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PUBLIC HEALTH ASSESSMENT

U.S. ARMY MATERIALS TECHNOLOGY LABORATORY
WATERTOWN, MIDDLESEX COUNTY, MASSACHUSETTS

COMMUNITY HEALTH CONCERNS EVALUATION

Watertown residents discussed their health concerns with ATSDR staff members during meetings held in December 1993 (32) and January 1994 (57). Information about health concerns was also gathered from members of the Watertown Board of Health, the Army, the Massachusetts Departments of Environmental Protection and Public Health, and the U.S. Environmental Protection Agency. Concerns 1-3 relate directly to MTL or other former Arsenal properties, while the other concerns center around environmental contamination in Watertown as a whole. We also responded to written comments received during the public comment period in Appendix E.

Concerns associated with the Arsenal:

1. Could long term health effects occur from past exposure to depleted Uranium (DU) that was burned at the Arsenal?

The amount of DU released to air during past burning of depleted Uranium at MTL and the GSA site was unlikely to be at levels considered harmful to residents of the surrounding community. Since significant exposures were not expected, adverse health effects would not occur. The reader is referred to pages 22 through 32 of this report for a detailed discussion of past air releases of DU.

2. There is concern that former Arsenal workers could have been exposed to harmful levels of beryllium and depleted Uranium.

Industrial hygiene practices at the Arsenal focused on minimizing worker exposures to these materials. (58,59,60) Consequently, the health risks associated with working with beryllium and DU were reduced. Studies among beryllium-exposed workers, within the industry as a whole, have shown the prevalence of chronic beryllium disease (CBD) to be only 5%. (61) Since there was little opportunity for workers to be exposed to beryllium at the Arsenal, their risk of developing CBD was even further reduced. With regard to depleted Uranium workers, sound industrial hygiene and health physics practices coupled with the results of a medical surveillance program do not suggest exposures occurred at levels of health concern. (60,62)

Beryllium:

Because the principal safety hazard in dealing with beryllium is inhalation, glove boxes and exhaust collection systems were in place for areas where beryllium work was carried out. (58) These industrial hygiene practices would greatly reduce possible worker exposures to the metal. Community members stated that a former Arsenal worker died of berylliosis. (63,64) The employee had previously worked at the Navy Yard in Charlestown and was reassigned to MTL. (45) Details regarding the circumstances which lead to the worker's exposure and the subsequent development of disease were unavailable. (58,60,62)

There are two types of diseases associated with inhalation exposure to beryllium: acute beryllium disease and chronic beryllium disease. Acute beryllium disease, which is a chemical pneumonitis, can result from breathing high concentrations of soluble beryllium. However, since the implementation of the Atomic Energy Commission's 1950 recommendations calling for a 99% reduction of beryllium concentrations in the work environment, acute beryllium pneumonitis was completely eliminated. (61,65)

Chronic beryllium disease (CBD), an immunologic disease, only occurs in a small number of people who are exposed to both soluble and insoluble forms of the metal. This finding was reported in studies of industry workers who were exposed to beryllium. CBD is an immunologic lung disease, characterized by chronic hypersensitivity, for which there is no effective treatment. (66,67) Sensitized individuals develop granulomas in their lungs, which are clusters of immune cells (lymphocytes) that accumulate around beryllium particles in the alveoli of the lungs. (61) Studies suggest that there are at least two risk factors for CBD; exposure to the metal and inheritance of a genetic marker linked with susceptibility to the disease. (61,68)

It is also known that the onset of CBD may occur up to 10 to 20 years after exposure. (66,67) A blood test, the beryllium lymphocyte proliferation test (BeLT), can be done to detect early CBD or to make a specific diagnosis of CBD. If an individual has been sensitized to beryllium, their blood lymphocytes will proliferate when cultured in the laboratory in the presence of beryllium salts. (61)

Depleted Uranium:

Industrial hygiene practices at the Arsenal focused on minimizing worker exposure to DU, which could occur through inhalation, ingestion, or through skin lesions. DU, a byproduct of the nuclear industry, is less radioactive than the naturally occurring uranium. All operations involving DU complied with safety and health physics standards applicable at that time, and individual radiation exposures were monitored to ensure that allowable exposure doses to workers were kept well within permissible limits. (59)

The most likely route of occupational exposure to DU is via inhalation. However, when an individual breathes in uranium dust, most of it leaves the lungs when the person coughs or breathes out. (69) Some of the more soluble compounds of DU that remain in the lung are taken into the blood stream. Once in the blood stream, the soluble DU may result in significant deposits in the kidneys, where chemical toxicity occurs. (70) However, DU is eliminated from the kidneys at a rate of about half every two weeks. Moderately severe damage to the kidney as a result of acute exposure is repairable, and a return toward normal kidney function may occur even during continued exposure. (59) Any insoluble DU compounds that are deposited in the respiratory system are mobilized slowly. Although these insoluble DU compounds pose a radiation hazard to the lungs, adverse health effects on the respiratory system are not expected to occur because individual exposure doses at the Arsenal were well within permissible limits.

If exposure occurs via ingestion, only about 1% of the soluble uranium (U) is absorbed from the digestive system and less than 0.2% of insoluble U is absorbed into the bloodstream. (71) Depleted Uranium that enters the bloodstream would be deposited primarily in bone and the kidney, and some would be excreted in the urine. Unabsorbed compounds would be quickly eliminated from the body in the feces.

Hazards associated with handling DU metal is beta radiation exposure to eyes, hands and fingers. Thermoluminescent dosimeters were recommended for monitoring DU exposures to the extremities. Personal protective equipment, such as leather gloves, reduced exposures to the hands by 50%. (59) DU could also enter the blood stream through contaminated wounds.

In addition to implementing safety procedures designed to reduce occupational exposure, the Arsenal maintained a medical surveillance program to check workers for uptake of DU. Urine testing was done quarterly to determine the concentration of DU excreted by workers. (59,60) Urine testing, which detects soluble DU, was used as an indicator of chronic exposure.

Also, exit physicals were available to workers, which included pulmonary function tests, and kidney function tests, as well as other evaluations. (60,62) Clinic medical staff remarked that there were no abnormalities in workers that might be associated with occupational exposures. (60,62) Workers were provided copies of their medical records upon request. Once an employee no longer worked at the Arsenal, that individual's records were sent to the National Personnel Records Center in St. Louis, Missouri. These records are filed by the individual's name, date of birth, social security number and the name of the agency where they had worked. (60)

3. Were any nuclear materials from the Arsenal buried in the community?

The information that we reviewed does not suggest that nuclear materials from the Arsenal were buried in the community. Disposal procedures described in the Former Watertown Arsenal Preliminary Investigation (7) indicate that no radioactive or hazardous wastes were discarded in Watertown landfills or the town incinerator.

Extensive investigations and environmental cleanup at the MTL facility are being conducted at this time. Much of the cleanup of residual radiological contamination from past industrial activities at that site has already been completed. Moreover, the property cannot be transferred for reuse until all necessary remedial actions, which are regulated by the Environmental Protection Agency, the Nuclear Regulatory Commission, and the Massachusetts Departments of Environmental Protection and Public Health, are taken.

There is residual radiologic contamination on the FUDS parcel, now the Arsenal Marketplace (5,7) and the GSA site (40,72), which were both part of the original Watertown Arsenal. However, these sites do not pose a health hazard to members of the general public because access to contaminated areas is restricted. The reader is referred to sections entitled Subsurface Contamination (FUDS Parcel, now the Arsenal Marketplace), pages 12-19 and GSA site - Northeast Area, pages 23-26 for detailed discussions regarding these areas.

Other Concerns in Watertown:

4. Watertown residents believe that cancer incidence in their community is higher than expected. They are particularly concerned that multiple sources of environmental pollution in their community could be contributing to cancer occurrence.

To address concerns about multiple sources of contamination in the community, ATSDR evaluated the likelihood of people coming in contact with hazardous materials in particular areas in Watertown. These included: the Arsenal, Arsenal Park, United Parcel Service, Watertown municipal landfills, and the neighborhoods of Frank Street, North Beacon Street, Bay Street, Palmer Street and Parker Street. We consider it unlikely that residents could be exposed to hazardous levels of contaminants in any of these areas. Our conclusions are based on observations we made during tours of areas that were brought to our attention by community members, and on our review of all the applicable environmental data relating to specified waste sites in Watertown. Details regarding our evaluation of specific sites are provided in Appendix A.

People have strong fears about cancers caused by environmental exposures. Although the term "environmental" causes of human cancer includes everything other than genetic factors, it has been estimated that only about 2% of cancer deaths are attributed to environmental pollution. (73) Often, cancer cases that are linked to chemical exposure afflict individuals who were occupationally exposed to high concentrations of particular types of chemicals. Such occupational exposures appear to account for about 5% of all cancer deaths. (74) The presence of environmental contamination in a community, does not necessarily mean that people are coming into contact with sufficient quantities of hazardous materials to cause disease. Again, we emphasize that it is our opinion that people have not come into contact with contamination.

It is widely recognized that cancers, like heart disease, are very common illnesses that occur in all communities. In order to put the number of individual cancer cases in Watertown into perspective, comparisons must be made to the occurrence of these same diseases in other populations. To accomplish this, the Massachusetts Department of Public Health (MDPH) provided an evaluation of cancer incidence in Watertown in comparison to cancer incidence in the state. (16) MDPH also evaluated cancer incidence for each census tract (CT 3701- CT3704) within Watertown (see Figure 2), to determine if there appeared to be clustering of disease. All cancers specifically named by community members -- bladder, brain, breast, Hodgkin's lymphoma, leukemia, liver, lung and lymphoma -- were included in the MDPH analyses.

We provide a summary of the MDPH findings and refer the reader to their report for more complete information. (16) Watertown as a whole did not experience statistically significant elevations in cancer incidence for the 12 diseases analyzed. Some cases of bladder cancer, non-Hodgkin's lymphoma, and stomach cancer appeared concentrated in different census tracts (i.e., bladder cancer in 3701, non-Hodgkin's lymphoma in 3703, and stomach cancer in 3704). Census tract boundaries within Watertown are illustrated in Figure 2, page 7. The MDPH is considering further evaluation of risk factor information and residential histories for certain cancer cases which appear concentrated in Watertown. In general, cancers have a variety of associated risk factors which are assumed to relate to development of the disease. In fact, many cancers are believed to be related largely to lifestyle factors (e.g., smoking, diet, alcohol consumption, etc). (16,73,75) Therefore, taking a more detailed history is necessary.

5. Residents of the neighborhood around Washburn and Parker streets are concerned about environmental contamination on abutting industrial properties (Swisstronics and Baileys/DuBois). These areas are not associated with the Arsenal. They also had complaints about debris and a condemned barn on one of these properties that had not been removed. Finally, they expressed concern about heavy wiring on Parker Street and a possible link between high electromagnetic fields and leukemia.

During our December 1993 site scoping visit to Watertown, we went to this neighborhood to observe the specific areas brought to our attention by community members. To address the residents' concerns we worked with the Watertown Board of Health and the Massachusetts Departments of Environmental Protection (MDEP) and Public Health (MDPH).

We reviewed MDEP files on the Swisstronics site (76) and determined that no current or future exposure to contaminants is likely because contaminated soil was removed and much of the property is now paved. We also contacted MDEP about the DuBois property, which was the location of Bailey's dry cleaners from the 1930s to 1960s. Although MDEP had little information about the property, based on our discussions they are investigating the parcel through their site discovery program. (77,78)

We referred the demolition of the condemned building and removal of refuse on the private property to the Watertown Health Department for resolution through enforcement of local ordinances. (79)

The findings reported in the MDPH health statistics review for cancer incidence in Watertown (16) does not support a link between the previously reported excessive electromagnetic field readings, which have been reduced, on Parker Street and leukemia. MDPH evaluated cancer types both for Watertown as a whole and for each of the four census tracts in Watertown (CT 3701, 3702, 3703 and 3704). The Washburn and Parker streets neighborhood is within CT 3704 (see Figure 2). No statistically significant elevation in leukemia incidence was observed for either the town as a whole or for any census tract. Moreover, there was no clustering of leukemia in any particular area of Watertown. (16)

6. Citizens believe there is an increased number of cases of multiple sclerosis (MS) in Watertown. They reported knowing of at least 11 cases of MS in Watertown.

No systematic registry exists for reporting the number of multiple sclerosis (MS) cases by town, county or state. However, the Massachusetts Department of Public Health (MDPH) estimated that about 13 to 14 cases of MS would be expected in Watertown (16), based on a study reporting MS prevalence in Boston of 41 cases per 100,000 population. (80,81) The 11 cases of MS reported by Watertown residents (if considered a rough estimate of the prevalence in Watertown) is below this prevalence estimate.

Prevalence studies of MS have shown that the disease is distributed throughout the world in zones of high, medium, and low frequency. (82,83,84,85,86,87) Areas with high prevalence rates -- over 30 cases per 100,000 population -- are Europe between 45 and 65 north latitude, southern Canada, the northern United States, New Zealand, and southern Australia. Thus, Massachusetts is in an area of high prevalence.

It is difficult to evaluate the occurrence of MS because there are no good databases available that contain information on cases. Although mortality data for MS are available, these data do not provide a good estimate of recent cases of the disease. MS has an 80% 20 year survival rate, so mortality during the 1980s and early 1990s reflect cases of MS that were diagnosed in the 1960s and early 1970s. Therefore, ATSDR looked at available mortality data for MS in Watertown, Middlesex County and the state using information provided by the MDPH Bureau of Health Statistics spanning from 1980 to 1992. However, there were too few deaths attributed to MS in Watertown during that time period to make any meaningful comparison with the county and state data.

Further limitations of the mortality data are that they provide little information about the geographic distribution of MS within Watertown. Information on death certificates only includes the person's address at the time of death, which may not be where they lived when they were diagnosed with MS. Furthermore, migration studies of people with MS have demonstrated that place of residence before age 15 appears to be important in the persons risk of developing MS. (88) We do not have residential history for the 11 cases of MS that were reported by citizens.

Because of the limitations associated with available data, we cannot conclude that Watertown is experiencing an increase in the occurrence of MS. We recognize that people are concerned that MS cases in their community might be associated with exposure to environmental contamination. Some studies have reported possible links between MS and occupational exposure to metals, but the predominance of epidemiologic data suggests that MS is associated with an infectious process. (89) Moreover, we have no evidence that Watertown residents have been exposed to environmental contamination from the Arsenal, or other waste sites in the community, that would adversely affect their health.

7. Some residents also mentioned general concerns about the occurrence of birth defects and Crohn's disease in Watertown.

ATSDR attempted to identify data sources to address these concerns. The Massachusetts Department of Public Health, Bureau of Health Statistics had one year of data readily available related to birth defects. These data did not suggest an elevation in birth defects in Watertown for the one year period, from October 1, 1992 through September 30, 1993 provided by Massachusetts Congenital Anomaly Surveillance Pilot Project. Because there was no evidence of exposure to chemical contamination associated with the Arsenal, we did not attempt to expand our evaluation to data not readily available from the state.

The state also provided mortality data for Crohn's disease, which is not a common illness, nor is it highly fatal. (90) Mortality rates, which increase with the duration of the disease, range from 5 to 10 percent. (66) Like MS, it has a long duration from diagnosis to time of death; therefore, all of the limitations of mortality data for MS, as discussed above, also apply to mortality data for Crohn's disease. In a 12 year period, only 2 deaths in Watertown were attributed to Crohn's disease. That number is too small to calculate meaningful mortality rates attributed to Crohn's disease.

Crohn's disease is a chronic inflammatory bowel disease characterized by recurrent inflammatory involvement of intestinal segments. It rarely occurs before the age of six, and the incidence increases progressively until it peaks in early adult life. Although the cause of Crohn's disease is unknown, some features of the disease suggest possible importance of genetic, immunologic, infectious and psychological factors. Crohn's disease is more common in whites, occurs with increased frequency in Jews and exhibits some family clustering. (66,91)

8. Volatile organic compounds, from a number of industrial sources, have contaminated shallow groundwater in the community. Some residents are concerned about possible exposure to these contaminants. They believe that vapors could enter their homes when basements flood. They also stated that there were probably drinking water wells used in the past that might have been contaminated.

The Massachusetts Department of Environmental Protection (MDEP) has investigated contamination associated with a number of waste sites in Watertown. If MDEP determines that groundwater contamination at any of these sites poses a health hazard to community members, actions are taken to reduce or eliminate exposure. Their evaluation includes potential vapor transfer from contaminated groundwater into indoor air. (92) An example of such state action occurred at the former EG & G Torque Systems site on Arlington Street; an area brought to our attention by community members. (57) Solvent released from an above ground storage tank on the property caused localized groundwater contamination. The maximum solvent concentration in groundwater was 55,000 ppb of tetrachloroethylene, which is an extremely high level of a very volatile compound. The MDEP evaluated indoor air quality data for a building that is immediately adjacent to where the spill occurred. The solvent vapors measured inside the building, which is now a health club, were below levels posing a health threat. Nevertheless, the state is continuing to work with the property owners to ensure that environmental contamination on the site is properly managed so that people are not exposed to chemicals at levels of health concern. (93,94)

Regarding the concern about private well use in Watertown, this urban area is not considered to be a suitable area for drawing well water for domestic purposes. In fact, for nearly a century, municipal water has been supplied to the Watertown community from sources outside the urban area. Massachusetts Water Resources Authority records show that service began on November 30, 1898. The source of the municipal water was the Wachusett reservoir up until 1940, when the Quabbin reservoir was also used. (95) Despite the availability of municipal water, undoubtedly some wells in the town continued to be used for drinking water. However, little is known about where and for what period of time those wells were used. Currently, only a few wells in town are being used for non-drinking water purposes. We advise Watertown residents not to use private wells for domestic purposes because past industrial activity has contaminated groundwater in some parts of the community. Moreover, unless private wells in this urban area are routinely tested for both chemical and biological contamination, it is impossible to ensure that the water is safe to drink.

9. Although no specific area was mentioned, a community member was concerned about growing vegetable gardens if soil contamination exists in yards.

Without reviewing soil data for the particular area in question, it is difficult to address this concern. If a property was historically used for residential purposes, soil contamination would not be expected, although metals such as lead could have accumulated from past use of lead-based paints and fallout from automobile emissions. It is certainly possible that former industrial areas could contain residual contamination if no site cleanup was done. Since about the mid 1980s, many lending institutions have required prospective buyers of industrial or commercial properties to have environmental sampling done to confirm that these properties are not contaminated. (96) Surface soil sampling would have to be done to determine if chemical contaminants are present. Even if contaminants are present, uptake in plants is influenced by factors such as the chemical type, its concentration, and the kind of vegetable grown.

In the case of MTL, areas with surface soil contamination will be cleaned up to levels that are protective of public health based on future land use, which consider direct soil contact. The risk estimates associated with direct soil contact are similar to those for ingestion of site grown vegetables. (97,98)

Finally, because groundwater in many parts of Watertown has been contaminated by a variety of past industrial practices, people who have private wells should not use them to water their vegetable gardens, unless the water has been tested to confirm that it does not contain chemicals that can bioconcentrate in crops.

10. People are concerned about recreational use of the Charles River because of pollution from industrial discharges. There is specific concern that people may be eating contaminated fish.

Recreational uses of the river, such as boating, wading, swimming and catch-and-release fishing, are of little public health concern. People are not likely to contact contaminants in surface water and sediment through such activities. Even if individuals are exposed, their intermittent, short-term contact with contaminants is not expected to cause illness. (98) However, eating fish caught in urban sections of the Charles River poses a possible health threat. The Massachusetts Department of Environmental Protection addressed this issue by coordinating fish sampling in the Watertown area. The Massachusetts Department of Public Health evaluated the fish tissue data and determined that high enough levels of PCBs were detected in carp to issue a fish consumption advisory for the Lower Charles River between Hemlock Gorge Dam and the Museum of Science. The advisory states that children under 12, pregnant women and nursing mothers should not eat carp. All other people are advised to limit their consumption of carp to two meals per month.(15) The MDPH has already issued a statewide fish consumption advisory recommending that pregnant women refrain from consuming certain fish caught in Massachusetts freshwater bodies due to mercury. (35)

PREPARERS OF REPORT

Lorna Bozeman, M.S., Environmental Health Scientist
Paul Charp, Ph.D., Senior Health Physicist
Federal Facilities Assessment Branch
Division of Health Assessment and Consultation

Edward Gregory, Ph.D.
Demographer
Federal Facilities Assessment Branch
Division of Health Assessment and Consultation

Virginia Lee, M.D., M.P.H.
Medical Officer
Epidemiology and Surveillance Branch
Division of Health Studies

Diane Jackson
Chief, Defense Facilities Section A
Federal Facilities Assessment Branch
Division of Health Assessment and Consultation

Advisors

Heather Tosteson, Ph.D.
Writer
Program Evaluation, Records and Information Services Branch
Division of Health Assessment and Consultation

Gary Campbell, Ph.D.
Environmental Health Scientist
Federal Facilities Assessment Branch
Division of Health Assessment and Consultation

Carol Connell, B.S.
Senior Health Physicist
Energy Section B
Federal Facilities Assessment Branch
Division of Health Assessment and Consultation

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