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PETITIONED HEALTH CONSULTATION

VALLEY VILLAGE (a/k/a SOUTHWEST JEFFERSON COUNTY)
LOUISVILLE, JEFFERSON COUNTY, KENTUCKY


DISCUSSION

In 1992, sulfur dioxide, carbon monoxide, ozone, nitrogen dioxide, and particulate levels did not exceed the EPA Air Quality Standards [6]. The 1993 data, including results for sulfur dioxide, carbon monoxide, ozone, and nitrogen dioxide, also showed that none of these chemicals exceeded the EPA Air Quality Standard [7]. However, the 1994 - 1997 Watson Lane data showed that there was one day in each of 1994, 1995, and 1996 in which ozone levels exceeded the EPA air quality standard. None of the 1994 - 1997 levels for the other four chemicals exceeded the standard [8]. These data suggest that recent air quality in Valley Village has been generally good and would not likely cause chronic respiratory problems and other health effects. However, ATSDR cannot rule out that sensitive individuals may be affected by the periodically elevated ozone levels.

On June 12, 1998, as a follow-up to previous discussions, ATSDR received correspondence from the petitioner. The petitioner stated that current conditions differ significantly from those present in 1992 and that a health assessment was no longer warranted. The petitioner indicated, however, that the request for a health assessment would be reinstated if adverse environmental conditions reoccurred [9].

The original request was based on existing air quality concerns as well as proposals for additional facilities which would create new emission sources. At that time, community members were concerned that the emissions from nearby facilities were contributing to the perceived elevated cancer rates and respiratory problems in the area. Proposals to build a hazardous waste incinerator and to convert Kosmos’ cement kiln from a conventional to a waste solvent-fired kiln served to heighten public concern [9, 10].

Following ATSDR’s receipt and review of the petition, several significant elements changed. A Jefferson County investigation determined that the primary contaminant source was LG&E’s stack emissions. In 1995, the plant began modifying its equipment and operations to include pollution control devices and monitoring procedures which have significantly reduced the emissions. Also, the proposals for a hazardous waste incinerator and the waste-fueled cement kiln were abandoned. More importantly, a detailed review of cancer mortality and incidence statistics for the area showed no significant difference between cancer rates for Valley Village compared to Jefferson County or Kentucky [9].

 Health Outcome Data

Since the petitioner’s and community’s primary health concern has included cancer rates in the Valley Village area, ATSDR reviewed a report prepared by the Louisville and Jefferson County Board of Health. The Board of Health convened an expert panel to examine differences, if any, between the occurrence of cancer (cancer incidence rates) and the deaths due to cancer (cancer mortality rates) across Jefferson County. The panel issued the report, entitled "Cancer Mortality and Incidence in Jefferson County, Kentucky", in September 1997. The panel evaluated cancer incidence rates and cancer mortality rates using cancer and vital statistics data from death certificates issued for 1992 - 1994. In the report, Jefferson County is divided geographically into zip code and health planning areas. Although there are no available data specific to Valley Village, data exists for the zip code 40272 area as well as the "southwest health planning area" (SWHPA) of Jefferson County, both of which include Valley Village. The SWHPA is comprised of the zip code areas 40214, 40215, 40216, 40258, and 40272. The population for zip code 40272 is 32,935 and for the SWHPA is 166,030 [11].

ATSDR also reviewed the Kentucky Cancer Registry’s "Report of 1991 Cancer Incidence for Jefferson County." In this report, the 1991 cancer incidence rates for Jefferson County were compared with the 1991 Kentucky and the 1989 National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) age-adjusted incidence rates for all types of cancer.

The SEER population data provides the cancer rates that would be expected in a "normal" population of the same size.

Cancer Incidence

In order to evaluate the available information on cancer incidence, ATSDR compared the incidence rates for several different populations by calculating rate ratios. In this case, a rate ratio is the comparison of the incidence rate of cancer in two populations. A rate ratio with a value of 1.0 or less indicates that the cancer incidences in the two populations are the same or that there are fewer cancer cases in the observed population than expected. Conversely, a ratio significantly higher than 1.0 shows that there may be more cases in the community than expected. However, this increase may be due to other factors such as small population size, years observed, inaccurate data, lifestyle, or other risk factors that may influence the results.

ATSDR compared the cancer incidence rate for zip code 40272 with the cancer incidence rate for each of the following populations: the SWHPA, Jefferson County, Kentucky, and SEER. The age-adjusted cancer incidence rate for zip code 40272 is 480.7 per 100,000 population [11]. Although this rate is slightly higher than the rates for the SWHPA, Jefferson County, Kentucky, and SEER, the rate ratios do not differ significantly from 1.0. Since individual case information was not available for review, ATSDR is not able to determine if this slight increase is due to variability in the data or other risk factors stated above. Therefore, the small difference in incidence rates may be due to chance or to factors unrelated to air quality.

Cancer Mortality

Similarly, ATSDR calculated the rate ratios for the cancer mortality rates in the same populations.

The age-adjusted cancer mortality rate for zip code 40272 is 222.9 per 100,000 [11]. Although this rate is slightly higher than the SWHPA, Jefferson County, and Kentucky, the rate ratios do not differ significantly from 1.0. As with the cancer incidence data, individual case information was not available for review and ATSDR is not able to determine if this slight increase is due to variability in the data or is statistically significant. Similarly, the small difference in mortality rates may be due to chance or to factors unrelated to air quality.

Although specific information was not available for the zip code 40272 area, information on the cancer deaths by type of cancer exists for the SWHPA. The leading cause of cancer death in SWHPA males is from lung cancer, followed by colorectal and prostate cancers. The leading cause of cancer death in SWHPA females is from lung cancer, followed by breast and colorectal cancers [10]. These data are consistent with data published by the National Center for Health Statistics for leading cancers observed in the United States population [11].


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