Update about NCEH/ATSDR's work on the "Public Health Implications of Great Lakes Areas of Concern" report

Published: February 12, 2008

Photo by Curtis Hendrickson

CDC/ATSDR believes people in the Great Lakes region deserve accurate, scientific information to help them address their concerns about their environment. The information provided in the ATSDR's Great Lakes report has been readily available for several years. CDC/ATSDR is committed to working with Congress, independent scientific peer-reviewers, and the International Joint Commission to ensure the Great Lakes report provides this information in a way that is useful to them.

CDC/ATSDR has serious concerns about research methods used in the draft Great Lakes report that has recently been circulated publicly (see details below). ATSDR has been working to correct the identified deficiencies and hopes to finalize the report for release in the spring of 2008.

CDC/ATSDR strongly supports scientific debate and respects the peer-review process . CDC/ATSDR has begun a complete examination of the steps taken in the review of this report. This will: 1) help determine where lines of professional and collegial review and communication may have broken down that lead to current misunderstandings about the process, and 2) help avoid future possible delays in issuing reports.

Note: ATSDR and NCEH have actively protected public health in the nine Great Lakes states and performed a range of activities to protect the public from exposure to hazardous chemicals. Each activity generates a report that is published and made available to the public. Examples include Public Health Assessments, health consultations, scientific investigations, and exposure investigations. Between January 2001 and February 2008 in the Great Lakes states, ATSDR and NCEH have developed and supported a total of 756 documents involving 528 sites.

One report of interest that is currently being discussed and covered by the media is the "Public Health Implications of Great Lakes Areas of Concern" report. The following information about the report and issues surrounding release of the draft report may be useful in further discussions.

The Great Lakes Report . . .

• ATSDR undertook the "Public Health Implications of Great Lakes Areas of Concern" Reportproject in response to a request by the International Joint Commission to learn more about levels of potentially hazardous substances and their impact in 26 specific locations (Areas of Concern) within the eight Great Lakes states.

• This was a descriptive report. It did not, nor was it capable of, providing an evaluation of associations between health outcomes and chemical exposures. The compilation of environmental data, gathered by ATSDR and the Environmental Protection Agency (EPA), was intended to help decision-makers set future priorities.

• The data used in this report came from existing public databases or published public documents that had been available for several years. For example,

– The county-wide health indicators included in the report were published in July 2000.

– The ATSDR reports were published before 2004.

– EPA data were released in 2001 and 2004.

• Although early drafts of the report had been seen by external and internal reviewers, many comments had not been addressed and significant scientific concerns were raised by Center leadership shortly before its anticipated release in July 2007.

• In the past seven months, a number of specific improvements were initiated, including:

– The methods used in the report had not been accurately or adequately described. Additional external review was sought to address specific questions on these methods. ATSDR is now incorporating these comments.

– All previously received peer review comments are now being addressed.

– The revised report will include accurate references that are readily available.

– Inappropriately implied associations between data and conclusions were removed.

• CDC has entered into discussions with the IOM to formally review the final report.

• The International Joint Commission has been kept apprised of the progress of the report and steps CDC/ATSDR are taking to ensure its quality.

Justice, Fairness, and Trust in the Workplace

• The status of the current Great Lakes Public Health AOC Report has for some raised personal and professional concerns about internal procedures. The terms "justice," "fairness," and "trust" have come up. These terms are sometimes used interchangeably and are closely related, but they have different meanings when talking about the workplace.

• To paraphrase what CDC Director Julie Gerberding has said to leadership on many occasions, "an individual's view of the extent to which he or she is treated fairly will influence their emotional and behavioral reactions to the work environment. Perceptions of justice affect organizational citizenship, trust in the agency, respect for leaders, and job performance."

• It's worth remembering and reminding others about the importance of organizational justice.

– There must be explicit understanding between employees and management regarding what is invested by each in their roles, responsibilities and the fair distribution of rewards.

– Employees must have a voice in the processes of rewards and outcomes and a means to voice objections.

• And, perhaps most importantly, there must be sensitivity in the way employees are treated. Employees must feel respected.

– In all interactions with the workforce, especially related to our core scientific work, leaders, managers, and employees should interact respectfully and follow procedures that are fair and just.

Integrity of CDC/ATSDR Science

• CDC/ATSDR's ability to positively influence public health depends on the public's trust and belief in its sound, unbiased, and scientifically based research and recommendations.

• CDC/ATSDR accepts scientific debate and respects the peer-review process. CDC embraces intellectual honesty in its release of information to fully empower public decision making.

• ATSDR is committed to providing useful, scientifically sound information that will help decision-makers and public protect human health and the environment in the Great Lakes Region and concluded that the July draft did not meet that standard. ATSDR has been working since then to correct the identified deficiencies and hopes to finalize the report for release in the spring of 2008.