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ENVIRONMENTAL EPIDEMIOLOGY: Volume 1
the point of view of public health. Decisions have been made not to list some sites on the National Priority List (NPL) of Superfund even though those sites have never been fully characterized. The congressional Office of Technology Assessment (OTA) notes that efforts to assess candidate NPL sites typically relegate public health concerns to a minor role; the process as a whole is directed at remediation, rather than at the assessment of public health risks.
The absence of a comprehensive national program to identify and evaluate hazardous-waste sites makes it difficult to assess fully the nature and magnitude of the problem for the health of the public. Similar difficulties attend efforts to estimate the public health effects of exposures to other potentially hazardous materials, such as unregulated nonconventional pollutants that can result from agricultural practices and industrial processes. The current regulatory system has failed to devise a protocol for managing hazardous-waste sites that incorporates the essential components of public health policy. Not only is it possible that the public residing in some of these neighborhoods is imperiled, but the conditions for development of environmental epidemiology programs and methods are so adverse as to impede useful scientific investigations of many important questions.
As the committee's review of federal programs concludes, there is no comprehensive national inventory of hazardous-waste sites, no site discovery program, no minimum data set on potential human exposures, no adequate system for the early identification of sites for which immediate action to protect public health or continued surveillance of health effects could be necessary, and no validation or evaluation of the components of the site assessment process. The Environmental Protection Agency (EPA) and the ATSDR are instituting some improvements in each of these areas, but these improvements are largely limited to sites proposed for or already on the NPL.
A six-part environmental epidemiology program needs to be developed to improve the bases for policy decisions about hazardouswaste sites.
Establish an active and coordinated system of site discovery for hazardous-waste sites, based in EPA and providing technical assistance to other federal and state programs. An aggressive site discovery program, in combination with improved assessments and triage of sites for interim and final remediation, will restore the original congressional intent to protect the health of the public from exposure to hazardous-waste sites.
Define a revised approach to site assessments that integrates epidemiologic determinations of population exposures, health effects,