The following table summarizes the potential exposure and public health conclusion
category for each environmental exposure pathway. A detailed discussion can
be found in the specific sections referenced by the appropriate page numbers.
Environmental Pathway
Potential
Exposure
Public Health Conclusion
Pages
Past Air Emissions
(Before
1996)
Yes
Indeterminate
(Further
Investigation Required)
28
Non-occupational On-base Employees
Yes
Indeterminate
(Further
Investigation Required)
28
Lead in Soil
Yes
Indeterminate
(Further
Investigation Required)
28-30
Present Air Emissions
(After
1995)
Yes
No Apparent Health Hazard
32-35
Leon Creek:
surface water
sediment
fish consumption
Yes
No Apparent Health Hazard
37-40
Groundwater
None Apparent
No Apparent Health Hazard
(East Kelly to be evaluated)
47-50
Soil Gas
Yes
No Apparent Health Hazard
(East Kelly to be evaluated)
51-52
Noise
Yes
No Apparent Health Hazard
(Condition Corrected)
54-56
Fuel Jettisoning
Yes
No Apparent Health Hazard
58-59
Homegrown Produce
Yes
No Apparent Health Hazard
60
Thallium in Drinking Water
Yes
No Apparent Health Hazard
48-49
Radioactive Waste
No
No Health Hazard
61
Community Health Concerns
Community residents have expressed concern that there is there a higher than
expected number of people with lupus, hearing problems, asthma, allergies, hepatitis
and diabetes in the area. ATSDR is presently attempting to locate data to attempt
to answer most of these concerns. However, data may not be available for all
of the health outcomes of concern since public health agencies do not routinely
collect this information. Once this information is complete, it will be made
available to the public and included in Phase II of the public health assessment.
Health Outcome Data
Cancers that were elevated in at least one of the initial zip code areas
evaluated (78237, 78211, and 78228) include leukemia, liver, kidney, and cervical
cancer. It is unknown what contributions, if any, past air emissions may have
made towards these elevations.
Liver cancer rates are elevated in many zip code areas around Kelly Air
Force Base, as well as other areas in Texas. The reasons for these elevations
are unknown.
Zip code area 78237 had elevations in the number of low birth weight babies
and children born with a specific birth defect (bulbus cordis anomalies and
anomalies of cardiac septal closure). These outcomes have not previously been
associated with contaminants at the levels currently measured at Kelly.
Elevated blood lead levels (above the Centers for Disease Control and Prevention
recommended guidelines) were reported among some children in 90% of the zip
code areas in Bexar County. Limited environmental data was available for lead
in soil but the reported values for neighborhood yards near Kelly were below
levels of health concern.
More specific conclusions from the evaluation of health outcome data to
date are provided in Appendix G, page
G-15.
Recommendations
ATSDR recommends the following activities.
Activities related to environmental data evaluation
Perform a refined air dispersion model to evaluate non-occupational on-base
employees exposures (Phase II).
Evaluate past air emissions to estimate past air concentrations. Kelly Air
Force Base will conduct a review of practices that may have generated past
air emissions and report the findings by the end of 1999. ATSDR will use this
data to evaluate past air emissions and present the results in Phase II of
the public health assessment.
Evaluate the environmental data for soil, water, and soil gas for the East
Kelly area and report the results in Phase III
Evaluate the potential contamination of on-base drinking water supplies
and report the results in Phase III of the public health assessment..
Identify and plug or seal Edwards aquifer wells located within the contaminated
areas of the shallow aquifer (Phase II).
Continue periodic monitoring of appropriate areas for radioactivity and
maintain institutional controls to prevent worker exposure to buried radioactive
waste in the event of future construction.
Activities related to health education
Provide environmental health education workshops for community members
and for medical personnel, primarily nurses and physicians (Phase I).
Conduct health education activities focused on risk factors for community-related
health concerns (Phase II).
Provide chemical-specific health education to the community to increase
their understanding of exposures as determined in the public health assessment
(Phase II).
Activities related to health outcome data(Phase
II)
Update health outcomes such as cancer, birth defects, and low birth weight
babies including additional years of information.
Continue to monitor liver cancer incidence and mortality as more years of
data become available.
Continue monitoring heart and circulatory system defects using vital statistic
information and data from the Texas Birth Defects Monitoring Division as it
becomes available.
Continue monitoring the number of low birth weight babies reported as additional
data becomes available.
Determine if data is available to address community concerns regarding lupus,
hearing problems, asthma, allergies, hepatitis and diabetes in the area.
Public Health Action
Plan
Ongoing Activities
ATSDR requested statistical reviews on health outcomes such as cancer, birth
defects, and low birth weights in zip codes around Kelly AFB. These statistical
reviews have been performed by the Texas Department of Health and evaluated
by ATSDR. Additional analysis is ongoing.
ATSDR performed a needs assessment and determined the need for health education
and community involvement activities with residents living around Kelly AFB
or personnel working at the base. Community involvement activities have been
ongoing. Health education activities began in June 1999 with an environmental
health workshop for nurses and continued in July for physicians and August
for community members.
ATSDR is developing information sheets summarizing information from this
public health assessment. Information sheets in English and Spanish will be
available to community residents.
Future Action Items
The ATSDR Division of Health Assessment and Consultation
will
perform a more extensive air model in Phase II to refine potential exposures
to non-occupational on-base employees;
evaluate past air emissions in Phase II. Kelly AFB will collect data on
past practices which may have resulted in past air emissions which is scheduled
to be completed by the fall of 1999;
evaluate environmental data from East Kelly and report results in Phase
III to the public health assessment;
perform a health consultation in Phase III on the past exposure of on-base
personnel to potentially contaminated drinking water provided by the Kelly
AFB water system..
The United States Air Force will
continue to monitor for radioactivity and maintain institutional controls
to protect workers in the event of construction in the vicinity of buried
radioactive waste.
The appropriate regulatory authorities should coordinate with the appropriate
organizations to determine the appropriate identification, and plugging or
sealing of Edwards aquifer wells in the vicinity of the contaminated shallow
aquifer.
The ATSDR Division of Health Education and Promotion will
Conduct health education activities focused on health outcomes that are
reported in the communities or through official registries (such as the cancer
registry, birth defects registry, and vital statistics.
Provide environmental health education for community members and for medical
personnel, primarily nurses and physicians, as appropriate.
Provide chemical-specific health education to the community to increase
their understanding of exposures as determined in the public health assessment.
The ATSDR Division of Health Studies will continue to evaluate
Health Outcome Data as it becomes available, will evaluate air modeling information
for historic emission data when available, and will make recommendations for
followup activities in Phase II, as appropriate.
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