ATSDR's Evaluation of Environmental Chemical Exposures on the Island of Vieques - Progress Report

November 2, 2011

Summary

The Agency for Toxic Substances and Disease Registry (ATSDR) is evaluating environmental health concerns on the Island of Vieques, Puerto Rico.  This report describes ATSDR’s progress in reviewing its own work and other reports on environmental exposures and possible health effects for people living in Vieques. 

Background

In 1999, a resident of the Island of Vieques petitioned ATSDR to evaluate environmental data for the island and determine if health risks had resulted from exposure to contamination from US Navy bombing operations on the island.  Between 2001 and 2003, ATSDR released four public health assessments (PHAs).  Each PHA assessed the possibility of community exposures to chemicals present in seafood (fish, shellfish, and land crabs), drinking water, air, and soil.  Scientists outside of ATSDR reviewed each PHA (peer review) before it was released.  Except for drinking water from one local well, ATSDR found no health hazards associated with any pathways evaluated.

Some scientists and Vieques community members questioned ATSDR’s findings. They believed military maneuvers left environmental contamination that harmed the health of Viequenses.  In March 2009, acknowledging the community’s concerns, ATSDR committed to a second evaluation of  Vieques. This evaluation would include all available environmental, human biomonitoring, and health outcome studies that had been conducted for Vieques.

In August 2009, then ATSDR director Dr. Howard Frumkin and other ATSDR scientists and staff traveled to Vieques. They met with community leaders, Puerto Rican scientists, and health and environmental officials.  ATSDR committed to involve local experts in ATSDR’s review of Vieques.  ATSDR asked Puerto Rican scientists and others who have studied Vieques to participate in a scientific consultation.  That meeting was held in Atlanta, Georgia on November 5-6, 2009. It involved a thorough review of many studies.  Participants identified the strengths and limitations of many of the studies and made recommendations for further work. ATSDR appreciates that these scientists traveled to Atlanta to share their findings and perspectives, and we appreciate the independent scientists and community leaders’ dedication to the health of the people of Vieques.  

Assessment and Analysis Processes

The residents of Vieques have asked important questions about their health. They deserve a thoughtful response. To be sure all aspects had been considered, ATSDR’s scientific assessment involved these steps:

1. Research scientific literature
   ATSDR looked at reports and articles from several sources. As a result, ATSDR gathered more than 75 reports on environmental sampling, health outcomes, and biomonitoring. The reports included studies conducted by federal agencies, non-federal organizations, and scientists. ATSDR scientists carefully reviewed these documents.   
2. Conduct screening
   ATSDR conducted screening to determine which chemicals need to be examined more closely. Screening allows scientists to sort substances into those that do not need further analysis and those that need to be examined more closely. (For more information about screening processes, see the Public Health Assessment Guidance Manual.
3. Determine exposure pathways
   An exposure pathway is the route a substance takes from where it begins (its source) to where it ends, and how people can come into contact with (or get exposed to) it. To determine the exposure pathways, ATSDR used current information about how contaminants move through and change in the environment.
4. Evaluate public health implications
   From the contaminants identified in the screening process, ATSDR found which chemicals and exposure situations might be a health hazard. ATSDR adjusted its evaluation of the exposure of the people of Vieques after taking a closer look at factors that affect dose calculations, such as body weight and the amount of fish eaten by Viequenses. This was a suggestion from the independent scientists.
5. Make conclusions and recommendations
   After analyzing all the information available, ATSDR reached conclusions and recommendations.
6. Write a draft report
   ATSDR prepared a draft report on the environmental, health outcome, and biomonitoring data for Vieques. The report considered recommendations from the scientific consultation.
7. Get an independent review
   Six scientific experts reviewed the draft report. This is called “peer review.” ATSDR greatly appreciates the time and effort these experts put into reviewing the report and providing insightful comments.
8. Modify the report
   ATSDR carefully reviewed the comments from the experts and modified the report based on their comments.

Report Status

ATSDR is in the final stages of preparing the report for release. ATSDR is committed to ensuring that every document released for public use is scientifically sound, technically accurate, useful, and easily understood. Thus, in keeping with agency policy, the report is now being reviewed by other scientists within ATSDR and CDC. After this review, the report will be released for public comment.  

Next Steps

The public comment period will last about three months. After the public comment period ends, ATSDR will review each comment and modify the report, if necessary. When this review is complete, ATSDR will release the final report.