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HEALTH CONSULTATION

Evaluation of Metals in Bullhead, Bass, and Kokanee from Lake Coeur D'Alene

COEUR D'ALENE RIVER BASIN
COEUR D'ALENE, KOOTENAI COUNTY, IDAHO


CONCLUSIONS

  1. In Lake Coeur d'Alene fish samples collected in 2002, 14 metals were eliminated as contaminants of concern (antimony, barium, beryllium, chromium, cobalt, copper, manganese, molybdenum, nickel, selenium, silver, thallium, vanadium, and zinc. Worst case exposure conditions were used and included maximum metal levels, a traditional subsistence fish consumption rate (540 g/day), and other factors (Appendix C). Although people are exposed to these metals in fish, adverse health effects are not likely to occur. No apparent public health hazard exists for children or adults exposed to these metals in bass, kokanee or bullheads from Lake Coeur d'Alene.


  2. Conservative evaluation for non-cancer effects of arsenic (i) used the highest average level (0.218 mg/kg, bullhead gutted carcass), (ii) assumed 20% inorganic arsenic, and (iii) used traditional subsistence consumption rates. Although people are exposed to arsenic in fish, the resulting exposure dose estimates for adults and children are below levels that have been associated with health effects. For non-cancer effects of arsenic, no apparent public health hazard exists for adults or children exposed to arsenic levels found in bass, kokanee or bullheads from Lake Coeur d'Alene.


  3. Conservative assessments for carcinogenic effects of arsenic exposures were done using (i) resident and non-resident exposure durations, (ii) the highest average arsenic levels for gutted carcass and fillet samples, and (iii) assuming that inorganic arsenic was 20% of total arsenic. Non-resident recreational consumer scenarios had the lowest excess cancer risk estimates while traditional subsistence consumer scenarios for gutted carcass portions had the highest (Table 6). No apparent public health hazard is considered to exist for non-resident recreational consumers exposed to arsenic in fillets of bullheads, bass or kokanee. A public health hazard may exist for traditional subsistence consumers exposed to arsenic in gutted carcass portions of bullheads, bass or kokanee because of increased consumption rates and higher arsenic concentrations in these samples.


  4. Conservative evaluation of cadmium used the maximum average concentration (0.139 mg/kg, kokanee gutted carcass) and traditional subsistence consumption rates. Although some exposure dose calculations indicate the possibility of elevated exposures to cadmium, people typically consume a variety of fish species, use both fillet portions and gutted carcass portions, and eat lower amounts of fish than we used in our calculations. Each of these factors would result in exposures below our estimates. Therefore, no apparent public health hazard is considered to exist for children or adults exposed to cadmium in bullheads, bass or kokanee from Lake Coeur d'Alene.


  5. Conservative evaluations of lead exposures were done using resident and non-resident exposure conditions. Average lead levels were used and the bioavailability of lead was assumed to be 100%. Estimated increases in blood lead were highest for traditional subsistence consumers of bullhead gutted carcass portions and lowest for non-resident, recreational consumers (Table 8). A public health hazard may exist for adult traditional and contemporary subsistence consumers of bullhead gutted carcass portions, especially from the center sampling area of the lake. A public health hazard may also exist for adult, resident recreational consumers with existing blood lead levels > 6-7 µg/dL who eat gutted bullhead portions, especially from the center sampling area of the lake. No apparent public health hazard is considered to exist for adult, non-resident recreational consumers exposed to lead in the species and portion types which we evaluated. No apparent public health hazard is likely to exist for adults eating fillets of bullhead, bass or kokanee, orfor adults eating gutted bass or kokanee portions.


  6. Conservative evaluation of child lead exposures indicated that bullhead gutted carcass portions could push blood lead levels beyond the CDC benchmark (10 µg/dL). Children (1-5 and 6-11 YOA) who are at the 95th percentile level reported by CDC (2003), bass and kokanee gutted carcass portions, and bullhead fillets, could have elevated blood lead levels if they consume 170 g/day (contemporary subsistence) or more. A public health hazard may exist for children who consume bullhead gutted carcass portions. A public health hazard may also exist for children (1-5 and 6-11 YOA) with elevated blood lead levels if they eat 170 g/day or more of gutted bass or kokanee portions or bullhead fillets. Children with major exposures to lead in soil or household dust are most likely to have elevated lead levels.


  7. Conservative evaluation of mercury used the maximum average concentration (0.188 mg/kg in bass fillets from the center sampling area). This was 2-4 times higher than mercury levels found in bullheads or kokanee. Exposure dose estimates for traditional and contemporary subsistence fish consumers indicated the possibility of elevated exposures and adverse effects. Thus, a public health hazard may exist for pregnant women, women of childbearing age, young children, and adults who are subsistence fish consumers. No apparent public health hazard is thought to exist for non-resident recreational fish consumers exposed to the mercury levels found in these Lake Coeur d'Alene fish. No apparent public health hazard is likely for children eating 6.5 g of fish per day or less. A public health hazard could exist for children (2-6 and 7-14 YOA) who eat more than 65 g day of fish per day.


  8. Overall average cadmium, lead and mercury concentrations were higher in the Lake Coeur d'Alene fish samples collected in 2002 than in the fish samples from the lateral lakes which were previously evaluated by ATSDR (1998). Different species and specimen sizes were collected these two studies.


  9. Average arsenic, cadmium, and mercury levels in the 2002 bass and bullhead gutted carcass samples from Lake Coeur d'Alene were below, or comparable to, whole-body samples from the USGS (2002) reference site. Average lead concentrations in bass and bullhead gutted carcass samples from Lake Coeur d'Alene were usually higher than the reference site and the highest sub-basin or station means reported by USGS (2002). In bullhead gutted carcass samples from the north and center Lake Coeur d'Alene sampling areas, average lead levels were higher than the maximum whole body lead value (Table 13) reported by USGS (2002).


  10. Average arsenic concentrations were lower in the Lake Coeur d'Alene samples than in eight fish-related food items found in the FDA Total Diet Studies Database (Table 14). Average cadmium levels in the Lake Coeur d'Alene fish samples were similar to levels found in eight fish-related food items found in the FDA Total Diet Studies Database. Lead and mercury concentrations in the 2002 Lake Coeur d'Alene fish samples, and in the lateral lakes samples evaluated by ATSDR (1998), were higher than in the eight fish-related food items found in the FDA Total Diet Studies database (Table 14).


  11. Several essential trace elements (copper, manganese, molybdenum, nickel, selenium, zinc) found in Lake Coeur d'Alene fish were determined not to be contaminants of concern. They were also considered to be within the respective tolerable upper intake limits that have been established (Table 15), especially for average exposure conditions. When making decisions about fish consumption, consideration should be given to balancing the risks versus benefits.


  12. We used conservative approaches to evaluate adverse health impacts from exposure to 18 metals found in two portion types of three fish species Lake Coeur d'Alene. We first determined that 14 metals were not likely to be of concern. Four metals (arsenic, cadmium, lead and mercury) were then evaluated further using maximum and average metal levels, subsistence and recreational fish consumption rates, and other factors (Appendix C). As a result, cadmium was determined to present no apparent public health hazard. The remaining three metals (arsenic, lead and mercury) were determined to present varying degrees of concern depending on the amount, portion type (gutted carcass or fillet), and fish species eaten (Table 16).


  13. Eating fish offers both benefits and risks. We recognize that fish consumption rates are an important factor in assessing exposures and the potential for adverse effects. A wide range of consumption rates (6.5 to 540 g/day) and several exposure scenarios are included in this consultation. These were used to help gain a better idea of which fish consumption habits are more likely to result in adverse exposures.

Table 16. Summary of hazard category conclusions.
  Subsistence Recreational
  Traditional Contemporary Resident Non-resident
  Adult Child Adult Child Adult Child Adult Child
Bullheads, Gutted        
As-Noncancer No No No No No No No No
As-Cancer Yes --- Yes --- Yes --- Yes ---
Cd No No No No No No No No
Pb Yes Yes Yes Yes Yes* Yes No Yes
Hg Yes Yes Yesa Yes No Yes No No
Bullheads, Fillet        
As-Noncancer No No No No No No No No
As-Cancer Yes --- Yes --- Yes --- No ---
Cd No No No No No No No No
Pb No Yes No Yes* No No No No
Hg Yes Yes Yesa Yes No Yes No No
Bass, Gutted        
As-Noncancer No No No No No No No No
As-Cancer Yes --- Yes --- Yes --- Yes ---
Cd No No No No No No No No
Pb No Yes No Yes* No Yes* No No
Hg Yes Yes Yes Yes Yesa Yes No No
Bass, Fillets        
As-Noncancer No No No No No No No No
As-Cancer Yes --- Yes --- Yes --- No ---
Cd No No No No No No No No
Pb No No No No No No No No
Hg Yes Yes Yes Yes Yesa Yes No No
Kokanee Gutted        
As-Noncancer No No No No No No No No
As-Cancer Yes --- Yes --- Yes --- Yes ---
Cd No No No No No No No No
Pb No Yes No Yes* No No No No
Hg Yes Yes Yesa Yes No Yes No No
Kokanee Fillets        
As-Noncancer No No No No No No No No
As-Cancer Yes --- Yes --- Yes --- No ---
Cd No No No No No No No No
Pb No Yes No No No No No No
Hg Yes Yes Yesa Yes No Yes No No

Note: For non-cancer categories, "Yes" denotes a conclusion of public health hazard; "Yesa" specifies pregnant women and women of child-bearing age; "No" denotes no apparent public health hazard.

For cancer, only lifetime exposures (70 yrs) are shown. No indicates low cancer risk (10-6 risk level); Yes indicates moderate (10-5 risk level) or increased (10-4 risk level) cancer risk. "Yes*" indicates public health hazard for people with elevated blood lead levels.


RECOMMENDATIONS/PUBLIC HEALTH ADVICE/PUBLIC HEALTH ACTION PLAN

ATSDR and the IDOH will provide the findings of this health consultation to the public and to the Coeur d'Alene Tribe. The following information will be included:

IDOH will provide fish consumption advisory information to the public.

In June 2003, the Idaho Division of Health released a fish consumption advisory based on the results reported by USEPA (2003) and the suggested meal limits shown in Appendix E. A large outreach effort has been initiated with the Division of Health and the Coeur d'Alene Tribe. Commonly used access areas are to be posted with the advisory. The advisory (Appendix F) can be accessed at Idaho agency internet sites such as http://www2.state.id.us/dhw/behs/index.htm Exiting ATSDR Website (click on Fish Advisories). Access to this site was verified on 21 August 2003. ATSDR provided a letter of support regarding the issuance of the fish consumption advisory in June 2003. This consult was prepared to complete our joint assessment of the fish data used for the advisory.

Update http://www.accessidaho.org/ Exiting ATSDR Website links to reflect the 2003 advisory information

Fish consumption advisory information can be accessed at http://www.accessidaho.org/ Exiting ATSDR Website, clicking on agency index, and selecting "Health and Welfare, Department of" (verified on 21 August 2003). The http://www.accessidaho.org/ Exiting ATSDR Website site can also be searched for "fish consumption advisories".

Fish advisory information should be provided through the Coeur d'Alene Tribe's web site http://www.cdatribe.org/ Exiting ATSDR Website

No fish advisory-related information could be found on the Coeur d'Alene Tribe's web site as of 21 August 2003. This should be added to the site as part of tribal education and outreach efforts.

Any future sampling and analysis of fish should include inorganic arsenic analysis.

The fish advisory issued by IDOH lists future actions that include sampling fish in future years, and analyzing the samples collected in 2002 for polychlorinated biphenyls (PCBs).


PREPARERS OF REPORT

Authors of Report

William A. Robison, Ph.D.
Toxicologist
Agency for Toxic Substances and Disease Registry (ATSDR)
Division of Health Assessment and Consultation

Lijun Jin, Toxicologist
Idaho Division of Health
Bureau of Community and Environmental Health


Reviewers of Report

Déborah A. Boling, M.P.H.
Health Assessor
ATSDR, Division of Health Assessment and Consultation
Superfund Site Assessment Branch

Richard Kauffman, M.S.
Senior Regional Representative, Region 10
ATSDR, Office of Regional Operations

Sven Rodenbeck, Sc.D., P.E., D.E.E.
Section Chief
ATSDR, Division of Health Assessment and Consultation
Superfund Site Assessment Branch

Marc Stifelman, Environmental Toxicologist
USEPA, Region 10
Office of Environmental Assessment, Risk Evaluation Unit

Ann E. Bradley
University of Washington, MPH Candidate
ATSDR Region 10

Elke Shaw-Tulloch, M.H.S, Chief
Bureau of Community and Environmental Health
Idaho Division of Health
Idaho Department of Health and Welfare

Aaron Scheff, M.Ed.
Bureau of Community and Environmental Health
Idaho Division of Health
Idaho Department of Health and Welfare


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