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HEALTH CONSULTATION

HILLSIDE TRAILER PARK
BROUSSARD CITY, LAFAYETTE PARISH, LOUISIANA


I. BACKGROUND AND STATEMENT OF ISSUES

On December 20, 2000, the Louisiana Department of Health and Hospitals (LDHH) ordered theresidents of the Hillside Mobile Trailer Park (the trailer park) in Broussard City, Lafayette Parish,Louisiana, to cease using their drinking water for all purposes except flushing toilets. A routine testof the trailer park's water system had found the industrial solvent trichloroethylene (TCE) in thewater at levels above the U.S. Environmental Protection Agency's (EPA) standard. After notificationof the water contamination, trailer park residents reported symptoms which they attribute to theirTCE exposure [1]. Residents asked LDHH, Office of Public Health (OPH) for the following: (1)recommendations or instructions relative to appropriate biomedical testing to evaluate potentialhealth effects of TCE exposure; (2) any specific data or other educational materials related to theTCE contamination which may be beneficial to medical personnel, and (3) any recommendationsfrom OPH regarding future health- related activities that may serve to minimize health effects ofTCE exposure. The purpose of this health consultation is to review the levels of contaminationdetected in the wells and determine if the those levels are of public health concern. In addition, theconsult provides answers to the community concerns stated above.

Broussard is located 8 miles south of Lafayette, Louisiana. The population was 3,514 in 1995. Broussard had 1,300 families in 1990. The trailer park, which had about 120 residents, is locatedbetween Offshore Drive and Mineral Road, which is parallel to Tideland Street. The neighborhoodincludes residential and commercial properties. Across Tideland Street, there is a machine shop. Thetrailer park obtained its tap water from three 75-foot deep groundwater wells (Wells No. 1-3,untreated supply wells). The water system serves between 35 and 40 trailer sites [2].

On December 4, 2000, OPH performed a scheduled triennial water system test for drinking watercontaminants regulated under the Safe Drinking Water Act, including inorganic, organic andmicrobial contaminants. On December 18 and 27, 2000, additional samples were collected andanalyzed (see Table 1) [2]. Water from the Well No.1 tap contained 20.2 micrograms per liter (g/Lor parts per billion (ppb)) and 37.2 g/L of TCE, while water from the Well No. 2 tap contained 7.61 g/L and 107 g/L TCE on December 4 and 8, respectively. Water drawn from both wells exceededthe EPA's national primary drinking water regulatory standard, the maximum contaminant level(MCL) of 5 g/L on both sample dates. When confirmation sampling was performed on December18, 2000, two samples were collected from distribution taps. The results were 72.0 g/L and 38.7 g/L, both exceeding the MCL. In a drinking water system, well water consists of the groundwaterpumped directly from the ground through the wells. This water is then sent to a treatment systemfor removal of contaminants, and sent to distribution wells. Distribution wells contain water that issent directly to homes for public use. Contamination contained in a well may not exist in adistribution well after treatment.

On December 20, 2000, state health officials went door-to-door at the trailer park to notify residentsto stop using the water except for flushing their toilets. OPH immediately began to look for a newwater supply for the trailer park. A nearby public supply (Lafayette Water District North) agreed tolay pipe and connect to the trailer park. The supply was connected, flushed, sampled for both TCE and bacteria, and determined to be safe for use within five days. On December23, 2000, the trailer park was connected to the public water supply of Lafayette Water District North.

Table 1.

Concentrations of Trichloroethylene found in the drinking water at the Hillside Trailer Park in Broussard, Lafayette Parish, Louisiana on December 2000.
Date of collection Source Trichloroethylene
micrograms per liter (g/L)
or parts per billion (ppb)
12/04/00 Well 1

20.2

Well 2

7.6

Well 3

not sampled

12/8/00 Well 1

37.2

Well 2

107.0

Well 3

not sampled

12/18/00
(Confirmatory samples from distribution taps in trailer park)
Sample 1
Distribution tap

72.0

Sample 2
Distribution tap

38.7

12/27/00
(After Abandonment)
Well 1

not sampled

Well 2

not sampled

Well 3
(Standby Well)

129.0

Wells No. 1-3, untreated supply wells;
Distribution Tap Water - treated drinking water

Adjacent to the trailer park there are several residences and a day care center. In addition, severalnearby businesses also have private wells. A survey by Louisiana Department of EnvironmentalQuality (DEQ) found 16 more wells in the immediate area (within 1/4 mile). On December 21,2000, the day care center, at the urging of DHH staff, had their well sampled by a private laboratory,but no trace of TCE was found at that time. In June 2001, DEQ initiated a program of sampling all16 wells in the area. DEQ sampled wells in the area on June 15, 2001, September 28, 2001, October 24, 2001, December 19, 2001, March 27, 2002, June 21, 2002, and October 28,2002. No TCE was detected in any of the 16 wells tested. Concentrations of TCE continue to remainelevated in the abandoned Hillside wells. No source of the TCE contamination has been located.

EPA regulations require sampling every three years for drinking water systems such as the one atthe trailer park. Samples which were drawn in March 1994 and June 1997 found no chemicalcontaminants in excess of drinking water standards. There is no information about when residents' exposure to TCE began between the June 1997 and December 2000 sampling events.

In response to the discovery of elevated TCE in the drinking water, LDHH/OPH, Section of Environmental Epidemiology and Toxicology sent a fact sheet about TCE to area hospitals (University Medical Center, Women and Children's Hospital, Lafayette General Medical Center, Our Lady of Lourdes Medical Center, and Medical Center of Southwest Louisiana).

After a press release on December 20, 2000, in the Daily Advertiser (Lafayette newspaper), OPH learned that residents were complaining about symptoms that they believed were related to TCEexposure. Among the residents were a 6-week-old baby and a woman with a history of miscarriage. Residents were advised by OPH to consult their physician if they felt sick. Residents' healthcomplaints were most frequent during the first two weeks after the press release.

The DEQ has conducted a study to identify possible TCE sources around the trailer park in order to find the source of contamination. This study has revealed no sources of TCE contamination.


II. DISCUSSION

TCE is a nonflammable, colorless liquid with a somewhat sweet odor and taste. It is used mainlyas a solvent to remove grease and oil from metal parts, but it is also an ingredient in adhesives, paintremovers, typewriter correction fluids, and spot removers [3].

Because TCE easily disolves in water, it can be carried from surface water to groundwater, whereit can remain for a long time. TCE in water is likely from the manufacture, use and/or disposal ofthe chemical [3]. Because TCE also sticks to particles in soil, when it gets into deep soils, it can staythere for a long time.

TCE is a volatile compound, evaporating from water into the air. When tap water at a home containsTCE, the residents can be exposed to TCE by drinking the water and breathing TCE which hasvolatilized. Using the dishwasher and the washing machine, and taking a shower release the mostTCE into the air. Residents can also be exposed to the chemical by breathing air in the home whichhas been contaminated by household products such as spot remover.

The following are answers to questions from residents.

What does "exceed the MCL mean?"

TCE was found at the tap in water from Well Nos. 1, 2, and 3 (see Table 1) at concentrations abovethe Maximum Contaminant Level (MCL) of 5 g/L [4]. The MCL is defined as the maximumpermissible level of a contaminant in water which is delivered to any user of a public water system. The MCL is set to protect public health, but is limited by technical feasibility. This is in contrast to the Maximum Contaminant Level Goal (MCLG), which is based exclusively on public health concerns. The MCL is set as close to the MCLG as is "feasible" with the use of the best technology, treatment techniques, and other means available. Because TCE is a probable carcinogen, its MCLG is 0 g/L.

The highest level of TCE found at the trailer park was 129 g/L in water from the Well No.3 tap onDecember 27, 2000 (Table 1). This well was a seldom used standby well and was not in serviceduring the December sampling events. The TCE concentration range during the period of 1997-2000is unknown. The highest level of TCE contamination in wells that supply water to the trailer parkwas 107 g/L (exceeding the TCE MCL of 5 g/L) and it was collected from Well 2 on December8, 2000 (All of the aforementioned wells are untreated water.). The highest level found in thedistribution system collected December 18, 2000, was 72.0 g/L, which also exceeded the TCEMCL. The trailer park had been taken off well water and transferred to the municipal system by December 23, 2000.

Is there a test for TCE Exposure?

Tests to determine TCE exposure are not routinely performed. TCE can be detected in your breath,blood and urine if you have been recently exposed. If performed soon after exposure, the breath testcan indicate if you have been exposed to even a small amount of TCE [3].

TCE is rapidly metabolized mostly into trichlorethanol and trichloroacetic acid by the liver and thenexcreted in the urine. Chloral hydrate is a third metabolite. Trichloroacetic acid has a longer bloodand urine half-life (70-100 hours) than trichloroethanol (10-15 hours) because trichloroacetic acidbinds to plasma proteins. Urinary metabolites can be detected 16 days after exposure [5].

In animal studies where TCE is ingested, the blood concentration peaks within 1 hour and thenrapidly declines. Metabolites appear and reach maximum concentrations in the blood within 1 to24 hours. The highest TCE concentrations are found in body fat. Studies in humans indicate thatonly small amounts of TCE are eliminated unchanged by the lungs. The metabolic products,trichloroethanol and/or chloral hydrate, may contribute to the central nervous system depressioncaused by TCE [5].

What are the toxicological effects of TCE?

Inhaling large amounts of TCE can be fatal. Breathing moderate levels of TCE can cause headachesand dizziness. Skin contact with concentrated solutions of TCE may cause rashes. High level TCEexposures can also damage the liver and kidneys, and affect the heart beat [3]. There is evidence that chronic exposure to TCE causes cancer. The International Agency for Research on Cancer (IARC) has determined that TCE is a probable human carcinogen. Epidemiologic and animal studies also suggest that TCE may cause birth defects in children of mothers exposed during pregnancy [3].

What health effects should residents watch out for?

Most health effects of TCE require exposures to large amounts and/or of long duration. The doseof TCE received by Hillside Trailer Park residents from contaminated water was relatively small. Assuming that (1) adults consume 2 liters of water per day and weigh 70 kilograms, and (2) infantsconsume 1 liter of water per day and weigh 10 kilograms, an adult would have ingested a dose of0.00369 milligrams TCE per kilogram of body weight per day (mg/kg/day), and an infant wouldhave ingested a dose of 0.0129 mg/kg/day. This figure does not take into account the contributionof inhalation and dermal exposure to TCE. The inhalation and dermal exposure routes may doubleto triple the estimated exposure dose from ingestion alone [7].

However, even if the dose is combined through total daily exposures, which includes exposures fromingestion, inhalation, and dermal contact, alone and combined, non-cancer health effects areunlikely. The estimated adult dose from all exposures combined is 0.0111 mg/kg/day, and for achild the estimated dose from all exposures is 0.0387 mg/kg/day.

Therefore, daily exposure, to TCE at these levels is unlikely to cause adverse health effects. The estimated daily TCE exposure from water at the Hillside Trailer Park is substantially less than the no observed adverse effect levels (NOAELs) and lowest observed adverse effect levels (LOAELs) found in animal studies of the effects of TCE. Animal testing data correlate with human health effects usually, but not always. In studies where animals drank TCE, the NOAELs typically average about 100 mg/kg/day. This is roughly 1,000 times greater per day than the TCE dose estimated for infants at the Hillside Trailer Park. One animal study reported an increase in birth defects at substantially lower doses. The LOAEL from this study was 0.18 mg/kg/day, which is still more than ten times the estimated infant TCE dose at Hillside Trailer Park [3].

Epidemiologic studies also indicate that exposure to TCE at levels estimated for Hillside Trailer Parkresidents is unlikely to cause health effects. Like animal studies, however, human experience withTCE suggests that it may cause birth defects. A study of New Jersey residents found that infantsborn to women who drank TCE-contaminated water had elevated rates of developmental effects,including central nervous system defects, neural tube defects, oral clefts and major cardiac defects. A study in Arizona found an association between congenital heart defects and TCE exposure [3]. Limited exposure information makes it difficult to determine the dose of TCE needed for these effects to occur. Though it is unlikely that the TCE doses receivedby Hillside Trailer Park residents were sufficient to cause birth defects, children of mothers whodrank the TCE-contaminated water during pregnancy could be at risk.

Cancer data for TCE are more equivocal. High doses of the chemical have been associated withincreased tumor incidence in some studies of laboratory rats and mice. Other animal studies havefailed to find TCE carcinogenic. Human studies of TCE and cancer likewise give conflicting results. The International Agency for Research on Cancer (IARC) has designated TCE a probablecarcinogen, based on the animal studies. Even if TCE is carcinogenic, dose-response relationshipsare unknown at this time. Exposure to TCE in drinking water in the amounts and durationexperienced by Hillside Trailer Park residents would, however, be very unlikely to cause cancer.

The ATSDR National Exposure Registry, Trichlorethylene Subregistry [6] has tracked healthoutcomes of more than 4,000 persons who were exposed to TCE at varying concentrations abovethe MCL in drinking water. The self-reported health outcomes were then compared to nationalnorms. In the TCE Subregistry significant increases were found in reporting of speech and hearingimpairment for children less than 10 years of age (increased at a baseline but not in follow-ups);anemia; stroke; urinary tract disorders; liver and kidney disease; diabetes and skin rashes. Thevalidity of the self-reported outcome data is debatable, due to the possibility of reporting bias on thepart of Subregistry participants. Apart from the self-reported data, excess respiratory cancer casesoccurred among older men in the Subregistry population, but were attributable to differences in cigarette smoking [6].


III. CHILD HEALTH CONSIDERATIONS

Children are uniquely susceptible to adverse effects through exposure to chemicals. Their organsare developing and can be more susceptible to harm. Also, malformations that might occur duringdevelopment can result in irreversible impairment.

This health consultation recognizes that the fetus and infant are more susceptible to certain effectsof TCE. Furthermore, drinking water is an exposure route of particular concern in infants, becausein the first 6 months of life, babies drink seven times as much water per pound of body weight as doadults. For this reason, emphasis was given to developmental effects in the Discussion section.


IV. CONCLUSIONS

In summary, the levels of TCE (7.6 to 129 g/L) detected in residential well water at the HillsideTrailer Park from December 4, 2000 to December 23, 2000, present no apparent public health hazardfor the general population.

Municipal water has been supplied since December 23, 2000, to the trailer park. The city waterpresents no public health hazard because it has been sampled and no elevated levels of contaminants found.


V. RECOMMENDATIONS

  1. It is recommended that OPH and DEQ continue to monitor groundwater from the HillsideTrailer park area and report its findings to residents.

  2. DEQ should continue to characterize the extent and movement of the Hillside TrailerPark area plume of groundwater contamination. In addition to the characterization of theplume, OPH and DEQ should determine if it has effected any other area wells, and thesource of the Hillside Trailer Park groundwater contamination should still be identified.

VI. PUBLIC HEALTH ACTION PLAN

Actions Taken

  1. On December 20, 2000, OPH went door-to-door asking residents to stop using the tapwater.

  2. On December 21, 2000, OPH provided five hospital emergency departments withtoxicological information about TCE.

  3. On December 23, 2000, public water from Lafayette Water District North was supplied tothe trailer park.

  4. On December 21, 2000, the nearby daycare center obtained a private laboratory to test itswell water. From June 15, 2001 through October 28, 2002, DEQ has tested water atnearby day care center, private residences, nearby business and industries and found noTCE in any samples taken to date outside of the trailer park wells.

  5. On December 21 and 22, 2000, OPH advised private businesses located close to thetrailer park to test for TCE contamination in their private wells to protect potable watersources and to avoid uses of water for purposes where volatilization would occur. ParishHealth Units were also advised about the TCE contamination at this time.

Actions Planned

  1. The source of groundwater TCE in the Hillside Trailer Park area should be identified by DEQ to prevent further contamination of both private and public water supplies. Public health activities conducted by Louisiana Department of Health & Hospitals staff (like notification, availability of municipals water supplies, etc,) should continue to protect the health of these impacted residents.

  2. DEQ will notify the owners of tested wells and OPH of the results of further groundwater sampling results.

VII. PREPARERS OF THE HEALTH CONSULTATION

Sharee Major Rusnak, MSPH
Public Health Assessor
Louisiana Department of Health and Hospitals
Office of Public Health
Section of Environmental Epidemiology and Toxicology

Genny Carrillo-Zuniga, MD, ScD
Public Health Assessor
Louisiana Department of Health and Hospitals
Office of Public Health
Section of Environmental Epidemiology and Toxicology

Margaret Metcalf, ScD
Public Health Epidemiologist Supervisor
Louisiana Department of Health and Hospitals
Office of Public Health
Section of Environmental Epidemiology and Toxicology

Joseph Sejud, MD, JD
Medical Director
Louisiana Department of Health and Hospitals
Office of Public Health
Section of Environmental Epidemiology and Toxicology

ATSDR Regional Representative

George Pettigrew
Office of Regional Operations
ATSDR Region 6

ATSDR Technical Project Officer

Tammie McRae, MS
Environmental Health Scientist
Division of Health Assessment and Consultation
Superfund Site Assessment Branch


VIII. REFERENCES

  1. Louisiana Department of Health and Hospitals, Office of Public Health. News releaseconcerning Water System Ordered to Shut Down at Hillside Trailer Park in Broussard,Louisiana. January 22, 2001.

  2. Louisiana Department of Health and Hospitals, Safe Drinking Program, Lafayette,Louisiana. Analytical results from the tap water sampled at Hillside Trailer Park inBroussard, Louisiana. December 4, 2000.

  3. Agency for Toxic Substances and Disease Registry, Toxicological Profile forTrichloroethylene. Atlanta: US Department of Health and Human Services, September1997.

  4. USEPA. Human Health Medium Specific Screening Levels. Web site address www.epa.gov/earth1r6/6pd/rcra_c/pd-n/screen.htm Region 6, USEPA. January 2001.

  5. Ellenhorn MJ, Barceloux DG. Trichloroethylene. In: Medical Toxicology, Diagnosisand Treatment of Human Poisoning. 1988. Elsevier Science Publishers. p. 990-993

  6. Agency for Toxic Substances and Disease Registry, National Exposure Registry.Trichloroethylene (TCE) Subregistry. Baseline Through Follow-up 3 Technical Report.Atlanta: US Department of Health and Human Services. October 1999.

  7. Andelman, Julian B. Inhalation Exposure in the Home to Volatile Organic Contaminantsof Drinking Water. The Science of the Total Environment. 1985.47:443-460.

CERTIFICATION

This Hillside Trailer Park, Review of Drinking Water health consultation was prepared by theLouisiana Department of Health and Hospitals under a cooperative agreement with the Agency forToxic Substances and Disease Registry (ATSDR). It is in accordance with approved methodologyand procedures existing at the time the health consultation was begun.

Tammie McRae, MS
Technical Project Officer, SPS, SSAB, DHAC


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

Roberta Erlwein
Chief, State Program Section, DHAC, ATSDR


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