ATSDR, Where are YOU?
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, also known as Superfund).
ATSDR's primary goals are:
1. To identify people at health risk because of their exposure to uncontrolled hazardous substances in the environment.
2. To evaluate relationships between hazardous substances in the environment and adverse human health outcomes.
3. To intervene to eliminate exposure of health concern and reduce or prevent harmful health effects related to releases of hazardous substances in the environment.
Identifying People Exposed to Hazardous Substances
ATSDR's health assessment activities help (1) identify people who may have been exposed to hazardous substances in the environment and (2) determine whether these people might be at risk of adverse health effects as a result of that exposure.
During fiscal year 2001, ATSDR and the states that have cooperative agreements with ATSDR performed more than 1,800 health assessment activities. These activities included health assessments, health consultations, exposure investigations, and other activities that were conducted in 44 states, Puerto Rico, the U.S. Virgin Islands, Guam, the Navajo Nation and Saipan.
ATSDR analyzed demographic data for 196 sites where health assessments or health consultations were conducted in fiscal year 2001. Approximately 2.1 million people lived within a mile of those sites. Of those, about 11% were children aged 6 years or younger, and about 26% were under 18. About 22% were women of childbearing age. About 11% were elderly, aged 65 or older.
National Emergency Response
As part of its goal to identify people who may be exposed to hazardous substances, ATSDR provides emergency response services, including a response line that offers technical assistance to federal, state and local responders during emergencies that involve the spills of hazardous substances.
During the weeks following the September 11 attacks on the World Trade Center and the Pentagon, ATSDR worked with other federal agencies, state and local health departments, and other organizations to respond to the enormous challenges of the tragedy.
ATSDR staff members assisted the response effort in a variety of ways-including mapping sampling locations, helping to develop screening guidelines for asbestos and other hazardous substances, sampling dust in Manhattan residences, and speaking with groups of business owners, residents, rescue workers and others in New York to answer their health questions.
Evaluating Relationships Between Hazardous Substances and Health
One of the ways ATSDR evaluates the relationships between hazardous substances in the environment and human health outcomes is through toxicologic research. ATSDR's toxicologic research program is filling many data gaps about how hazardous substances affect human health.
ATSDR oversees two major research programs designed to help fill these data gaps -- the ATSDR Great Lakes Human Health Effects Research Program and the ATSDR Minority Health Professions Foundation Research Program.
ATSDR's toxicologic research provides critical information to public health decision makers about the health effects of hazardous substances. For example, findings from ATSDR's Great Lakes Human Health Effects Research Program have been published in an International Joint Commission report on the priorities and progress made under the Great Lakes Water Quality Agreement.
During fiscal year 2001, researchers supported by the Great Lakes research program reported findings from their study of the relationship between maternal consumption of contaminated fish and infants' birth weight. Children born to mothers who consumed more than 116 fish meals before their pregnancy were more than five times more likely to have low birth weight.
ATSDR toxicological profiles provide information about the relationship between hazardous substances and health outcomes. These profiles summarize information about many of the most hazardous substances found at Superfund sites.
As of fiscal year 2001, ATSDR has published 159 toxicological profiles covering about 800 substances.
During fiscal year 2001, ATSDR made significant progress in filling the priority data needs that have been identified for 50 hazardous substances. During fiscal year 2001, ATSDR re-evaluated the current exposure and toxicity information for the 50 substances, identifying 190 distinct priority data needs. To date, 101 priority data needs are being addressed via the mechanisms that ATSDR has implemented, and 62 of these have been filled.
Conducting Health Studies
ATSDR conducts and supports health studies to evaluate the relationship between exposure to hazardous substances and adverse health effects. ATSDR also conducts studies to evaluate how people become exposed to hazardous substances.
ATSDR continued its work evaluating residents and former residents of Libby, Montana, during fiscal year 2001. Vermiculite mined in the area was found to have been contaminated with asbestos,and people had been potentially exposed for a number of years.
ATSDR conducted a medical screening program to evaluate the health of Libby residents and former residents. The testing included an interview, chest x-ray, and a spirometry test of lung function. The program screened more than 7,000 people and provided them with health status information and any needed referrals.
About 1,000 of 5,590 participants (18%) who were x-rayed between July and November 2000 had pleural abnormalities. The risk of pleural abnormalities was greatest for former vermiculite workers, females in workers' households and for people who had recreational exposures to vermiculite.
ATSDR also analyzed Libby's mortality statistics for 1979 -- 1998 and found the death rate for asbestosis was 40 to 60 times higher than expected, as compared to rates in Montana and in the entire United States, respectively.
ATSDR has collaborated with other agencies of the Department of Health and Human Services to have additional medical services provided in Libby. During 2001, the Health Resources and Services Administration's Bureau of Primary Health Care awarded a grant to establish a clinic in Lincoln County. The clinic began operation on December 31, 2001.
Preventing Health Effects Related to Hazardous Substances
ATSDR draws on its resources in health education, risk communication, environmental medicine, and health promotion to prevent or reduce the harmful health effects of exposure to hazardous substances in communities.
ATSDR provides such preventive measures as training local physicians about the health concerns associated with contaminants, providing communities with information about the health effects of hazardous substances, and providing clinical evaluations and screenings. ATSDR also conducts health education and promotion activities that have a nationwide focus, such as its case study program on environmental medicine.
These activities are conducted with the assistance of numerous partners with whom the agency has cooperative agreements, including states, American Indian tribal nations or groups, and national organizations. ATSDR, in cooperation with its state partners, performed health education activities at approximately 310 sites this year. ATSDR expanded its network of Pediatric Environmental Health Specialty Units (PEHSUs) in fiscal year 2001 to 11 operating units.
ATSDR expanded its community stress program during fiscal year 2001. The program provides assistance to communities and training to state and local health care providers and health officials on issues relating to the stress that communities experience concerning hazardous substances.
For example, ATSDR, in partnership with the Pennsylvania Department of Health and local mental health personnel in Hazleton, Pa., has mounted a response to the significant stress in the community affected by the Tranguch gasoline spill. Efforts have focused on community education, workshops on community stress for local health care professionals and support for the community-created Behavioral Healthcare Response team.
In addition, a counseling hotline was established for residents.
