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PUBLIC HEALTH ASSESSMENT

KELLY AIR FORCE BASE
SAN ANTONIO, BEXAR COUNTY, TEXAS
CERCLIS NO. TX2571724333

September 9, 1999

Prepared by:

Agency for Toxic Substances and Disease Registry
Division of Health Assessment and Consultation
Exposure Investigations and Consultations Branch

Foreword

SUMMARY

ATSDR was petitioned by the late congressman Frank Tejeda to perform a public health assessment of neighborhoods north and southeast of Kelly Air Force Base (AFB). Residents in these areas had concerns that their health may have been effected by releases of hazardous substances from the base. This document is a report of Phase I of the public health assessment process and provides ATSDR's evaluation of potential releases of hazardous substances from Kelly AFB.

During the time that ATSDR was conducting this assessment, concern was also expressed by residents of the East Kelly area. Because of this concern, ATSDR will evaluate the East Kelly area and the results will be provided in Phase III of the public health assessment. (See Figure 1, page 7, for the location of Kelly AFB and surrounding areas.)

Current Exposures

The community is not currently exposed to levels of contaminants from Kelly AFB that would cause people to become sick.

ATSDR evaluated the possible ways that community members could come into contact with contaminants that may be in the air, groundwater, surface water, and soil (See Table 1, page 6). ATSDR concluded that it is NOT likely there will be noncancer health effects (like liver or kidney injury) because of current exposure to contaminants from Kelly AFB. The amounts of contaminants are too low to cause residents to get sick. ATSDR also looked at the projection of cancer cases in areas surrounding Kelly AFB. Figure 2 (page 8) shows the locations of the highest estimated cumulative risk for cancer from current air emissions. These locations of highest estimated risk are either on base or in unpopulated areas off base. It is unlikely that exposure to current air emissions would result in a significant increase in the risk of developing cancer.

Although unlikely linked to base contamination, ATSDR is recommending health education about lead exposures, blood lead testing and subsequent environmental investigation under existing programs to address potential lead exposures.

Other environmental pathways (see Table 1, page 6) do not currently appear to play a role in making residents sick.

Past Exposures

The community may have been exposed to higher levels of contaminants in the past. ATSDR will investigate further.


There is not enough information about past levels of contamination to make conclusions about past levels of exposure. Past air emissions represent a pathway requiring additional evaluation because of the potential for higher levels of chemical exposure on and off base. Figure 3 (page 9) depicts the estimated past location of the air plume and therefore, areas where past air emissions may have been present. ATSDR will evaluate air emissions that may have occurred in the past. The results will be presented in Phase II of the public health assessment.

Health Data

ATSDR is further investigating reports of elevated cancers and adverse birth outcomes. ATSDR will continue health education activities and health outcome evaluation.


ATSDR found elevations in certain health data at some locations around the base. Cancers that were elevated in at least one zip code included leukemia, liver, kidney, lung, bladder, and cervical cancers (see Figure 4, page 10). Birth outcomes that were elevated included low birth weight and certain birth defects. ATSDR's preliminary evaluation indicates that some of the elevated health data may be due to expected fluctuation, some may be due to general public health problems, and some may be associated with environmental exposures. Further investigation is necessary to clarify these issues; additional health data as well as environmental data is being collected. ATSDR has concluded that follow-up activities are needed and results will be presented in Phase II of the public health assessment.

Conclusions

    Current levels of exposure are not expected to make people sick.

    Past levels may have been high enough to cause some health concern. ATSDR is still investigating.

    Follow-up activities are needed involving health education and health outcome evaluation.

Professional public health representatives at these locations are available to provide information:

San Antonio Metropolitan Health District
Texas Department of Health
ATSDR
210-207-8853
512-458-7269
1-888-42-ATSDR or 1-888-422-8737
Weekdays, 8-5 CDT
Weekdays, 8-5 CDT
Weekdays, 9-4 EDT

Table 1.

Exposure Pathways
Pathway Name Contaminants Exposure Pathway Elements Time Comments
Source Environmental Media Point of Exposure Route of Exposure Exposed Population
Past Air Emissions VOCs
Fuel
Metals
Industrial
Processes,
Aircraft
Air Off-base
On-base
Inhalation Child
Adult
Worker
Past Indeterminate. Completed exposure pathway. Past levels (before 1996) are unknown. More investigation is indicated.
Non-occupational On-base Employees VOCs
Fuel
Metals
Industrial Processes,
Aircraft
Air On-base Inhalation Worker Present Indeterminate. Completed exposure pathway. Refined air modeling is recommended.
Soil Migration Lead S-1 Storage Area Soil Residential Soil Incidental Ingestion Child Present Indeterminate. Lead levels in samples taken by community are below levels of health concern. Health education activities are recommended.
Current Air
Emissions
VOCs
Fuel
Metals
Industrial Processes,
Aircraft
Air Off-base
On-base
Inhalation Child
Adult
Worker
Present No apparent health hazard. Completed exposure pathway. Current levels (after 1995) are below levels of health concern.
Leon Creek Metals
PAHs, PCBs
Pesticides
Abandoned Landfills, NPDES Dischg. Surface Water
Sediment
Biota
Leon Creek Ingestion,
Fish Consumption
Child
Youth
Adult
Present No apparent health hazard. Intermittent potential exposure below levels of heath concern. TNRCC and EPA monitor NPDES discharges and water quality.
Surficial

Aquifer
VOCs
Fuel, Metals
Spills, Leachate Leaks Groundwater Non-potable
wells
Ingestion Child
Adult
Present No apparent health hazard. No known exposure at levels of health concern. Drinking water from different source.
Soil Gas VOCs
Fuel
Contaminated
Groundwater
Air Residence Inhalation Child
Adult
Present No apparent health hazard. Below levels of health concern for North Kelly Gardens and Quintana Road.
Noise Noise Level Aircraft Air Residence NA Child
Adult
Present No apparent health hazard. Noise determined to be at disturbance levels but not hearing loss.
Fuel Jettisoning Jet Fuel Aircraft Air Residence Inhalation Child
Adult
Past No apparent health hazard. Unlikely based on policy restrictions and atmospheric science.
Garden
Produce
VOCs
Fuel
Contaminated
Groundwater
Groundwater Residential Ingestion Child
Adult
Present No apparent health hazard. Contaminants not taken up by plants at levels of health concern.
Thallium in Drinking
Water
Thallium Unknown Groundwater Residence Ingestion Child
Adult
Past No apparent health hazard. Exposure to thallium in drinking water for 3.25 years. Below level for expected health effects.
Radioactive
Waste
Radio nuclides Landfills in
Zone 1
Soil
Groundwater
None NA NA Present No health hazard. Radioactive material buried on base. No known exposure; area is restricted.


Figure 1
Area Map of Kelly AFB.

 

Figure 2
Cumulative Health Risk Map.

 

Figure 3
Airborne Contaminant Plume Map.

 

Figure 4
Health Outcome Data Map.



TABLE OF CONTENTS

List of Figures

List of Tables

Acronyms and Abbreviations

Glossary

Summary

Introduction

Background

    Site Description and History
    Demographics and Land Use

Exposure Pathways and Human Health Assessment

    Indeterminate Issues
      Past Air Exposure Pathway
      Non-occupational On-base Employees
      Lead Exposure from Soil Transport from S-1 Area

    No Apparent Public Health Hazard
      Present Air Exposure Pathway
        Sources of Air Emissions
          Fuel Tank Farm
          Industrial and Flight Line Activities
        Evaluation of Present Air Emissions
        Conclusions
      Leon Creek
        Surface Water
        Sediment
        Fish Consumption

      Groundwater/Drinking Water
        Contamination
        Protection
      Soil Gas
      Noise
      Fuel Jettisoning

      Thallium in Drinking Water (Discussed in Groundwater/Drinking Water)
        Garden Produce

    No Public Health Hazard
      Radioactive Waste

Community Concerns

Health Outcome Data

Child Health Issues

Conclusions

Recommendations

Public Health Action Plan

References

Preparers of Report

APPENDIX A. ATSDR Public Health Hazard Categories

APPENDIX B. Demographic Data

APPENDIX C. Evaluation Methodology

APPENDIX D. Air Exposure Pathway

    Air Dispersion Model
    Risk Evaluation
    Uncertainty

APPENDIX E. Leon Creek Assumptions and Risk Evaluation

    Surface Water
    Sediment
    Fish Consumption

APPENDIX F. Community Health Reports

    Primary Health Care Review, District 4
    North Kelly Gardens Comprehensive Symptom Survey

APPENDIX G. Health Outcome Data Report

APPENDIX H. Fact Sheets

List of Figures

Figure 1. Area Map of Kelly Air Force Base

Figure 2. Cumulative Health Risk Map

Figure 3. Airborne Contaminant Plume Map

Figure 4. Health Outcome Data Map

Figure 5. Demographic Introduction Map

Figure 6. S-1 Site Map

Figure 7. Leon Creek Segments

Figure 8. Leon Creek Reaches

Figure 9. Threshold Limit Values for Noise

Appendix F

Figure F-1. District 4 Map

Figure F-2. North Kelly Gardens Survey Map

 

List of Tables

Table 1. Exposure Pathways

Table 2. Present Air Quality Non-Cancer Screening

Table 3. Present Air Quality Cancer Screening

Table 4. Leon Creek Exposure Pathways

Table 5. Surface Water Evaluation

Table 6. Sediment Evaluation

Table 7. Fish Tissue Evaluation

Table 8. Groundwater Comparison

Appendix D

Table D-1. Effects on Predicted Down-Wind Breathing Zone Concentrations

Table D-2. Present Air Dispersion

Table D-3.Category Definitions Used by ATSDR

Abbreviations, Acronyms, and Symbols
AF Air Force
AFB Air Force base
ATSDR Agency for Toxic Substances and Disease Registry
CREG Cancer Risk Evaluation Guide
DHS Department of Health Services
EMEG Environmental Media Evaluation Guide
EPA Environmental Protection Agency
HEAST Health Effects Assessment and Summary Tables
IRIS integrated risk information system
IRP installation restoration program
m3 cubic meter
MCL maximum contaminant level
MCLG maximum contaminant level goal
Met Health San Antonio Metropolitan Health District
mg milligram
MRL minimum risk level
NIOSH National Institute of Occupational Safety and Health
NPL National Priorities List of Uncontrolled Hazardous Substances
OSHA Occupational Safety and Health Administration
PAH polycyclic aromatic hydrocarbon
PCB polychlorinated biphenyl
PCE tetrachloroethylene
PHA public health assessment
PMCL proposed maximum contaminant level
ppb parts per billion
ppm parts per million
RBC risk-based concentration
RfC reference concentration
RfD reference dose
TCE trichloroethylene
TNRCC Texas Natural Resources Conservation Commission
TPH total petroleum hydrocarbons
mg microgram
US United States
USGS United States Geological Survey
UST underground storage tank
VOC volatile organic compound

 

GLOSSARY

Acute
Occurring over a short time, usually a few minutes or hours. An acute exposure can result in short-term or long-term health effects.

Ambient
Surrounding. For example, ambient air is usually outdoor air (as opposed to indoor air).

Background Level
A typical or average level of a chemical in the environment. Background often indicates levels that occur naturally or uncontaminated levels.

Carcinogen
Any substance that may cause cancer.

CERCLA
The Comprehensive Environmental Response, Compensation, and Liability Act of 1980, also known as Superfund. This is the legislation that created ATSDR.

Chronic
Occurring over a long period of time (more than 1 year).

Comparison Values
Estimated contaminant concentrations in specific environmental media that are not likely to cause adverse health effects, given a standard daily intake or exposure rate and standard body weight. The comparison values are calculated from the scientific literature available on exposure and health effects.

Concentration
The amount of a specified substance in a given amount of another substance. For example, the concentration of salt in sea water is higher than the concentration of salt in fresh water.

Contaminant
Any substance or material that enters a system (the environment, human body, food, etc.) where it is not normally found.

Dermal
Referring to or relating to the skin. Dermal absorption is absorption through the skin.

Disease Registry
A systematic record for collecting and maintaining in a structured format, information on persons having a common illness or adverse health condition.

Dose
The amount of a substance to which a person is exposed. Dose often takes body weight into account.

Environmental Contamination
The presence of hazardous substances in the environment. From the public health perspective, environmental contamination is addressed when it potentially affects the health and quality of life of people living and working near the contamination.

Epidemiology
The branch of medicine that studies epidemics and epidemic diseases. Epidemiologists study the occurrence and causes of health effects in human populations. An epidemiological study often compares two groups of people who are alike except for one factor, such as exposure to a chemical or the presence of a health effect. Epidemiologists try to determine which factors, if any, are associated with the health effect.

Exposure
Contact with a chemical by swallowing, by breathing, or by direct contact (with the skin or eyes). Exposure may be short term (acute) or long term (chronic).

Geographic Information System (GIS)
A computer hardware and software system designed to collect, manipulate, analyze, and display spatially referenced data for use in analyzing and solving complex resource, environmental, and social problems.

Hazard
A chance of being harmed. A hazard is a source of risk that does not necessarily imply potential for occurrence. A hazard produces risk only if an exposure pathway exists, and if exposures create the possibility of adverse consequences.

Health Education
A program of activities to promote health and provide information and training about hazardous substances in the environment. The purpose of health education is to reduce exposure, illness, or disease. Health education activities may be site-specific or national in focus. Information on diagnosis and treatment is made available for health care providers, and community activities are conducted to enable community members to prevent or mitigate health effects from exposure to hazardous substances.

Health Outcome Data
Community-specific health information that may be derived from databases at the local, state, and national levels, as well as from data collected by private health care organizations and professional institutions and associations. Databases to be considered include morbidity and mortality data, birth statistics, medical records, tumor and disease registries, surveillance data, and completed health studies. Health outcome data may constitute a major source of data for public health assessments. The identification, review, and evaluation of health outcome parameters are interactive processes involving the health assessors, data source generators, and the local community.

Health Investigation
Any investigation of a defined population, using epidemiologic methods, which would assist in determining exposures or possible public health impact by identifying health problems requiring further investigation through epidemiologic studies, environmental monitoring or sampling, or surveillance.

Ingestion
The act of swallowing (such as eating or drinking). Hazardous substances can get on food, cigarettes, hands, or utensils and then be ingested into the body. After ingestion, the hazardous substances may be absorbed into the blood and distributed throughout the body.

Inhalation
The act of breathing. Exposure to a hazardous substance may occur from inhaling contaminants in the air. These contaminants can enter the bloodstream or be deposited in the lungs or both.

Media (Environmental)
Environmental media are the specific parts of the environment, such as soil, water, air, plants and animals, that can contain contamination.

Metabolism
All the chemical reactions that enable the body to work. For example, food is metabolized (chemically changed) to supply the body with energy. Chemicals can be metabolized and made either more or less harmful by the body.

Metabolite
Any product of metabolism.

Minimal Risk Level (MRL)
A minimal risk level is an estimate of daily human exposure to a substance that is unlikely to have an appreciable risk of adverse noncancer health effects over a specified duration of exposure. MRLs are determined when reliable and sufficient data exist to identify the target organs of effect or the most sensitive health effects associated with a specific chemical for a specific duration by a given route of exposure. MRLs are based on noncancer health effects only. MRLs can be derived for acute, intermediate, and chronic duration exposures by the inhalation and oral routes.

Morbidity
Illness or disease. The morbidity rate is the number of illnesses or cases of disease in a population.

No Apparent Public Health Hazard
Category applied to sites at which human exposure to contaminated media is occurring or has occurred in the past, but the exposure is below a level of health hazard.

No Public Health Hazard
Category applied to a site for which data indicate no current or past exposure or no potential for exposure and therefore no health hazard.

Petitioned Public Health Assessment
A public health assessment conducted at the request of a member of the public. When a petition is received, a team of environmental and health scientists is assigned to gather information to ascertain, using standard public health criteria, whether there is a reasonable basis for conducting a public health assessment. Once ATSDR confirms that a public health assessment is needed, the process for a petitioned health assessment is essentially the same as for any other public health assessment.

Plume
An area of chemicals in a particular medium, such as air or groundwater, moving away from its source in a long band or column. A plume can be a column of smoke from a chimney or chemicals moving with groundwater.

Potential/Indeterminate Public Health Hazard
Category applied to a site for which no conclusions about public health hazard can be made because data are lacking.

Public Health Assessment
The evaluation of data and information on the release of hazardous substances into the environment in order to assess any current or future impact on public health, develop health advisories or other recommendations, and identify studies or actions needed to evaluate and mitigate or prevent adverse health effects to humans. The document resulting from that evaluation is also called a public health assessment.

Public Health Hazard
Category applied to sites that pose a public health hazard as the result of long-term exposures to hazardous substances.

Risk
In risk assessment, the probability that something will cause injury, combined with the potential severity of that injury.

Route of Exposure
The way in which a person may contact a chemical substance. For example, drinking (ingestion) and bathing (skin contact) are two different routes of exposure to contaminants that may be found in water.

Superfund
Another name for the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), which created ATSDR.

Superfund Amendments and Reauthorization Act (SARA)
The 1986 legislation that broadened ATSDR's responsibilities in the areas of public health assessments, establishment and maintenance of toxicologic databases, information dissemination, and medical education.

Volatile Organic Compounds (VOCs)
Substances containing carbon and different proportions of other elements such as hydrogen, oxygen, fluorine, chlorine, bromine, sulfur, or nitrogen; these substances easily become vapors or gases. A significant number of the VOCs are commonly used as solvents (paint thinners, lacquer thinners, degreasers, and dry cleaning fluids).

Urgent Public Health Hazard
Category applied to sites that pose a serious risk to the public health as the result of short-term exposures to hazardous substances.



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