years. Before coming to ATSDR in '91, I worked for the EPA's
Office of Research and Development for 10 years as Branch Chief
and then Acting Director of the Environmental Criteria and
Assessment Office.
I am author or coauthor of over 200 peer-reviewed
publications and have served on the editorial review committees
of over ten professional journals. I have been a charter member
of the World Health Organization Steering Group for Risk
Assessment since 1994. I am a member of the American College of
Toxicology and one of the 180 elected fellows of the Collegium
Ramazzini.
The mission of ATSDR is 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.
There are a range of activities that ATSDR undertakes as a
response to the health mandates outlined in the CERCLA or Super
Fund Legislation. Of these, one of these is a health
consultation, developed as a formal response to time-sensitive
issues as was the case in the aftermath of Hurricane Katrina.
Following the Agency's initial response to this tragic event,
ATSDR was also engaged in ongoing verbal and written
evaluations and discussions for a wide range of information on
behalf of EPA and FEMA.
These included the evaluation of formaldehyde levels in the
air of unoccupied FEMA trailers. In contrast to a health
consultation, such evaluations are more informal, usually
verbal, periodic discussions of available data as it emerges.
Initial discussions regarding sampling protocols and data
collection of formaldehyde in trailers used by EPA, used by
FEMA, and analyzed by EPA began in June of 2006.
Because of the sensitivity of emergency events and
preparedness and other coordination activities, I began a
series of weekly reports in 1999, for all senior staff
including senior agency leadership. These reports summarized
significant events in these often time-sensitive programmatic
areas. The details that we provided regarding the work we did
in support of EPA and FEMA were frequently included in these
reports.
In early December 2006, Dr. Howard Frumkin stated to me I
had not kept him adequately informed of the fact that we were
evaluating samples on behalf of FEMA that were collected by
EPA. I advised Dr. Frumkin that this was a routine
collaboration that has occurred between ATSDR and EPA over a
period of 25 years, especially dealing with time-sensitive
events of environmental contamination. Dr. Frumkin requested
that his name be deleted from the mailing list for these weekly
reports in September of 2007, because he found them to be
unhelpful.
In early December 2006, my division's Emergency Response
Team, ERT, was asked to provide an evaluation of EPA's sampling
data regarding the levels of formaldehyde in unoccupied
trailers. Dr. Frumkin was aware of this evaluation as early as
December 4, 2006. At the specific direction of FEMA, its
attorney for the Office of Legal Counsel, my division's ERT did
not share the evaluation through the usual division review and
approval channels. Instead they provided the drafts of the
consultation to the Director's Office of Preparedness,
Terrorism, and Emergency Response, OPTER. This was done without
my knowledge, and I was unaware of the role of Dr. Frumkin's
office in the oversight of this effort until summer 2007. It
was through this channel that Drs. Frumkin and Sinks provided
review and comment on the draft.
During the period between which--is this indicating my time
is up, Mr. Chairman?
Chairman Miller. No.
Mr. De Rosa. Okay. Thank you. I appreciate that. This was
done without my knowledge, and I was unaware of the role of Dr.
Frumkin's office in the oversight of this effort until summer
2007. It was through this channel that Drs. Frumkin and Sinks
provided review and comment on the draft consultation.
During the period intervening between the point at which
the sampling data was provided to my division's ERT and the
release of the consultation to FEMA on February 1, 2007, Drs.
Sinks and Frumkin provided review and comment on the draft
consultation during this period. At no time did I have any
contact regarding this effort with either FEMA or EPA.
The health consultation was forwarded to FEMA February 1,
2007. I was unaware of this until receipt of the health
consultation on February 27, when a copy of the report appeared
upon my desk. After an initial review of the consultation, I
immediately contacted Dr. Frumkin's office by telephone and e-
mail to state my concerns regarding the limitations of the
consultation. I stated the report failed to address longer-term
health affects, especially the issue that formaldehyde is a
carcinogen. That same day I sent a second e-mail transmitting a
proposed amendment to the consult to address these longer-term
health concerns.
After repeated requests to issue an amendment to the
original consult, I was directed by Dr. Frumkin to forward my
proposed response to Dr. Mark Keim, then acting Director of
OPTER. At this point I concluded that the lead for this effort
resided solely within the Office of the Director, specifically
the Office of Preparedness, Terrorism, and Emergency Response
(OPTER).
I had no further involvement with the FEMA consultation
until late June 2007, when there was a briefing for
Congressional Staff regarding this issue. However, in the
interim I repeatedly cautioned Dr. Frumkin and other senior
staff regarding the issues confronted by the agency in this
matter. For example, on June 1 I wrote to Dr. Frumkin outlining
my concerns in response to a request from FEMA to identify,
``safe levels of exposure to formaldehyde.'' I----
Chairman Miller. Dr. De Rosa, if you could summarize your
testimony.
Mr. De Rosa. Okay. So despite the repeated efforts to bring
these issues to the attention of my management, we had very
little constructive follow-up effort. I recommended that we use
the Health Guidance Values in the toxicological profile for
formaldehyde as a point of departure for any discussion
regarding safe levels.
This was after repeated requests from FEMA to restrict our
evaluations to short-term exposures. I did state that as our
efforts went forward that health interventions must be pursued
to address the clinical manifestations of acute formaldehyde
toxicity. I stated that such clinical signs were harbinger of a
pending public health catastrophe that may be trans-
generational in its impact.
And I stressed the importance of alerting residents to the
potential reproductive, developmental, and carcinogenic affects
of formaldehyde. The response I received was that such matters
should not be discussed in e-mails, since they might be
misinterpreted.
Chairman Miller. Thank you. If you have anything further--
--
Dr. De Rosa. I think I would simply close by saying that I
know that this has been a complicated matter for everyone
involved, that there are often no straightforward answers to
complicated situations. However, I think that we need to invoke
the maxim of public health practice articulated by Bernardino
Ramazzini four centuries ago, that, ``It is better to prevent
than cure.'' And that the precautionary principle should be
invoked in matters of this nature.
Thank you.
[The prepared statement of Dr. De Rosa follows:]
Prepared Statement of Christopher T. De Rosa
INTRODUCTION
Good Morning, Chairman Miller, and Ranking Minority Member Mr.
Sensenbrenner other distinguished Members of the Subcommittee. I am
Christopher De Rosa and I have worked for the Federal Government for 28
years. Today I will respond to the issues posed in your letter of
invitation dated February 27, 2008. I would like to note for the record
that I am not here as a representative of The Agency for Toxic
Substances and Disease Registry (ATSDR) but as an individual scientist.
I would also like to emphasize that my remarks today and other stated
concerns should in no way be construed as a reflection on the highly
talented, motivated and well intentioned staff at all levels of the
ATSDR, as well as the Centers for Disease Control and Prevention (CDC).
At present I serve as the Assistant Director for Toxicology and
Risk Analysis at the National Center for Environmental Health/Agency
for Toxic Substances and Disease Registry, Centers for Disease Control
and Prevention. Previously, I served as the Director, Division of
Toxicology and Environmental Medicine, Agency for Toxic Substances and
Disease Registry (ATSDR) from 1991 to 2007. Prior to my selection as
Division Director, I was the Deputy Associate Administrator for
Science, also at ATSDR.
After receiving my Master's Degree in Ecology and Ph.D. in Biology
from Miami University, Oxford, Ohio, I held academic appointments at
the Universities of Virginia and Maine over a period of ten years.
Before coming to ATSDR in 1991, I worked for the Environmental
Protection Agency's Office of Research and Development (EPA/ORD) for
ten years. With the EPA, I served as Branch Chief of the Chemical
Mixtures Assessment Branch and Acting Director of the Environmental
Criteria and Assessment Office (ORD).
I have been the recipient of the U.S. EPA Bronze Medal four times
and continue to serve on a number of EPA advisory committees. I have
also served in a similar capacity for the Departments of Justice,
Energy, and Defense and other federal agencies, the World Health
Organization (WHO) and a range of foreign countries in Europe, Asia,
South America and Africa. I am an author/co-author of over 200 peer-
reviewed publications and have served on the editorial/review boards of
over ten professional journals.
I have been a charter member of the World Health Organizations'
Steering Group for Risk Assessment since 1994, and I am a member of the
American College of Toxicology, the American Association for the
Advancement of Science, and the Research Society of North America and
other professional organizations. I am one of 180 elected fellows of
the Collegium Ramazzini in the world, a credentialed member of the
Senior Biomedical Research Service (1998-2007) and now am classified as
a ``Distinguished Consultant'' (ATSDR/CDC).
The ATSDR is one of eight operational units within the Department
of Health and Human Services, and is co-located with the CDC in
Atlanta, Georgia.
The mission of ATSDR is ``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.'' It is the primary federal agency that addresses the
health mandates of the Comprehensive Emergency Response, Compensation
and Liability Act (CERCLA) often referred to as Superfund.
ATSDR's mission is remarkably congruent with my own personal
mission statement that is ``to be an advocate for public health by
translating science into public health service and policy.'' My
opinions regarding the range of potential health affects to
Formaldehyde exposure are those articulated in ATSDR's Toxicological
Profile on this substance. ATSDR's Toxicological Profiles on priority
chemicals are peered and publicly reviewed in accordance with the
Superfund Authorization Reauthorization and Amendment Act (SARA 1994).
There are a range of activities and programs that have been
developed to fulfill CERCLA public health mandates. One of these is a
``Health Consultation,'' developed as a formal response to what may be
time sensitive issues as was the case in the aftermath of Hurricane
Katrina, which occurred in August 2005. Following the Agency's initial
response to this tragic event, ATSDR was also engaged in ongoing verbal
and written evaluations and discussions for a wide range of information
on behalf of EPA and FEMA.
This included the evaluation of formaldehyde levels in the air of
unoccupied FEMA trailers. In contrast to a Health Consultation, such
evaluations are more informal, usually verbal, periodic discussions of
available data. Initial discussions regarding sampling protocols and
data collection of formaldehyde in trailers used by the EPA began in
late June of 2006.
Because of the sensitivity of emergency event, preparedness and
coordination activities, I began weekly reports in 1999 for all senior
staff including senior Agency leadership. These reports summarized
significant events in these often, time sensitive programmatic areas.
The details regarding the work we did in support of EPA and FEMA were
frequently reported in these reports.
In early December of 2006, Dr. Howard Frumkin stated to me that I
had not kept him adequately informed of the fact that we were
evaluating air samples from FEMA trailers collected by EPA and in
support of EPA's efforts following Hurricane Katrina. I advised Dr.
Frumkin that this was the product of a routine collaboration between
ATSDR and EPA for approximately 25 years for time sensitive events
involving environmental contamination. These efforts had been reported
frequently in the weekly reports to senior management. Dr. Frumkin
requested that his name be deleted from the mailing list for these
weekly reports in September of 2007 since he found them to be
unhelpful.
In early December 2006, two members of my division's Emergency
Response Team (ERT) were asked to provide an evaluation of EPA's
sampling data regarding the levels of formaldehyde in unoccupied
trailers. Dr. Frumkin was aware of this evaluation as early as December
4, 2006. At the specific direction of FEMA's attorney, these two
members of my division's ERT did not share the evaluation through the
usual division review and approval channels. Instead they provided the
drafts of the consultation to the Director's Office for Preparedness,
Terrorism and Emergency Response (OPTER). However, this was done
without my knowledge and I was unaware of the role of Dr. Frumkin's
office in the oversight of this effort until summer 2007. It was
through this channel that Drs. Frumkin and Sinks provided review and
comment on the draft Health Consultation.
During the period intervening between the point at which the
sampling data was provided to my division's ERT by FEMA's Office of
Legal Council (OLC) on December 4, 2006 and the release of the Health
Consultation to FEMA on February 1, 2007, Drs. Sinks and Frumkin
provided review and comment on the draft consultation. During this
period, at no time did I have contact with either FEMA or EPA on this
issue.
This Health Consultation was forwarded to FEMA on February 1, 2007.
I was unaware of this until the receipt of the Health Consultation on
February 27, 2007, when a copy of the report appeared on my desk. After
an initial review of the Health Consultation, I immediately contacted
Dr. Frumkin's office by telephone and e-mail to state my concerns
regarding the limitations of the Health Consultation. I stated that the
report failed to address longer-term health effects especially the
issue that formaldehyde is a carcinogen. That same day I sent a second
e-mail transmitting a proposed amendment to the consult to address
these longer-term health concerns.
After repeated requests to issue an amendment to the original
consult, I was directed by Dr. Frumkin to forward my proposed response
to Dr. Mark Keim, acting Director of the Office of Preparedness,
Terrorism and Emergency Response. This letter amending the February 1st
consult was subsequently sent to FEMA over the signature of Dr. Mark
Keim on March 17, 2007. At this point, I concluded that the lead for
this effort resided solely within the Office of the Director.
I had no further formal involvement with the FEMA consultation
until late June, 2007, when an impromptu briefing for Congressional
Staff occurred, regarding this issue. However, in the interim, I
repeatedly cautioned Dr. Frumkin and other senior staff regarding the
formaldehyde issue in FEMA trailers. For example, on June 1, 2007, I
wrote to Dr. Frumkin outlining my concerns in response to a request
from FEMA to identify ``safe levels of formaldehyde exposure.'' I
cautioned that since formaldehyde is a carcinogen, it is a matter of
U.S. Federal Government science policy, that there is technically no
``safe level'' of exposure. I wrote that the Department of Health and
Human Services had classified formaldehyde as ``reasonably anticipated
to be a human carcinogen.'' I also wrote that in 1995, the World Health
Organization's (WHO), International Agency for Research on Carcinogens
(IARC) had classified formaldehyde as ``probably carcinogenic to
humans'' while EPA had determined that formaldehyde is a ``probable
human carcinogen.''
I further cautioned that:
<bullet> formaldehyde may be a reproductive and developmental
toxicant;
<bullet> it is a irritant as evidenced by the reported
symptoms of the children in the trailers in Mississippi; and
<bullet> that the overt symptoms would probably trigger
sensitization in some proportion of the population, to varying
degrees in children and others housed in the FEMA trailers.
I also recommended that ATSDR's Health Guidance Values for short-
term, intermediate and long-term exposures to formaldehyde be used in
assessing the hazards posed by formaldehyde in the FEMA trailers. Dr.
Frumkin concurred with my concerns with an e-mail response.
Finally, I wrote that to my knowledge this was the third time that
we had been approached by FEMA requesting that we provide health
guidance on safe levels of exposure to formaldehyde and that we
restrict our evaluation to short-term exposures.
The first instance occurred in the Spring of 2006 when FEMA
requested that I review a draft statement that encompassed only the
short-term health information that had been abstracted from our
Toxicological Profile. I indicated that FEMA had neglected to address
longer-term exposures and indicated that failure to address longer-term
health effects could be misleading.
Subsequently, starting in the summer of 2007, particularly after
Congressional hearings and reports in the media, I repeatedly requested
that we initiate health interventions to interdict these exposures and
mitigate health effects. This was based on reports of acute clinical
signs consistent with formaldehyde toxicity and presented by residents
of FEMA trailers. Most importantly, I pointed to the primal need to
alert the trailer residents regarding all health hazards.
In August 2007, ATSDR began to respond to Congressional requests
for documents related to the FEMA trailers. It was during this time
that I first became aware that the scope and content of the February
1st consult was specifically directed by Dr. Frumkin's office. Drs.
Frumkin and Sinks and senior management of Dr. Frumkin's OPTER, had
reviewed and/or had been made aware of the ongoing evaluation of
sampling data on behalf of FEMA as early as December 2006. Mr. Don
Benkin then Acting Director for OPTER, was involved from the beginning
of this activity dating back to June 19, 2006.
In discussing this issue at the weekly Senior Staff meeting on Aug.
29, 2007, Dr. Frumkin addressed the need for all staff to grasp the
broader public health implications of any request we received from
outside agencies. He indicated that it was a failure of my division's
ERT to take into account the broader implications of the FEMA request
by restricting the review to short-term exposures only (as directed by
FEMA's Office of Legal Council), even though the ERT believed they were
following the instructions issued by Dr. Frumkin's office.
As our efforts in the Gulf Coast Region and elsewhere went forward,
I repeatedly requested (albeit without success), that health
interventions be pursued to address the clinical manifestations of
acute formaldehyde toxicity presented in clinical settings by residents
of the FEMA trailers. I stated that such clinical signs were a
``harbinger of a pending public health catastrophe'' that may be
``transgenerational'' in its impact. I stressed the importance of
alerting the trailer residents to the potential reproductive,
developmental and carcinogenic effects of formaldehyde exposure.
The only response I received was that such matters should not be
discussed in e-mails since they might be ``misinterpreted.'' In March
of 2007, after I reviewed a draft of CDC Director, Dr. Julie
Gerberding's proposed response to Congressman Taylor's letter, I
responded that there was still no mention of carcinogenicity and that
it was not appropriate to compare formaldehyde exposures in trailers to
that of conventional housing.
Based upon follow-up discussions with my ERT staff regarding the
February Health Consultation it was clear to me, Drs. Frumkin and Sinks
provided review and comment on multiple occasions prior to the
development of the Health Consultation and that they must have been
aware of the content and scope of the February 1st consult. I found
this to be deeply troubling since the Emergency Response Team's efforts
were now being identified as the primary basis for Congressional
concerns about the scope and nature of the Agency's conclusions as
stated in the first Health Consultation. Internally, Dr. Frumkin stated
that the ERT should have been aware of the broader implications of the
FEMA request particularly since it involved FEMA's Office of Legal
Council.
On August 10, 2007 Dr. Frumkin assigned to my division the lead to
develop a revised Health Consultation based upon the sampling data
provided by FEMA. On September 19, 2007, I forwarded a draft, but
unedited, revised consultation, to Dr. Frumkin in response to his
comments received the previous day.
At that point the document had been completed to the satisfaction
of three other divisions within ATSDR who had been involved in the
review, data analysis and authorship of the revised consultation. The
following day Dr. Frumkin reassigned the lead to his Office of Science.
The resulting consultation that appeared in October was notable in that
the executive summary was changed to read that health interventions to
interdict exposures and or mitigate health effects should be
``identified'' as opposed to ``identified'' and ``implemented.''
Further, some of the references addressing reproductive and
developmental effects were deleted.
Based upon my concerns, as previously outlined, I wrote a letter on
September 21st addressing these and other issues were based on
important health findings were not being shared with the public. In
this letter I requested a meeting with senior management to identify
``a constructive path forward.'' Drs. Falk, Frumkin, Sinks, and Louise
Galaska met with me on October 5, 2007.
At that meeting, I was asked what I proposed as a constructive path
forward. In response to that question, I stated that it was my hope
that they would provide such guidance, since I had already stated my
concerns in my letter of September 21, 2007. In response, they stated
that they had no guidance to provide. As a result, the meeting was
adjourned within 15 minutes and I was told by Dr. Frumkin that he would
provide a written response to my letter.
After my September 21st letter to Dr. Frumkin, my evaluation, which
was scheduled for October 4, 2007, was then deferred until October 22,
2007. The meeting was then rescheduled three different times.
Originally it was scheduled to be at 7:30 AM, then at 4:00 PM and then
finally at 3:00 PM. Drs. Frumkin and Sinks knew that I was preparing to
leave on international travel within the next hour of the appointment
scheduled 3:00 PM. The proposed evaluation of my performance was not
presented to me for review five days in advance in accordance with
Agency guidelines and policy. Due to complications in preparing for my
travel, the evaluation was done telephonically, as it was done in the
previous evaluation cycle. I was told that my evaluation was
``unsatisfactory.'' When I asked why, I was told that I was not a
``team player.''
Subsequently my written evaluation was presented to me by Dr.
Frumkin three minutes before the beginning of the Ramazzini Award
Ceremony and Presentation in Carpi, Italy. This was done in a public
forum, in the presence of my father, who attended the meeting as my
guest, as well as colleagues with whom I was seated near the front of
the auditorium. At that same time, Dr. Frumkin also presented me with a
memorandum stating that I was being removed from my position as
Division Director. This memorandum stated that I was being reassigned
to a position that had no job description until December 20, 2007.
Since this was the first day of my annual holiday leave, I did not
receive the written job description until January 7, 2008 when I
returned to work. My office was moved in November 2007; in December
2007 and again in February 2008 involving three offices and two
geographic locations.
In summary, I was removed from my position after 16 years of
superior performance and having met or exceeded 95 percent of all of my
division's performance objectives in the past three years. In 2006, an
independent year long external peer review of all division activities
concluded that my former division was ``meeting an important national
need,'' that our Division's consensus based ``goals and objectives''
were consistent with this ``national need and the mission of the
Agency'' and was ``performing at a high level.''
As a voting member of the credentialing committee for the Senior
Biomedical Research Service since 1998, one of 180 elected Fellows of
the Collegium Ramazzini, and having served on the editorial boards for
over 10 professional journals, I know that scientists can make
mistakes. However, the only rationale provided to me at the time of my
evaluation was that I was not a ``team player.'' There were no written
narratives associated with the evaluation presented to me in Italy,
addressing the rationale for the elements in my performance plan that
were rated as unsatisfactory.
As documented in my curriculum vitae, I have served as an expert
witness on behalf of the U.S. Government on multiple occasions (in
which the government prevailed). I currently serve on approximately 25
committees of national and international significance and have served
as author or co-author on approximately 200 publications. I have made
numerous invited and plenary presentations on behalf of multiple
organizations, including: the National Academy of Sciences, the
Institute of Medicine and the National Institutes of Health, The EPA,
and the WHO. Nevertheless, in Dr. Frumkin's response to my September
21st letter, he maligned my technical ability, communication skills,
managerial competence and my professional reputation.
The issues addressed in my testimony today, as well as others
conveyed in my September 21, 2007 memo to Dr. Frumkin presented me with
a profound professional dilemma. In addressing this dilemma, I recalled
a framed document entitled The Centers for Disease Control and
Prevention's ``Pledges to the Citizens of the United States'' which was
displayed in my former office. One of the five points in this pledge,
that served as a key point in my own deliberative process was that ``We
will place the benefit to society above the benefits to the
institution.'' I also recalled the first time when I was undergoing the
background investigation for top secret security clearance several
years ago. The best advice I was given was to ``speak the truth even
when it hurts.'' Finally, I recalled the central core of public health
practice and environmental medicine first articulated by Bernardino
Ramazzini four centuries ago. ``That it is better to prevent than
cure.'' This is what I have attempted to do addressing the FEMA
trailers issue. This is what I am continuing to pursue in this and
other matters.
In addition to the FEMA consultation, my letter of September 21,
2007 also addressed the Great Lakes Report and the presence of the
carcinogen 1,4-Dioxane in baby shampoos, bubble bath and approximately
30 percent of cosmetic products. These were the three issues that were
addressed in Dr. Frumkin's response to my letter, and that were used to
justify my unsatisfactory rating. I pursued these issues because I
believe important public health information, that had been vetted in
accordance with all Agency review and clearance procedures, was being
withheld from the public. Accordingly, it was not available to promote
the best informed public health decisions by citizens, community
leaders, health care professionals and those responsible for the
oversight of public health more generally.
Given the visibility of my former position within the Agency, and
what had been viewed as a respected contribution to the Agency's goals
and mission, my removal, which closely followed my attempt to speak the
truth to authorities, sends a chilling message, not only to other
Agency employees, but to all federal employees and more importantly
those dependent upon support from our nation's federal agencies.
Citizens of the United States who pay for the services provided by
these agencies should benefit from the best possible scientific
information in a timely, responsive, and responsible fashion. Because
of my commitment to this concept, it is my ardent desire to be
reinstated to my former position as Director of the Division of
Toxicology and Environmental Medicine which has been the very heart of
my professional career.
I would like to express my sincere thanks to the Members and staff
of this subcommittee for their time and attention concerning these
matters.
Biography for Christopher T. De Rosa
Born: Cincinnati, Ohio, June 18, 1949.
Married (28 years), four children (ages 27, 24, 21, 18).
EDUCATION:
B.A. Ohio Wesleyan University, Delaware, Ohio, 1971 (Pre-professional).
M.S. Miami University, Oxford, Ohio, 1974 (Ecology).
Ph.D. Miami University, Oxford, Ohio, 1976 (Biology).
CERTIFICATION:
Credentialed Distinguished Consultant (2007-present)
Credentialed Member of the Senior Biomedical Research Service (SBRS).
ATSDR/CDC (1997-2007)
Security Clearance: Top Secret
Elected Fellow of the Colloquium Ramazzini (1995-present)
POSITIONS:
2005-Present
Director, Division of Toxicology and Environmental Medicine, Agency for
Toxic Substances and Disease Registry, Atlanta, Georgia.
Duties: As below and
1. Coordinates professional development programs across ATSDR and with
external partners.
2. Develops educational materials in support of Environmental
Medicine.
1992-2004
Director, Division of Toxicology, Agency for Toxic Substances and
Disease Registry. Atlanta, Georgia.
Duties:
1. Development and implementation of an integrated program of
toxicology, encompassing the listing and prioritization of hazardous
materials identified at National Priorities List Sites, a critical
assessment of the available world literature on priority chemicals, and
identification of priority data needs.
2. Supervise a scientific and technical support staff of 60
individuals in three Branches, two Sections and the Office of the
Director, and 12 on site contractors.
3. Direction of strategic planning for implementation of applied
research.
4. Coordination of programs with the EPA, NTP, WHO, IPCS, and NIEHS,
the public, the private sector, and other interested parties.
5. Development and implementation of ATSDR's emergency response,
preparedness, and prevention programs based upon peer review research
findings and scientifically sound decision support methods.
6. Coordinates professional development programs across ATSDR and with
external partners.
7. Develops educational materials in support of environmental
medicine.
Reason for leaving: Reorganization
1991-1992
Deputy Associate Administrator for Science and, Acting Director,
Division of Toxicology, Agency for Toxic Substances and Disease
Registry. Atlanta, Georgia.
Duties:
1. Direct and manage the technical planning and implementation of a
scientific health risk assessment and related methodology research
program for the agency.
2. Provide leadership for the agency's determination of public health
action levels.
3. Provide leadership and agency-wide coordination and evaluation of
the agency's risk assessment activities.
4. Share with the Associate Administrator responsibility for
developing and implementing research plans and science policy for the
agency, including: interagency liaison (CDC/NIH/EPA), five-year
research plans, liaison with WHO, United Nations, coordination of
research with other relevant programs, quality assurance strategy for
research activities, and management of the agency's Board of Scientific
Counselors.
5. Serve as agency spokesperson in matters of science, especially
regarding risk assessment and exposure action levels.
Reason for leaving: Selection as Director, Division of Toxicology.
Agency for Toxic Substances and Disease Registry, Atlanta, Georgia.
1989-1991
Acting Director, Environmental Criteria and Assessment Office. United
States Environmental Protection Agency. Cincinnati, Ohio.
Duties:
1. Responsible for the oversight of the technical planning and
implementation of a scientific health risk assessment and related
assessment methodology research program. This includes responsibility
for the oversight of approximately 40 technical staff and an annual
budget of five million dollars.
2. Provide leadership for the establishment and operation of the
administrative/resource management/supervisory and scientific/technical
support systems and office infrastructure necessary for the daily
operation of the office.
3. Provide scientific leadership to the ECAO office, and also to the
Office of Health and Environmental Assessment, Office of Research and
Development, and other EPA offices in the area of health risk
assessment and research to insure the technical quality of activities.
4. Function as a senior scientist, manager, and policy-making official
of the Office of Health and Environmental assessment, Office of
Research and Development, and EPA and represent these organizations in
appropriate professional, scientific, regulatory, public health, and
public policy-making activities.
Reason for leaving: Growing Interest in Public Health Practice and
Policy.
1986-1989
Branch Chief: Chemical Mixtures Assessment Branch, Environmental
Criteria and Assessment Office. United States Environmental Protection
Agency. Cincinnati, Ohio.
Duties:
1. Planning and coordination of office activities in support of
Superfund (CERCLA) and Solid Waste (RCRA) legislative mandates.
2. Group leader of ECAO scientists with the specific mission of
providing scientific and technical expertise assessment of chemical
mixtures.
3. Oversight of authorship, review of methods and technical reports in
the fields of ecotoxicology and health effects assessment.
3. Provision of technical advice to public and private sector
scientists.
Reason for leaving: Promotion
1985-1986
Acting Branch Chief: Chemical Mixtures Assessment Branch, Environmental
Criteria and Assessment Office. U.S. Environment Protection Agency.
Cincinnati, Ohio.
Duties: As above
1984-1985
Group Leader, Chemical Mixtures Assessment Group, Environmental
Criteria and Assessment Office, U.S. Environmental Protection Agency,
Cincinnati, Ohio.
Duties: As above but without budgetary responsibility.
Reason for leaving: Promotion
1982-1984
Assistant Professor of Botany/Zoology. University of Maine, Oromo,
Maine.
Duties:
1. Development of introductory biology lectures (enrollment 1,500
students/year, 20 graduate teaching assistants).
2. Development of introductory biology laboratories.
3. Participation in team taught courses and seminars for undergraduate
and graduate students.
4. Design, implementation and funding procurement for research
projects, publications in appropriate journals, presentations at
professional meetings, and supervision of student research.
Reason for leaving: Recognized impact of environmental programs on
human health.
1980-1982
Environmental Health Scientist/Ecologist, Environmental Criteria and
Assessment Office, U.S. Environmental Protection Agency, Cincinnati,
Ohio.
Duties:
1. Provide office expertise on health and ecological effects of
environmental pollutants.
2. Document manager, contributor for 11 water qualifies criteria
documents.
3. Preparation of other criteria documents, hazard profile summaries,
scientific and technical assessment reports, risk assessment methods
for single chemicals and complex mixtures, and special reports.
4. Project officer on contracts pertaining to the effects of
environmental agents on health and the stability of exposed ecosystems;
ensure the adequacy of extramural scientists' reviews and evaluations,
review drafts for scientific and technical accuracy, assure conformance
to agency policy, and make revisions and modifications as necessary.
Reason for leaving: Interest in teaching and basic research.
1977-1980
Assistant Professor, Department of Biology, University of Virginia,
Charlottesville, Virginia.
Duties:
1. Development and delivery of introductory biology lectures
(enrollment 1,000 students/year.
2. Development and delivery of additional courses in Genetics, Cell
Physiology, and Biochemistry, Behavioral Ecology and Specialty Seminars
for advanced students.
3. Design, implementation, and funding procurement for research
projects, publications in appropriate journals, presentations at
professional meetings and supervision of student research.
Reason for leaving: A growing interest in applied aspects of ecological
and environmental health research.
1976-1977
Instructor, Department of Biology, University of Virginia,
Charlottesville, Virginia.
Duties:
1. Lecturing in introductory biology.
2. Supervision, development, and coordination of undergraduate
laboratories, including equipment, experiments, demonstration
materials, organizational format and staff.
3. Initiation of personal research program in applied ecology.
4. Development of Advanced Placement (AP) Curriculum for High School
Biology in State of Maine.
Reason for leaving: Promotion.
1975-1976
National Science Foundation Research Fellowship, Department of Zoology,
Miami University, Oxford, Ohio.
Duties:
Design and implementation of environmental research projects. These
responsibilities included the development of equipment, definition of
research aims, utilization of computer programs for statistical
analysis of data, and publication of results.
Reason for leaving: Graduation and faculty appointment at University of
Virginia.
1973-1975
Teaching Assistantship, Department of Zoology, Miami University,
Oxford, Ohio.
Duties:
Preparation and implementation of undergraduate and graduate biology
laboratories in biochemistry, zoology, physiology, and ecology.
Reason for leaving: Research appointment.
1972-1973
Laboratory Assistant, Laboratory Assistant, Miami University, Oxford,
Ohio.
Duties:
Preparation of solutions and laboratory materials for use by students.
Reason for leaving: Teaching appointment.
HONORARY AND PROFESSIONAL ORGANIZATIONS:
American Society of Integrative and Comparative Biology.
American Association for the Advancement of Science.
Animal Behavior Society.
Ecological Society of America.
Society of the Sigma Xi (Scientific Research Society of North America).
Society for Risk Analysis.
American College of Toxicology.
Elected Fellow, Collegium Ramazzini.
Credentialed Member of the Senior Biomedical Research Service, CDC/
ATSDR.
New York Academy of Sciences.
Society of Occupational and Environmental Health.
Discussion
Chairman Miller. Thank you, Dr. De Rosa.
The Chair now recognizes himself for five minutes, and the
Chair may call time, but the Chairman will try to do it more
gently than to sound a horn to let either Members or witnesses
know that their time has expired.
Safe Formaldehyde Exposure Levels
Dr. De Rosa, it does appear that there was testing at
various points, first by the Sierra Club, then by FEMA, that
there were different standards for safe exposure or concern
from exposure, and that this particular exposure didn't fit
neatly into some standard. But based upon the testing that had
already occurred by February of 2007, and despite the fact that
there wasn't a specific standard in existence for these
particular circumstances, did you, do you think that the ATSDR
and CDC knew enough in February 2007, to know that there was
something to worry about?
Dr. De Rosa. I think that the reports in the media and
elsewhere were strikingly consistent with the health affects of
formaldehyde. I felt that the level that had originally been
used was not an appropriate level, that the levels I referred
to just recently were many times lower than that, .008 parts
per million. If people were going to be there for a period of a
year or longer, less than that, perhaps .03 parts per million.
Those would have been the values that I would have insisted be
included in such a consultation as a point of departure looking
at the other parameters that may govern exposures and the
health effects of formaldehyde in the situation presented by
the trailers.
Chairman Miller. Dr. Karol, do you have anything to add on
that topic?
Dr. Karol. Yes. There are other agencies in other countries
that have established guidelines for safe indoor air. One of
them is the Canadian health concern, and they established 0.1
ppm as safe for indoor air, WHO recommends a level of .12 ppm,
so these are all very consistent that this should have been the
safe level and that this should have been measured in the
trailers, see what the levels actually were.
ATSDR Review Process
Chairman Miller. Thank you. Dr. Frumkin, you said in your
testimony that you were not here to--excuse me. Dr. De Rosa.
You said in your testimony you were not here testifying on
behalf of ATSDR. I do think that is abundantly clear. In the
early stages of our investigation there was some suggestion
that there was actually a conscious effort to exclude you from
the review chain for the report, and your superiors adamantly
deny because they knew what your position would be. Your
superiors adamantly deny that is the case, and they say that
they put into place expedited review procedures because of the
urgency surrounding Katrina and Rita. And I certainly applaud
the government trying to act quickly on its feet when
circumstances require that.
But were you part of, did you design the review procedures
that excluded you, that did not include you in the review?
Dr. De Rosa. I did not.
Chairman Miller. Okay. Did you review, in fact, review this
report?
Dr. De Rosa. I did not review the February 1 consultation
at all.
Chairman Miller. Okay. And when did you first see it again?
Dr. De Rosa. February 27.
Chairman Miller. And how quickly after that did you, when
did you do something, if ever?
Dr. De Rosa. Upon reading the report I called the Office of
the Director, I spoke with personnel there, and indicated that
we had a significant issue with this document because it was
incomplete and perhaps misleading. I followed that up with an
e-mail to that effect. I then rapidly drafted a proposed
amendment, pointing out that there was a concern regarding the
longer-term health affects that same afternoon and that this
was the letter that could be forwarded over my signature or
forwarded over anyone's signature for that matter to amend our
initial consult.
Chairman Miller. I understand that your superiors both, at
ATSDR both in their interviews with our staff and then their
expected testimony later today, will say that you were
responsible for the work of your team, even though it was not
directly reviewed by you. Do you have a response to that?
Dr. De Rosa. In fact, that was the reason I was most
concerned in my initial review. I felt that our internal
procedures governing the review of any division document had
not been followed and that this was why the consult turned out
as it did. I later learned that that was not the case. I later
learned that this was being dealt with in the aftermath of
Katrina, where staff were tasked as needed, independent of
giving management chain to provide the needed input on a
consultation or other evaluation. Typically, this would have
gone through several levels of review prior to that. Not
knowing the involvement of Dr. Frumkin and Sinks at the time, I
did meet with my staff to reaffirm our standard operating
procedures in clear terms and didn't learn about the other
aspects of the review and clearance process prior to summer of
2007.
Dr. De Rosa's Performance Reviews
Chairman Miller. In the last few months it is apparent that
your superiors at ATSDR have grown to view you as a problem
employee, but I know that the Federal Employment System had
incented bonuses for the best employees, to keep them in
federal employment.
Have you gotten one of those in the past?
Dr. De Rosa. In 2006, I received a very substantial and
generous bonus and salary raise based on my performance.
Chairman Miller. And how much was that?
Dr. De Rosa. It was five percent of my salary as an
increase I believe, and 10 percent bonus.
Chairman Miller. And that was the most recent review before
the one at which you were found to be lacking?
Dr. De Rosa. It was.
Consequences of Inaction: Health Effects of Additional Exposure
Chairman Miller. Okay. For both Dr. Karol--the Chair now
warns himself that he is over his time.
It does appear that the conduct of ATSDR in issuing the
report in February of 2007, and then failing to act with some
urgency when it was very clear that FEMA was continuing to tout
that report as authority for their needing to do nothing more
than what they were doing, may have delayed, may very well have
delayed moving people out of the trailers for a year.
Some people have been in the trailers for two and one-half
years, some people much less. How much can we calculate or
estimate what difference it might make for the families, for
children, for pregnant mothers, for the older folks to have had
an additional year of exposure to formaldehyde fumes?
Dr. Karol.
Dr. Karol. The important thing to do now is to track those
people to get good records and to have a health assessment so
that you have got good data to evaluate in the future, and it
is difficult to evaluate what the effect might have been. But,
you know, right now what you can do is to track the people, get
them evaluated, and get the trailers evaluated as well.
Chairman Miller. Dr. De Rosa.
Dr. De Rosa. I would agree. I think that what we refer to
as a health registry of those individuals who had been exposed
throughout that period should be instituted to the extent that
it can be so that the people can be followed through time.
Because we know many of the affects that Dr. Karol referred to
have a latency of 10 to 20 years. And so this is something that
may not manifest itself for a period of time. We do know that
people have already been clearly affected by the reports of
sensitization and as well as the other classic signs of acute
formaldehyde toxicity.
Chairman Miller. The Chair's time has expired.
The Chair now recognizes Ms. Eddie Bernice Johnson for five
minutes.
Protecting the Public
Ms. Johnson. Thank you very much, Mr. Chairman.
Dr. De Rosa, the mission of your agency is to be protective
toward the public with scientific information, isn't it?
Dr. De Rosa. Yes, ma'am.
Ms. Johnson. Do you feel confident that your agency is
fulfilling that mission?
Dr. De Rosa. I believe that there are many ongoing efforts
that meet that criteria of protecting the public's health. I
believe in some areas, and again, I am speaking personally, not
for my agency----
Ms. Johnson. Uh-huh.
Dr. De Rosa.--that perhaps a more precautionary approach
could be taken in dealing with the uncertainties that surround
many of these types of unfortunate incidents that occur
throughout our country and elsewhere.
Ms. Johnson. Is there a procedure by which once information
is gained and it is, it lends itself to being a rather negative
about what is going on, how is it received by the leadership of
the agency?
Dr. De Rosa. There have been many instances in which such
concerns have been raised and have resulted in the development
of health alerts that are, again, developed in coordination
with other agencies and placed on our website and duly noted.
In other instances there seems sometimes I would suggest a
reluctance to deal with things such as multiple chemical
sensitivity.
Ms. Johnson. Uh-huh.
Dr. De Rosa. My own view is that we should be addressing
this issue, agreeing on what we know, agreeing on what we don't
know, and identifying how to deal with the latter.
More on Long-term Health Tracking
Ms. Johnson. When you arrive at a position that there is
some question about the effects of an environment or whatever,
and perhaps a person is exposed, need to be tracked, how is
that handled?
Dr. De Rosa. Generally speaking when we have a group of
individuals that have been exposed, we will attempt to follow
those individuals through time to identify subsequent health
issues that they may experience.
Ms. Johnson. Do you know whether or not this has been
instituted with Katrina victims?
Dr. De Rosa. To my knowledge it has not been, but I believe
it is being considered, and I would think that it would be an
appropriate path forward.
Ms. Johnson. Well, thank you very much.
Dr. Karol, being an expert on toxicology, I noticed that
you just mentioned that some tracking would probably bring
forth future information. Do you feel that your consultation
with the ATSDR has been useful?
Dr. Karol. Well, I think that there has to be a systematic
approach in the future to document who is living in the
trailers, what the conditions are, what are the other exposures
in the trailer, and what are the health concerns. I, you know,
I think that is absolutely essential to go forward.
Ms. Johnson. Thank you, Mr. Chairman.
Chairman Miller. Thank you, Ms. Johnson.
The Chair now recognizes not a Member of this committee but
the Chairman of the Environment and Energy Subcommittee, Mr.
Lampson.
Dr. De Rosa Excluded From Past Reviews?
Mr. Lampson. Thank you, Mr. Chairman.
Dr. De Rosa, have you been left out of reviews and other
times, other circumstances do you recall?
Dr. De Rosa. I have not had further involvement with the
ongoing activities regarding formaldehyde in trailers issue,
nor with what was referenced earlier as the report on the Great
Lakes, 26 areas of concern. I have had very limited involvement
since October with reviews of that nature.
Mr. Lampson. What about before that? Were there other times
that you were left out of a review?
Dr. De Rosa. It is hard to know if one has been left out of
a review, but, you know, it is certainly possible, you know. I
would not be aware if I had been left out.
Mr. Lampson. Generally, how have you been treated of late
in the agency?
Dr. De Rosa. My experiences in the last period of months
since October have been complicated. I have been removed from
my position as I mentioned as the Director of the Division of
Toxicology and Environmental Medicine. I have limited
opportunity to interact with my peers in terms of technical
exchange due to my physical relocation on three different
instances since October; October, December, and February. I
have been put on a performance improvement plan as of February
21, as I recall, 90-day period, after which my performance will
be evaluated.
ATSDR Emergency Health Evaluations
Mr. Lampson. I am at a loss of words to follow that
comment, so let me switch. You indicate that you requested that
health interventions be pursued to address the clinical
symptoms that people were experiencing. Are you, are there
protocols of ATSDR in place for dealing with emergency
situations, situations where people are experiencing health
effects and some intervention is needed immediately?
Dr. De Rosa. There are, but I would have to point out that
ATSDR is an advisory and not a regulatory agency, though we do
serve in an advisory capacity to organizations such as FEMA and
EPA. And there are things that have been done in the past, for
example, providing alternative drinking water supplies to
communities whose water has been contaminated. There are also a
range of health education activities that can be pursued that
people can readily invoke that represent relatively low-hanging
fruit. And generally speaking when people are given appropriate
information, they act in the interest of their health.
Mr. Lampson. How typical, I guess that is what I am trying
to understand, how typical the situation is that or has been at
your agency? It seems poor science was converted to poor
information that, and the result was inaction. And I would add
that the process took far too long to provide an emergency
response. So how do we fix this?
Dr. De Rosa. The initial response of the agency was very
proactive. We had individuals deployed in the field prior to
Katrina. We had stood up the range of resources available to us
and had participated extensively in some of the initial
triaging of people that were affected by Hurricane Katrina. I
think the issue becomes what happens in the longer-term
aftermath of these events.
What do we do to take into account that something that
happens in a very short timeframe for a very--at an extended
level of exposure, perhaps. How do we track those individuals
longer-term to understand what the longer-term consequences
might be? And what interventions might be pursued to minimize
any consequences of those acute exposures?
More on Reproductive Health
Mr. Lampson. Are you aware of whether or not any of this
can be passed onto future generations?
Dr. De Rosa. Well, I did say that there were, potentially
trans-generational impacts. That means in my mind that the
developing fetus may well be affected by this, that there may
well be reproductive developmental outcomes that would be
evident in the children perhaps not yet born. That is an area
in which there is some scientific debate. It is important to
note that while the debate occurs that these reports have been
described as inconsistent as opposed to contradictory,
inconsistent means that because of the variable nature of the
different studies that have been done, different findings will
be reported by different studies at different points in time
using different protocols. But the International Agency for
Research on Carcinogens from a consult on occasion has
indicated that the evidence in this case is suggestive but
inconsistent.
Mr. Lampson. My time has expired. I have other questions. I
will submit them for the record, and I think that it would be--
I want to say that we appreciate the service that you have
given to us and your willingness to stand up and speak about
the things that you believe so strongly in. We need more people
like you, not fewer.
Thank you very much. I yield back my time.
Deficiencies in the February 2007 Health Consultation
Chairman Miller. Thank you. Just one question on
clarification.
Dr. Karol, the reason we have asked you to be a part of
this panel is that you are obviously an expert in toxicology,
and you were not involved in this in any way. And we are, we
expect you to be a neutral witness. You don't have a dog in
this fight except the public health generally.
When you reviewed the February, 2007, health consultation,
how much research, how much thought, how apparent was it to you
was required, how much, how apparent was it to you that there
was some deficiencies in that consultation?
Dr. Karol. The best way to answer that was to, is to say
that after I read that consultation, I immediately went into
literature to see what else was known, because it seems
insufficient as far as its coverage of long-term chronic
effects. And as far as its coverage of sensitive, asthmatic
individuals, hypersensitivity, allergic sensitivity so that,
you know, I think it could have been done in a much more
thorough manner. And it should have been done. There is a lot
in the literature as far as reviews from the National Research
Council, from the WHO, from numerous groups that have looked at
formaldehyde as far as long-term consequences. And I don't
think that is reflected adequately in the ATSDR document.
Chairman Miller. Well, I still, I am not quite clear. Did
you put the consultation down and say, well, that sounds right,
but let me do a little research and see what the other
literature says? Or did you put it down and say, and think to
yourself, this just doesn't ring true?
Dr. Karol. Well, parts of it I said, there has got to be
more than this, and this isn't what sounds right to me, and
that is why I went into the literature. Parts of it covering
the acute effects, I think they tried hard to look at what was
known but did not do a sufficient job.
So I think it really falls down in the area of chronic
effects, possible reproductive effects, possible carcinogens in
someone.
Chairman Miller. Dr. De Rosa, I want to join in--you can
relax. I don't have any more questions, but I want to join in
what Mr. Lampson has said. It is not second nature for many
managers to value whistleblowers. There is some tendency to see
them as insubordinate, as disloyal to their superiors. But the
loyalty we expect is a loyalty to the mission of the agency,
the loyalty to the mission to protect the public health, and we
appreciate your willingness to step forward and say that when
that, you think that the agency is not faithfully serving that
mission.
So we so value, we do appreciate whistleblowers, and would
be deeply disappointed if you had adverse employment
consequences as a result of blowing the whistle on conduct that
we needed to know about.
You may. You don't have to but you may.
Dr. De Rosa. Just briefly I would comment that in
struggling with what was a dilemma for me in pursuing this
issue, I referred to a plaque that hung on my wall that was a
pledge to the citizens of the United States by the CDC at that
time in 1990. One of the elements, five elements was that we
will put the benefits to society above the benefits to the
institution, and so that is what I tried to do.
Chairman Miller. Thank you, Doctor. This, we have now
completed this panel. We will again take a two-minute break
before beginning the next panel. Thank you.
[Recess.]
Panel III:
Chairman Miller. I would now like to welcome our third
panel, our final panel. Dr. Howard Frumkin is the Director of
the National Center for Environmental Health in the Agency for
Toxic Substances and Disease Registry, the Centers for Disease
Control, the ATSDR. Dr. Frumkin is joined by Dr. Tom Sinks, the
Deputy Director at the National Center for Environmental Health
at the ATSDR, and our final witness is Vice Admiral Harvey
Johnson, Jr., the Deputy Administrator of the Federal Emergency
Management Agency, FEMA.
You each have five minutes for your spoken testimony, your
oral testimony. Your written testimony will be included in the
record. When you complete your testimony, we will begin with
questions, and each Member will have five minutes to question
the panel. It is the practice of the Subcommittee to take
testimony under oath. Do any of you have an objection to
swearing an oath, being sworn in? You also may be represented
by counsel. Do any of you have counsel in this hearing today?
The witnesses have all said that they do not object to swearing
an oath, and they have no counsel with them. Would you please
all now stand and raise your right hand?
[Witnesses sworn]
Chairman Miller. Thank you. The witnesses have all entered
into the oath.
Dr. Frumkin, I understand that you will be reading a joint
statement for yourself and Dr. Sinks. You may begin.
STATEMENT OF DR. HOWARD FRUMKIN, DIRECTOR, AND DR. THOMAS
SINKS, DEPUTY DIRECTOR, AGENCY FOR TOXIC SUBSTANCES AND DISEASE
REGISTRY, AND NATIONAL CENTER FOR ENVIRONMENTAL HEALTH, CENTERS
FOR DISEASE CONTROL AND PREVENTION, U.S. DEPARTMENT OF HEALTH
AND HUMAN SERVICES
Dr. Frumkin. Good morning, Chairman Miller, other
distinguished Members of the Subcommittee. Thank you for the
opportunity to be here today. I am Dr. Howard Frumkin, Director
for the Centers for Disease Control and Prevention's National
Center for Environmental Health and the Agency for Toxic
Substances and Disease Registry. I am accompanied, as the
Chairman said, by Dr. Thomas Sinks, Deputy Director of NCEH/
ATSDR. We share with the Committee a firm commitment to strong
science, to public health protection, and to good government.
We recognize the need to be accountable. Perhaps most
importantly, we know that the tens of thousands of people
throughout the Gulf Region who suffered through the 2005
hurricanes and then lived for too long in structures not
intended for long-term residence deserve our very best. We have
accomplished a great deal in protecting public health, and I
welcome the opportunity to describe our work. I will do so in
three parts.
First, in our overall response to Hurricanes Katrina and
Rita, we did a great deal to protect public health. Hundreds of
CDC and ATSDR staff were deployed to the Gulf Region, and
hundreds more back in Atlanta supported their work. Setting
aside our general public health work and focusing on
environmental health alone, we helped restore safe drinking
water and safe food; we helped evaluate all superfund sites in
the damage zone for hazardous conditions; we mapped and
assessed industrial facilities to identify hazards; we
protected the public from carbon monoxide poisoning linked with
generator use; we investigated mold in buildings and protected
the public from that hazard; we assessed hospitals, clinics,
schools, and other facilities and cleared them for re-entry as
appropriate; and we assessed dozens of sets of environmental
sampling data for health risks. Our work was extraordinarily
effective and successful in protecting public health.
Second, with respect to the specific focus of today's
hearing, formaldehyde exposure in FEMA-supplied trailers and
mobile homes, as I have previously acknowledged, our initial
work could have been better. In retrospect, there were
indications of a formaldehyde problem as early as the first
half of 2006, and we could have engaged the issue earlier and
more aggressively. Our initial work product, our February 2007
report on formaldehyde in unoccupied trailers was narrowly
focused, used an inappropriate level of concern, and did not
deliver a sufficiently clear and complete public health
message. The steps we took to rectify the report, while
ultimately successful, took several months to complete, longer
than they should have.
Our initial formaldehyde work did not meet our own
standards of excellence. We have carefully reviewed the factors
that contributed, and we have taken concrete corrective
actions. Some were immediate. For example, since irregular
communication between FEMA and our agency contributed to the
problem, we clarified with our own staff and with FEMA the
appropriate channels of communication. Other corrective actions
are ongoing, a review by our expert external Board of
Scientific Counselors of our scientific clearance procedures,
and an external review of our management procedures. I regret
that our initial work on formaldehyde in trailers did not meet
our own expectations. I am confident that we have learned
important lessons, that we are acting on those lessons, and
that we will be an even stronger, more effective agency moving
forward.
Third, I wish to update the Subcommittee of our ongoing
work on formaldehyde in trailers. Our portfolio is broad and
deep.
Our study of 519 occupied trailers whose results are shown
on the graphic provide the most solid evidence to date that
formaldehyde levels were high. These data led to action, FEMA's
decision to relocate trailer residents to more permanent
housing and to discontinue the use of travel trailers. Our
study of trailer structures with Lawrence Berkeley Laboratory
is examining what features of trailers contribute to
formaldehyde emissions. A remediation study with NASA is
examining technologies that could lower formaldehyde levels.
Our clinical record review of children in Mississippi will help
clarify respiratory health implications of the hurricane
aftermath including living in trailers. A long-term cohort
study of children who resided in trailers will yield extensive
data on the health implications of that experience. We will
work with FEMA to create a registry of trailer registrants to
facilitate follow-up and tracking over time as was discussed in
the earlier panels. Our expert panel continues to meet to
review our science and to advise us on our work. Our extensive
communication effort continues our outreach to the public with
health information. We are updating our toxicology profile on
formaldehyde, and we have engaged other agencies to move toward
long-term coordinated approaches to safe, healthy manufactured
housing. This is a record of active, sustained, successful
protection of public health.
We share with the Members of the Subcommittee a common
goal, to serve the public and to bring to bear the best science
in doing so. As public servants, we are accountable for
achieving this goal. I am very proud of our overall efforts to
protect public health following Hurricanes Katrina and Rita,
including our more recent efforts relating to formaldehyde. I
recognize that in some respects we could and should have done
better. We welcome the oversight of the Committee as we strive
constantly to improve, and we stand ready to cooperate as we
move forward.
Thank you.
[The prepared statement of Dr. Frumkin and Dr. Sink
follows:]
Prepared Statement of Howard Frumkin and Thomas Sinks
Good morning Chairman Miller, Mr. Sensenbrenner, and other
distinguished Members of the Subcommittee. Thank you for the
opportunity to be here today. I am Dr. Howard Frumkin, Director of the
Agency for Toxic Substances and Disease Registry (ATSDR) and the
Centers for Disease Control and Prevention's (CDC's) National Center
for Environmental Health (NCEH). ATSDR and CDC/NCEH are separate
Department of Health and Human Services agencies that are managed
jointly from an administrative perspective. I am accompanied by Dr.
Thomas Sinks, Deputy Director of ATSDR and CDC/NCEH.
I am a physician with 26 years of experience in environmental and
occupational medicine and epidemiology. I have been Director of NCEH/
ATSDR since September 2005. Previously, I served as chairman of the
Department of Environmental and Occupational Health at Emory
University's Rollins School of Public Health and professor of medicine
at Emory Medical School. Dr. Sinks is a career CDC epidemiologist,
having served in scientific and leadership positions for more than 23
years.
We share with the members of the Subcommittee a common goal--to
serve the public, and to bring to bear the best science in doing so. As
public servants, we are accountable for achieving this goal. I am very
proud of our overall efforts to protect public health following
Hurricanes Katrina and Rita, including our more recent efforts related
to formaldehyde in Federal Emergency Management Agency (FEMA)-provided
travel trailers, park and mobile homes (hereafter referred to as
trailers). I recognize that in some respects we could and should have
done better. There are key lessons to be learned, and we have taken
important steps to ensure that our current and future work reflects
those lessons we have learned. Our testimony will focus on three areas.
First, I will provide an overview of NCEH/ATSDR activities and
accomplishments related to Hurricane Katrina in general and
formaldehyde and FEMA-provided trailers in particular.
Next, I will discuss events leading to the original (2/07) ATSDR
health consultation and management decisions during this period, and
describe measures we have taken to ensure that as we move forward our
work reflects lessons learned.
Finally, I will summarize CDC/ATSDR ongoing and future scientific
endeavors to further expand our understanding of, and ability to
address, public health impacts of formaldehyde in FEMA-provided
trailers.
Overview: NCEH/ATSDR Accomplishments and Activities Regarding Hurricane
Katrina, Formaldehyde, and Health
Under the leadership of the CDC Director's Emergency Operations
Center, CDC and ATSDR took a wide range of actions to protect the
public against even greater health impacts from devastation caused by
Hurricanes Katrina and Rita. Our Agencies' contribution to the broader
disaster response included----
<bullet> Deploying hundreds of CDC and ATSDR staff to the Gulf
Coast region to provide hands-on technical support.
<bullet> Staffing emergency response operations with several
hundred full-time staff to manage and triage requests for
assistance from state and local health departments and other
local partners.
<bullet> Taking measures to ensure early detection of possible
epidemics of infectious diseases and providing real-time
guidance on how to control and prevent future outbreaks.
<bullet> Monitoring the health needs of people in shelters and
providing printed public health education information.
<bullet> Protecting the health of emergency responders.
<bullet> Evaluating vaccination needs and practices.
<bullet> Supplying materials and medications through the
National Pharmaceutical Stockpile.
<bullet> Providing up-to-date communication materials to
health professionals, the media, and the public.
NCEH/ATSDR served as the CDC/ATSDR lead for environmental health
aspects of the response to Hurricanes Katrina and Rita. The list below
provides several examples of NCEH/ATSDR accomplishments and other
contributions.
<bullet> Supported federal, State and local officials in
restoring environmental public health services (safe drinking
water, food safety).
<bullet> In coordination with the Environmental Protection
Agency (EPA), evaluated all Superfund sites in the area for
hazards and assessed industrial facilities to identify
hazardous conditions related to hurricane damage.
<bullet> Anticipated and assessed well established hazards in
indoor environments related to carbon monoxide poisoning and
mold.
<bullet> Collaborated in assessing numerous community and
individual facilities such as schools to clear them for re-
entry.
<bullet> Conducted state-of-the-art assessment of
environmental sampling data for human health implications and
made health recommendations to federal, State and local health
and environmental officials.
In May of 2007, CDC launched a formal program to address the
formaldehyde health concerns in FEMA-provided trailers. The program is
led by the Director of the Division of Environmental Hazards and Health
Effects within NCEH, with oversight from Dr. Sinks and me. We also
developed an interagency agreement with FEMA to support the NCEH
activities. The program has several components, described below:
<bullet> Expert Panel: We established an expert panel to
obtain individual guidance in developing CDC's methods for
studying aspects of formaldehyde exposure.
<bullet> Study of Occupied Trailers: Through an Interagency
Agreement with FEMA, CDC is conducting a formal study that
included testing formaldehyde levels in 519 occupied FEMA-
provided trailers in Mississippi and Louisiana.
Interim results were announced on February 14, 2008.
The formaldehyde levels in indoor air were higher than
typical (based on recent data) levels of U.S. indoor
exposure in single family homes and apartments.\1\
---------------------------------------------------------------------------
\1\ While this study was not designed to be nationally
representative (for example 75 percent of homes did not have indoor
carpet), these data represent some of the best available recent
information.
Results were presented in person to occupants of
each of the 519 trailers that were tested as part of
the study, with assistance of the United States Public
Health Service Commissioned Corps. FEMA housing staff
---------------------------------------------------------------------------
also participated in these visits.
CDC/ATSDR recommended that individuals and families
be relocated from FEMA-provided trailers in the Gulf
Coast Region before warmer weather returns, based on
these interim findings. We also provided guidance on
setting priorities for relocation.
On March 3, 2008, we released a more detailed
interim report (available on our web site at http://
www.cdc.gov/Features/FEMAtrailersFindings/). The
interim report provides additional findings, including
formaldehyde levels by trailer type and manufacturer.
We expect to issue a final report this Spring. This
report will contain a more detailed analysis than in
the interim report.
<bullet> Communications:
Our communication project team responded to more
than 6,000 calls for information related to
formaldehyde and/or FEMA-provided trailers since July
2007.
More than 1,000 persons attended 15 public
availability sessions in Louisiana and Mississippi to
learn about the results of CDC's formaldehyde sampling
of FEMA-provided trailers.
Health education materials were aggressively
distributed in locations frequented by residents of
FEMA-provided trailers.
New information has been released rapidly and made
available on CDC's web site.
<bullet> A chart review has been conducted of medical records
of children living in Hancock County, Mississippi, in 2005-
2007, for respiratory illness, skin conditions, or
gastrointestinal illnesses. The review is expected to be
completed in the near future.
<bullet> Studies of Unoccupied Trailers: CDC is assessing
formaldehyde levels across different models and classes of
unoccupied travel trailers and mobile homes used by FEMA as
temporary housing. The purpose of this sampling is to identify
factors that may predict high exposure scenarios inside the
units, and to investigate cost effective solutions to reduce
the formaldehyde concentrations. CDC is conducting additional
work:
With the Lawrence Berkeley National Laboratory, to
test components of unoccupied trailers from FEMA's
inventory for off-gassing of formaldehyde.
With NASA, to evaluate potential methods to mitigate
formaldehyde levels in trailers.
To test unoccupied trailers to determine
formaldehyde levels by manufacturer, time of day, and
temperature.
Retrospective Look at the ATSDR Health Consultation
The information below reflects the facts and events as I currently
understand them regarding the February 2007 ATSDR health consultation
and measures we have taken to insure that our work moving forward
reflects lessons learned.
In July 2006, a representative of EPA contacted members of ATSDR's
Division of Toxicology and Environmental Medicine (hereafter referred
to as Division of Toxicology) requesting that ATSDR participate in a
conference call with representatives of FEMA. The purpose of the call
was to discuss EPA's sampling for formaldehyde in FEMA-provided
unoccupied trailers.
After the initial contact, the Acting Deputy Director of NCEH/
ATSDR's Office of Terrorism Preparedness and Emergency Response
(hereafter referred to as Office of Emergency Response), who was also
NCEH/ATSDR's coordinator for Hurricane Katrina-associated actions,
informed Dr. Sinks of the request for ATSDR participation in discussion
with EPA and FEMA regarding EPA sampling of formaldehyde. This request
was handled by staff of ATSDR's Division of Toxicology who routinely
handled emergency requests. At the time, the request for assistance
appeared to be consistent with previous efforts to support EPA in the
aftermath of Hurricanes Katrina and Rita, and Dr. Sinks encouraged
agency involvement.
During the next several months, staff of ATSDR's Division of
Toxicology managed and handled ATSDR's involvement in regular
communications with representatives of FEMA and EPA on this issue.
Specifically, the staff participated in conference calls with EPA and
FEMA concerning sampling plans for measuring formaldehyde levels in
unoccupied trailers. The resulting sampling design involved 96
unoccupied travel trailers newly purchased by FEMA. The specific role
of staff of the Division of Toxicology was to interpret the data
generated by EPA sampling activities in order to: (1) evaluate levels
of formaldehyde measured by EPA in closed, unoccupied trailers; and (2)
determine whether two mitigation strategies (opening windows and
running air conditioning) would substantially reduce formaldehyde
levels. Staff of the Division of Toxicology regularly listed this
project in their routine report of activities distributed through
supervisory and management channels.
EPA sampled the trailers in October 2006, and provided the data to
FEMA on November 17, 2006. FEMA transmitted the data to staff of
ATSDR's Division of Toxicology on December 1, 2006, for analysis. The
data were accompanied by a cover letter from a FEMA attorney who had
participated in the interagency conference calls regarding testing for
formaldehyde in trailers. The letter did not restrict the scope of
ATSDR's analysis or conclusions, nor am I aware of any communication
from FEMA attempting to impose such a restriction.
Upon completion of a draft of the report, Division of Toxicology
staff provided a copy to the coordinating office for response
activities related to Hurricanes Katrina and Rita, the Office of
Emergency Response. Staff from that Office reported this status in
early January 2007 at a routine meeting with Dr. Sinks and me. A
follow-up e-mail from the Office of Emergency Response suggests that I
looked at the draft report during the meeting and noted the absence of
an executive summary and conclusions/recommendations. Following the
meeting Dr. Sinks read the draft and provided handwritten comments on
the hard copy. Those comments were relayed to the Division of
Toxicology staff working on the project and they finalized the
document. In his role as coordinator of our continued response to
Hurricanes Katrina and Rita, the Acting Director of the Office of
Emergency Response transmitted the health consultation to FEMA on
February 1, 2007.
As noted earlier, the focus of ATSDR's analysis was narrow. As
stated in the health consultation, ``FEMA has not requested ATSDR to
evaluate longer-term formaldehyde concentrations in trailers or health
concerns related to potential exposures. ATSDR will be available to
provide assistance if such data becomes available in the future.''
In late February 2007, Dr. Christopher De Rosa, Director of the
Division of Toxicology, notified Dr. Sinks that he had only recently
reviewed the health consultation. Although this project was listed in
regular reports of work in his Division, he stated that he had not seen
the document previously and that it failed to address the potential
long-term health consequences related to chronic exposure to
formaldehyde. The Director of the Division of Toxicology had not raised
this concern to staff in his Division earlier, prior to release of the
report. Regarding health consequences of long-term exposure, I
concurred with this concern once it was raised to me. I encouraged the
Division Director to draft a letter to FEMA highlighting ATSDR's
concerns and clarifying the scope of the health consultation. The
letter, dated March 17, 2007, states:
``I am concerned that this health consultation is incomplete
and perhaps misleading. Formaldehyde is classified as
`reasonably anticipated to be a human carcinogen.' As such,
there is no recognized safe level of exposure. Thus any level
of exposure to formaldehyde may pose a cancer risk regardless
of duration. Failure to communicate this issue is possibly
misleading and a threat to public health.''
During a hearing held by the House Committee on Oversight and
Government Reform in July 2007, a witness questioned the ``level of
concern'' referenced in the February 2007 ATSDR health consultation.
This prompted a careful re-evaluation of the report. That re-evaluation
revealed several issues. First, the report did not make sufficiently
clear that the purpose of the health consultation was very narrow--
characterizing formaldehyde levels in closed unoccupied trailers and
the effect of two mitigation strategies. Second, ATSDR's use of a
``level of concern'' provided a false impression of what constitutes an
acceptable health risk, further contributing to misinterpretation.
Third, the analysis had not examined how formaldehyde levels varied by
manufacturer, time of day, or temperature.
In August 2007, because of these and other issues, Dr. Sinks
recommended that the data be reanalyzed and the report completely
rewritten. I concurred and in October the revised report was released.
Both the original report and the final report remain available on the
ATSDR web site at: http://www.atsdr.cdc.gov/substances/formaldehyde/
public<INF>-</INF>assessment.html
Lessons Learned
CDC/ATSDR recognize that our agencies should have moved more
forcefully to address the emerging concern related to formaldehyde
levels in FEMA-provided trailers, particularly as it became apparent
that people were living in them for longer periods of time, not as a
short-term solution as they had been widely considered in the past. As
Director of NCEH/ATSDR, I accept responsibility for shortfalls in our
response, and for taking steps to prevent similar situations in the
future.
Issue: We addressed formaldehyde exposures too slowly and too
narrowly.
Issue: The initial health consultation fell short of our own
standards.
Lessons Learned/Actions Taken: Hurricane Katrina presented many
scientific and organizational challenges. Through this experience, we
identified gaps in how scientific work is assigned, supervised, and
reviewed.
We have taken responsibility ourselves and have directed all of our
managers to implement several steps to address these issues. These
include:
<bullet> Triaging key assignments to appropriate scientific
staff depending on the content of the request and staff
expertise
<bullet> Providing appropriate scientific and supervisory
oversight of all staff
<bullet> Applying consistent peer review across all divisions
We have also requested that our Board of Scientific Counselors
examine our review and clearance process for all scientific materials,
and we have commissioned an external review of management procedures to
identify opportunities for improvements.
Finally, all of our staff have been asked to make sure that any
contacts with other agencies are directed through the most appropriate
channels to insure consistent and correct communication.
Moving Forward
CDC/ATSDR now recognize formaldehyde in FEMA-provided trailers as
an important public health issue, and have made research in this area a
high priority to which we are devoting a tremendous amount of effort
and are making significant progress. Beginning in May of 2007, before
the hearing that prompted us to revisit the health consultation and
reissue the report in October 2007, and continuing today, NCEH's
Division of Environmental Hazards and Health Effects has been
proceeding with a broad set of formaldehyde-related activities. These
activities are being conducted with the full support of the NCEH
Division Director as well as Center, Coordinating Center and Agency-
wide leadership. And, we have an extensive and transparent
communication network through which we are keeping policy-makers and
the public apprised of our activities and findings.
CDC/ATSDR will continue to build the science base and to protect
public health from formaldehyde exposures in indoor environments. To
help clarify the health impacts of formaldehyde exposure, we are
planning several additional activities, including:
<bullet> A five-year study of children who resided in FEMA-
supplied trailers in Alabama, Louisiana, Mississippi, and Texas
is being initiated; the protocol currently is under review.
<bullet> A broad and proactive approach to formaldehyde in
manufactured structures. We have reached out to FEMA, HUD, and
other partners, and will collaborate with them in addressing
this multi-jurisdictional challenge.
<bullet> A registry/census of current and former residents of
FEMA-provided trailers, which would facilitate communication
with them in the future. For example, this could facilitate
conducting future studies.
In summary, CDC/ATSDR remains firmly committed to building the
science base and protecting public health from formaldehyde exposures
in indoor environments, and more broadly, to helping assure safe,
healthy indoor environments for all Americans. These are all important
issues to assure that science and public health are fully addressed and
CDC looks forward to the opportunity to work with the Committee on
these important issues.
Conclusion
As we continue our ongoing research, we recognize fully our
obligation to the American public, to Congress, and most importantly to
residents of the travel trailers, to deliver the independent, credible
science that helps inform good decision-making by the individuals who
were displaced by Hurricanes Katrina and Rita.
Thank you for the opportunity to present this information to you
today. We would be happy to answer any questions.
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Biography for Howard Frumkin
Howard Frumkin is Director of the Agency for Toxic Substances and
Disease Registry and also Director of the National Center for
Environmental Health at the Centers for Disease Control and Prevention,
U.S. Department of Health and Human Services. NCEH/ATSDR works to
maintain and improve the health of the American people by promoting a
healthy environment and by preventing premature death and avoidable
illness and disability caused by toxic substances and other
environmental hazards.
Dr. Frumkin is an internist, environmental and occupational
medicine specialist, and epidemiologist. Before joining the CDC in
September, 2005, he was Professor and Chair of the Department of
Environmental and Occupational Health at the Rollins School of Public
Health of Emory University, and Professor of Medicine at Emory Medical
School, in Atlanta. At Emory he founded and directed the Environmental
and Occupational Medicine Consultation Clinic, the Occupational
Medicine Residency training program, and the Southeast Pediatric
Environmental Health Specialty Unit.
Dr. Frumkin previously served on the Board of Directors of
Physicians for Social Responsibility (PSR), where he co-chaired the
Environment Committee; as president of the Association of Occupational
and Environmental Clinics (AOEC); as Chair of the Science Board of the
American Public Health Association (APHA), as a member of EPA's
Children's Health Protection Advisory Committee, where he chaired the
Smart Growth and Climate Change work groups; and on the National
Toxicology Program Board of Scientific Counselors. He currently serves
on the Institute of Medicine Roundtable on Environmental Health
Sciences, Research, and Medicine. In Georgia, he was a member of the
state's Hazardous Waste Management Authority, the Department of
Agriculture Pesticide Advisory Committee, and the Pollution Prevention
Assistance Division Partnership Program Advisory Committee, and is a
graduate of the Institute for Georgia Environmental Leadership. In
Georgia's Clean Air Campaign, he served on the Board and chaired the
Health/Technical Committee. He was named Environmental Professional of
the Year by the Georgia Environmental Council in 2004. He has served as
a consultant to several corporations, including Hewlett-Packard,
Southwire, Georgia Power, and Polaroid, and to several unions,
including the Chemical Workers Association and the Utility Workers
Union. His research interests include public health aspects of urban
sprawl and the built environment; air pollution; metal and PCB
toxicity; climate change; health benefits of contact with nature; and
environmental and occupational health policy, especially regarding
minority workers and communities, and those in developing nations. He
is the author or co-author of over 100 scientific journal articles and
chapters, and his books include Urban Sprawl and Public Health (Island
Press, 2004, co-authored with Larry Frank and Dick Jackson), Emerging
Illness and Society (Johns Hopkins Press, 2004, co-edited with Randall
Packard, Peter Brown, and Ruth Berkelman), Environmental Health: From
Global to Local (Jossey-Bass, 2005), and Safe and Healthy School
Environments (Oxford University Press, 2006, co-edited with Leslie
Rubin and Robert Geller).
Dr. Frumkin received his A.B. from Brown University, his M.D. from
the University of Pennsylvania, his M.P.H. and Dr.P.H. from Harvard,
his Internal Medicine training at the Hospital of the University of
Pennsylvania and Cambridge Hospital, and his Occupational Medicine
training at Harvard. He is Board-certified in both Internal Medicine
and Occupational Medicine, and is a Fellow of the American College of
Physicians and the American College of Occupational and Environmental
Medicine.
Dr. Frumkin was born in Poughkeepsie, New York. He is married to
Beryl Ann Cowan, an attorney and child advocate. They live in Atlanta
with their two children, Gabriel (age 18) and Amara (age 14).
Chairman Miller. Thank you. Admiral Johnson.
STATEMENT OF VICE ADMIRAL HARVEY E. JOHNSON, JR. (RET.), ACTING
DEPUTY ADMINISTRATOR AND CHIEF OPERATING OFFICER, FEDERAL
EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY
Vice Admiral Johnson. Good morning, Chairman Miller,
Congressman Lampson, Members of the Committee. I am Harvey
Johnson, the Acting Deputy Administrator and Chief Operating
Officer of FEMA within the Department of Homeland Security. I
am here this morning, Mr. Chairman, to assure the Committee
that FEMA is taking responsible steps to address the concerns
regarding the presence of formaldehyde in temporary housing
units. I would like to do this by making three principal
points. First, the health and safety of temporary housing
occupants is of paramount importance to FEMA. One of our
primary missions is to provide individual citizens, disaster
victims; and communities and members of the FEMA team, many of
whom are disaster victims themselves, take this very seriously.
Since March of 2006 to the present, we have investigated each
instance where an occupant has reported concern due to
formaldehyde, and we sought to find remedy by swapping out the
housing unit or relocating the family to a rental housing unit.
FEMA has been aggressive to search within communities to find
available housing options which sometimes have been rare to
offer current occupants mobile homes and travel trailers. We
have seen in the population of households, the temporary units
dropped from a peak of almost 143,000 units to now just over
now 30,000. Since February 14th and the release of the
preliminary findings, FEMA has prioritized relocation of those
occupants who have expressed a health concern, those who are
most susceptible to health risks such as elderly to households
with young children and those with respiratory challenges. That
category is comprised of just over 12,000 households.
For current and future disasters, FEMA will test the level
of formaldehyde in every unoccupied unit prior to deployment
and provide the certified results to the state as well as to
the occupant. FEMA will deliver the units that are determined
acceptable by the state. FEMA has also updated specifications
for purchases of new manufactured housing units and park models
to be more stringent on air quality.
Second, FEMA has been completely transparent on this issue.
FEMA sought to ensure that the occupants of temporary housing
units have access to all of the available information about
formaldehyde. We have established and still maintain an open
call center where callers can talk to FEMA or representatives
from the Centers for Disease Control. We maintain a website
that provides access to all current formaldehyde information,
and we have distributed fliers to occupants on three separate
occasions informing occupants of the symptoms of formaldehyde
exposure and suggesting actions they can take to reduce
formaldehyde levels based on guidance from public health
officials at the time.
FEMA has provided more than 20,000 pages of documents to
Congress, including this subcommittee. We have provided similar
information to the Government Accounting Office to the
department's Office of Inspector General. Our staffs have met
with Congressional staff and various investigators on numerous
occasions. FEMA has hosted meetings and provided information on
various advocacy groups to ensure transparency of FEMA's
actions regarding formaldehyde.
And finally, FEMA recognizes the importance and
significance of this issue and is intent on becoming part of
the solution. FEMA recognizes our limitations as well. We are
not a public health agency, and frankly, we are not a long-term
housing agency, either. We have sought medical and
environmental assistance from the very beginning, engaging with
the Environmental Protection Agency, the Department of Health
and Human Services, the Centers for Disease Control, and the
Office of Health Affairs within the Department of Homeland
Security. Even today we engage in all or some of them every day
in our shared desire to best meet the health and safety
challenges of disaster victims. We have tried to be a smart
consumer of their advice and have tried to implement that
advice in the practical settings of a disaster site. We have
made some mistakes along the way. All of us have. But it has
occurred as the act has been in the service of providing
assistance to disaster victims with the best of intentions, and
we have all learned and gained a significant knowledge along
the way. At no time has FEMA ever turned from the challenge
because of concern for litigation or thought that we might be
criticized for our actions. We have also tried to learn more
from the challenges. For example, we are working right now with
a temporary housing manufacturer and believe that our public/
private cooperation will lead to a temporary housing unit at
extremely low levels of formaldehyde and that these new units
will be available for the upcoming hurricane season.
Importantly, Mr. Chairman, FEMA shares the objectives of
this committee that our collective efforts to examine this
complex issue will result in better policy and greater
awareness and more consistent assurance to the public, more
specifically to current and prospective disaster victims, that
FEMA and our federal and state partners can better ensure their
health and safety.
I am pleased to answer any of your questions.
[The prepared statement of Vice Admiral Johnson follows:]
Prepared Statement of Harvey E. Johnson, Jr.
Good morning Chairman Miller, Congressman Lampson, and Members of
the Committee. I am Harvey Johnson, Acting Deputy Administrator and
Chief Operating Officer for the Department of Homeland Security's
Federal Emergency Management Agency (FEMA). Thank you for inviting me
here and giving me an opportunity to assure this committee that FEMA is
taking responsible steps to address the concerns regarding the presence
of formaldehyde in temporary housing units provided to disaster
assistance applicants.
The health and safety of the residents of travel trailers provided
to disaster victims is of paramount importance to FEMA. These are more
than simple words, as they reflect an element of the ethos of FEMA--
providing effective assistance to communities and disaster victims.
Today, I will briefly highlight actions FEMA took in 2006 and early
2007 regarding the issue of formaldehyde in temporary housing units.
Second, I will address FEMA's agreement with the Centers for Disease
Control and Prevention (CDC) under which CDC performed testing of more
than 500 units in the Gulf Coast and the actions taken based on the
preliminary results. Third, I will highlight the additional actions
FEMA is taking to provide for the safety and well being of the
residents of these travel trailers by finding them alternative housing.
Finally, I will address the additional interim measures regarding the
use of temporary housing units that FEMA has adopted as a precaution,
and which FEMA will employ for all disaster housing operations until
permanent indoor air quality standards related to formaldehyde are
developed by appropriate health officials.
2006-2007 Actions Taken Regarding Formaldehyde
Formaldehyde is a substance that is widespread in today's
environment. Indeed, formaldehyde is commonly found in a wide-range of
manufactured items, including materials used to construct manufactured
items, including materials used to construct travel trailers and
manufactured housing (also known as ``mobile homes''). The trailers
purchased by FEMA are not unique in this regard. At higher levels,
especially indoors, formaldehyde can be irritating to the respiratory
system, and has been identified by the National Toxicology Program
(NTP) as reasonably anticipated to be a human carcinogen. The issue of
formaldehyde in travel trailers is complicated by the fact that,
despite over 30 years of research, no federal agency has determined an
acceptable level of formaldehyde in residential indoor air. There is no
established or recognized standard or benchmark for formaldehyde
exposure in indoor residential air-quality. Nor are there any
government standards relating to formaldehyde levels in the types of
travel trailers provided by FEMA to Gulf Coast housing applicants.
FEMA began tracking formaldehyde-related concerns by Gulf Coast
travel trailer occupants in early 2006. FEMA addressed applicant
concerns on a case-by-case basis in the Gulf Coast. FEMA's response to
complaints about formaldehyde levels included sending a housing staff
employee to visit with the occupants of the units to discuss mitigation
techniques for the units including: increased ventilation, keeping
indoor air temperatures moderate, lowering the humidity, and not
smoking in the unit. In instances when these mitigation efforts did not
resolve the residents' concerns, FEMA also offered to provide residents
with a different unit.
As FEMA continued to monitor formaldehyde reports throughout spring
2006, FEMA became concerned that the complaints might not be isolated
occurrences. As a result, FEMA began consulting with the Environmental
Protection Agency (EPA), the Agency for Toxic Substances and Disease
Registry (ATSDR) within the Department of Health and Human Services
(HHS), and the manufactured home industry to gather information about
the presence and effects of formaldehyde.
We also began widespread distribution of information to travel
trailer occupants across the Gulf Coast identifying potential sources
of formaldehyde and explaining to applicants how they could mitigate
the exposure to formaldehyde. Flyers capturing this information were
hand delivered to all travel trailer occupants beginning in summer
2006.
In September 2006, FEMA began a study to test formaldehyde levels
in travel trailers, and to identify the most effective methods for
reducing formaldehyde levels in travel trailers and manufactured
housing (also known as ``mobile homes'') in use in the Gulf Coast
region. Given the lack of alternative housing in the Gulf, finding
alternative housing for all mobile home and trailer occupants from
their temporary housing would have taken too long, and would have left
residents with no way to address their concerns in the immediate term.
We had to find a way to mitigate the levels immediately. The mitigation
study involved collecting air samples from new, unused travel trailers
that were ventilated in various ways during the months of September and
October at a staging area in Baton Rouge, Louisiana. FEMA modified an
Interagency Agreement with EPA to perform this sampling.
In November 2006, EPA provided the data gathered during the
sampling phase to FEMA for further analysis. A FEMA staff attorney
forwarded the data to ATSDR emergency response staff for evaluation.
ATSDR's Health Consultation, provided to that FEMA staff attorney in
February 2007, confirmed that proper ventilation (i.e., opening all
windows, rather than using air conditioning) could reduce the
formaldehyde levels. FEMA believed that this guidance was based on the
best available published studies and standards in light of the absence
of standards directly relating to formaldehyde and indoor air quality.
FEMA developed information and guidance based on the results of the
study and provided this information and guidance to the residents of
the travel trailers.
Given the absence of applicable indoor air-quality standards, the
initial consultation with ATSDR was intended to evaluate the
effectiveness of formaldehyde-mitigation measures rather than the long-
term health impacts associated with particular residential
concentrations of formaldehyde. As is noted in the Health Consultation,
``FEMA has not requested ATSDR to evaluate long-term formaldehyde
concentrations in trailers or health concerns related to potential
exposures.''
In March 2007, the FEMA staff attorney who had requested the ATSDR
analysis in November, and to whom ATSDR had sent its February Health
Consultation, received a follow-up letter from ATSDR stating that the
February 2007 Health Consultation was ``incomplete and perhaps
misleading.'' Unfortunately, this letter only came to the attention of
senior leadership several months later. Had the March 2007 follow-up
letter from ATSDR been brought to senior leadership's attention when it
was received, we would have sought clarification from ATSDR. ATSDR also
subsequently revised its Health Consultation in October 2007 to include
a number of caveats relating to potential health impacts of long-term
exposure. At the time of the release of the revised report, FEMA was
already moving ahead with CDC on more comprehensive testing, including
for long-term effects. FEMA has always taken these health concerns
seriously, which is why we initially reached out to EPA and CDC and
continue to closely coordinate with appropriate agencies as we make
policy decisions regarding the use of temporary housing units (travel
trailers, park models and mobile homes).
From early 2006 through May 2007, FEMA received approximately 130
complaints regarding formaldehyde, including 47 requests that a
resident's unit be ``swapped-out'' for another unit. To put that number
in context, during its response to Hurricanes Katrina and Rita, FEMA
provided temporary housing units to more than 143,000 families across
the Gulf Coast.
In May 2007, renewed focus on the formaldehyde issue followed media
reports of concerns by a doctor in Mississippi about health trends he
believed he was seeing in residents of temporary housing. FEMA
immediately engaged with the Department of Homeland Security's Office
of Health Affairs (DHS OHA) as well as the experts from the CDC and
ATSDR to better understand the potential health concerns associated
with formaldehyde and determine the best scientifically valid approach
to address this issue. On behalf of FEMA, DHS OHA officials met at the
CDC headquarters in Atlanta with representatives of the National Center
for Environmental Health and the ATSDR to develop a strategy to rapidly
test actual indoor air quality conditions in occupied units, determine
a scientifically valid target for air quality improvement, and further
assess potential mitigating actions that could be taken to further
reduce formaldehyde levels. This meeting eventually resulted in the
Inter-Agency Agreement with CDC discussed below.
In order to address the ongoing health and safety concerns of those
still residing in temporary housing units while FEMA was working with
the CDC and other health agencies, FEMA established a Formaldehyde Call
Center for occupants living in travel trailers and mobile homes. All
occupants who contact the help line with questions or concerns are
offered an immediate move to a hotel or motel. Additionally, FEMA
distributed a second formaldehyde and housing fact sheet to the
occupants of every FEMA trailer across the Gulf Coast (70,000 flyers
were distributed across the Gulf), as well as throughout the rest of
the country. The fact sheet provided basic information about
formaldehyde, including possible medical effects, ventilation
techniques to reduce formaldehyde levels, and contact information for
assistance.
In addition to offering immediate housing options to current
trailer occupants, the Agency issued an Interim Direction on the Use of
Temporary Housing Units on July 31, 2007, which took the added step of
temporarily suspending the installation, sale, transfer or donation of
travel trailers or park model recreational vehicles while the agency
worked with health and environmental experts to assess air quality and
health-related concerns.
Interagency Agreement With CDC
In August 2007, FEMA and CDC entered into an Interagency Agreement
to initiate and complete testing of a statistical sampling of occupied
units and to provide technical assistance and public health guidance to
FEMA to evaluate the indoor environmental air quality in temporary
housing units and the associated health effects to residents. At FEMA's
request, CDC is also conducting a health study of children who lived in
FEMA-supplied temporary housing in Mississippi and Louisiana, as well
as mitigation strategies for unoccupied units, focusing on components
that off-gas and technologies that reduce off-gassing or accumulation.
Testing of occupied units was to have begun in early November 2007,
but did not begin until December 2007. However, because there are no
federal standards for formaldehyde exposure in a residential setting,
testing was delayed to allow for the necessary development of a
consensus among public health experts as to how to interpret the
testing results in order to provide health advice. This was necessary
to have a basis to explain to the occupants what the test results would
mean. FEMA wanted to make sure that the results of that testing would
help occupants make informed decisions about their health concerns and
permanent housing needs. I made the decision to delay this testing, and
believe events have confirmed it as the right decision.
While we would have preferred to initiate testing in November,
please be assured that FEMA and the CDC were fully committed to this
effort. It was, however, imperative that testing was conducted
appropriately and intelligently such that it would yield scientifically
valid and accurate results. Of equal importance was ensuring we could
provide appropriate public health guidance to enable occupants to make
an informed decision on the risks involved with continued exposure as
compared to the range of alternative housing available to them.
After public health guidance was developed, CDC began indoor air
sampling of occupied temporary housing units in Mississippi and
Louisiana in December 2007. On February 14, 2008, CDC released
preliminary test results, and FEMA and CDC outlined the steps to be
taken to provide for the safety and well being of the residents of
temporary housing units. CDC's preliminary evaluation of a
scientifically established random sample of 519 travel trailers and
mobile homes tested between December 21, 2007 and January 23, 2008
found that, in many of the travel trailers and mobile homes tested,
formaldehyde levels were higher than typical levels (based on recent
sampling) of U.S. indoor exposure in single-family homes and
apartments. The average level of formaldehyde was about 77 parts per
billion (ppb), or .077 parts per million (ppm). In general formaldehyde
levels in travel trailers were higher then levels found in manufactured
homes.
Following the completion of the testing, CDC and FEMA
representatives visited all participants whose units were tested as
part of the study to discuss the levels of formaldehyde measured in
their temporary housing unit. All participants who had their unit
tested were offered an immediate move to a hotel, motel, or apartment.
108 of the 519 participants accepted this offer (88 moved to alternate
housing, 20 are in hotels/motels).
In addition to these results-specific visits, CDC and FEMA
distributed a third fact sheet on the preliminary results of
formaldehyde levels to all temporary housing occupants between February
15 and 18, 2008. FEMA and CDC have jointly hosted several community
availability sessions to provide information to residents who are
concerned about the testing results, and to answer questions.
Furthermore, for those residents that were not included in the initial
testing, we have offered to test any occupied unit and provide those
results to the occupant. FEMA awarded a contract for such additional
testing to Bureau Veritas, the same testing company that was used by
CDC for its testing in late 2007. Testing is currently underway, and is
available to occupants living in FEMA-supplied temporary housing units
nationwide. The test results will be provided to the occupant so they
can make informed decisions about their housing options. As of March
25, 2008, 1,554 households have requested testing. The contractor has
contacted 965 of those households and scheduled 479 tests. As of March
25, 2008, 291 tests have been completed.
Alternative Housing Options for Residents of Temporary Housing Units
Since early 2006, FEMA has offered immediate alternative housing to
anyone who has requested to move out of their unit for any reason,
including concerns about formaldehyde. FEMA has never believed that
travel trailers are an acceptable long-term housing solution, and it is
our desire to ensure that all residents move into more appropriate
housing as soon as possible.
FEMA is aggressively identifying alternate temporary and long-term
housing and matching up housing occupants with available units as
quickly as the occupants can accept the offer and move. Those occupants
who have voiced a health concern in response to continued engagement
from FEMA have all been afforded multiple options to relocate out of
their travel trailer.
FEMA previously announced a plan to close all group sites and
relocate residents by June 1, 2008 and will continue this activity as
part of our ongoing efforts. FEMA has already moved over 111,000
households out of temporary housing units as residents move into long-
term housing solutions. However, the task is not complete, since as of
March 25, 2008 there are 31,136 households occupying temporary housing
units in the Gulf Coast.
FEMA has begun to expedite the relocation of residents from
temporary housing units to apartments or other alternative housing,
including hotels, motels and ``Katrina cottages.'' The priority in
relocation will be those occupants expressing a health concern and
those most susceptible to health risk such as the elderly, households
with young children and those with respiratory challenges. FEMA has
implemented an aggressive outreach plan for these priority occupants.
In addition to offering alternatives to all applicants that call the
formaldehyde call centers, FEMA caseworkers are reaching out to
occupants to explain the relocation and testing options available to
them.
In late February 2008, FEMA and CDC identified 14,266 households as
a priority because the applicants expressed specific health concerns or
may be more susceptible to health risks. As of March 25, 2008, 1,378 of
these priority households have been relocated, and we continue to
target the remaining 12,888 for relocation. In late February, FEMA also
identified an additional 9,367 households as a priority for relocation
because they are living in group or commercial sites, or they are pre-
disaster renters living on private sites. As of March 25, 2008, 1,358
of these households have been relocated.
From February 14 to March 25, 2008, FEMA caseworkers have offered
6,145 households an immediate move to a hotel or motel--644 have
accepted the hotel/motel offer, while 5,502 households have refused
that option. From February 14 to March 25, 2008, FEMA caseworkers have
offered alternative housing resources (rental resources or Alternative
Housing Pilot Program units) to 4,662 households--2,813 have accepted
an alternative housing resource or their decision is pending, 1,842
have refused all options, and nine have decided to live with family or
friends. These data include both calls from occupants to the
formaldehyde call center and calls made by FEMA caseworkers to
occupants. FEMA applicant services staff continue to identify and
provide options and resources to remaining occupants while they make
final decisions about their relocation alternatives.
As part of the effort to provide occupants with alternate housing,
FEMA is implementing new and expanded policies and executing contracts
to:
<bullet> Enter into direct contracts with hotels in order to
obtain additional hotel/motel capacity if needed.
<bullet> Utilize contract resources to support local
relocation.
<bullet> Provide food vouchers or stipends for households
relocated to hotels without cooking facilities.
<bullet> Enter into direct lease agreements with landlords.
<bullet> Contract for temporary storage and/or shipping of
household property.
<bullet> Contract for the boarding and care of household pets
for families relocated to hotels or apartments that do not
allow pets.
<bullet> Provide furniture for rental units by working with
Voluntary Agencies where possible, or purchasing the furniture
when necessary.
<bullet> Contract for moving teams and equipment to assist in
the movement of households with special medical needs.
<bullet> Provide additional staff to our offices on the ground
to facilitate and manage the expedited relocation of
households.
These efforts are in addition to several other initiatives FEMA
already had in progress to provide additional housing options and
reduce common barriers for the remaining disaster population. FEMA is
providing more incentives to encourage landlords to offer and extend
rental opportunities to those victims still seeking a long-term housing
solution. FEMA has also taken steps to reduce or eliminate barriers
that some families experience when trying to relocate to a rental unit,
such as utility payments, deposits, and fees. These incentives and
additional actions include:
<bullet> Authorizing payment of rental assistance above the
current Fair Market Rate;
<bullet> Payment to landlords for utilities if included in the
rent payment;
<bullet> Payment to landlords for repairs to property damage
made by disaster applicants;
<bullet> Payment of security deposits, and processing fees for
background checks required by some landlords; and,
<bullet> Assistance with locating furniture and other
necessities to meet basic living needs.
In addition, in October 2007, FEMA established a reimbursement
program that provides relocation assistance to disaster victims
displaced by Hurricanes Katrina and Rita. This program reimburses
relocation expenses up to $4,000 for applicants returning to their pre-
disaster states. For those families that are already living in their
pre-disaster state in FEMA-provided temporary housing, FEMA will pay
moving expenses to a FEMA-funded rental resource anywhere in the
continental United States, if the new location is greater than 50 miles
from applicants' current location in the state. Relocation assistance
is limited to travel costs, furniture transportation expenses, and
moving services, and is subject to the applicant's overall cap of
assistance under the IHP program.
FEMA has assigned case workers to contact every applicant currently
residing in a travel trailer, park model or mobile home in the Gulf
Coast to make them aware of available housing resources, and we
continue to provide case management services to applicants while they
make final decisions about their housing alternatives. No occupant of a
FEMA provided travel trailer has to wait for the results of air quality
testing to take advantage of these alternative housing options--they
are available now. It is important to note that nearly 80 percent of
the remaining travel trailers and park models in use in the Gulf Coast
are on private home sites. These households are, for the most part,
making repairs so they can return to their pre-disaster dwelling.
Additional Precautionary Measures
On March 10, 2008, FEMA issued a revision to the July 31, 2007
Interim Direction on the Use of Temporary Housing Units based on the
preliminary results of the testing conducted by CDC. FEMA will continue
to utilize and offer manufactured housing (mobile homes) that meets or
exceeds the Department of Housing and Urban Development (HUD)
standards, as a temporary housing option. FEMA will not deploy,
transfer or sell travel trailers. However, FEMA may continue to provide
larger, better ventilated park models in support of future disasters,
but only in accordance with the mandatory testing and State
notification.
Under the Interim Direction, FEMA will have the air quality of the
unit independently tested to determine formaldehyde levels prior to
allowing any disaster victim to occupy an existing manufactured home,
park model or any new form of housing. FEMA will provide the certified
results of such testing, as well as a compendium of formaldehyde risk
and warning information to the State and the disaster assistance
applicant, and will subsequently only deliver and provide units
determined to be acceptable by the state.
FEMA has entered into a contract with an approved Industrial
Hygienist to conduct air quality testing on temporary housing units
prior to allowing such units to be occupied by eligible disaster
victims. The air quality testing will use a testing strategy
appropriate to the conditions that follows the same NIOSH testing
protocols that the CDC contractor used to test occupied units. FEMA has
relied heavily upon the expertise of the officials from the DHS ORA in
the development of the testing guidance. The same protocol will be used
for all air quality testing, no matter where it takes place, whether at
storage sites, staging areas or on private property.
FEMA has initiated testing of mobile homes that will be utilized in
response to the current disasters in Arkansas, Tennessee, California
and Oregon. Mobile homes have been accepted and deployed in California
and Oregon. FEMA will continue the testing process for mobile homes in
Hope, Arkansas and Selma, Alabama. Once tested, these mobile homes will
be offered to Arkansas and Tennessee for consideration to house
disaster victims in response to the tornadoes that affected those
states.
FEMA has also implemented new requirements for future purchases of
to-be-built manufactured homes, park models, and other new forms of
alternative temporary housing that will ensure such units are
specifically designed and constructed to emit (and tested to assure)
the lowest possible levels of formaldehyde. FEMA has updated housing
specifications for purchases of Uniform Federal Accessibility Standard
(UFAS) and non-UFAS park models, as well as mobile homes. These units
must meet the design and construction requirements established in Title
24 of the Code of Federal Regulations sections 3280.308-309. Units must
include weather radios and manufacturers must not use materials which
emit high levels of formaldehyde during production.
FEMA has also offered to refund the purchase price of travel
trailers or park models to all individuals who bought their unit
between July 24, 2006 and July 23, 2007. This applies to units
purchased directly from FEMA by disaster assistance applicants already
occupying the unit, and to those who purchased units through the
General Services Administration. As of March 13, 2008, two disaster
assistance applicants who purchased their unit directly from FEMA had
requested a refund and FEMA received 756 requests for refunds from
those who purchased a unit through GSA auction sales. To put that
number in perspective, it represents 7% of the 10,839 travel trailers
and park models that were sold through GSA between July 2006 and July
2007.
Since the suspension in the sale of travel trailers, FEMA has also
continued to receive a significant number of inquiries requesting that
we re-instate the sale of units. However, because of unresolved health
concerns associated with the units, we will not transfer or sell travel
trailers at this point in time.
Summary
In summary, we remain committed to assisting all residents of
temporary housing units in finding permanent housing solutions. We
continue to address the formaldehyde issue forthrightly: sharing
information with temporary housing residents; testing occupied as well
as new units and providing results to the occupants and the states;
working with occupants to encourage alternative housing solutions;
removing barriers for relocation to apartments; closing group sites;
and providing case management services to assist all eligible
households.
Allegations have been made, and inferences drawn, from a limited
review of a large number of e-mails FEMA produced to Congress in the
spring and summer of 2007. These allegations include that the Agency
suppressed or influenced formaldehyde reports because of fear of
litigation and liability for injuries to occupants. Let me be clear,
FEMA has not, nor will we condone any action that interferes with
scientific experts conducting their work in a scientifically
responsible manner. The health and safety of residents has been and
continues to be our primary concern. FEMA has not and will not attempt
to, nor will we condone any effort to, suppress or inappropriately
influence any report from the CDC, or ATSDR or any report from any
agency, including any report related to the effects of formaldehyde on
residents in the direct housing program.
Together, with our outstanding partners throughout the federal,
State, local, private, and voluntary agency communities, we will
continue to advance ideas and pursue housing assistance solutions that
will effectively, and compassionately, help individuals and communities
recover, re-establish, and reclaim their neighborhoods and communities.
Thank you for the opportunity to testify. I would be pleased to
answer any questions you may have.
Biography for Harvey E. Johnson, Jr.
Harvey E. Johnson, Jr. (USCG, retired Vice Admiral) is the Deputy
Administrator and Chief Operating Officer of FEMA. He came to FEMA in
April 2006 after serving as Commander, Pacific Area of the U.S. Coast
Guard since June 2004.
Mr. Johnson has a wealth of emergency and crisis management
experience, including support to Admiral Thad Allen and the Coast
Guard's Hurricane Katrina response efforts by coordinating and
deploying West Coast resources.
His operational experience includes various Coast Guard efforts,
including search and rescue, freighter grounding, vessel break-up and
pollution response for the motor vessel Selendang Ayu and the tank
vessel Seabulk Pride in Alaskan waters. In addition, he participated in
multiple Naval War College, Lead Shield and Rogue Vessel exercises in
response to simulated maritime homeland security threats and the
management of hundreds of Coast Guard law enforcement, search and
rescue and pollution response cases in the Pacific.
While serving as Commander, Pacific Area, Mr. Johnson led efforts
that encompassed more than 73 million miles west of the Rocky Mountains
and throughout the Pacific Basin to the Far East. Prior to this
assignment, he was the Commander, Seventh Coast Guard District and
served as the Director, Homeland Security Task Force-Southeast, where
he directed Operation Able Sentry, the Department of Homeland
Security's response to the crisis in Haiti. In addition to these
duties, he served as the Executive Director of the Coast Guard's
transition into the Department of Homeland Security, Director of
Operations Capability and Director of Operations Policy.
Prior to promotion to Flag rank in 2001, Mr. Johnson served as the
Executive Assistant to the Commandant of the Coast Guard. Other
assignments included: Commanding Officer of Air Station Brooklyn, and
concurrently as Commanding Officer of Air Station San Diego and
Commander, Activities San Diego. He also served as a fellow at the
Chief of Naval Operations Strategic Studies Group in Newport, Rhode
Island.
Mr. Johnson began his career as a Deck Watch Officer aboard the
Cutter Steadfast (WMEC-623). He then earned his Naval Aviator wings in
1977. He flew the HH-52A helicopter at Coast Guard Air Station Houston,
the HH-3F at Coast Guard Air Station Kodiak, the HH-65A in Brooklyn and
Corpus Christi and the HH-60J in San Diego. His staff assignments
include: Aviation Assignment Officer in the Office of Personnel and
Training; Program Reviewer and Analyst within the Office of the Chief
of Staff; Deputy Chief, Programs Division within the Office of the
Chief of Staff; and member of the Streamlining Team.
His major decorations include the Legion of Merit (3), the
Meritorious Service Medal (3), the Coast Guard Commendation Medal (2)
and the Coast Guard Achievement Medal. Mr. Johnson received a Bachelor
of Science degree at the U.S. Coast Guard Academy in 1975. He earned a
Master of Science degree at the Naval Postgraduate School in 1983 and a
Master of Science degree in Management as a Sloan Fellow at the Sloan
School of Management at the Massachusetts Institute of Technology in
1993.
Mr. Johnson is a native of Tampa, Florida. He is married to the
former Janet L. Cronin of Boston, Massachusetts, and they have two
children, Jennifer and Scott.
Discussion
Warning FEMA Employees About Formaldehyde
Chairman Miller. The Chair now recognizes himself for five
minutes for an initial round of questions.
Admiral Johnson, this is not the only Committee or
Subcommittee of Congress that has looked at the trailers
provided by FEMA. In the documents produced to other
Committees, either the Government Reform and Accountability
Committee or the Homeland Security Committee, documents from
FEMA show that FEMA employees were warned about formaldehyde in
trailers. Is that correct?
Vice Admiral Johnson. What is correct, sir, is that from
2005, Bechtel Corporation asked as a matter of routine to
conduct assessments for formaldehyde in travel trailers. That
was done in 2005. That was a Bechtel effort that was really not
made aware to FEMA. Also in 2005, that was just a few months
after Katrina where there were hundreds of thousands of
families without any type of housing. And so we were still
providing--in the initial stage of providing housing and that
issue did not come to our attention. It did not seem--it did
not rise to the level of the decision-makers' attention in
2005.
In 2006, we became aware by the first reports in
Mississippi by occupants who reported problems with
formaldehyde, and at that point on I think--and without going
through the timeline, I think you will see that FEMA reacted to
every one of those reports. We began consulting with EPA, with
CDC, and with others and we sought medical advice. I believe we
have taken responsible actions based on that medical advice
over the last two years.
Chairman Miller. The documents included an e-mail, March
22, 2006, from Bronson Brown to Richard Sease, Owen Motter, and
David Shawaga that said, staff are to be instructed that prior
to entering the trailers there should be a period of time for
off-gassing before conducting any work operations inside the
trailers.
Vice Admiral Johnson. That is correct. The gentleman who
wrote the e-mail was our head of Occupational, Health, Safety
in FEMA, and the trailers he was referring to were unoccupied
trailers that had been closed and sealed for some amount of
time. Those were not occupied trailers by disaster victims. And
so it is, when those trailers have been sealed in the heat, we
do want to make sure that our employees take the proper
precautions to ventilate those units before they go into them.
Chairman Miller. And how long would be the period of
exposure by a FEMA employee entering a trailer to do some work?
Vice Admiral Johnson. Well, those are typically--those are
workers who in this case were either preparing trailers to be
occupied or were preparing trailers to be sent back--had been
already used and to be disposed of in some manner. So they
would usually be in those for a short amount of time.
February 2007 Health Assessment
Chairman Miller. Dr. Frumkin, turning your attention to the
February 2007 Health Assessment, do you know who it was at FEMA
who requested that health assessment?
Dr. Frumkin. My understanding it was Mr. Preston in the
Counsel's Office.
Chairman Miller. And do you know the purpose of the
assessment?
Dr. Frumkin. We understood that it was a request for a
review of data in terms of its health implications, a fairly
standard kind of request.
Chairman Miller. Was it for purposes of acting to protect
the safety of the occupants or was it tied to any pending
liability?
Dr. Frumkin. I am not aware of any liability issues at the
time, although in retrospect, there have been documents that we
have seen that demonstrate that concern.
Chairman Miller. Well, there was an e-mail from Dr. Sinks
on October 12 of last year, 2007, that said, unfortunately the
request was generated by FEMA lawyers attempting to respond to
legal actions against FEMA. Were you aware of that e-mail?
Dr. Frumkin. I think in retrospect, one of the issues that
we could have done better was to have recognized the
significance of a request from an attorney that is an irregular
form of a request, and we could have flagged concerns with that
to the agency.
Chairman Miller. Okay. Is it your practice to provide
expertise to lawyers involved in litigation?
Dr. Frumkin. No, it is our practice to provide expertise to
sister agencies that request that expertise. We did not in this
case recognize that this was a different sort of request from a
sister agency than the usual one.
Chairman Miller. Second round. The initial e-mail to you--
well, first of all, could you describe the chain of review for
the February health consultation provided to FEMA, February
2007 health consultation provided? Were you in that chain? Who
else was in that chain?
Dr. Frumkin. The ordinary chain of review that prevailed at
the time and that was used across all of our divisions was as
follows. A product would be developed by staff in the division,
it would move up through the division leadership, and then in
some cases, usually on a discretionary basis, be brought to the
attention of center leadership. There was also an
accountability to the Emergency Response Office as Dr. De Rosa
explained earlier, but that did not replace, that simply
supplemented the standing line of review.
Chairman Miller. I am sorry, was there a separate emergency
response chain or were there different procedures for emergency
responses?
Dr. Frumkin. The baseline procedure was the one that
usually prevails and that is that staff within a given division
would move their documents, their work, through their division
for clearance. In addition, because of the complexity of the
Katrina work and the fact that all of our divisions were
involved, we had created sort of a central point of information
and contact in the Emergency Response Office so that documents
were moved up the chain as well.
Chairman Miller. Well, I am sorry. I am still not quite
understanding. Which procedure was used with respect to the
Health Assessment in 2007, February 2007?
Dr. Frumkin. What we have learned in retrospect was that
the clearance within the division did not occur as it
ordinarily would and should have. So the staff went directly
through the emergency response chain, and that was the only
chain that they used.
Chairman Miller. And you were part of that chain, that is
correct, is it not?
Dr. Frumkin. After the review in the Emergency Response
Office, it came to the Office of the Director, yes.
Chairman Miller. Okay. And when did you--I have an
organizational chart that shows that the chain appears to
consist of Marilyn DiSirio, Nabil Issa, Mark Keim, Gina Motrie,
Linda Anderson, Tom Sinks, and you. Would those be the people
in the chain?
[The chart follows:]
<GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT>
Dr. Frumkin. No, sir. Those are various Associate Directors
within the Office of the Director. The specific person who was
part of the emergency response chain was Dr. Keim. He would
report directly to Dr. Sinks and to me.
Chairman Miller. Who would?
Dr. Frumkin. Dr. Keim.
Chairman Miller. Dr. Keim? Okay. And when did you learn
that it had not gone by Dr. De Rosa for review?
Dr. Frumkin. In late February when Dr. De Rosa contacted me
with his concerns, I was surprised to realize that he had not
had a role in overseeing his staff in preparing the report.
Chairman Miller. You did not know before that time that he
had not seen the review, the assessment?
Dr. Frumkin. No.
Chairman Miller. Dr. Sinks, you are in that chain as well.
Did you know in February of 2007 that Dr. De Rosa was not in
the link, in the chain?
Dr. Sinks. Absolutely, I did not. Dr. De Rosa called me and
stated that he was informed that his staff had been instructed
not to share the document with him on orders from the Office of
the Director. I commented to him at the time that that was--
those instructions never came from the Office of the Director.
He then went back, spoke to his staff, and sent a second e-mail
which included the letter that he recommended be sent forward
to FEMA which about 10 days later we did send forward.
Chairman Miller. Is your recollection now--well, Dr. Sinks
and then Dr. Frumkin, the same question. Is your recollection
now different from when you were interviewed by our staff about
all of this?
Dr. Sinks. My recollection is not. I think I have been very
consistent in speaking to your staff for more than six hours on
this issue, and I think I said this same information.
Chairman Miller. Dr. Frumkin, is your recollection the same
now as it was when you interviewed with our staff?
Dr. Frumkin. If there is a disparity, I cannot recall it,
no.
Chairman Miller. Okay. And is it correct that the emergency
response procedures would have gone directly from whatever
employees were involved in developing this assessment to Dr.
Keim, to Dr. Sinks, to you, and would not--the emergency
response procedures did not include Dr. De Rosa.
Dr. Sinks. I will try to handle that. There is a small
group in Dr. De Rosa's division which is an emergency response
team which under the National Contingency Plan, and Dr. De Rosa
is our representative under the National Contingency Plan, does
operate and operates independently of our emergency response
group that coordinates things in our Office of the Director.
They do report to a team lead, that team lead reports to a
branch chief, and ultimately that branch chief reports to Dr.
De Rosa. Those individuals were informing their chain of
command of the work they were doing since June of 2006 and
weekly updates. Dr. Frumkin became aware of the work they were
doing in December 4th of 2006 and sent Dr. De Rosa an e-mail at
that time specifically asking Dr. De Rosa to keep us informed
and to update us routinely at our senior staff meeting which
occurs once a week.
Chairman Miller. I understand that the employees involved
in preparing the assessment have told our staff in extensive
interviews, probably every bit as extensive as yours, that the
ordinary procedure for the emergency response--and they
understood that this was subject to the emergency response
procedures--went directly to Dr. Keim. Is that, that is
different from what your understanding is? And that routinely
with respect to emergency response, it did not go past Dr. De
Rosa, it went directly to Dr. Keim to Dr. Sinks to Dr. Frumkin.
Is their testimony incorrect? Or not testimonies, but what they
have said incorrect?
Dr. Sinks. Let me try to respond to this for you, Mr.
Miller. I believe their testimony is correct in terms of what
actually happened to the document. I do not believe Dr. De Rosa
saw the document until three weeks after the document was
issued. It was never our expectation that the division
supervisors be excluded from the review. I do not believe there
is any written e-mails to that effect or any type of
information that would suggest that that was done. It may very
well be that the individuals in his team had that perception,
but it was not a perception that was given to them by us.
Dr. De Rosa's Concerns Over the Health Consultation
Chairman Miller. Dr. Sinks, I am also inclined to conclude
when there is silence in e-mails, when that seems to be of the
ordinary method of communication, that that means that it did
not happen. Do you have an e-mail--this is to both Dr. Frumkin
and Dr. Sinks--to support the testimony today that you
encouraged Dr. De Rosa to prepare a response to the February
2007 Health Assessment to say that it was flawed, it had not
gone through ordinary views, and there were scientific concerns
about it and that it might be misleading?
Dr. Frumkin. I don't recall e-mail communication on that
point, Mr. Chairman, but I do recall very clearly that when Dr.
De Rosa finally weighed in on the issue of the report several
weeks after it was released, I recognized that his concerns
were correct and indicated that we should act on them.
Chairman Miller. Okay. When you said finally, do you have
any basis to contradict what he said earlier which was that he
acted as soon as he had a chance to read it? He immediately e-
mailed you to express his concerns?
Dr. Frumkin. Well, Dr. De Rosa's opportunity to be involved
began in June of '06 when his staff began their involvement on
the issue or certainly in December of '06 when I asked him to
involve himself and keep me informed, but for reasons that are
unclear to me, he didn't take that opportunity to be involved
until much later.
Chairman Miller. Well, the wording of his second e-mail to
you would be very peculiar if in fact there were oral
discussions during that period since his first e-mail he says,
``I am resending the previous e-mail which describes my
concerns regarding the formaldehyde health consultation. If I
receive no objections from you, I will send the attached letter
to FEMA by COB.'' What is COB? Close of business. Excuse me.
Friday, March 9. Had there been conversations apart from e-mail
communications between the time of the first e-mail and second
e-mail? I mean, it is certainly the tenor, the tone of this e-
mail. The e-mail implies that he hadn't heard from you.
Dr. Frumkin. I think that is correct. I had not seen his
first e-mail until he resent it.
Chairman Miller. Dr. Sinks, did you see the first e-mail? I
think it was copied to you as well.
Dr. Sinks. Dr. De Rosa sent the e-mail. I can't say that I
did see the e-mail. I did not respond to the e-mail, and when
Dr. De Rosa sent it about one week later, Dr. Frumkin responded
to it.
Chairman Miller. Thank you. But I am gloriously over. Mr.
Lampson?
2005 Formaldehyde Testing
Mr. Lampson. My apology, Mr. Chairman. I was waiting for
you to give me time, and I didn't know you had recognized me.
Please accept my apology. Thank you very much. Admiral Johnson,
did you say a while ago--did I hear--maybe I heard something
incorrect, but did you say that there had been some testing
done in 2005?
Vice Admiral Johnson. The report to us was that there was
some testing of Bechtel Corporation who was the subcontractor--
a contractor for FEMA that had asked for some testing for
formaldehyde in units that their employees were working. We
were really unaware that that had taken place, but it did occur
in 2005.
FEMA's Emergency Housing
Mr. Lampson. When FEMA proceeded, was it under some
direction or the emergency housing that it provided, did you
have a mandate to go forward with the knowledge that you had,
indicating that the housing it was providing was safe and fit
for short- and long-term housing?
Vice Admiral Johnson. When we began, we had actually been
using travel trailers and mobile homes for a number of years
for disasters. It is a very common form of temporary housing,
and when we used them in post-Katrina, it was a full
expectation it would be suitable housing for all the disaster
victims who would use them.
Mr. Lampson. What would be temporary?
Vice Admiral Johnson. Typically temporary in most disasters
is going to be less than--perhaps less than six months. This is
only the second time I think in our history that we have had a
disaster that has gone beyond that and had people in travel
trailers which was not typically duration expected of their
stay.
Acute Formaldehyde Exposure Levels
Mr. Lampson. Why did FEMA, when requesting the ATSDR,
provide health guidance on safe levels of exposure to
formaldehyde as late as 2007, ask that the evaluation be
restricted to short-term exposures? And why would FEMA request
that when residents had already been living in those trailers
for two years?
Vice Admiral Johnson. The primary concern at that time
again wouldn't--with knowledge, now we look back and wish we
knew what we knew then. At the time that we were asked of that
support, we were really trying to mitigate the effects from
formaldehyde. At that time as well, sir, as I mentioned in my
opening statement, there were up to--we were leading up to
143,000 families in travel trailers. We were still standing up
new group sites at that time just a few months after the
disaster. So we began to recognize that formaldehyde was
causing issues with our occupants, so we were trying to figure
out how can we do something about it, how can we mitigate the
effects, and that was the primary effort of the first request
for support.
Tracking Former Trailer Occupants
Mr. Lampson. As a part of that mitigation, did you--have
you begun to keep a list of all of the people who have lived in
these trailers and set up a plan for monitoring the effects on
anybody who may suffer illnesses because of it?
Vice Admiral Johnson. I say sort of yes and no to your
question. Yes, we do have a record of all those who have lived
in travel trailers and mobile homes, and at this point we are
working with CDC to begin to establish a registry that would
track those families. The registry doesn't exist now, but we
are working with CDC to establish that registry.
Trailer Costs, Inventory, and Sales
Mr. Lampson. There was a FEMA and HUD press release on
April 26th of 2007 and it announced that individuals in travel
trailers would be able to purchase their trailers at a fair and
equitable price. What would you pay for one of those trailers?
Vice Admiral Johnson. Sir, I can tell you, we sold those on
an average for about $300. Even today, with all of the media
attention, the public attention, the government attention from
formaldehyde, I was asked just yesterday, when will FEMA begin
selling travel trailers again to the public.
Mr. Lampson. How much did we pay for them?
Vice Admiral Johnson. I think in travel trailers, I would
be guessing, I think it is about $8,000--$8,000 to $10,000.
Mr. Lampson. Did the manufacturers give us a break on the
price because we were purchasing a large number of them?
Vice Admiral Johnson. I am sure we got a good price. We
bought a number of them. I would have to get back to the staff
on the exact cost of the units.
Mr. Lampson. Would you, please?
Vice Admiral Johnson. Yes, sir.
Mr. Lampson. I don't believe we know the actual number
purchased and the price per item, giving us a total. That could
be a pretty big number, couldn't it?
Vice Admiral Johnson. Yes, sir. We still have--as of August
last year, we stopped using travel trailers. We still have
3,500 travel trailers in our inventory that we are not using in
current disasters today in Tennessee and Arkansas and other
places around the Nation.
Mr. Lampson. Do you know when we purchased those whether
they had done--was it a bid process?
Vice Admiral Johnson. Yes, sir. We bought--well, two
things. First is that immediately when the disaster occurred,
again, overwhelming catastrophic disaster, we used all of the
units that were in our inventory. We actually went and bought
thousands of units that were on the lots of manufacturers and
their distributors, and then we went back to the manufacturer
themselves and had a separate order. So there were actually
sort of three phases of providing the temporary housing.
Mr. Lampson. Do you know how many actual--how many of those
living in trailers have actually chosen to purchase them?
Vice Admiral Johnson. I think we sold about 900 units from
FEMA, and then we worked through GSA and they sold I believe
some number of 5,000 additional units. We can provide that
specific data. But we sold many thousands of units to the
public, some were occupants and some were just people who
wanted to buy them for a recreational vehicle.
FEMA Outreach on Formaldehyde Health Effects
Mr. Lampson. And were they given the same instructions
regarding potential health effects? Were they warned before
they decided to purchase trailers about the formaldehyde
levels?
Vice Admiral Johnson. When we began to--I think July of '06
was our first flier that we sent out to all of the residents of
mobile homes and travel trailers. Anything that we sold beyond
that point when we recognized the situation as it was, we did
provide full information, access to our website, copies of the
fliers so that they were fully informed on their purchase.
Mr. Lampson. I have a copy of a flier here, and the
language that is used in this flier is fairly innocuous
language. I would hope that there would be more detailed
information given certainly by the time that we began to have
all of this information. And Mr. Chairman, I have gone way over
my time. Are we going to have a second round? Are we going to
have a second round? I'll----
Chairman Miller. Yes.
Mr. Lampson.--reopen my time right now and wait.
Chairman Miller. Yes.
Mr. Lampson. Then I yield back my time right now.
Chairman Miller. Apparently I was not paying any closer
attention to you than you were to me.
Mr. Lampson. I will do better next time.
Drs. Frumkin and Sinks Health Consultation Review
Chairman Miller. All right. Thank you. Dr. Frumkin and Dr.
Sinks, according to documents provided by ATSDR, in addition
simply to this February health consultation being copied to
you, routed to you, there was a briefing on it, an oral
briefing that included both of you. Now, when you testified--
well, not testified but when you were interviewed by our staff,
you said you really didn't remember much about that. Do you
remember anything more about it now?
Dr. Frumkin. The document was described to us in our
regular weekly staff meeting, and there was a discussion about
it fairly briefly as we have many items that we cover. I took a
quick look at it at the time and asked for an executive summary
and for some conclusions since I noticed that they were
missing, and readers would have a hard time getting to the
bottom line.
Chairman Miller. Do you recall who was there? I assume that
Dr. De Rosa wasn't there because the evidence is undisputed
that he didn't know about it at that time.
Dr. Frumkin. Yes, sir, he wasn't there.
Chairman Miller. Was Dr. Keim, was he there?
Dr. Frumkin. I don't recall.
Dr. Sinks. It would have either been Dr. Keim or his deputy
who would have presented to us in that issues management
meeting. It is a weekly meeting. We go over many of the issues
that we would be dealing with during that week, and it was
presented probably in a couple of minutes as this is a document
that has been prepared by the division. And at that point, I
know I did take a look at the document following the meeting.
We were never provided a briefing. A briefing I would describe
as the principal investigators and their supervisors meeting
with us to describe what the work was that they were doing, why
they were making certain decisions. We do have those briefings
on a large number of subjects that our agency is involved in.
There was never a briefing provided to us by the staff or the
division.
Chairman Miller. Did you ever ask any questions? Do you
recall asking any questions at that meeting?
Dr. Sinks. I can't recall the meeting specifically. I did
ask to see the document. I did sit down and read the document.
Once I did provide some comments in the margins of the text and
provided that back to probably Mr. Alred who provided that to
us.
Chairman Miller. And you don't recall whether there was any
discussion of what the procedures were for reviewing it,
whether it had been reviewed by Dr. De Rosa or who had reviewed
it at the Division of Toxicology and Environmental Medicine?
Dr. Sinks. There was no discussion about it. We had made
the assumption, and apparently incorrectly, that it had been
reviewed by the division.
Chairman Miller. Okay. And was there any discussion of why
it was being provided? Who had asked for it?
Dr. Sinks. We knew that it was work that was going on. I
can't tell you why it was presented to us at that time. If one
of us had asked to see it or not, this was more than a year
ago, but it was brought to us. I can tell you, sir, that in our
policy, we do have a policy on review of health consultations,
and it very clearly states that those health consultations are
reviewed by various individuals in the divisions with the
discretion to bring it to the Office of the Director. And
whether that discretion is based on the division's
recommendation or our recommendation, it can be either way.
Chairman Miller. Do you recall the March 9 e-mail from Dr.
De Rosa, and it is according to what it says. It was from Dr.
De Rosa to both of you, or to each of you. Re, draft letter to
FEMA. The consultation was developed, sent forward, and signed
by DTE and staff. Now, the earlier e-mail had already said that
he had not seen it. ``They indicated to me that they had been
directed to not share the information further and not to
address longer-term health effects. That is why IARC was cited
repeatedly without reference to cancer and was not included in
the literature cited. FEMA's initial contact came directly to
me nine months ago on this issue. I reviewed the proposed
statement and specified that they neglected to address longer-
term risk including cancer. FEMA then came back to our
OPTER''--I assume that is an acronym, obviously, it is--``with
the same request, and this was assigned to DTE and staff. After
the completion of the consultation, our staff sent their signed
consultation directly to OPTER who sent out the letter. By
separate e-mail, I shared the response with Mark Keim. If you
wish for him to send it out, that is fine. Otherwise, I will
send it at your direction. Either way is fine with me.''
So you obviously knew after this e-mail that he had not
reviewed the letter, is that correct? Dr. Frumkin?
Dr. Frumkin. Yes, I think there are several points in that
e-mail on which we can agree. One is that we didn't adequately
include consideration of longer-term health impacts in the
original consultation. And the second is that our document
review process which should have included Dr. De Rosa didn't
function as well as it should have. We have been very careful
about relooking at our document review process, looking for
where things may have operated, not as well as they should
have, an for opportunities to do better in the future.
Chairman Miller. Is there a procedure that shows--is there
a procedure for initialing I think it is called buck sheets?
Anything like that at ATSDR to show who has seen a document?
Dr. Frumkin. There is for correspondence and for certain
kinds of documents, but generally not for the documents within
divisions.
Chairman Miller. Under your procedures, you would have no
way of being able to look at the document, look at any document
and know who has reviewed it, is that correct?
Dr. Frumkin. The ways that we have of tracking documents
across the agency are complex, and that is one of the things we
have recognized the need to look at as we move toward improving
in the future.
Chairman Miller. This e-mail, again, they indicated to me--
these were the DTM staff and members involved in developing the
consultation--that they had been directed not to share the
information further and not to address longer-term health
effects. That would appear to me to be a startling sentence in
that e-mail that should have gotten a great deal of attention
for what had happened and why it had happened. But there
doesn't seem to be any response that matches up to my response
which is to be startled that they had been told by FEMA what
kind of report they wanted. Do you have any document--I mean,
do you have e-mails that say that you wanted to get to the
bottom of this?
Dr. Sinks. Let me respond to that in two ways. First of
all, in Dr. De Rosa's e-mail of the week before discussing
this, he says that he has spoken to his staff and he has taken
care of the issue of making sure that adequate clearance goes
through his division. I believe that is the e-mail you
mentioned the first time he sent a letter. I think our focus
was actually on the content of his letter and what should be
going forward which was an appropriate thing to be doing, and
we embraced his coming forward and recommending that level; and
Dr. Frumkin concurred, and we sent it forward.
Chairman Miller. Even after the letter went out, not the
one that Dr. De Rosa had drafted but someone else at your
direction sent a letter to FEMA, a letter that apparently was
placed in a file and not circulated at all at FEMA or given to
anybody responsible for public health instead of liability,
FEMA continued to tout ATSDR's assessment. It was in the press,
it was in testimony before the Government Reform and
Accountability Office, Accountability Committee here last
summer. It did not always refer to ATSDR by name. It simply
said scientific agency. When did you become aware that FEMA was
continuing to tout ATSDR's flawed Health Assessment?
Dr. Frumkin. We were not adequately aware of the way the
assessment was being used or interpreted or misinterpreted
during that several month period in early 2007. We focused on
it much more intensively during the middle of 2007 when the
media reports and the Congressional oversight drew our
attention to it. But we don't routinely track media reports
about what other agencies are doing.
Dr. Sinks. Sir, if I may add to that----
Chairman Miller. Sure, Dr. Sinks.
Dr. Sinks.--response, we also became much more heavily
engaged in May, about the middle of May, when we were contacted
by the Department of Homeland Security to become more engaged
in the issue; and that is when we started to develop our plans
for more robust response to the formaldehyde issue.
FEMA's Office of General Council's Involvement With the Health
Consultation
Chairman Miller. Dr. Sinks, you did say a moment ago that
you had in fact reviewed the letter, the Health Assessment?
Dr. Sinks. Yes, I did see the Health Assessment. The first
one, the first week of February, yes.
Chairman Miller. Did you read the first sentence which
reads, ``the ATSDR Emergency Response Program was requested by
the Federal Emergency Management Agency, FEMA, Office of
General Counsel, to review and provide an evaluation of
analytical data related to a project involving formaldehyde
sampling at FEMA temporary housing units/trailers located in
Baton Rouge, Louisiana?''
Dr. Sinks. Sir, I would have read that statement and I
believe there are actually earlier clues in the e-mails that
would have indicated to me that the Office of General Counsel
at FEMA had made that request of us. It was not something that
caught my attention at the time.
Chairman Miller. Okay. Well, the e-mail that you sent I
think in October, in the fall of last year, that you were
shocked to learn that it had been provided to a lawyer for
presumably liability concerns, not based upon concerns about
public health. Did you just not pay any attention? Do lawyers
usually get involved in the public health considerations?
Dr. Sinks. Occasionally lawyers do get involved in public
health considerations. I think, Mr. Miller, I certainly had the
opportunity to recognize that. All of us who did review the
document or did read the document would have had that
opportunity. There were also e-mails that had gone on before
that would have given us that opportunity. It was simply
something that did not catch my attention at the time.
Chairman Miller. The second paragraph of that e-mail,
unfortunately the request was generated by FEMA lawyers
attempting to respond to legal actions against FEMA. You said
that this request must not have seemed extraordinary to our
staff, but it didn't seem extraordinary to you, either.
Dr. Frumkin. Mr. Miller, I think in retrospect, we failed
to recognize the import of a contact that came from an attorney
rather than through typical technical channels. Please be
assured that we are about protecting public health. We are not
about litigation support. We undertook this work in a sincere
effort to advance public health and in no way ever would
compromise that mission.
Chairman Miller. Just one moment, please. Actually, Mr.
Lampson is recognized for another round of questions.
Trailers at Maxwell Air Force Base
Mr. Lampson. Thank you, Mr. Chairman. Mr. Johnson, is FEMA
taking mobile homes to Maxwell Air Force Base for testing?
Vice Admiral Johnson. I am not aware currently that we are
taking them to Maxwell Air Force Base.
Mr. Lampson. We have learned that there is a plan to take
some trailers there, I don't know the number, heat them up,
measure the formaldehyde content, and then send them to
Tennessee. You can't clarify that in any way?
Vice Admiral Johnson. Just what I would say is right now,
as I mentioned before, if we provide a mobile home to any
disaster site currently, which would be Tennessee, Arkansas,
Oregon, those who have a current disaster, we developed
protocol working with the Office of Health Affairs and DHS of
how to test that unit so we can provide the test result to the
state and to the potential occupant of that unit. Right now it
is seven days of not heating up, and seven days of simulated
actual situation which in most cases involves using the air-
conditioner and climate control, humidity control. And so we
have this standard protocol. We do test it. We use the same
test company, the same protocol, the NIOSH protocol that was
used by CDC, and we have actually done that successfully for
the last probably 2 months. We provided housing units that
tested very low in formaldehyde to Oregon, and we are currently
prepared to provide mobile homes to Tennessee and Arkansas at
levels where the state has accepted those units.
Mr. Lampson. But you don't know for certain that that
testing is going on at Maxwell Air Force----
Vice Admiral Johnson. Well, we are doing testing in Selma
and in Hope, Arkansas. So I am not quite sure in Selma, if that
is Maxwell Air Force Base but that is where we have a facility
that exists now for mobile home storage.
Emergency Housing Alternatives
Mr. Lampson. Although I would like to believe that we won't
have any more natural disasters that leave people homeless, we
all know that it is probably going to happen at some time in
the future. Is FEMA looking at alternatives for emergency
housing? Can we use new green building materials to manufacture
temporary housing that is healthier? What is your agency doing
along these lines? And can you also tell me when FEMA
anticipates that residents will be moved out of the trailers
entirely?
Vice Admiral Johnson. Yes, sir. Good question. We have a
joint housing solutions group that we stood up about a year
ago, and their job is to reach out to industry and identify
potential alternatives to mobile homes and travel trailers; and
they have actually tested--some are shipping containers, some
are other modular homes, and they have actually looked at about
40 different alternatives that cost different amounts. Some
take more set-up than others, and we are exploring different
alternatives to mobile homes and travel trailers. Last year
Congress appropriated $400 million for us to run an alternative
housing pilot program in the Gulf Coast, and we currently have
what are called Katrina cottages in Mississippi and there is a
current program in Louisiana, Texas, Mississippi, all to look
at alternatives to mobile homes and travel trailers. And so we
are very attuned to the need to find a broader range of
solutions.
Within the Gulf Coast right now, it is our desire to move
all the residents out of travel trailers into more permanent
alternatives such as rental units, apartments, and the like. We
want to have all out of group sites before hurricane season on
the first of June, and we are working very hard every day to
move an average of about 500 to 700 families a day to leave a
mobile home or a travel trailer inside the Gulf Coast today,
moving towards more permanent locations. In some cases, that is
their house. They have a travel trailer that is in their
driveway as they begin to repair a house post-Katrina, and so
it ranges from moving back into their house, moving in with
relatives, or moving actively into apartments and hotels and
motels and other sorts of housing alternatives.
Mr. Lampson. At 500 to 700 a day and you're looking at
hopefully completing it by June?
Vice Admiral Johnson. Well, we hope to get all the group
sites--in some locations, and I think it came up in a prior
panel, in Louisiana, there appears to be an almost adequate
number of alternative housing apartments and rental units. In
Mississippi, the local housing has not recovered nearly as
quick. The issue with Mrs. Huckabee is in an area of
Mississippi where there are not available rental units. In some
parts, in other parishes and counties, very, very difficult to
find alternatives; and so some people do feel in order to stay
close to family, to school, to work, to church they are making
the choice to stay where they are as opposed to moving to an
alternative that we hope that we can provide to them.
How Will ATSDR Prevent Future Problems?
Mr. Lampson. Dr. Frumkin, your statement that we could and
should have done better is an understatement. Your agency has
failed to protect public health, failed to produce the best
science. I still don't understand how your agency produced such
a poor quality scientific report to FEMA, why you failed to
improve or correct that report, and I also can't understand why
you didn't personally communicate with your counterparts at CDC
and FEMA when it was reported that trailer residents were
experiencing clinical symptoms associated with formaldehyde
exposure. In light of that incident, what changes have you
instituted specifically at ATSDR to eliminate a recurrence of
that situation?
Dr. Frumkin. With respect, sir, we have done an awful lot
of very effective public health protection, but I have to agree
that we didn't do the job we would have liked to have done with
regard to the trailers. The opportunities for improvement that
we have identified are in several domains. One has to do with
the clearance and review of scientific documents. The Board of
Scientific Counselors, which is an external group, is reviewing
our scientific clearance procedure to see whether there are
ways to improve that. In the meantime, we have reinforced to
the divisions the need to abide by standard existing procedures
because that hadn't always been done and it wasn't done in this
case.
With regard to management issues, also a potential
opportunity for improvement, we have commissioned an outside
review of our management procedures, if we can identify
opportunities for improvement there. And then as detailed in
our written testimony, there is a series of short-term
solutions or improvements that we have implemented, for
example, clarifying communication channels within in between
agencies. The ways that we are triaging and tracking the issues
that we manage have been considerably strengthened. We have our
weekly meetings both for issues management and senior staff,
and we have clarified with all participants of the meetings the
need to raise important issues and to raise them repeatedly if
they remain active. We are tracking those actively now.
So we have made some improvements internally. We have
sought external oversight so that we can identify the very best
opportunities for improvement as we move forward.
More on Dr. De Rosa's Performance
Mr. Lampson. A little while ago, Dr. De Rosa testified that
he has been put on a 90-day notice that he must show personal
improvement and must embark on a personal improvement program
in order to do so. Yet, he is the one who helped identify
shortcomings that were there. Is that fair? Dr. Sinks.
Dr. Sinks. Let me try to respond to that. First of all, Dr.
De Rosa did identify one of two key issues with the report that
were relevant, the February 2007 report. He identified the lack
of long-term health issues being identified. Unfortunately, he
did not identify the fact that it was using an emergency
medical guidance as a level of concern, and I wish that he had
actually identified that. I heard him testify earlier that in
fact he had mentioned this to us, but I never recall having
heard him bring this up before; and in fact, the first time we
became aware of the problem was in the hearing that was
mentioned in July. And I believe this was something I had the
opportunity to have seen and I missed, and I believe everybody
who reviewed that document had the opportunity to see that, and
we missed that.
Going back to the performance improvement plan, and this is
a standard document that is essentially an agreement that
identifies the fundamental steps one should be taking in terms
of their job to improve their performance, and that document
was developed with several discussions with Dr. De Rosa about
the types of activities that we thought his new position should
be doing. What he wanted to do, he had significant input into
that document. The elements in that document do relate to the
type of work that he wished to do and I concurred with, and it
is simply a document that identifies expectations for adequate
performance. It is actually a document that is designed to help
Dr. De Rosa to understand what the expectations are for his
performance.
Mr. Lampson. Are comparable steps being taken--level
because were you not involved in the same level of failure?
Dr. Frumkin. There is accountability across all levels of
our organization, sir, from the Director's office, from myself,
and Dr. Sinks to the Division Directors, to the Branch Chiefs,
to the individual staff members. At every level of
accountability, we take responsibility when we haven't
performed well, and we work to make improvements. I need to
emphasize that the reassignment of Dr. De Rosa was not in any
way a retaliation for his actions in this case. His
reassignment was a result of personnel actions that are best
not discussed in a public forum like this. With regard to Dr.
De Rosa's involvement in this particular situation, his major
intervention during the one-year period between mid-'06 and
mid-'07 was a suggestion that long-term health effects had been
omitted from the report and it needed to be included; and that
suggestion was gratefully accepted and acted on. So it is
important to decouple the personnel action that occurred in
late '07 from a review of the events we are talking about
today.
Mr. Lampson. Is his job at stake?
Dr. Frumkin. There is absolutely no plan or no intention by
me or anybody else I know to threaten his employment. His
reassignment is at the same grade level, same seniority level,
and I view it as a long-term reassignment.
Mr. Lampson. Do you feel that he interprets any of these
actions as related to this issue?
Dr. Frumkin. That would be a question for him.
Mr. Lampson. That was certainly the impression that came
here. What steps exactly are you all taking, and if you can't
discuss them in public, can you submit it to us, to the
Committee? The steps are for anybody including yourselves as
far as accountability is concerned.
Dr. Frumkin. Yes, we can submit that in writing.
Mr. Lampson. Okay. Thank you. Mr. Chairman, I yield back.
Chairman Miller. Thank you, Mr. Lampson. I think we are
getting close to the end. There are obviously many points of
dispute in the testimony and in the interviews, but I think
everyone involved is going to have many opportunities to
testify under oath about these events in deposition and
probably at trial as well.
I respect, Dr. Frumkin, that you don't want to go into the
personnel issues, but the memorandum of October 24 that you
prepared, I want to read just an excerpt of that, that provided
Dr. De Rosa with an unsatisfactory rating a year after being
given a substantial bonus as an incentive to stay in federal
employment. ``During the past year, he,'' Dr. De Rosa, ``was
unaware of significant projects. His staff became involved in a
project to assess formaldehyde levels in unoccupied FEMA
trailers. In June 2006, his office took it upon themselves to
engage in this long-term, non-emergency evaluation. They were
technically unprepared to do the work. In addition, they took
direction from a FEMA lawyer without consulting their
supervisors. ATSDR consultation resulting from their work was
of inadequate quality and has since been revised.'' Is that
still your view?
Dr. Frumkin. Yes.
Review of the Events Surrounding the Health Consultation
Chairman Miller. Okay. And again, I the e-mail that I
earlier referred to and read from, Dr. Sinks; and that e-mail,
you saw that e-mail, did you not, in October to all the staff
at ATSDR about the levels of formaldehyde and the inadequacies
of the work done to that point?
Dr. Frumkin. I am sorry. I am not sure which e-mail you are
referring to.
Chairman Miller. It is dated October 12, 2007. It is from
Dr. Sinks to all the CDC. The attachment is final outside
contact procedures.
Dr. Frumkin. Yes.
Chairman Miller. And did you direct that he send that e-
mail?
Dr. Frumkin. I concurred with sending it. We decided
together that it needed to be sent.
Chairman Miller. Okay. And that says, unfortunately that
request was generated by FEMA lawyers attempting to respond to
legal actions against FEMA. Staff was asked to handle EPA
generated data as confidential. Those were extraordinary--that
was extraordinary, is that correct?
Dr. Frumkin. It is a very irregular process for an
interagency collaboration, yes.
Chairman Miller. Okay. But again, the assessment itself in
the first sentence says it was at the direction or at the
request of FEMA's general counsel, isn't that right?
Dr. Frumkin. In the previous document that you read?
Chairman Miller. In the assessment, the February 2007
assessment.
Dr. Frumkin. Yes.
Chairman Miller. Dr. Sinks?
Dr. Sinks. That is correct.
Chairman Miller. And Dr. De Rosa's e-mail of March 9, 2007,
said also that the staff at ATSDR who prepared the report said
that they were directed not to share the information further
and not to address longer-term health effects. Is that also not
something that would--it would be very extraordinary?
Dr. Sinks. I think half of that is certainly correct if you
look at the incoming letter of transmittal to the data from the
lawyer to the ATSDR staff, it does direct them not to share the
data. It does not limit the scope of the evaluation, at least
in my reading. Now, I don't believe Dr. De Rosa, Dr. Frumkin,
or I were ever in a discussion with FEMA about this consult. So
we don't know exactly what the discussions were verbally, but
in the letter of transmittal, it does ask the staff to hold the
data confidential, but it does not, at least in my read of it,
restrict the scope of the work.
Chairman Miller. But the e-mail from Dr. De Rosa, which
apparently is based upon old discussions with those staff
members, said that they were directed not to address longer-
term health effects.
Dr. Frumkin. That would be a claim that you would have to
discuss with Dr. De Rosa. Certainly that direction to the best
of my knowledge didn't come from FEMA, and I know that it
didn't come from within our agency.
Chairman Miller. I am sorry. So when you got this e-mail on
March 9, 2007, about the Health Assessment that had just gone
out the previous month, and it said that the employees involved
were directed not to address longer-term health effects, you
decided that what Dr. De Rosa said was wrong, that there was no
such direction?
Dr. Frumkin. Rather than correct that statement, I focused
on getting a correction out to FEMA so that we could set the
record straight.
Chairman Miller. And I understand that a letter did go out,
it went out to the lawyer who had asked for this in the first
place and because of that, litigation had been resolved. He put
it in his file. He didn't give it to anybody. But what is very
hard to fathom is that with the first sentence of the Health
Assessment which Dr. Sinks says he read, saying that the
request came from a lawyer, with the lawyer for FEMA, with the
e-mail saying that the staff involved had been told not to
share the information, not to address longer-term health
effects, apparently dictating what was to be considered and
what was not, you did not feel some sense of urgency other than
to send a letter. And even when FEMA continued to tout the
ATSDR's assessment as being scientific support, that everything
was fine, if you just open the windows and doors, you didn't
feel any sense of urgency to call somebody and say, didn't you
get our letter?
Dr. Frumkin. The initial fix for the problem of too narrow
a scope in the original health consultation was simply to
broaden the scope. Rather than engage the assertion that there
had been some limitation on the initial scope, we simply
corrected it and set the record straight by sending the letter
to FEMA. We did not follow up with FEMA to check on the
implementation of the letter. And in retrospect, I think that
we should have engaged during that first half of '07 more
actively than we did.
More on Obstacles to Safe Housing
Chairman Miller. Admiral, I don't want you to feel left
out. FEMA Administrator David Paulson testified before the
House Homeland Security Committee in May of last year and
testified, we have been told that the formaldehyde does not
present a health hazard. However, we do encourage our occupants
of those trailers to air them out, keep them open as much as
possible to let the fumes out. Was there a basis--did anyone
tell you besides ATSDR?
Vice Admiral Johnson. If I can answer that question by
correcting one issue, there seems to be a focus on dealing with
the lawyer and on FEMA's desire to avoid litigation, and I
would like to at least make the record clear that while we had
a lawyer, Preston, who was primarily in communications with
CDC, there were other people from other disaster assistant
directors who were also involved and that FEMA's primary
motivation was not to avoid litigation because we clearly went
public with the information as soon as we received it. Our
primary motivation was to get as much information as we could
as non-medical people to do the best that we could to preserve
the health and safety of the people who were living in these
travel trailers.
So I would like to make it clear that we were not trying to
avoid litigation, and that wasn't our reason for going to CDC.
When Administrator Paulson testified before Congress, I think
it does reflect perhaps a misinterpretation of the report. It
was our feeling at the time that based on the information that
we had, both from EPA and CDC, that we didn't confront the
health situation that we now know that we did.
Chairman Miller. Mr. Lampson?
Mr. Lampson. Let me get one point of clarification, Mr.
Johnson. When I asked regarding the provision of safe and fit
housing for a short- or long-term period, would you agree that
your mandate is to provide safe and fit housing, whether it be
long-term or short-term?
Vice Admiral Johnson. That is correct. I agree with that.
Mr. Lampson. And was FEMA acting under that mandate when it
provided those trailers----
Vice Admiral Johnson. That is correct.
Mr. Lampson.--for both short- and long-term?
Vice Admiral Johnson. Yes, sir.
Mr. Lampson. And is there a backup plan now adequate in
your mind that if you come into another situation where you
find that your step number one isn't working and you have to
take emergency actions that there is a way that we are not
going to have people in harm's way again?
Vice Admiral Johnson. I think it would be nice to say
clearly that the answer is yes, we have got this plan and it
won't ever happen again. I think where we are is that while we
are here, members of the manufacturing housing community are
also watching; and we are working with them, as I indicated
before. We have been able to identify what parts of a mobile
home or a trailer actually present the greatest risk for
formaldehyde. We worked with them recently to establish a unit
that doesn't use urea insulation, it doesn't use vinyl gypsum
board, and we have been able to reduce the level of
formaldehyde to a much, much, much lower level now in one
prototype unit than we have ever had before. We have just
issued a contract to buy more of those units. And so it is our
intent we think that we will need mobile homes in the future,
and we want to be able to write a spec that requires
significantly lower amounts of formaldehyde.
We also have a range of options from sheltering to
apartments and motels and hotels and other things that we try
to do and we use them even now. But the situation in Greenburg,
Kansas, where the town is exactly blown away by a tornado,
there are no close options that meet the needs of the
individuals unless they travel great distances to work and
where they are home.
And so we are working very hard to expand the range of
options, look at things beyond mobile homes and travel
trailers, that where we have mobile homes to have them
significantly reflect lower formaldehyde.
Health Care Costs
Mr. Lampson. And then one last question. I brought up
with--I can't think of her name right now, the lady from the
trailer.
Vice Admiral Johnson. Mrs. Huckabee.
Mr. Lampson. The dollars in health care costs that she has
faced and many others have faced, and I did understand that
FEMA has established a program to reimburse families for these
medical bills. If that is the case, how many people have
applied for such reimbursements; and if FEMA has paid money out
at this point, how much?
Vice Admiral Johnson. Mr. Lampson, unfortunately, it is not
the case. FEMA does not have authority, an order to reimburse
medical expenses. It is not the policy of FEMA or the
government at this point to reimburse medical expenses.
Mr. Lampson. I yield back my time, Mr. Chairman.
Vice Admiral Johnson. Let me just correct one number that I
gave you. We are actually moving 1,000 households a week, not a
day, out of travel trailers and mobile homes in the Gulf Coast,
just to give you the right number.
Mr. Lampson. Thank you. Thank you very much.
CDC Actions: May-July, 2007
Chairman Miller. Dr. Frumkin, we have only talked about a
couple e-mails, and in fact there have been a good many e-mails
about this but one that Dr. De Rosa sent from his Blackberry on
July 24 of last year, 2007, kind of late at night.
``Colleagues, while testing may be warranted, what immediate
interventions are being pursued through appropriate channels to
interdict exposures or to mitigate health impacts? I am
concerned that the reported clinical signs are the harbinger of
an impending public health disaster. We know based on data
provided to us that levels are up to 80 times higher than peak
occupational limits and up to 300 times higher than our health
guidance values. I think we must be more proactive in
protecting the people while assisting FEMA.'' Do you remember
getting that e-mail?
Dr. Frumkin. Yes.
Chairman Miller. What did you do?
Dr. Frumkin. There was a lot underway already. First, I
have to say that I agree with the sentiments in that e-mail
completely. We have to be proactive in protecting the people
living in trailers. And it happens that at that point in time
we were undertaking a large range of actions that would lead to
exactly that goal. Beginning in May we undertook discussions
with FEMA that launched all of the activities that are now
under way that I described, the testing of occupied trailers,
and that was a data set that we needed to determine exactly
what the level of risk was. We couldn't extrapolate from the
unoccupied trailers to the occupied trailers, so we needed
solid data to help with that. The follow-up studies, the
clinical reviews, and so on, all of those were under way or
being planned at that point in time.
But the sentiment behind Dr. De Rosa's e-mail, the concern
for the well-being of people in the region was very much a
shared concern, and there were, in fact, a lot of activities
under way at that point to help protect their health.
Chairman Miller. Did you do anything at that point to
advise FEMA again other than that letter sent to the lawyer,
and when Admiral Johnson said FEMA didn't know about it, at
least one employee at FEMA knew about it. The February 2007
consultation, health assessment, was not one that they should
be paying attention to, should be relied upon. It was flawed. I
mean, you are very critical of it later. You are very critical
of it in your evaluation of Dr. De Rosa, something that came
out of his shop. But do you have anything in writing or can you
recall an oral discussion with anyone at FEMA that made those
same criticisms and said stop using that?
Dr. Frumkin. At about that time in July, we were revisiting
the original consultation with a lot more attention than it had
gotten before; and at that point, we fully realized the
limitations of that original consultation, and it was soon
after that, I can't remember the exact date, when we made the
decision to pull back the original consultation and reissue a
more accurate document.
Chairman Miller. October?
Dr. Frumkin. October was when it was released, yes.
Chairman Miller. Okay. It was retracted in October. This
was in July?
Dr. Frumkin. Yes, sir.
Chairman Miller. Okay.
Mr. Lampson. Mr. Chairman?
Chairman Miller. Yes.
Mr. Lampson. Are you about to wrap up?
Chairman Miller. Yes. Mr. Lampson.
Were Discussions Being Made By FEMA's Lawyers?
Mr. Lampson. Unless someone wants to make a comment about
it, let me just make a comment here I guess at the end. Admiral
Johnson, because this hearing is focused probably more on the
events of 2007, I am going to overlook I guess your several I
think misleading statements about FEMA's response to the
formaldehyde issue in 2006. Suffice it to say that FEMA spent
most of that year telling trailer occupants that there was no
problem and worrying about the impact of testing those trailers
on FEMA's legal liability, in March of '06, FEMA's attorneys
knew that EPA had determined that some people had negative
reactions to formaldehyde at 0.1 parts per million and said any
testing would have to be done quietly. But in May of '06,
before it had done any investigation, FEMA issued a statement
that there are ``no health concerns associated with
formaldehyde inside out FEMA mobile homes and travel trailers.
FEMA then delayed testing, even unoccupied trailers, because of
the words of a FEMA attorney, ``testing would imply ownership
of the issue.'' And your Office of General Counsel said that it
didn't want the testing to determine what levels were unsafe
but only how to ventilate the trailers. Then when ATSDR issued
its seriously flawed health consultation which FEMA officials
described as giving them what we were looking for, FEMA's
lawyers directed ATSDR not to release the study publicly so it
could be reviewed. We all know that there is plenty of blame to
go around, but we sure want to be talking about this in '07.
The lawyers were running the show.
Vice Admiral Johnson. Mr. Lampson, respectfully I reject
the notion that the lawyers were running the show. I reject the
notion that FEMA made any decisions based on concern for
litigation. What you see in e-mails is you see what occurs in
many organizations, staff people talking with each other,
raising pros and cons and concerns that should be considered by
leadership but don't make decisions by leadership. Every action
that FEMA took I think was responsible given the level of
knowledge that we had at the time and what is clearly an
insufficient sophistication about medical implications of
formaldehyde. But the lawyers were advising, they were dealing
litigation. We consistently made other options available to
residents. We consistently put information on our website,
twice. We hand-delivered 70,000 fliers to individual units. So
I think if you judge us by our actions as opposed to the
interaction between our lawyers, I believe that given the
knowledge that we had at the time, I believe we took
responsible steps.
Mr. Lampson. At least the e-mails that we have been able to
see up here, it seems that all of the decisions were being made
by the lawyers. And that is a problem from here, as we see it.
I voted against the creation of the Department of Homeland
Security a number of years ago. I thought that it was going to
create a horrible bureaucracy. I think it has, and I think that
we are suffering a lot of effects because of our haste, because
of our unwillingness to try to look and see what impact our
decisions are going to have on the American people. Perhaps we
have made too many decisions, Chairman Miller, on the political
strengths of our parties, rather than the real needs of the
people who are this country and our government. And I think
that to some extent I am ashamed with the way we have reacted
and the fact that people have had to come and tell us some of
the stories that we have heard is embarrassing. To know that we
have not followed typical protocol that you teach in basic
science classes about how you go about trying to make good,
reasonable decisions with only taking into consideration real
science is hard for me to go back to my ninth grade physical
science class that I taught in many years ago and show them
that this government was acting in the best interests of its
citizens when we took some of the steps that we did.
It is a little disheartening, ladies and gentlemen, to have
to sit up here and say these things or even think them or to
have heard from some of the brave people that did take the time
to come up, and I hope that we never, ever have to go through
something like this again.
Mr. Chairman, I yield back my time. And again, I thank you
for the effort that you have made and this committee has made
in keeping this issue to the forefront.
Chairman Miller. I think this hearing is now concluded,
although certainly not this matter. I think there will be a
good deal more inquiry, both by perhaps other oversight
committees, including perhaps this one, and certainly very
possibly, very certainly in litigation as well, private
litigation as well.
Thank you for appearing. Under the rules of our committee,
the record will be held open for two weeks for Members to
submit additional statements and any additional questions they
might have of the witnesses. This hearing is now adjourned.
[Whereupon, at 12:56 p.m., the Subcommittee was adjourned.]
Appendix:
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Additional Material for the Record
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