Description Purpose Health Education. Health Assessment. Outcomes of the program Partners Contact Information
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2 Description Purpose Health Education Message Mapping Developing Community Interaction Health Assessment Identifying Contaminants of Concern Elements of Exposure Pathways Outcomes of the program Partners Contact Information 2
3 3 Non-regulatory public health authority Initiated under CERCLA laws Promotes healthy and safe environments ATSDR headquarters at the CDC Chamblee campus in Atlanta, Georgia
4 ATSDR Basic Training Course 4
5 5
6 6 Cooperative agreement between ATSDR and VDH Administered by the Division of Environmental Epidemiology/Office of Epidemiology Helps identify pathways of exposure to hazardous substances at waste sites and releases Health education and community outreach to achieve program goals
7 7 1. Assess the presence and nature of health hazards at specific sites 2. Prevent or reduce further chemical exposure and the illnesses that result from such exposures 3. Expand the knowledge base about health effects from exposure to hazardous substances
8
9 9
10 10 Work with local health departments to inform community members Serve as a liaison between health professionals, officials, and community members of an affected population Plan, develop, coordinate, and implement health education programs
11 11
12 ATSDR Community Assessment Model 12
13 13 Understand goals, objectives, and responsibilities for effective community involvement Community Engagement Touch Point 1 Touch Point 2 Touch Point 3 Touch Point 4 Identify community concerns and interest Plan community involvement activities Identify possible tools and implement community involvement activities Respond to community health concerns in public health Assessment documents
14 International Association for Public Preparedness Model 14
15 15
16 Example: Simmons-Rand Community Profile Site Visit In-depth Interviews Community Assessment Outreach Materials/Health Education 16
17 A science-based risk communication tool A template for organizing messages and responses to anticipated questions Is very useful in highstress high-concern situations Steps: 1. Identify issues and stakeholders 2. Prioritize and organize 3. Identify common questions 4. Develop answers and supporting information 17
18 18 General Rule Key Messages Advice Develop key messages that answer anticipated questions and can stand on their own AGL-4 Write messages that are at least 4 grade levels below reading level of the community 1/3/2 rule Write the most important message at the beginning, the second most important at the end, and the least important in the middle 29/9/3 template Develop 3 messages, of 9 words each, for a total of no more than 27 words 1N=3P Develop 3 positive messages for each negative one
19 Question/Concern: How can exposure to mercury affect my health? 1. Mercury, at low levels, might temporarily cause irritability, tremors, and coordination problems. 2. The nervous system is sensitive to mercury. 3. These health effects should disappear once exposure is over. 19
20 Public Meeting Bring site team and community members together Structured and formal, presentations then Q&A Held at a milestone in site activities Discreet time periods for presentations and questions Public Availability Session General used for high level of community concern Informal and used for individual or small groups interaction Forum for community members to talk to different agencies Addresses specific aspects of site activities 20
21 Printed Materials Public fact sheets Brochures Non-printed Materials Presentations Online information for communities Other Assistance with message mapping and talking points Support at community meetings Health promotion activities 21
22 22
23 23
24 24
25 START TRIGGERS Petition National Priorities Listing Other Agency Request END ATSDR Basic Training Course 25
26 Review environmental data, exposure data & community concerns Evaluate health effects by comparing to ATSDR comparison values Provide valuable conclusions and recommendation Provide necessary chemical or exposure information to Health Educator Writes published or non published documents 26
27 27 Step 1 Written request by Local Health Director, Local government or State Agency submitted to Dr. Dwight Flammia Step 2 Step 3 Technical project team reviews & discusses with Office Director Division/Office Director informs VDH Senior Leadership Health Assessment activity approved
28 28 Residents and community members should write to: Petition Administrator Division of Health Assessment and Consultation Agency for Toxic Substances and Disease Registry 4770 Buford Highway NE, (MS F-59), Atlanta, GA 30341
29 29
30 30
31 Specific chemicals or elements Found in environmental media Could possibly affect public health May or may not be associated with the site 31
32 Defined as contaminants which are to be investigated further in the assessment. I. Evaluating data quality II. Screening against comparison values III. Considering background concentrations IV. Considering community health concerns 32
33 33 Comparison values are calculated concentrations of a chemical in air, water, food, or soil that are unlikely to cause harmful (adverse) health effects in exposed people. Comparison values are set well below levels that are known or anticipated to result in adverse health effects. Comparison values are used to assess large data sets in an efficient and consistent manner during the screening analysis.
34 34 Screening levels Below CVs, health threat unlikely Above CVs, further action or review is needed Media-specific concentrations Calculated from very conservative assumptions Used to select Contaminants of Concern
35 Non-cancer health effects: EMEG - Environmental Media Evaluation Guide RMEG - Reference Dose Media Evaluation Guide Cancer health effects: CREG - Cancer Risk Evaluation Guide 35
36 If: concentration exceeds a CV, or It was detected and is a carcinogen, or Its detection limit exceeds the CV and it may occur at the site (remember non-detect 0), or There is no CV 36
37 all units in µg/l Comparison Values Contaminant Avg High EMEG (C) EMEG (I) RMEG CREG Child Adult Child Adult Child Adult cis-1,2-dichloroethene 900 8,800 3,000 10, trans-1,2- Dichloroethene ,000 7, Methylene chloride , Tetrachloroethene 824 7, Toluene ,000 Trichloroethene 145 1, Vinyl Chloride Bold = Concentration of contaminants that exceed one or more CVs.
38 1.Source What? Where? 2. Medium 3. Point of Exposure 4. Route of Exposure How? Who? 5. Receptor Population ATSDR Basic Training Course 38
39 Examples of sources: Burning area Detonation area Pond/lagoon Landfill Drums Buried Emission stacks Waste piles Spills Disposal pits Pipes/culverts Land application site ATSDR Basic Training Course 39
40 Soil surface subsurface Air Soil gas Surface water Sediment Groundwater Biota plants, animals ATSDR Basic Training Course 40
41 Fate = what happens to contaminant in environment Transport = how contaminants move within and between media Chemical-specific factors water solubility, vapor pressure Climatic factors rain, temperature Geologic factors aquifers ATSDR Basic Training Course 41
42 42 Location at which human contact is made with contamination Exposure points Media-specific
43 Pathways through which contaminants enter the body. Ingestion (e.g. accidentally eating). Inhalation (breathing). Dermal contact (skin contact). External exposure to radiation. Identify which routes are viable for each exposure point. ATSDR Basic Training Course 43
44 Identify specific populations Who? How many? What activities? High risk age groups Children Elderly Underlying medical problems ATSDR Basic Training Course 44
45 Source: 2005 Public Health Assessment Guidance Manual. 45
46 46
47 1.Source 2. Medium 3. Point of Exposure 4. Route of Exposure 5. Receptor Population ATSDR Basic Training Course 47
48 All elements are present, people are coming in contact with contaminants. Therefore Continue with health evaluation for all complete pathways of exposure ATSDR Basic Training Course 48
49 Some element(s) are missing or uncertain, people could come into contact with contaminants. 1.Source Consider Health Evaluation 2. Medium?? 3. Point of Exposure 4. Route of Exposure 5. Receptor Population ATSDR Basic Training Course
50 STOP 1. Source 2. Medium 3. Point of Exposure STOP 4. Route of Exposure 5. Receptor Population ATSDR Basic Training Course 50
51 51 Source Media Exposure Point Exposure Route Receptor Population Time Frame Exposure Pathway Onsite contaminated soil Groundwater On site Dermal Contact & Ingestion Workers or people that come on site Past Present Future Eliminated Onsite contaminated GW Vapor from Groundwater Indoor air in buildings over the site Inhalation Workers or people on site Past Present Future Potential Eliminated Potential Onsite contaminated soil Soil On site Dermal contact & Ingestion Workers or people that come on site Past Present Future Potential Eliminated Eliminated Onsite contaminated soil Soil Off site Ingestion People living in nearby homes Past Present Future Eliminated
52 52 Conclusions are dependent on the characteristics of the chemical exposure (i.e., route, extent, magnitude, and duration). Conclusions are based upon information presented in document.
53 VDH concludes that the VOCs in soil will not harm people s health because contaminated soil has been removed from the site and replaced with clean soil. VDH concludes that the VOCs in groundwater will not harm people s health because no one is drinking contaminated groundwater. VDH concludes that the potential for vapor intrusion exists for any building constructed on site and for homes and buildings in the direction of the contaminated groundwater plume. 53
54 Recommendations are actions needed to Stop, reduce, or prevent exposure Ex. discontinue private well use or fence a specific area Further characterize the site or exposure Ex. additional wells samples or collect blood lead samples Further health service or research-oriented activities Ex. health education, health study, or substance-specific research 54
55 VDH recommends that the natural attenuation of the remaining contaminant groundwater plume be monitored on at least an annual basis. As a precautionary measure, VDH recommends that any future buildings constructed on the site above the contaminated groundwater plume should include construction practices that minimize the potential for vapor and water intrusion. VDH recommends EPA to remediate the groundwater to prevent future exposure to VOCs that might occur through vapor intrusion. 55
56 56 A Public Health Action Plan (PHAP) describes the actions that have been completed the actions that are underway the actions that are planned
57 57 Published Documents Public Health Assessment (PHA) Health Consultation (HC) Letter of Health Consultation (LHC) Non-Published Documents Technical Assists Community involvement Health promotion activities
58 US Environmental Protection Agency (EPA) Department of Environmental Quality (DEQ) VDH Local Health Districts Nonprofit organizations Community leaders and members 58
59 ATSDR- Central Office Technical Project Officer Commander Jennifer Freed ATSDR, Atlanta, GA ATSDR- Region 3 Sr. Regional Representative - Lora Werner, MPH Regional Representative - Karl Markiewicz, PhD Philadelphia, PA VDH- Team Program Manager - Rebecca LePrell, MPH Principal Investigator - Dwight Flammia, PhD Health Assessor - Vinay Allagadda, MS Health Educator- Kenndra Warabak, BS 59
60 60 Vinay Allagadda, MS (804) Kenndra Warabak, BS (804)
61 61
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