ATSDR in Partnership With Indiana
The Agency for Toxic Substances and Disease Registry (ATSDR) is the lead
public health agency responsible for implementing the health-related provisions
of the Comprehensive Environmental Response, Compensation, and Liability Act of
1980 (CERCLA). ATSDR is an Atlanta-based federal agency with more than 400
employees and an annual budget for 2003 of approximately $82 million. ATSDR is
responsible for assessing the presence and nature of health hazards at specific
Superfund sites, helping to prevent or reduce further exposure and illnesses
resulting from those hazards, and expanding the knowledge base about the health
effects of exposure to hazardous substances.
ATSDR works closely with state agencies to carry out its mission to serve the
public by using the best science, taking responsive public health actions, and
providing trusted health information to prevent harmful exposures and disease
related to toxic substances. ATSDR provides funding and technical assistance to
states and other partners through cooperative agreements and grants to identify
and evaluate environmental health threats to communities. These resources enable
state and local health departments and other grantees to further investigate
environmental health concerns and to educate communities. From
fiscal
years 1986 through 2003, ATSDR awarded more than
$3.5 million—more
than
$600,000 in the last 2 years—in direct funds and services
to
Indiana for comprehensive support of its environmental
health unit. In addition to direct funds and services, ATSDR staff provides
technical and administrative guidance for state-conducted site activities.
ATSDR Site-Specific Activities
Public Health Assessment-Related Activities
One of the agency's important mandates is to conduct
public health
assessments of all National Priorities List (NPL) sites and of other
sites where a significant threat to public health might exist.
Thirty-nine sites have been designated to the NPL in
Indiana.
A public health assessment is a written, comprehensive
evaluation of available data and information on the release of hazardous
substances into the environment in a specific geographic area. Such releases are
assessed for current or future impact on public health. ATSDR, in collaboration
with public health and environmental officials from Indiana,
has conducted 61 public health assessments in the state,
including the following recent example.
Keil Chemical Company—In 1999,
Representative Peter J. Visclosky (D-1st-IN) asked ATSDR to conduct a public
health assessment on behalf of petitioners concerned with potential air
emissions from the Keil Chemical Company in Hammond.
Residents were concerned that the incidence of pediatric cancers in their
neighborhood may have been caused by the release of 1,2-dichloroethane
(ethylene dichloride, or EDC) and vinyl chloride (VC) from the plant during
the Pyro-Chek manufacturing process. EDC and VC are by-products of the
process.
A final public health assessment released in June 2001 concluded that
contaminants detected in samples from an air monitoring station 1.5 miles
from the site were not at levels of health concern. During the exposure
investigation, VC and other contaminants were not detected; EDC was detected
below levels of health concern. No contaminants were detected in the soil or
wastewater above health comparison values, and people would not be exposed
to wastewater generated by the plant or exposed to on-site contaminated
soils. Therefore, this site does not currently represent a health hazard.
The Pyro-Chek process no longer is used at this site, and supplies of EDC
have been removed. The Indiana State Department of Health (ISDH)
conducted a review of reported cases of childhood cancers to determine
whether cancer rates in children living in the Lake County area are
elevated. ISDH concurrently released its findings in a health consultation
and concluded that rates of childhood cancer were not elevated for Lake
County or for the community surrounding the Keil Chemical Company.
A health consultation is a written or oral response from
ATSDR to a specific request for information about health risks related to a
specific site, chemical release, or hazardous material. A health consultation is
a more limited response than a public health assessment is. To date, 72
documented health consultations have been conducted at 51 sites
in Indiana, including the following recent examples.
Vapor Intrusion of Perchloroethylene (PCE)
in a Residential Community—Region 5 ATSDR and ISDH
were asked by the Indiana Department of Environmental Management
(IDEM) to evaluate possible health effects from exposures
to elevated levels of perchloroethylene (also known as PCE,
tetrachloroethylene, or PERC) detected in some Evansville
residential houses. While investigating groundwater contamination associated
with the Former Crescent Cleaners site in Evansville, IDEM detected elevated
levels of PCE in groundwater and soil. Because the soil in this area is
sandy, IDEM evaluated the potential for PCE vapors from the groundwater to
infiltrate nearby homes and businesses. IDEM continues to conduct additional
sampling studies of contamination of indoor air, soil, and groundwater to
characterize the extent of the PCE plume.
In a health consultation released in October 2003, ATSDR concluded that this
site poses a public health hazard because long-term exposure to PCE could
have resulted in an increased cancer risk. Although mitigation systems were
installed in homes and in one business that had elevated PCE levels, only
one system was effective; two others failed. Repairs were made to the
systems that failed, but test results are not yet available to determine
their current effectiveness.
Future exposures to PCE pose an indeterminate public health hazard, because
PCE levels could be present or increase over time in buildings without
mitigation systems. These levels could increase or be found in other
buildings if existing mitigation systems are not maintained or if the plume
continues to migrate to other areas.
ISDH is planning to conduct a needs assessment and to provide
community members with information that will assist in answering their
questions about the possible health effects from PCE.
Methyl tert-Butyl Ether (MTBE)
Contamination in a School Water System and in Residential Wells—MTBE,
a gasoline by-product, was first found in the well that supplies the
Lincoln Elementary School and residences in Roselawn
in March 2000; these concentrations increased in 2001 and 2002. Exposure
stopped in April 2002, when the school was provided with an alternate water
supply and affected residences were provided with filters to remove MTBE
from the water. IDEM performed sampling of the school and
selected areas surrounding it, including a nearby gas station. IDEM then
asked ISDH to review existing data from the site and
evaluate the public health implications of contamination at the school and
surrounding neighborhoods. ISDH and IDEM provided information to the
community during a public availability session in May 2002.
In a health consultation released in March 2003, ISDH and ATSDR concluded
that as long as an alternate water supply is used and the residential
filters on the water from contaminated water wells are maintained, people
are not likely to become ill from the drinking water at the school or in the
nearby residences. The contaminated groundwater poses no apparent public
health hazard, because the contaminant levels are lower than those expected
to cause adverse health effects. ISDH and ATSDR also recommended continuing
the investigation to identify the geographical extent of the MTBE plume and
other private wells that might be impacted.
Prestolite Battery Plant—The former Prestolite Battery Plant
in Vincennes is undergoing redevelopment efforts to return
the property to productive land use. While the plant was in operation,
manufacturing process wastes and wastewater became laden with lead, lead
oxides, lead sulfates, and sulfuric acid. These lead-containing sludges and
wastewater were discharged to an on-site sewer system. Over time, these
sewer lines became plugged with lead-contained sludges and, as a result of
leaks and sewer line back-ups, the soils around these sewers and associated
pumps became contaminated. Additionally, lead dust was also released from
the plant's ventilation system. The lead dust is believed to have
contaminated the surface soils, sediments, and groundwater near the plant.
Accidental spills of process materials also contributed to the lead
contamination of on-site soils. All residences near the former Prestolite
site have been placed on municipal water.
In a health consultation released in September 2003, ISDH concluded that no
apparent health hazard exists at the site. Off-site and on-site
contamination are still present, but at levels that are not expected to
cause human health concerns. However, ISDH also concluded that a physical
hazard is present on-site because of construction debris, and ISDH
recommended its removal.
An exposure investigation collects information on specific
human exposures through biologic sampling, personal monitoring, related
environmental assessment, and exposure-dose reconstruction. ATSDR staff members
have conducted four exposure investigations in Indiana,
including the following recent example.
Keil Chemical—Hammond
residents were concerned that emissions from Keil Chemical are adversely
impacting their health, and they petitioned ATSDR to evaluate whether
chemical releases from the Keil Chemical facility posed a health hazard. To
make the health evaluation, ATSDR proposed an exposure investigation to
sample the community's air for chemicals emitted by the facility.
The purpose of the exposure investigation released in February 2001 was to
determine whether residents who live downwind from the facility are being
exposed to airborne EDC and VC at health hazard levels. The investigation
was jointly completed by the Hammond Department of Environmental
Management, ATSDR, and the residents of Hammond. Data used included
the following: air samples collected downwind of Keil's EDC and VC
emissions, source samples collected at Keil during air sampling, and
dispersion modeling of the emissions after air sampling. The target
population was all residents who live within 1.5 miles of the facility.
The exposure investigation concluded that concentrations of EDC and VC
detected in Hammond's ambient air do not pose a public health hazard.
Emissions of EDC and VC are ongoing and variable, indicating inconsistent
efficiency of air pollution control. Past exposures will be addressed in an
ATSDR petitioned health consultation.
Health Education and Community Activities
Indiana has been a participant in ATSDR's cooperative agreement
program since 1988. Under this program,
ISDH has received
funding and technical assistance for the development of community education and
activities associated with human exposure to hazardous substances in the
environment. During fiscal year 2003, nine different educational materials were
developed in support of environmental health education activities at 10 sites.
Activity in
Elkhart (the Conrail Rail Yard site) began with a
community needs assessment as the basis for a comprehensive health education
program for residents. Among material developed for residents was a brochure on
handling common household chemicals. This brochure was also used for health
education at other sites throughout the state.
Considerable health education activity has been conducted for residents near the
Bedford General Motor site. Sixty-nine percent of residents and 20% of
physicians responded to a community needs assessment focused on polychlorinated
biphenyls (PCBs). Seventy-six percent of residents responded that they would
like to receive information on how to protect their family's health, and 56% of
physicians responded that they would like to receive information on ways their
patients could protect their health. These results led to news releases,
community informational meetings, and the development of fact sheets addressing
health issues associated with PCBs. In November 2002, physicians from the Great
Lakes Center for Children's Health met with local health care providers to
discuss health effects associated with PCBs. At the same time, ATSDR, the U.S.
Environmental Protection Agency, and state and local health department
representatives met with residents to provide background data and address
misconceptions about PCBs and about individual health issues.
Health Studies
Health studies are investigations conducted to determine the relations
between exposures to hazardous substances and adverse health effects. Health
studies also define health problems that require further investigation through,
for example, health surveillance or an epidemiologic study. Following are
examples of health studies or investigations that ATSDR conducted or supported
in Indiana.
National Exposure Registry (NER): Trichloroethylene
(TCE) Subregistry—NER comprises chemical-specific subregistries
designed to aid in assessing the long-term health consequences of low-level,
long-term exposures to hazardous chemicals identified at hazardous waste
sites. TCE, a synthetic chemical that does not occur naturally in the
environment, was selected for NER's first chemical subregistry. The greatest
source of TCE in the environment is industrial; factories use TCE to remove
grease from metals. TCE also can enter air and water when it is released
from hazardous waste sites. Occupational and animal studies suggest that TCE
is associated with neurotoxicity, genotoxicity, and immunotoxicity. However,
data concerning nonoccupational exposures, such as environmental exposures
and their potential health effects are sparse and inconclusive. ATSDR has
selected sites across the United States at which TCE exposures have
occurred. At these sites, initial (or baseline) and follow-up interviews
have been conducted; 4,986 people from 15 areas associated with hazardous
waste sites in five states have been enrolled in the subregistry.
The Indiana sites included in the TCE Subregistry are all in Elkhart
and include the Gemeinhardt Company Inc., Superior Street Area, Elkhart
Central Area (formerly known as the Marshall-Gordon Street Area), and the
Conrail Rail Yard. Baseline data collection occurred in 1989; follow-up
interviews were conducted in 1990, 1991, 1993, 1995, 1997, and 2000.
Baseline Analysis of the TCE Subregistry Risks of Health Outcomes
Among Female Registrants: The Impact of TCE Exposures on Women—Existing
information on the impact of health for females exposed to hazardous
substances, particularly the low-level, long-term exposures found at waste
sites, is sparse. Most information on the health impact of chemical exposure
comes from occupational studies of predominantly healthy male workers and
from toxicologic studies of higher levels and shorter duration. To gain more
knowledge about the potential impact of TCE environmental exposures on
females, the data collected as part of the NER TCE Subregistry was used to
compare the female subpopulation reporting rates with (1) national norms as
determined by National Health Interview Survey and (2) their male
counterparts' rates for 19 health conditions and 6 symptoms.
Study results were suggestive that the environmental exposures (TCE and
other chemicals) experienced by the TCE Subregistry members might have had a
greater health impact on the female registrants than on the male
registrants.
January 2004