Environmental Epidemiology, Volume 1 Public Health and Hazardous Wastes (1991) / Chapter Skim
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According to recent opinion polls, the American public believes that hazardous wastes constitute a serious threat to public health. In contrast, many scientists and administrators in the field do not share this belief.
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. This first report of the committee reviews and assesses the published scientific literature on health effects that could be linked with exposure to substances from hazardous-waste disposal sites and makes recommendations about major data gaps that need to be filled as scientists go on to answer important questions in the field.
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Chapter 3 discusses available data on materials commonly found at listed hazardous-waste sites and notes some problems in estimating human exposures to these agents. The remainder of the report reviews the published literature and considers the problems of obtaining epidemiologic information about specific routes of exposure to hazardous wastes.
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For others, especially for airborne and waterborne exposures, knowledge of health risks will come from studies of the general effects of the pollutants and from clinical reports, case-comparison studies, and animal studies, and it can be extended to circumstances where such pollutants are emitted from hazardous-waste sites. · Knowledge of symptomatology or disease occurrence has in some instances been derived from studies of populations exposed to hazardous-waste sites.
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Chapter 2 questions how so much effort and money could have been spent with such a moderate yield in knowledge. It reviews 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; and what proportion of hazardous-waste-control budgets is spent on as
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Finally, Congress's intent was that the remediation programs would do the most possible, with limited resources, to protect the health of the public. These objectives are in fact the traditional elements of a public health strategy: The discovery and preliminary assessment of as many sites as possible to describe the universe of potential exposures; the priority ranking of sites by a defined protocol, to identify and act on those most urgently requiring attention; the collection and use of data on current human exposures and health effects early in the triage and evaluation processes; and the development of remediation programs with direct and continuous attention to the public health effects of releases from the sites.
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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.
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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.
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OTA concludes that there could be as many as 439,000 candidate sites. These sites include mining waste sites, leaking underground storage tanks, pesticide-contaminated sites, federal facilities, radioactive release sites, underground injection wells, municipal gas facilities, and wood-preserving plants, among others.
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The absence of evidence of their risk is solely the result of the failure to conduct research; it should not be misconstrued as demonstrating that NCPs and "inert" pesticide components are without risk. SECTION TWO: HAZARDOUS WASTES IN AIR, WATER, SOIL, AND FOOD; BIOLOGIC MARKERS Chapter 4: Air Exposures Chapter 4 notes that although there is an extensive body of literature on the epidemiology of air pollution, there is little information about airborne exposures from hazardous-waste sites.
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Excesses of the rare cancer angiosarcoma occurred in residents near a vinyl chloride manufacturing plant. Another study found increased rates of birth defects in children whose parents lived near such plants.
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Although few studies directly assess airborne exposures to hazardous wastes, the committee finds persuasive evidence that health effects can occur from such exposures. Review of the relevant animal literature on compounds known to occur at hazardous-waste sites, along with the few epidemiologic studies, shows that a wide range of effects may occur, including such serious diseases as cancer, birth defects, and neurologic disease.
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Accordingly, this chapter reviews evidence about some compounds commonly found at hazardous-waste sites that have been shown to cause adverse effects in humans exposed to these materials through the use of domestic water. Epidemiologic evidence on the risk to health from contaminated water from hazardous-waste sites or from other sources of contamination, such as pesticide runoff, has largely been derived from ecologic (descriptive)
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The study of adverse reproductive effects on males and females exposed to hazardous-waste sites remains surprisingly sparse. Nonetheless, several important reports have found adverse reproductive effects associated with use of contaminated domestic water.
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A limited number of reports in the peer-reviewed scientific literature have linked spontaneous abortion, low birth weight, and birth defects to the consumption of domestic water or to other environmental exposures. A variety of other health effects, including liver and neurologic disease, have also been associated with waterborne exposure to substances from hazardous-waste sites.
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, or there is extensive dust contamination of food and residences, exposure due chiefly to contaminated soil is unusual. However, contaminated soil and domestic water can act as vehicles for contamination of plant or animal foods that are subsequently ingested as is the case for mercury and pesticide contamination of fish and heavy metal or pesticide contamination of fruits and vegetables.
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This chapter reviews studies of biologic markers in persons exposed to materials such as those commonly encountered at hazardous-waste sites, along with the few studies of persons directly exposed at sites. Examples of markers of exposure, effect, and susceptibility are provided and methodologic or other important considerations in their use are presented.
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Researchers also have studied markers of neurologic function in persons from Woburn, Massachusetts, some six years after exposure to TCE ceased, and in others with similar exposure. In Woburn, TCE levels in domestic water had been from 30 to 80 times higher than the recommended EPA Maximum Contamination Level of 5 parts per billion (ppb)
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CONCLUSIONS Whether Superfund and other hazardous-waste programs actually protect human health is a critical question with respect to federal and state efforts to clean up hazardous wastes. To answer this question requires information on the scope of potential and actual human exposures to hazardous wastes and about the health effects that could be associated with these exposures.
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In some cases, unnecessary or inappropriate remediation might create more of a hazard than would be caused by leaving such materials undisturbed. Despite the lack of adequate data with which to characterize the effects of hazardous wastes on public health in general, the committee does find sufficient evidence that hazardous wastes have produced serious health effects in some populations.
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Our report indicates that the nation is not adequately identifying, assessing, or ranking hazardous-waste site exposures and their potential effects on public health. We are currently unable to answer the question of the overall impact on public health of hazardous wastes.
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