and the necessity of interim and final remediation or other actions into a continuum of site evaluation. Establish protocols and criteria for the revised preliminary assessment of all sites, with triggers for interim remediation or other action, such as relocation, and require that all sites undergo a revised preliminary assessment within one year of discovery.

  • Establish a comprehensive national inventory of hazardous-waste sites that will track the status of all sites through assessment and remediation or closure and include health hazard assessments. Use the inventory to ensure that sites are not deferred or placed in closure status without a revised preliminary assessment as described above.

  • Rigorously evaluate the data and methodologies used in site assessment, including the characterization of potential and actual releases of contaminants to groundwater, surface water, air, and soil that result in human exposure. Evaluate the methodologies for estimating which populations are exposed to hazardous-waste-site emissions, and use this information in preliminary assessments and in deciding how to protect the public health. Evaluate compliance with public health recommendations for the protection of exposed populations and site remediation.

  • Improve and expand research in environmental epidemiology to illuminate the distribution and severity of exposures, risks, and health effects associated with hazardous-waste sites. Authorize ATSDR to direct responsible parties to conduct research to fill data gaps on critical substances. Expand the ATSDR mandate to establish an extensive program of applied research, including exposure registries linked to priority substances, and further the development of surveillance methods such as community health data bases, biologic monitoring, and sentinel events, that is, events that may signal environmental health problems.

  • ATSDR, the National Institute of Environmental Health Sciences (NIEHS), and other relevant agencies should expand cooperative agreements with states and develop a comprehensive program of technical assistance for state and local agencies. They also should provide funding for competitive research grants and contracts in environmental epidemiology.

Chapter 3: Dimensions of the Problem: Exposure Assessment

Chapter 3 notes that exposure assessment is a crucial, and often inadequate, component of studies in environmental epidemiology. In order to establish causal relationships between exposure to chemi-

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