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HEALTH CONSULTATION

Lead Investigation

NORTHSIDE DRIVE AREA
(a/k/a NORTHSIDE DRIVE LEAD)
ATLANTA, FULTON COUNTY, GEORGIA


SUMMARY

The Georgia Department of Human Resources, Division of Public Health (GDPH) has prepared this health consultation under a cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR). The objective of this health consultation is to evaluate whether a public health hazard exists as a result of environmental exposures to lead-contaminated soil in specific neighborhoods located near Northside Drive in Atlanta, Georgia (Figure 1 and 2). Since 1901, industrial activities from two facilities in Atlanta have been a source of lead contamination for residents in the surrounding neighborhoods.

In 2001, the U.S. Environmental Protection Agency (EPA) began to investigate the levels of lead in residential yards within an approximate one-mile radius of these facilities. Soil sampling results from the Northside Drive Area Lead Investigation indicate that lead levels found in soil in some yards are above levels considered protective of health and the environment. However, additional sampling needs to be conducted to characterize the full extent of contamination. Most homes in the area have substantial ground cover that would minimize the potential for direct exposure to contaminated soil; however, repeated exposure to lead-contaminated soil and from other sources could result in higher exposures than what is considered safe.

As a result, EPA began excavating contaminated soil from the Investigation Area in November 2003. GDPH coordinated a blood lead testing program for children in the area, and no elevated blood lead levels have been reported. Blood testing will continue to be offered during the remediation phase of the EPA investigation. In addition, GDPH continues to provide health education to residents about lead exposure, including ways to reduce and eliminate exposure to lead in soil and other sources.

This document contains information about the environmental transport and extent of human exposure to lead, conclusions about the health risks posed to residents, and recommendations intended to protect public health. A health consultation is specifically designed to provide the community with information about the public health implications from exposure to regulated substances at a specific site, and to identify populations for which further health actions are needed. It is not intended to serve the purpose of or influence any other environmental investigation such as a risk assessment, or to address liability, remediation, or other non-health issues.

GDPH has determined that this site poses a past and current public health hazard to children because evidence exists that exposures to lead-contaminated soil above 400 mg/kg (milligrams per kilogram) have occurred, are occurring, and are likely to occur in the future until remediation is complete. The full extent of lead contamination in soil has not been determined; additional sampling is required to determine the total number of residences affected. Removal of lead-contaminated soil is a prudent public health action and will eliminate a future exposure pathway.

GDPH recommends that:

  1. All residents with soil lead levels above 400 mg/kg should follow best practices as outlined in Appendix E to minimize exposure.

  2. Based on soil sample results, GDPH will identify residents with elevated lead levels in soil and provide blood lead testing for children under six years old. Women of childbearing age and pregnant women in the Investigation Area should consult with their physician about getting their blood tested for lead.

  3. Additional sampling should be conducted for lead in surface soils on the remaining properties in the Investigation Area.

  4. EPA will ensure measures are in place to monitor and reduce residents' exposure to contaminated soil during remediation efforts.

  5. People who enter the former smelter site and may experience physical injury from onsite hazards and may be exposured to on-site contamination. The property owner should be properly secure the site.

  6. Although limited vegetable garden sampling results do not indicate lead at levels of health concern, residents in the Investigation Area should not consume food from gardens without taking precautions to minimize their potential exposures to lead from plant uptake. This recommendation will remain in effect until soil remediation has been completed.

STATEMENT OF ISSUES AND BACKGROUND

The Georgia Division of Public Health (GDPH) was asked by the U.S. Environmental Protection Agency (EPA) to review soil-sampling data to determine if lead concentrations measured in soil posed a health hazard to residents living in the Northside Drive Area Lead Investigation (Investigation Area) boundaries (Figure 2). GDPH was also asked to provide health education to residents regarding potential health effects associated with exposure to lead in soil, including ways to reduce and eliminate exposure to lead in soil and other sources, and blood lead level testing for children.

Site Description

The area of concern encompasses three neighborhoods northwest of downtown Atlanta, Georgia approximately centered at the intersection of Mecaslin and Trabert Streets (Figure 1). The Investigation Area is bordered to the east by Interstates I-75/85, and to the north, west, and south by mixed-use urban development.

There are approximately 234 private properties included in the initial assessment boundary [1]. The area is comprised primarily of mid-sized homes and several small businesses. Today, most homes and businesses are renovated and/or maintained by long-time residents, or rented to those attracted to the area's proximity to downtown Atlanta. Most of the homes in all three neighborhoods were built prior to 1978; therefore, it is probable that they contain lead-based paint. They may also contain lead solder for water pipes.

Natural Resource Use

Residents and businesses in the area have been connected to municipal water for the last several decades. There are no known private or municipal wells in the area. There are no surface water bodies (lakes, streams, rivers, etc.) in the Investigation Area. Several residents cultivate fruits, vegetables and herbs for consumption. The vast majority of yards have unlimited access. There are no schools or playgrounds in the area. 2000 census data indicate that 87 children under the age of six reside in the Investigation Area (Figure 1).

Site History

The neighborhoods in the investigation area are adjacent to the former National Smelting and Refining Industries, Incorporated and Atlantic Steel Company sites.

From 1914 until 1981, National Lead Industries, Incorporated owned and operated a smelter facility at 430 Bishop Street. Their operations consisted of lead recovery (i.e., secondary lead smelting) from lead-acid batteries and lead-bearing scrap. National Smelting and Refining, Incorporated purchased the property in 1981, and continued operations until 1984 when it filed for bankruptcy [2]. The site is currently abandoned. There are several structures on site and the site is fenced completely around the perimeter; however, at some locations the fence is not secure and access can be achieved. There are numerous physical hazards on site, including manufacturing and other debris.

Atlanta Steel Hoop Company was founded in 1901 and reorganized into Atlantic Steel Company in 1915. Atlantic Steel smelted steel from recycled automobile frames and scrap metal. Steel was reheated in furnaces and rolled into finished products such as steel bar and wire rod. Selected products were also galvanized or coated for durability. The final operation at the site, steel rolling, ceased in 1998 [2]. The former facility was demolished, and the site is currently being redeveloped as Atlantic Station, a large mixed-use development. The site has unlimited access and there are many physical hazards including heavy construction equipment.

Environmental Investigation and Regulatory History

In 1992, soil sampling was conducted for residential properties by Service Training for Environmental Programs. Thirteen samples collected from yards in the neighborhoods of concern were analyzed, and lead levels ranged from 105 milligrams of lead per kilogram of soil (mg/kg) to 1725 mg/kg [2]. The EPA has set a residential soil lead screening value of 400 mg/kg. This value is derived from a model and is considered to be protective of health and the environment [3]. The report from this sampling event was not available, and these results have not been verified.

In February 2001, EPA was asked by residents to investigate possible lead contamination of soil in the area [4]. Soil sampling results indicate that potentially one-third of the residential yards have lead in soil above 400 mg/kg [2,5]. EPA sent a letter to each residence sampled with specific information about their soil sample results.

In June 2001, the site was placed in EPA's Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS, or "Superfund") database. Superfund is the Federal government's program to clean up the nation's uncontrolled hazardous waste sites (visit www.epa.gov/superfund or call EPA in Atlanta at (404) 562-9900 for more information about CERCLIS).

In May 2002, Atlantic Steel and National Lead Industries voluntarily entered into an Administrative Order on Consent with EPA. The major objectives of the Order are to identify those properties that possess average soil-lead concentrations above the EPA residential soil lead screening value, and to conduct removals (i.e., cleanups) at those affected sites. In addition:

  • Health and Safety Plan approved by EPA August 2002
  • Quality Assurance Project Plan approved by EPA October 2002
  • Sampling and Analysis Plan approved by EPA October 2002
  • Removal Action Plan approved by EPA October 2002
  • Landscape Restoration Plan approved by EPA October 2002

Because levels of lead in some residential soil exceed the screening level of 400 mg/kg, and with additional considerations as outlined in EPA's Soil Screening Guidelines [3], EPA determined that contaminated soil in some residential yards could pose a health risk to children, and a removal action was initiated in Fall, 2003. This action should eliminate the potential for future exposure to lead-contaminated soil in the area and is considered a prudent public health action by GDPH. Not all yards in the neighborhoods have been sampled.

Public Health Activities

In response to the EPA sampling results showing elevated levels of lead in some residential yards, GDPH offers a program for blood lead testing for all children under six years of age who live in, play in, and visit the area. To date, no children have been identified with elevated blood lead levels. GDPH will also continue to provide health education to residents in the community to help reduce and eliminate exposure to contaminated soil, and other potential sources of lead.


REVIEW OF ENVIRONMENTAL SAMPLING

In 2001, the EPA began a sampling program to determine the levels of lead in residential yards in the Investigation Area. For sample identification and collection purposes, EPA divided the neighborhoods into three areas (Figure 2): Lyndhurst (Area 1) is between Bishop Street and Deering Road; Lorring Heights (Area 2), lies north of Lyndhurst and is bordered by Deering Road and North Garden Lane; and, Homepark (Area 3), which is south of the Atlantic Steel site and bordered by Mecaslin Street to the west and 14th Street to the south. EPA's sampling program was initially designed to randomly select residential properties in the area of concern for analysis. However, due to time constraints and difficulty gaining access to some properties, EPA sampled at locations where residents voluntarily allowed access to their property.

EPA staff and contractors collect composite soil samples from residential yards in the Investigation Area.

EPA performed composite surface soil sampling in the Investigation Area. Soil samples were collected and combined from three to six locations within front, back and side portions of each yard [2]. EPA modified the number of sampling locations for some yards because of varying site conditions. EPA collected surficial soil samples from depths of 0" to 6" [2]. In addition, five composite subsurface (6" to 8") soil samples were collected during the first sampling event [2]. This sampling method may not identify all areas with lead contamination, and residents are encouraged to request additional sampling if there is considerable contact with yard soil at their home.

First Sampling Event

Between April and September 2001, EPA evaluated 142 residential properties and Underwood Park, a public park located about one mile northwest of the Investigation Area [2]. Analyses confirmed 51 soil samples were above the EPA residential soil lead screening value of 400 mg/kg. The soil lead concentrations above 400 mg/kg ranged from 405 mg/kg to 1400 mg/kg. Of the 51 samples above 400 mg/kg, 44 were between 400 mg/kg and 800 mg/kg and six were between 801 mg/kg and 1000 mg/kg. One was greater than 1000 mg/kg with the highest concentration of 1400 mg/kg (Table 1). The park sample was 100 mg/kg, which is considered typical for urban environments [2].

Second Sampling Event

In October and November 2002, 136 more properties were sampled, and 40 of these had average soil-lead concentrations above 400 mg/kg [5]. The soil lead concentrations above 400 mg/kg ranged from 410 mg/kg to 1400 mg/kg. Of the 40 samples above 400 mg/kg, 34 were between 400 mg/kg and 800 mg/kg and five were between 801 mg/kg and 1000 mg/kg. The highest concentration was 1400 mg/kg (Table 1).

Table 1. Soil lead concentrations above the EPA Action Level in soil in the Investigation Area

Sampling Event (Dates) Total Number of Properties Lead Concentration 400 - 800 mg/kg* Lead Concentration 800 - 1000 mg/kg Lead Concentration > 1000 mg/kg
First
(April/September 2001)
142 44 6 1
Second
(October/November 2002)
136 34 5 1

* mg/kg: milligrams per kilogram

To date approximately 70% of the residential yards in the Investigation Area have been sampled. Additional soil sampling is proposed for properties proximate to those properties with results greater than 400 mg/kg and will be conducted once access agreements are executed by property owners [5].

Physical And Other Hazards

On the site of the former smelter, there are many observed physical hazards. These include abandoned manufacturing and other debris. The site is enclosed by a locked fence; however, there is site access through the fence at a few locations. The former smelter site may pose a threat to children for injury and exposure to on-site contamination and should be properly secured. The former Atlantic Steel site has unlimited access and there are many physical hazards including heavy construction equipment. Access to these properties and exposure to physical hazards were also present historically.

The National Smelting and Refining Company site poses physical hazards.

Cleanup Activities

In Fall, 2003, contractors under EPA oversight began excavate yards with lead levels of 400 mg/kg and above. Additional properties will be sampled and remediated as access agreements are secured. GDPH considers this to be a prudent public health action to help prevent future exposure to contaminated soil at this site.

Soil remediation began in Fall, 2003. This is a prudent public health action to prevent future exposure.


DISCUSSION

Exposure Pathway Analysis

GDPH determines exposure to environmental contamination by examining exposure pathways. An exposure pathway is generally classified by environmental medium (e.g., groundwater, soil, air). A completed exposure pathway exists when people are actually exposed through ingestion or inhalation of, or by skin contact with a contaminated medium. GDPH evaluates the environmental and human components that lead to human exposure to determine whether people are exposed to environmental contaminants. An exposure pathway consists of five elements: 1) a source of contamination; 2) transport through an environmental medium; 3) a point of exposure; 4) a route of exposure; and 5) a receptor population. In addition, GDPH determines whether exposure, if it exists, occurs at levels of concern and over what period of time.

GDPH categorizes an exposure pathway as a completed or potential exposure pathway if the exposure pathway cannot be eliminated. In completed exposure pathways, all five elements exist, and exposure to a contaminant has occurred in the past, is occurring, or will occur in the future. In potential pathways, at least one of the five elements is missing but could exist. An exposure pathway can be eliminated if at least one of the five elements is missing and will never be present.

Completed Exposure Pathways

In the Investigation Area, a completed exposure pathway exists for lead-contaminated soil. Table 2 details the completed exposure pathways for the Investigation Area.

Exposure to lead in soil can occur as a result of activities associated with residential property use. For example, children playing in yards may be exposed to lead in soil. As part of normal outdoor play and hand-to-mouth exploratory activities, young children are at higher risk of ingesting lead-contaminated soil, and are at significantly greater risk from adverse health effects from exposure [6]. Children are more prone to exposure to soil because of their play activities, and often bring lead-contaminated soil into the home on their bodies, clothes, and toys. Children usually come into close contact with pets that transport contaminated soil.

In addition, some children exhibit Pica or geophagy, the eating of soil or other nonfood items. Pica is seen more in children between the ages of 2 to 6 years of age. If children residing in the Investigation Area exhibit Pica behavior, it should be reported to a pediatrician or health care provider, and a blood lead level test should be conducted for the child.

Adults may be exposed to lead in soil as well. For example, adults involved in yard maintenance activities could become exposed to lead through inhalation (dust) or through incidental ingestion of soil.

After visiting the neighborhoods in the Investigation Area on several occasions, GDPH staff noted that a vast majority of the properties have yards with substantial ground cover (grass) and mature trees and shrubs, which would lessen the potential for human exposure to lead in the soil. Bare soil was noted in limited areas of some yards. Only a few yards contained outdoor play equipment designed for small children. Most yards were landscaped with flowers and other ornamental plants requiring gardening activities by residents and professionals.

Table 2. Completed exposure pathways in the Investigation Area

Pathway Exposure Pathway Elements Time
  Sources Medium Point of Exposure Route of Exposure Exposed Population  
Surface Soil Various Surface Soil Surface soil throughout the Investigation Area Ingestion
Inhalation
Dermal
Residents of entire area Past
Present

Potential Exposure Pathways

This health consultation evaluates exposure to contaminated soil in the Investigation Area. EPA's soil removal action will eliminate the future pathway of exposure to lead in soil. However, it is important to note that other sources of lead such as lead in garden vegetables, lead-based paint, and vehicle emissions may be a potential pathway for additional exposure to lead.

Food

Foods such as fruits, vegetables, herbs and grains grown in soil contaminated with lead may have lead in them. Lead gets into food from dust that contains lead falling onto crops and from plants absorbing lead that is in the soil. You may ingest lead by eating contaminated food, but most of the lead that they eat will pass through your body [6]. The amount that gets into your body from your stomach partially depends on when you ate your last meal. It also depends on how old you are and how well the lead particles you ate dissolved in your stomach juices. Experiments using adult volunteers showed that, for adults who had just eaten, the amount of lead that got into the blood from the stomach was only about 6% of the total amount taken in. In adults who had not eaten for a day, about 60-80% of the lead from the stomach got into their blood [6]. In general, if adults and children swallow the same amount of lead, a bigger proportion of the amount swallowed will enter the blood in children than in adults [6].

Lead Paint

From the early 1900's until the 1960's, house paint used white lead as a base pigment to brighten paint. In the 1960's, manufacturers began to introduce products that used alternative substances for paint, as studies began to link lead with certain catastrophic childhood illnesses. For example, when lead paint degrades around doorjambs and contact points on window frames, it is released into the air as a fine dust that is not visible to the naked eye. It can be inhaled as fine dust particles and ingested. As a response to what is now viewed as a major public health issue, the Consumer Product Safety Commission banned the residential use of lead paint in 1978. Approximately three-quarters of the nation's housing built before 1978 contains some lead-based paint. This paint, if properly managed and maintained, poses little risk. However, normal wear and tear, and renovation activities can release lead dust and lead paint chips. These contaminated particles pose long term health hazards if not properly handled and disposed of, and become a source for contamination of soil and dust.

In the Investigation Area, most homes and businesses were built before 1978 and, therefore, are considered potential sources of lead to the environment. The most accurate way to determine if your home has lead-based paint is to hire a lead inspector to test the paint. Lead inspectors use s-ray instruments to determine content of lead in paint immediately. Another way is to hire a risk assessor who will take samples from several locations in your home and have them analyzed for lead content. If an individual is concerned about a specific area in a home and wants to take a simple paint chip, dust, or soil sample themselves, they can mail the sample directly to a certified laboratory and have it analyzed. Taking a sample without an assessor is easy and may be less expensive, but it only tests the area from which the paint, soil, or dust sample was taken. A house may contain several layers of paint from different periods so one or two samples may not be representative of the entire residence.

EPA has not approved and does not recommend do-it-yourself lead test kits. These kits, which do not require lab analyses, are not very accurate in determining the existence of lead paint. For more information, or to locate lead-based paint inspectors, risk assessors and certified laboratories, call the National Lead Information Center at (800) 424-5323.


TOXICOLOGICAL EVALUATION

GDPH based this toxicological evaluation on previously described exposure scenarios for the residents of the area and health effect studies. These evaluations consist of the analysis of persons exposed to lead in residential soil. Exposures to lead have been quantified using standard exposure assessment methods. Inhalation (breathing in), ingestion (swallowing), and dermal (skin) absorption are the routes of exposure for the completed exposure pathway. Although the dermal exposure pathway is included, the actual dermal absorption of lead is not quantified. This is because very little lead enters the body through the skin compared to the ingestion route [6]. However, because lead contamination is so common in the environment (i.e., lead paint, vehicle emissions) these exposures are considered as additional potential routes of exposure, and are addressed in Appendix B. All actual and potential exposure sources should be considered when evaluating health risks.

GDPH has made several assumptions regarding dose intake and to quantify exposures. Many variables were based on observations made during visits to the Investigation Area, and on conversations with members of the community and with staff from EPA. When evaluating exposure, GDPH assumes that people will be exposed to contaminants in dust and soil through incidental ingestion for 24 hours per day for 30 years. Higher soil ingestion rates and lower body weights were assumed when estimating children's exposure in order to more accurately evaluate health risks for children.

Chemical-specific information is contained in documents known as toxicological profiles, which are published by the federal Agency for Toxic Substances and Disease Registry (ATSDR). These chemical-specific profiles provide information on health effects, environmental transport, human exposure, and regulatory status. In the following discussion, GDPH primarily used the ATSDR Toxicological Profile for Lead, and information from a number of other sources. These sources are listed in the reference section of this health consultation.

Lead

Lead is a naturally occurring bluish-gray soft metal found naturally in small amounts in the earth's crust. It has no characteristic taste or smell. Lead is mined for varied human utility including the production of batteries, ammunition, ceramic glazes, and metal products (such as sheet lead, solder, some brass and bronze products, and pipes). For additional information about lead, refer to Appendix A.

Shortly after lead gets into your body, it travels in the blood to the "soft tissues" (such as the liver, kidneys, lungs, brain, spleen, muscles, and heart). Once it is taken into the body and distributed to organs, the lead that is not stored in bones leaves your body in urine and feces. About 99% of the amount of lead taken into the body of an adult will leave in the waste within a couple of weeks, but only about 32% of the lead taken into the body of a child will leave in the waste [6]. Most of the remaining lead moves into your bones and teeth. In adults, about 94% of the total amount of lead in the body is contained in the bones and teeth [6]. About 73% of the lead in children's bodies is stored in their bones [6]. Some of the lead can stay in your bones for decades; however, some lead can leave your bones and reenter your blood and organs under certain circumstances; for example, during pregnancy and periods of breast feeding, after a bone is broken, and during advancing age.

Lead has no physiological value, and repeated exposure to elevated levels can cause a wide range of health effects (Table 3). Small children are especially sensitive to lead, and many of its effects are observed at lower blood lead concentrations than in adults (6). Lead can also affect the development of the fetus. Unborn children can be exposed to lead through their mothers. Harmful effects to the fetus include premature births, smaller babies, decreased mental ability in the infant, learning difficulties, and reduced growth in young children. Most exposed children have no apparent symptoms, and consequently, many cases go undiagnosed and untreated.

Ingestion of Lead

Soil

Soil and dust act as an exposure pathway for lead deposited by primary sources such as lead paint dust, leaded gasoline, and industrial air emissions. When lead is released to the air, it may travel long distances before settling to the ground. Once lead falls onto soil, it does not dissipate, biodegrade, or decay easily, and usually sticks to soil particles. Lead deposited from the air is generally retained in the upper 2-5 centimeters of undisturbed soil [8].

Because lead does not break down, the lead deposited into dust and soil becomes a long-term source of lead exposure. Exposure to lead in soil occurs primarily through indirect ingestion of contaminated soil. People can ingest lead-contaminated soil if they put their hands or other objects covered with lead dust in their mouths and breathe in lead dust. Because of the large particle size of lead contaminated dust (diameter greater than 5 micrometers), it is usually expelled from the lungs and swallowed (ingested). Particle size, ground cover, soil conditions, seasonal variation, behavior patterns, a person's age, outdoor activity, and a variety of other factors influence what dose or amount of lead a person receives during exposure to contaminated soil [6].

EPA's residential soil lead screening value is 400 mg/kg. This value is derived from a model and is considered to be protective of health and the environment [3]. The Centers for Disease Control and Prevention (CDC) considers children to have an elevated blood lead level if the amount of lead in blood is 10 micrograms of lead per deciliter of whole blood (µg/dL) or greater [9] but, given our increasing scientific knowledge, the levels of lead thought to be associated with negative health effects in children have been dropping in recent years [7]. Because of the varied nature of lead-containing compounds, ATSDR has not developed a health-based comparison value for lead.

There is currently no value for elevated lead levels in adults, but the American Conference of Government Industrial Hygienists notes that women of childbearing age whose blood lead level exceeds the CDC guideline value are at risk of delivering a child with a blood level greater than 10 µg/dL [6]. GDPH recommends that women of childbearing age and pregnant women in the Investigation Area consult with their physician about getting their blood tested for lead.

People exposed to lead in the Investigation Area are much more likely to experience chronic low to moderate-level exposure to lead in soil than acute, high-level exposure. If not detected early, chronic, low/moderate-level lead exposure may cause the health effects in adults and children listed in Table 3.

Table 3. Potential health effects from chronic exposure to low/moderate lead levels [7]

Body System Health Effects
Brain and Nervous System damage to the brain and nervous system
behavior and learning problems (such as hyperactivity)
slowed growth
hearing problems
headaches
learning deficiencies
decreased intellectual function
memory problems
problems with behavioral or attention
problems with coordination
Blood-making System anemia (not enough blood cells to carry oxygen)
Digestive System constipation or diarrhea
abdominal discomfort
Renal System (kidneys) elevated blood pressure
abnormal kidney function
Reproductive System abnormal reproductive function
possible infertility

After repeated exposure, these effects may persist after exposure has ceased and blood lead levels have returned to normal. There is inadequate evidence to clearly determine if lead is carcinogenic (causes cancer) to people [6].

Food

In June 2003, EPA contractors collected and analyzed two surficial composite soil samples and two vegetable samples from the residential yard with the highest soil lead concentration that has a vegetable garden. Sample ND-01-SS was collected from an area within the garden planned for future plantings. Sample ND-02-SS was collected from an area within the garden currently under cultivation with squash plants. The vegetable samples consisted of the flowers, stems, and leaves from the squash plants. The vegetable samples were rinsed with analyte-free water three times prior to placing the sample in an appropriate container. A sample of the analyte-free water was collected prior to rinsing the vegetables and a sample of the rinse water was also collected. The following table summarizes the analytical results for the samples analyzed for lead only:

Table 5: Soil and vegetable garden sampling results for the Investigation Area

Station Location Location/Sample Type Lead Concentration Units
ND-01-SS future planting area 340 A mg/kg
ND-02-SS current growing area 390 A mg/kg
ND-03-FB Field Blank 1.0 U µg/L
ND-04-RB Rinse Blank 6.2 µg/L
ND-05-VG Squash plant 0.16 mg/kg
ND-06-VG Squash plant 0.32 mg/kg

Pb - Lead
ND - Northside Drive (Area Lead Investigation)
SS - Surface Soil
A - Analyte analyzed in replicate. Reported value is "average" of replicates
mg/kg - milligrams per kilogram
µg/L - micrograms per Liter
FB - Field Blank
RB - Rinse Blank
U - Material was analyzed for, but not detected. The number is the minimum quantitation limit.
VG - Vegetable

Based on these results, there is no indication that people who eat food grown in the Investigation Area are ingesting levels of lead of health concern. However, because other potential sources of lead exposure may be present at residences with these gardens, GDPH will advise residents in the Investigation Area not to consume food from gardens without taking the following precautions to minimize their potential exposures to lead from plant uptake:

  1. If your home was built before 1978, keep your garden at a distance from the house foundation. Studies show that lead levels in soil directly adjacent to older homes can be much higher than in the center of the yard. As outdoor house paint weathers away or undergoes renovation activities such as scraping prior to repainting, it chips and falls onto the ground near the foundation.
  2. Consider the types of vegetables most likely to be consumed by children and limit their consumption.
  3. Wash and rinse foods grown in your garden thoroughly with a 1% vinegar in water solution (1 to 2 oz./gal. water) or soapy water as soon as they are brought into the home.
  4. Avoid growing leafy vegetables and root crops in this soil. Grow these crops in raised beds or containers with lead free soil.
  5. While gardening, follow best practices to prevent exposure to lead as outlined in Appendix E.

This recommendation will remain in effect until soil remediation has been completed.

Blood Lead Testing

At several public meetings attended by GDPH staff, residents requested blood lead testing. In response, GDPH coordinated with the Fulton County Department of Health and Wellness to provide blood lead testing for all children up to six years old that live, or have been exposed to the soil in the Investigation Area. GDPH informed the community about blood lead level testing through door-to-door distribution of flyers and at a public meeting. During the ongoing testing program beginning October 1, 2002, no residents have requested blood lead testing. Evaluation of the blood lead testing program revealed that most residents have had their children tested through their private physicians, and no parents have reported elevated lead levels in their children. No reports of elevated blood lead levels in children from the area have been received by the GDPH under the Georgia Lead Screening Plan (Appendix C). As a precaution, GDPH will continue to offer blood lead testing for children up to six years old during the remediation process. After remediation is complete, blood lead level testing will continue to be offered to residents by the Fulton County Department of Health and Wellness as outlined in the statewide Georgia Lead Screening Plan.

Persons interested in blood lead testing should consult their doctor or contact the GDPH. A simple blood test can detect high levels of lead. Blood tests are important for:

  • Children at ages 1 and 2.
  • Children and other family members who have been exposed a known source of lead.
  • Children who are 3 to 6 years old should be tested for lead if they have never been tested for lead before and if they receive services from public assistance programs; if they live in or regularly visit a building built before 1950; if they live in or visit a home built before 1978 that is being remodeled; or if they have a brother, sister, or playmate who has had lead poisoning.
  • Children who should be tested under your state or local health screening plan (see Appendix C for the Georgia Lead Screening Plan).

For additional information about treatment following exposure, see Appendix D.


CHILD HEALTH CONSIDERATIONS

The ATSDR Child Health Initiative recognizes the unique vulnerabilities of young children exposed to chemicals in the environment. Because of their size, body weight, frequent hand to mouth activity, and developing systems, children require special emphasis in communities faced with lead contamination. They are more likely to come into contact with dust and soil on the ground because they play outdoors, and they often bring food and toys into contaminated areas. Also, they receive higher doses of exposure because children's growing bodies absorb more lead. Because their brains and nervous systems are more sensitive to the damaging effects of lead, children can sustain permanent damage if exposures occur during critical growth stages. When children are exposed to lead, they:

  1. absorb the lead into their bodies at a higher rate than adults.
  2. have brains that are actively growing, and lead alters the development of growing brain cells [7].
  3. have a less developed barrier between the blood and the brain, allowing relatively more lead to pass into their developing brains [7].
  4. are more likely to show health effects from the same amount of lead exposure, even at relatively low levels.

In the Investigation Area, children have been, are currently being, and may in the future be exposed to lead contaminated soil in some residential yards. Because lead does not break down in soil, it is a long-term source for potential exposure to children who regularly play outdoors. Residents with young children should exercise caution and implement interim measures to limit their child's exposure to lead in soil and other possible sources in their home. For example, in bare soil, residents might consider planting grass, ground cover or even covering bare soil with several inches of clean fill dirt until a permanent remedy is put into place. If the yard has not been targeted for cleanup, parents with young children should have their soil tested specifically in bare soil areas where children play. See Appendix E for interim steps one can take to reduce exposure to lead in soil and other sources. Also, parents should ensure children playing outside don't bring soil into the house on their shoes, toys, or pet [6].


CONCLUSIONS

  1. A past and current public health hazard exists for children who are regularly exposed to bare soil contaminated with elevated levels of lead at concentrations

  2. An ongoing removal action, initiated by EPA beginning in Fall, 2003 will eliminate the potential for future exposure to lead-contaminated soil in the area and is a prudent public health action.

  3. Additional sampling is required to determine the total number of residences affected in the Investigation Area.

  4. Physical hazards on the former smelter site, including abandoned manufacturing and other debris, may pose a threat to people who enter the site.

RECOMMENDATIONS

  1. All residents with soil lead levels above 400 mg/kg should follow best practices as outlined in Appendix E to minimize exposure.

  2. Additional sampling should be conducted for lead in surface soils on the remaining properties in the Investigation Area.

  3. Abandoned manufacturing and other debris on the former smelter site may pose a physical hazard to people who enter the site and should be properly secured by the property owner.

  4. Although limited vegetable garden sampling results do not indicate lead at levels of health concern, residents in the Investigation Area should not consume food from gardens without taking precautions to minimize their potential exposures to lead from plant uptake. This recommendation will remain in effect until soil remediation has been completed.

PUBLIC HEALTH ACTION PLAN

Actions Completed

  • The U.S. Environmental Protection Agency established a website, (http://dm.westonproject.net/northside ) to keep residents informed about the EPA investigation. This website also provides links to ATSDR and other resources for health effects from lead exposure.

  • On June 5, 2002, GDPH staff contacted via telephone, and then distributed via email a Notice of Involvement (NOI) to Home Park and Lorring Heights Homeowners' Association presidents for distribution to their members. The NOI was also mailed to state and federal agency staff involved in the site investigation, and to the county health department.

  • GDPH attended the Homepark and Loring Heights Homeowners' Association meetings on June 7, 2002 and August 13, 2002, respectively. An EPA representative discussed the consent order and the remediation process for the Northside Drive Area Lead Investigation. GDPH provided contact information and blood lead testing procedures to residents.

  • On August 22, 2002, GDPH staff attended an EPA Public Availability Meeting for the Atlantic Steel site to answer general questions on our role in the Northside Drive Area Lead Investigation, and to distribute written procedures for blood lead testing.

  • In September, 2002 and September, 2003, GDPH staff distributed blood lead testing flyers to the 91 homes in the three neighborhoods found to have soil lead concentrations of 400 mg/kg and higher during the first and second sampling events.

  • GDPH contacted via phone and sent blood lead testing information to the editor of the Home Park Homeowners' Association where it was published in the October, 2002 issue of their newsletter.

Actions Planned

  • In cooperation with the Fulton County Department of Health and Wellness, the GDPH will continue to promote blood lead testing and follow up services for children up to six years of age living in the Investigation Area.

  • Based on soil sample results, GDPH will identify residents with elevated lead levels in soil and provide blood lead testing for children under six years old. Women of childbearing age and pregnant women in the Investigation Area should consult with their physician about getting their blood tested for lead.

  • EPA will ensure measures are in place to monitor and reduce residents' exposure to contaminated soil during remediation efforts.

  • GDPH will review soil data collected from the remaining residential properties and provide additional documents, including a follow-up health consultation, if appropriate.

  • GDPH will continue to provide health education materials to the local population regarding the health effects from exposure to lead, and effective methods of preventing and reducing exposure.

  • GDPH will respond to all requests for health information regarding this site.

REFERENCES

  1. E-mail from Dr. James Webster, United States Environmental Protection Agency (EPA), to Maurice Redmond, Georgia Division of Public Health. Re: background information on National Smelting and Refining and Atlantic Steel Companies, Atlanta, Georgia. May 6, 2002.

  2. EPA, Final Summary Report Northside Drive Area Lead Investigation, Atlanta, Fulton County, Georgia. January 2002.

  3. EPA, Soil Screening Guidance: User's Guide. Publication 9355.4-23; July 1996.

  4. Letter from Loring Heights Neighborhood Association to U.S. EPA, http://dm.westonproject.net/northside/documents/epa_investigation/loring_ltr.pdf . February 7, 2001.

  5. Law Engineering and Environmental Services, In., Monthly Progress Report (March 11, 2003 - April 11, 2003): Northside Drive Superfund Site, April 11, 2003.

  6. Agency for Toxic Substances and Disease Registry, Toxicological Profile For Lead (Update). July 1999.

  7. Pediatric Environmental Health Specialty Unit, Southeast Region, Emory University, Lead, Atlanta, GA, www.sph.emory.edu/PEHSU .

  8. Arizona Department of Health Services, Public Health Assessment: Asarco Hayden Smelter Site (A/K/A Asarco Incorporated Hayden Plant), Hayden, Gila County, Arizona, September 30, 2002.

  9. Eldred RA Cahill TA, Trends in elemental concentrations of fine particles at remote sites in the United States of America, Atmospheric Environ 28:1009-1019. 1994.

  10. EPA, Air Quality criteria for lead, Research Triangle Park, NC: Environmental Criteria and Assessment Office, EPA 600/8-83-028F. 1986.

  11. Bolger PM, Carrington CD, Caper SG, et al, Reductions in dietary lead exposure in the Untied States, Chemical Speciation and Bioavailability 3(314):31-36. 1991

  12. EPA, Maximum contaminant level goals and national primary drinking water regulations for lead and copper, Federal Register 56: 26461-26564. 1991d.

  13. Angle CR, Marcus A, Cheng I-H, et al, Omaha childhood blood lead and environmental lead: A linear total exposure model, Environmental Res 35: 160-170. 1984.

  14. Laxen DP, Raab GM, Fulton M. Children's blood lead and exposure to lead in household dust and water--a basis for an environmental standard lead in dust, Sc. Total Environ 66: 235-244. 1987.

  15. Ryu JE, Ziegler EE, Nelson SE, et al, Dietary intake of lead and blood lead concentrations in early infancy, Am J Dis Child 137: 986-991. 1983.

  16. Shacklette HT, Boerngen JG, Elemental composition of surficial materials in the conterminous United States, Washington D.C.: US Department of the Interior, Geological Survey; Geological Survey Professional Paper no. 1270. 1972.

  17. Georgia Department of Human Resources, Division of Public Health, Georgia Lead Screening Plan, http://health.state.ga.us/epi/disease/lead.shtml .

PREPARERS AND REVIEWERS OF REPORT

Authors

Jane M. Perry, MPH
Program Director
Chemical Hazards Program
Georgia Division of Public Health

Maurice Redmond, MA
Program Consultant
Georgia Division of Public Health


Reviewers

James Webster, PhD
On-Scene Coordinator
Emergency Response and Removal Branch
U.S. EPA Region IV

CAPT John Steward, REHS, MPH
Technical Project Officer
Agency for Toxic Substances and Disease Registry

CDR William T. Going III, MPH
Technical Project Officer
Agency for Toxic Substances and Disease Registry

Bob Safay, MS
Senior Regional Representative
Agency for Toxic Substances and Disease Registry


CERTIFICATION

The Georgia Division of Public Health prepared this Northside Drive Area Lead Investigation, Atlanta, Fulton County, Georgia, health consultation under a cooperative agreement with the Agency for Toxic Substances and Disease Registry. It is in accordance with approved methodology and procedures existing at the time the health consultation was begun.

William T. Going III
Technical Project Officer, SPS, RPB, DHAC


The Division of Health Assessment and Consultation, ATSDR, has reviewed this public health consultation and concurs with the findings.

Roberta Erlwein
Chief, SSAB, DHAC, ATSDR


FIGURES

Site Location and Demographics
Figure 1. Site Location and Demographics

Northside Drive Area Lead Investigation Neighborhoods
Figure 2. Northside Drive Area Lead Investigation Neighborhoods


APPENDICES

APPENDIX A: FACT SHEETS

Click here to view Appendix A in PDF format (70KB, PDF)


APPENDIX B: POTENTIAL SOURCES FOR LEAD EXPOSURE [7]

Much of the lead released into the environment results from human activities such as mining, manufacturing processes, and burning of fossil fuels. There are three main ways that people can still be exposed to lead: in the general environment, in the workplace, and in the home.

  1. Sources of lead exposure in the general environment include:
    • Food grown on soil contaminated with lead or covered with lead dust
    • Water carried by lead pipes or pipes with lead soldering
    • Lead-contaminated air or dust near a hazardous waste site
    • Smoke from cigarettes contaminated with lead
    • Lead-based paint on homes built before 1978.

  2. Sources of workplace lead exposure include air in industries such as lead refining, battery manufacturing, and construction.

  3. Sources of lead exposure in the home include:
    • Eating or breathing paint chips or dust contaminated with lead, especially in homes built before 1978.
    • Drinking water carried by lead pipes or with lead soldering. This is a problem in many older homes.
    • Certain hobbies such as making stained glass, glazed pottery, remodeling of older homes, etc.
    • Toys or pottery containing lead-based paints.
    • Certain folk remedies.
    • Lead-containing cosmetics such as surma and kohl.
    • Some calcium supplements made of bone or oyster shell.

APPENDIX C: GEORGIA LEAD SCREENING PLAN [17]

Method
A blood test is the preferred method for lead screening. There are two tests used to obtain blood lead specimens, capillary blood test or venous blood test. Finger stick capillary blood tests can be done as the initial screening. A venous blood test can be done as the initial screening as well. This method should always be used to confirm elevated blood lead test results when a capillary test was used as the initial screening. Diagnostic (venous) testing should be conducted according to the schedule in Table 1. The urgency and type of follow up required are based solely on a child's blood lead level.

Table 1. Recommended Schedule for Obtaining a Confirmatory Venous Sample

Screening test result (µg/dL) Perform a confirmation test within:
10-19 3 months
20-44 1 week-1 montha
45-59 48 hours
60-69 24 hours
> 70 Immediately as an emergency lab test

All Georgia health care providers and laboratories who perform blood lead analyses for Georgia residents are required to report blood lead levels > 10 micrograms of lead per deciliter of blood (µg/dL) within seven days to the local health department, District Health Officer, or to the State Epidemiology Branch.

Lab Submission
The Georgia State Laboratory in Albany, Georgia, provides free analysis of blood lead specimens for all Georgia children less than 72 months of age. The primary care provider's (i.e., personal physician) office should contact the laboratory to use this service. The Georgia Childhood Lead Poisoning Prevention Program (GCLPPP) does not recommend or endorse the use of another lab.

Data & Reports
The GCLPPP collects and analyzes data that is used to help plan, implement, and evaluate Georgia's lead poisoning prevention activities. Lead screening data are entered into the Stellar database that was created by the Centers for Disease Control and Prevention (CDC). The Georgia Stellar database contains data for 1999 through 2002 for children less than 16 years of age. Analyses are done using statistical analysis software. The data available on the website summarize surveillance information that has been reviewed and accepted by the CDC. You can contact GCLPPP at (404) 463-6580 to request more detailed or more recently collected data. Health information is available in both English and Spanish.

Data Notes

  1. A child can only be screened once within a specified period of time (ex. 2003). All other tests are confirmatory and/or follow-up tests. Elevated blood lead data are based on the highest test result within that period of time. Records for which the child's date of birth is unknown or incorrect are dropped.
  2. Age is based on the child's age when the blood specimen with highest test result was collected.
  3. The data represent all records reported to the GCLPPP during the year.

APPENDIX D: TREATMENT FOR LEAD EXPOSURE [17]

Treatment and medical management includes follow-up blood lead testing. Table 1 presents the suggested frequency of follow-up tests. This table is to be used as guidance. Case managers and PCPs should consider individual patient characteristics and caregiver capabilities and adjust the frequency of follow-up tests accordingly

Table 3.4. Schedule for Follow-Up Blood Lead Testing*

Venous blood lead level (µg/dL) Early follow-up (first 2-4 tests after identification) Late follow-up (after BLL begins to decline)
10-14 3 monthsb 6-9 months
15-19 1-3 monthsb 3-6 months
20-24 1-3 monthsb 1-3 months
25-44 2 weeks-1 month 1 month
> 45 As soon as possible Chelation with subsequent follow-up

a Seasonal variation of BLLs exists and may be more apparent in colder climate areas. Greater exposure in the summer months may necessitate more frequent follow-ups.

Case Management

  • Nursing Case Management is initiated when a child has a venous blood lead level (BLL) greater than or equal to 10 ug/dL and includes services such as repeat blood testing, counseling, program referrals, (Babies Can't Wait, WIC, and PeachCare) and health education.
  • Medical Case Management begins when a child has a venous BLL greater than or equal to 15 ug/dL and includes a medical evaluation (possible chelation therapy), repeat blood testing, program referrals, counseling, and health education.
  • Environmental Case Management begins when a child has a venous BLL greater than or equal to 15 ug/dL and includes a source of investigations of a patient's environment.

Chelation Therapy
While chelation therapy is considered a mainstay in the medical management of children with blood lead levels (BLLs) > 45 micrograms of lead per deciliter of blood (µg/dL), it should be used with caution. Primary care providers, including personal physicians, should consult with an expert in the management of lead chemotherapy prior to using chelation agents. If unaware of a center with such expertise, contact the Georgia Childhood Lead Poisoning Prevention Program at the Georgia Division of Public Health (404) 463-6580 for the names of accessible experts. A child with an elevated BLL and signs or symptoms consistent with encephalopathy should be chelated in a center capable of providing appropriate intensive care services.

Controversy exists as to the appropriate level at which to initiate chelation therapy, and which drugs are most appropriate. If oral outpatient chelation therapy is undertaken, the case manager should ensure that caregivers adhere to the prescribed dosing schedule and should serve as the liaison between the medical community and the child's caregiver. Treatment should occur in a lead-safe environment.


APPENDIX E: BEST PRACTICES TO REDUCE EXPOSURE TO LEAD

Lead in Soil
To reduce exposure to lead in soil, follow these guidelines:

  • Have children play in grassy areas in your yard and not on bare soil (cover bare soil areas)
  • Clean or remove shoes before entering your home to avoid tracking in lead from soil
  • Wash children's hands often, especially after playing outdoors and before they eat
  • Wash toys used outdoors often
  • Because children often handle pets, and for the health of the pet, keep pets away from areas of contaminated soil. Wash pets after they are exposed to contaminated soil.

Lead in Dust
Lead dust can form from many sources, such as contaminated soil, and when lead-based paint is dry scraped, dry sanded, or heated. Dust also forms when painted surfaces bump or rub together. Lead chips and dust can get on surfaces and objects that people touch. Settled lead dust can re-enter the air when people vacuum, sweep, or walk through it.

Lead in Paint
Other potential sources of lead exposure might come from lead based paint used in older homes. The federal government banned lead-based paint for indoor use in housing in 1978. If a home or dwelling was built before 1978, and especially if the paint is deteriorating (peeling, cracking, chipping or damaged), you may want to test your home for lead. Lead-based paint in good condition is not usually a hazard except on impact or friction surface that rub against each other and create dust, like a windowsill [7]. Removing lead-based paint improperly can increase the danger to your family. If you suspect that your house has lead hazards, you can take immediate steps to reduce risk:

  • Renters should notify landlords of peeling or chipping paint
  • Clean up paint chips immediately.
  • Clean floors, window frames, windowsills and other surfaces weekly. Use a mop or sponge with warm water and a general all-purpose cleaner.
  • Keep children away from chipping paint on windowsills or other surfaces
  • Keep play areas clean and wash pacifiers, bottles and stuffed animals regularly
  • Have your home inspected by a trained or certified professional

Lead in Your Home
If you suspect that your house has lead hazards, you can take some immediate steps to reduce your family's risk:

  • Clean floors, window frames, window sills, and other surfaces weekly. Use a mop, sponge, or paper towel with warm water and a general all-purpose cleaner or a cleaner made specifically for lead.
  • Thoroughly rinse sponges and mop heads after cleaning dirty or dusty areas.
  • Wash children's hands often, especially before they eat and before nap time and bed time.
  • Keep play areas clean. Wash bottles, pacifiers, toys, and stuffed animals regularly.
  • Clean or remove shoes before entering your home to avoid tracking in lead from soil.
  • Make sure children eat nutritious, low-fat meals high in iron and calcium, such as spinach and dairy products. Children with good diets absorb less lead.

In addition to day-to-day cleaning and good nutrition, you can temporarily reduce lead hazards by taking actions such as planting grass to cover soil with high lead levels and repairing damaged painted surfaces. These actions (called "interim controls") are not permanent solutions and will need ongoing attention.

You can get your home checked in one of two ways, or both:

  • A paint inspection tells you the lead content of every different type of painted surface in your home. It won't tell you whether the paint is a hazard or how you should deal with it.
  • A risk assessment tells you if there are any sources of serious lead exposure (such as peeling paint and lead dust). It also tells you what actions to take to address these hazards.

Note: Home test kits for lead are available, but studies suggest that they are not always accurate.


FOR MORE INFORMATION ABOUT LEAD, PLEASE CONTACT THE FOLLOWING RESOURCES:

Georgia Division of Public Health
Chemical Hazards Program
2 Peachtree St. NW, 16th Floor
Atlanta, GA 30303-3141
Phone: 404.657.6534
Fax: 404.657.6533

Agency for Toxic Substances and Disease Registry (ATSDR)
Division of Toxicology
1600 Clifton Road NE, Mailstop E-29
Atlanta, GA 30333
Phone: (888) 422-8737
FAX: (404) 498-0057

Pediatric Environmental Health Specialty Unit
Rollins School of Public Health
Department of Environmental and Occupational Health
Emory University
1518 Clifton Road, NE
Atlanta, GA 30322
Tel: (770) 956-9636
Fax: (770) 956-8907
Toll Free: (877) 33 PEHSU or (877) 337-3478

Agency for Toxic Substances and Disease Registry, Public Health Statement on Lead: www.atsdr.cdc.gov/toxprofiles/phs13.html.

U.S. Environmental Protection Agency, Office of Pollution Prevention and Toxics: www.epa.gov/opptintr/lead .

Centers for Disease Control and Prevention, Childhood Lead Poisoning Prevention Program, www.cdc.gov/nceh/lead/lead.htm .

National Lead Information Center, 1 (800) LEAD-FYI 532-3394), www.nsc.org/index.htm .



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