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LIST OF APPENDICES

Appendix A - Selection of Contaminants

Appendix B - Exposure Doses and Health-Based Guidelines

Appendix C - Community Concerns

Appendix D - Fernald Dosimetry Reconstruction Project

Appendix E - Air Particulate Releases and ICRP Lung Models

Appendix F - Comparison of ATSDR/NAREL and DOE Radon Monitoring Program Data

Appendix G - ATSDR's Glossary of Terms


LIST OF TABLES

Table 1A. Demographic characteristics of the population residing within 5 and 10 kilometers of the Fernald Site property boundary (based on the 1990 Census)

Table 1B. Summary of demographic characteristics of the population residing within 5 and 10 kilometers of the Fernald Site property boundary (based on the 1990 Census)

Table 2A. Completed exposure pathways for the Fernald site

Table 2B. Potential exposure pathways for the Fernald site

Table 3. Maximum measured uranium concentrations in water from private wells (numbers 12, 13, 15, and 17) off site of the Fernald facility

Table 4. Maximum concentrations and estimated chemical exposure doses for current and past exposure to uranium in water from private well 15 off site of the Fernald facility

Table 5. Concentrations and estimated committed effective (whole body) and committed equivalent (bone surface) doses for current radiation exposure to uranium in private wells off site of the Fernald facility (based on annual ingestion)

Table 6. Estimated current and past chemical exposure doses for ingestion of uranumin surface soil off site of the Fernald facility by a small child

Table 7. Estimated current committed effective (whole-body) and committed equivalent (bone-surface) doses from 1 year of incidental ingestion of contaminated off-site surface soil by a child

Table 8. Current and past airborne concentrations and estimated exposure doses for exposure to uranium in air off site of the Fernald facility by a child (scenario #1) and an adult farmer (scenario #2)

Table 9. Estimated committed effective (whole body) and committed equivalent (lung and bone surface) doses for current exposure to radioactive contaminants in air off site of the Fernald facility by a child (scenario #1) and an adult farmer (scenario #2)

Table 10. Summary of DOE's alpha-track monitoring results at fenceline and at potentially affected residences (with background subtracted and reported in pCi/L and Bq/L)

Table 11. Estimated average annual lung dose for an adult male exposed continuously to maximum concentrations (with background subtracted)

Table 12. Annual average external exposure doses at fenceline air monitoring stations west of the silos and northeast of the site (with background subtracted)

Table 13. Estimated maximum past uranium concentrations at potential exposure points in surface water off site of the Fernald facility

Table 14. Estimated maximum past uranium (chemical) exposure doses for hypothetical exposure scenarios for surface water pathways

Table 15. Current uranium concentrations at potential exposure points in surface water off site of the Fernald facility

Table 16. Estimated current uranium (chemical) exposure doses for hypothetical exposure scenarios for surface water pathways

Table 17. Maximum concentrations of radioactive contaminants, by year, at potential exposure points in surface water off site of the Fernald facility

Table 18. Estimated exposure doses for radioactive contaminants in surface water for the hypothetical exposure scenarios

Table 19. Estimated and measured maximum past and current uranium concentrations in biota off site of the Fernald facility

Table 20. Measured maximum current radioactive contaminant concentrations in biota off site of the Fernald facility in pCi/g (Bq/g) for vegetables, meat, and fish; pCi/L (Bq/L) for milk 73

Table 21. Age-specific ingestion rates and percent of biota consumed by Fernald residents for two hypothetical exposure scenarios for the biota pathway

Table 22. Estimated maximum past uranium (chemical) exposure doses for hypothetical exposure scenarios for biota pathways

Table 23. Estimated maximum current uranium (chemical) exposure doses for hypothetical exposure scenarios for biota pathways

Table 24. Estimated maximum current exposure doses from radioactive contaminants for hypothetical exposure scenarios for biota pathways

Table 25. Summary of estimated chemical uranium exposure doses for completed and potential past exposure pathways for the Fernald site

Table 26. Summary of estimated chemical uranium exposure doses for completed and potential current exposure pathways for the Fernald site

Table 27. Relative water solubility and kidney toxicity of various uranium compounds

Table 28. Summary of estimated radiation exposure doses for completed and potential current exposure pathways for the Fernald site

Table 29. Total chemical uranium and radiation estimated exposure doses for all exposure pathways at the Fernald site


LIST OF FIGURES

Figure 1. Location of the Fernald site and surrounding area

Figure 2. Layout of the Fernald facility

Figure 3. Demographic characteristics of the population residing within 1 mile of the Fernald site

Figure 4. Pathways of exposure to contaminants from the Fernald site

Figure 5. Location of privately owned sampled wells near the Fernald site

Figure 6. Surface water discharge points from the Fernald site to Paddy's Run Creek and the Great Miami River

Figure 7. Probability distribution of toxic thresholds for uranium in the kidney.


LIST OF ABBREVIATIONS

ABS
AMAD
AT
ATSDR
BW
Bq
CDC
CEL
CERCLA
CF
CI
Ci
CPF
CREG
CSF
Conc
DC
DHHS
dL
DOE
dy
ED
EF
EMEG
EPA
ESADDI
FCAB
FDRP
FEMP
FHES
FMMP
FMPC
FRAP
FRESH
FWMMP
GIS
Gy
HC
hr
ICRP
IDLH
IR
kg
L
LOAEL
m-
mCi
MCL
mg/kg
mg/kg/day
mg/L or mg/kg
mg/m3
mGy
mrad
mrem
MRL
mSv
NAAQS
NAREL
NCEH
NCI
NCRP
NIOSH
NOAEL
NOx
NPL
NRC
ODH
OEPA
OSHA
PAHs
PCBs
PEL
PHA
pCi
ppb
RAC
RfD
RMEG
ppm
SEER
SIR
SMR
SO2
SSOD
TLDs
TLV
WHO
yr

Absorption factor
Activity mean aerodynamic diameter
Averaging time
Agency for Toxic Substances and Disease Registry
Body weight
Becquerel
Centers for Disease Control and Prevention
Cancer effect level
Comprehensive Environmental Response, Compensation, and Liability Act
Conversion factor
Cancer Incidence
Curie
Cancer potency factor
ATSDR's Cancer Risk Evaluation Guide
Cancer slope factor
(or conc) Concentration
Distribution factor
U.S. Department of Health and Human Services
Deciliter
U.S. Department of Energy
Day
Exposure duration
Exposure frequency
ATSDR's Environmental Media Evaluation Guide
U.S. Environmental Protection Agency
Estimated safe and adequate daily dietary intake
Fernald Citizens Advisory Board
CDC's Fernald Dosimetry Reconstruction Project
Fernald Environmental Management Project
Fernald Health Effects Subcommittee
Fernald Medical Monitoring Program
Feed Materials Production Center
Fernald Risk Assessment Project
Fernald Residents for Environmental Safety and Health, Inc.
Fernald Workers Medical Monitoring Program
Geographic information system
Gray
ATSDR Health Consultation
Hour
International Commission on Radiological Protection
Immediately Dangerous to Life and Health
Ingestion rate
Kilogram
Liter
Lowest-Observed-Adverse-Effect-Level
micro-
Millicurie
Maximum Contaminant Level
Milligrams per kilogram
Milligrams per kilogram per day
Micrograms per liter or micrograms per kilogram
Milligrams per cubic meter
Milligray
Millirad
Millirem
Minimal Risk Level
Millisievert
National Ambient Air Quality Standards
EPA's National Air and Radiation Environmental Laboratory
National Center for Environmental Health
National Cancer Institute
National Council on Radiation Protection and Measurements
National Institute for Occupational Safety and Health
No-Observed-Adverse-Effect-Level
Nitrogen Oxides
National Priorities List
National Research Council, National Academy of Sciences
Ohio Department of Health
Ohio Environmental Protection Agency
Occupational Safety and Health Organization
Polyaromatic hydrocarbons
Polychlorinated biphenyls
OSHA Permissible Exposure Limit
ATSDR Public Health Assessment
picocurie
Parts per billion (equivalent to mg/L or mg/kg)
Radiological Assessments Corporation
EPA's Reference dose
ATSDR's Reference Dose Media Evaluation Guide
Parts per million (equivalent to mg/kg or mg/ml)
Surveillance Epidemiology, End Result (NCI's data)
Standardized incidence rate
Standardized mortality ratio
Sulfur dioxide
Storm sewer outfall ditch
Thermoluminescent dosimeters
Threshold Limit Value
World Health Organization
Year


EXECUTIVE SUMMARY

The Fernald Environmental Management Project (FEMP), formerly the Feed Materials Production Center, is a 1,050-acre complex located about 17 miles northwest of downtown Cincinnati, Ohio. The facility is owned by the U.S. Department of Energy. From 1951 to 1988, it produced high-purity uranium metal products for the defense industry and was known as the USDOE Feed Materials Production Center. The site was added to the U.S. Environmental Protection Agency's Superfund in 1989. Remediation has been ongoing at the site since 1991. Currently, there is a large quantity of radioactive waste materials stored in three silos on site. The K-65 silos (silos 1 and 2) contain radium waste from the K-65 process. Silo 3 contains thorium waste and cold metal oxides. As part of the on-site remediation activities, wastes from the silos will be stabilized and temporarily stored on site. These wastes will ultimately be transported to an off-National Priorities List (NPL) site disposal facility. In addition, a large volume of contaminated material (soil and debris), that meets approved waste acceptance criteria, has been removed from the facility production areas and disposed of in on-site disposal cells. Other wastes that do not meet the waste acceptance criteria are currently being transported to an off-site disposal facility.

In this public health assessment, ATSDR scientists evaluated the environmental and health information for the Fernald site and identified pathways through which people are currently being exposed, have been exposed in the past, or may be exposed in the future to chemicals or radioactive materials from the site. For each of the pathways, we evaluated whether Fernald area residents may be exposed to chemicals and radioactive materials at levels that pose a public health hazard. The table below presents our findings. This public health assessment discusses each pathway, giving a rationale in each case for ATSDR's assignment of a public health hazard level.

ATSDR Conclusion Category

Exposure Pathway

Public health hazard

Groundwater: past (uranium)
Air: past (radon)

Indeterminate public health hazard

Groundwater: current

No apparent public health hazard

Surface water: past

Air: current (radon)

Biota: past, current

No public health hazard

Soil: past, current, and potential future

Surface water: current

According to the data reviewed for this public health assessment, there are no known exposure pathways that pose a public health hazard to Fernald residents under current conditions at the site. Although residents near the site may be exposed to low levels of chemicals and radioactive materials in the environment, the concentrations of these substances are not at levels that would cause harm to humans. However, information is limited for one current exposure pathway, ingestion of water in privately owned wells in the South Plume, making it difficult to make a definitive statement about whether adverse health effects are likely to occur. Therefore, we determined that this pathway poses an indeterminate public health hazard under current conditions at the site. For this public health assessment, we define "current" as between 1989 (when the Fernald facility stopped operating) and the present. The conclusions take into account the clean-up activities that have been conducted, and are currently in progress, at the site.

ATSDR considered historic releases of chemicals from the Fernald site to the environment. We identified one exposure pathway, ingestion of groundwater from privately owned wells in the South Plume, for which past exposure to chemical uranium poses a public health hazard for children and adults. The Centers for Disease Control and Prevention (CDC) has identified an additional pathway, exposure to radioactive materials (e.g., radon and radon daughters) in air, that poses a human health hazard under past conditions at the site.

Because on-site cleanup operations involve storage, removal, and transport of radioactive materials in the K-65 silos, a future air exposure pathway could exist if an accident, such as a natural disaster or act of terrorism, caused the release of radioactive materials into the environment. ATSDR is conducting a Health Consultation, separate from this public health assessment, to evaluate the potential public health hazard to the Fernald community of an accidental release of materials from the K-65 silos.

The health data evaluated for Fernald residents support the conclusions made in this public health assessment and indicate that continued evaluation of the site should be considered. The results of CDC's Fernald Dosimetry Reconstruction Project (FDRP) and Fernald Risk Assessment Project indicate that while the Fernald facility was operating, Fernald residents were exposed to radioactive materials from the site that resulted in a higher than expected risk for lung cancer. Continued monitoring of off-site radon levels should ensure that radon does not pose a health hazard to the Fernald community now or in the future. The results of the FDRP also suggest that residents have an elevated kidney burden of uranium from past exposure, primarily from consumption of contaminated water in privately owned wells in the South Plume. Preliminary analyses of residents participating in the University of Cincinnati's Fernald Medical Monitoring Program suggest a higher than expected occurrence of adverse effects on the kidney. It is not known whether these excesses are related to chemicals and radioactive releases from the Fernald site. A more in-depth assessment of site-related past exposures to contaminants in these wells is needed.

Over several years, ATSDR representatives collected information from the Fernald community about their concerns related to health and environmental issues. Many persons expressed concerns about cancer and other illnesses from exposures to contaminants from the Fernald site. Community concerns are documented and addressed in the main part of this document.

Following recommendations from the Fernald Health Effects Subcommittee, ATSDR co-sponsored two educational workshops for health care providers in the Fernald and Cincinnati areas. The first workshop was held in November 1998; the second was held in February 2000. The main part of this report briefly discusses these workshops.

Considering the data and information reviewed for this public health assessment, ATSDR recommends the following: (1) a more in-depth assessment of past exposure to contaminants in privately owned residential wells near the Fernald site; (2) continued monitoring of groundwater in the South Plume, including analyses for contaminants that may be drawn into the South Plume from other sources due to groundwater remediation activities at the Fernald site; (3) an in-depth assessment of current usage of, and potential exposure to, chemicals and radioactive materials from privately owned residential wells that are most likely to be impacted by contaminants from the site; (4) more frequent analyses of uranium/thorium decay products, especially radium 226 and 228, in biota samples collected by the facility, and a quality control review of these analyses; and (5) continued monitoring for radon and radon daughters in the Fernald area during remediation activities at the site, especially those involving the K-65 silos. (As part of item 5, ATSDR recommends that consideration be given to using alpha-track detectors in addition to continuous monitoring.)

ATSDR also recommends that two additional follow-up actions be considered. These are (1) further evaluation of health outcomes among participants in the Fernald Medical Monitoring Program, and (2) additional health education activities, including educational workshops for health care providers in the Cincinnati area and the Fernald community.

The interpretation, conclusions, and recommendations provided in this public health assessment are based on the data and information referenced herein. Additional data could alter these conditions and recommendations. The conclusions and recommendations are site-specific and are, therefore, not applicable to any other situation.


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