ATSDR - Hazardous Waste Congress '95: Abstracts for Sessions 11-20

Science Corner

The International Congress on Hazardous Waste:
Impact on Human and Ecological Health

Atlanta Marriott Marquis Hotel
Atlanta, Georgia

June 5-8, 1995

Link to ATSDR Science Corner Home Page

Congress '95 Abstracts

Link to Abstracts for Poster Presentations

Abstracts for Breakout Sessions (Tracks 11-20)

(NOTE: You can use EDIT / FIND to search for an Author or a Keyword.)

Session 11 - (Health Effects Track) Abnormal Immune Findings in ATSDR Studies

Overview of the Agency for Toxic Substances and Disease Registry's Multisite Database.
M. A. McGeehin, Agency for Toxic Substances and Disease Registry

Adoption of an Immune Function Test Battery for Environmental Health Studies.
R. W. Amler, Agency for Toxic Substances and Disease Registry

Detection of Chronic Lymphocytic Leukemia-Like Monoclonal B- cell Proliferation in Peripheral Blood Samples from Environmental Health Studies.
R. F. Vogt, Jr., Centers for Disease Control and Prevention

Public Health Implications of Abnormal Immune Findings in ATSDR's Multisite Database.
J. A. Lybarger, Agency for Toxic Substances and Disease Registry

TBA

Session 16 - (Engineering Track) Remediation Approaches

A Structured Approach to Remediation.
G. F. Vajda, Dames & Moore, Inc.

Expedited Site Characterization by a Dynamic Process that Employs Field Analytics.
A. Henderson-Kinney, Tufts University

Resource Allocation Modeling in Environmental Monitoring Design.
R. Kuchibhatla, ManTech Environmental Technology, Inc.

Costs and Benefits of the RCRA Corrective Action Program: A National Perspective.
B. Johnson, U.S. Environmental Protection Agency

Session 17 - (Risk Assessment Track) Strategies for Risk Assessment

Comparative Risk Analysis: A Panacea or Risky Business?
V. Molak, GAIA Unlimited, Inc.

A Survey of Perceptions of Environmental Risks: A Comparative Risk Approach at the Local Level.
V. R. Nathan, Wayne State University

Health Hazards of Hazardous Waste Sites Identified Through Petitions for Public Health Assessments.
J. A. Steward, Agency for Toxic Substances and Disease Registry

Health-based Contaminant Screening Levels.
D. M. Abouelnasr, Agency for Toxic Substances and Disease Registry

Session 18 - Environmental Justice

Small Area Analysis Techniques for Environmental Justice in Minority and Disadvantaged Communities.
E. A. Taylor, Centers for Disease Control and Prevention

Washtenaw County (MI) Environmental Justice Community Outreach Program.
R. A. Head, Washtenaw Department of Environment & Infrastructure Services

Environmental Justice and an Urban Community: A Unique Approach at a Superfund Site.
P. K. Seppi, U.S. Environmental Protection Agency

Hazardous Waste Disposal Decisions: Democracy, Justice and NIMBYism.
H. Elliott

Session 19 - (Health Effects Track) Cancer

Brain Cancer and Multiple Hazardous Exposures, Especially EMF.
T. E. Aldrich, University of North Carolina

Case-Control Study of Lung Cancer Mortality in Four Arizona Smelter Towns.
G. M. Marsh, University of Pittsburgh

A Study of Cancer Mortality of Louisiana Parishes in Relation to Environmental and Occupational Factors.
A. E. Gomaa, Agency for Toxic Substances and Disease Registry

Pancreatic Cancer Mortality and Railroad Refueling Facilities in Montana.
S. R. Prausnitz, Agency for Toxic Substances and Disease Registry

Session 20 - (Health Effects Track) Adverse Reproductive Outcomes

Birth Defects, Fetal Loss and Developmental Disorders in an Eleven Year Study of an Herbicide Manufacturing Facility with Dioxin Contamination.
M. A. Brewster, Arkansas Children's Hospital

A Community-based Study of Adverse Pregnancy Outcomes Near a Large Hazardous Waste Landfill in California.
M. Kharrazi, California Department of Health Services

Maternal Residential Exposure to Hazardous Waste Sites and the Risk of Central Nervous System and Musculoskeletal Birth Defects.
E. G. Marshall, New York State Department of Health

The Relationship between Birth Defects and Oral Exposure to Trichloroethylene-Contaminated Water in Woburn, Massachusetts.
D. Schendel, Centers for Disease Control and Prevention

Abstracts for Sessions 11-20

230

Overview of the Agency for Toxic Substances and Disease Registry's Multisite Database

Michael A. McGeehin, Ph.D., M.S.P.H., Sara M. Sarasua, M.S.P.H., Gina J. Terracciano, D.O., M.P.H., LeeYang Wong, M.S., Jeffrey A. Lybarger, M.D., M.S. Agency for Toxic Substances and Disease Registry, Atlanta, Georgia

The Agency for Toxic Substances and Disease Registry (ATSDR), in pursuit of one of its goals to evaluate relationships between hazardous substances in the environment and adverse human health outcomes, conducts health studies in communities near hazardous waste sites. One methodology ATSDR uses is cross- sectional, symptom-and-disease-prevalence studies to assess the overall health status of target populations living near sites compared with control populations that have no site-related exposure. Although each study is designed to answer specific health concerns about the individual site, the investigations share many common methodologic features, including using a standardized questionnaire and employing the same panels of biologic tests (biomarkers) to evaluate function of the kidney, liver, and immune systems. Using identical data-collection techniques has enabled the agency to combine into a single database the results of multiple studies of sites that have similar exposures.

The present database for six sites with exposure from volatile organic contaminants in groundwater includes records for 2,089 participants from target areas and 1,524 from comparison areas. Because many biomarker tests have not been used extensively in epidemiologic investigations, information from this dataset will permit ATSDR to establish reference ranges for each test in the panels, using a large, geographically diverse study population. More importantly, analysis of this database will enable ATSDR to evaluate possible adverse effects of organ systems for persons living near hazardous waste sites and will greatly improve the agency's knowledge about possible health effects of exposure to hazardous substances.

191

Adopting an Immune Function Test Battery for Environmental Health Studies

Robert W. Amler, M.D., M.S., J. Michael Straight, M.D., Agency for Toxic Substances and Disease Registry, Robert F. Vogt, Jr., Ph.D., Centers for Disease Control and Prevention, Atlanta, Georgia, Howard M. Kipen, M.D., Robert Wood Johnson Medical School, New Brunswick, New Jersey

To evaluate the occurrence of immune function disorders and other priority health conditions, the Agency for Toxic Substances and Disease Registry (ATSDR) has selected biomarker panels and used them consistently in exposed and reference populations at different study sites. The immune system is particularly susceptible to toxicant effects because its essential purpose--to recognize and destroy substances identified as foreign--increases the likelihood of its exposure to such substances.

To better evaluate immune function disorders as a priority health condition, ATSDR convened nationally recognized experts in a 2-day workshop to propose basic and focused test batteries for use in evaluating populations living near hazardous chemical sites. The basic panel of tests is to be used in any population- based study of toxicant effects on the immune system; focused tests can follow up abnormal results in the basic panel or evaluate specific symptoms or exposures. Ideal tests for a basic immune test battery are cost effective and clinically interpretable and use standardized methods to detect hypersensitivity, immune deficiency, or autoimmunity.

The Basic Immune Test Battery (BITB) adopted by ATSDR evaluates all three principal classes of immune function disorders--hypersensitivity, immune deficiency, and autoimmunity- -that are most likely to be affected by toxicants. The BITB consists of antinuclear antibody, C reactive protein, serum immunoglobulin levels, complete blood count (total lymphocyte and eosinophil counts), lymphocyte phenotyping (when feasible), and serum total protein. The focused tests include serum autoantibodies, additional lymphocyte phenotyping, and certain highly specialized tests. The experts identified additional tests for research settings that would require additional development before results can be meaningfully interpreted in public health settings.

The rapid growth of knowledge in immunotoxicology and the growth of experience reflected in ATSDR's immune testing database from completed field studies, indicates the need for periodic review of component tests in all three tiers of immune tests. Long-term use of consistent immune test batteries will contribute substantial information to establish reference ranges, sensitivity, specificity, and predictive value.

225

Public Health Implications of Abnormal Immune Findings in ATSDR s Multisite Database

Jeffrey A. Lybarger, M.D., M.S., Michael McGeehin, Ph.D., M.S.P.H., Gina Terracciano, D.O., M.P.H., Sara M. Sarasua, M.S.P.H., Lee Yang Wong, M.S., Agency for Toxic Substances and Disease Registry, and Robert F. Vogt, Ph.D., Centers for Disease Control and Prevention, Atlanta, Georgia

The Agency for Toxic Substances and Disease Registry (ATSDR) has used a standardized panel of immune tests in 10 studies to characterize the occurrence of immune-function disorders in persons living near hazardous waste sites. As a result of the testing, ATSDR has identified 11 individuals who have chronic lymphocytic leukemia (CLL)-like lymphocyte immunophenotypes. The true prevalence of B-cell CLL (B-CLL), including the early preclinical state, and the prevalence of B-cell lymphocytosis is unknown. SEER age-standardized incidence rates for CLL were used to obtain expected numbers for ATSDR study participants between the ages of 45 and 79 years. The number of CLL-like phenotypes was 104-fold higher than the expected number of CLL cases: 131-fold higher for participants living near hazardous waste sites (n=832), and 70-fold higher for participants not living near hazardous waste sites (n=593).

B-CLL has been associated with occupational exposures, including exposure to benzene, xylene, coal-based solvents, and electromagnetic fields. The presence of several CLL-like phenotypes in populations around Superfund sites raises the question of whether long-term exposure to chemicals at these sites has increased the risk of developing this disease. The CLL- like phenotypes found in these studies represent a substantial increase over the expected age-adjusted incidence of clinical disease. However, the natural history of progression to disease with CLL-like phenotypes or monoclonal B-cell lymphocytosis remains unknown. Although these findings must be viewed with caution, the public health implications indicate the need for further investigation.

117

Bioaccumulation of PAHs, PCBs, and PCDFs from Sediments by Chironomus tentans Larvae in the Laboratory and by Caged Carp in the Field

Patrick W. O'Keefe, Ph.D., New York State Department of Health (NYSDH), and State University of New York (SUNY), Albany, New York, Lindsay Wood ,Ph.D., NYSDH, Brian Bush, Ph.D., Chia-Swee Hong, Ph.D., NYSDH and SUNY, and Steven Connor, NYSDH

Sediments were collected in the Massena area of the St. Lawrence River basin near effluent discharge points from two aluminum smelters (A and C) and from a plant manufacturing aluminum automotive parts (B). Plant A sediment contained high concentrations of PAHs (3,234 mg/kg), PCBs (702 mg/kg), and PCDFs (1652 ng/g). Contaminants were present at x10 to x100 lower concentrations in sediments from the other two locations.

When Chironomus tentans larvae were exposed to the sediments for 2 weeks, the biota/sediment accumulation factors (BASFs) varied from 0.02 to 0.3 for PAHs, from 0.3 to 1.4 for PCBs, and from 0.4 to 1.5 for PCDFs. The lower BASFs for PAHs may reflect a higher rate of metabolism of these compounds compared with PCBs and PCDFs. Patterns of contaminants in the larvae and sediments were different, with the larvae showing a preference for the higher molecular weight PCBs and PAHs. In contrast to other biota, the insect larvae did not show a preference for 2,3,7,8-substituted PCDFs. However carp caged near plant B did preferentially bioaccumulate 2,3,7,8-substituted PCDFs, and after 36 days, Cytochrome P450 enzyme activity in the carp livers was enhanced by a factor of three compared with controls. This work was partially supported by the NIEHS Superfund Basic Research Program Grant # 5P45ES0491305.

061

Toxicity and Bioaccumulation of a Mixture of Heavy Metals in Chironomus tentans (Diptera: Chironomidae) in Sediment

Elisabeth A. Harrahy, M.S., and William H. Clements, Ph.D., Department of Fishery and Wildlife Biology, Colorado State University, Fort Collins, Colorado

This laboratory study examined the toxicity and bioaccumulation of a mixture of cadmium, copper, lead, and zinc in a synthetic sediment on Chironomus tentans. C. tentans were exposed to 0.0875X, 0.175X, 0.35X, 0.7X, 1.0X, 1.4X, 2.8X, and 5.6X a base concentration of 5.0 mg/kg Cd, 10 mg/kg Cu, 70 mg/kg Pb, and 300 mg/kg Zn in a toxicity test. The base concentration (1.0X) of the four metals was established on sediment data collected just downstream from an Environmental Protection Agency Superfund site on the Arkansas River, located near Leadville, Colorado. Following a 10-day exposure period, we observed a dose response for bioaccumulation of each of the four metals. Mortality ranged from 17% (controls) to 100% (5.6X base concentration). Results of the toxicity experiment suggest that sediments at the Arkansas River may be toxic to benthic invertebrates.

In uptake and depuration experiments, C. tentans were exposed to 0.35X the base concentration of the four metals in sediment. Chironomids were sampled over 14 days for uptake and over 7 days for depuration. Concentrations of the metals in the chironomids correlated well with exposure time (for example R2=0.93 for uptake of copper). Uptake and depuration rate constants and bioaccumulation factors were calculated. Results indicate that heavy metals readily accumulate in a benthic invertebrate that serves as an important link to higher trophic levels.

248

Biologic Control of the Flux of Heavy Metals from Contaminated Marine Sediments

Timothy E. Ford, Ph.D., James P. Shine, Ph.D., Raveendra Ika, M.S., Harvard School of Public Health, Boston, Massachusetts

The role of benthic respiration on the magnitude and direction of heavy metal flux between sediments and overlying water was examined at two locations: New Bedford Harbor and Buzzards Bay, Massachusetts. New Bedford Harbor is highly contaminated with PCBs and heavy metals and has been designated as a Superfund site by the Environmental Protection Agency.

The flux of six heavy metals (Co, Ni, Cu, Zn, Cd, and Pb) was examined in microcosms collected with a box corer and incubated in the laboratory at in-situ temperature. Multiple microcosms were collected seasonally to examine the temporal variability of the fluxes. The flux experiments were run for a maximum of 15 days, after which benthic oxygen demand (respiration) was determined in each microcosm. Sediment metal, organic carbon, and sulfide content were also determined in each microcosm.

The net flux of all metals was generally out of the sediments. However, at low rates of benthic oxygen demand, net flux of Pb and Co was into the sediments. When data from the control and experimental site are combined, the regression of metal flux--normalized to sediment metal content against benthic oxygen demand--is significant for each metal (r� = 0.6 - 0.8). Normalized flux values showed the following relationship: Cd > Co, Ni, Cu, Zn > Pb, indicating higher relative mobility for Cd and lower mobility for Pb, with the others midway between. The flux of Cd was also the most sensitive to changes in benthic oxygen demand. This presentation will cover the importance of the biota on fate and distribution of toxic metals in aquatic sediments.

002

Accumulation of Copper, Lead, and Cadmium in Snail Intermediate Hosts of Schistosomiasis and Fascioliasis in Southwest Nigeria

Clement 0. Adewunmi, Obafemi Awolowo University (OAU), Ile-Ife Nigeria, Wilhem Becker, Olaf Kuhnast, Zoologisches Institut und Museum (ZIM), Hamburg, Germany, Francis Oluwole, OAU, and G. D�rfler, ZIM

The accumulation of copper, lead and cadmium in freshwater snails (Biomphalaria pfeifferi, Bulinus globosus, Lanistes libicus, Lymnaea natalensis, Potadoma moerchi, Melanoides tuberculata, Gabiella africana, Pila ovum, and Bellamya species) was analyzed in man-made dams and rivers in southwest Nigeria using flameless atomic absorption spectrophotometer. Metal concentrations varied widely among snail species and sites. Metal concentrations within the same snail species were strongly correlated with other metals within those species. Seasonal changes in metal concentrations occured in some locations. The highest concentration of copper (2,352.33 g/g) was found in L. natalensis recovered from Owena- Ondo dam in May, lead (52.14 g/g) in B. globosus at Esa-Odo dam in July, and cadmium (31.61 g/g) was recorded in B. globosus sampled at Owena-Jesa dam in April 1993. The results implicate the use of freshwater snails as a valuable tool for future monitoring programs to evaluate the environmental quality of man-made dams and rivers in the tropics.

013

Use of MolecuIar Similarity in Assessing the Toxicity of Chemicals

Subhash C. Basak, Ph.D., Natural Resources Research Institute, University of Minnesota, Duluth, Minnesota

Risk assessment of environmental pollutants is often carried out with limited or no test data necessary for hazard estimation. In such cases, regulators often use selected "analogs" of candidate chemicals to assess the risk posed by these chemicals. Such analogs are chosen with the intuitive notion of the individual scientist about chemical similarity.

We have been involved in developing novel, computationally feasible methods for quantifying chemical structural similarity, using calculated parameters. Such parameters can be derived for any chemical species, real or hypothetical. We have applied these methods in selecting analogs and in estimating properties of different congeneric sets.

We will present new results on the application of different molecular similarity methods in estimating toxicologically important properties of chemicals.

112

Groundwater and Contaminant Modeling for Exposure Assessment

John A. Mundell, M.S.C.E., P.E., ATEC Associates, Inc., Indianapolis, Indiana

In the exposure-assessment phase of a human health risk assessment, the degree to which existing groundwater contamination may impact human health is estimated through simulations of groundwater flow and contaminant transport. Several analytic and numerical modeling techniques for predicting contaminant concentrations at points in space and time may be used to perform these simulations. The number and kind of assumptions made during the modeling phase are based on the kind and amount of data that have been collected regarding the type, severity, and extent of contamination; the rate and directions of groundwater flow on and off site; the geometric orientation of the migratory pathways present and their hydraulic and geochemical characteristics; and the potential leaching contribution of the remaining contaminant source areas.

This presentation will address the potential effects that the assumptions have on predicted contaminant concentrations generated from the modeling simulations. Several case studies will be used to illustrate key points. From the lessons learned, a methodology is proposed to provide reasonable bounds on conditions that must be present to cause exposures that create excess human health risk. Requirements are provided for collecting necessary field and laboratory testing data to support the methodology.

156

Using Measured Contaminant Concentrations Versus Modeling Results for CERCLA-Related Air Pathway Risk Assessments

Sandra A. Smith, M.S., Radian Corporation, Austin, Texas, Clive C. Mecham, C.I.H., Radian Corporation, Salt Lake City, Utah, Brian J. Schimmoller, M.S., Radian Corporation, Austin Texas, Mark H. Wheeler, M.S., U.S. Air Force, Hill AFB, Utah

The process established by the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) requires that exposure pathways be identified and potential risk to specific chemicals be assessed to ultimately influence the decision for cleanup versus no cleanup and to evaluate cleanup technology alternatives. At one CERCLA site in Utah, volatile organic chemicals in the shallow groundwater have migrated to nearby residential areas and entered the basements of homes. This presentation uses the remedial investigation data and risk assessment results for this site to address the advantages and disadvantages of using integrative sampling data versus modeling results for assessing the risks associated with the air pathway.

A modified version of method EPA TO-14 was used to collect and analyze air samples from basements of homes potentially affected by contaminants found in groundwater beneath these structures and surface water in nearby seeps and springs. Air sample results were used in the risk assessment calculations. Modeling was also conducted so that model results could be compared with the measurement data.

Advantages of using measurement data include: 1) elimination of uncertainty associated with multiple assumptions required by modeling; 2) availability of data early in the process (during the investigation stage), which allows early assessment of the need for immediate remedial measures or response actions before completing the quantitative risk assessment; and 3) ability to set priorities and focus interim actions in areas of highest actual exposure. Disadvantages include: 1) higher cost; 2) potential for detecting contaminants that are not related to the site under investigation; and 3) the inability to evaluate future migration potential if contaminants have not yet reached populated areas.

253

The Relationship Between Site Characteristics and Reported Health Concerns

Dana Abouelnasr, Ph.D., Moses Kapu, Ph.D., Stephen Richardson, Deborah Boling, Sven Rodenbeck, P.E., Tina Forrester, Ph.D., and Adrienne Hollis, Ph.D., Agency for Toxic Substances and Disease Registry, Atlanta, Georgia

Community members living near hazardous waste sites often express concern about possible health effects. These concerns may be about a variety of non-cancer effects and about different types of cancer. The purpose of this investigation is to determine whether an association exists between characteristics of hazardous waste sites and the number and types of health concerns reported by the community. As part of its public health assessment process, ATSDR collects community health concerns from public meetings, state and local health departments, and other federal agencies. Information from public health assessments dated 1992 to the present was obtained from the ATSDR HazDat database. Site characteristics studied were site ownership, activities, operational status, ATSDR's public health conclusion category, and whether ATSDR activities were initiated by petition. Results indicate that more concerns were reported at sites that had been petitioned and at federally owned sites; fewer concerns were reported at sites owned by local governments. Trends were observed between conclusion category and the number of reported concerns. Sites categorized as "urgent public health hazards" had more reported non-cancer concerns and fewer cancer concerns. Sites deemed "indeterminate" or with "no apparent health hazard" had fewer reported concerns than did sites categorized as "public health hazards". Patterns were apparent between site activities and the type of concerns reported; no such patterns were observed for operational status.

020

Community Involvement in Public Health Investigations: Improved Response and Data Collection Using Neighborhood Volunteers in a South Texas City

Betty G. Brown, M.P.H., and Kathryn A. Evans, M.P.H., Texas Department of Health, Austin, Texas

In response to community health, safety, and environmental concerns, the Texas Department of Health (TDH) initiated an investigation of three neighborhoods adjacent to a heavily industrialized and refining area of a south Texas city. An initial health survey mail-out generated a 29% response from the pilot neighborhood. Concerned that difficulties using survey mail-outs influenced survey participation, residents requested that TDH repeat the survey with the help of neighborhood volunteers.

TDH subsequently developed a new survey strategy that both protected confidentiality and directly involved the community in gathering health data. A two-part survey was created and implemented in the pilot neighborhood: In Part 1, neighborhood volunteers were enlisted and trained to collect demographic and special-needs information. In Part 2, based on information obtained in Part 1, TDH staff collected more sensitive and confidential health, safety, and environmental data. The survey methodology was adapted to address the needs of the other two neighborhoods of concern, using input from area residents and a reevaluation of the survey process by TDH.

Findings to date indicate that community involvement has greatly improved the amount and quality of data collected and has enhanced the understanding of community needs. (The pilot neighborhood survey response rate for Part 1 was 71%.) Although the investigation is still in progress, advantages and disadvantages of the survey strategy have been identified. Various aspects of the survey methodology and the value of survey data as an integral part of the public health assessment process will be presented.

201

Case Studies in Community Health Education: Partnering Federal and Local Health Agencies with Community Members--Past, Present, and Future

Dan Middleton, M.D., Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia, Will Selser, Lewis and Clark City-County Health Department, Helena, Montana, Naomi G. Penney, M.P.H., ATSDR

An active lead smelter in East Helena, Montana, has contaminated the soil in the surrounding community with lead and other heavy metals. To assess exposure to lead in children 0-6 years of age and in pregnant or nursing women, the Lewis and Clark City-County Health Department will begin a 5-year lead- abatement and -prevention program in the spring of 1995 to monitor blood lead levels. Besides blood lead monitoring, the health department will conduct an educational program aimed at children and their parents, and at the general community, to identify new community members who may not be aware of the lead problem.

The Agency for Toxic Substances and Disease Registry (ATSDR) was asked to help the health department with education for community members and their health care providers. The goal is to establish a partnership among these stakeholders in planning, implementing, and evaluating the community lead education program. Using a participative decision-making process, stakeholders will identify the education needs of the community and the best method for meeting these needs. This presentation will give examples of past, present, and future health education activites at various sites, with emphasis on a creative approach to identifying, developing, and involving local partners at the East Helena Smelter Site.

048

The Process of Community Involvement--A Case Study: The Bartlesville, Oklahoma, Lead Project

Lawrence A. Gales, M.S., R.S., Montressa Jo Elder, M.S. R.S., Oklahoma Department of Environmental Quality, Street, Oklahoma City, Oklahoma

Bartlesville, Oklahoma, a community historically impacted by emissions of lead and cadmium from a zinc smelting facility, was the subject of comprehensive environmental and biomedical sampling during the 1970s. Few efforts were devoted to informing the community of the sampling results. Thus, the community's concerns were not addressed, and lack of involvement led the community to become deeply divided over environmental issues.

Before resuming environmental investigations in Bartlesville in 1991, the Oklahoma Department of Environmental Quality developed new strategies for community involvement in environmental issues. These strategies have been successful in uniting an historically divided community.

Blood lead studies, conducted in the 1990s, indicated elevated blood lead levels in 14% of children living within the area of historical soil contamination. Awareness of these results increased the community commitment to identifying feasible solutions to the problem. The solutions included changing the Environmental Protection Agency policy to allow a first-time-ever State Delegation of a proposed Superfund site.

194

Local Health Department Activity at Hazardous Waste Sites: A Spectrum of Responses

Heidi M. Klein, M.S., National Association of County and City Health Officials, Washington, D.C.

Beginning in February 1995, the National Association of County and City Health Officials (NACCHO) conducted an informal telephone survey of 100 local health departments to determine their level of involvement at selected hazardous waste sites and their perception of community concerns and to assess other agency activities. Using the information collected, this presentation will cover the way local health departments define their role with respect to hazardous waste sites and variations in their activities. It will also suggest resources and approaches that would enhance their capacity to address community concerns at such sites more effectively.

142

Clinical Research Results Using L-Line-X-Ray Fluorescence in Lead-Exposed and Non-Lead-Exposed Children, Teen-Agers, and Adults

John F. Rosen, M.D., Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York

The clinical utility of L-Line-X-Ray Fluorescence (LXRF) has been shown. a) In lead (Pb)-poisoned children <36 months of age, with blood lead (BPb) <35 ug/dl and bone Pb <12 ppm, no child had a positive mobilization test (MT). In children >36 months of age, with BPb >35 ug/dl and bone Pb >12 ppm, 93% had positive MTs. LXRF plus BPb values can eliminate the need for the MT in about 50% of children. b) In a study of bone Pb in moderate Pb-poisoned children, bone Pb declined in all treatment groups except the unchelated group, in which baseline Pb was stable over 6 months. Children, who were chelated twice and still required treatment at 6 months, had the highest bone Pb values at enrollment; at 6 months, this group had bone Pb values comparable to children treated once or twice. In all groups, bone Pb values at 6 months were about 2-5 times higher than tibial Pb measured in normally exposed children. c) In a study of a U.S. suburban population exposed for 18 years to high levels of Pb emissions from a battery re-cycling factory, we found that the mean bone Pb content was about 3 times higher than in the reference suburb. BPb failed to distinguish the two populations. Bone Pb values in the highly exposed population approximated levels documented in industrially exposed workers.

These results demonstrate the utility of LXRF in studies of lead-poisoned children. LXRF is an effective technique for identifying populations excessively exposed to lead many years previously when compared with a normal suburban area.

222

Body Burden of Lead in a Cohort of Women Formerly Employed at a Lead Smelter

C. Virginia Lee, M.D, M.P.H., Wendy E. Kaye, Ph.D., Deborah B. Rolka, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, Fiona E. McNeill, Ph.D., University of Maryland, Baltimore, Maryland

The Bunker Hill site includes mines, a mill and concentrator, a lead smelter, an electrolytic zinc plant, sulfuric acid recovery facilities, and a dry chemical fertilizer plant. Previous assessments of worker exposures documented exposures exceeding occupational health standards for lead, cadmium, zinc, arsenic, mercury, and sulfur dioxide. In 1975, 63 female employees worked in production and maintenance, and 245 worked in clerical positions. More than 50% of the female workers were aged 20-39 in 1976. Worker blood lead levels averaged 63 ug/dL (n=1,509) with a range of 6-208 ug/dL. The OSHA standard during that period (80 ug/dL) was exceeded by 14.2% of the workers. The mean blood level for women was 53 ug/dL (n=53), with a range of 12-96 ug/dL. Two percent of the women exceeded the 80 ug/dL limit and 82.8% exceeded 40 ug/dL.

Humans accumulate lead in the bone. Experimental data indicate that bone lead can be released during conditions of bone demineralization, such as menopause. The consequences of mobilizing lead from bone during menopause are largely unknown. X-ray fluorescence (XRF) uses low-dose radiation to give a rapid estimation of the lead content in bone. A cohort of 197 female smelter workers was identified using employment records, the local union, and self identification. We located 171, interviewed 142, and completed medical testing for 108. Exposed former workers had significantly higher bone lead levels than did unexposed comparison groups. Additional results and the use of XRF in environmental epidemiology studies are discussed.

240

X-Ray Fluorescence Results for Bunker Hill Residents Exposed to Lead and for a Sample From the General Population

Lynette D. Stokes, Ph.D., M.P.H., Wendy E. Kaye, Ph.D., Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, Fiona E. McNeill, Ph.D., University of Maryland, Baltimore, Maryland

The Bunker Hill Superfund site is in Shoshone County in the Silver Valley of northern Idaho. The site is 3 miles wide and 7 miles long and includes facilities where lead exposure occurred. The communities of Kellogg, Page, Pinehurst, Smelterville, and Wardner are also within the boundaries of the Superfund site. A cohort of 2,109 subjects was reconstructed from birth and school records of Silver Valley residents. Subjects were eligible if they were between 9 months and 9 years of age in 1974 or 1975 and had previously lived in the 5-town (Kellogg, Page, Pinehurst, Smelterville, and Wardner) area around the Bunker Hill Smelter. The control population consisted of men and women who were 19-29 years of age and were randomly selected from Department of Licensing records from Spokane, Washington.

Of the 2,109 eligible cohort members, 917 subjects were successfully traced to their current residences. A random sample of 281 exposed subjects was selected for medical testing. Of 754 unexposed subjects identified from Department of Licensing records, a random sample of 287 was selected for medical testing.

X-ray fluorescence is an exposure-assessment method that identifies lead stored in bone (tibia), indicating previous exposure to lead. This method was used to determine the total body burden of historical lead exposure in 281 exposed and 287 unexposed subjects. Data presented will show the descriptive range of lead body burden values identified by X-ray fluorescence in the exposed and unexposed populations.

193

Expedited Site Characterizations by a Dynamic Process that Employs Field Analytics

Andrea Henderson-Kinney, Albert Robbat, Jr., Center for Field Analytical Studies and Technology, Tufts University, Medford Massachusetts.

The Center for Field Analytical Studies and Technology (CFAST) at Tufts University conducts research, development, and validation studies leading to commercialization of field-based analytic instruments and methodologies. CFAST's goal is to build among private and public sector developers, users, and regulatory communities the bridges required to gain expedient and wide acceptance of field instruments that can address complex questions associated with characterizing and cleaning up hazardous waste sites. CFAST has developed a dynamic process that employs adaptive sampling strategies and field analytics to expedite the characterization and clean-up process. This has led to 50% cost savings and substantial time savings concomitant with more data collected to answer site-specific questions with increasing precision. CFAST research includes fiber optic sensors for a variety of environmental pollutants, electrochemical and TDGC/MS detection of metals and organic compounds in situ, and rapid on- site field characterization for detecting organic compounds and metals using portable TDGC-MS, ICP/AE, XRF, and MIP/MS instruments. Advances in field-based technology and wider use will ultimately have a positive impact on human health decisions.

195

Resource Allocation Models in Environmental Monitoring Design

Ramana Kuchibhatla, ManTech Environmental Technology, Inc. Research Triangle Park, North Carolina

No single set of monitoring decisions is optimal for all monitoring programs. Cost-effective decisions must be made in an adaptive framework, constantly changing yet having a basic structure. Because monitoring budgets are getting scarce, optimal allocation of monitoring resources to achieve study objectives has gained more importance. The objectives of this presentation are to develop and illustrate such a model structure for decisions on monitoring groundwater quality.

Monitoring decisions are shown to be governed by an interplay of qualitative and quantitative factors, such as the specificity of the stated objectives, the level of desired precision and accuracy in estimates, and the quasi-objective method of estimating the health effects of contaminants. A detailed analysis for allocating monitoring resources in the absence of clearly specified objectives is performed to show that uniform allocation of resources does not mean "equitable" allocation. These findings are illustrated with the optimization model using more than 50 years of groundwater quality data in Iowa. Although this research used groundwater quality data, the issues addressed are applicable to any type of monitoring, including monitoring to study human exposure to chemicals in the environment.

074

Costs and Benefits of the RCRA Corrective Action Program: A National Perspective

Barnes Johnson, Mark Ralston, Linda Martin, Gary Ballard, Environmental Protection Agency, Office of Solid Waste, Washington, D.C., Ravi Singh, Reid Harvey, Ravindra Sannareddy, Tom Gherlein, Birute Vanatta, Randy Freed, ICF Incorporated, Vienna, Virginia, Lisa Robinson, Industrial Economics Incorporated, Cambridge, Massachusetts

The Hazardous and Solid Waste Amendments of 1984 (HSWA) expanded the scope of cleanup at permitted hazardous waste treatment, storage, and disposal facilities. HSWA authorized cleanup of all releases of hazardous constituents to all environmental media, regardless of the source.

This presentation will summarize the findings of a study that was conducted to understand the impact of this program. Findings include a summary of the costs of multimedia remedial programs, the human health risks associated with contaminated sites, and the eco- nomic benefits of site cleanup. Finally, a recent analysis of the cost impacts of various remedial options will be presented. The options analysis includes an evaluation of various alternative remedial policies.

Results suggest that the costs of remedial programs are substantial. In comparison, the present actual human exposure to environmental contaminants appears to be small; nevertheless, sub- stantial soil and groundwater contamination can be found at many sites and may pose a potential for human exposure in the future. Although conventional measures of economic benefit associated with site cleanup appear to be low, the extent to which the public holds substantial stewardship values for cleaning up contaminated ground- water is uncertain but potentially large. Finally, the results also suggest that options for reformulating the risk and engineering basis of remedial policies show great promise for lowering the social cost of site cleanup with little adverse impact on human health.

107

Comparative Risk Analysis: A Panacea or Risky Business?

Vlasta Molak, Ph.D., D.A.B.T., GAIA Unlimited, Inc., Cincinnati, Ohio

Comparative risk analysis (CRA) is a term used to describe projects around the United States that have been conducted by states and local communities as a promised cure for "irrational" environmental management. CRA is supposed to "bring together sound science, the interests of the public, and the commitment to improve environmental policy." Moreover, CRA is "to set priority risks by ranking them" and "to establish priorities for environmental action."

Evaluation of several CRAs performed by the states or local communities indicates that neither "sound science" (of risk analysis) nor community values and "interests of the public" are properly incorporated. Thus, "Comparative Risk Analysis" appears to be a misnomer and a distortion of the term "risk analysis." Most members of committees involved in performing CRAs are neither trained in performing valid scientifically defendable risk analysis nor fairly represent the public (most are industry or government representatives who often have vested interests in the outcome). Moreover, trying to use such CRAs to set environmental priorities may do more harm than good, because they are based on both incomplete or non-existent and erroneous data and on improper use of data to derive conclusions.

Although properly conducted CRA may be a worthwhile project for critically evaluating all available data on the state of the environment at the local or state level, the project cannot be easily or hastily conducted by untrained people. The data are so complex that an interdisciplinary effort of many qualified risk analysts would be needed to derive conclusions of any validity. If the results of CRA are to be used to set environmental priorities (presumably by eliminating "unimportant" problems and concentrating on important ones), all available facts and all limitations of data and methodology must be clearly spelled out. Risk-based decisions must rest on solid science, not (as often happens) unqualified opinions disguised as science. Some currently performed CRAs may lead to environmental degradation and the lowering of environmental standards because the public is led to believe that conclusions reached are based on sound science. In fact, unfortunately, they are only opinions (often unqualified) of a selected group of individuals involved in the CRA.

113

Perceptions of Environmental Issues: A Comparative Risk Approach

Vincent R. Nathan, M.P.H., Ph.D., Wayne State University, Detroit, Michigan

The Environmental Protection Agency (EPA), other federal agencies, and state governments have focused on reducing environmental risks. The process includes numerous complications and impediments. The largest, limitation of resources, has prompted a need to set priorities or rank hazards. "Official" U.S. ranking of environmental hazards and translation into policies for risk reduction are assumed to be driven by technically objective criteria. But the approach has several shortcomings, and EPA priorities have varied in response to the expanded range of factors that underpin environmental policies.

These factors include

- statutory mandates,
- cost-benefit considerations,
- environmental equity,
- technological advances, and
- public perceptions and values.

Conceptual and practical problems are inherent in the objective risk assessment process used by environmental regulators. Thus, the bases for policy formulation and implementation are often at variance with other considerations that drive environmental policies. These include public perceptions and values and statutory or court-ordered mandates for local control.

This presentation focuses on how EPA approaches risk reduction through the process of comparative risk assessment and how the public perceives the risk-based approach.

Risk-ranking from the public perspective may not necessarily coincide with regulatory agency approach. Therefore, the question of local control of cleanups and local decisionmaking of priorities (ranking) has surfaced as a challenge to regulatory agencies. Wayne County, Michigan, has proposed such a challenge. The county is supporting legislation to form a county authority to run environmental cleanups. Wayne County officials feel the need to speed up cleanups and ensure an adequate share of state funding. This study was designed to survey both the general public (Wayne County residents) and officials of the Michigan Department of Natural Resources (regulators) to determine their perceptions of environmental pollution. This exploratory study is intended to document official and public perceptions of environmental risks.

239

Health Hazards of Hazardous Waste Sites Identified Through Petitions for Public Health Assessments

John A. Steward, R.S., M.P.H., Hanh La, M.S., Cynthia M. Harris, Ph.D., D.A.B.T., Agency for Toxic Substances and Disease Registry, Atlanta, Georgia

Approximately 38,000 abandoned waste sites have been identified in the United States. The Comprehensive Environmental Response, Compensation, and Liability Act, as amended in 1986, authorizes the Agency for Toxic Substances and Disease Registry (ATSDR) to conduct public health assessments of releases of hazardous substances into the environment in response to requests from individuals, health providers, and organizations. Since 1987, members of the public have identified more than 300 sites or facilities in the United States through petitions for public health assessments. Through 1994, 54 petitioned public health assessments have been completed.

Using ATSDR's HazDat database, data from those petitioned public health assessments were analyzed. The data were summarized and compared with data from non-petitioned public health assessments that ATSDR conducted at National Priorities List (NPL) sites. Petitioned public health assessments are an effective way to identify the health hazards associated with waste sites and releases and the needed public health actions.

245

Health-Based Contaminant Screening Levels

Dana M. Abouelnasr, Ph.D., Agency for Toxic Substances and Disease Registry, Atlanta, Georgia

To determine whether a hazardous waste site may affect the health of neighboring communities requires several different types of information. Among this necessary information is the concentration of contaminates in the environment. The lower the concentration, the less likely that adverse health effects may occur should there be any exposure. Using this principle, contaminant concentration values below which no adverse human health effects are expected to occur may be derived from current toxicologic information. These screening levels, or "comparison values," can then be used as initial screens to determine whether contaminants need further evaluation of their potential to affect public health.

Comparison values are designed to be conservative and non- site specific and are, therefore, protective for all probable exposures. They are intended only to screen out contaminants that do not need further evaluation. They are not intended as clean-up levels, or as indicators of public health effects. They are derived from toxicologic information, using assumptions regarding body weights, ingestion rates, and exposure frequency and duration. Two different types of comparison values exist, those based on carcinogenic (cancer-causing) effects, and those based on non-carcinogenic effects. Cancer-based comparison values are calculated from EPA's oral cancer slope factor or inhalation unit risk. They are calculated for lifetime exposure, with a risk of excess cancer equal to one in one million exposed persons. Non-cancer comparison values are calculated from ATSDR's Minimal Risk Levels, or EPA's Reference Doses or Reference Concentrations. These values are calculated for adults, for children, and for small children who may ingest significant amounts of soil.

165

Small-Area Analysis Techniques for Environmental Justice in Minority and Disadvantaged Communities

Emmanuel A. Taylor, M.Sc., Dr.P.H., Karen E. Harris, M.P.H., Rueben C. Warren, D.D.S., Dr.P.H., Centers for Disease Control and Prevention, E.B. Attah, Ph.D., Clark Atlanta University, Atlanta, Georgia

Minority populations suffer disproportionately from preventable morbidity and mortality, regardless of income, education, or geographic locale. However, the health impact of the environment on minority populations has not been adequately characterized. This presentation will explore alternative demographic and epidemiologic models for small-area analysis of the distribution of health and exposure phenomena in defined populations.

In 1994, President William J. Clinton signed Executive Order No. 12898, mandating that federal agencies collect, maintain, and analyze information to assess and compare environmental and human health risks borne by populations identified by race, national origin, or income. However, current statistical models that document disproportionate impacts of environmental stressors on these populations are limited. Geographic-information-system (GIS) mapping for quantitative analyses provides only anecdotal information.

The Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry are collaborating with other federal and non-federal agencies and organizations to identify and reduce the disparities of environmental hazards experienced by disadvantaged communities and persons of color in the Mississippi Delta Region. A critical first step is to complete a needs assessment. This needs assessment will be developed around four areas, including an environmental profile of key environmental hazards and a demographic profile of communities near the sources of environmental hazards.

To maintain scientific rigor in the environmental justice movement, analytic models are needed for intra-racial and site- referenced indices of disproportionate impact of environmental hazards. The use of GIS mapping coupled with analytic capabilities of the PC software, "Cluster," for public health assessment of disproportionate burden among disadvantaged populations in a defined area will be discussed. The proposed methodologies will yield local-level information needed to plan and evaluate environmental health intervention programs in communities throughout the United States.

063

Washtenaw County, Michigan, Environmental Justice, Community-Outreach Program

Rebecca A. Head, Ph.D., Tetchiana Y. Anderson, Sarah B. Gramlich, M.S., and Kimberly S. Wade, M.S., Washtenaw County Environment and Infrastructure Services, Ann Arbor, Michigan

Studies at national and local levels document ways in which environmental decision-making both neglects and harms racial minority or low-income communities. The Washtenaw County (Michigan) Community Outreach Program has been initiated to address some of these issues. The program purpose is twofold: 1) to forge citizen involvement in protective environmental practices in low-income communities and communities of color, and 2) to build partnerships between diverse communities and county government to improve development and delivery of environmental services.

Objectives are to

a) Increase citizen awareness of and access to environmentally related services available from Washtenaw County government agencies
b) Gain input from citizens to ensure that the county's environmentally related programs and policies meet expressed needs of underrepresented communities
c) Promote change by partnering with citizens to implement ongoing practical environmental projects and practices in their communities and homes.

Methods are to
a) Cultivate community contacts with the help of students who participated in the 1992 and 1993 Environmental Careers Internship for Students of Color
b) Educate citizens about available county environmental services through community presentations
c) Conduct community workshops on topics chosen by local residents
d) Help citizens design community environmental projects.

The long-term result is improved capacity of citizen and county government to prevent local environmental degradation. Short-term results are the creation of community environmental projects and a Community Advisory Committee, composed of members of traditionally underrepresented communities.

149

Environmental Justice and an Urban Community: A Unique Approach at a Superfund Site

Patricia Seppi, Lance Richman, Environmental Protection Agency, New York, New York, Joanne Wireman, ICF Kaiser Engineers, Edison, New Jersey

The Environmental Protection Agency's (EPA) project at the Diamond Alkali site is an example of how technical, environmental justice, and community relations issues all affect actions at a Superfund site. The site consists of a former pesticides manufacturing facility in Newark, New Jersey, and the adjoining 6- mile reach of the Passaic River. Dioxin, PCBs, metals, and other hazardous substances have been found at the site.

As technical work at the site progresses, EPA is facing several economic, environmental justice, and community relations issues. First, the site is located directly upriver from Newark Bay and ports operated by the Port Authority of New York and New Jersey. Maintenance dredging of these ports has become a controversial issue because elevated levels of dioxin and other contaminants were found in channel sediments.

Second, the site is located in the Ironbound Section--a densely populated, heavily industrialized urban area with a significant percentage of non-English-speaking residents. Residents have been active in the past over environmental issues in their neighborhood, including the construction of a solid waste incinerator a few years ago.

Finally, community relations at the site had deteriorated because of the community's lack of trust and loss of confidence in EPA. Reasons for this include length of time required for site cleanup, lack of information about the site and fish consumption advisories, and EPA's decision to contain the contamination on-site rather than treating the materials or moving them off-site.

To address these concerns, EPA has implemented an innovative public outreach program to improve how it communicates with minority and low-income communities living in the vicinity of the site, and to involve them in the decision-making process. The program includes extensive use of translators and provision of trilingual (English, Spanish, Portuguese) signs, fact sheets, and notices. EPA is working with grassroots organizations, tenant associations, and churches in the Ironbound to help distribute information to residents. A Community Advisory Group has been established and meets quarterly. In addition, EPA awarded more than $220,000 in grants to the states of New York and New Jersey for a public outreach program to notify residents of seafood consumption advisories in local waterways, including the Passaic River.

049

Hazardous Waste Disposal Decisions: Democracy, Justice, and NIMBYism

Heather Elliott, M.Phil., Department of Political Science, Yale University, New Haven, Connecticut

Analysts of hazardous waste policy have recommended public input at the local level as a remedy for NIMBYism (Not in My Backyard); some advocates also rely on democratic procedures to make the outcome of the siting process more just. However, emphasizing public input does not necessarily eliminate either problem. I will discuss two reasons for this.

First, many suggestions for public participation rely on a pluralist view of politics: interest groups exist or will be formed, and these groups will have access to the formal process. Critics of pluralistic views of politics emphasize barriers to group formation and participation. Similarly, a focus on individual rather than group participation can ignore the constraints of political and economic inequality on citizen participation. Thus, a facility may be unjustly imposed on individuals who lack access to the process; these individuals may also protest outside the process.

Second, requiring public input may have the perverse effect of excluding communities where participation is likely to be vigorous. Participatory democracy is time-consuming and often contentious. Thus, companies or government agencies seeking an expeditious process for siting a hazardous waste facility may eliminate high-participation communities from consideration and seek communities where individuals, again, lack voice. The NIMBY protest may be avoided, but at the expense of justice.

Public input at the local level, therefore, is not a panacea for unsuccessful or unjust siting decisions. Policy recommendations for just and efficient hazardous waste siting must include criteria of justice that do not take silence during the official process for consent.

006

Brain Cancer and Multiple Hazardous Exposures, Especially Electromagnetic Fields

Tim E. Aldrich, Ph.D., M.P.H., Carol Hanchette, M.S., State Center for Health and Environmental Statistics, Raleigh, North Carolina, and Kurt Andrews, M.S., Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina

Cancer cluster studies in North Carolina identified several communities experiencing greater-than-expected brain cancer risk. These findings along with expanding organizational capabilities of Geographic Information Systems (GIS) led to two, population- based, case-control studies of brain cancer risk.

The studies were designed to evaluate the association of brain cancer with a variety of potentially hazardous exposures (e.g., industrial emissions, pesticides, poultry farms, and electromagnetic fields [EMF]). In the latter case, GIS proved a promising means for making innovations in the way exposure to EMF had previously been evaluated on a population scale. GIS techniques were used to include the aspects of polar gradient, elevation, and distance from an electrical power source of specified magnitude in the exposure assessment of environmental EMF sources.

These studies exemplify the maturing of environmental epidemiology technology for large-scale studies. In addition to the direct issue for this brain cancer study, the discussion will include use of sentinel event surveillance (e.g., mapping brain cancer cases) as a systematic public health approach to contamination studies and assessment of health effects around hazardous exposures sources. The extension of methods applied here in a retrospective setting to prospective data analyses relates well to emerging population-based registries and the ATSDR mandate.

Funding for this project came from the Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.

097

Case-Control Study of Lung Cancer Mortality in Four Arizona Smelter Towns

Gary M. Marsh, Ph.D., Roslyn A. Stone, Ph.D., Mary Jean Gula, M.S., Christine K. Gause, Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, Nurtan A. Esmen, Ph.D., The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, Norman J. Petersen, F. John Meaney, Ph.D., Arizona Department of Health Services, Phoenix, Steve Rodney, Dimitri Prybylski, M.P.H., University of Arizona Health Sciences Center, Tuscon, Arizona

An ATSDR-sponsored, case-control study was conducted in four Arizona smelter towns (Ajo, Douglas, Clifton/Morenci, and San Manuel) to investigate factors related to lung cancer mortality. This study parallels an ongoing case-control study in several Gila Basin, Arizona smelter towns where lung cancer mortality rates are 50% higher than in the Phoenix/Tucson metropolitan areas.

From Arizona state mortality files, 142 cases were identified as occurring in all town residents who died from lung cancer during 1979-90. For each case, two controls were selected randomly (excluding deaths from respiratory system and skin cancer) with group matching on year of death and age at death. Attempts were made to contact a knowledgeable respondent for each decedent and to administer blindly a structured telephone interview that sought detailed information on lifetime residential, occupational, and cigarette-smoking history. Interview data were collected for 80.3% of the cases and 73.9 % of the controls.

Atmospheric diffusion modeling of data on smelter SO2 (as a surrogate for smelter emissions) and local aerometric and topographic parameters was performed to estimate historical environmental exposures in the four towns. Exposure estimates were linked with residential histories to derive individual profiles of community exposure; occupational histories were characterized by potential exposures to smelter emissions, asbestos, solvents, gasoline, and radiation.

Preliminary conditional logistic-regression analysis revealed no evidence of a positive association between lung cancer and any of the indices of residential exposure to smelter emissions considered. Statistically significant positive associations were observed between lung cancer risk and potential occupational exposure to asbestos and to smelter emissions with submultiplicative joint effects.

211

A Study of Cancer Mortality in Louisiana Parishes in Relation to Environmental and Occupational Factors

Ahmed E. Gomaa, M.D., Sc.D., Vivian W. Chen, Ph.D., Pelayo Correa, M.D., William R. Hartely, Sc.D., Janet M. Hughes, Ph.D, and LuAnn White, Ph.D. Tulane University, New Orleans, Louisiana

Cancer statistics and epidemiologic investigations have indicated that Louisiana, particularly the southern portion of the state, experiences some of the highest cancer rates in the country, especially prominent for the respiratory organs.

This study investigated Louisiana Parish-specific cancer mortality rates for 1970-1979 in relation to indicators of environmental and occupational exposures in these Parishes.

Mortality rates for six site-specific cancers were regressed on environmental and occupational indices, before and after controlling for socioeconomic and demographic variables. This regression analysis was done by race and sex.

Consistent associations existed between mortality rates and urbanization (positive association) and educational level (negative association). The percentage of wetlands in the Parish showed strong associations for all cancers combined and for lung cancer in the male populations. Use of disinfected water showed strong positive association only for colon cancer in female populations. The presence of hazardous waste sites and the amount of chemical released per Parish showed weak and inconsistent positive associations. Working in agriculture and forestry, construction, mining, and manufacturing were associated positively with several cancer sites and race-sex groups.

Strong associations among cancer and several environmental and occupational indicators were in agreement with previous studies. Striking association was found between lung cancer in males and the percentage of wetlands in the Parish.

235

Pancreatic Cancer Mortality and Railroad Refueling Facilities in Montana

Stephanie R. Prausnitz, Michael A. McGeehin, Leeyang C. Wong, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia

The association between pancreatic cancer mortality and exposure to contaminants from railroad refueling facilities was investigated by the Montana Department of Health and Environmental Sciences and the Agency for Toxic Substances and Disease Registry. A previous investigation of a pancreatic cancer cluster suggested the possibility of such an association. A pilot study using death certificate data investigated pancreatic cancer mortality from 1980 through 1990 in the 12 populated areas where railroad refueling facilities are located in Montana. The study population included 471 case decedents and 881 controls matched on age, sex, time of death, and county of death. A review of death records and a spatial analysis of residential distance from the refueling stations showed no statistical relationship between residential proximity and pancreatic cancer mortality. In addition, no association was found for pancreatic cancer deaths and employment in the railroad industry as indicated on the death certificates.

019

Birth Defects, Fetal Loss, and Developmental Disorders in an 11-Year Study of an Herbicide Manufacturing Facility with Dioxin Contamination

Marge A. Brewster, Ph.D., Russell Kirby, Ph.D., Arkansas Reproductive Health Monitoring System (ARHMS) and University of Arkansas for Medical Sciences, and Carole Canino, ARHMS, Arkansas Children s Hospital, Little Rock, Arkansas

Adverse reproductive outcomes (major birth defects, fetal loss, and developmental disorders) have been studied for temporal and geographic relationships to a Superfund facility that previously manufactured Agent Orange (2,3,5-T) and other herbicides and had documented on- and off-site dioxin contamination. Population-based case ascertainment was conducted actively by an established monitoring system, the Arkansas Reproductive Health Monitoring System, in cooperation with ATSDR and the Arkansas Department of Health. The study area was Pulaski County, Arkansas, and the birth years covered were 1980-1990. Cases were sought from records of all known institutions providing diagnosis or care for this population, including hospitals, diagnostic centers, community programs, and public schools. Cases of birth defects and fetal loss were ascertained for the entire 11-year period and developmental disorders for the last 6 years of this period. Cases were linked to birth and death records for this period. Births and cases were mapped via Geographic Information Systems.

The overall and race-specific rates of these outcome categories will be presented for the whole county, the facility community, and for potentially exposed areas. The temporal relationships of rates to the clean-up activities and the search for clusters of adverse events will be described.

080

A Community-Based Study of Adverse Pregnancy Outcomes Near a Large Hazardous Waste Landfill in California

Martin Kharrazi, Ph.D., Julie Von Behren, M.P.H., Margot Smith, Dr.P.H., Tim Lomas, Michael Armstrong, Rachel Broadwin, M.P.H, Elinor Blake, M.S.W, Bob McLaughlin, Gordon Worstell, Lynn Goldman, M.D., M.P.H., California Department of Health Services, Emeryville, California.

Various adverse pregnancy outcomes were investigated in residents living within 3 miles of a large hazardous waste landfill in Southern California to determine whether a dose-response relationship existed to fugitive air emissions from the site.

Outcome data derived from 9 years of live birth, fetal death, and infant death records (N=25,216). Exposure measures were based on distance from the site, waste manifests, odor complaints, vinyl chloride monitoring, topography, and meteorologic data. A geographic information system was used to assign exposure levels to births according to the mother's street address and month of conception. Adverse pregnancy outcomes included fetal, early neonatal, and one year mortality; developmental indices based on birthweight and gestational age; and rates of fertility and multiple births. Numerous potentially confounding factors from vital records and from census block groups were used in conjunction with multiple linear and logistic regression modeling to control for the effect of differing sociodemographic factors across the study area.

Rates of adverse outcomes did not increase with decreasing distance from the landfill. However, two findings were noteworthy. During the 4 years with the highest air emissions, the rate of early neonatal death was elevated in an area with a medium level of reported odors (adjusted odds ratio = 3.8, p<0.05, total N=175), and mean birthweight and mean gestational age in term--but not low- birthweight--infants were lower in a high odor area (adjusted mean difference = -59 grams and -1.8 days, respectively, both p values <0.05, total N=255) than in a large comparison area without odors (total N=9240).

Overall, although no large-scale, dose-response effects were observed around the landfill, small effects could be detected in the residential area with the heaviest odors.

098

Maternal Residential Exposure to Hazardous Waste Sites and the Risk of Central Nervous System and Musculoskeletal Birth Defects

Elizabeth Marshall, Ph.D., Lenore Gensburg, M.S., Nanette Geary, Debra Deres, M.S., Michael Cayo, M.S. New York State Department of Health, Albany, New York

Risks of birth defects in the central nervous system (CNS) and in the musculoskeletal system (MUS) were evaluated in relation to maternal exposure to solvents, metal, and pesticide contaminants from hazardous waste sites in 18 counties in New York State. Environmental ratings using address at birth were developed for 473 offspring with CNS, 3305 offspring with MUS, and for 12,436 controls. Residences within 1 mile of each inactive hazardous waste site were classified by their probability of exposure to solvents, metals, and pesticides. Residences were also rated on proximity to industrial facilities and contamination of community water supplies. Compared with mothers who had low probability of exposure, mothers assigned medium or high probability of exposure did not show increased risks of birth defects in their offspring. The adjusted odds ratio (OR) for CNS defects and exposure to solvents was 0.8 (95%CI: 0.4-1.6), for CNS and metals was 1.0 (95%CI:.7-1.7), for MUS defects and solvents was 0.9 (95%CI:0.8-1.1), and for MUS defects and pesticides was 0.8 (95%CI:0.5-1.3). Residence near an industrial or commercial facility emitting solvents showed an elevated risk for CNS (OR=1.3, 95%CI:1.0-1.7) or emitting metals showed an elevated risk for CNS (1.4, 95%CI:1.0-1.8) but not for MUS defects. The low prevalence of potential exposure to chemicals from hazardous waste sites (1%-5% for pesticides, solvents, and metals) limited analysis of particular pathways or disease subgroups. The results indicate no overall association between two types of defects and contaminants from hazardous waste sites, but associations with industrial releases of solvents and metals need further investigation.

292

The Relationship Between Birth Defects and Exposure to Trichloroethylene-Contaminated Water in Woburn, Massachusetts

Diana E. Schendel, Ph.D., Marilyn DiSirio, Centers for Disease Control and Prevention, Atlanta Georgia, Robert Knorr, Ph.D., Suzanne Condon, and Elaine Krueger, Massachusetts Department of Public Health, Boston, Massachusetts

The prevalence of birth defects in Woburn, Massachusetts, was examined relative to 1) potential exposure to trichloroethylene- contaminated water from two municipal wells, and 2) a referent birth defects registry. Data on birth defects diagnosed in the newborn period were obtained by hospital medical record review of a 10-year (1975-1984) cohort of Woburn births (N = 4708). Exposure was based on an estimate of whether any contaminated water reached each birth residence during the first trimester.

In Woburn, no significant differences in birth defect rates were found between exposed and unexposed newborns born during the period of well operation or between newborns born during and after operation of the wells (odds ratios [ORs]: 0.0 - 4.4). Relative to the registry, significantly higher Woburn rates of respiratory (OR=3.1) and genital (OR=1.6) defects were evident before well closure. Except for rates of choanal atresia (a rare, specific respiratory defect), however, the latter differences also persisted after well closure.

These data provide little evidence for an adverse effect of trichloroethylene exposure on the prevalence of birth defects in Woburn. Small sample sizes, however, limited study power.

263

Case Study in Evaluating Radiation and Chemical Exposures: Hunters Point Annex, San Francisco, California

Joan Davis, Michael J. Grayson, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia

Military landfills pose particular problems in risk assessment because they often combine radioactive waste with other chemical hazards.

Representatives of the Agency for Toxic Substances and Disease Registry (ATSDR) conducted a public health assessment for Naval Station Treasure Island, Hunters Point Annex, San Francisco, California. The landfill at Hunters Point, a National Priorities List base-closure site, contains radioactive wastes as well as other hazardous materials.

ATSDR health assessors evaluated known contaminant concentrations, probable exposure scenarios (past and current), and the potential for adverse health effects at this site. In this presentation, we will focus on results of the radiation analysis, comparing methods used with those typically used to assess hazardous chemical contaminants. We will also discuss implications of the differences in these methods for establishing overall risk categories at a site.

227

Detection of Chronic Lymphocytic Leukemia-Like Monoclonal B-cell Proliferation in Peripheral Blood Samples from Environmental Health Studies.

Robert F. Vogt, Jr., Ph.D., L. Omar Henderson, Ph.D., Nancy K. Meredith, M.T. (A.S.C.P.), Judy Powell, M.T. (A.S.C.P.), W. Harry Hannon, Ph.D., Centers for Disease Control and Prevention, Atlanta, Georgia, Gerald E. Marti, M.D., Ph.D., Food and Drug Administration, National Cancer Institute (NCI), Bethesda, Maryland, Mary Alice Stetler-Stevenson, M.D., Neil Caporaso, M.D., NCI, and Gina Terracciano, D.O., M.P.H., Agency for Toxic Substances and Disease Registry, Atlanta

B-cell lymphocyte phenotypes consistent with chronic lymphocytic leukemia (CLL) were detected in 11 peripheral blood samples from individuals in epidemiologic studies conducted at Superfund sites. Monoclonality was confirmed in all of three cases analyzed further at the Food and Drug Administration. Each of these three had differing lymphocyte morphology, including a typical B-cell chronic lymphocytic leukemia (B-CLL), an atypical variant with myeloid marker expression, and a plasmacytoid feature consistent with a B-cell immunocytoma (Waldenstrom's disease).

Because the ultimate relationship of these phenotypes to disease is uncertain, we refer to them as monoclonal B-cell lymphocytoses (MBL). We report these initial findings to stress the importance of the cytomorphology in the differential diagnosis of monoclonal lymphocytosis and its relevance to clinical presentation, treatment, and prognosis. Because B-cells have inherently unstable genomes as part of their antibody-producing function, they may be particularly sensitive targets for environmentally induced damage and serve as sentinels for such exposures. Further studies are planned to test this hypothesis.

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The International Congress on Hazardous Waste: Impact on Human and Ecological Health

Abstracts for Breakout Sessions (Tracks 11-20)

Session 11 - (Health Effects Track) Abnormal Immune Findings in ATSDR Studies

Abstracts for Sessions 11-20

The International Congress on Hazardous Waste:
Impact on Human and Ecological Health