Blood Lead Results for 2002 Calendar Year
HERCULANEUM LEAD SMELTER SITE
HERCULANEUM, JEFFERSON COUNTY, MISSOURI
Statement of Issues
In March 2003, the Missouri Department of Health and Senior Services (DHSS), in cooperationwith the Agency for Toxic Substances and Disease Registry (ATSDR), presented to theHerculaneum Community Advisory Group preliminary results of all known blood lead datacollected in 2002 from Herculaneum, Missouri residents. This health consultation will furtherevaluate that data and compare it to the 2001 blood lead data. Additionally, this healthconsultation will evaluate the blood lead data collected for children under 72 months of age whowere serially tested in both years 2001 and 2002. Conclusions and recommendations in thisdocument were made on the basis of data available as of March 14, 2003.
The Herculaneum lead smelter is an active facility that has been in operation in the communitysince 1892. The Doe Run Company currently owns and operates the smelter. The facility islocated at 881 Main Street in Herculaneum, Missouri, approximately 25 miles south of St. Louis,Missouri, on the Mississippi River. It abuts residential neighborhoods on the north, west, andsouth, with the Mississippi River on the east. A lead ore concentrate, consisting ofapproximately 80% lead sulfide, is processed at the smelter. The ore is transported by truck fromeight lead mines operated by the company near Viburnum, Missouri, approximately 75 milessouth-southwest of Herculaneum. The 52-acre Herculaneum facility consists of a smelter plant, a24-acre waste slag storage pile, and an onsite sulfuric acid plant .
The city of Herculaneum has an estimated population of 2,805 people, according to the 2000 USCensus. Several homes are within 200 feet of the smelter plant, and currently at least threehomes are within 200 feet of the slag pile, of which one is being occupied. Figures 1 and 2 display the location of the smelter in relationship to the community . Three schools are in thecity: a high school, a middle school, and a junior high school. The elementary school is in nearbyPevely. No licensed day-care facilities are in the city of Herculaneum.
Environmental sampling has indicated that there is lead contamination throughout the community. For example, lead has been found in yard soils at concentrations up to 33,100 parts per million (ppm) ; in air ranging from non-detectable (ND) to 85 micrograms per cubic meter (µg/m3) ; and in dust on streets up to 300,000 ppm . Although multiple sources of lead could be contributing to the overall contamination (e.g., lead-based paint), an Exposure Investigation (EI) conducted by ATSDR in 2001 indicated that lead in paint and water at the two homes evaluated did not appear to be significant sources of lead exposure in the children with elevated blood lead concentrations from these homes . Additionally, it has been documented that proximity to the smelter appears to be associated with higher blood lead levels (BLL) . In 2001, 28 percent of the children in this community under 72 months of age who were tested had BLLs equal to or above 10 micrograms of lead per deciliter of blood (10 µg/dL) . In the area closest to the smelter, east of U.S. Hwy 61/Commercial Blvd., 45% of the children under 72 months of age who were tested in 2001 had BLLs equal to or above 10 µg/dL . BLLs above 10 µg/dL have been associated with the development of adverse health effects .
Efforts to address the overall contamination in the community have been ongoing sinceSeptember 2001, when the Missouri Department of Natural Resources (MDNR) and theEnvironmental Protection Agency (EPA) confirmed that spillage of lead concentrate wasoccurring along transportation routes in the city . This information prompted DHSS to alertMDNR that the risks to the public surrounding the site were clear and present and that they werean imminent and substantial endangerment to the health of residents of Herculaneum . Subsequently, MDNR and EPA directed the Doe Run Company to expedite activities to clean upexisting contamination and reduce/eliminate future contamination throughout Herculaneum. TheDoe Run Company, with oversight from MDNR and EPA, has implemented several exposurereduction activities since that time, including the following:
- smelter air emissions and fugitive dust have been reduced by installation of a number ofequipment up-grades and process modifications . Only since the fall of 2002 has thefacility come into compliance with the National Ambient Air Quality Standards for leademissions of 1.5 micrograms per dry standard cubic meter (quarterly average);
- soil removal and replacement is being performed by the Doe Run Company (withoversight by EPA) in public and private yards, parks, and schools, as well as alongroadsides, where lead levels are greater than 400 ppm (as determined by establishedmethods). First priority was given to those yards where children under 72 months reside ;
- in-house dust is being removed by the Doe Run Company in accordance with establishedmethods, with oversight from EPA, in those residences with elevated lead dust levels ;
- residences are being offered HEPA filter vacuums, regardless of whether their homeshave been cleaned, to assist in controlling interior dust levels ;
- the Doe Run Company has made modifications in the handling and transportation of thelead ore concentrate ; and,
- the Doe Run Company is offering a voluntary property acquisition of homes within aspecified geographic area approximately 3/8 mile around the smelter. Priority was placedon those homes where children under 72 months of age reside .
Additionally, DHSS, in cooperation with ATSDR, has initiated health education for arearesidents and physicians to increase their awareness of public health issues associated with leadand the benefits of routine blood lead testing. In the past, DHSS and the Jefferson County HealthDepartment (JCHD), in cooperation with ATSDR, have offered blood lead testing to theresidents of Herculaneum and surrounding communities. One such testing effort occurred inHerculaneum in the past year. In September 2002, DHSS and JCHD offered a voluntarycommunity-wide venous blood lead testing event.
According to Missouri state regulation 19 CSR 20-20.020, the results of all persons' blood leadtests, regardless of age or BLL, must be reported to DHSS by physicians, laboratories, andhospitals. The State Public Health Laboratory (SPHL), private physicians, and variouslaboratories have provided BLL data to the DHSS Office of Surveillance, which maintainsdatabases on all reported blood lead tests.
The data set evaluated in this health consultation includes blood lead data collected by and/orreported to DHSS over the course of calendar year 2002, as required by the state regulation, aswell as results from the screening event conducted in Herculaneum in September 2002. Additionally, this health consultation will include a comparison of the blood lead data collectedin both 2001 and 2002 for children under 72 months of age. Laboratory analytical methods arenot described, and they vary for all the data. However, the data are sufficient to permit adetermination of whether BLLs in the community were elevated in 2002, and they are adequateto permit performance of a comparison of blood lead data of children serially tested in both 2001and 2002.
Only data for Herculaneum residents are considered in this analysis (zip code 63048). Forindividuals who have multiple BLL results for the year, the highest BLL reported for theindividual has been used in the summary of the 2002 data and in the comparison of the 2002 datawith data from 2001. The evaluation of blood lead data for children under 72 months of age andserially tested in both 2001 and 2002 includes all blood lead data for those children tested in bothyears. For those children who have multiple BLL results for each year, the highest BLL reportedin 2001 was compared to the last BLL reported in 2002. This comparison method was chosen inorder to determine the overall decline in BLLs from the highest in 2001 to the most recent in2002. Only test results from venous blood draws were used; any capillary test results have beenremoved from the data set.
2002 Blood Lead Data Summary
A total of 340 people were tested in 2002; 58 of these were children under the age of 72 months, 129 were children between the ages of 6 and 17 years, and 153 were adults age 18 or more. Of the children under 72 months of age, 8 had BLLs of 10 µg/dL or higher (14%). The children in this age group had BLLs ranging from 2-28 µg/dL, with an average BLL of approximately 6.4 µg/dL. Among children between the ages of 6 and 17 years, 2 had BLLs of 10 µg/dL or higher (1.5 %). The BLL range for this age group was from 2 to 14 µg/dL. Of the 153 adults tested, 6 had BLLs of 25 µg/dL or higher. The BLLs of men ranged from 2 to 33 µg/dL, and women's BLLs ranged from 1 µg/dL to 42 µg/dL.
|Blood lead levels in µg/dL||Number of individuals|
|30 or higher||0|
|Blood lead levels in µg/dL||Number of Individuals|
|30 or higher||0|
|Blood lead level (µg/dL)||Number of Individuals|
|50 and higher||0|
Data for other sensitive subgroups, such as fetuses theoretically exposed through women of childbearing age (15-44 years) and the elderly (i.e., 65 and older), were examined more closely. Table 4 summarizes this evaluation. This analysis found that 63 women of childbearing age were tested. In this group, only 1 had a BLL of 10 µg/dL or higher (42 µg/dL). Twenty-three of the women tested in this group were aged 15 to 17 years; the remaining 40 were 18 or older.
A total of 36 residents 65 years of age and older were tested. Six had BLLs of 10 µg/dL or higher, 2 females and 4 males. Twelve µg/dL was the highest female BLL, and 19 µg/dL was the highest male BLL.
|Blood lead level (µg/dL)||Women of child bearing age |
15-44 years (n=63)
|Elderly, 65 years and older (n=36)|
|30 or higher||1||0|
Comparison of the 2001 blood lead data with 2002 data
In 2001, a total of 935 people were tested; 118 were children under the age of 72 months, 162were children between the ages of 6 and 17 years, and 655 were adults age 18 or higher . There was a 64% reduction in the number of individuals tested in 2002 compared to those testedin 2001.
Of the children tested in 2001 between the ages of 6 and 17 years, 13 of 162 had BLLs of 10 µg/dL or higher (8%), ranging from 10 to 19 µg/dL . In comparison and as stated earlier, in 2002, 2 of the 129 children in this age group had BLLs of 10 µg/dL or higher (1.5%). A comparison of data from 2001 to 2002 shows an apparent 81% reduction in the prevalence of BLLs of 10 µg/dL or higher for children tested in this age group.
Additionally, in 2001 there were 655 adults tested. Two had BLLs of 25 µg/dL or higher . The men ranged from non-detect (non-detect = BLLs too low to be detected by laboratory instrument) to 31 µg/dL, and women were from non-detect to 55 µg/dL . In 2002, 6 of the 153 individuals had BLLs of 25 µg/dL or higher. For this age group, there were notably fewer people tested in 2002 than in 2001. Overall, there were no notable changes in the ranges of BLLs for the adult age group. However, there was an increase in the prevalence of adults with BLLs of 25 µg/dL or higher. Fewer than 1% of the adults tested in 2001 had BLLs higher than 25 µg/dL, compared to slightly less than 4% of adults tested in 2002. This change in rates could be due to increased awareness and screening of individuals most at risk for exposure to lead.
In 2001, 197 women of childbearing age were tested (15-44 years) . With the exception of one woman who had a BLL of 55 µg/dL in 2001 and 42 µg/dL in 2002, all other women of childbearing age tested had BLLs less than 10 µg/dL. Of the 166 residents 65 years and older tested in 2001, 21 had BLLs of 10 µg/dL or higher--5 females and 16 males . Twenty-one µg/dL was the highest female BLL, and 24 µg/dL was the highest male BLL . Comparatively, in 2002, 6 of the 36 people tested had BLLs of 10 µg/dL or higher, 2 females and 4 males. In 2002, 12 µg/dL was the highest female BLL and 19 µg/dL was the highest male BLL.
When comparing the data, DHSS evaluated the children under 72 months who were tested in 2001 and 2002 more closely. Of the children under 72 months tested in 2001, 33 of the 118 had BLLs of 10 µg/dL or higher (28%), ranging from 10-31 µg/dL . Comparatively, in 2002, 8 of the 58 children tested had BLLs of 10 µg/dL or higher (14%), ranging from 10-28 µg/dL. The 2002 blood lead numbers indicate an apparent 50% reduction in the prevalence of elevated BLLs for children tested in 2001 in this age group.
When BLLs for children under 72 months of age residing east of Highway 61/ Commercial Blvd. (the portion of the community closer to the smelter) were examined exclusively, 30 of the 67 children tested had BLLs of 10 µg/dL or higher (45%) in 2001. In 2002, 8 of the 46 children tested in this age group had BLLs of 10 µg/dL or higher (17%). The 2002 blood lead data for the children under 72 months of age residing in this area show an apparent 62% reduction in the prevalence of elevated BLLs compared to 2001 data.
Table 5 summarizes the comparison of 2001 and 2002 blood lead data for children under 72months of age.
|Total number of children under 72 months of age blood lead tested.||118||58|
|Range of BLLs for children tested who were under 72 months of age.||Non-detect*-31 µg/dL||2 µg/dL-28 µg/dL|
|Average BLL for children tested who were under 72 months of age.||8.0 µg/dL||6.4 µg/dL|
|Children under 72 months of age with BLLs of 10 µg/dL or higher.||33 (28%) of 118||8 (14%) of 58|
|Children under 72 months of age residing east of Highway 61/Commercial Blvd. (the portion of the community closer to the smelter) who were blood lead tested.||67||46|
|Children under 72 months of age residing east of Hwy. 61/Commerical Blvd. with BLLs of 10 µg/dL or higher.||30 (45%) of 67||8 (17%) of 46|
* Non-detect = BLLs too low to be detected by laboratory instrument.
Additionally, DHSS reviewed the blood lead data collected from January 1, 2001 thoughDecember 31, 2002 with a focus onthe subset ofchildren under 72 months of age living inHerculaneum who were tested in both years 2001 and 2002 . A total of 141 different childrenwere tested for BLL during that time period, 35 of which had serial blood lead screenings in both2001 and 2002. Of the 35 children tested in both years, 31 were located east of Hwy61/Commercial Blvd. (the portion of the community closer to the smelter). For those childrenwho have multiple BLL results for each year, the highest BLL reported in 2001 was compared tothe last BLL reported in 2002. This comparison method was chosen in order to determine theoverall decline in BLLs from the highest in 2001 to the most recent in 2002. Twenty of the 35children tested in both years had BLLs that remained less than 10 µg/dL. Twelve of thesechildren who had BLLs less than 10 µg/dL in 2001 had a decrease in BLL in 2002. Theremaining 8 of the 20 children who had BLLs less than 10 µg/dL in both years had BLLs thatwere either unchanged or because they were below the various laboratories' reporting limits,DHSS was unable to verify the change definitively. Nine of the 35 children with BLLs higherthan or equal to 10 µg/dL in 2001 had a decrease to a BLL of less than 10 µg/dL in 2002. Fivechildren had BLLs higher than or equal to 10 µg/dL in 2001 and a decreased BLL that was stillhigher than or equal to 10 µg/dL in 2002. One child had an increase in BLL from 2001 to 2002. The blood lead level for this child increased from 11 µg/dL to 25 µg/dL. This child and his/herfamily have moved away from Herculaneum. The most recent venus blood lead level for thechild, collected in 2003, has decreased to less than 10 µg/dL.
|Total number of children tested in both 2001 and 2002 ||35|
|Number of children with blood lead levels always less than 10 µg/dL in 2001 and 2002 ||20|
|Number of children with blood lead levels higher than or equal to 10 µg/dL in 2001 with a decrease to a blood lead level of less than 10 µg/dL in 2002||9|
|Number of children with blood lead levels higher than or equal to 10 µg/dL in 2001 with a decreased blood lead level but still higher than or equal to 10 µg/dL in 2002||5|
|Children with an increase in blood lead level from 2001 to 2002 ||1|
Childhood lead poisoning is a major, but preventable, environmental health problem. Children are a high-risk group. They are generally assumed to be at an increased risk of exposure to chemicals in soil because of their more frequent soil contact and their tendency to ingest soil, either intentionally or through normal hand-to-mouth behavior. Exposure to lead in utero, in infancy, and in early childhood may slow mental development and lower intelligence later in life. The Centers for Disease Control and Prevention (CDC) recommends that BLLs remain below 10 µg/dL to decrease the likelihood of neurological and learning problems in children. Other unusually susceptible populations include the elderly, people with inheritable genetic diseases, alcoholics and smokers, and people with neurological dysfunction or kidney disease [8, 10].
Recent data from the Second National Report on Human Exposure to Environmental Chemicals, 1999-2000 (NHANES) conducted by the CDC stated that the mean children's BLL in the United States is 2.23 µg/dL . Average BLLs in the United States have fallen dramatically since the 1970s. In 1976-1980, the average BLL in children was 15 µg/dL, and in 1991-1994, the average was 2.7 µg/dL . The national prevalence rate, 1999-2000 (NHANES), of BLLs higher than or equal to 10 µg/dL in children is 2.2% .
According to all the blood lead data provided to DHSS, there have been notable reductions in BLLs in the community from 2001 to 2002. However, blood lead elevations continue to be documented in this community. The data provided neither represent a random sample of the community nor represent the entire community; these BLLs are reflective of physician selection and/or self-selection. Although there has been an apparent 50 % reduction in the prevalence of elevated BLLs from 2001 to 2002 for children tested under 72 months of age living in this community, 8 of the 58 children tested in 2002 (14%) were found to have BLLs of 10 µg/dL or higher. This percentage is still notably higher than the national prevalence rate of 2.2%  and the State of Missouri rate of 5.0% for calendar year 2002 .
When BLLs for children residing east of Highway 61/Commercial Blvd. (the portion of the community closer to the smelter) are examined exclusively, 8 of the 46 children under 72 months of age tested in 2002 (17%) had BLLs of 10 µg/dL or higher. The 2002 blood lead data for the children residing in this area show an apparent 62% reduction in the prevalence of elevated BLLs compared to 2001 data for this age group. The average BLL in children under 72 months, regardless of proximity to the smelter, was approximately 8.0 µg/dL for 2001. In 2002, there has been a reduction in the average BLL to approximately 6.4 µg/dL. Although there has been a decrease in the average BLL for tested children of this age group, the average BLL is still notably higher than the national mean BLL of 2.23 µg/dL .
Twenty-six children of 35 tested in both years had decreases in BLL in 2002. Of the 35 children tested inboth years, one child had an increase in BLL from 2001 to 2002.
In 2002, 2 of the 129 children between the ages of 6 and 17 had BLLs of 10 µg/dL or higher (1.5%), compared to 13 of 162 children in 2001 (8%). A comparison of data from 2001 to 2002 reveals an apparent 81% reduction in the prevalence of BLLs of 10 µg/dL or higher for children tested in this age group.
Several factors could be responsible for the apparent reduction in the prevalence of elevated BLLs inchildren living in Herculaneum from 2001 to 2002. These factors include the actions taken bythe MDNR and EPA to ensure that the Doe Run Company eliminates or reduces the sources ofexposure; the community's increased awareness of potential pathways of exposure; modificationsof home cleaning methods and changes in hygienic practices; and the actions taken by DHSS,ATSDR, and the JCHD to increase childhood lead testing in order to increase awareness of leadpoisoning and its adverse health effects and to provide information about how to reduceexposures, especially for children. In addition, some of the children in the area most at risk tolead exposure from the smelter no longer reside in that area as a result of property buy-outs.
Although there have been notable reductions in the prevalence of elevated BLLs in children residing in thiscommunity, the prevalence of elevated BLL remains unacceptably high.
Any effects of lead at these levels on the health of children are likely to be subtle. Therefore, blood leadlevels alone are not an indicator of adverse effects for an individual child. However, inconsidering populations (groups of individuals) exposed to lead, adverse health effects can beseen in groups with elevated blood lead levels . Therefore, it is important that efforts toreduce exposure to lead in Herculaneum continue.
The 2002 data indicate that the average BLL for women between the ages of 15-44 is approximately 3.6 µg/dL. Comparatively, in 2001 the approximate average BLL for women in this age group was essentially the same--3.4 µg/dL . However, in both years, the BLL has been higher than the national mean of 1.8 µg/dL for this age group . No adverse health effects would be expected for women at this BLL level. Nevertheless, lead has been demonstrated to cross the placenta at levels less than 10 µg/dL and could potentially impact the health of the fetus . The one female having a BLL of 55 µg/dL in 2001 and 42 µg/dL in 2002 has been advised that should she become pregnant she should alert her physician to her history of elevated blood lead levels. This individual was also given guidance on actions that could be taken to reduce exposure.
Individuals 65 years and older were found to have an approximate mean BLL of 5.7 µg/dL in 2002, slightly less than the approximate mean BLL of 5.9 µg/dL in 2001 . However, again, the 2002 mean BLL is higher than the national mean BLL of 3.3 µg/dL. Six of the 36 people in this age group that were tested had BLLs of 10 µg/dL; however, no individual had a BLL of 25 µg/dL or greater. No adverse health effects would be expected from current BLLs . Still, some past and present occupational and recreational exposures(e.g., crafts and hobbies)have been identified for this subgroup that may be contributing to the elevations.
Child Health Considerations
Children and adults are exposed to lead in many of the same ways. But children are not small adults. Theydiffer in the behaviors that lead to their exposures as well as in their susceptibility to toxic effectsfrom lead exposures. Children are more likely to play outdoors and bring food into contaminatedareas. They are also shorter than adults, so they are more likely to breathe dust and soil that areclose to the ground. Children are also smaller, resulting in higher doses of chemical exposure perpound of body weight .
Further, children have developing body systems that can sustain permanent damage if toxic exposures occurduring critical growth stages. Compared to adults, children absorb more of the lead they take intotheir bodies, retain more of the lead they take in, and are more sensitive to its effects .
Children may be exposed to lead inside their homes, in and around their schools, and outside in their yards,playgrounds, and parks. This community is faced with widespread environmental contamination. Because children depend on adults for risk identification and management decisions, it is prudent that further lead exposure be prevented.
The blood lead data reviewed indicate that exposures have occurred, are occurring, and are likely to occur inthe future and that these exposures may have an adverse impact on human health. Consequently,this site has been classified as a public health hazard. Specifically, DHSS concludes thefollowing:
- Fourteen percent (14%) of children living in this community who were tested in 2002 have blood lead levelsknown to cause adverse health effects (BLLs above 10 µg/dL). Seventeen percent (17%) of thechildren who were tested in 2002 who reside east of Hwy 61/Commercial Blvd. (the portion ofthe community closer to the smelter) have blood lead levels known to cause adverse healtheffectson a population level.
- Of the females of childbearing age in this community tested for BLLs in 2001 and 2002, onefemale had BLLs in both years that could cause adverse health effects to her developing fetus if she became pregnant.
- Although there have been sixty-four percent (64%) fewer people blood lead tested in 2002compared to 2001, the data seem to indicate that less lead exposure occurred in 2002 than in2001. This fact is evidenced by the apparent decrease in prevalence rates of elevated BLLsamong children tested in 2002 when compared to those tested in 2001 and the notable number of children with decreased BLLs who were serially tested in both 2001 and 2002.
- EPA and MDNR should continue to ensure that steps are taken by the lead smelter owners to eliminate/reduce the source(s) of lead exposure as soon as possible.
- The one female of child bearing years who has an elevated blood lead level should make her physicianaware of her history, especially if she should become pregnant, and take steps to reduce her current exposures to lead.
- EPA and MDNR should continue to conduct environmental sampling to evaluate all lead exposure pathways for this community.
- DHSS and JCHD should continue health education activities for the people in the community as well asfor area health care providers. These activities should focus on awareness of lead poisoning, itsadverse health effects, and how to reduce exposures and encourage blood lead testing, especially for children.
- A health study should be conducted to evaluate the health impacts of lead on the community.
When additional information becomes available, DHSS will evaluate it thoroughly and, if appropriate,update existing assessment documents. ATSDR and DHSS will respond appropriately to anyrequest for additional information or action.
The Public Health Action Plan (PHAP) for the Herculaneum Lead Smelter site contains a description ofactions to be taken by the Missouri Department of Health and Senior Services (DHSS), theAgency for Toxic Substances and Disease Registry (ATSDR), and others. The purpose of thePHAP is to ensure that this health consultation not only identifies public health hazards, but alsoprovides an action plan to mitigate and prevent adverse human health effects resulting frompresent and/or future exposure to hazardous substances at or near the site. Implicit in this plan isa commitment from DHSS and/or ATSDR to follow-up on this plan to ensure that it isimplemented. The public health actions to be implemented by DHSS, ATSDR, and /orcooperators are as follows:
- DHSS/ATSDR will coordinate with the appropriate environmental agencies to identifyenvironmental sampling that needs to occur so that exposure pathways can be adequatelyidentified and characterized.
- DHSS/ATSDR will continue to evaluate any additional data that become availableregarding human exposure or contaminants at the site, including identifying additionalexposure pathways and evaluating health impacts of risk reduction and remediation plans.
- DHSS/ATSDR have developed and are implementing a comprehensive health educationplan in this community. Those efforts will continue, and they will focus on increasedchildhood lead testing, awareness of lead poisoning and its adverse health effects, andhow to reduce exposures, especially for children.
- JCHD/DHSS/ATSDR will continue to assure case management of children and othersensitive populations such as women of child bearing age with elevated BLLs.
- DHSS/ATSDR are in the preliminary stages of initiating health study activities in thiscommunity.
Rachelle Kuster, Missouri Department of Health & Senior Services
Gale Carlson, Missouri Department of Health & Senior Services
Scott Clardy, Missouri Department of Health & Senior Services
This health consultation for the Herculaneum Lead Smelter Site was prepared by the MissouriDepartment of Health and Senior Services under a cooperative agreement with the federalAgency for Toxic Substances and Disease Registry (ATSDR). It is in accordance with theapproved methodology and procedures at the time the health consultation was initiated.
Alan G. Parham
Technical Project Officer, SPS, SSAB, DAC
The Division of Health Assessment and Consultation (DHAC), ATSDR, has reviewed this health consultation and concurs with its findings.
for Richard Gillig
Section Chief, SPS, DHAC, ATSDR
- Missouri Department of Natural Resources, Division of Environmental Quality,Hazardous Waste Program. Preliminary Assessment: Herculaneum Lead Smelter Site, JeffersonCounty, Missouri. 1999 Mar 30.
- Agency for Toxic Substances and Disease Registry. Health Consultation for HerculaneumLead Smelter Site: Atlanta: US Department of Health and Human Services; 2001 Jul 13.
- Environmental Protection Agency. Transmittal from Bruce Morrison to MissouriDepartment of Health and Senior Services, January 8, 2002.
- Missouri Department of Natural Resources. Transmittal from David Mosby to TonyPetruska, Environmental Protection Agency, Sample#A58, November 28, 2001.
- Walker P. Herculaneum, Missouri Lead Contamination Health Threat. MissouriDepartment of Health and Senior Services; 2001 Sep13.
- Agency for Toxic Substances and Disease Registry. Health Consultation onExposure Investigation on Herculaneum Lead Smelter Site, Herculaneum, Missouri. Atlanta: US Department of Health and Human Services; 2001 Sep 14.
- Agency for Toxic Substances and Disease Registry. Health Consultation onBlood Lead Results for 2001 Calendar Year, Herculaneum Lead Smelter Site, Herculaneum,Missouri. Atlanta: US Department of Health and Human Services; 2002 Feb 26.
- Centers for Disease Control and Prevention. Screening Young Children for LeadPoisoning: Guidance for State and Local Public Health Officials. Atlanta, Georgia: USDepartment of Health and Human Services; 1997 Nov.
- Agency for Toxic Substances and Disease Registry. Health Consultation onDetermination if Remedial Actions are Protective of Public Health, Herculaneum Lead Smelter Site, Herculaneum, Missouri. Atlanta: US Department of Health and Human Services; 2002 Apr 16.
- Agency for Toxic Substances and Disease Registry. Toxicological Profile for Lead(update). Atlanta: US Department of Health and Human Services; 1999.
- Centers for Disease Control and Prevention. Second National Report on HumanExposure to Environmental Chemicals, NCEH Pub, No. 03-0022. 2003 Jan.
- Missouri Department of Health and Senior Services. 2002 Calendar Year Blood LeadTesting Data, January through December 2002, Children Less than Six Years of Age; 2003 Jun 4.
- Centers for Disease Control and Prevention. Blood Lead Levels--United States,1991-1994. Morb Mortal Wkly Rep 1997; 46: 141-6.
- Agency for Toxic Substances and Disease Registry. Toxicological Profile for Lead.Atlanta: US Department of Health and Human Services; 1990.
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