PUBLIC HEALTH ASSESSMENT
LONE STAR ARMY AMMUNITION PLANT
TEXARKANA, BOWIE COUNTY, TEXAS
COMMUNITY HEALTH CONCERNS/HEALTH OUTCOME DATA/CHILD HEALTH INITIATIVE
In an initial effort to obtain community health concerns, we contacted the EPA Region VI office, the Texas Natural Resource Conservation Commission, the TDH Region 4 office, the Texarkana-Bowie County Family Health Center, the ATSDR Region VI office, and the TDH Epidemiology Investigation Index File. The Epidemiology Index File is maintained by the TDH Bureau of Epidemiology and covers investigations conducted from the 1960s to the present time. In addition, we contacted local health care providers and area residents. We received concerns from a local health care provider and area residents regarding a perceived increase in cancer rates over the last ten (10) years. Specifically, there was a concern that the rates for brain, leukemia, and respiratory cancers were increasing.
Although Lone Star was not specifically implicated to the concern that rates of brain cancer, leukemia, and respiratory cancers were increasing, we asked the TDH Cancer Registry Division (CRD) to review available cancer data for the selected types of cancer for Bowie County and Texarkana, Texas for a ten (10) year period. The CRD evaluated the cancer mortality data for cancers of the nose, larynx, lung, pleura, trachea, brain, leukemia, and all sites combined for the period 1986 to 1995 [6].
They found among both male and female residents of Bowie County, during the period 1986-1995, the number of deaths due to cancer was either lower than or within the range that we would expect based on the cancer mortality experience of the rest of the state (Table 4). Among male residents in Texarkana, Texas (Table 5), during this time period, they found the number of deaths from cancers of the nose, larynx pleura, trachea, brain, and leukemia to either be lower than or within the range expected; however, they reported the number of deaths from cancer of the lung and all sites combined to be higher than expected (statistically significant at the 5% level of significance). Among the female residents of Texarkana, Texas during the same time period, they found the number of cancer deaths to be either lower than or within the range that would be expected.
The category "all sites" is non-specific and includes all types of cancer. The public health implications of the significant excess cancer deaths for all sites combined reported for males in Texarkana is difficult to evaluate and could partially be the result of the significant excess deaths due to cancer of the lung. While we can not say with absolute certainty, it is unlikely that the significant excess of deaths from cancer of the lung observed among males is due to some specific environmental exposure. Usually, when an environmental agent is involved, we would expect the increase to be consistent between genders; both males and females would be exposed to a contaminant in the general environment. While the number of male deaths from cancer of the lung is greater than expected, the number of female deaths from lung cancer is not. Thus, other factors may be responsible for the observed excess lung cancer deaths among Texarkana males. The most prominent risk factor that has been associated with lung cancer is smoking. In the United States, the rate of lung cancer deaths among males has started to decrease; however, the rate for women is increasing.
ATSDR's Child Health Initiative recognizes that the unique vulnerabilities of infants and children demand special emphasis in communities faced with contamination of their water, soil, air, or food. Children are at greater risk than adults from certain kinds of exposures to hazardous substances emitted from waste sites and emergency events. They are more likely to be exposed because they play outdoors and they often bring food into contaminated areas. They are shorter than adults, which means they breathe dust, soil, and heavy vapors close to the ground. Children are also smaller, resulting in higher doses of chemical exposure per body weight. The developing body systems of children can sustain permanent damage if toxic exposures occur during critical growth stages. Most importantly, children depend completely on adults for risk identification and management decisions, housing decision, and access to medical care.
ATSDR evaluated the likelihood for children living in the vicinity of the Old Demolition Area on the Lone Star Army Ammunition Plant site to be exposed to site contaminants at levels of health concern. ATSDR did not identify situations in the past in which children were likely to have been exposed to site contaminants. Because site access is restricted, children are not likely to be exposed to contaminated surface water, soil, or sediments from the site. Children currently are not likely to be exposed to site contaminants in groundwater unless the extent of the contamination spreads to water wells which are being used by families with children.
Table 4. Number of Observed and Expected Cancer Deaths and Race-Adjusted Standardized Mortality Ratios, Selected Sites, Bowie County, 1986-1995
| Males | ||||
| Site | Observed | Expected | SMR | 95% CI |
| Nose,Sinus | 1 | 1.2 | 0.8 | 0.0-4.6 |
| Larynx | 8 | 11.5 | 0.7 | 0.3-1.4 |
| Lung | 410 | 361.2 | 1.1 | 1.0-1.3 |
| Pleura | 1 | 1.5 | 0.7 | 0.0-3.7 |
| Trachea | 2 | 0.9 | 2.2 | 0.3-8.0 |
| Brain | 31 | 22.9 | 1.4 | 0.9-1.9 |
| Leukemia | 45 | 38.6 | 1.2 | 0.9-1.6 |
| All Sites | 1,026 | 1,019.4 | 1.0 | 0.9-1.1 |
| Females | ||||
| Site | Observed | Expected | SMR | 95% CI |
| Nose,Sinus | 1 | 1.0 | 1.0 | 0.0-5.6 |
| Larynx | 2 | 3.0 | 0.7 | 0.1-2.4 |
| Lung | 187 | 197.8 | 0.9 | 0.8-1.1 |
| Pleura | 1 | 0.5 | 2.0 | 0.1-11.1 |
| Trachea | 1 | 0.6 | 1.7 | 0.0-9.3 |
| Brain | 24 | 20.5 | 1.2 | 0.8-1.7 |
| Leukemia | 33 | 32.1 | 1.0 | 0.7-1.4 |
| All Sites | 851 | 871.4 | 1.0 | 0.9-1.0 |
Note: The SMR (standardized mortality ratio) is defined as the number of observed deaths divided by the number of expected deaths. The latter is based on race-, sex-, and age-adjusted cancer mortality rates for Texas during the period 1986-1995 (the SMR has been rounded to the first decimal place).
Prepared by:Cancer Registry Division, Texas Department of Health, 7/1/97
Table 5. Number of Observed and Expected Cancer Deaths and
Race-Adjusted Standardized Mortality Ratios, Selected Sites, Texarkana, Texas,
1986-1995
| Males | ||||
| Site | Observed | Expected | SMR | 95% CI |
| Nose,Sinus | 0 | 0.5 | 0.0 | 0.0-7.4 |
| Larynx | 4 | 4.8 | 0.8 | 0.2-2.1 |
| Lung | 186 | 149.5 | 1.2* | 1.1-1.4 |
| Pleura | 0 | 0.6 | 0.0 | 0.0-6.1 |
| Trachea | 0 | 0.4 | 0.0 | 0.0-9.2 |
| Brain | 14 | 8.5 | 1.6 | 0.9-2.8 |
| Leukemia | 24 | 15.5 | 1.5 | 1.0-2.3 |
| All Sites | 486 | 421.5 | 1.2* | 1.1-1.3 |
| Females | ||||
| Site | Observed | Expected | SMR | 95% CI |
| Nose,Sinus | 1 | 0.5 | 2.0 | 0.1-11.1 |
| Larynx | 2 | 1.4 | 1.4 | 0.2-5.2 |
| Lung | 87 | 89.3 | 1.0 | 0.8-1.2 |
| Pleura | 1 | 0.2 | 5.0 | 0.1-27.9 |
| Trachea | 1 | 0.3 | 3.3 | 0.1-18.6 |
| Brain | 5 | 8.8 | 0.6 | 0.2-1.3 |
| Leukemia | 18 | 15.0 | 1.2 | 0.7-1.9 |
| All Sites | 438 | 403.7 | 1.1 | 1.0-1.2 |
Note: The SMR (standardized mortality ratio) is defined as the number of observed deaths divided by the number of expected deaths. The latter is based on race-, sex-, and age-adjusted cancer mortality rates for Texas during the period 1986-1995 (the SMR has been rounded to the first decimal place).
* Significantly higher (at the 5% level) than expected.
Prepared by: Cancer Registry Division, Texas Department of Health, 7/1/97
John F. Villanacci, Ph.D.
Director
Health Risk Assessment and Toxicology Program
Susan L. Prosperie, M.S., R.S.
Environmental Specialist
Health Risk Assessment & Toxicology Program
Elena G. Capsuto, M.S.
Epidemiologist
Health Risk Assessment and Toxicology Program
Nancy B. Ingram
Public Health Technician
Health Risk Assessment and Toxicology Program
Dixie Davis
Administrative Technician I
Health Risk Assessment and Toxicology Program
ATSDR Regional Representative
George Pettigrew, P.E.
Senior Regional Representative
ATSDR - Region 6
Jeff Kellam
Technical Project Officer
This Health Assessment was prepared by the Texas Department of Health under a cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR). It is in accordance with approved methodology and procedures existing at the time the Health Assessment was initiated.
Anne Keller
Technical Project Officer, DSB, FFAB, DHAC
The Division of Health Assessment and Consultation, ATSDR, has reviewed this Public Health Assessment and concurs with its findings.
Gary Campbell
Chief, DSB, FFAB, DHAC, ATSDR
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