ous-waste sites among the most serious environmental risks and the environment as the greatest public concern (Roberts, 1990). Hazardous-waste sites are a major public health management issue in every state. Half of the entire U.S. population and 95 percent of the rural population rely on groundwater as the main source of drinking water, and each year thousands of wells are closed because of hazardous-waste contamination (Wells, 1990). The public fears hazardous waste, wants it cleaned up, and is willing to pay the enormous sums currently spent on Superfund because of the belief that this program will protect public health.

Whether Superfund and other environmental programs are actually protecting human health is a critical question for environmental epidemiology with respect to federal and state efforts in environmental protection. To answer it would require information on the scope of potential and actual human exposures to hazardous wastes and on the health effects that could be associated with these exposures. Yet during the past 10 years, of the estimated $4.2 billion spent each year on hazardous-waste sites in the U.S. (OTA, 1989), less than 1 percent has been devoted to the evaluation of health risks at these sites. As a result, existing data on exposures and health effects are inadequate not only for decisions on the management of hazardous-waste sites, but for epidemiologic investigations of the health impact of the sites as well.

The purpose of this chapter is to describe how so much effort and money could have been spent with such a moderate yield in knowledge. This chapter will describe federal and state legislation, policies, and programs that determine how hazardous-waste sites are evaluated; what information on exposure and health effects is collected; how the data are analyzed and used in setting priorities and planning remediation programs; what proportion of hazardous-waste-control budgets is spent on assessing population exposures and risks; and what are the nature and extent of environmental epidemiology carried out by these agencies.

The intent of Congress in enacting legislation on hazardous-waste sites was clear. As set forth in the legislative history of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), passed in 1980 and generally known as Superfund, the goals of the bill included

an inventory of inactive hazardous-waste sites in a systematic manner, establishment of priorities among the sites based on relative danger, a response program to contain dangerous releases from inactive hazardous-waste sites, acceleration of the elimination of unsafe hazardous-waste sites, and a systematic program of funding

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