PUBLIC HEALTH ASSESSMENT
FAIRCHILD AIR FORCE BASE
SPOKANE, SPOKANE COUNTY, WASHINGTON
HEALTH OUTCOME DATA EVALUATION
As shown above, residents living near the base were exposed primarily to TCE and Tordon. The toxicological literature indicates that the most likely cancer outcomes from high exposures to TCE include ling, liver, kidney, and bladder cancer as well as leukemia. The most likely outcome from Tordon exposure is liver cancer. The Washington State Cancer Registry was used to evaluate whether any increase of these cancers was evident in the residents living near the base. Cancer occurrence from 1992 through 1994 was used for the evaluation. Vietzke Village and West Thorpe Road area residents were considered to be the populations at greatest risk.
Several problems in this type of evaluation must be overcome. The first is that data in the registry are compiled to the zip code level only (i.e., 99022). It is not possible to pull out and study only those residents who might be exposed in the small community near the base. The entire population served by the zip code must be studied together. This means that many people not living in the exposure area are included in the evaluation of cancer rates. The addition of unexposed persons to the study population can eliminate an otherwise measurable cancer increase in the exposed population. Conversely, if those people living outside the area of exposure are included in the study population and have cancer risk factors not found in the exposed population, a cancer increase unrelated to the exposure in question may be found.
An additional problem is that the studied population is relatively small. In order to detect small increases in cancer risk, large study populations are required. Estimates of cancer risk resulting from the identified exposures of Vietzke Village and West Thorpe Road residents are less than 1 in 10,000 while the population of the entire zip code is about 6,500. The exposed population within the zip code is even smaller. Another problem associated with cancer rates calculated from small populations is that the chance of random occurrence causing large errors is very high. Because of these factors, care must be exercised in the interpretation of the rates.
Since occurrence of these cancers in this population is relatively rare, rather than calculate direct rates, a ratio of observed to expected rates was calculated. This is more time consuming, but allows a more accurate estimation of any true increase. In this method, specific cancer rates, as they occur in all Washington state residents, are applied to the population living in the study area. This is done by applying Washington state age specific rates for each 5 year age group (0 to 4 years old, 5 to 9 years old, 10 to 14 years old, etc. up to age 85+) to each 5 year age group in the study area. The numbers of calculated cases are added together and the result is the number of cancers that would be expected to occur if the community near the base was developing cancers at the same rate as the rest of Washington state. The actual number of cancer cases occurring is then retrieved from the cancer registry. The number expected is compared with the number observed to evaluate the possibility of increased cancer in the community. If the number of cases expected to occur (from the calculation) is substantially smaller than what is actually found (from the cancer registry), there may be an increased risk of cancer in the community.
The following are specific types of cancer evaluated as described above.
Leukemia
Liver
Kidney/bladder
Lung Cancer
If this slight elevation in lung cancer represents a true increase, it is unlikely to be related to TCE exposure. Although inhalation exposure of mice to very high doses of TCE can cause an increase in lung tumors, the cancer risk estimate based on this evidence suggests that the low levels of exposure found near Fairchild would not result in an elevated rate of lung cancers. In addition, there is no human evidence associating lung cancer with TCE exposure.
There are several risk factors that may be responsible for elevated lung cancer rates within a community. The first is a possible differential rate in smoking. It is well known that those who smoke have a greatly elevated risk of developing lung cancer. If the residents in this zip code area smoke more than the those in the state as a whole, an elevated lung cancer rate would be found. Also, if the residents in this zip code area are more likely to work in industrial settings, they would also be more likely to have contaminated air exposures at work and would be more likely to develop lung cancer than the residents in the state as a whole. Either of these factors would be sufficient to cause the elevated rate seen in this population. Also, while not well documented, there could be other sources of air contaminants in this community, not related to the base, that might effect the lung cancer rates.
To fully explain the cause of the elevated rate in this population would require a major study at considerable expense. Due to the limited size of the population, even with an extensive study, a definitive answer may not be possible. Given these limitations, a study can only be done when there is known exposure to assist in designing and conducting the study. In this instance, the known exposure does NOT give reason to expect increased lung cancer, and it can be safely assumed that the increase is due to some other exposure that is currently unknown.
COMMUNITY HEALTH CONCERNS EVALUATION
Two public availability sessions were held by Washington State Department of Health (DOH) on January 28, 1997, in order to gather community health concerns related to the site. One session was held at the Deel Community Center at Fairchild from 2 to 4 p.m. and the other was held at the Harmon Community Center from 7 to 9 p.m. These and other concerns communicated to DOH are listed below.
1. Resident expressed concern that her family is experiencing health effects related to drinking water containing trichloroethylene, nitrates and metals originating from the Craig Road Landfill. Of major concern has been the development of porphyria in three of four family members and possible developmental effects from in utero exposure.
The only contaminant of concern associated with the Craig Road Landfill that has been found in off-base water supply wells is trichloroethylene (TCE). Exposure of residents to drinking water contaminated with TCE originating from the Craig Road Landfill is discussed in the Pathways Analysis/Public Health Implications section of this document as completed exposure pathway 1a (page 16). Nitrate is also discussed in this pathway relative to the elevated levels found in the Vietzke Village drinking water supply wells but is not thought to be related to the Craig Road Landfill.
Although elevated metals were detected in monitoring wells located on the landfill, samples from wells located at the perimeter of the landfill show no substantial elevation of metals. In addition, metals analysis of Vietzke well samples taken in September 1982, July 1985 and May 1988 did not show elevated metals. No metals have been identified as contaminants of concern in residential drinking water.
Porphyrias are a group of diseases in which the synthesis of heme is disrupted causing excess precursors of this molecule to be excreted in the urine. The heme molecule binds iron and is an important part of hemoglobin and other heme-containing proteins. The symptoms of porphyria depend on the type and severity of the disease and often include increased skin sensitivity to light and abdominal pain. Clinical diagnoses classify the disease as chronic or acute involving the liver or blood. Porphyria can be inherited or acquired as a complication of liver disease and various other conditions. The most common form of acquired porphyria is known as porphyria cutanea tarda which shows only skin sensitivity symptoms. 46
The ability of drugs and chemicals to induce urinary excretion of porphyrins is well known. Such a response is not usually followed by other symptoms of the disease, however, unless the patient is genetically susceptible. This chemical-induced excretion of porphyrins without symptoms is considered to be a secondary porphyrinuria. Some chemicals that have been shown to induce the symptoms associated with porphyria cutanea tarda include alcohol, hexachlorobenzene, dioxin, polychlorinated biphenyls (PCB) and heavy metals. Although there are many chemicals that have been shown to induce secondary porphyrinuria, no direct evidence could be found associating TCE and nitrate with this ability. It appears that persons genetically susceptible are far more likely to experience symptoms as a result of a chemical exposure. Diagnosing porphyria is accomplished through careful measurement of enzyme activity and porphyrin levels in blood, urine, and stool. Those who are genetically susceptible will show consistently abnormal results for both enzyme function and porphyrin levels. Enzyme function alone has not been validated as a means for diagnosis. 47
2. Resident expressed concern that many pregnant mothers who lived temporarily in Vietzke Village were exposed to contaminated drinking water.
Vietzke Village residents living at the trailer park prior to July 18, 1989, were exposed to TCE through ingestion of drinking water and inhalation of TCE vapors off-gassing from drinking water. During initial sampling in July 1989, a maximum level of TCE at 80 ppb was detected in one of three blended wells (RW-9) serving this trailer park. Exposure via ingestion of drinking water ceased on July 18, 1989, when residents were supplied with bottled drinking water by the base. All exposure ceased in early August 1989 when residents were connected to the base water supply. Exposure to TCE in Vietzke drinking water is not expected to be a health risk for the general population. However, the developing fetus of pregnant women exposed via ingestion, skin contact and inhalation of TCE in Vietzke drinking water could have been at a low risk for birth defects. Exposure of Vietzke Village residents to TCE in drinking water is evaluated in the Pathways Analysis/Public Health Implications section of this document as completed exposure pathway 1a.
3. Concern was expressed about the potential for residential drinking water wells located on Graham Road being impacted by contaminants originating from the Craig Road Landfill.
This would be virtually impossible as the Craig Road Landfill is approximately 2.5 miles west of Graham Road. Groundwater flows east/northeast from the Craig Road Landfill and, therefore, would not threaten residential wells on Graham Road. All sources on-base are downgradient of Graham Road drinking water wells. This means that all contaminated sites are east of Graham Road and groundwater flows to the east. The site furthest to the west is SW-1 located at the southern end of Graham Road. No residential wells are located at this end of Graham Road. Although there are wells located near SW-1 on West Thorpe Road, they are also downgradient and have tested negative for VOCs in the past.
4. Resident is concerned about deformed livestock raised near the Fairchild dump (Craig Road Landfill).
The only important pathway of exposure here would be animals drinking water contaminated by the Craig Road Landfill. No drinking water wells except the three supply wells at Vietzke Village had levels of contaminants high enough to be of concern. Considering the highest level of TCE ever detected in the primary supply well at Vietzke Village (79 ppb), none of these effects would be expected in livestock drinking this water. If the livestock in question were watered with Vietzke Village well water prior to August 1989, there is a possibility that the animals were exposed to higher TCE levels. The risks associated with this potentially higher level of TCE in the Vietzke wells is dependant on the length of the exposure and the level of TCE.
5. Will toxins in water continue to spread?
The movement of contaminants in groundwater from a source depends upon several things including the size of the source, the contaminants in question and the flow of the groundwater. Contaminants in groundwater, primarily TCE, originating from the Craig Road Landfill are not likely to migrate beyond the currently identified area. A treatment system currently operating at the landfill should begin to reduce the source which will eventually cause the perimeter of the plume to recede. Groundwater flows east/northeast in the area near the landfill.
TCE in groundwater is also moving off-base from the wastewater lagoon area (WW-1). Recent testing data indicate that levels of TCE are increasing in the area east of the WW-1 site. Low levels of TCE thought to be related to WW-1 area are currently being detected in West Thorpe Road residential wells. The potential exists for these levels to increase. Contaminants in groundwater at the FT-1 site do not appear to have moved off-base, but this potential does exist. Groundwater moves east/southeast in the area near the WW-1 and FT-1 sites. Treatment systems designed to restrict further movement of the plume are operating at both the WW-1 and FT-1 sites. In addition, West Thorpe Road area residential wells are currently being monitored by the base through their Long Term Monitoring (LTM) plan. It is, therefore, likely that any spread of contamination will be detected and actions taken, if necessary.
6. Potential source areas seem to exist on the property east of Rambo Road and the wastewater lagoons. The focus of the environmental sampling may be missing these areas.
This concern has been related to Fairchild, EPA and Ecology. The source of the contamination is not well defined. The base is currently operating a groundwater treatment system in this area. Several extraction wells located east of the wastewater lagoons are designed to pull contaminated groundwater into the system and remove volatile contaminants. In addition, monitoring wells in this area are sampled on a quarterly basis as part of the Long Term Monitoring plan operated by the base. These data provide current information on the movement of the contaminants in groundwater and allow the base to respond to changes, if necessary.
7. Concern was expressed that not all on-base and off-base source areas have been identified.
The base contractor conducted extensive document review and personnel interviews during the IRP Phase I investigation completed in 1985. In addition to the sites that were identified during this process, several other areas of concern have been identified through remedial investigations. Geological surveys, including ground-penetrating radar, have been conducted in order to identify buried waste around the base. Many source areas of groundwater contamination have been identified some of which have been cleaned up by extracting and treating the groundwater. Other actions that have been carried out include removal of underground fuel storage tanks, highly contaminated soil, and oil/water separators.
Concerns about specific areas on and near the base have been received by DOH and passed on to Ecology and EPA. Any evidence of hazardous waste in residential areas should be reported to the Department of Ecology (Ecology). The Ecology site manager for the Fairchild Air Force Base is Bill Harris, with the Toxics Cleanup Program, who can be reached at 360-407-7228. The Toxics Cleanup Program can also be reached at the Eastern Region Office at 509-456-7693. The Hazardous Waste Cleanup and Underground Storage Tank Hotline at 800-826-7716 is also available for reports of hazardous waste releases.
8. A resident expressed concern that munitions may have been dumped in residential areas.
Extensive records searches, interviews and environmental investigations have revealed many contaminated sites of potential concern both on and off base. It is highly unlikely that live ammunition was dumped off base. It is possible, however, that some areas of potential concern may have been missed. Any evidence of hazardous waste in residential areas should be reported to the Department of Ecology (Ecology). The Ecology site manager for the Fairchild Air Force Base is Bill Harris with the Toxics Cleanup Program who can be reached at 360-407-7228. The Toxics Cleanup Program can also be reached at the Eastern Region Office at 509-456-7693. The Hazardous Waste Cleanup and Underground Storage Tank Hotline at 800-826-7716 is also available for reports of hazardous waste releases.
9. Residents living near a jet fuel line are concerned that their drinking water well has been impacted. They have noted that the water is slimy.
The base currently uses a jet fuel called JP-8 and formerly used JP-4. The chemical content of these fuels are very similar. Jet fuel was originally transported to the bulk fuel storage area (site PS-1) via rail car prior to the use of an underground commercial pipeline operated by the Conoco Company. Truck transportation of fuel began in October 1996 and is expected to continue until a new pipeline is established with the Chevron Corporation.
The Conoco pipeline originates in Spokane and delivers fuel to aboveground storage tanks at the intersection between the railroad and Graham Road. The fuel was then transferred via another underground pipeline (Yellowstone) to the bulk fuel storage area. The Yellowstone pipeline delivered fuel to the base until May 1997. The Yellowstone line enters the base approximately 2,400 feet northeast of the bulk fuel storage area. The fuel is stored in aboveground storage tanks where it is distributed via underground pipes or truck to the flight line area. The potential for an off-base leak in the Yellowstone fuel line was investigated. Based on a discussion with a Conoco representative, there have been no leaks in the Yellowstone line. This conclusion was reached based on measurement of fuel pumped and fuel received as well as occasional visual inspection. Questions about this fuel line can be addressed to Kim Varre (509-536-8414) at the Conoco Company, Environmental Division, Spokane, Washington.
There are many instances of jet fuel spills and leaks along the flight line that have been investigated. The potential for groundwater contamination at these sites moving to off-base residential wells is small since these sites are not at the base boundary. The only sites on-base that are a threat to off-base groundwater are the Craig Road Landfill (SW-8), the wastewater lagoons (WW-1) and fire training area (FT-1). These sites are discussed above as completed exposure pathways 1 and 2 and potential exposure pathway 1.
10. Concern was expressed about nitrate levels of 19 points.
DOH assumes that the nitrate level of concern is intended to read 19 parts per million (ppm). There are many sources of nitrate/nitrite contamination in drinking water wells including landfills, septic systems, and agricultural/livestock areas. Based on sampling of monitoring wells, the Craig Road Landfill does not appear to be a source of nitrate/nitrite contamination in residential wells. The levels measured at the landfill are low and the nearest downgradient drinking water wells currently in-use (Airway Heights public supply wells RW-1 and RW-4) have not shown elevated nitrate/nitrites.
In general, only shallow (dug) wells are at risk for nitrate/nitrite contamination. The deeper the well, the lower the risk of problems. The major health hazard associated with nitrate/nitrites in drinking water is the development of methemoglobinemia in infants. This condition results in decreased oxygen delivered to body tissue by the blood and is directly linked to nitrite created from the reduction of nitrate in the body. A nitrate level of 19 ppm exceeds EPA's MCL of 10 ppm for nitrate in drinking water. The MCL for nitrite is set at 1 ppm. Existing evidence has shown infants to be at risk for methemoglinemia at levels above 20 ppm. More recent evidence has indicated that pregnant women are at risk for spontaneous abortions at levels above 20 ppm. The risk for these health effects at 19 ppm nitrate in drinking water could be of concern depending on the amount nitrate/nitrite in the diet. Drinking water with nitrate or nitrite levels in excess of their respective MCLs should not be used for the preparation of infant feeding formulas. Pregnant women should not drink water containing nitrate levels above the MCL. In general, drinking water with nitrate levels above the MCL should be used for non-drinking purposes only.
If you suspect an alternate source of nitrate/nitrite contamination and would like to have your well tested, a list of state certified drinking water analytical laboratories is available from DOH. Please contact Rob Duff toll-free at 1-888-586-9427 (1-888-5-TOXICS).
11. My well was tested in 1977 by Fairchild for nitrites and bacteria but not since. Why can't I have my well tested again for contaminants associated with Fairchild? I want to know where to go next.
Nitrites and bacteria are not contaminants associated with the Fairchild Air Force Base. These well contaminants are common with shallow (dug) wells and can cause adverse health effects if present at high enough levels. If you suspect an alternate source of nitrate/nitrite or bacteria contamination and would like to have your well tested, a list of state certified drinking water analytical laboratories is available from DOH. Please contact Rob Duff toll-free at 1-888-586-9427 (1-888-5-TOXICS).
12. What about dust from Fairchild and Hanford?
The majority of on-base soil (and dust) contamination is related to the various jet fuel spills and leaks. Soil contaminants from these spills are often referred to as total petroleum hydrocarbons (TPH). Some petroleum hydrocarbons are very volatile (VOCs) and will evaporate before migrating off base via dust to any substantial extent. Other less volatile petroleum hydrocarbons could be blown off base in dust. However, the amount of petroleum hydrocarbons in the dust is not expected to be a health concern.
Issues related to dust migration from Hanford can be addressed by contacting the Hanford Health Information Network toll-free at 800-522-4446.
13. Storms move east to west over the landfill (Craig Road Landfill) and then over our homes. What is being released from Fairchild that may impact the air quality?
The Craig Road Landfill is located on the eastern perimeter of the base. Air contaminants from the landfill are not expected to reach levels of concern at the western perimeter of the base. Air emissions from the landfill are currently monitored by the Spokane County Air Pollution Control Authority (SCAPCA). SCAPCA uses this monitoring data in conjunction with computer air modeling to estimate off-base levels of air contaminants that would result from landfill emissions. A discussion of the potential health hazard associated with Craig Road Landfill emissions is given in the Pathways Analysis section as potential exposure pathway 1b.
14. Will the air quality be affected by evaporation of contaminated water?
There is very little contamination of surface water on base. Volatile organic compounds (VOCs) in groundwater will not impact outdoor air but can travel to homes off base where it may infiltrate wells and off-gas into indoor air via showering and washing. The amount of VOCs currently being detected in residential wells does not pose a health hazard via inhalation of VOCs off-gassing from drinking water into indoor air.
VOCs in groundwater may also move into indoor air directly from the groundwater under your home. The potential health hazard from this pathway depends on several factors including the integrity of the foundation, depth of contaminated groundwater, and concentration of contaminants in groundwater. The highest levels of VOCs in groundwater were found near Vietzke Village. However, very little of this contamination is near the surface and so poses no indoor air problem.
15. A resident complained about water turning yellow in the toilets and tub and would like to have her well tested.
This type of staining is usually related to minerals in the water. Minerals are metal-containing chemicals that occur naturally in groundwater. Many of these metals are essential nutrients and beneficial at low levels. Excess levels of metals in drinking water, however, have been associated with adverse health effects. The base is not considered to be a source of metals in residential wells. If you would like to have your well tested, a list of state certified drinking water analysis laboratories is available from DOH. Please contact Rob Duff toll-free at 1-888-5TOXICS (888-586-9427).
16. The increased activity at the site (Craig Road Landfill) has created a noise problem.
The Craig Road Landfill has undergone substantial remedial activity. A groundwater treatment system is currently operating at the landfill. According to the base, some noise is generated from a manhole cover where treated water merges prior to reinfiltration into the ground. The treatment system was designed to meet noise standards set by the Occupational Safety and Health Administration (OSHA).
17. A resident is concerned that the certification requirement for operators of Fairchild wastewater treatment facilities was dropped. The resident feels that Ecology (Washington State Department of Ecology) should require this certification.
The wastewater treatment plant located near the Craig Road Landfill ceased operations in November 1993. The base no longer operates a wastewater treatment plant. Base wastewater is now treated off base by the City of Spokane. If this question was intended to refer to the current groundwater pump-and-treat system at the Craig Road Landfill, DOH is aware of no certification program requirements for operators at these facilities.
18. Several residents expressed concern that contaminants from the Graham Road Landfill are leaching into underlying aquifers and nearby residential drinking water wells. The following concerns relate to that landfill. These concerns are addressed briefly below.
The Graham Road Recycling and Disposal Facility (GRRDF) is located approximately 1000 feet west of Fairchild on Graham Road. The GRRDF is not operated by the base. It is a private landfill currently permitted to accept demolition debris. Some non-hazardous petroleum-contaminated soils from the base have been sent to GRRDF. The landfill is lined and groundwater is monitored quarterly via sampling of several monitoring wells. A proposed expansion of the landfill is currently being evaluated by the Spokane Regional Health District (formerly Spokane County Health District) which is the lead agency for all issues related to the landfill.
The obvious exposure pathway of concern is the possibility that materials buried in the landfill will leach into groundwater and contaminate nearby residential drinking water wells. DOH will review past quarterly groundwater monitoring reports and an upcoming environmental impact statement for the proposed expansion of the GRRDF. The conclusions of this review will be addressed separately in a letter to the West Plains Neighborhood Association as this issue does not fall within the scope of this document. For more information, please call Robert Duff at 1-888-5TOXICS (1-888-586-9427).
The Public Health Action Plan (PHAP) for the Fairchild Air Force Base is outlined below. The purpose of the PHAP is to ensure that this health assessment not only identifies public health hazards, but provides a plan of action designed to prevent or mitigate adverse human health effects resulting from exposure to hazardous substances in the environment. Included is a commitment on the part of ATSDR and DOH to ensure that these actions are taken.
Actions Taken:
Actions Proposed:
Robert M. Duff
Public Health Advisor
Washington Department of Health
Office of Toxic Substances
ATSDR REGIONAL REPRESENTATIVES
Greg Thomas
Senior Regional Representative
Office of Regional Operations
ATSDR TECHNICAL REVIEW
Carole Hossom
Environmental Health Scientist
Federal Facilities Assessment Branch
Division of Health Assessment and Consultation
Diane Jackson
Environmental Engineer
Federal Facilities Assessment Branch
Division of Health Assessment and Consultation
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