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PETITIONED PUBLIC HEALTH ASSESSMENT

GSX LANDFILL
PINEWOOD, SUMTER COUNTY, SOUTH CAROLINA


ENVIRONMENTAL CONTAMINATION AND OTHER HAZARDS

A. On-site Contamination

1. Groundwater Contamination

Groundwater in the uppermost aquifer (Sawdust Landing) of the GSX site has been contaminatedwith VOCs and heavy metals (21,22). Chromium was detected in on-site groundwater above theEPA Maximum Contaminant Level (MCL) in November 1983 (1). A change in groundwaterquality for some on-site monitoring wells was reported to SCDHEC in May 1984 (1). VOCswere detected in on-site groundwater in June 1986 and November 1986 (23). GSX conducted agroundwater assessment to define the extent of groundwater contamination in 1990 (21,22). Maximum concentrations of contaminants detected in groundwater during the 1990 groundwaterassessment are shown in Appendix C. The extent of the groundwater contamination plume is alsoshown in Appendix C. GSX attributed the groundwater contamination to opaline claystonemining and waste disposal activities conducted by previous owners, rather than to releases fromlined hazardous waste landfill cells. Corrective action to extract and treat contaminatedgroundwater beneath the site has been conducted since June 1987 (21).

In accordance with its operating permits, Laidlaw conducts quarterly sampling of more than 100monitoring wells downgradient of the waste cells. In addition, groundwater flow direction ismeasured monthly. This sampling data and groundwater flow information is reviewed by EPAand the SCDHEC. As of 1997, regulators report no evidence of groundwater contamination fromcurrent landfill and waste disposal activities and that existing contamination is being contained(i.e., contamination is not migrating beyond a limited area on site) (135).

2. Surface Water Contamination

During the groundwater assessment conducted in 1990, GSX analyzed samples collected fromman-made surface water streams that were constructed to control surface water runoff on site(21). Results of those analyses indicate that these on-site streams were contaminated with VOCs. Contamination of surface water was attributed to past mining operations and waste disposalactivities conducted by previous owners of the property. Maximum concentrations ofcontaminants detected in the streams are shown in Appendix C. The streams discharge into twoon-site sedimentation ponds, which are monitored monthly. The sedimentation ponds dischargeinto Lake Marion. Contaminants have not been detected in the sedimentation ponds (24). Locations of on-site surface water sampling points are shown in Appendix C.

As required by its operating permits, Laidlaw performs quarterly sampling of on-site surface waterand submits the sampling data to EPA and the SCDHEC. As of 1997, regulators report noevidence of more recent contamination of surface water.

3. Air Contamination

Several studies of on-site air quality have been conducted by GSX and by SCDHEC (25-28). Thedates of these studies are included in the Site History in Appendix B. VOCs such as xylenes andmethylene chloride have been detected in air on site. In addition, respirable dust above U.S.Occupational Safety and Health Administration (OSHA) Permissible Exposure Limits (PELs) hasbeen detected at several locations on site. Locations of air sampling points are shown inAppendix C.

The rotary kiln, which operated until 1990 at the on-site opaline claystone drying plant, waspermitted by SCDHEC to burn waste oil as fuel. SCDHEC permitted GSX to discharge up to4,000 parts per million halogens into the air. Compound-specific monitoring of stack emissionsfrom the rotary kiln was not conducted. Because the kiln reportedly burned oil at fairly lowtemperatures, organic compounds may not have been destroyed in the kiln (1). Concentrations oforganic compounds that may have been emitted to the atmosphere as a result of these activitiesare not known.

In 1997, air modeling commissioned by Laidlaw and approved by SCDHEC has determined thatthe facility meets South Carolina Maximum Acceptable Air Concentrations at both the fencelineand the property boundary. The facility's current operating permit requires that a detailed airmonitoring plan be developed and implemented. Air monitoring will commence after the plan isapproved by SCDHEC and will serve to verify air modeling results.

B. Off-site Contamination

1. Groundwater Contamination

SCDHEC analyzed samples collected from several domestic drinking water wells adjacent to theGSX Landfill in 1986 and in 1987 (22,30). No contaminants known to be related to the GSX sitewere detected. Coliform bacteria at concentrations exceeding SCDHEC water quality standardswere detected in two residential water wells, and 4-methyl-3-pentanoic acid was also detected inone of the residential water wells contaminated by bacteria. The concentration of this organiccompound was not reported by the SCDHEC laboratory. One of the contaminated water wellswas in a fenced area containing various livestock. The SCDHEC representative describedconditions around the other contaminated residential water well as "not very good," with nofurther elaboration. The SCDHEC representative noted that some residential water wells did nothave sufficient grout around the surface casing to prevent infiltration of contaminants fromground surface into the well annuli. The presence of coliform bacteria, coupled with the fact thatthe domestic water wells are hydraulically upgradient from the GSX landfill, and the fact that theyare poorly constructed and poorly sited, indicates that contaminants detected in these wells arenot related to waste disposal activities at the site. Locations of residential water wells analyzed bySCDHEC are shown in Appendix C.

2. Surface Water Quality

Surface water from the GSX Landfill discharges into Lake Marion from the two on-sitesedimentation ponds. Water, fish tissue, and sediment samples have been collected from LakeMarion by SCDHEC and by EPA on several occasions (June 1986, July 1986, July 1987, andNovember 1987) (31-36). Locations of surface water sampling points are shown in Appendix C. No contamination of off-site surface water, sediment, or fish tissue could be attributed to theGSX landfill.

A massive fish kill occurred in Lake Marion in the general vicinity of the GSX Landfill in August1986 (37). SCDHEC aquatic biologists attributed the fish kill to natural causes (lack of dissolvedoxygen in the water, a fairly common occurrence in slow-moving water bodies).

3. Air Quality

No off-site air monitoring had been conducted at the time of this public health assessment. Development and implementation of an air monitoring plan is required as a condition of thefacility's operating permit. In 1994, the facility developed an Ambient Air Monitoring Plan,which is currently (summer 1997) being reviewed by the SCDHEC.

4. Releases from Waste Transportation Practices

Wastes are transported to the GSX Landfill via trucks and rail cars. Several incidents have beenrecorded in which trucks and rail cars have released waste en route to the facility as a result ofaccidents or as a result of leakage out of the waste containment areas of the vehicles. In October1982, a truck arrived at the landfill with waste "oozing out of the tailgate," according to aSCDHEC inspector (38). Bulk waste was spilled in transit at the junction of State Routes 378and 261 in October 1982. In February 1985, a rail car carrying waste rolled off the track 2 milesfrom the GSX site (39). In May 1985, a truckload of waste being carried into the facility ignited,resulting in the evacuation of the landfill (40). The wastes consisted of incinerator ash and oilyrags. A similar incident occurred the following month, in June 1985, when a truck carryingbaghouse dust and rags contaminated with lead and mercury arrived at the facility with the wasteload smoldering (41). A SCDHEC inspector reported that a truck arrived at the facility in August1985 with leaking wastes containing treated hexavalent chromium, and that the wastes leaked for3 days into a holding pool (42). In December 1986, waste leakage was detected in 12 of 18 railcars carrying soil contaminated with sodium dichromate into the facility (43).

Environmental monitoring was not conducted at the time of these releases to determine theimpact of the releases on the environment and on public health. However, spills were remediatedin accordance with SCDHEC regulations, and no outstanding cleanup issues were related to thesereleases.

C. Quality Assurance and Quality Control

Quality assurance and quality control (QA/QC) programs assure the reliability and accuracy of monitoring and measurement data. In preparing this public health assessment, ATSDR relied on information provided in the reference documents and assumes that adequate quality controlmeasures were followed with regard to chain-of-custody, laboratory procedures, and datareporting. Validity of the analysis and conclusions drawn for this public health assessment isdetermined by the availability and reliability of referenced information.

When descriptions were provided, QA/QC measures appeared consistent with measures normallytaken with environmental sampling and analysis. Detailed sample collection and preservationprocedures, as well as laboratory QA/QC data for analyses, were included in SCDHEC airsampling report for samples collected from June to September 1985. Sample collection andpreservation procedures were described in reports of SCDHEC analyses of tissue taken fromLake Marion fish 1986. These analyses were conducted according to SCDHEC QA/QCprocedures for analyses of fish tissue. Analyses results of trip blanks, surrogate recovery results, and acceptable limits were included in reports of air samples analyzed by GSX in November 1986.

In some cases, a description of QA/QC measures was not provided. No QA/QC data wereincluded in an air sampling report prepared for the landfill operators by a consultant in 1980. QA/QC information was not available in the information reviewed by ATSDR for SCDHECsamples collected at residential water wells in 1986. In addition, SCDHEC did not report theconcentration of 4-methyl-3-pentanoic acid detected in one residential water well. QA/QC datawere not included in the 1990 groundwater assessment report prepared by consultants for GSX.

D. Physical and Other Hazards

The GSX site, which continues to operate as a waste disposal facility, requires the use of heavyequipment. On-site earth-moving equipment and on-site soil excavations may pose physicalhazards to site trespassers, especially to small children. Because access to the site is restricted,the likelihood of human contact with on-site physical hazards is reduced.

Before the ATSDR site visit, residents presented concerns to ATSDR representatives regardingthe speed and volume of trucks carrying hazardous waste to the GSX Landfill. The reason forthese concerns was confirmed by ATSDR during the site visit in May 1990. ATSDRrepresentatives traveled in a vehicle to the GSX Landfill over small, two-lane roads. The vehiclecarrying ATSDR representatives was traveling at the speed limit, but several dump trucks withbeds covered by tarpaulins overtook and passed the ATSDR vehicle. One of these trucks wasobserved turning into the GSX Landfill. Observations during the site visit indicated that truckshauling waste to the facility present a physical hazard to other motorists when the trucks aretraveling in excess of the speed limit. Waste transporters traveling at high speeds on narrowroads present a physical hazard to other motorists traveling on those roads.

PATHWAYS ANALYSES

An environmental exposure pathway consists of a source of contamination; an environmentalmedium in which the contaminants may be present or may migrate; points of human exposure;routes of human exposure such as inhalation, ingestion, or dermal absorption; and a receptorpopulation. The potential for contaminants to represent public health hazards via environmentalexposure pathways in the past, present, and future are discussed in the following section. Environmental exposure pathway components are shown in Appendix C in relation tocontaminants detected in the environment in and around the GSX Landfill.

A. Sources of Contamination

1. Transportation Sources

Because releases from transporters have been documented several times, transporters ofhazardous wastes to the GSX Landfill may be considered either potential or actual sources ofcontamination from the points of origin to the GSX Landfill. Rail cars pass over Lake Marion en route to the landfill, and leaking rail cars may have discharged wastes into the lake. Trucks leaking wastes, or trucks whose cargos of waste are blowing in the wind or burning, are sources of contamination. Trucks that are involved in accidents are also sources of contamination. Transporters have been sources of contamination in the past and are potential sources of contamination in the future.

2. On-site Sources

Mining of opaline claystone presents a past and current source of air contaminants in the form ofrespirable dust and crystalline silica. The former waste oil holding pits were past potential sourcesof contamination via volatilization of organic compounds into the air and potential migration ofcontaminants to the groundwater.

Waste handling operations are past, current, and future sources of air contaminants. VOCs havebeen detected on site, and readings for respirable dusts have exceeded OSHA PELs. Thepotential for air contamination is higher during material handling activities. A recentlyconstructed building enclosing the waste treatment area now limits fugitive dust.

The landfill is a potential source of groundwater contamination if leachate escapes the landfill andleaks into the surrounding soil and groundwater, or if the water table saturates the landfill andcauses migration of contaminated groundwater. Laidlaw currently reduces the toxicity of wastesby pretreating them before burying them in the waste cells. Landfill liners, consisting of severallayers of natural and synthetic materials, are in place to contain leachate from the waste cells, andLaidlaw's groundwater monitoring system should detect leaks in time to prevent contaminationfrom migrating off site. The waste cells also incorporate a leachate collection system thatminimizes the amount of free liquid seeping onto the liner. In addition, a french drain system,installed along the northern and eastern boundaries of the landfill, lowers the natural water tableand prevents groundwater from infiltrating the waste cells. The liners, leachate collectionsystems, and french drain are currently very effective in containing contaminants within the wastecells and reducing the water table below the buried waste. However, some wastes in the cells willremain toxic over a very long period of time. During that period, the condition of the waste cellcomponents, the local geology, or the behavior of the groundwater could change and cause arelease of contaminants into the environment. Although none of these conditions is expected tochange in the future, the sound condition of the landfill can be verified only with a long-termmonitoring program. The landfill's operating permits require quarterly sampling of themonitoring wells surrounding each waste cell; these sample results are reviewed by EPA and theSCDHEC to ensure that any release of contaminants from the landfill will be identified andcleaned up before it can harm the environment or affect public health (135). The permit requiresLaidlaw to conduct groundwater monitoring for a period of 100 years following closure of thefacility (assuming no contamination is detected during that 100-year period).

Other potential sources of contamination on the GSX Landfill include the drum-storage areas,drum-treating areas, overnight truck-parking areas, an on-site drinking water well, and the rail-carwaste transfer station. Contaminants could be released during waste handling activities in theseareas.

3. Off-site Sources

Off-site sources of contaminants in the Rimini area consist primarily of agricultural fields treatedwith pesticides (unrelated to the GSX Landfill). The types of pesticides used in the area werementioned previously in the Demographics, Land Use, and Natural Resource Use section. Theagricultural fields are located adjacent to residences along Route 51, and also between Route 51and the rail-car waste transfer station east of the main GSX facility. Information on the specifictypes of pesticides applied to the agricultural areas was not available at the time of thisassessment. Herbicides and pesticides have also been used to control aquatic weeds andmosquitos in Lake Marion. Livestock feeding and shelter areas adjacent to residential water wellsare also off-site sources of bacterial contamination, particularly when residential water wells arepoorly constructed.

B. Environmental Media

1. Groundwater Contamination

As of 1997, groundwater monitoring conducted by the facility and SCDHEC indicates that thegroundwater contamination plume does not extend beyond the facility property boundary;Laidlaw is containing contamination through active removal and treatment of water from theupper aquifer (21). Off-site groundwater contamination in residential water wells consistsprimarily of bacterial contamination, reportedly resulting from poorly constructed wells in badlocations.

2. Surface Water Contamination

Surface water monitoring data indicate that contaminants from the GSX landfill have been presentin on-site streams in the past. This historical contamination is attributed to mining and wasteburning activities conducted previous owners. As of 1997, contaminants have not been detectedin on-site ponds that are fed by those streams and discharge into Lake Marion, nor have they beendetected in off-site surface water, sediment, or fish tissue taken from Lake Marion.

3. Air Contamination

Past sampling has found on-site air to be contaminated with VOCs and respirable dust. Airmonitoring was not conducted during periods when smoldering wastes were transported to thefacility, nor did the landfill operators conduct off-site air monitoring or compound-specific airmonitoring of stack emissions from burning waste oil in the rotary kiln. Therefore, it is notknown whether air contaminants migrated off site during kiln operations. However, air modelingof current landfill operations has been conducted by Laidlaw and reviewed by SCDHEC; thismodeling has determined that the landfill meets state requirements for air emissions. An AmbientAir Monitoring Plan developed by Laidlaw for the facility is currently under review by regulators(135).

4. Transportation Releases

Concentrations of contaminants released to the environment as a result of leakage duringtransportation and as a result of transportation accidents are not known because monitoring wasnot conducted at the time the releases occurred. However, cleanup actions were performed atthese sites in accordance with SCDHEC regulations.

C. Human Exposure Points

Humans may be exposed to air contaminants on site. It is not known whether human exposureoccurred off-site as a result of air emissions from the accidental burning of waste duringtransportation to the facility, or as a result of burning waste oil in the rotary kiln, or due to othersite-related activities. A recently-constructed building enclosing the waste treatment area hasreduced the potential for exposure to air contamination from that source. An on-site drinkingwater well, installed within the past four years, may been used in the past by on-site workers fordrinking water purposes; however, available data indicate that the well is not contaminated. Atthis time, Laidlaw employees drink bottled water on site, the plume of groundwater contaminationis being treated for VOCs and has not migrated off site, and there are no indications thatlandfilling operations are causing groundwater contamination, or that contaminants from thefacility are reaching Lake Marion. Limited human exposure to on-site surface water contaminantsis possible. It is not known whether people have been exposed to releases of hazardous wastesduring waste transportation activities.

D. Human Exposure Routes

Humans may be exposed to respirable dust in air primarily via inhalation, and they may beexposed to organic compounds in air via inhalation, ingestion, and dermal absorption or dermalcontact. Dermal contact with VOCs in on-site streams is the most likely route of human exposureto surface water contaminants. Dermal contact, dermal absorption of permeable organiccompounds, inhalation, and incidental ingestion are potential routes of human exposure tocontaminants released during waste transportation activities.

E. Receptor Populations

Employees on-site may be exposed to air contaminants, although laborers working close to activewaste disposal cells and in drum storage and treatment areas wear protective clothing andequipment to mitigate these exposures. Visitors to the site may receive sporadic, low doses of aircontaminants released during routine operations, although the recently-constructed wastetreatment building should limit this exposure. ATSDR representatives noted the presence ofchemical odors on site during a past site visit.

It is not known whether the surrounding population was exposed to airborne contaminants duringreleases that occurred while accidentally ignited wastes were transported to the site. It is also notknown whether the surrounding community was exposed to airborne organic compounds as aresult of burning waste oil (as a fuel) at the rotary kiln.

The population that may have been exposed because of waste transportation releases is notknown.

F. Summary of Pathways Analyses

Air: Air contamination presents a potential environmental exposure pathway for employees at thesite. However, the use of protective clothing and equipment will mitigate exposure. Because off-site air data are lacking, it is not known whether off-site residents have been exposed to aircontaminants. It is also not known whether residents were exposed to contaminants potentiallyreleased off site during transportation of wastes, although no evidence exists that such exposuresoccurred.

Surface Water: On-site exposure to surface water contaminants may have occurred in the past,but off-site exposure to surface water contaminants has not been documented.

Groundwater: Groundwater contamination has not resulted in a completed exposure pathway. Workers are not believed to have been exposed to on-site groundwater contamination because thefacility provides the workers with bottled water for drinking water purposes. A potentialexposure pathway would exist if contaminated groundwater were to migrate off-site. Contaminated groundwater, however, is being extracted and treated. Regular monitoring revealsthat contamination is being contained on-site. Sampling results also indicated that current landfillactivities are not contaminating the groundwater. The current liner, leachate collection system,and french drain effectively contain leachate and lower the surrounding water table. However,placement of hazardous wastes below the natural water table presents a long-term potential forcontamination and subsequent exposure and requires continued long-term monitoring andevaluation by the facility and regulators. As previously stated, the facility's permit requiresLaidlaw to conduct groundwater monitoring for a period of 100 years, assuming nocontamination is detected during this time, following the closure of the landfill.

PUBLIC HEALTH IMPLICATIONS

Information on the toxicology of contaminants detected in the vicinity of the site and evaluationsof residents' medical information are presented in this section. In addition, the community healthconcerns presented previously are evaluated in the subsection entitled "Community HealthConcern Evaluation".

A. Toxicological Implications

The pathways analysis did not indicate a complete pathway for any specific compound.

The community would like to know where compounds that were detected in the serum samplestaken in 1986 could have originated. This section will focus on those compounds and attempt todetermine whether they can be attributed to the site. In addition, this section will address theresidents' symptoms and the issue of fish contamination, which were raised as communityconcerns.

Compounds found in Blood Samples from People in the Community:

Polychlorinated Biphenyls (PCBs)

PCBs were not detected in either the groundwater or the surface water at the landfill. Nocompleted pathway for PCBs exists at the facility. PCBs are commercial compounds that werewidely used for insulation and lubrication in electrical cables, transformers, and other equipment. There are 209 individual PCB compounds. Commercial manufacture of PCBs was stopped in theUnited States in 1977. Their uses were halted because of the persistence of these compounds inthe environment and the potential for adverse health effects from exposure to PCBs (44,45).

Commercial formulations consist of a variety of PCBs and impurities. Monsanto was the onlydomestic producer of PCBs. The trade names consisted of Aroclor followed by a four-digitnumber. The last two digits of the number indicated the approximate concentrations of chlorinein the mixture. The more highly chlorinated PCB mixtures (Aroclor 1254, Aroclor 1260) havebeen shown to be carcinogenic in some species of animals. At this time, evidence is inadequate tostate that PCBs are carcinogenic in humans. EPA has classified PCBs as probable humancarcinogens. The International Agency for Research on Cancer (IARC) has classified PCBs inGroup 2B (Group 2B includes those chemicals classified as potential human carcinogens) basedon sufficient evidence in animals, inadequate evidence in humans, and inadequate evidence formutagenicity. The National Institute for Occupational Safety and Health (NIOSH) hasrecommended that PCBs be regarded as potential human carcinogens in the workplace (44,46).

Studies in animals and workers have indicated that the liver and skin are the major affectedorgans. Increased serum levels of liver enzymes have been seen in some studies of workers(44,47,48). Other studies have not found a large number of workers with high enzymes(49,50,51). Dermatologic effects such as chloracne, pigmentary changes, rashes, and changessuch as swelling or thickening have been described (44,49,50,52,53,54). Chloracne is a chronicskin condition produced by environmental exposures to certain compounds containing chemicalssuch as chlorine or bromine. Two predominant skin lesions are seen in chloracne cases: thechloracne cyst and the comedo (blackhead). The chloracne cyst is a skin colored sac with acentral opening. Most studies in workers indicated that persons with chloracne also have someevidence of liver injury (51,55).

PCBs have been shown to cross the placenta, so that fetuses of women who have been exposed toPCBs will also be exposed. Several reports have indicated slight effects on child developmentwhen mothers were occupationally exposed to PCBs during pregnancy or were consumers ofPCB-contaminated fish during pregnancy. These effects have included decreases in birth weight,gestational age, and cognitive functioning (44,56,57).

Nursing infants represent a subpopulation especially sensitive to PCB exposure. Breast milk has ahigh fat content, and PCBs are excreted in the milk. Breast-fed infants have an additional riskcaused by a steroid that is excreted in human breast milk that inhibits the infants' ability to excretePCBs. A study by Gladen et al did not demonstrate any effect on infant psychomotor responseassociated with exposure through breast feeding (58). Serum samples taken in the communityincluded samples from 14 children. The frequency of breast-feeding among women in the area isnot known.

In the United States, the median PCB level in blood of the population without occupationalexposure has been found to be less than 10 nanograms per milliliter (ng/mL) (this may also benoted as 10 parts per billion [ppb]). The sex and age of the population under study must betaken into account (59). Mean serum levels were usually 4-8 ng/mL (ppb), and 95% of peopletested had levels less than 20 ng/mL (ppb) (44). Fewer studies have used adipose samples in thepopulation. Although variation occurred in the groups studied, PCB levels in adipose tissue are100-200 times the levels in blood serum (51). Studies attempting to correlate serum and adiposelevels with health effects have had inconsistent results (44).

No cross sectional studies have been done of PCB levels in people who have not had unusualexposures (such as through work). (A cross sectional study examines health-relatedcharacteristics in a population at a single point in time.) However, several small studies have usedunexposed controls. This gives some information on the levels seen in unexposed groups. Although differences in methodology make it difficult to directly compare these studies, they dogive an indication of the ranges of PCB levels that have been seen. A summary of some of thesestudies is found in Appendix C.

The community around the GSX Landfill is concerned about environmental exposures to PCBsfrom the facility. A few studies of populations living near hazardous waste sites have assessedexposure. These studies have not demonstrated significantly higher PCB levels in sera frompopulations living around hazardous waste sites than the ranges found in other non-occupationallyexposed populations (60). Levels of PCBs in residents around the GSX facility are not higherthan those seen in other non-occupational exposed populations.

Pesticides

No known pathway for DDT exists at the facility; it was not found in the groundwater or surfacewater at the facility.

DDT was first produced in 1944. The peak production in the United States was in 1964(200,000-250,000 tons). In 1966, DDT, Aldrin, and Toxaphene represented 50%-75% of theworld's production of insecticides. In 1969, some states restricted DDT use, and, in 1972, DDTwas banned because of concern over its persistence in the environment, the possibility oflong-term effects, and the increasing resistance of insects to its effects. DDE, a metabolite of DDT, is the major storage product of DDT in fats. DDE is as toxic to mammals as DDT, butinsects are not sensitive to DDE.

DDT has not been shown to cause significant chromosomal aberrations in rabbit or human bloodcultures. Worker study comparisons indicate no increase in chromosomal aberrations. Chronicexposure caused increased cancer in mice, rats, and hamsters but not in dogs or nonhumanprimates. EPA classifies DDT as a probable carcinogen (61).

DDT exhibits effects similar to those of estrogen (one of the "female" hormones). Chronic doseshave shown numerous adverse health effects such as infertility, decreased libido, and increasedmortality of offspring in animals (61). No ill effects on health have been demonstrated fromlong-term, low-dose exposure to DDT in humans (61,62). Single high doses have resulted inheadache, nausea, tachycardia (fast heartbeat), and convulsions (62).

No exposure pathway was identified for trans-Nonachlor at this site because it was not detected insamples taken at the site. Trans-Nonachlor is an organochlorine residue from chlordane orheptachlor. It was detected at levels greater than 2 ppb in 6% of serum sampled in the secondNational Health and Nutrition Examination Survey (NHANES II, 1976-1980). The median serumlevel observed was 1.7 ppb. The range of levels was 1-17 ppb (63). Levels in adipose tissue weregreater than 20 ppb in 97% of samples in the Fiscal Year 1978 survey, National Human AdiposeTissue Monitoring Program (64).

Chlordane does not have an identified completed pathway from the facility at the present time. Chlordane was used as an insecticide in the United States until 1988. In the 1970s, the pattern ofuse was: termite control - 35%, agricultural crops - 28%, home and garden use - 30%, and turf &ornamental - 7%. In 1978, use of chlordane was restricted to the control of termites and use onnon-food crops. In 1983, its use on non-food crops was canceled (65). The literature indicatesthat chlordane does not break down rapidly in soils and can persist for up to 20 years. Noharmful health effects have been observed from studies of workers making or using chlordane. Incases where a person has swallowed large amounts of chlordane, convulsions and death haveresulted. Exposure to more moderate levels can cause headaches, confusion, visual problems,nausea, stomach cramping, and diarrhea (65).

No completed pathway from the facility exists for heptachlor epoxide at this time. Heptachlorepoxide is the oxidation product of heptachlor. The production of heptachlor in the United Stateswas stopped in 1987. Previous uses of heptachlor included termite control, dipping of non-foodplants, and treatment of utility pedestals for fire ant control. Heptachlor epoxide is more acutelytoxic than the parent compound. Heptachlor epoxide is extremely persistent in the environmentwith a half-life of 14 years. These compounds tend to bioaccumulate in the environment.

No studies have been located that identify the direct effects of exposure to heptachlor epoxide onhuman health. Animal studies indicate that the liver is the most sensitive target organ. Animalshave also demonstrated tremors and convulsions from exposure to heptachlor epoxide (45,66).

Levels of heptachlor epoxide greater than 1-2 ppb in serum were found in 4% of the population;levels greater than 10-20 ppb were found in adipose tissue in 96% of the population (64). Levelsin breast milk can be substantial. See Appendix C for further information on the levels ofheptachlor epoxide seen in populations that have been described in the literature.

Potential exposures to heptachlor epoxide, other than for infants through breast feeding include:inhalation in areas where termites have been treated, exposure to soils in areas where the chemicalwas used as a pesticide, waste sites, and foodstuffs (although all studies were conducted before1980) (67).

Hexachlorobenzene has not been found in on-site surface water or groundwater. No exposurepathway from the facility has been identified. Hexachlorobenzene (HCB, Perchlorobenzene) isnot currently commercially manufactured in the United States but is found as a manufacturingby-product or impurity in the production of chlorinated solvents and pesticides. It was used as apesticide until 1985 and is widely distributed as a contaminant in industrial areas and inagricultural areas producing grain (45). HCB levels have been found in 93% of adipose tissuesamples in the United States and 4% of serum samples (64).

Studies on the effects of oral ingestion of HCB come from Turkey, where, in the mid-50s, HCB-contaminated grain was ingested resulting in the occurrence of more than 3,000 cases of acquiredtoxic porphyria cutanea tarda (PCT) (66). The amount ingested averaged 0.05-2.0 gram/day(68). The symptoms of PCT are chronic skin lesions and liver (hepatic) disease. PCT resultsfrom a decrease in hepatic uroporphyrinogen decarboxylase activity (a liver enzyme). This leadsto a disturbance in hepatic heme synthesis and skin photosensitivity. Skin symptoms includeincreased facial pigmentation, increased fragility, erythema (redness), vesicular (blisters), andulcerative lesions. Skin thickening and increased hair on forehead, cheeks, and forearms arecommon. Neuropsychiatric attacks (these may include such things as numbness or pain in thearms and legs, paralysis, restlessness, or visual hallucinations) occur in other forms of porphyria,but not in PCT (69). Appendix C indicates values in the literature from previous studies for HCBin the serum of the general population.

Nursing infants are at risk of developing higher levels of HCB. Tissue levels can increase 2-5 times maternal levels (68).

Volatile Organic Compounds

Only three of the VOCs detected in the blood of community residents were also found in on-sitesamples (toluene and 1,1,1-trichloroethane in groundwater, tetrachloroethylene and 1,1,1-trichloroethane in surface water). None of these compounds were seen in off-site samples,and the wells in the community are upgradient from the facility so no exposure pathways arepresent. Thus, no indication is present that people are being exposed to those compounds fromthe facility. This class of compounds includes many major industrial and commercial chemicals. These chemicals are ubiquitous in the environment as a result of their widespread use, particularlyin fuels. Most of the population is exposed to low levels of these chemicals during the course ofeveryday activities. No normal ranges have been established for levels of these compounds in theblood, and very few studies have been done on levels in populations not occupationally exposed(70,71,72,73). Serum samples from the NHANES III are being analyzed for the presence ofVOCs (74). See Appendix III for the results of two studies.

No potential human exposure points for toluene were found in on-site groundwater. Toluene is inwidespread use in manufacturing benzene; as a solvent in paints, lacquers, and glues; and as acomponent of gasoline. The most common means of exposure is through occupational use andglue or solvent abuse. Among the many products that contain toluene are: gasoline, nail polish,cosmetics, rubber cement, stain removers, fabric dyes, inks, aviation fuels, adhesives, andcigarette smoke. Toluene does not persist in the environment but tends to evaporate readily. Most toluene leaves the body within 12 hours of exposure (75,76,45).

Exposure to levels of toluene in the range of 100-500 ppm has resulted in central nervous systemsymptoms such as fatigue, confusion, incoordination (lack of coordination), and decreasedreaction time. Exposure to low concentrations does not appear to cause any systemic effects. Toluene does not have the hematopoietic (the blood system) effects of benzene. Exposure to veryhigh doses in animals has resulted in some depression of immunological function (77). Solventabuse during pregnancy has resulted in a syndrome of Toluene Embryopathy (a group of birthdefects--including mental retardation and some facial defects--occurring in children whosemothers abused solvents during pregnancy) (78).

Xylenes were not detected in on-site groundwater, and no completed exposure pathway forxylenes has been identified. Xylene, a mixture of the ortho, para, and meta isomers, is widelyused as a solvent and to manufacture organic compounds. Xylene is found naturally in petroleumand coal tar and is produced in forest fires and cigarette smoke. It is also used in paint, lacquer,varnish, ink, dyes, adhesives, cements, cleaning fluids, gasoline, and aviation fuel. Xylene is usedin leather processing and to manufacture hydrogen peroxide, perfumes, insect repellents, epoxyresins, pharmaceuticals, and coatings for fabric (45).

Exposures to levels of xylenes in the range of 100-300 ppm can cause giddiness, anorexia, nausea,mucous-membrane irritation, and slight drunkenness (increased reaction time, memoryimpairment) (76,79). Exposure to low levels of xylenes (< 5 ppm) has not been shown to haveany adverse health effects.

No completed pathway for ethylbenzene from the site has been identified. Ethylbenzene occursnaturally in coal tar, petroleum, and cigarette smoke. It is a component of paints, inks,insecticides, and gasoline and is used to manufacture synthetic rubber. The highest environmentalexposures occur in people who use self-service gas pumps, reside near gas stations or highways,and in smokers (80,45). Ethylbenzene leaves the body fairly quickly, so serum levels tend toreflect recent exposure. Chronic exposures to concentrations of >100 ppm have been noted toresult in fatigue, sleepiness, headache, and mild mucous membrane irritation (76). Ethylbenzene isa defatting agent, so it may result in dermatitis (inflammation of the skin) from long-term skinexposure. No data exists linking ethylbenzene to increased cancers in humans. EPA classifies itas a Class D carcinogen (not classifiable as carcinogens because of a lack of information).

Tetrachloroethylene was detected in the groundwater beneath the site; however, the humanexposure pathway is not complete (see pathway analysis section). Tetrachloroethylene (PCE) iswidely used as a solvent, degreaser, and dry cleaning agent. Consumer products that may containPCE include auto brake fluid, suede protectors, paint removers, water repellents, siliconelubricants, belt lubricants, certain aerosol cleaners, fabric finishers, spot removers, adhesives, andwood cleaners. The general population in the United States is frequently exposed to PCE inambient air (81).

PCE has been found in drinking water throughout the United States. One attempt to correlatePCE concentrations in drinking water with concentrations in serum indicated that PCE was notdetected in serum unless concentrations in water exceeded 200 µg/L (82). PCE has been shownto be carcinogenic in animals. Data from humans have been determined to be inadequate to assessthe risk (81). Exposures to levels of PCE of 100 ppm in air resulted in such effects as mucousmembrane irritation, facial flushing (redness), headache, somnolence (sleepiness), and slurredspeech. Prolonged exposures to higher levels have resulted in peripheral neuropathy (nervedamage in the extremities), CNS depression, and liver damage (76).

No completed pathway for trichloroethane from the site has been identified. The use oftrichloroethane (TCA) has been increasing as a substitute for carbon tetrachloride. It is used as adegreaser, metal cleaner, dry-cleaning agent, and propellant (45). Exposure to concentrationsaround 350 ppm has resulted in impaired psychomotor function. Levels of 900-1000 ppm havecaused light-headedness, incoordination, eye irritation, and disequilibrium (lack of balance) (76).

Very high levels can cause cardiac sensitization to epinephrine. Trichloroethane has not beendetermined to be carcinogenic. A recent epidemiology study of adverse pregnancy outcomes inwomen potentially exposed to TCA in drinking water at concentrations up to 1,700 ppb failed todetermine any excess adverse outcome that could be attributed to the exposure (83).

Dichlorobenzene has not been identified in the surface or groundwater at the site. Dichlorobenzene is in widespread use as a moth killer and block room deodorant. Eye and noseirritations are noted at levels of 50-80 ppm. Higher levels can cause headache and dizziness. Extremely high levels have caused death (45,76,84). Although dichlorobenzene has been shownto be carcinogenic in animals, human data on carcinogenicity are insufficient. The primaryexposure for the general population is inhalation of indoor air after use of products containing thesubstance.

Styrene has not been identified in the surface or groundwater at the site. Styrene is used toproduce plastics. Industries that use styrene in their operations are the most important source ofexposure to the compound. Other sources of exposure include tobacco smoke, automobileexhaust, and foods packaged in polystyrene containers (85).

Compounds in Hair Analyses

In addition to the serum samples, hair analyses for trace elements were conducted on nine personsin the community. The use of hair analysis to indicate internal or external human contaminationfrom trace element pollutants has been the focus of much research. It has the advantage of beingnon-invasive, easy to transport and store, and provides a historical perspective on trace elementconcentration in the body. Once elements are deposited in the hair root, they are bound in thehair shaft permanently. Many problems are associated with the use of hair analysis as a tool todiagnose contamination. The results may vary with different sites on the scalp, different methodsof collection or storage, different ways of sample preparation, and with the use of shampoos, hairsprays, bleaches, or dyes. In addition, variations in the concentration of trace elements have beenassociated with a person's age, gender, hair length, and hair color (86-101). Some studies haveshown a seasonal variation of elements such as cadmium, lead, and zinc (88,90). One study usingautopsy samples found mercury the only element in which concentrations in hair correlated wellwith concentrations in internal organs (87). Information on these factors must be taken intoaccount when interpreting the results of hair analyses. Those results are evaluated in the HealthOutcome Data Evaluation section.

B. Health Outcome Data Evaluation

Health outcome data were not available for the local area around the site. Available data on thecounty can provide a broad general indication of the health status of the population in the countywhere the facility is located. Births exceeded deaths in Sumter County by almost 3 to 1 as of1984 (1,781 births, 641 deaths) (8). The Sumter County infant death rate was 18.0 per 1,000 livebirths, compared with a state average of 14.7 infant deaths per 1,000 live births and a nationalaverage of 10 infant deaths per 1,000 live births (102). In some studies, the infant death rate hasbeen shown to be a fairly sensitive indicator of socioeconomic, environmental, and health carefactors. Nationally the infant mortality (death) rate for blacks is almost double the infant mortality(death) rate for whites. The high infant mortality (death) rate associated with minoritypopulations is a result of several public health factors, including poor prenatal nutrition, lack ofaccess to prenatal care, and poor maternal health. Therefore, the infant mortality rate in SumterCounty may be consistent with nationwide populations having large minority subpopulations.

Seven cases of occupational illness related to direct contact with wastes were reported by GSX inan Exposure Information Report submitted to EPA in August 1985 (10). Six cases involveddirect skin contact with wastes. None of the incidents was a lost-time accident (accidents thatrequired loss of time from work). Occupational lung disease has been reported in a few personswho worked at the "kitty litter operations" at the site.

Local residents have been examined as a group on two occasions in the past for evidence ofeffects from possible exposure. The group examined was not randomly selected from thepopulation living closest to the landfill so selection bias (an error due to differences in thecharacteristics of the people who are studied and those who are not) is possible. A group ofchildren from the community was examined at the Department of Pediatrics at the MedicalUniversity of South Carolina. No toxicological studies were performed at the time of theseexams. All exams were conducted on September 10, 1986. None of the children was below the25th percentile (from growth charts constructed by the National Center for Health Statistics) inheight or weight. The predominant complaints of these children were rash, eye irritation, and hairloss. The diagnoses of the children were consistent with common conditions in this area of SouthCarolina (insect bites with secondary infection, fungal infections [tinea versicola], ringworm,scarring from trauma, and allergic skin disorders [atopic dermatitis]). Hair loss was attributed toa fungal infection of the scalp (tinea capitis) and tight pulling or braiding of the hair (tensionalopecia) (19).

CASE (Citizens Asking for a Safe Environment) wanted a second opinion on the physicals, so agroup of 21 local residents was taken to Dr. Allan Lieberman, the Director of the Center forEcologic Medicine in Charleston, South Carolina (103). Results of these exams are presented in Tables 3-5.

The general physical and laboratory results are similar to health problems experienced by rural,lower socioeconomic groups. In 1980, it was estimated that 17% of rural populations lived inpoverty. Conditions in these areas such as poor sanitation, poor nutrition, and isolation fromhealth services has an adverse impact on health. People living in agricultural areas have exposuresto a wide number of diseases that are shared between animals and humans (zoonotic diseases). The agricultural environment has pollens, molds, grain dusts, and animal danders, which areexcellent agents for producing allergic reactions in the lungs. In addition, there are a variety ofskin problems that are more common in agricultural areas because of contact with irritatingsubstances (such as plants like tobacco or pesticides), damage from sun exposure, infections, and diseases carried by insects.

Table 3.

Most frequent complaints and positive physical findings, GSX landfill,
Sumter County, South Carolina

Family History:
      Atopic Diseases
      Migraines
Present Symptoms:
      Congestion
      Rash
      Headaches
      "Nervousness"
Personal History:
      Atopic Diseases
      Hair Loss
      Depression
      Migraines
Physical:
      Enlarged Turbinates
      Scars
      Adenopathy
      Rash
Source: Reference 115



Table 4.

General Laboratory Studies, GSX landfill, Sumter County, South Carolina
Study:Abnormal Findings:
SCMA: 14 studies.
Cholesterol, Triglycerides 2 were above 200 (nonfasting)
Glucose 1 was 148 (nonfasting)
Gamma-Glutamyl Transpeptidase 2 with levels above 90 (Both Adults)
Potassium 3 with levels just below
normal range (3.3)
Hematology: 11 studies.
Red Cell Counts 4 were less than 4.00
Hemoglobin 3 less than 11.0, 3 between 11.0 and 12.0
Hematocrit 2 less than 35.0
4 between 35.0 and 36.0
Mean Corpustular Volume 2 less than 80
Mean CH 2 less than 25, 1 was above 34
MCHC 1 less than 31
Platelets 1 less than 140,000
1 above 450,000
White Cell Counts 1 was less than 4300
Lymphocytes 4 children had counts less than 3000
Eosinophils 2 had counts above 1000
Lymphocyte Subsets: 18 studies.
1 had values felt to be out of range due to technical artifact
2 had values consistent with a viral infection
1 had elevation of OKT4 (4/8 ratio of 3.9)
1 had elevation of percentage of total t-cells
Source: Reference 103



Table 5.

Toxicological Studies, GSX landfill, Sumter County, South Carolina
Eighteen individuals (11 children, 7 adults) were studied for 42 different compounds (includes10 types of PCBs).
Compound Number with
Detectable Levels
Range (ppb) Mean
(ppb)
DDE181.9 - 99.416.18
DDT16ND - 3.6 1.21
Total PCBs *14ND - 4.2 1.00
Toluene14ND - 3.7 0.96
Trans-Nonachlor12ND - 1.0 0.29
Tetrachloroethylene10ND - 1.9 0.56
Heptachlor Epoxide 9ND - 2.1 0.44
HCB8ND - 0.7 0.14
Xylenes7ND - 15.2 1.85
1,1,1-Trichloroethane7ND - 3.50.58
Beta-BHC5ND - 1.1 0.21
Ethylbenzene2ND - 3.2 0.28
DDD1ND - 0.3 0.02
Dichlorobenzene 1ND - 3.1 0.17
Styrene 1ND - 0.6 0.03
* Most common PCBs were 2,2',3,4,4',5'         Hexa; 2,2',4,4',5,5' Hexa; and 2,3',4,4',5Penta.

      Source: Reference 103

Hair loss can have a variety of causes. Alopecia areata (hair loss without other symptoms) isassociated with conditions such as atopy, Down's Syndrome, and thyroiditis; although, its cause hasnot been identified (104). Other causes of hair loss include high fever, severe infection, severepsychological stress, hypothyroidism, crash diets, certain drugs, and heavy metals (105). Severalchildren had scarring of the lower extremities from previous rashes. The most common descriptionincluded blistering and pustule formation. Attempting to ascertain the etiology of a rash from thisdescription is difficult. Many chemicals can cause contact dermatitis (106). The description didnot include the primary lesions of chloracne: comedones and cysts (107). Many infectious causesof rashes also have these features (108). Several persons had mild anemia. The only liver functionabnormalities were the isolated elevation of Gamma-Glutamyl-Transpeptidase in two adults. Nohistory of alcohol use is known among the people. Tests of kidney function were normal in allcases. The lymphocyte studies did not show markedly abnormal results. Test results wereconsistent with the individuals' medical histories and present symptoms.

Levels of the above compounds in this group are consistent with levels seen in studies of generalpopulations. Two persons had serum levels of xylene greater than twice the mean of the NHANESIII results (74). One person lived more than 5 miles from the site, so it is not evident how thisexposure could be related to the site. The health outcomes observed in these people are consistentwith the general symptoms of people exposed to VOCs (benzene, xylenes, styrene, ethylbenzene,toluene) such as headaches and rash. Many people reported using kerosene heat, living in mobilehomes, and living with smokers, all of which are sources for several VOCs (109).

Analysis for elements in hair samples was carried out on nine persons. Information was notavailable on the laboratory preparation methods or on the individual characteristics (such as haircolor, use of dyes or permanents) that influence results; therefore, no clinical evaluation of theseresults is possible. Results of these analyses are presented in Table 6.

Table 6.

Hair Analyses Results, GSX landfill, Sumter County, South Carolina
ElementMeanRange Notes
Zinc20739 - 556 1 value > 320
Lead229 - 86 1 value > 30
Cadmium1.30.4 - 3.9 1 value > 2
Copper808 - 250 2 values > 90
Manganese2.81.1 - 5.5
Iron4926 - 102 1 value > 70
Aluminum7425 - 167 2 values > 80
Source: Reference 103

C. Community Health Concerns Evaluation

During the site visit in May 1990, ATSDR representatives explained to a resident that a publichealth assessment is necessary to determine which, if any, exposure pathways are completed, andwhich persons may have been exposed. Proceeding directly to a health study without conductinga public health assessment may result in unnecessary expense or in failure to include all potentiallyexposed persons. During the public availability session in March 1991, a few communitymembers expressed a desire to be relocated if they are being exposed.

The Department of Psychology at the University of South Carolina conducted a study in the areaentitled "Coping with an Environmental Stressor: Perception of Risk, Attribution ofResponsibility, and Psychological Distress in a Community Living near a Hazardous WasteFacility" (110). The study was a survey of residents over 18 years of age living within a 25-mileradius of the GSX Landfill. This study indicated an increase of psychological distress andperception of risk to health in residents of the Rimini community. An ATSDR review of thisstudy indicated several biases and design flaws.

Analysis of the health outcome data for the area indicates excess psychological distress in thecommunity. The toxicological studies conducted on people in the Rimini community indicate thecommunity is exposed to low levels of PCBs, DDT, and VOCs; however, these compounds areubiquitous in the environment and the levels were not significantly greater than levels innon-occupationally exposed groups. The information is therefore not sufficient to attribute thesecontaminants to the landfill. Health outcome data are consistent with previous studies that havenot been able to link residential proximity to chemical waste with major diseases or illnesses, buthave linked high levels of stress and anxiety and feeling of poor overall health with the presence ofhazardous wastes in the community (111,112,113). Health outcome data do not indicate whetherthe community is presently being exposed to hazardous materials from the landfill; however, whenhealth in the broadest sense is considered, the presence of the landfill can be said to have had a negative effect (114,115).



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