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PUBLIC HEALTH ASSESSMENT

HIPPS ROAD LANDFILL
JACKSONVILLE, DUVAL COUNTY, FLORIDA


SUMMARY

The seven acre Hipps Road Landfill is in the Jacksonville Heights area of Jacksonville, Duval County, Florida. From 1967 to 1970, several hauling companies reportedly disposed of many substances at the site from two nearby naval air stations. These substances included but were not limited to: airplane parts, electric cable, paints, various solvents, grease, oils, and possibly plating and medical wastes. The property owner then covered the landfill and subdivided it for residential lots. Six homes on the site as well as other nearby homes used private wells as their drinking water source, and many homes continue to use private wells for drinking and household water uses today. In 1983, the Duval County Public Health Unit discovered contamination in nearby private wells and EPA added the site to the Superfund National Priority List. From 1988 to 1990, contractors for Waste Control of Florida, a potentially responsible party, purchased and demolished the six on-site houses and constructed a landfill cover. In the 1990 amended Record of Decision, EPA selected extraction and air stripping for groundwater clean up. ATSDR published the first public health assessment for this site in 1986. Because of a citizen's request and congressional directives, the Florida Department of Health and Rehabilitative Services began a new public health assessment in 1993.

Over 200 nearby residents have expressed site-related health concerns. In general, nearby residents are concerned that exposure to site-related contaminants via ingestion of contaminated groundwater and other exposure routes has seriously affected their health. Residents are also concerned that the groundwater treatment system will again expose them to site-related contaminants and cause additional illnesses.

Over 130 contaminants have been detected in various environmental media near the site. During our initial analysis, we eliminated 90 of these chemicals from further evaluation because they were either found in concentrations below standard comparison values or did not have sufficient toxicological information for further evaluation. We categorized the remaining 43 contaminants into two broad groups, 8 contaminants with drinking water standards and 35 contaminants of concern. Evaluating the 35 contaminants of concern is the focus of this health assessment.

The 35 contaminants of concern were detected in one or more of the following on- and off-site media: subsurface soil, sediment, surface water, groundwater, and air. Most of these media did not have adequate numbers of samples or adequate numbers of analyses for these contaminants. Two media, surface soil (0-3 inches deep) and biota (plants and animals), did not have any sample analyses. This lack of data contributes uncertainty to our toxicological evaluation and a more complete evaluation of exposure pathways.

Based on existing environmental data, the completed exposure pathways were incidental ingestion and skin absorption of contaminants in subsurface soils and sediments; ingestion, skin absorption, and vapor inhalation of contaminants in surface water and groundwater; and inhalation of contaminants from the air stripping tower. The potential exposure pathways include incidental ingestion and skin absorption of contaminants in surface soil; inhalation of contaminants in ambient air; and ingestion of contaminants in biota (plants and animals).

After further data analyses for the 35 contaminants of concern, we subdivided this group into categories, 15 minimal risk contaminants and the following 20 possible risk contaminants: arsenic, barium, benzene, bromodichloromethane, cadmium, chromium(VI), cresol (total), 1,1-dichloroethane, 1,2-dichloroethane, di(2-ethylhexyl)phthalate, hexachloroethane, lead, manganese, methylene chloride, n-nitrosodiphenylamine, PCBs (total), 1,1,2,2-tetrachloroethane, tetrachloroethene, trichloroethene, and vinyl chloride. Even though toxicological data were available for these 20 contaminants, the literature was sometimes insufficient to draw conclusions about all potential routes of exposure, particularly skin absorption.

Nevertheless, in the past, nearby residents were exposed to arsenic, cadmium, lead, and tetrachloroethene in the environment at doses associated with (noncancer) illnesses in human and animal studies. Furthermore, residents were exposed to arsenic, benzene, 1,2-dichloroethane, di(2-ethylhexyl)phthalate, methylene chloride, PCBs, and vinyl chloride in the environment at levels that could increase their cancer risk. Presently, all nearby residents drinking from private well water might be exposed to low levels of solvents and metals.

Based on these findings, we classified this site as a public health hazard and made several recommendations. To cease or reduce exposure, we recommend performing a well survey to determine which residents living near groundwater contamination are still using their well water, connecting homes with contaminated wells to public supplies, and maintaining the demister on the air stripper as long as the air stripper is used. To complete site-related characterization, we recommend conducting further analyses of off-site surface soils, sediments, and surface and flood waters; and conducting a groundwater characterization study in directions other than northeast of the site. To detect further contaminant migration, we recommend continuing groundwater monitoring in the area, including analyzing influent to the air stripper. To increase public awareness, we recommend implementing an education program for nearby residents, local physicians, and other health care professionals concerning the possible health effects from exposure to contaminants found around the site. Finally, we recommend conducting a health study of nearby residents to determine if adverse health effects have occurred from exposure to contaminants found on or near the site.

BACKGROUND

The Florida Department of Health and Rehabilitative Services (FHRS), in cooperation with the Agency for Toxic Substances and Disease Registry (ATSDR), will evaluate the public health significance of the Hipps Road Landfill site. Specifically, FHRS will determine whether health effects are possible and will recommend actions to reduce or prevent them. ATSDR, located in Atlanta, Georgia, is a federal agency within the U.S. Department of Health and Human Services and is authorized by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA, also known as "Superfund") to conduct public health assessments at hazardous waste sites.

There are uncertainties inherent in the public health assessment process. In general, these uncertainties fall into four categories: 1) the uncertainty of science in general (that is, science is never 100% certain), 2) the inexactness of the health assessment process, 3) the incompleteness of the information collected thus far, and 4) differences in opinion as to the implications of the information (NJDEP 1990). In general, scientists and public health officials incorporate uncertainties into health assessments by using worst-case assumptions when estimating or interpreting health risks, and by using wide safety margins when setting health-related threshold values. Because of these actions, health assessments tend to err on the side of protecting public health. In accordance with this practice, the assumptions, interpretations, and recommendations we make throughout this public health assessment tend to err in the direction of protecting public health.

A. Site Description and History

The Hipps Road Landfill is in the Jacksonville Heights area of Jacksonville, Duval County, Florida (Figures 1 and 2, Appendix A). The landfill is southeast of the intersection of Hipps Road and Exline Road in the middle of this residential community (Figures 3 and 4, Appendix A). Two small grocery stores, a plant nursery, and a church are located near the site; there are no other commercial or public facilities within the immediate area. Similarly, there are no National Priorities List (NPL), Resource Conservation and Recovery Act, or other industrial facilities within one-half mile of the site. The U.S. Environmental Protection Agency's (EPA) project manager for the Hipps Road Landfill is Patsy Goldberg; her phone number is (404) 347-2643. The Florida Department of Environmental Protection's (formerly known as FDER, the Florida Department of Environmental Regulation) project manager is George Linder; his phone number is (904) 488-0190.

Prior to 1967, the site was a freshwater cypress swamp. Late in 1967, the property owner began using the site as a landfill to eliminate its swampy conditions. Eventually, the landfill covered 6.8 acres and was approximately 25-30 feet deep. During the landfill's operation, several hauling companies reportedly brought many waste materials to the site from two nearby naval air stations. These materials included but were not limited to: lumber, airplane parts, wire, electrical cable, ordnance shells, paint, paint strippers, other solvents, grease, oils, and possibly plating and medical wastes. Septic tank trucks also may have dumped wastes of unknown composition at the site (FDER 1983d, 1983e). Landfill operations continued until January 1970. The property owner then covered the landfill with a thin layer of soil, subdivided the property, and sold the lots to homeowners. Eventually, six families built homes on, or adjacent to, this landfill. Private wells provided potable water for these homes; one private well actually penetrated the landfill. Other homes in the area also used private wells as their drinking water source. Residents report some homes close to the contaminant plume continue to use private wells for drinking water and other household uses (FDER 1984b; Hipps Road residents, pers. comm.).

From 1967 - 1989, site access was unrestricted. Area residents scavenged materials from the landfill, and children used the site as a play area. In addition, neighborhood children swam and fished in ponds adjacent to the landfill (FHRS 1993b; Hipps Road residents, pers. comm.).

Environmental problems began in 1968, when an area resident reported the presence of a brown sludge, that smelled like airplane stripper, covering one of the ponds adjacent to the landfill. There was a fish kill in this pond in 1968, and in an adjacent pond in 1971 (FDER 1983d). Sporadic complaints about potable water quality in the Hipps Road area began in 1972 (Keneagy 1991). In 1981, taste and odor complaints led to hydrocarbon and pesticide testing for two private wells near the landfill. No contamination was found (FDER 1984a; FHRS 1981a, 1981b). Following another taste and odor complaint in February 1983, the Duval County Public Health Unit (CPHU) found vinyl chloride, methylene chloride, and toluene in an off-site well. By April 1, 1983, the Duval CPHU had sampled ten more wells in the Hipps Road area and found volatile organic compounds (VOCs; hereafter called "solvent") in five wells northeast of the landfill. The four homes with contaminated wells were placed on bottled water. The fifth home had only a trace of the solvent, methylene chloride. Other wells were scheduled for testing (FDER 1983a).

In response to the groundwater contamination at Hipps Road, FDER, the U.S. Geological Survey, Duval CPHU, Jacksonville's Bio-Environmental Services Division (BESD), and the St. Johns River Water Management District formed a multi-agency committee to evaluate the type and extent of contamination (FDER 1983g). Study results indicated a plume of solvents had moved at least 1000 feet northeast of the site. Some of the local wells also contained heavy metals (FDER 1984b). By mid-October 1983, the City of Jacksonville extended public water lines into the neighborhood; however, only those residents who were willing and could afford to pay a "tap in" fee, as well as the monthly water charges, were hooked to city water (FHRS 1983b). In November 1983, the Mayor of Jacksonville declared a water pollution emergency area within a zone delineated around the landfill (City of Jacksonville 1983). All residents within the emergency area were urged, but could not be required, to cease using their private wells and to hook up to city water. The City stopped providing bottled water in December 1983 since the public supply was available to all residences in the plume area (BESD 1983b, 1984). By November 1984, only 44 of 131 residences had hooked up to the public water supply (FDER 1984b, 1993). In January 1985, EPA used CERCLA funds to connect the remaining residents within the contaminated area, who gave permission, to city water (FDER 1993).

In September 1983, EPA assigned the Hipps Road Landfill a MITRE score of 31.94 and placed it on the NPL (EPA 1986d). EPA took the lead role for conducting the remedial investigation/feasibility study (RI/FS) in February 1984 (FDER 1993). The 1985 remedial investigation found a variety of metals and organic compounds within the landfill in quantities exceeding federal Clean Water Act water quality criteria and at least one contaminant exceeding cancer-based criteria for drinking water. Contaminants in the landfill were likely to migrate downward into the lower water table zone and horizontally to the northeast, the direction of groundwater flow. The remedial investigation concluded the landfill was the primary source of nearby groundwater contamination, and confirmed the contaminant plume was approximately 1000 feet northeast of the site. The remedial investigation also concluded that unknown pollution sources, in addition to the landfill, were contributing to the low level groundwater, surface water, and sediment contamination found in the area (EPA 1985a). In May 1986, EPA completed the draft RI/FS, and held a public meeting to discuss the RI/FS results and site cleanup alternatives (FDER 1993). EPA recommended capping and fencing the site, and continuing groundwater monitoring (Burr 1986). Also in May 1986, ATSDR published their public health assessment for the site. The public health assessment concluded that by providing an alternate supply of potable water, EPA had eliminated the only significant route of human exposure creating a public health threat. ATSDR concurred with EPA's cleanup plans by recommending the site be properly closed and the groundwater monitored (ATSDR 1986). Because of strong public opposition to this cleanup proposal, EPA decided to investigate other cleanup alternatives. EPA completed the revised FS in July 1986. The September 1986 Record of Decision (ROD) formalized EPA and FDER's alternative cleanup agreement which included: 1) capping the site, 2) monitoring the groundwater, 3) instituting exposure controls (for example, fencing the site, plugging existing private wells, banning new well drilling in the area, etc.), 4) extracting contaminated groundwater and treating it at the local sewage treatment plant, and 5) beginning site operations and maintenance activities (EPA 1988; FDER 1993).

During the site investigation, EPA identified the U.S. Navy and Waste Control of Florida (WCF) as the primary responsible parties for the Hipps Road Landfill. WCF originally committed to closing the landfill, relocating residents within the cleanup area, conducting groundwater studies, and designing the groundwater recovery system. The Navy, still not admitting liability for site contamination, entered into a separate agreement with WCF, agreeing to fund half of the cleanup activities' cost and provide project oversight (EPA 1991, FDER 1993).

In August 1987, WCF's contractor submitted a satisfactory remedial design work plan to EPA. In January 1989, a partial Consent Decree formalizing WCF's role in the site cleanup was entered by the U.S. District Court in Jacksonville. In this decree, the responsible parties agreed to undertake landfill closure, but did not agree to clean up the groundwater (FDER 1993). To make room for the landfill cover and other cleanup structures, WCF purchased and demolished or moved the homes of the six families located within the site cleanup area (EPA 1989; Keneagy 1987). Landfill cover construction began in May 1989 and finished in September 1990. In March 1990, the responsible parties filed a brief in U.S. District Court stating that groundwater cleanup at the Hipps Road Landfill was not necessary. At the same time, the responsible parties also submitted an alternate groundwater cleanup proposal to air strip contaminated water and return the treated water to the ground via retention ponds. The legal attempts to eliminate groundwater cleanup from the ROD failed, but EPA accepted the alternative cleanup plan (FDER 1993). At the July 1990 public meeting, many residents opposed the air-stripping proposal for two reasons: 1) the air stripper would merely turn water pollution into air pollution that would re-expose residents who had already been exposed to contaminated drinking water, and 2) EPA had not adequately considered the cleanup of all harmful contaminants in the groundwater, especially the heavy metals (BESD 1990; EPA 1990c). EPA did not concur with the residents' arguments, and in October 1990 signed an amended ROD approving the air-stripping plan. In November 1990, EPA approved the revised the groundwater treatment and design plan (Figure 5, Appendix A). The responsible parties signed a new Consent Decree in August 1991, and it was entered by the U.S. District Court in December 1991.

Preconstruction activities for the groundwater treatment system began in December 1991. In June 1992, EPA held a public meeting to present the groundwater treatment system construction plan. In January 1993, the responsible parties attempted to gain access to local properties for well installation (FDER 1993). Because of difficulties in gaining access to private properties, the responsible parties' contractor installed the needed piezometers and extraction wells along the street right-of-way in front of homes in the contaminated area. In July 1993, they finished constructing the retention ponds (Hipps Road residents, pers. comm.) and began air-stripper operation on September 2, 1993. In response to a FHRS request, EPA agreed to shut down the air stripper after two weeks of operation to allow air sample analysis and data evaluation to ensure protection of public health in the stripper's vicinity (EPA 1993b; FHRS 1993a). Air-stripper operation stopped on September 18, 1993 (Golder Associates 1993a). FHRS' health consultation for the air stripper found the individual contaminant concentrations reaching the nearest residence were unlikely to cause any health effects. Interactive effects among contaminants and combined effects from past exposures were not evaluated in the health consultation (FHRS 1994a). Air stripping resumed in March 1994 (WMF 1994).

Community concern about the Hipps Road Landfill has been and continues to be high. After discovery of the groundwater contamination, fears about health and property values prompted nearby residents to organize a citizens' group known as the Jacksonville Citizens Against Contaminated Water (JCACW). Nearly one-third of the families in the Hipps Road area joined this group to voice their concerns. In June 1983, two JCACW members testified before the U.S. House of Representatives' Environment, Energy, and Natural Resources Subcommittee. They described problems with local government supervision of the landfill, involvement of the U.S. Navy, and community health problems allegedly caused by ingestion of contaminated groundwater coming from the landfill (EPA 1985a). Community health concerns still exist and range from nonspecific symptoms such as headache and dizziness to birth defects, cancer, and other diseases (FHRS 1993b). Community leaders also believe residents are not adequately informed of site-associated activities or the true health hazards posed by the site (EPA 1985a; Hipps Road residents, pers. comm.). In June 1991, at least 50 residents joined a second citizens' group, the Misinformed, Uninformed Concerned Citizens to gain more information about the landfill, the extent of contamination in the private wells, and the chemicals associated with the site (Keneagy 1991; Hipps Road residents, pers. comm). Later, the Hipps Road Landfill Coalition, Inc., including both citizens' groups, formed and was awarded a $50,000 EPA grant to hire their own technical adviser to review and interpret site-related documents (Hipps Road residents, pers. comm.; Nyenhuis 1993).

In February 1987, 172 Hipps Road residents filed suit against the U.S. Navy, WCF, and three other waste disposal companies in U.S. District court, seeking $463 million for the physical, financial, and emotional losses of homeowners. Of these litigants, only 11 plaintiffs (3 families) had their cases heard in court (Hipps Road residents, pers. comm.; Keneagy 1987, 1991). In December 1991, WCF reached an out-of-court settlement with the original 1987 litigants; settlement terms were undisclosed (Florida Times Union 1991). In January 1992, a U.S. District Court judge found the U.S. Navy and WCF liable for the Hipps Road contamination (Keneagy 1992c). In March 1992, the judge ruled only one plaintiff could recover damages, on the basis his symptoms stopped shortly after he stopped drinking the water. The judge also ruled all plaintiffs were exposed to toxic levels of cancer-causing agents, and were entitled to receive medical monitoring to be paid for by the government (Keneagy 1992b, Marshall 1992). In November 1992, 150 residents returned to court to obtain a medical monitoring program (Keneagy 1992a). To date, the award disbursement to the one plaintiff and the initiation of a medical monitoring program are still pending (Hipps Road residents, pers. comm.). In February 1993, more than 200 residents filed claims against the U.S. Navy, seeking $150 million in damages, for drinking contaminated water in the Hipps Road area (Avery 1993). In July 1993, 23 more lawsuits were filed, claiming toxic wastes from the landfill caused illnesses in the neighborhood (Pinkham and Nyenhuis, 1993). These cases are currently pending. In March 1994, the family of one resident who died of cancer filed suit against the U.S. Navy, seeking compensation for medical expenses, lost wages, and pain and suffering. The judge's decision in this case is still pending (Nyenhuis 1994).

B. Site Visits

Ms. Carolyn Voyles and Mr. Randy Merchant, FHRS, visited the site on June 30 and August 24, 1993; and on May 23, August 31, and November 18, 1994. Each site visit consisted of a windshield survey of the site and surrounding neighborhood to observe current site conditions and verify file information.

A chain-link fence topped with barbed wire surrounds the site, and warning signs are posted on the fence at regular intervals. The landfill itself occupies the western half of the site and has a grass-covered cap that is 5-6 feet above ground level. Monitor wells are visible along the northern and western boundaries of the site. The southern boundary of the site cannot be seen very well from the road because it borders private property.

Off site, there are storm water swales immediately outside of the northern and western fence boundaries. After heavy rains, water collects in these ditches and percolates into the ground. A small cypress pond, approximately ¼ acre in size and located just east of the northeastern side of the site, is part of a second storm water collection system. Storm water runoff from the site flows into this cypress pond, between two homes, and underneath Camfield Road into a storm water conduit. There is a third storm water runoff pathway northeast of the site. This pathway begins in a vacant lot north of the intersection of Hipps and Bunion Roads, and continues north to Mile Branch Creek (also known as the unnamed tributary to the Ortega River). It is unclear how much of the site's storm water runoff enters this third pathway.

The residential neighborhood around the site is well-established, and there is no new construction in the immediate neighborhood except for that related to site cleanup. Area homes are mostly single-wide trailers and small block houses. Many homes have vegetable gardens, and a few have livestock (horses, fowl, cows). The closest residence to the fenced boundary is approximately 50 feet east of the northeast corner of the site; another residence is less than 100 feet south of the southwestern fenced boundary. There are no schools or special facilities (for example, day care, nursing homes, hospitals) within a one mile radius of the site.

During the June 30, 1993 visit, two retention ponds were being excavated on the eastern side of the site as part of the air-stripping system (Figure 5, Appendix A). Temporary buildings (trailers) and other construction-related equipment were visible on the northeastern part of the site. The groundwater extraction system for the air stripper had been installed along Camfield and Paul Howard Roads, but the air-stripper tower was not yet built. By the August 24, 1993 visit, the air stripper system's construction had been completed. During both site visits, the gate to the site was closed and locked.

At the time of the May 23, 1994 visit, tall plastic sheets, extending several feet upwards from the ground along the fence, had been placed along the site's eastern boundary. These sheets appeared to channel rain water from the site into the off-site cypress pond, and were bulging with dirt in some places. It is not known how effective these structures are in containing dirt on site or channeling storm water into the pond. There was no obvious evidence of contamination in the off-site storm water collection systems. During the May visit, the gate to the site was closed and locked. Nevertheless, FHRS staff saw a large hole in the site's fence along Exline Road, permitting site access. Outside of the fence along Hipps Road, the City of Jacksonville had installed a municipal tap to provide public water temporarily to area residents. Nearby, the City had posted large signs describing their plans for extending public water to all area residents. Finally, HRS staff walked for a short distance along the banks of Mile Branch Creek to observe its depth and flow rate. Near Shindler Road, the creek appeared slow moving with depths ranging from a couple of inches to four or five feet.

During the August 31, 1994 site visit, the tall plastic sheets containing dirt along the eastern fence had been removed, but shorter plastic sheeting remained. New fencing had been placed around the southern periphery of the off-site cypress pond; the northern shore was difficult to see from the road, and FHRS staff could not tell if it had also been fenced off. The hole in the fence along Exline Road still existed.

During the November 18, 1994 site visit, the short plastic sheets still lined the eastern fence boundary. In some places, there were large gaps between the sheets. In other places, the sheeting had been pressed to the ground. Water was being pumped from the back pond (closest to the air stripper) to the front pond, and from the front pond onto the front of the site, reportedly because of a filtration problem in the back pond. The water in the swales on Exline Road was dark and clear with no odor. The hole in the fence along Exline Road still existed. From the back yard of a home on Camfield Road, a hole in the side of the air stripper was visible.

Either before or after each site visit, Ms. Voyles and Mr. Merchant met with community leaders to discuss the public health assessment process, verify site history, and gather community health concerns. During these meetings, residents reported:

  • Prior to the posting of warning signs, local residents routinely walked on the site. After the site was fenced, vandals occasionally gained site access. In addition, a few residents occasionally enter the site through the hole in the fence to observe cleanup activities, exercise their dogs, etc.
  • Prior to 1985, neighborhood children attended schools 6-7 miles away. Currently, the closest school is approximately 1 mile away.
  • Storm water runs off the site to the north and northeast through the series of swales, ditches, and creeks. Children frequently play in the storm water ponds, and used to swim in the cypress pond close to the site.
  • Neighborhood children swam and fished in the on-site ponds before cleanup activities began. Currently, residents swim and fish in Mile Branch Creek, the local receiving body of water for storm water runoff.
  • Neighborhood children hunt and eat squirrel, doves, and other birds that may have contact with the site.
  • Even though public water lines will eventually be available to residents in the Hipps Road area, homeowners will still have to pay to tap in and many residents cannot afford the connection fees. Cost was also a problem in 1983, when public supply lines were extended to homes within the water pollution emergency area, and only 44 of 131 homes connected to city water.
  • Residents report repeated trouble with the on-site retention ponds overflowing and flood waters pouring into adjacent yards east of the site. Such flooding reportedly has occurred several times during the fall of 1994.

On February 3, 1994, Mr. Merchant, Ms. Winter, and Ms. Lanzon, FHRS, held an additional meeting with community leaders to discuss the status of the public health assessment, FHRS' preliminary evaluation of the air stripper, and the availability of environmental medicine training for local doctors. This latter issue is of particular interest to nearby residents because they believe local health care professionals are not adequately trained to consider the effects of environmental exposures when treating the residents' illnesses.

On September 1, 1994, Dr. Isabel Stabile, M.D., PhD., an Associate Research Scientist at Florida State University's Center for Biomedical and Toxicological Research and Hazardous Waste Management, gave a seminar entitled "Hipps Road Landfill: Clinical Environmental Issues" to approximately 25 health care providers at the St. Vincent's Medical Center in Jacksonville, Florida. This presentation was paid for under an existing cooperative agreement between FHRS and ATSDR's Division of Health Studies. Doctors attending the seminar not only learned about possible health effects related to the site, but also received Continuing Medical Education credit for their attendance. Nearby residents have requested another seminar be given to doctors at the Orange Park Hospital in the near future.

C. Demographics, Land Use, and Natural Resource Use

Demographics

There are approximately 150 homes in the residential neighborhood surrounding the Hipps Road Landfill, and 190 residences located within one mile topographically down slope and hydraulically down gradient of the site (EPA 1992b, Golder Associates 1992a). Extrapolating from 1990 census data, there are an estimated 400-500 people currently living in the Hipps Road area. The racial makeup of the census tract containing the site is 88% White, 8% Black, and 3% Hispanic. The median age for the tract is 28 years, and 21% of the tract residents are children between the ages 0-9 years. The median family income for the census tract is $37,045 (BOC 1992).

Land Use

The land use within one mile of the site is mostly residential with a few commercial facilities. A church, a plant nursery, and two small grocery stores (one of which sells gasoline) are the only public and commercial facilities located within the immediate neighborhood of the site. New residential developments are located 1+ miles south and southeast of the site. The closest school is 1.6 miles south of the site. There are no day care facilities, hospitals, nursing homes, or recreational areas within one mile of the site.

Natural Resource Use

Groundwater in the site area occurs in a surficial aquifer underlain by the Floridan aquifer (Figure 6). In the vicinity of the site, the surficial aquifer is a four- layered system consisting of (in descending order): the Sand aquifer, the semi-confining Clay Marl unit, the Limestone aquifer, and the Lower Marl unit. The Sand aquifer and Limestone aquifer are the main water-bearing units in this system. The surficial aquifer is approximately 200 feet thick and is underlain by the Hawthorn Group, a confining aquiclude approximately 300 feet thick. The Floridan aquifer underlies the Hawthorn Group (EPA 1986d; Golder Associates 1992a).

The Sand aquifer is of primary interest to this public health assessment, as it contains both the contaminant plume and most drinking water wells for local residents. Water is usually reached between 2-5 feet below ground surface in this unit. Near the landfill, groundwater flows downward at an average linear vertical flow velocity of 0.007-0.012 feet per day. Groundwater flows outward from the landfill to the north and east toward the Ortega River system at an average linear horizontal flow velocity of 0.02-0.10 feet per day (EPA 1986d).

Before the site was fenced, neighborhood children swam and fished in two ponds near the landfill. These ponds have since been destroyed by cleanup activities. Currently, area residents fish and swim in Mile Branch Creek, a tributary of the Ortega River ½ mile north of the site (Hipps Road residents, pers. comm.). 1986 groundwater modeling data indicate plume contaminants could enter this creek by 1993, with maximum contaminant concentrations entering the creek by 2008. These models estimate the maximum concentrations entering the creek will be less than 0.07 µg/l (micrograms per liter), using assumptions that do not consider biodegradation, adsorption, or volatilization of groundwater contaminants, nor contaminant dilution in the surface water (EPA 1986d).

Many area homes have small vegetable gardens, and neighborhood children hunt and eat small game that may have contact with the site.

D. Health Outcome Data

FHRS epidemiologists attempted to evaluate the cancer rates in the 32222 zip code encompassing the site. This evaluation considered all cancer data contained in the Florida Cancer Data System (FCDS), a FHRS program operated by the University of Miami School of Medicine that covers all cancers reported in Florida between 1981 and 1987. In addition, in response to the residents' request, FHRS epidemiologists reviewed the 1991 epidemiology report prepared for the Hipps Road residents' lawsuit against the U.S. Navy (Paigen 1991). We discuss the results of these reviews in the Public Health Implications, Health Outcome Data Evaluation section.

COMMUNITY HEALTH CONCERNS

Over 200 nearby residents have expressed site-related health concerns. In general, nearby residents are concerned that exposure to site-related contaminants via ingestion of contaminated groundwater and other exposure routes has seriously affected their health. Residents are also concerned that the groundwater cleanup system will again expose them to site-related contaminants and cause additional illnesses. In addition, residents are concerned that testing of environmental media has been inadequate to identify all of the contaminants, that their illnesses are undiagnosed due to a lack of environmental medicine training for local physicians, and that governmental officials have minimized the extent of contamination and severity of their illnesses.

We compiled the following health concerns from newspaper articles, EPA reports, transcripts of public meetings, court records, and our June 30, 1993, August 24, 1993, February 3, 1994 and May 23, 1994 meetings with community leaders:

Circulatory System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused heart and circulatory problems in the community, including: blood clots, anemia, blood disorders, blood poisoning, phlebitis, heart murmurs (including mitral valve prolapse in males), arrhythmias, palpitations, cardiomyopathy, pericarditis, atherosclerosis, high blood pressure, angina, other chest pain, aortic aneurysms, heart attacks, and stroke.
  2. Nearby residents are concerned that some children in the community have never had normal blood counts (that is, red cell to white cell ratio) and many residents have chronically high white cell counts.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused leukemia in the community.
  4. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused some residents to die from heart disease.

Digestive System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused digestive problems in the community, including: oral ulcers, submaxillary gland problems, stomach pain, stomach ulcers (in children 10+ years and older, and in adults), reflux problems, herniated bowels, appendicitis, gas pains, pancreas attacks, gallbladder attacks, gallstones, gallbladder removal, chronic disaccharidase deficiencies, gastroenteritis (including gastritis, enteritis, and gastrointestinitis), hepatitis (in both children and adults), other liver dysfunction (including jaundice and enlarged liver), colitis, diverticulitis, spastic colon, proctitis, constipation, acute and chronic diarrhea, and rectal bleeding.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy caused a child to be born with decayed teeth (decayed in the sack) and another child to be born with a navel hernia.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused esophageal, stomach, liver, and colon cancer in the community.

Endocrine System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused endocrine system problems in the community, including: hypoglycemia, diabetes, and thyroid trouble.

Excretory System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused excretory problems in the community, including: bladder infections, kidney infections, urinary tract infections, hematuria, cystitis, urethritis, ureteral reflux, incontinence, bladder suspension, kidney stones, and kidney disease (requiring kidney removal).
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy caused a child to be born without any kidneys and another child to be born with severe kidney disease that required kidney removal shortly after birth.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused bladder and kidney cancer in the community.
  4. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused residents to die from kidney disease.

Hypersensitivity Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused them to become hypersensitive to the presence of chemicals. Several residents report they can smell chemicals in the air even when nonresidents cannot smell them, and other residents report they cannot tolerate any chemical smell (for example, while using oven cleaners or going into hardware stores where chemicals are present). One resident reports experiencing a runny nose, a feeling of bulging eyes, and an almost emotional response to immediately get away from the chemicals when encountering a chemical smell.

Immune System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused immune system problems in the community, including: swelling of lymph nodes, mononucleosis, and lupus.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air caused residents to die from lymphoma.

Learning Disabilities:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused community children to have learning disabilities, low IQ (intelligence quotient) scores, memory problems, and behavioral problems in school.

Mental Health Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused depression, panic attacks, nervous breakdowns, psychosis (including schizophrenia), and attempted suicides in the community.

Nervous System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused nervous disorders in the community, including tremors or trembling; pain, numbness, tingling, or loss of feeling in hands, feet, arms, or around the lips; weakness in hands and dropping things; ringing in ears; neuralgia; ganglion cysts; Parkinson's disease; and meningitis.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy caused a child to be born with 1/3 of the brain missing, and another child to be born with only half of the brain developed and cerebral palsy.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air caused a resident to die from a brain tumor.
  4. Nearby residents are concerned the neurotoxin tri-ortho-cresyl phosphate has not been analyzed for but was present in the groundwater. Residents are concerned exposure to this substance may have adversely affected their health.

Reproductive System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused female reproductive system problems in the community, including: abnormal female breast development, abnormal female reproductive organ development, ovarian adhesions and cysts, vaginal cysts, reproductive organ tumors, pelvic inflammatory disease, heavy menstrual bleeding (requiring a visit to a doctor), difficulty in conceiving, postpartum difficulty, persistent lactation, hysterectomy (in both young and older women), abnormal vaginal bleeding after a hysterectomy, abnormal or precancerous cervical cells (in teenagers and older women, requiring rechecks every 3-6 months), oophorectomy, and breast cysts.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused male reproductive system problems in the community, including: lumps or swelling in the groin (in children), epididymitis (in children), other swelling or pain in the testes (in children and adults), and difficulty in conceiving.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy caused a child to be born with a twisted testicle.
  4. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy has caused miscarriages (including loss due to blighted ovum and nonimmune fetal hydrops), premature birth, and delayed birth in the community.
  5. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused breast, cervical, ovarian, and prostate cancer in the community.

Respiratory System Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused respiratory problems in the community, including: sinus problems, allergy problems, asthma, bronchitis, pleurisy, pneumonia, shortness of breath, dyspnea, and infant apnea.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy caused children to be born with rib cage/chest deformities and hyaline membrane disease.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused lung cancer in the community.
  4. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused some residents to die from lung disease, including lung cancer.

Skeletal/Muscular and Other Connective Tissue Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused skeletal/muscular problems and connective tissue disorders, including: rhabdomyolysis, weak joints and bones, arthritis, cold gout, bursitis, bone deterioration, disc problems (in adults, 20+ years and older), chondromalacia patella, hip infections, vertebral spurs, Schmoral's nodes on lumbar vertebrae, and back pain.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy caused children in the community to be born with turned feet, twisted legs, crooked spines, and a cleft palate.

Skin Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused: abnormally dry skin, unexplained hand and foot rashes, itching skin, various benign skin tumors, actinic keratosis, lichen planus, warts, hives, and Herpes viral infections in children.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air during pregnancy caused a child to be born with skin cancer and other children to be born with benign skin tumors.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused melanoma, basal cell carcinoma, and other skin cancers in the community.

Visual Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused visual problems in the community, including: cataracts, blurred vision, eye irritation, burning eyes while showering, and other visual disturbances.

Nonspecific Illness and Unexplained Death Complaints:

  1. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused the following nonspecific illnesses and complaints in the community: dental problems (including loose teeth), nose bleeds, muscle spasms, equilibrium loss (including dizziness, loss of balance, vertigo, Meniere's syndrome, lightheadedness, unsteadiness), clumsiness, falling, difficulty walking, swelling (including edema, angioedema, and swelling in limbs), nausea, vomiting, dehydration, acute and chronic headaches, migraines, fatigue, lethargy, fainting (including syncope and black outs), seizures, fevers, frequent flus and colds, chronic sore throats, chronic ear infections, premature hair loss, chronic insomnia and other sleep disturbances, anxiety, nervousness, irritability, memory problems, and difficulty in healing after surgery.
  2. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused the following illnesses and complaints in the community: vocal cord nodules, fluid in ears (infant), and adenocarcinoma.
  3. Nearby residents are concerned that exposure to contaminated groundwater, surface water, sediment, soil, and air has caused several unexplained deaths in the community. A child died shortly after birth from unknown causes. In addition, residents report there are several other cases in which the causes of death could not be found, even after autopsies were performed on the deceased.

Health of Pets:

  1. Nearby residents report that pets in the community have had the following health problems: dogs have had cancer, kidney problems, and birth defects; one dog developed an abnormally swollen head; thoroughbred horses have gone crazy, necessitating their removal from racing; one horse died from kidney problems after drinking from surface waters close to the site; and several cats, monkeys, ferrets, chickens, and pet birds have died unexpectedly.

Other (Nonhealth) Concerns:

  1. Nearby residents are concerned about declining values of property near the site. Some residents report they cannot sell their homes because of their proximity to the site. These residents also believe even if they were able to sell their homes, they would not have enough money to move out of the neighborhood because of the money they've lost from declining property values. At least one resident has rental property in the area and reports a loss of income because of the difficulty in finding tenants to live near the site.
  2. Nearby residents are concerned that government officials responsible for investigating or cleaning up the site have not considered or do not have all of the data generated about the site, particularly the data values showing the greatest contamination. Some residents believe officials have played down the examination of site-related illnesses and will continue to do so in the future.
  3. Nearby residents are concerned that site-related contamination has not been fully identified or delineated. Some residents point out the lack of sampling data for some exposure points, such as volatilization of solvents from nearby surface waters, landfill and yard soils, and while showering. Others think the extent of groundwater contamination has not been properly delineated, and the contaminant plume is actually much larger in all directions than government officials currently believe or publicly state.

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