PUBLIC HEALTH ASSESSMENT
(a/k/a HUNTINGTON TOWN LANDFILL)
HUNTINGTON, SUFFOLK COUNTY, NEW YORK
INTERIM PUBLIC HEALTH HAZARD CATEGORIES
|CATEGORY / DEFINITION||DATA SUFFICIENCY||CRITERIA|
|A. Urgent Public Health Hazard
This category is used for sites where short-term exposures (< 1 yr) to hazardous substances or conditions could result in adverse health effects that require rapid intervention.
|This determination represents a professional judgement based on critical data which ATSDR has judged sufficient to support a decision. This does not necessarily imply that the available data are complete; in some cases additional data may be required to confirm or further support the decision made.||Evaluation of available relevant information* indicates that site-specific conditions or likely exposures have had, are having, or are likely to have in the future, an adverse impact on human health that requires immediate action or intervention. Such site-specific conditions or exposures may include the presence of serious physical or safety hazards.|
|B. Public Health Hazard
This category is used for sites that pose a public health hazard due to the existence of long-term exposures (> 1 yr) to hazardous substance or conditions that could result in adverse health effects.
|This determination represents a professional judgement based on critical data which ATSDR has judged sufficient to support a decision. This does not necessarily imply that the available data are complete; in some cases additional data may be required to confirm or further support the decision made.||Evaluation of available relevant information* suggests that, under site-specific conditions of exposure, long-term exposures to site-specific contaminants (including radionuclides) have had, are having, or are likely to have in the future, an adverse impact on human health that requires one or more public health interventions. Such site-specific exposures may include the presence of serious physical or safety hazards.|
|C. Indeterminate Public Health Hazard
This category is used for sites in which "critical" data are insufficient with regard to extent of exposure and/or toxicologic properties at estimated exposure levels.
|This determination represents a professional judgement that critical data are missing and ATSDR has judged the data are insufficient to support a decision. This does not necessarily imply all data are incomplete; but that some additional data are required to support a decision.||The health assessor must determine, using professional judgement, the "criticality" of such data and the likelihood that the data can be obtained and will be obtained in a timely manner. Where some data are available, even limited data, the health assessor is encouraged to the extent possible to select other hazard categories and to support their decision with clear narrative that explains the limits of the data and the rationale for the decision.|
|D. No Apparent Public Health Hazard
This category is used for sites where human exposure to contaminated media may be occurring, may have occurred in the past, and/or may occur in the future, but the exposure is not expected to cause any adverse health effects.
|This determination represents a professional judgement based on critical data which ATSDR considers sufficient to support a decision. This does not necessarily imply that the available data are complete; in some cases additional data may be required to confirm or further support the decision made.||Evaluation of available relevant information* indicates that, under site-specific conditions of exposure, exposures to site-specific contaminants in the past, present, or future are not likely to result in any adverse impact on human health.|
|E: No Public Health Hazard
This category is used for sites that, because of the absence of exposure, do NOT pose a public health hazard.
|Sufficient evidence indicates that no human exposures to contaminated media have occurred, none are now occurring, and none are likely to occur in the future|
*Such as environmental and demographic data; health outcome data; exposure data; community health concerns information; toxicologic, medical, and epidemiologic data; monitoring and management plans.
NEW YORK STATE DEPARTMENT OF HEALTH
October 3, 1991
Office of Public Health
Linda A. Randolph, M.D., M.P.H., Director
Sue Kelly, Executive Deputy Director
Enclosed is a copy of the report describing the recently completed cancer investigation for census tracts 1117.03, 1117.04, 1118.02, 1118.03, 1351.01, 1351.02, 1347.02 and 1108.02 in East Northport, Commack and King's Park, NY. The study area was defined to include areas where you indicated that citizens were concerned about the possibility of health effects caused by the proximity of Huntington Landfill.
The study focused on the years 1978 through 1987, which is the most recent period for which cancer reporting is complete for small area analysis. In summary, the number of newly diagnosed cancer cases was similar to expected among females. Among males, a statistically significant excess of cases was observed.
The specific sites of cancer that showed statistically significant elevations were malignant melanoma in males and females, colon cancer among males, leukemia among males, breast cancer among females and lung cancer among females.
Malignant melanoma, breast and colon cancer are known to be more common in areas of higher socioeconomic status. The median household income for the study area is higher than that of Nassau County and considerably higher than that of New York State as a whole. When cancer cases for those sites showing a statistically significant excess were plotted on a map, no obvious spatial clustering was seen around the landfill or in the area of groundwater contamination. Risk factors for these cancers are discussed in the report and the summary.
If you have any questions about this report, please contact Carole Ju of my staff at (518) 458-6212.
James M. Melius, M.D., Dr. P.H.
Division of Occupational Health and Environmental Epidemiology
NEW YORK STATE DEPARTMENT OF HEALTH
CANCER INCIDENCE IN CENSUS TRACTS 1117.03,
1117.04, 1118.02, 1118.03, 1351.01, 1351.02, 1347.01, 1347.02, 1108.02,
EAST NORTHPORT, SUFFOLK, NEW YORK, 1978-1987
- The expected number of newly-diagnosed cancer cases, by sex and location of cancer in the body, was calculated based on the age and sex distribution of persons in the study area.
- The actual observed number of newly-diagnosed cancer cases, by sex and location of cancer in the body, was counted from New York State Cancer Register records.
- Among males overall, a statistically significant excess of cases was observed for newly-diagnosed cancer cases (634 cases observed, 563 cases expected). Among females, there was no statistically significant difference between the overall number of newly-diagnosed cancer cases and the number expected (674 cases observed, 633 cases expected). Specific cancer sites where differences were observed are identified below.
Male Cancer Cases
- A statistically significant excess of cases was observed for cancer of the colon (87 cases observed, 62 cases expected); for malignant melanoma (31 cases observed, 16 cases expected); and for leukemia (30 cases observed, 18 cases expected).
- The excess in colon cancer found in males was not present in females. Colon cancer incidence increases with age. Persons with a family history of polyps or a personal history of inflammatory bowel disease are at increased risk of developing colon cancer. A high intake of dietary fat has been linked with increased incidence, while diets rich in fruits, vegetables and dietary fiber appear to reduce colon cancer risk. Increased colon cancer incidence has also been reported among more affluent persons.
- Malignant melanoma of the skin is known to be related to sun exposure and is more common among individuals with light skin. The anatomic distribution of malignant melanoma cases demonstrates the influence of exposure to sunlight, with cases in males most frequently occurring on the head, neck and trunk and on the leg in females. Among both males and females in the study area, the anatomic distribution of cases was consistent with this pattern. Malignant melanoma occurs more often among higher socioeconomic groups.
- The excess of leukemia among males was not observed in females. No excess was found in either males or females for any single age group. A number of risk factors have been identified for the leukemias. These include certain genetic conditions, exposure to ionizing radiation, benzene and other solvents, and certain anti-cancer drugs. No obvious spatial clustering around the landfill or in any other location was apparent. Only one of the thirty cases resided in the census tract containing the landfill, and only one case resided in the area of groundwater contamination, in an adjoining census tract.
- With the exception of those noted above, no other type of cancer among males was found to demonstrate a significant excess of deficit of cases.
Female Cancer Cases
- A statistically significant excess of cases was observed for malignant melanoma (23 cases observed, 14 cases expected); for cancer of the breast (217 cases observed, 184 cases expected) and for cases of lung cancer (78 cases observed, 59 cases expected).
- Risk factors for breast cancer include age, family history of breast cancer, age over 30 at first childbirth, never carrying a pregnancy to term, personal history of fibrocystic breast disease, obesity, urban residence, white race and high socieconomic status. Consistent with increases seen at the Country, State and National levels, the number of breast cancer cases diagnosed in the last five years of the study was higher than the number of cases diagnosed during the first five years. However, the increased in breast cancer cases in the latter five year period can be account for, almost entirely, by an increase in the numbers of breast cancers detected at the localized or "early" stage. This may be indicative of the increased level of breast cancer screening in this area.
- Lung cancer among males and females was greater than expected. Only among females was this difference statistically significant. Risk of lung cancer is greatly increased among smokers, with about 85% of all lung cancer attributable to cigarette smoking. Among those diagnosed with lung cancer, 50% of males and 53% of females were smokers at the time of diagnosis. An additional 39% of males and 21% of females were former smokers at diagnosis. The smoking rates of those diagnosed with lung cancer is much higher than that observed in the general population.
- With the exception of those noted above, no other type of cancer among females was found to demonstrate a significant excess or deficit of cases.
- Of the cancers found to be in excess, malignant melanoma, breast cancer and colon cancer are known to be more common in areas of higher socioeconomic status. Based on estimates from the 1980 US Census the median household incomes for all census tracts in the study area were higher than the Suffolk County median household income and considerably higher than the New York State median household income.
- Observed and expected numbers of cases of those cancer sites in excess were computed for the individual census tracts. No unusual patterns were observed in any census tract, with the exception of Census Tract 1347.02, where statistically significant excesses were observed in numbers of lung cancer cases among both males and females. This census tract does not contain the landfill, and it has not been found to show groundwater contamination. It is, however, the census tract with the lowest median family income of the nine tracts included in this investigation. Lung cancer incidence is often observed to be greater in areas of lower socioeconomic status, due to a high prevalence of cigarette smoking.
For further information on the occurrence of cancer of for additional questions regarding this investigation, please contact Dr. Philip C. Nasca or Ms. Mary Chris Schultz, New York State Department of Health, Cancer Surveillance Program, at 518-474-2354.
CANCER INCIDENCE IN CENSUS TRACTS 1117.03,
1117.04, 1118.02, 1118.03, 1351.01, 1351.02, 1347.01, 1347.02,
EAST NORTHPORT, SUFFOLK COUNTY, NEW YORK
Prepared by the:
Cancer Surveillance Program
Bureau of Cancer Epidemiology
New York State Department of Health
with the assistance of
New York State Cancer Registry staff
For further information please contact:
Philip C. Nasca, Ph.D.
Director, Cancer Surveillance Program
In January of 1990, the Cancer Surveillance Program of the New York State Department of Health received a request from the Department's Bureau of Environmental and Occupational Epidemiology to conduct a study of cancer incidence in the area of the Huntington Landfill in East Northport, Suffolk County. The Bureau of Environmental and Occupational Epidemiology had been made aware of a number of health concerns among residents living near the site. In additional, the federal Agency for Toxic Substances and Disease Registries has been compiling a health assessment for the population residing in the vicinity of the landfill. This report presents the findings of the Cancer Surveillance Program of the Bureau of Cancer Epidemiology with regard to cancer incidence in nine tracts surrounding the landfill.
Study Area: The study area was defined as Census Tracts 1117.03, 1117.04, 1118.02, 1118.03, 1351.01, 1351.02, 1347.01, 1347.02, and 1108.02 in Suffolk County, which includes persons residing in East Northport, Northport, Commack, and Kings Park (see attached map). The time period for the investigation of cancer incidence was selected as 1978 through 1987, the most recent period for which cancer reporting was considered complete for analysis within small geographic areas at the time this study was initiated.
Identification of Observed Incidence Cancers: In order to proceed with the investigation it was necessary to identify all cases of cancer diagnosed among residents of the study area between 1978 and 1987. The source for these data was the New York State Cancer Registry. The Cancer Registry contains information on all cases of cancer reported to the New York State Department of Health, as mandated by law.
Variation in cancer incidence among different geographic areas reflects not only true differences in cancer incidence, but also the practices of diagnosing, treating, and recording cancers in various areas in the state. The completeness and accuracy of the Cancer Registry depend upon reporting from hospitals. It is estimated that over 95% of all cancer cases are reported to the Registry (1).
The computerized Cancer Registry files are continuously updated to reflect multiple reports on the same cancer; to eliminated metastatic cancers which spread from a primary site; to identify true multiple primary cancers; and to determine correct dates of diagnosis. Cancer incidence data presented in this report represent cancer cases diagnosed from 1978 through 1987 with information updated as of August 1990.
A listing of cases by street name was obtained for the East Northport area. The address of each case was examined to determine whether the person resided in the study area at the time of diagnosis. All cases with a street address located within the study area were grouped by tumor site, sex, and age. These are referred to as "observed" cases.
Calculation of Expected Incident Cancers: In order to determine whether the number of observed cases was unusual, it was necessary to calculate the number of cancer cases that would be expected in an area with the same population size, and age and sex composition as the study area. Since cancer incidence varies between urban and rural areas, this calculation also considered the population density (the number of residents per square mile) of the study area. This was accomplished using standard cancer rates based on population density categories to generate expected numbers of cancer cases.
All of the cities and towns of New York State, exclusive of New York City, have been assigned to one of five population density categories based on the number of residents per square mile in 1980. Group I (urban) contains areas with the highest population density, while areas with the lowest population density comprise Group V (rural). The towns containing the study area are in Group III (suburban).
According to the 1980 United States Census, the total population of the study area was 40,632 persons, with 19,824 males and 20,808 females. Cancer incidence rates by age and sex for suburban areas of New York State, exclusive of New York City, for the years 1978-1982 were used to calculate the expected numbers of cases for the more common cancer sites and for all sites combined. This procedure allowed the calculation of expected numbers of cancer cases after adjustment for differences in sex, age, and population density among residents of the study area.
Sixteen of the most common cancer sites were examined among males, including lung, colon, rectum, prostate, and bladder, and lymphomas and leukemias. Eighteen of the most common sites were examined among females. In addition to the aforementioned sites (except prostate), cancers of the breast and female reproductive organs were also included.
Statistical Testing: The Poisson model was used to determine the probability that chance alone could explain an increase or decrease in the observed number of cancer cases compared to the expected number (2). If the probability of observing an excess or deficit was 0.025 or less for any cancer site, it was considered to be statistically significant. Non-significant excesses or deficits were considered to represent random variations in observed patterns of disease.
A total of 1308 cancers were observed among males and females residing in the study area during the 1978-1987 study period. In males, 634 cancer cases were observed and 563 cases were expected, while among females 674 cancer cases were observed and 663 cases were expected for all anatomic sites combined. Among males, the excess in numbers of observed cancer cases compared with the expected number was statistically significant. Numbers of observed cancer cases were not significantly different from expected numbers among females. These results are summarize in Table 1.
Common cancer sites among males included lung with 127 cases observed (121 cases expected); colon, 87 cases observed (62 cases expected); prostate, 62 cases observed (67 cases expected); bladder, 48 cases observed (45 cases expected); rectum, 35 cases observed (30 cases expected); malignant melanoma of the skin, 31 cases observed (16 cases expected); leukemias, 30 cases observed (18 cases expected); lymphomas, 29 cases observed (28 cases expected); stomach, 26 cases observed (18 cases expected); oral cavity, 23 cases observed (21 cases expected); brain, 17 cases observed (11 cases expected); pancreas, 14 cases observed (17 cases expected); kidney, 12 cases observed (17 cases expected); testis, 10 cases observed (9 cases expected); and liver, 6 cases observed (5 cases expected). Fewer than six cases were observed for other common sites of cancer. (For cancer sites with fewer than six observed cases, the specific number of observed cases has not been indicated to protect patient confidentiality.)
Common cancer sites among females included breast with 217 cases observed (184 cases expected); lung, 78 cases observed (59 cases expected); colon, 56 cases observed (71 cases expected); rectum, 32 cases observed (25 cases expected); uterus, 31 cases observed (43 cases expected); lymphomas, 27 cases observed (25 cases expected); malignant melanoma of the skin, 23 cases observed (14 cases expected): ovary, 21 cases observed (28 cases expected); pancreas, 20 cases observed (18 cases expected); stomach, 19 cases observed (13 cases expected); bladder, 19 cases observed (16 cases expected); oral cavity, 14 cases observed (12 cases expected); leukemias, 14 cases observed (15 cases expected); uterine cervix, 12 cases observed (15 cases expected); kidney, 11 cases observed (9 cases expected); thyroid gland, 11 cases observed (10 cases expected); and brain, 10 cases observed (10 cases expected). Fewer than six cases were observed for several other cancer sites.
Within specific anatomic sites of cancer, significant excess were observed among males for cases of colon cancer (87 cases observed, 62 cases expected), malignant melanoma of the skin (31 cases observed, 16 cases expected) and leukemias (30 cases observed, 18 cases expected) and among females for cases of lung cancer (78 cases observed, 59 cases expected), malignant melanoma of the skin (23 cases observed, 14 cases expected) and breast cancer (217 cases observed, 184 cases expected). With the exception of the excesses noted above, no other cancer site among males or females was found to demonstrate a significant excess or deficit of cases.
In drawing conclusions from these data, several aspects of the methodology need to be addressed. First, since there were 36 individual tests of significance (16 among males, 18 among females and 1 each among males and females overall), it was anticipated that one or two results might appear statistically significant even though the differences between observed and expected events were due entirely to random fluctuations in the data.
The second aspect is the power of the statistical test, that is, the probability that a true departure from the expected number can be detected by significance testing. The power of a significance test varies with the number of expected cases. For example, using the statistical test described above, the probability of detecting a true doubling in cancer incidence over the expected value will be 90 percent or higher when the expected number is at least 16. For this investigation, the power of detecting a doubling was high for the total number of cancer cases for each sex and for most common cancer sites.
An additional limitation is the fact that cancer cases were identified among persons who both resided in the study area and were diagnosed with cancer during the period 1978-1987. Migration into and out of the study area could not be taken into account. As a secondary data source, US Census information for 1980 was used to review patterns of migration in the study area, as well as in all of Suffolk County, based on the length of time residents had reported residing at their 1980 residence. About 76% of study area residents over the age of 5 have resided in the same house for at least five years. This compares to 67% of Suffolk county residents over the age of 5 who have resided in the same house for at least five years. Although a somewhat greater proportion of study area residents than residents of the county as a whole had resided in the same house for at least five years, a sizeable proportion were still recent arrivals, suggesting that the population continues to be mobile and indicating that migration may be an issue for this area. Census data are not available to measure more recent migration occurring between 1980 and 1987, the most recent year included in this study.
Malignant melanoma: The present study found significant excesses in numbers of malignant melanomas of the skin among both males (31 cases observed, 16 cases expected) and females (23 cases observed, 14 cases expected). One of the strongest risk factors for malignant melanoma of the skin is sun exposure. As with other skin cancers, malignant melanoma of the skin is more common among light-skinned people, and incidence is greatest in regions closest to the equator. The incidence of malignant melanoma has been observed to be greater in persons of higher socioeconomic status, with some indication that the disease may be more common among persons who work indoors than among persons who work outdoors. Some melanomas can develop from abnormal changes in moles on the skin, and in some families this tendency appears to be hereditary (3,4). When detected at an early stage, malignant melanomas of the skin are highly curable.
The incidence of malignant melanoma of the skin in both males and females has been rising steadily in recent years, both in the nation as a whole (5) and in New York State (6), although in the study area numbers of cases were approximately equal in the first and the last five years of the study period. It has been reported (4) that malignant melanomas occur more frequently on the head and neck and trunk among males, and on the leg in females. The anatomic distribution of malignant melanoma cases among males and females in the study area was consistent with expected.
Colon cancer: Among males in the study area, a significant excess was found in cases of colon cancer (87 cases observed, 62 cases expected). This excess was not present in females (56 cases observed, 71 cases expected). The risk of colon cancer is influenced by personal, genetic, and dietary factors. Colon cancer incidence increases with increasing age (3,7). Persons with a family history of polyps of the colon are at risk of developing colon cancer; incidence is also increased among persons with a history of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease (3,7). In addition, a high intake of dietary fat has been linked with increased colon cancer incidence, while diets rich in fruits, vegetables, and dietary fiber appear to reduce colon cancer risk (3,7). Increased colon cancer incidence has also been reported among more affluent persons (7).
Early detection of colon cancer is generally considered to be beneficial in improving chances for survival, although there are at present no firm recommendations regarding the use of specific colon cancer screening procedures. Information on state of disease at time of diagnosis was available for 79 of the 87 cases of colon cancer among males. Of these, 49% were diagnosed at a localized state, 20% were diagnosed at a region stage, and 30% were diagnosed at a distant stage. (Localized disease is confined to the colon, regional disease has spread beyond the colon to nearby organs, while distant disease has spread throughout the body.) Among males in New York State, exclusive of New York City, for 1976-1987, the respective staging proportions were 36%, 34%, and 30%, indicating a more favorable experience among men in the study area, at least with regard to localized and regional disease. This suggests that men in the study area may be undergoing screening procedures or recognizing early symptoms of the disease more frequently.
Leukemias: A significant excess was also found in cases of leukemias among males (30 cases observed, 18 cases expected) but not among females (14 cases observed, 15 cases expected), There are both chronic and acute forms of leukemia, each with unique disease patterns. Acute forms of leukemia commonly occur among persons of all ages, while chronic forms of leukemia are most commonly diagnosed among persons over age 50. The incidence of the acute forms of leukemia generally shows two peaks with age: one in children under the age of 5 and the second, larger peak in the elderly (3,8). The patterns of leukemia in the study area were generally consistent with expected, with no excess in any single age group in either males or females.
A number of risk factors have been identified for the leukemias. Among these are genetic conditions (e.g. Philadelphia chromosome, Down's syndrome), exposure to ionizing radiation, and exposures to benzene and other solvents and to certain anti-cancer drugs (3,8). At least one rate type of leukemia has been associated with a virus (3).
To further explore the distribution of leukemia cases within the study area, cases of leukemia among males and females were plotted on a map. A plume of contaminated groundwater extends from the Huntington Landfill to the northeast. Several private drinking water wells had been found to be contaminated with organic solvents, resulting in extension of the public water supply to these areas. No obvious spatial clustering of cases around the landfill or in any other location was apparent. Only one of the thirty cases resided in the census tract containing the landfill, and only one other case resided in the census tract containing the landfill, and only one other cases resided in the area of groundwater contamination, in an adjoining census tract.
Many of the known and suspected risk factors for leukemia may be encountered in an occupational setting. To address this issue, cancer case reports and, where available, death certificates, were examined for male and female leukemia cases for information on occupation. Of the 33 cases for whom such information was available, eight had occupations which put them at risk for possible occupational exposures to petrochemicals, organic solvents, or ionizing radiation.
Breast cancer: Among females in the study area, a significant excess of breast cancers was observed (217 cases observed, 184 cases expected). Breast cancer is the most common form of cancer among women in the United States. Risk of breast cancer increases as a woman grows older, and it is now estimated that about 1 out of every 10 women will develop breast cancer at some time in her life (5).
Breast cancer has been widely studied. Current knowledge suggests that many variables act together in determining one's risk for the disease. Aside from age, breast cancer has been associated with a family history of breast cancer, being older than age 30 at the birth of the first child or never having carried a pregnancy to term, a personal history of fibrocystic breast disease, obesity, living in an urban area, and white race. The incidence of breast cancer is also grater in more affluent areas (9). Based on estimates from the 1980 US Census, the median household income in 1979 for the nine census tracts in the study area ranged from $22,950 to $33,360, with seven of the tracts having median incomes above $28,000. Median incomes for all tracts were higher than the Suffolk County median household income of $22,359 and the New York State median household income of $16,647.
Examination of age at breast cancer diagnosis showed statistically significant excess of cases among women in the 25-34 and the 55-64 age groups. A total of 96 cases were diagnosed during the first five years of the study period, while 121 cases were diagnosed during the last five years. In Suffolk County, the average annual age-adjusted breast cancer incidence rate has increased from 84 per 100,000 females during the period 1978 through 1982 to 97 per 100,000 females for 1983 through 1987. In New York State excluding New York City, rates increased from 85 to 95 per 100,000 over these two periods.
Stage of breast cancer at the time of diagnosis can have important implications for long-term survival. Staging information was available for 207 of the 217 breast cancer cases identified in this investigation. Of these, 52% were diagnosed at a localized stage, 14% at a regional stage, and 35% at a distant stage. These figures are somewhat less favorable than the overall stage distribution for breast cancer cases diagnosed 1978-1987 in New York State, excluding New York City, where the respective staging proportions were 52%, 31% and 17%. The increase in breast cancer cases in the study area from 96 cases in 1978-1982 to 121 cases in1983-1987 can be accounted for almost entirely by an increase in numbers of breast cancers detected at the localized stage, which rose from 39 to 68. This may be indicative of an increased level of breast cancer screening among some women in the area, since screening tends to detect cancers at an earlier stage while others may be delaying diagnosis as evidenced by the high incidence of distant disease.
Early detection of breast cancer, through a combination of clinical breast examination and mammography, followed by prompt treatment, can aid in improving the chances for survival. A number of studies from Europe and this country have consistently demonstrated reduced mortality in populations of women screened with routine mammography, a low-level X ray of the breast. Guidelines for breast cancer screening among women not exhibiting symptoms include 1) monthly breast self-examination after age 20; 2) "baseline" mammography at age 40 or earlier on the advice of a physician; 3) mammography and clinical examination every second year between ages 40 and 50; 4) annual mammography and clinical examination after age 50; and 5) individualized, more intensive screening for women who are at high risk of contracting the disease.
Lung cancer: Among females, a significant excess of lung cancer cases was also observed (78 cases observed, 59 cases expected). Lung cancer among males was also greater than expected (127 cases observed, 120 cases expected), but this excess was not statistically significant. The risk of developing lung cancer is greatly increased among smokers, with about 85% of all lung cancers attributable to cigarette smoking (3).
Lung cancer cases in the study area may be related to smoking habits among individuals with this malignancy. Information on smoking status is reported to the New York State Cancer Registry as part of the standard cancer case report. This information is more complete during more recent years. Among individuals in the study area who developed lung cancer between 1978 and 1987 fro whom smoking status could be ascertained, 50% of males and 53% of females were identified as current smokers and an additional 39% of males and 21% of females were former smokers at the time of diagnosis. The smoking rates observed among the lung cancer patients are much higher than those observed in the general population. Data from a 1987 national survey indicated that 31% of males and 26% of females were current smokers and an additional 29% of males and 17% of females were former smokers (10).
Although all major lung cancer cell types have been associated with cigarette smoking, certain lung cancer cell types have been observed to be more strongly associated with cigarette smoking than others (11). For the 139 male and female lung cancer cases for which a specific cell type was reported,117 (84%) were one of the types most strongly associated with cigarette smoking, and 16 (12%) other cases were of cell types thought to be less strongly associated with cigarette smoking. The remaining six cancers were distributed among four less common cell types.
Brain cancer: Although not statistically significant, an excess of cases was observed for brain cancer in males (17 cases observed, 11 cases expected). Numbers of cases were not elevated in females (10 cases observed, 10 cases expected). Since brain cancer has been associated with (occupational) exposures to vinyl chloride and vinyl chloride has been detected in the methane gas collection system for the Huntington landfill, these observed cases were also examined in some detail.
The incidence of primary brain tumors typically is slightly greater in males than females. Incidence generally exhibits a small peak in childhood, followed by a higher peak between the ages of 60 and 80 years (12). The observed incidence of brain cancer in the study area is consistent with this pattern, with the exception of a statistically significant excess in numbers in cases among males age 25-34. No other age group in males or females showed a statistically significant excess or deficit of cases. When the addresses of the brain cancer cases were plotted on a map of the study area, there was no obvious spatial clustering of cases around the landfill. Three of the 27 cases resided in the census tract containing the landfill, although these were all at the other end of the tract in an area upstream of groundwater flow. None of the brain cancer cases resided in the area of groundwater contamination downgradient of the landfill.
Comparatively little is known about the causes of brain tumors. They have been associated with certain hereditary conditions, as well as occupational exposures including vinyl chloride, petroleum products, and rubber manufacturing. There is also some evidence for a viral origin of nervous system tumors, as well as associations with head trauma (in women) and lead and X-ray exposures in children (12). Examination of the cancer case reports and, where available, death certificates from cases of brain cancer in this study showed that, of the 24 cases for whom an occupation could be determined, four worked in occupations with potential exposures to agents that have been linked with brain cancer.
As an additional check on the possible relation of the observed cancer excesses with the Huntington landfill, observed and expected numbers of cases of those cancer sites in excess were computed for the individual census tracts. No unusual patterns were observed in any census tract, with the exception of Census Tract 1347.02, where statistically significant excesses were observed in numbers of lung cancer cases among both males and females. This census tract does not contain the landfill, and it has not been found to show groundwater contamination. It is, however, the census tract with the lowest median family income of the nine tracts included in this investigation. Lung cancer incidence is often observed to be greater in areas of lower socioeconomic status, due to a higher prevalence of cigarette smoking. Although the income for this census tract is close to the county average, income levels may not be such a reliable indicators of socioeconomic status in areas, such as Long Island, with a higher cost of living relative to the remainder of the state. Investigation into this excess is continuing, however it is not likely that the excess is related to the landfill.
General cancer information: Cancer may result from either genetic or environmental influences or an interaction of both genetics and environment (e.g. diet, social habits, occupation, air, water). Furthermore, it appears that for some cancers, the development of disease may depend upon two kinds of exposures. First, a cancer initiating agent must transform a previously normal cell into a cancerous cell. Subsequently, a cancer promoting agent must be present, allowing uncontrolled growth of this cell. For many cancers, it has been observed that exposures to cancer-causing agents only affect cancer incidence following a relatively long latency period. (In cancer, latency refers to the time between the initiation of the disease process and the onset of clinically recognizable symptoms.) Cancer-causing agents believed to act as initiators often exhibit latencies on the order of at least 10 and sometimes 20 or 30 years. Latency may be shorter, however, if the agent were to act as a cancer promoter.
Cancer, unfortunately, is a common disease. One of every three persons will develop cancer during his/her lifetime, and it eventually affects three of every four families (5). The number of people with cancer is increasing in most communities because more people are living to the older ages, where cancer is more common.
Much more research is necessary before the causes of cancer are well understood. Current knowledge, however, suggests that the leading preventable cause of cancer is cigarette smoking. Dietary practices such as excessive alcohol consumption and the eating of high fat foods are also believed to be important. In fact, tobacco and diet may account for as many as two-thirds of all cancer deaths (13). Other avoidable risk factors include excessive exposure to sunlight, ionizing radiation, and various occupational exposures to cancer-causing agents.
It is important to realize that many cancers can be effectively treated if they are diagnosed at an early stage. Screening for cancers of the breast, cervix, rectum, colon, and prostate, for example, helps to identify these diseases before the onset of symptoms and at a time when they are usually the most curable. Many persons could reduce their chances of developing or dying from cancer by adopting a healthier lifestyle and by visiting their physician for a cancer-related checkup.
- Burnett WS, et al. Cancer Incidence by County: New York State 1978-1982. New York State Department of Health, 1987.
- Molina EC. Poisson's Exponential Binomial Limit. Huntington, NY: Robert E. Krieger Co., 1973.
- Page HS and Asire AJ. Cancer Rates and Risks. US Department of Health and Human Services, NIH Publ No. 85-691, 1985.
- Lee JAH. Melanoma, in Schottenfeld D and Fraumeni JF, (eds). Cancer Epidemiology and Prevention. Philadelphia: WB Saunders, 1982.
- American Cancer Society. Cancer Facts and Figures. New York: American Cancer Society, 1990.
- Wolfgang PE, et al. Time Trends in Cancer Incidence 1977-1986. New York State Department of Health, 1990.
- Schottenfeld D and Winawer SJ. Large intestine, in Schottenfeld D and Faraumeni JF, (eds). Cancer Epidemiology and Prevention. Philadelphia: WB Saunders, 1982.
- Heath C. The leukemias, in Schottenfeld D and Fraumeni JF, (eds). Cancer Epidemiology and Prevention. Philadelphia: WB Saunders, 1982.
- Kelsey JL. A review of the epidemiology of human breast cancer. Epidemiologic Reviews 1:74-109, 1979.
- US Department of Health and Human Services. Smoking, Tobacco and Cancer Program. 1985-1989 Status Report. US Department of Health and Human Services, NIH Publ No. 90-3107, 1990.
- Fraumeni JF and Blot WJ, Lung and Pleura, in Schottenfeld D and Fraumeni JF, (eds). Cancer Epidemiology and Prevention. Philadelphia: WB Saunders, 1982.
- Schoenberg BS, Nervous System, in Schottenfeld D and Fraumeni JF, (eds). Cancer Epidemiology and Prevention. Philadelphia: WB Saunders, 1982.
- Doll R and Peto R. The Causes of Cancer. Oxford: Oxford University Press, 1981.
Table 1. BUREAU OF CANCER EPIDEMIOLOGY, NEW YORK STATE DEPARTMENT OF HEALTH
Observed and Expected Numbers of Incident Cancer Cases,
All Sites (140-208), Census Tracts 1117.03, 1117.04, 1118.02, 1118.03, 1351.01, 1351.02, 1347.01, 1347.02, 1108.02,
Suffolk County, New York, 1978-1987
Quintile III (Suburban), 1978-1982 Standard
|All Sites (140-208)||634d||563||674||633|
|Oral Cavity (140-149)||23||21||14||12|
|Female Breast (174)||-||-||217d||184|
|Uterus (179, 182)||-||-||31||43|
|All Other Sites||77f||73||59f||63|
|a Classification of site based
on International Classification of Diseases, ninth revision.
b Data obtained from the New York State Cancer Registry (database as of August 1990).
c Expected numbers based on cancer incidence rates by age and sex for suburban areas of New York State exclusive of New York City, 1978-1982, applied to the 1980 populations of Census Tracts 1117.03, 1117.04, 1118.02, 1118.03, 1351.01, 1351.02, 1347.01, 1347.02, 1108.02 in Suffolk Country. Individual sites may not sum to total due to rounding.
e Number of cases not shown to protect patient confidentiality.
f Includes cases not shown above.
Summary of Public Comments and Responses
Huntington Landfill Public Health Assessment
This summary was prepared to address comments and questions on the public comment draft of the Huntington Landfill Public Health Assessment. The public was invited to review the draft during the public comment period which ran from September 1 to November 15, 2000. We received 10 written comments from residents and a concerned public agency. Similar comments may be consolidated or grouped together and some statements reworded to clarify the comment. If you have any questions about this summary, you may contact the New York State Department of Health's (NYS DOH) Outreach Unit at the toll-free number: 1-800-458-1158.
Comment #1 - A resident would like the sediment and fish samples collected on a quarterly basis from the Sunken Meadow Creek.
Response #1 - Surface water samples were collected from the Sunken Meadow Creek once in 1994, then semi-annually starting in 1996. Since collection of surface water samples began, volatile organic chemical (VOC) contaminants related to the site have been detected at levels of 1.0-6.9 micrograms per liter (mcg/L). Chloride and sulfates were the only inorganic parameters (landfill leachate indicators) detected at levels exceeding New York State Department of Environmental Conservation surface water standards. However, the elevated levels of chloride and sulfate are detected in surface water samples collected within the tidal portion of the Sunken Meadow Creek and thus are believed to be affected by saline water. Sediment samples were collected from Sunken Meadow Creek in 1994. Contamination related to the site was not detected. Since the level of site-related contaminants detected in surface water is sufficiently low so as not to represent an exposure concern for potential bathers or for people eating fish, further monitoring of sediments and monitoring of fish from the creek are not warranted.
Comment #2 - A resident would like the upper glacial aquifer to be monitored on a quarterly basis.
Response #2 - Since 1996, groundwater samples have been collected on a semi-annual basis from eleven monitoring wells developed in the shallow, middle and deep zones of the upper glacial aquifer. The results of the most recent sampling event in April of 2002 detected volatile organic compounds and inorganic parameters above New York State Department of Health public drinking water standards/guidelines in nine of the eleven monitoring wells. Sodium was the only parameter exceeding NYS DOH guidelines in three of these nine wells. In review of the monitoring well data, contaminant levels in the groundwater monitoring wells have not increased over time. Exposure to site-related contaminants in drinking water is unlikely since homes and businesses with wells contaminated or threatened by the contaminant plume migrating from the landfill have been connected to public water. Considering the existing groundwater monitoring well data and the elimination of potential drinking water exposures through connection to public water, an increase in the frequency of groundwater monitoring of the Upper Glacial Aquifer is not necessary.
Comment #3 - A concerned public agency and a resident requested monitoring of the landfill gasses and ambient air to determine if site-related contaminants are migrating off-site in concentrations that represent a health concern.
Response #3 - During the investigation of this site, the industrial source complex (ISC) dispersion model was used to evaluate potential exposure to airborne contaminants migrating from the landfill. Using the concentration of a contaminant measured at the pollutant source, the ISC model considers meteorological and topographical conditions to predict annual average concentrations of a contaminant potentially present at an on-site or off-site receptor location. The maximum annual contaminant levels predicted were below background ambient air concentrations reported in US EPA's "National Ambient Volatile Organic Compounds (VOCs) Data Base." Based on the ISC modeled data, non-cancer health risks are minimal, and the excess lifetime cancer risk associated with exposure to air contaminants are very low (equal to or less than one in a million) for employees (on-site workers) and residents living at the maximally impacted off-site location.
In 1996, landfill gas samples for specific volatile organic compound (VOC) analysis were collected for use in the ISC model. Additional rounds of landfill gas samples were analyzed for VOCs in 1998, 1999 and 2001. The level of VOCs detected in these subsequent sampling events are comparable to those from 1996, and indicates that additional landfill gas control measures are not necessary. Collection of landfill gas samples for VOCs will be conducted on an annual basis. The results of these samples will be reviewed by the NYS DOH and the NYS DEC to determine if there is an increase in contaminant levels and if additional control measures are necessary.
Comment #4 - A resident would like to know the rate at which the contaminant plume is traveling per year, if residential wells are within the path of the plume and if the plume has reached Long Island Sound.
Response #4 - The contaminant plume migrating from the landfill is traveling northeast essentially at the rate of groundwater flow which was determined during the groundwater investigation to be between 0.7 to 1.0 feet per day in the Upper Glacial aquifer. Northeast of the site, Sunken Meadow Creek serves as a zone of shallow groundwater discharge. Based on groundwater model simulations, leachate impacted groundwater will discharge to Sunken Meadow Creek. Field data support this conclusion. If, however, any contaminants did reach Long Island Sound, the dilution factor would be significant and thus minimize any effect of plume discharge. All residences downgradient from the landfill with wells contaminated or threatened by the contaminant plume have been connected to public water.
Comment #5 - A public agency is concerned that ammonia was not included in the sampling program and that there is no discussion of dioxins and furans in the report.
Response #5 - Groundwater and the surface water in Sunken Meadow Creek are sampled on a semi-annual basis for organic and inorganic parameters including ammonia. Although ammonia has been detected in elevated levels in some of the groundwater monitoring wells downgradient from the landfill, exposure to ammonia or other site-related compounds in drinking water is not likely since homes and businesses downgradient from the landfill are connected to public water. Ammonia has not been detected in elevated levels in surface water samples from the Sunken Meadow Creek. Dibenzodioxins (DBDs) and dibenzofurans (DBFs) can be produced as byproducts of incomplete incineration. While we recognize that DBDs and DBFs were most likely present in the incinerator ash placed in the landfill, samples were not specifically analyzed for these compounds. When the former area of ash disposal was remediated in 1989, all ash and soil potentially contaminated with DBDs and DBFs were excavated and placed under the landfill cap.
Comment #6 - A concerned public agency believes that additional leachate samples should have been collected to determine if the elevated level of metals detected in the samples were attributable to site activities or to sample acidification as indicated in the PHA.
Response #6 - As indicated in the PHA under the "Environmental Contamination and Other Hazards" Section, sub-section A, "On-site contamination", Landfill Leachate, since surface outbreaks of leachate were not evident at the time of the investigation, samples were obtained by digging into the fill area to expose an inactive subsurface drain. Due to the high turbidity of the resulting samples, it is likely that acidification of the samples for preservation leached (dissolved) some fraction of the metals from the particulates into the liquid phase of the sample, thus increasing the level of contamination. Filtration of the sample to remove particulates before preservation would have helped to determine actual levels of metals dissolved in the liquid, however, this was not done.
The cap constructed on the landfill controls the generation of leachate and prevents the possibility of direct exposure to leachate on-site. Since homes and businesses downgradient from the landfill have been connected to public water, exposure to leachate contaminated drinking water is not expected.
Comment #7 - One resident was concerned about the quality of their drinking water since a plumber working in the residence found holes in some of the copper water lines.
Response #7 - NYS DOH staff called the homeowner and determined the residence in question was connected to public water. Staff explained that since the residence was connected to public water when the home was constructed, exposure to site-related contaminants in drinking water is unlikely. The SCDHS was asked to contact the homeowner so that any concerns about the public drinking water supply could be addressed. The homeowner was provided with SCDHS contact names and telephone numbers and the NYS DOH toll-free telephone number should they have further concerns or questions.
Comment #8 - Two residents have concerns about the higher then expected rate of some cancers observed in 1978 - 1987 for the census tracts including and surrounding the landfill and would like to know the 1987 - 1997 cancer specific rates for the study area.
Response #8 - The cancer study for the years 1978 through 1987 for the area near the landfill evaluated cancer rates in census tracts (Appendix E). For the more recent time period 1987 to 1997, this information is not routinely available at the census tract level. However, the NYS DOH Cancer Surveillance Improvement Initiative has produced maps showing comparative cancer incidence in ZIP codes for the four most frequently diagnosed types of cancer; breast, lung, colorectal, and prostate for five recent years. The ZIP codes that contain the census tracts used in the earlier study are 11768, 11754, 11731 and 11725. These maps are available at the NYS DOH website, www.health.state.ny.us.
The ZIP code level cancer maps show that for lung cancer, the observed number of cases among females in the 11754 ZIP was 15-49% above the expected number. For the other ZIP codes, the lung cancer rates for males and females were below or within 15% of expected. The expected number is calculated using the population size and age distribution in each ZIP code and applying it to the age-specific rate for that type of cancer in the state as a whole. The observed number is the number of cases diagnosed among residents of the ZIP code. (Information on cancer diagnoses is mandated by law to be reported to the NYS Cancer Registry.)
The colorectal maps show that males and females in 11725, and males in 11731, showed rates that were 15 to 49% above expected. The rates for colon and rectal cancers for the other ZIP codes were below or within 15% of expected. For breast cancer, one ZIP code, 11768 showed a 15 to 49% elevation of observed cases compared to the expected number of cases. The other three ZIP codes showed breast cancer diagnoses within 15% of the expected numbers. For prostate cancer, ZIP code 11768 had a 15 to 49% elevated incidence, while the other three ZIP codes had an occurrence of within or below 15% of expected numbers.
The ZIP code cancer incidence patterns were evaluated statistically to find out if there were areas in the State with elevated cancer incidence, most likely not due to chance alone. These areas are shown by slanted lines, crossed lines, or double-crossed lines on the maps. As part of the Cancer Surveillance Improvement Initiative, follow-up evaluations will be conducted for areas identified as having elevated incidence, not likely due to cancer. For one type of cancer only, colorectal cancer among females, one ZIP code among the group being considered here, 11725, was identified as part of an area of elevated incidence.
Comment #9 - One resident would like to know if residents exposed to site-related volatile organic compounds (VOCs) in their private wells will be included in the NYS DOH VOC exposure registry.
Response #9 - To date, residents from this area have not been included in the New York State Volatile Organic Compounds (VOC) Exposure Registry. This site will continue to be considered for inclusion in the Registry. If this site is selected in the future, residents of households who were exposed in the past to VOCs from private well drinking water supplies will be asked by the NYS DOH to participate. The exposure registry allows long-term follow-up on the health status of persons with documented exposures to VOCs. An exposure registry such as this one is a resource for research that may help us learn whether exposures to VOCs are related to health effects. Future analysis based on VOC Exposure Registry information may increase understanding of potential health effects from exposures similar to those experienced by residents in the area affected by the Huntington Landfill site. People who are enrolled in the Registry will be kept informed of any research results that come from the Registry data.
Comment #10- A resident would like other sources of pollution near the site, including but not limited to the past incinerators, Ogden Martin incinerator, medical waste incinerator at the VA hospital and the electrical generation plant in Northport, evaluated along with the Huntington Landfill to determine the associated "accumulated effect" on the health of the community.
Response #10- While we understand that exposure to other sources of pollution may contribute to the overall risk of an adverse health outcome, the focus of this Public Health Assessment is to evaluate the exposure and associated human health risks from contaminants related to the Huntington Landfill.
- How a chemical enters a person's blood after the chemical has been swallowed, has come into contact with the skin, or has been breathed in.
- Acute Exposure:
- Contact with a chemical that happens once or only for a limited period of time. ATSDR defines acute exposures as those that might last up to 14 days.
- Additive Effect:
- A response to a chemical mixture, or combination of substances, that might be expected if the known effects of individual chemicals, seen at specific doses, were added together.
- Adverse Health Effect:
- A change in body function or the structures of cells that can lead to disease or health problems.
- Antagonistic Effect:
- A response to a mixture of chemicals or combination of substances that is less than might be expected if the known effects of individual chemicals, seen at specific doses, were added together.
- The Agency for Toxic Substances and Disease Registry. ATSDR is a federal health agency in Atlanta, Georgia that deals with hazardous substance and waste site issues. ATSDR gives people information about harmful chemicals in their environment and tells people how to protect themselves from coming into contact with chemicals.
- Background Level:
- An average or expected amount of a chemical in a specific environment. Or, amounts of chemicals that occur naturally in a specific environment.
- Used in public health, things that humans would eat - including animals, fish and plants.
- See Community Assistance Panel.
- A group of diseases which occur when cells in the body become abnormal and grow, or multiply, out of control
- Any substance shown to cause tumors or cancer in experimental studies.
- See Comprehensive Environmental Response, Compensation, and Liability Act.
- Chronic Exposure:
- A contact with a substance or chemical that happens over a long period of time. ATSDR considers exposures of more than one year to be chronic.
- Completed Exposure Pathway:
- See Exposure Pathway.
- Community Assistance Panel (CAP):
- A group of people from the community and health and environmental agencies who work together on issues and problems at hazardous waste sites.
- Comparison Value (CVs):
- Concentrations or the amount of substances in air, water, food, and soil that are unlikely, upon exposure, to cause adverse health effects. Comparison values are used by health assessors to select which substances and environmental media (air, water, food and soil) need additional evaluation while health concerns or effects are investigated.
- Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA):
- CERCLA was put into place in 1980. It is also known as Superfund. This act concerns releases of hazardous substances into the environment, and the cleanup of these substances and hazardous waste sites. ATSDR was created by this act and is responsible for looking into the health issues related to hazardous waste sites.
- A belief or worry that chemicals in the environment might cause harm to people.
- How much or the amount of a substance present in a certain amount of soil, water, air, or food.
- See Environmental Contaminant.
- Delayed Health Effect:
- A disease or injury that happens as a result of exposures that may have occurred far in the past.
- Dermal Contact:
- A chemical getting onto your skin. (see Route of Exposure).
- The amount of a substance to which a person may be exposed, usually on a daily basis. Dose is often explained as "amount of substance(s) per body weight per day".
- Dose / Response:
- The relationship between the amount of exposure (dose) and the change in body function or health that result.
- The amount of time (days, months, years) that a person is exposed to a chemical.
- Environmental Contaminant:
- A substance (chemical) that gets into a system (person, animal, or the environment) in amounts higher than that found in Background Level, or what would be expected.
- Environmental Media:
- Usually refers to the air, water, and soil in which chemical of interest are found. Sometimes refers to the plants and animals that are eaten by humans. Environmental Media is the second part of an Exposure Pathway.
- U.S. Environmental Protection Agency (EPA):
- The federal agency that develops and enforces environmental laws to protect the environment and the public's health.
- The study of the different factors that determine how often, in how many people, and in which people will disease occur.
- Coming into contact with a chemical substance.(For the three ways people can come in contact with substances, see Route of Exposure.)
- Exposure Assessment:
- The process of finding the ways people come in contact with chemicals, how often and how long they come in contact with chemicals, and the amounts of chemicals with which they come in contact.
- Exposure Pathway:
- A description of the way that a chemical moves from its source (where it
began) to where and how people can come into contact with (or get exposed
to) the chemical.
ATSDR defines an exposure pathway as having 5 parts:
- Source of Contamination,
- Environmental Media and Transport Mechanism,
- Point of Exposure,
- Route of Exposure; and,
- Receptor Population.
- How often a person is exposed to a chemical over time; for example, every day, once a week, twice a month.
- Hazardous Waste:
- Substances that have been released or thrown away into the environment and, under certain conditions, could be harmful to people who come into contact with them.
- Health Effect:
- ATSDR deals only with Adverse Health Effects (see definition in this Glossary).
- Indeterminate Public Health Hazard:
- The category is used in Public Health Assessment documents for sites where important information is lacking (missing or has not yet been gathered) about site-related chemical exposures.
- Swallowing something, as in eating or drinking. It is a way a chemical can enter your body (See Route of Exposure).
- Breathing. It is a way a chemical can enter your body (See Route of Exposure).
- Lowest Observed Adverse Effect Level. The lowest dose of a chemical in a study, or group of studies, that has caused harmful health effects in people or animals.
- See Cancer.
- Minimal Risk Level. An estimate of daily human exposure - by a specified route and length of time -- to a dose of chemical that is likely to be without a measurable risk of adverse, noncancerous effects. An MRL should not be used as a predictor of adverse health effects.
- The National Priorities List. (Which is part of Superfund.) A list kept by the U.S. Environmental Protection Agency (EPA) of the most serious, uncontrolled or abandoned hazardous waste sites in the country. An NPL site needs to be cleaned up or is being looked at to see if people can be exposed to chemicals from the site.
- No Observed Adverse Effect Level. The highest dose of a chemical in a study, or group of studies, that did not cause harmful health effects in people or animals.
- No Apparent Public Health Hazard:
- The category is used in ATSDR's Public Health Assessment documents for sites where exposure to site-related chemicals may have occurred in the past or is still occurring but the exposures are not at levels expected to cause adverse health effects.
- No Public Health Hazard:
- The category is used in ATSDR's Public Health Assessment documents for sites where there is evidence of an absence of exposure to site-related chemicals.
- Public Health Assessment. A report or document that looks at chemicals at a hazardous waste site and tells if people could be harmed from coming into contact with those chemicals. The PHA also tells if possible further public health actions are needed.
- A line or column of air or water containing chemicals moving from the source to areas further away. A plume can be a column or clouds of smoke from a chimney or contaminated underground water sources or contaminated surface water (such as lakes, ponds and streams).
- Point of Exposure:
- The place where someone can come into contact with a contaminated environmental
medium (air, water, food or soil). For examples:
the area of a playground that has contaminated dirt, a contaminated spring used for drinking water, the location where fruits or vegetables are grown in contaminated soil, or the backyard area where someone might breathe contaminated air.
- A group of people living in a certain area; or the number of people in a certain area.
- Potentially Responsible Party. A company, government or person that is responsible for causing the pollution at a hazardous waste site. PRP's are expected to help pay for the clean up of a site.
- Public Health Assessment(s):
- See PHA.
- Public Health Hazard:
- The category is used in PHAs for sites that have certain physical features or evidence of chronic, site-related chemical exposure that could result in adverse health effects.
- Public Health Hazard Criteria:
- PHA categories given to a site which tell whether people could be harmed
by conditions present at the site. Each are defined in the Glossary. The categories
- Urgent Public Health Hazard
- Public Health Hazard
- Indeterminate Public Health Hazard
- No Apparent Public Health Hazard
- No Public Health Hazard
- Receptor Population:
- People who live or work in the path of one or more chemicals, and who could come into contact with them (See Exposure Pathway).
- Reference Dose (RfD):
- An estimate, with safety factors (see safety factor) built in, of the daily, life-time exposure of human populations to a possible hazard that is not likely to cause harm to the person.
- Route of Exposure:
- The way a chemical can get into a person's body. There are three exposure
- breathing (also called inhalation),
- eating or drinking (also called ingestion), and
- or getting something on the skin (also called dermal contact).
- Safety Factor:
- Also called Uncertainty Factor. When scientists don't have enough information to decide if an exposure will cause harm to people, they use "safety factors" and formulas in place of the information that is not known. These factors and formulas can help determine the amount of a chemical that is not likely to cause harm to people.
- The Superfund Amendments and Reauthorization Act in 1986 amended CERCLA and expanded the health-related responsibilities of ATSDR. CERCLA and SARA direct ATSDR to look into the health effects from chemical exposures at hazardous waste sites.
- Sample Size:
- The number of people that are needed for a health study.
- A small number of people chosen from a larger population (See Population).
- Source (of Contamination):
- The place where a chemical comes from, such as a landfill, pond, creek, incinerator, tank, or drum. Contaminant source is the first part of an Exposure Pathway.
- Special Populations:
- People who may be more sensitive to chemical exposures because of certain factors such as age, a disease they already have, occupation, sex, or certain behaviors (like cigarette smoking). Children, pregnant women, and older people are often considered special populations.
- A branch of the math process of collecting, looking at, and summarizing data or information.
- Superfund Site:
- See NPL.
- A way to collect information or data from a group of people (population). Surveys can be done by phone, mail, or in person. ATSDR cannot do surveys of more than nine people without approval from the U.S. Department of Health and Human Services.
- Synergistic effect:
- A health effect from an exposure to more than one chemical, where one of the chemicals worsens the effect of another chemical. The combined effect of the chemicals acting together are greater than the effects of the chemicals acting by themselves.
- Harmful. Any substance or chemical can be toxic at a certain dose (amount). The dose is what determines the potential harm of a chemical and whether it would cause someone to get sick.
- The study of the harmful effects of chemicals on humans or animals.
- Abnormal growth of tissue or cells that have formed a lump or mass.
- Uncertainty Factor:
- See Safety Factor.
- Urgent Public Health Hazard:
- This category is used in ATSDR's Public Health Assessment documents for sites that have certain physical features or evidence of short-term (less than 1 year), site-related chemical exposure that could result in adverse health effects and require quick intervention to stop people from being exposed.