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PETITIONED PUBLIC HEALTH ASSESSMENT

BELLEVUE PARK
ANCHORAGE, JEFFERSON COUNTY, KENTUCKY


SUMMARY

ATSDR was petitioned for a public health assessment for the Bellevue Park Site in Jefferson County, Kentucky, by a local resident living near the site, in March 2000. In response to this petition, ATSDR evaluated soil, sediment, and surface water data collected by the Environmental Protection Agency in February 1999 and May 2000. ATSDR concluded from this evaluation that the contaminant levels detected during these sampling events were not at levels of public health significance. Several contaminants were detected at levels above ATSDR comparison values; however, no adverse health effects would be expected for adults, children, or pica children from exposure to the soil, sediment or surface water during activities such as playing and horse grooming.

Therefore, based on the available environmental sampling data for surface soil, subsurface soil, sediment and surface water, ATSDR categorized the Bellevue Park Site as posing No Apparent Public Health Hazard. If soils were to be excavated or otherwise disturbed in the future, further evaluation of these media at the dump site should be evaluated to determine whether contaminants from the site could result in exposures at levels that may impact health.


PURPOSE AND HEALTH ISSUES

In March 2000, ATSDR received a petition from a resident living near the Bellevue Park Site in Jefferson County, Kentucky. The petitioner's main health concern involved the results of surface soil, sediment, and surface water sampling conducted on the site by the U.S. Environmental Protection Agency (EPA). The petitioner questioned whether the identified levels of organic and inorganic chemicals found on the site were of public health concern for both children and adults. [Memo 2000] ATSDR released a draft public health consultation for public comment in August 2000 that concluded the Bellevue Park Site posed an Indeterminate Public Health Hazard [ATSDR 2000]. That determination was made because sediment and surface water data were not yet available from EPA for evaluation. The data for sediment and surface water samples are now available for evaluation. This health assessment evaluates all available data provided by EPA including soil, sediment and surface water for public health significance.


BACKGROUND

Site Description and History

The Bellevue Park Site is located in a subdivision north of Old Henry Road in Jefferson County, Kentucky (see Appendix A for site maps). In 1919 the Bellevue Park Site (consisting of a lake with an island, and an unspecified amount of land surrounding the lake) was dedicated for public use. [EPA 1998]. The lake (approximately 370 feet by 120 feet) was drained in the early 1960s. Although there was no permit, unregulated dumping continued on the southern portion of the site until 1996. Among the materials reportedly deposited on the site were construction and demolition debris, remnants from road projects, household garbage, tree stumps, empty and rusted 55-gallon oil drums, and possibly animal wastes [EPA 1998].

In February 1997, the Kentucky Department of Environmental Protection issued a notice of violation to the city of Anchorage for dumping and disposing of waste on the landfill without a permit. In order to comply with the notice of violations, the city hired a contractor to remove the waste located at Bellevue Park. In April 1997 the contractor removed wastes, which primarily consisted of construction and demolition debris that had been located above the surface of the ground, and the area was graded and seeded [EPA 1998]. Although some waste was removed from the site in April, 1997, according to an inspection by Kentucky Division of Waste Management personnel on May 7, 1997, several areas of dark, compacted solid waste, possibly asphalt fines, remained on site.

A horse-riding ring was constructed in 1984 on top of the waste and other material previously dumped at the site. This horse-riding ring is located on the northern portion of the site. Children reportedly frequent the area south of the horse-riding ring when there are events or lessons, according to a February 23, 2000, memo from the petitioner to the administrator of ATSDR. Surface water drainage from the site flows into an intermittent stream leading to a waterway that eventually drains into the Ohio river.

Public Health Assessment Activities

ATSDR staff members visited the Bellevue Park Site on May 22 and 23, 2000. The purpose of the visit was to meet with the petitioner and local health authorities to assist in evaluating the site for public health significance. The petitioner gave a brief history of the site and gave ATSDR staff members a tour of the park area. Debris, such as glass and asphalt, was noted on the site, as well as soil discoloration in some areas. The petitioner reported waste removal activity in November 1997, which included subsurface excavation accomplished with a track hoe and other heavy equipment. The petitioner expressed concern that the cleanup done by the city removed fill debris only, and soils were graded and redistributed over the landfill area prior to the EPA sampling in February 1999.

The petitioner has various health concerns regarding the nature and extent of contamination at the site. The petitioner is concerned about the contamination levels in soil that were confirmed by EPA's February 1999 sampling, and whether or not those levels pose a health risk to him, his family and livestock, and to others who use the park property. The petitioner also expressed concerns that if there is any contaminated runoff, it may reach streams and rivers that feed municipal water sources. The petitioner has small children, and is concerned they might inhale or ingest contaminated dust or dirt. He also owns horses, and has concerns that the horses may have lain or rolled on contaminated soil and that members of his family, while grooming or riding the horses, might be exposed to contaminants. He reports that other residents use the property for recreational purposes and may also be at risk for exposure. The petitioner would like assurances that the contaminants are at levels that are safe enough to allow children to play in the area, and safe enough to allow horses to pasture there.

Demographics

According to the 1990 U.S. Census of Population and Housing, there were 4,341 persons residing in 1,784 households within 1 mile of the Bellevue Park Site. Of these, 87% were white, 11% were black, and less than 2% were of another race. There were 1,119 children 6 years of age or younger; 997 females aged 15-44; and 1,338 adults 65 years of age and older [Census 2000]. Additional demographic statistics are in Appendix A.


DISCUSSION

Methods

ATSDR reviewed surface soil, surface water and sediment data provided by EPA Region 4, to evaluate the potential for area residents to be exposed in the present, past, or future to contaminated surface soil.

ATSDR has established health-based comparison values for many substances. These health-based comparison values have been determined to be unlikely to result in adverse health effects if human exposure occurs to these levels of contamination. If ATSDR reviews available environmental data and finds that the contaminants in an area are at levels above the comparison values, these contaminants are called the "contaminants of concern" which are selected for further evaluation.

ATSDR staff members then determine whether people are currently exposed to the contaminants or whether they may have been exposed in the past or may be exposed in the future. (Appendix C gives more detail on ATSDR's methodology.)

EPA Site Investigation Report--Soil Sample Results

In 1999, EPA prepared a site investigation report for Bellevue Park that included taking a series of inorganic and organic surface and subsurface soil samples [EPA 1999]. EPA collected surface and subsurface soil samples primarily from the Bellevue Park area in February 1999. To serve as background samples, EPA collected one surface soil sample and one subsurface soil sample from an area approximately 1 mile east of the Bellevue Park area on the Holy Angels Academy property. Most surface soil samples were collected at the 0-3 inch depth range. The samples were collected from paths used frequently by both adults and children in going to and from the play areas or horse-riding areas. Of the 24 samples collected, 12 were surface soil samples and 12 were subsurface soil samples. All of the samples were analyzed for the presence of metals and semivolatile organic compounds [EPA 1999]. None of the subsurface soil samples were found to contain contaminants at levels likely to cause adverse health effects under the current exposure situations. In the surface soil samples, levels of manganese and polycyclic aromatic hydrocarbons (PAHs) were found to be higher than ATSDR comparison values; these are discussed in the following sections (Table 1 in Appendix A shows the results of the analysis of the surface soil sample results).

Surface Soil

Polycyclic Aromatic Hydrocarbons (PAHs)

The maximum levels of benzo(a)anthracene, benzo(a)pyrene, dibenzo(a,h)anthracene, benzo(b)fluoranthene, and indeno(1,2,3-cd)pyrene detected in soil exceeded their respective cancer-based comparison values [Table 1]. These PAHs were detected in only a few of the composite samples collected. Few adverse health effects clearly attributable to PAHs have ever been demonstrated in humans, and there are no comparison values for PAHs based on non-carcinogenic effects. Thus, only cancer-based comparison values were available to screen PAH concentrations in Table 1. ATSDR's CREG for benzo(a)pyrene (BaP), the most toxic of the natural polycyclic aromatic hydrocarbons (PAHs), is 0.1 ppm.. Because ATSDR has no comparison values for benzo(a)anthracene, benzo(b)fluoranthene, benzo(k)fluoranthene, chrysene, dibenzo(a,h)anthracene, and indeno(1,2,3-cd)pyrene in soil, the cancer-category Risk Based Concentrations (RBCs) calculated by EPA Region III were used for these PAHs in Table 1. All of these comparison values are based on extrapolations from high-dose animal experiments. In some of these experiments, mice were shaved, their bare skin was "painted" with PAHs, and strong promoting substances were added at regular intervals over periods of weeks or months. In other experiments, rodents were force-fed high doses of PAHs dissolved in oil. (PAHs are largely insoluble in water.) These animal experiments are of limited relevance to human exposure scenarios. There is no evidence that either dermal or oral exposure to PAHs causes cancer in humans [ATSDR 1995]. Volatilization from soil was not considered as a significant health concern because of the low concentration of PAHs, the affinity for moderate to strong adsorption to organic material, and the limited number of low molecular weight PAHs reported (the most likely to volatilize).

The levels of PAHs detected in even the most highly contaminated soils at Bellevue Park are below levels known to produce adverse health effects in animals or humans. For oral exposure, all known effect levels for both cancerous and non-cancerous endpoints are greater than 1 mg/kg body weight, and most are greater than 100 mg/kg [ATSDR 1995]. If a child eats 200 mg of the most contaminated soil at Bellevue Park every day, the resulting daily intake of BaP TEQs would be only 0.002 mg (2 ug) which is comparable to the amount of BaP that might be found in a grilled quarter-pound hamburger. (See page 92 in Food Safety & Toxicology, DeVries, 1996, and page 439 in Handbook of Human Toxicology, Massaro, 1997.) Therefore, ATSDR concludes that no adverse health effects, including cancer, would be expected to result from exposure to soils at Bellevue Park containing PAHs at the maximum levels detected.

Manganese

Documented cases of chronic manganese toxicity in humans has been limited primarily to workers (e.g., manganese miners) exposed by inhalation, generally over a period of more than 2 years (ATSDR 1992; Donaldson, 1987; Casarett & Doul, 1996). In contrast to inhaled manganese, ingested manganese has rarely been associated with toxicity. Manganese is an essential element required for normal human growth and maintenance of health, and efficient homeostatic controls exist in the liver and gut that keep blood levels relatively constant in the face of rather wide variations in diet. Oral absorption of manganese is slow and incomplete. Gastrointestinal absorption of Mn is approximately 5%, and may be decreased further by high dietary intake of iron, calcium, phosphorus, and other metals. In addition, the tendency for extremely large doses to irritate the G.I. tract and induce vomiting tends to prevent systemic toxicity following oral administration of toxic doses.

The World Health Organization (WHO) estimates that the average daily intake of Mn ranges from 2 to 8.8 mg Mn., that 2-3 mg/day is adequate, and that 8-9 mg/day is "perfectly safe". A normal diet may contain well over 10 mg Mn/day (IRIS).

In one surface sample at Bellevue Park, manganese exceeded ATSDR's soil reference dose media evaluation guide (RMEG) for children (3000 ppm), but not those for adults [Table 1]. ATSDR's RMEGs are derived from EPA's chronic reference doses (RfDs) by multiplying by the default body weight and dividing by the default intake rate of the medium in question, in this case soil. In addition, ATSDR applied a modifying factor of 2-3. The resulting child RMEG is a very conservative value because (1) the bioavailability of Mn should be no greater in soil than it is in food and EPA does not apply any uncertainty factors or modifying factors to its RfD for food, and (2) ATSDR's child RMEGs do not take into account that children and pica children do not remain children and pica children for 70 years. (EPA's RfDs assume essentially lifetime exposure.) Assuming that a child eats 200 mg of the most contaminated soil at Bellevue Park every day, the resulting daily intake of soil manganese would be only 0.96 mg which is below the minimum daily requirement of Mn in a normal diet. Therefore, considering the low concentrations involved, and the conservatism of soil RMEGs for children, ATSDR does not consider manganese or any other metal detected in soil in the Bellevue Park Area to pose a threat to public health.

Lead

Lead-contaminated soil and dust have been identified as important sources of exposure for children, especially in an urban setting (Duggan 1977). The Centers for Disease Control and Prevention (CDC) has established an action level of 10 ug/dL blood lead level for children (CDC 1991). Mean blood lead levels >10 ug/dL in children have been associated with yard soils > 500 mg/kg (ATSDR 1995a). EPA has established an action level of 400 mg/kg lead in residential soil and The New Jersey Department of Health recommends a maximum permissible level of 250 ppm of lead in soil in areas without grass cover, and repeatedly used by children below 5 years of age who exhibit persistent pica behavior. However, this study also recommends a level of 600 ppm of lead in soil "in areas repeatedly used by children below 12 years of age" (Madhaven 1989).

The highest concentration of lead was found in one surface soil sample at a level of 300 ppm. Children exhibiting pica behavior are usually toddlers, and usually exhibit the behavior for a very short period of time (six month or less). Toddlers and very young children (<5 years) are unlikely to play in this area unsupervised by parents, and are equally unlikely to be exposed for a long enough duration and eat enough soil to result in elevated blood levels. The acceptable level proposed by the New Jersey Department of Health is 600 ppm, which is suggested as a 'safe' level of exposure for children with normal exposure scenarios (i.e., not exhibiting pica behavior).

EPA Site Investigation Report - Sediment and Surface Water

The United States Environmental Protection Agency (EPA) prepared a Site Investigation Report for Bellevue Park in 1999 which included taking a series of inorganic and organic surface and subsurface soil samples [EPA 1999]. The site investigation report recommended that additional samples be taken of surface water and sediment in the Bellevue area to close an identified data gap. As a result, EPA collected surface water and sediment samples from the Bellevue Park area in May 2000. Of the 15 samples taken 11 were sediment samples and 4 were of surface water. All sediment and surface water samples were analyzed for volatile organic compounds (VOCs), semi extractable volatile organic compounds (SVOCs), and metals. Tables 2 and 4, Appendix A, contain the results of the surface water and sediment samples [EPA 1999]

Sediment Samples

PAHs

Benzo(a)anthracene, benzo(a)pyrene, dibenzo(a,h)anthracene, exceeded the ATSDR cancer risk evaluation guide (CREG) comparison value for benzo(a)pyrene [ATSDR 1995]. Because ATSDR has no comparison values for benzo(a)anthracene, dibenzo(a,h)anthracene, in sediment, the CREG for benzo(a)pyrene, the most toxic of the natural polycyclic aromatic hydrocarbons (PAHs), was used as a surrogate for all of these other, less toxic, PAHs. This is a conservative procedure, particularly considering that these PAHs were not detected in the majority of the samples collected. Because these PAHs are less toxic than benzo(a)pyrene and because they were not detected in the majority of samples collected, no adverse health effects, including cancer, would be expected from exposure to sediment containing these PAHs at the levels detected.

Arsenic

Arsenic exceeded ATSDR's reference dose media evaluation guide (RMEG) for pica and non-pica children in seven of the eleven sediment samples, but not those for adults [ATSDR 1992]. Arsenic in the sediment samples ranged from less than 1 ppm to 79 ppm. The estimated mean for arsenic in sediment at the Bellevue site is 37ppm, which is in the margin of error for an Arsenic EMEG of 20 ppm for children and 200 ppm for adults. Risk assessments for arsenic indicated no apparent increase in the risk of developing cancer with this exposure scenario and concentration. Child comparison values do not take into account that children and pica children do not remain children and pica children for 70 years. It is not likely anyone would receive a toxic dose of arsenic from these levels in soil alone. Therefore, considering the limitations of RMEGs for pica children, and the concentrations involved, ATSDR does not consider arsenic levels detected in sediment in the Bellevue Park Area to pose a threat to public health.

Iron

Iron exceeded the Environmental Protection Agency's (EPAs) Risk Based Concentrations (RBCs) in nine out of eleven soil samples. Iron is the second most abundant metal in the earth's crust and averages about 5% or 50,000 mg/kg, which compares with the amount detected in sediment samples (60,180 mg/kg mean). Sediment concentrations may be slightly higher than soil concentrations due to the leaching of soluble materials.

Elemental iron is toxic to humans in quantities from 20 - 60 mg/kg body weight. Elemental iron is usually found mixed with other iron compounds. Depending on the type of soil and the type of iron compound found in the soil, the percentage of elemental iron varies. The type of iron compound also influences the degree to which iron is absorbed by the digestive tract. Because we do not know the type of iron compound represented in the sediment sample, we can only estimate the amount of elemental iron that might be present. Elemental iron can range between 12% and 48% of iron compounds. The sediment samples contained 12,000 - 110,000 mg/kg so the amount of elemental iron in the sediment samples could range from 1440 - 52,800 mg/kg with a mean range of 7222. - 28,800. mg/kg, which is equivalent to the EPA RBC of 23,000. Therefore, exposure to these levels of iron in the soil are not expected to result in adverse health effects.

Manganese

Manganese exceeded ATSDR's reference dose media evaluation guide (RMEG) for pica and non-pica children in six of the eleven sediment samples, but not those for adults [ATSDR 1992]. Levels ranged from 370 - 16000 mg/kg with a mean of 5300. The maximum detected value in sediment is equivalent to a dosage of about 3mg/day for a child and less than 2mg/day for an adult. The levels are below the average daily intake of manganese in the diet (10mg/day) that is considered adequate and safe [NAS, NRC 1989]. Child comparison values do not take into account that children and pica children do not remain children and pica children for 70 years. It is not likely anyone would receive a toxic dose of manganese from sediment alone. Therefore, considering the limitations of RMEGs for pica children, and the concentrations involved, ATSDR does not consider manganese levels detected in sediment in the Bellevue Park Area to pose a threat to public health.

Surface Water Samples

None of the contaminants from the surface water samples exceeded ATSDR's health based comparison values.

Combined Effects

The levels of the individual contaminants detected at this site are not at levels expected to cause adverse health effects. On the basis of animal studies, ATSDR does not believe that the combined effect of all these contaminants is likely to be of public health concern. This conclusion is based on studies which suggest that a mixture of contaminants produces no adverse health effects in animals if the components of that mixture are present at levels below concentrations that would have produced no adverse effects in animals treated separately with those component chemicals [Feron et al. 1993; Groton et al. 1991; Jonker et al. 1990; Jonker et al. 1993].

Based on the evaluation of the available site-specific data and selected exposure scenarios, ATSDR concluded that none of the surface soil, sediment or surface water samples from the Bellevue Park Site contained organic or inorganic compounds at levels that would pose a health hazard to anyone exposed to these compounds through the incidental ingestion of surface soils, sediments or surface water.

Extent of Contamination and Public Health Implications

Adverse health effects are not expected from exposure to contaminant levels found in surface soil, sediment or surface water at the dumpsite. The potential for contacting contaminants at concentrations associated with adverse health effects is limited. It is therefore doubtful that exposure to surface soil, sediment or surface water--either through ingestion, inhalation or dermal contact--would present a public health hazard to humans. ATSDR can only comment on probable human health effects. If soils were disturbed in the future (for example, during new construction), further evaluation of the nature and extent of disturbed soil contamination would be warranted.

Community Health Concerns

The petitioner has various health concerns regarding the nature and extent of contamination at the site, concerns were addressed in italics below.

  • The petitioner is concerned about the contamination levels in soil, sediment and surface water that were confirmed by EPA's February 1999 and May 2000 sampling events, and whether or not those levels pose a health risk to him, his family and livestock, and to others who use the park property.
  • In the data evaluated at the Bellevue Park Site, ATSDR did not identify any chemical contaminants at levels of health concern for children or adults. However, if concern exists regarding health effects from possible exposure to contaminants for horses, a veterinarian should be contacted for more information.

  • The petitioner also expressed concerns that if there is any contaminated runoff, it may reach streams and rivers that feed municipal water sources.
  • Since none of the contaminants from the surface water samples exceeded ATSDR's health based comparison values, it is unlikely that surface water runoff would be at levels of public health concern.

  • The petitioner has small children, and is concerned they might inhale or ingest contaminated dust or dirt.
  • In the data evaluated at the Bellevue Park Site, ATSDR did not identify any chemical contaminants at levels of health concern for children.

  • The petitioner owns horses, has concerns that the horses may have lain or rolled on contaminated soil and that members of his family, while grooming or riding the horses, might be exposed to contaminants. He reports that other residents use the property for recreational purposes and may also be at risk for exposure.
  • Based on the evaluation of the available site-specific data and selected exposure scenarios, ATSDR concluded that none of the surface soil, sediment or surface water samples from the Bellevue Park Site contained organic or inorganic compounds at levels that would pose a health hazard to anyone exposed to these compounds through the incidental ingestion of surface soils, sediments or surface water.


OTHER PUBLIC HEALTH ISSUES

ATSDR Child Health Initiative

ATSDR recognizes that infants and children may be more vulnerable to exposures than adults when faced with contamination of air, water, soil, or food. This vulnerability is a result of the following factors [ATSDR 1998].

  • Children are more likely to play outdoors and bring food into contaminated areas.

  • Children are shorter and their breathing zone is closer to the ground, resulting in a greater likelihood to breathe dust, soil, and heavy vapors.

  • Children are smaller than adults and receive comparitively higher doses of chemical exposure per body weight.

  • Children's developing body systems are more vulnerable to toxic exposures, especially during critical growth stages in which permanent damage may be incurred.

In the data evaluated at the Bellevue Park Site, ATSDR did not identify any chemical contaminants at levels of health concern for children.

Public Comments

The Agency for Toxic Substances and Disease Registry (ATSDR) issued this public health consultation draft addressing the surface and subsurface soil samples for a 30-day public comment period ending January 8, 2001. A summary of the comments received and ATSDR responses on the Public Comment Petitioned Health Assessment for the Bellevue Park Site, dated December 21, 2000 are summarized in Appendix D.


CONCLUSIONS

ATSDR reviewed and evaluated available data and information and concluded the following:

  • ATSDR concludes that the contaminant levels detected during the February 1999, and the May 2000 soil, sediment and surface water sampling events in the Bellevue Park area are not at levels of public health significance. Several contaminants were detected at levels above ATSDR comparison values; however, no adverse health effects would be expected for adults, children, or pica children from exposure to the sediment or surface water during activities such as playing and horse grooming.

  • Based on the available environmental sampling data for surface soil, subsurface soil, sediment and surface water, ATSDR categorizes the Bellevue Park Site as posing No Apparent Public Health Hazard.

  • While current surface soil, sediment and surface water investigations revealed limited contamination at levels not associated with acute and chronic health problems, further evaluation of these media at the dump site should be evaluated to determine whether contaminants from the site could result in exposures at levels that may impact health if soils were to be excavated or otherwise disturbed in the future.

RECOMMENDATIONS

Based on the available information, ATSDR makes the following public health recommendations:

  • If soils are disturbed in the future (for example, during new construction), further evaluation of the nature and extent of soil contamination may be warranted.

  • If concern exists regarding health effects from possible exposure to contaminants for horses, a veterinarian should be contacted for more information.

PUBLIC HEALTH ACTION PLAN

Past Activities

  • Scoping Visit - March 2000 Agency for Toxic Substance and Disease Registry (ATSDR)

  • Public Health Consultation - August 2000 ATSDR released a draft public health consultation for public comment that concluded the Bellevue Park Site poses an Indeterminate Public Health Hazard.

Current Activities

  • Public Health Assessment - Addresses all available data from EPA including sediment, surface water, and soil.

SITE TEAM AND AUTHORS

This health assessment was prepared by

Theresa McDarmont, Environmental Health Scientist
Exposure Investigation and Consultation Branch
Division of Health Assessment and Consultation
Agency for Toxic Substances and Disease Registry

Michelle A. Colledge, Environmental Health Scientist
Exposure Investigation and Consultation Branch
Division of Health Assessment and Consultation
Agency for Toxic Substances and Disease Registry

Frank Schnell, Toxicologist
Exposure Investigation and Consultation Branch
Division of Health Assessment and Consultation
Agency for Toxic Substances and Disease Registry

Concurrence

Carl Blair, Regional Representative
Region 4
Office of Regional Operations
Agency for Toxic Substances and Disease Registry

PerStephanie Thomspon, Community Involvement Specialist
Community Involvement Branch
Division of Health Assessment and Consultation
Agency for Toxic Substances and Disease Registry

Donald Joe, Section Chief
Exposure Investigation and Consultation Branch
Division of Health Assessment and Consultation
Agency for Toxic Substances and Disease Registry


REFERENCES

Agency for Toxic Substances and Disease Registry. 2000. Bellevue Park, Petitioned Public Health Consultation, ATSDR, dated August 2000.

Agency for Toxic Substances and Disease Registry. 1992. Toxicological profile for manganese. Atlanta: U.S. Department of Health and Human Services.

Agency for Toxic Substances and Disease Registry. 1995. Toxicological profile for polycyclic aromatic hydrocarbons (PAHs) (Update). Atlanta: U.S. Department of Health and Human Services.

Agency for Toxic Substances and Disease Registry.1995a. Multisite lead and cadmium exposure study with biological markers incorporated. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry.

Agency for Toxic Substances and Disease Registry. 1998. Interim guidance on including child health issues in Division of Health Assessment and Consultation documents. Atlanta: U.S. Department of Health and Human Services.

US Census Bureau, TIGER/Line Files, 1990 (Jefferson County, Kentucky), prepared by the Bureau of Census, US Census Bureau, Washington, DC, 1991.

Centers for Disease Control and Prevention. 1991. Preventing lead poisoning in young children. Atlanta, GA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control.

Duggan 1977. Duggan MJ and Williams S. 1977. Lead-in-Dust in City Streets. The Science of the Total Environment. Vol. 7, pp 91-97. Elsevier Scientific, Amsterdam.

Memo from petitioner to Dr. Henry Faulk, Administrator, ATSDR, dated February 23, 2000.

Feron VJ, Jonker D, Groten JP, Horbach GJMJ, Cassee FR, Schoen ED, Opdam JJG. 1993. Combination technology: from challenge to reality. Toxicology Tribune 14:1-3.

Groton JP, Sinkeldam EJ, Luten JB, van Bladeren PJ. 1991. Interaction of dietary calcium, potassium, magnesium, manganese, copper, iron, zinc, and selenium with the accumulation and oral toxicity of cadmium in rats. Food and Chemical Toxicology 4:249-258.

Jonker D, Woutersen RA, van Bladeren PJ, Til HP, Feron VJ. 1990. 4-week oral toxicity study of a combination of eight chemicals in rats: comparison with the toxicity of the individual compounds. Food and Chemical Toxicology 28: 623-631.

Jonker D, Woutersen RA, van Bladeren PJ, Til HP, Feron VJ. 1993. Subacute (4-week) oral toxicity of a combination of four nephrotoxicants in rats: comparison with the toxicity of the individual compounds. Food and Chemical Toxicology 31:45-52.

Madhaven 1989. Madhavan S, Rosenman KD, and Shehata T. 1989. Lead in Soil: Recommended Maximum Permissible Levels. Environmental Research 49:136-142.

U.S. Bureau of the Census. 2000. Census 2000, U.S. Census Bureau TIGER/Line Files, 1990 (Jefferson County, Kentucky). Washington: U.S. Bureau of the Census, 1991.

U.S. Environmental Protection Agency. 1999. Draft site investigation report for Bellevue Park. Summary of inorganic analytical results, surface/subsurface soil samples. Atlanta: U.S. Environmental Protection Agency.

U.S. Environmental Protection Agency. 1998. Revised final preliminary assessment Bellevue Park, Anchorage, Jefferson County, Kentucky. (EPA ID No. KY0002329225.) Atlanta: U.S. Environmental Protection Agency.

United States Environmental Protection Agency, Revised Final Preliminary Health Assessment Bellevue Park, Anchorage, Jefferson County, Kentucky. EPA ID No. KY0002329225. Atlanta, Georgia.

United States Environmental Protection Agency, draft Site Investigation Report for Bellevue Park. Summary of Inorganic Analytical Results, Surface/Subsurface Soil Samples. December 1999.


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