Rueben C. Warren, DDS, MPH, DrPH, who is now leading the urban affairs efforts of the Agency for Toxic Substances and Disease Registry (ATSDR), hopes the program helps create an environment for urban areas where health promotion abounds and quality of life is increased for everyone, particularly those in greatest need.

Dr. Warren was appointed in February to the new position of Associate Administrator for Urban Affairs, ATSDR. He formerly served for 8 years as Associate Director for Minority Health, Centers for Disease Control and Prevention (CDC) and ATSDR.

The ATSDR program he now heads focuses on three areas: (1) environmental justice, (2) brownfields, and (3) minority health. These priority areas under Urban Affairs are complementary, which will allow greater synergy throughout the agency, Dr. Warren said.

"My goal for the program is to create an environment where health promotion abounds, that is, we reduce our reaction to the environment by trying to control it and increase our action through care, remediation, and global planning," said Dr. Warren. "We need to make a paradigm shift to health promotion--to determine how to enhance well being and the quality of life."

The infrastructures needed for creating, maintaining, and sustaining quality of life in urban areas, and now the suburbs, were not in place during their creation, which has led to a lot of health and social problems as well as damage to the environment, he said.

Dr. Warren is focusing on taking environmental research results related to racial and ethnic minority and socioeconomically disadvantaged populations and developing a program of public health interventions responsive to the needs of these populations.

He is also providing leadership to help shape and direct ATSDR's environmental justice efforts that will impact both large and small urban and rural areas. In February 1994, President Clinton signed Executive order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations. This order requires federal agencies to make achieving environmental justice part of their missions by identifying and addressing through their programs, as appropriate, disproportionately high and adverse human health or environmental effects experienced by low-income and minority populations.

"Environmental justice far exceeds equity--it speaks to a greater vision of how things ought to be," Dr. Warren said.

Dr. Warren's second area of concern is the brownfields initiative to revitalize and reuse former industrial sites in urban and some rural areas.

"We want to help communities--residential, business, health, faith, and educational--to first understand what the vision for brownfields is, and that is basically job opportunities and commercial development," Dr. Warren said. "For communities to develop, they have to be healthy. Health is a process which enables individuals to reach their goals in life. For example, health is not in competition with the major goals of the brownfield initiatives (job opportunities and commercial development), but allows one to more successfully reach them."

The minority health programs will expand on lessons learned since 1985 when the "Report of the Secretary's Task Force on Black and Minority Health" was published. Minority health embraces a broadened notion for health, which can be described as a dynamic relationship focused on the physical, social, psychological, and spiritual well-being of the individual and group, and their interaction with the physical and social environment. ATSDR began a targeted minority health program in 1987.

For more information about the urban affairs program, contact Rueben C. Warren, DDS, MPH, DrPH at ATSDR, 1600 Clifton Road, NE, MS E28, Atlanta, GA; telephone (404) 639-5060; fax (404) 639-0586.

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First SSARP Voluntary Study Will Help Fill Methylene Chloride Data Gaps

A private-sector study, the first voluntary research study to be completed under the Substance-Specific Applied Research Program (SSARP) of the Agency for Toxic Substances and Disease Registry (ATSDR), will help fill knowledge gaps concerning the health effects of the organic solvent methylene chloride.

At no cost to the government or public, the Halogenated Solvents Industry Alliance, Inc. (HSIA) volunteered under SSARP to conduct research to find out how ingestion of methylene chloride may affect the central nervous system and liver and the development of newborns.

Based in Washington, DC, HSIA, which represents manufacturers, distributors, and commercial users of halogenated solvents, is the first private-sector organization to complete a voluntary study under the SSARP. [See sidebar How Private-Sector Volunteerism Works in ATSDR's Substance-Specific Applied Research Program."]

"The study is expected to provide useful information for developing health guidelines, such as ATSDR's minimal risk levels, to assess the toxicity of methylene chloride resulting from oral exposure," said Chris De Rosa, PhD, director of ATSDR's Division of Toxicology.

Methylene chloride is a hazardous substance that is widely used as a paint stripper and component in certain aerosol and pesticide products, and in the manufacture of photographic film.

"Most of the available data for methylene chloride toxicity are for inhalation exposure, and only limited information exists on exposure from other routes," said Dr. De Rosa. "The ingestion of contaminated media may be of equal or more concern to individuals exposed to methylene chloride at hazardous waste sites. Thus, ATSDR's priority data needs for methylene chloride involve studies to assess health effects following oral exposure."

To help fill this knowledge gap, HSIA extrapolated data across exposure routes and from rodents to humans using physiologically based pharmacokinetics modeling. The study's objective was to estimate levels of oral methylene chloride intake by humans that would result in developmental effects and adverse health effects on the central nervous system and liver.

The HSIA study predicts that adverse health effects on the central nervous system, liver, and the development of newborns may occur if people drink water containing large amounts of methylene chloride (565 to 6,170 milligrams [mg] methylene chloride per liter [L] of water). These amounts are much larger than what most people are exposed to in the environment. For example, methylene chloride has been detected in groundwater across the United States, with concentrations ranging from 0.0 to 3.6 mg/L. The average concentrations of methylene chloride in drinking water are generally less than 0.001 mg/L; however, the concentrations of methylene chloride reported in the HSIA study approach levels found in industrial and municipal waste waters (up to 3,400 mg/L).

The results from the HSIA study were obtained using state-of-the-art methodologies in a cost-effective manner and reduce the need for additional animal testing. The final report was reviewed and approved by peer reviewers and is available upon request.

HSIA is continuing its voluntary research activities under SSARP. HSIA has proposed to conduct an assessment of methylene chloride's effects on the immune system. HSIA and ATSDR are also discussing possible voluntary research efforts concerning the solvents trichloroethylene and tetrachloroethylene.

Other private organizations are also conducting voluntary research under SSARP. ATSDR has signed agreements with the General Electric Company to conduct studies on polychlorinated biphenyl compounds and with the Chemical Manufacturers Association to conduct research on vinyl chloride.

For more information about the methylene chloride study or the Substance-Specific Applied Research Program, contact William Cibulas, PhD, or Yee-Wan Stevens, MS, ATSDR, Division of Toxicology, 1600 Clifton Road, NE, MS E29, Atlanta, GA 30333; telephone (404) 639-6306; fax (404) 639-6315.

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How Private-Sector Volunteerism Works in ATSDR's Substance-Specific Applied Research Program

In 1991, the Agency for Toxic Substances and Disease Registry (ATSDR) initiated its Substance-Specific Applied Research Program (SSARP). The program's major goals are to (1) provide the public and scientific community with the hazardous substances information they need, and (2) supply information necessary for conducting comprehensive public health assessments of populations living near hazardous waste sites.

ATSDR started the program by identifying 117 priority data needs (knowledge gaps) for 38 hazardous substances found at Superfund hazardous waste sites. Identifying and filling these data gaps is crucial to ATSDR and other health assessors in determining the types and levels of hazardous substance exposures that may present significant risks of adverse human health effects. ATSDR established a number of mechanisms to fill the identified data gaps, one of which was SSARP. Private-sector organizations are encouraged to volunteer through SSARP to conduct -- at their own expense and under ATSDR peer review -- the needed research.

To prevent potential bias in the voluntary studies that may favor results desirable or profitable to industry or business, ATSDR requires that private-sector organizations submit their research protocols and final reports for peer review. These protocols and reports are reviewed by ATSDR's peer reviewers and a Tri-Agency Superfund Applied Research Committee consisting of scientists from ATSDR, the National Toxicology Program, and the US Environmental Protection Agency. ATSDR accepts or rejects study protocols and final reports based on reviewers' recommendations and final reports are made available to the public.

For more information about SSARP, contact William Cibulas, PhD, ATSDR, Division of Toxicology, 1600 Clifton Road, NE, MS E29, Atlanta, GA 30333; telephone (404) 639-6306; fax (404) 639-6315.

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National Pesticide Telecommunications Network Offers Toll-free Information Service

Have you ever wanted a source of objective pesticide information or a place to refer your clients? Have you ever wondered about or been asked the following questions?: Is it dangerous to use pesticides for insect control if I am pregnant or have small children? What is the persistence of the chemicals used on my lawn for weed control? Will they contaminate my well? Could this old bottle of liquid I found in the garage be a pesticide? If so, next time you need answers, you can call the National Pesticide Telecommunications Network (NPTN) at 1-(800)-858-7378.

NPTN provides callers in the United States, Puerto Rico, and the Virgin Islands with objective, science-based information about pesticides. Callers can obtain chemical, health, and environmental information about more than 600 active pesticide ingredients in more than 50,000 US-registered products. Callers can also be directed to the appropriate organization for a pesticide incident investigation, emergency human and animal treatment, safety practices, cleanup and disposal, and laboratory analyses.

NPTN operates from 6:30 AM to 4:30 PM Pacific Time, Monday through Friday, excluding holidays. Service on Saturday and Sunday will begin in spring 1997. Information is available at no cost over the phone, and noncopyrighted materials can be mailed or faxed for a nominal fee. Information is also available through the NPTN World Wide Web site at http://ace.orst.edu/info/nptn/.

The service is sponsored by Oregon State University and the US Environmental Protection Agency (EPA) and is open to questions from professionals and the public. It is staffed by pesticide specialists who have the toxicology and environmental training needed to provide knowledgeable answers to pesticide questions. NPTN uses a variety of information resources, including scientific literature on pesticides (e.g., EPA documents, US Department of Agriculture cooperative extension publications, and other research information) and a pesticide product database.

The service receives more than 2,000 calls per month. Most callers are homeowners concerned about their families' health when pesticides are used in and around their homes. NPTN can provide information on the pesticides used in these situations and methods to reduce exposure. Although NPTN does not make recommendations about which pesticides to use for pest control, it can direct callers to local sources for products. Callers who have pesticide emergencies can be connected directly to the Oregon Poison Control Center or the National Animal Poison Control Center.

NPTN can also be contacted at the Agricultural Chemistry Extension, Oregon State University, 333 Weniger, Corvallis, OR 97331-6502; fax (541) 737-0761; e-mail nptn@ace.orst.edu.

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Study Identifies Successful Community Involvement Practices at Hazardous Waste Sites

Health agency officials and community members together have made important contributions to successful relationships, improved the quality of agency response, and advanced the state of the art pertaining to community involvement practices, a new study has shown.

The results of this study, including examples of successful community involvement practices, are now available in the report "Learning From Success: Health Agency Effort To Improve Community Involvement in Communities Affected by Hazardous Waste Sites."

The study concludes that "by recognizing and anticipating community needs and by actively soliciting community concerns and input, agencies could do a great deal to eliminate rancor, controversy, and adverse publicity, and deliver services that better suit the health-related needs of communities at a lower cost."

The study was funded under a cooperative agreement between Boston University School of Public Health and Henry S. Cole & Associates, Inc. and the Association of Schools of Public Health, Centers for Disease Control and Prevention, and the Agency for Toxic Substances and Disease Registry (ATSDR).

The study focused on health agency activity from 1990 to 1995, a period in which ATSDR and many state and local health agencies increased their community involvement efforts. The purpose of the study was to (1) identify sites that both agency and community officials characterize as community involvement "success stories"; (2) determine what practices and factors contribute to "success" at the sites; and (3) provide a wide range of examples of successful practices and recommendations for improved community involvement practices.

The report includes case studies of activities concerning 11 hazardous waste sites, and describes sites at which ATSDR, state, or local health agencies were the lead agency.

Other significant findings include these:

• Community leaders often serve as health educators to the broader community and help teach government officials about the ways of the community; thus, community involvement should be viewed as a dynamic and developing relationship between community members and agencies in which a variety of players and stakeholders have a role.
• Local health departments are often well positioned to take the lead on community involvement and might effectively play a much larger role in providing community involvement services in cases where federal and state agencies have major responsibilities.
• Successful interactions involve a "community-guided approach" or model in which agency and community members work together to develop a community involvement plan and a course of action that represents a match between community needs and concerns (even demands) and agency requirements, capabilities, and limitations.
• Effective outreach often requires more than announcements for participation; community members are often in the best position to design outreach programs because they are familiar with community ways and preferences.
• Trust is built by soliciting, acknowledging, and following up on community concerns.
• Realistic expectations must be set. It is essential for health agencies to explain from the outset (and to restate) the roles and limitations of the agency and the limitations of studies, science, and scientists to answer questions of critical concern.
• A key ingredient to good community involvement is the accessibility of agency officials to community members. Ongoing advisory panels (e.g., community assistance panels) can increase the accessibility of health agency staff to the community.

For copies of the report, contact ATSDR, Division of Toxicology and Environmental Medicine, 1600 Clifton Rd., NE, MS E33, Atlanta, GA 30333; telephone (404) 639-6204; fax (404) 639-6207.

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This page last updated on October 24, 2003
Contact Name: Wilma López/ WLópez@cdc.gov