exposures to lead and cadmium and other mine wastes occurred chiefly through domestic water use. Some surface soils may also have provided airborne exposure. Significant elevations in rates of a number of causes of death and disease were evident in persons over age 44. Among residents of the three towns who had lived there at least five years, there was either a statistically significant or borderline excess in women for chronic kidney disease (aged 65), heart disease (aged 45 and older), and anemia (aged 45 and above). This sex difference may reflect the fact that factors such as smoking, work, and drinking are more important determinants of some of these diseases in men than women. A significant excess of mortality also occurred from ischemic heart disease in males and females (aged 65 and older). The authors conclude that environmental agents in Galena City may have contributed to the causation of several chronic diseases in residents.

OTHER HEALTH END POINTS

An environmental health survey of residents who had consumed drinking water contaminated with leachate from a waste dump where a pesticide plant had deposited large amounts of liquid and solid waste between 1964 and 1972 was conducted in Hardeman County, Tennessee (Clark et al., 1982). Twelve chlorinated organic compounds were found in wells that served individuals living near the dump site. Carbon tetrachloride was the most abundant, and residents had complained of a number of symptoms, including eye and skin irritation; upper respiratory infection; and gastrointestinal symptoms including nausea, diarrhea, and abdominal cramping. The survey used a health questionnaire, a clinical examination, and biochemical screening for liver and kidney dysfunction. Results of the physical examination of 118 individuals found six of 48 individuals in the exposed group had slight hepatomegaly (enlargement of the liver), compared to one of 24 in an intermediate exposed group and none in the 46-member group of unexposed control subjects. The difference between the groups was significant (p=.034) with the Pearson chi-square test. Elevated concentrations of alkaline phosphatase and serum glutamic oxaloacetic transaminase, measures of liver function, were found more often in the exposed group than in the controls. The concentrations fell significantly in follow-up testing two months after use of the contaminated water had ceased. The authors conclude that the clinical and biochemical observations were consistent with transitory liver injury. In a subsequent independent study, Rhamy (1982, cited by Harris et al., 1984) collected health histories and conducted physical examinations on 112 persons who then lived or had formerly



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