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PUBLIC HEALTH ASSESSMENT


Historical Document

This Web site is provided by the Agency for Toxic Substances and Disease Registry (ATSDR) ONLY as an historical reference for the public health community. It is no longer being maintained and the data it contains may no longer be current and/or accurate.


Y-12 Uranium Releases

OAK RIDGE RESERVATION (USDOE)
OAK RIDGE, ANDERSON COUNTY, TENNESSEE


IV. PUBLIC HEALTH IMPLICATIONS

IV.A. Summary of Public Health Implications

ATSDR evaluated past and current off-site exposures to uranium releases from the Y-12 plant for both chemical and radiation health effects. Uranium from the Y-12 plant was released into the air from vents and stacks; uranium was also released into the surface water via East Fork Poplar Creek (EFPC) (ChemRisk 1999).

The city of Oak Ridge is the established community where people lived during the years of uranium releases that could have been impacted by the Y-12 uranium releases. The Scarboro community, within the city of Oak Ridge, was selected as a reference location that represents the whole city. The Scarboro location was used to estimate concentrations of uranium in the air, surface water, and soil in an off-site area where residents resided during years of past Y-12 plant uranium releases. The Scarboro community was selected as the reference population after air dispersion modeling indicated that its residents were expected to have received the highest uranium exposures (ChemRisk 1999). The Task 6 report stated that "while other potentially exposed communities were considered in the selection process, the reference locations [Scarboro] represent residents who lived closest to the ORR facilities and would have received the highest exposures from past uranium releases...Scarboro is the most suitable for screening both a maximally and typically exposed individual" (ChemRisk 1999). Therefore this evaluation's conclusions regarding exposures of Scarboro residents to uranium are also applicable to residents living in the city of Oak Ridge.

As Table 25 shows, all of the exposure pathways evaluated by ATSDR for both radiation and chemical health effects resulted in uranium exposures that were too low to be a health hazard. Therefore, the residents of Scarboro were not exposed to harmful levels of uranium from the Y-12 plant in the past, and they are not currently being exposed to harmful levels of uranium from the Y-12 plant. If the Scarboro community–the population likely to have received the highest uranium exposures from the Y-12 plant–was not in the past and is not currently being exposed to harmful levels of uranium from the Y-12 plant, then other residents living near the Y-12 plant, including those within the city of Oak Ridge, are also not being exposed to harmful levels of uranium. For more details about each of the pathways evaluated, see the Public Health Evaluation section (Section III.B.).

Table 25. Summary of Public Health Implications from ATSDR's Evaluation of Past and Current Uranium Exposure to Off-Site Populations
Exposure Effects Pathway Are People Being Exposed? Estimated Dose Screening Comparison Value Is the Dose Above or Below the Screening Value (Magnitude)? Conclusion Category
Past Radiation Total Yes 155 mrem over 70 years 5,000 mrem over 70 years Below (32 times less) No apparent public health hazard: exposures are not at levels expected to cause adverse health effects.
2.2 mrem/year 100 mrem/year Below (45 times less)
Chemical Inhalation Yes 2.1 × 10-8 to 6.0 × 10-5 mg/m3 8 × 10-3 mg/m3 Below (130 times less)
Ingestion Yes 2.7 × 10-5 to 1.3 × 10-2 mg/kg/day 2 × 10-3 mg/kg/day Above. However, all doses are less than the dose (5 × 10-2 mg/kg/day) at which renal health effects have been observed in the most sensitive mammalian species.
Current Radiation Ingestion and Inhalation Yes 0.216 mrem over 70 years 5,000 mrem over 70 years Below (23,000 times less) No apparent public health hazard: exposures are not at levels expected to cause adverse health effects.
0.003 mrem/year 100 mrem/year Below (33,000 times less)
Chemical Inhalation Yes 5.4 × 10-11 and 1.4 × 10-10 mg/m3 8 × 10-3 mg/m3 Below (more than a million times less)
Ingestion Yes 5.3 × 10-5 mg/kg/day 2 × 10-3 mg/kg/day Below (37 times less)

IV.B. Past Exposure Evaluation

ATSDR's evaluations of uranium released from the Y?12 plant indicate that past off-site exposures to uranium are not a health hazard. For every exposure pathway evaluated, the doses were too low to be of health hazard for both radiation and chemical health effects.

IV.B.1. Past Radiation Exposure

To evaluate the carcinogenic effects of past radiation exposure to uranium releases from the Y-12 plant, ATSDR compared the estimated total radiation dose over 70 years from exposure to uranium in the air, surface water, and soil pathways (presented in the Task 6 report)18 to the ATSDR radiogenic cancer comparison value of 5,000 mrem over 70 years. The radiation dose expected for the reference community–the Scarboro population–was 155 mrem over 70 years (see Table 4), and accounts for multiple routes of exposure (see Figure 11). This radiation dose of 155 mrem is 32 times less than the radiogenic cancer comparison value of 5,000 mrem (see Figure 12). Doses below this comparison value are not expected to result in adverse health effects. Therefore, ATSDR does not expect carcinogenic health effects to have occurred from past off-site exposures to radiation doses received from Y-12 uranium releases. ATSDR derived this committed effective dose equivalent (CEDE) value of 5,000 mrem over 70 years after reviewing the peer-reviewed literature and other documents developed to review the health effects of ionizing radiation (see Appendix D for more information about ATSDR's derivation of the radiogenic cancer comparison value of 5,000 mrem over 70 years).

To evaluate noncancer health effect from the total past uranium radiation dose received by the Scarboro community (a CEDE of 155 mrem over 70 years), an approximation can be made to compare the CEDE of 155 mrem, which is based on 70 years of exposure, to the ATSDR chronic exposure minimal risk level (MRL) for ionizing radiation (100 mrem/year), which is based on 1 year of exposure. The CEDE of 155 mrem over 70 years could be divided by 70 years to approximate a value of 2.2 mrem as the radiation dose for the first year, which is well below (45 times less than) the 100 mrem/year ATSDR chronic exposure MRL for ionizing radiation (see Figures 10 and 12).

The ATSDR MRLs are based on noncancer health effects only, not on a consideration of cancer effects. MRLs are estimates of daily human exposure to a substance that are unlikely to result in noncancer effects over a specified duration. MRLs are intended to serve only as a screening tool to assist in determining which contaminants should be more closely evaluated in the public health assessment process. Exposure to estimated doses less than the MRL are safe and not considered to be of health concern; exposure to estimated doses above the MRL does not necessarily mean that adverse health effects will occur. Rather, it is an indication that ATSDR should further examine the harmful effect levels reported in the scientific literature and more fully review exposure potential.

ATSDR believes the chronic ionizing radiation MRL of 100 mrem/year is below levels that might cause adverse health effects in people most sensitive to such effects. Therefore, ATSDR does not expect noncancer health effects to have occurred from past off-site exposures to radiation doses received from past Y-12 uranium releases.

IV.B.2 Past Chemical Exposure

To evaluate past chemical exposure to uranium releases from the Y-12 plant, ATSDR compared the estimated average annual air concentrations of uranium in Scarboro (generated during the Task 6 evaluation) to ATSDR's intermediate-duration inhalation MRL for insoluble forms of uranium. All the estimated average air concentrations of uranium for each year were less than 1% of the inhalation MRL of 0.008 mg/m3 (see Figures 9 and 19, Table 12).

ATSDR also compared the estimated total uranium dose from ingestion via both the surface water and soil exposure pathways (also generated during the Task 6 evaluation), to ATSDR's intermediate-duration oral MRL for uranium. Remember that MRLs are used only as a screening tool and have built-in uncertainty or safety factors, making these values considerably lower than levels at which health effects have been observed. Even though some of the doses were higher than the MRL, it does not necessarily follow that harmful health effects will occur–values above the MRL indicate that the contaminant should be evaluated further. Because some of the estimated doses were above the MRL, ATSDR further investigated the toxicologic literature to find doses associated with known health effects. The minimum lowest-observed-adverse-effect level (LOAEL) for oral exposure to uranium that has caused the most sensitive harmful health effects considered to be of relevance to humans was 0.05 mg/kg/day, which caused renal (kidney) toxicity in rabbits (Gilman et al 1998b as cited in ATSDR 1999a). The rabbit is the mammalian species most sensitive to uranium kidney toxicity and is likely to be even more sensitive that humans (ATSDR 1999a). Therefore, ATSDR is comfortable with extrapolating the results from this animal toxicity study to humans. All of the estimated total ingestion doses were less than the LOAEL of 0.05 mg/kg/day at which health effects (renal toxicity) have been observed in rabbits; therefore, past exposure via all the surface water and soil exposure pathways is not a health hazard (see Figures 8 and 20, Table 13).

Additionally, it should be noted that several levels of conservatism were built into this evaluation of past exposures. As mentioned previously, the values that ATSDR relied on to evaluate past exposures (those from the Task 6 report) came from a screening evaluation that routinely and appropriately used conservative and protective assumptions and approaches. This led to an overestimation of concentrations and doses. Even using these conservative overestimations of concentrations and doses, the estimated levels of uranium that persons in the reference community, Scarboro, were exposed to were below levels of health concern. Following is a list of this evaluation's conservative aspects:

  1. The majority of the total uranium dose (54% of the total U 234/235 dose and 78% of the total U 238 dose) is attributed to frequently eating fish from the EFPC and eating vegetables grown in contaminated soil over several years (see Tables 9 and 10). If a person did not regularly eat fish from the creek or homegrown vegetables over a prolonged period of time (which is very probable), then that person's uranium dose would likely have been substantially lower than the estimated doses reported in this public health assessment.


  2. The Task 6 report noted that, late in the project, it was ascertained that the Y-12 uranium releases for some of the years used to develop the empirical c/Q value may have been understated due to omission of some unmonitored release estimates. This would cause the empirical c/Q values to be overestimated, which in turn would cause the air concentrations to be overestimated.


  3. According to ATSDR's regression analysis, the method that the Task 6 team used to estimate historical uranium air concentrations overestimated U 234/235 concentrations by as much as a factor of 5. Consequently, airborne U 234/235 doses based on this method were most likely overestimated (see Figure 15 and Appendix E).


  4. In evaluating the soil exposure pathway, the Task 6 team used EFPC floodplain soil data to calculate doses. Actual measured uranium concentrations in Scarboro soil are much lower than the uranium concentrations in the floodplain soil. Consequently, the uranium doses that were estimated for the residents were overestimated. The estimated doses would be much lower if they were based on actual measured concentrations in Scarboro.

IV.C. Current Exposure Evaluation

ATSDR's evaluations of uranium released from the Y?12 plant indicate that current off-site exposures are not a health hazard. For every exposure pathway evaluated, the doses were too low to be of health hazard for both radiation and chemical health effects.

IV.C.1. Current Radiation Exposure

To evaluate carcinogenic effects of current radiation exposure to uranium releases from the Y-12 plant, ATSDR calculated the radiation dose (see Table 14) from inhalation of air, ingestion of soils, and ingestion of foods. ATSDR then compared the dose to the radiogenic cancer comparison value. The radiation dose received by the reference population, the Scarboro community, is 0.216 mrem, which is well below (more than 23,000 times less than) the radiogenic cancer comparison value of 5,000 mrem over 70 years (see Figure 12).

ATSDR derived the CEDE of 5,000 mrem over 70 years after reviewing the peer-reviewed literature and other documents developed to review the health effects of ionizing radiation (see Appendix D for more information about ATSDR's derivation of the radiogenic cancer comparison value of 5,000 mrem over 70 years). The CEDE assumes that from the intake of uranium, the entire dose (a 70-year dose, in this case) is received in the first year following the intake. Doses below this value are not expected to result in adverse health effects. Therefore, ATSDR does not expect that harmful radiation effects from exposure to uranium are now occurring.

As noted previously, to evaluate noncancer health effects from the current radiation dose (a CEDE of 0.216 mrem over 70 years), an approximation can be made to compare the CEDE of 0.216 mrem, which is based on 70 years of exposure, to the ATSDR chronic exposure MRL of 100 mrem/year, which is based on 1 year of exposure. The CEDE of 0.216 mrem over 70 years can be divided by 70 years, yielding an approximate value of 0.003 mrem as the radiation dose for the first year. This is well below (33,000 times less than) the 100 mrem/year ATSDR chronic exposure MRL for ionizing radiation (see Figures 10 and 12). ATSDR MRLs are based on noncancer adverse health effects only, not on a consideration of cancer effects. ATSDR believes the chronic ionizing radiation MRL of 100 mrem/year is below levels that might cause noncancer adverse health effects in persons most sensitive to such effects. ATSDR, therefore, does not expect noncancer health effects to be occurring from radiation doses received from current off-site uranium exposure.

ATSDR compared off-site surface water concentrations of uranium to the EMEG of 20 µg/L. The average uranium concentrations found in surface water from Scarboro ditches (0.197 µg/L) and in surface water of Lower EFPC (12.8 µg/L) are below ATSDR's EMEG. Therefore, ATSDR does not expect harmful heath effects to occur (see Table 16).

ATSDR also compared Scarboro soil concentrations to natural background concentrations, and to background concentrations collected at uncontaminated areas on and around the ORR (see Tables 17 and 18 and Figures 21, 24, and 25). The soil concentrations found in Scarboro are indistinguishable from natural background concentrations.

Therefore, the level of radiation a person receives from current off-site exposures to uranium in air, surface water, and soil (including ingestion of soil and vegetables) would not cause harmful health effects.

IV.C.2. Current Chemical Exposure

To evaluate current chemical exposure to uranium releases from the Y-12 plant, ATSDR compared the average air concentrations from several monitoring stations, including ones in Scarboro and the city of Oak Ridge, to the intermediate-duration inhalation MRL for insoluble forms of uranium. The average uranium air concentrations from all of the monitoring stations evaluated, including the ones in Scarboro and the city of Oak Ridge, were well below (more than a million times less than) ATSDR's intermediate-duration inhalation MRL of 0.008 mg/m3 for insoluble forms of uranium (see Figure 27). The average uranium air concentrations, therefore, are well below levels that would be expected to cause harmful chemical effects (see Figure 9).

ATSDR also compared the doses from ingestion of uranium through the soil pathway (see Table 23 and Figure 28)–including ingestion of soil and vegetables from the reference location, Scarboro (see Table 24 and Figure 29)–to the oral intermediate-duration MRL of 0.002 mg/kg/day for insoluble forms of uranium. The maximum uranium dose from ingestion of Scarboro soil (1.4 × 10-5 mg/kg/day for a 6-year-old child, see Table 23) is approximately 140 times less than the MRL, and the uranium dose from ingestion of vegetables grown in the private gardens in Scarboro (3.9 × 10-5 mg/kg/day from Plot 46, see Table 24) is more than 50 times less than the MRL. Therefore, the uranium doses are well below the MRL and not a health hazard.

Further, the uranium doses following ingestion of soils and vegetables from a private garden in Scarboro are so low that even if the exposures from the two pathways are combined, the resulting dose is still lower than the MRL. For example, if the highest dose following ingestion of soil is added to the total intake from ingestion of vegetables grown in Scarboro, the total ingestion dose is 5.3 × 10-5 mg/kg/day, which is about two orders of magnitude below the MRL (see Figure 8). Therefore, even the combined exposure from both ingestion pathways would not result in harmful health effects.

EFPC is not used as a drinking water source. The city of Oak Ridge, including Scarboro, is served by municipal water, which must meet specific drinking water quality standards set by EPA. Regardless, the total mean concentrations of uranium in surface water collected from Scarboro ditches and in water collected from Lower EFPC are below EPA's maximum contaminant level (MCL) for uranium (30 µg/L). In addition, Table 16 shows that the mean total uranium concentrations for surface water samples collected from Scarboro and Lower EFPC are below ATSDR's environmental media evaluation guide (EMEG) of 20 µg/L. Therefore, the concentrations of uranium that people might be exposed to in surface water are not a health hazard.


V. HEALTH OUTCOME DATA EVALUATION

Health outcome data are measures of disease occurrence in a population. Common sources of health outcome data are existing databases (cancer registries, birth defects registries, death certificates) that measure morbidity or mortality–that is, disease or death. Health outcome data can provide information on the general health status of a community: where, when, and what types of disease occurs and to whom it occurs. Public health officials use health outcome data to look for unusual patterns or trends in disease occurrence by comparing disease occurrences in different populations over periods of years. These health outcome data evaluations are descriptive epidemiologic analyses that are exploratory in that they may provide additional information about human health effects and can help identify the need for public health intervention activities such as community health education. Health outcome data cannot–and are not meant to–establish cause and effect between environmental exposures to hazardous materials and adverse health effects in a community.

ATSDR scientists generally consider health outcome data evaluation for one of two reasons: (1) to evaluate the possible health effects in a population that is known to have been exposed to enough environmental contamination to experience health effects or (2) to help address community concerns about a particular illness in a community. In this public health assessment on Y-12 uranium releases, ATSDR scientists determined that people living near the Y-12 plant were exposed to uranium released from the Y-12 plant from the 1940s through the 1990s. In addition, community members have expressed much concern about a perceived increase in respiration illness in Scarboro community children and an increase in cancer in the areas surrounding the ORR.

Criteria for Conducting a Health Outcome Data Evaluation

To determine how to use or analyze health outcome data in the public health assessment process, or even whether to use it at all, ATSDR scientists receive input from epidemiologists, toxicologists, environmental scientists, and community involvement specialists. These scientists consider the following criteria, based on site-specific exposure considerations only, to determine whether or not a health outcome evaluation should be included in the public health assessment.

  1. Are there one or more current (or past) potential or completed exposure pathways at the site?


  2. Can the time period of exposure be determined?


  3. Can the population that was or is being exposed be quantified?


  4. Are the estimated exposure doses(s) and the duration of exposure sufficient for a plausible, reasonable expectation of health effects?


  5. Are health outcome data available at a geographic level or with enough specificity to be correlated to the exposed population?


  6. Do the validated data sources or databases have information on the specific health outcome(s) or disease(s) of interest–i.e., the outcome(s) or disease(s) likely to occur from exposure to the site contaminants–and are those data accessible?

Based on the finding of the exposure evaluation in this public health assessment, ATSDR sufficiently documented completed exposure pathways to uranium released from the Y-12 plant via the air, surface water, and soil pathways from the mid-1940s to the late 1990s for residents in the city of Oak Ridge, specifically in the Scarboro community. The estimated exposures of Scarboro residents to Y-12 uranium, though, are not sufficient for a plausible, reasonable expectation of health effects. The documented evidence of off-site exposure to uranium indicates that estimates of past and current uranium doses are too low to be a public health hazard for both radiation and chemical health effects (see Section IV. Public Health Implications).

Although natural and depleted uranium are weakly radioactive, their radiation is not likely to cause cancer. No human cancer of any type has ever been seen as a result of exposure to natural or depleted uranium. The National Academy of Sciences reported that eating food or water that has normal amounts of uranium is not likely to cause cancer or other health problems in most people. They also stated that people ingesting large quantities of uranium could possibly get a kind of bone cancer called a sarcoma.

The estimated radiation dose to Scarboro residents from Y-12 uranium is less than the average U.S. background radiation dose and well below (32 to 23,000 times less than) the ATSDR radiogenic cancer comparison value (see Figure 9). Doses below these values are not expected to result in adverse health effects. Therefore, the residents living in Scarboro were not exposed to harmful levels of uranium from the Y-12 plant in the past, and they are not currently being exposed to harmful levels of uranium from the Y-12 plant. Consequently, if the Scarboro community–the population likely to have received the highest exposures from the Y-12 plant–was not exposed to hazardous levels of uranium, then other residents living near the Y-12 plant, including those within the city of Oak Ridge, are also not being exposed to levels of uranium expected to cause harmful health effects. Since the estimated uranium doses are not expected to cause health effects, no further analysis of health outcome data is appropriate. Analysis of site-related health outcome data is not scientifically reasonable unless the level of estimated exposure is likely to result in health effects. Since such an estimate of exposure cannot be made, the requirement to consider analysis of site-related health outcome data on the basis of exposure is complete.

In addition, health outcome databases are not available for the known specific health effect or disease associated with exposure to uranium. Uranium is a chemical substance that is also radioactive. Scientists have never detected harmful radiation effects from low levels of natural uranium, although some may be possible. Scientists have, however, seen chemical effects in the kidneys (nephrotoxicity in the renal proximal tubules or kidney disease) of a few people and animals after ingestion of large amounts of uranium. Currently there are not validated data sources or databases with information on nephrotoxicity in the renal proximal tubules, renal damage, or kidney disease for people living in the Oak Ridge area. Also, renal damage or kidney disease is not unique to high-level exposure to uranium. Many other non-radioactive heavy metals (cadmium, lead, mercury) are more potent classical nephrotoxic metals that produce very severe, perhaps fatal, injury at the level of exposures reported for uranium in the literature.

Responding to Community Health Concerns

Responding to community health concerns is an essential part of ATSDR's overall mission and commitment to public health. The concerns of all community members are important and must be addressed during the public health assessment process. The individual concerns addressed in the Community Health Concerns section (Section VI.) of this public health assessment are those concerns in the ATSDR Community Health Concerns Database that are related to issues associated with uranium releases from the Y-12 plant.

Also, in 1997, residents of the Scarboro community expressed concerns about the rate of respiratory illness among children in Scarboro. In response to this community concern, the CDC and TDOH conducted the Scarboro Community Health Investigation, which included a community health survey and a follow-up medical evaluation of children. This investigation is summarized in Section II.F.3. and in Appendix I.

Area residents have also voiced concern about cancer. Citizens living in the communities surrounding the ORR have expressed many concerns to the ORRHES about a perceived increase in cancer in areas surrounding the ORR. Furthermore, a 1993 TDOH survey of eight counties surrounding the ORR indicated that cancer was mentioned as a health problem more than twice as much as any other health problem. (The survey also showed that 83% of the surveyed population in the surrounding counties believes it is very important to examine the actual occurrence of disease among residents in the Oak Ridge area.)

'Cancer incidence' refers to newly diagnosed cases of cancer that are reported to the Tennessee Cancer Registry.In order to address these concerns, ORRHES requested that the ATSDR conduct an assessment of health outcome data (cancer incidence) in the eight counties surrounding the ORR. Therefore, ATSDR is currently conducting a cancer incidence review using data that are already collected by the Tennessee Cancer Registry. This cancer incidence review is a descriptive epidemiologic analysis that will provide a general picture of the occurrence of cancer in a community. The purpose of conducting this evaluation is to provide citizens living in the ORR area with information regarding cancer rates in their area compared to the state of Tennessee. This evaluation will only examine cancer rates at the population level, not at the individual level. It is not designed to evaluate specific associations between adverse health outcomes and documented human exposures, and it will not and cannot establish cause and effect.

In addition, over the last 20 years, local, state, and federal health agencies have conducted public health activities to address and evaluate public health issues and concerns related to chemical and radioactive substances released from the ORR. See Appendix B for a summary of previous public health activities.


VI. COMMUNITY HEALTH CONCERNS

Responding to community health concerns is an essential part of ATSDR's overall mission and commitment to public health. ATSDR actively gathers comments and other information from the people who live or work near the ORR. ATSDR is particularly interested in hearing from residents of the area, civic leaders, health professionals, and community groups. ATSDR will be addressing these community health concerns in the ORR public health assessments that are related to those concerns.

To improve the documentation and organization of community health concerns at the ORR, ATSDR developed a Community Health Concerns Database specifically designed to compile and track community health concerns related to the site. The database allows ATSDR to record, to track, and to respond appropriately to all community concerns and to document ATSDR's responses to these concerns.

In 2001 and 2002, ATSDR compiled more than 1,800 community health concerns obtained from the ATSDR/ORRHES community health concerns comment sheets, written correspondence, phone calls, newspapers, comments made at public meetings (ORRHES and workgroup meetings), and surveys conducted by other agencies and organizations. These concerns were organized in a consistent and uniform format and imported into the database.

The community health concerns addressed in this public health assessment are those concerns in the ATSDR Community Health Concerns Database that are related to issues associated with uranium releases from the Y-12 plant. The following table contains summarized concerns and issues along with ATSDR's responses. The concerns and responses are sorted by category (health concerns/general, cancer health effects, noncancer health effects, and health concerns/procedural issues).


Community Health Concerns From the Oak Ridge Reservation Community Health Concerns Database

  Summarized Concern/Issue ATSDR's Response
Health Concerns/General
1 The U 235 contamination is significant.

ATSDR evaluated past and current exposure to uranium contamination released from the Y-12 plant and determined that in every exposure pathway, the levels of uranium were too low to be of public health hazard for both radiation and chemical health effects (please see Figures 8, 9, and 12 and Table 25).

ATSDR evaluated whether the levels of U 235 in the soil in Scarboro were significant by comparing the radioactivity concentrations detected in Scarboro by FAMU (FAMU 1998) and EPA (EPA 2003) to average background levels in the area around Oak Ridge and to background concentrations typically found in nature. ATSDR found that the levels of U 235 that were detected were indistinguishable from background levels when considering the uncertainty associated with the analysis of the uranium measurements. Please see the Current Soil Exposure Pathway discussion under the Current Radiation Effects section (Section III.B.2.a.) and Figures 21, 24, and 25 for more details about this evaluation.

ATSDR also evaluated whether the radioactivity concentrations of uranium detected in the air in Scarboro were higher than those detected at background air monitoring stations. The data indicate that the concentrations in Scarboro are about 60% higher than the remote background locations; however, all of the air concentrations, including those from Scarboro, were well below levels of health concern. Please see the Current Inhalation Exposure Pathway discussion under the Current Chemical Effects section (Section III.B.2.b.) and Figure 27 for additional details.

2 ORR facilities were engaged in plutonium production.

A pilot-scale plutonium production plant was built at the X-10 site in 1943 and was operated until November 1963. For more details, please see Section 2.1.1. The Original Mission in the Oak Ridge Health Studies Phase 1 Report, Volume II, Part A: Dose Reconstruction Feasibility Study, Tasks 1 & 2 (ChemRisk 1993a).

During Phase 1 of the Oak Ridge Health Studies, the quantity of plutonium released was estimated and determined to not warrant further health study. Plutonium was low in the preliminary ranking of potential hazards. Please see Section 5.4, Relative Importance of Releases from the ORR and Table 5-11 in the Oak Ridge Health Studies Phase 1 Report, Volume II, Part B: Dose Reconstruction Feasibility Study, Tasks 3 & 4 (ChemRisk 1993b).

These reports are available at the DOE Information Center located at 475 Oak Ridge Turnpike, Oak Ridge, Tennessee. You can also obtain documents from the Information Center at http://www.oakridge.doe.gov/info_cntr/index.html Exiting ATSDR Website or by calling 865-241-4780.

3

We would like for environmental tests to be performed on other neighborhoods in Oak Ridge so that it can be determined if the trace levels of uranium contaminants detected in our neighborhood are significantly different from Oak Ridge in general.

Do you have any statistics comparing illness in Scarboro and other sections of Oak Ridge?

There are no other residential data to compare to Scarboro.

It is generally believed by most people who live in Tennessee and perhaps the nation that the Scarboro neighborhood in Oak Ridge, Tennessee, is contaminated with mercury.... The data showed very high levels of mercury contamination in several areas of Oak Ridge; however, the media primarily focused attention on mercury contamination in the Scarboro neighborhood (where no significant mercury was ever found).

We would like for those interested in helping our neighborhood with health and contamination issues to be mindful of the psychological, sociological, and economic consequences that result whether contamination issues are real or imaginary.

During this evaluation of Y-12 uranium releases, ATSDR attempted to locate uranium soil sampling data from other areas in Oak Ridge (for example, data from the Atomic City Auto Parts remediation, the CSX Railroad remediation, and sampling data collected in the Woodland area of Oak Ridge), but as of this writing was unsuccessful.

ATSDR evaluated whether the levels of uranium in the soil were significantly different in Scarboro by comparing the levels detected in Scarboro by FAMU (FAMU 1998) and EPA (EPA 2003) to the average background levels in the area around Oak Ridge and to background concentrations typically found in nature. ATSDR found that the levels of uranium that were detected were indistinguishable from background, when considering the uncertainty associated with the analysis of the uranium measurements. Please see the Current Soil Exposure Pathway discussion under Current Radiation Effects section (Section III.B.2.a.) and Figures 21, 24, and 25 for more details about this evaluation.

ATSDR also evaluated whether the radioactivity concentrations of U 235 detected in the air in Scarboro were higher than those detected at background stations. The data indicate that the concentrations in Scarboro are about 60% higher than the background locations; however, all of the air concentrations, including those from Scarboro, were well below levels of health concern. Please see the Current Inhalation Exposure Pathway discussion under the Current Chemical Effects section (Section III.B.2.b.) and Figure 27 for additional details.

ATSDR evaluated past and current exposure to uranium contamination released from the Y-12 plant and determined that in every exposure pathway, the levels of uranium were too low to be of public health concern for both radiation and chemical health effects.

ATSDR will be conducting a public health assessment on mercury releases from Y-12, which will evaluate exposure to the mercury concentrations in Scarboro.

4

We know the soil is contaminated and want someone to prove it. (Just tell us the truth.)

There must be something wrong if the government does so many studies, and the newspaper gives it so much attention.

Scarboro is the most contaminated residential area.

The city of Oak Ridge is the established community where residents resided during the years of uranium releases that could have been impacted by Y-12 uranium releases. In this public health assessment, the Scarboro community was used as a reference location that represents the city of Oak Ridge. The Scarboro community was selected as the reference population after air dispersion modeling indicated that its residents were expected to have received the highest exposures (ChemRisk 1999). However, when ATSDR compared the levels of uranium in the soil in Scarboro (FAMU 1998 and EPA 2003) to levels of uranium naturally occurring in the soil and to average background levels in the Oak Ridge area, it was determined that the uranium radioactivity concentrations in Scarboro were indistinguishable from levels occurring naturally. Please see the Current Soil Exposure Pathway discussion under Current Radiation Effects section (Section III.B.2.a.) and Figures 21, 24, and 25 for more details about this evaluation.

5

The sirens in Y-12 are all nuclear alarms.

The following Web site provides information on warning sirens, the latest news, and other information in case of an emergency at the ORR: http://www.oakridge.doe.gov/emercomm/ Exiting ATSDR Website.

The Web site also provides general information about the DOE Emergency Preparedness Program. If you have questions about this program, please visit the Web site or call the DOE Public Affairs Office at 865-576-0885.

The sirens are tested at noon eastern time on the first Wednesday of each month. Any other tests and exercises are announced in advance through area newspapers, radio, and television.

6

The SED/AEC dumped "hot" waste from Y-12 in/near Scarboro.

Scarboro is a part of ORR, is owned by the government, is leased to the residents, and can be used as a DOE dump at any time.

Concerned about the locations of actual and alleged "dumps."

A municipal landfill (on Tuskegee Drive across from Scarboro) and a building material dump site (at the corner of Tuskegee Drive and Tulsa) were present in Oak Ridge in the past. Both sites are currently closed. Neither area was identified as having radioactive wastes during the aerial radiological surveys conducted in the Scarboro area in 1959, 1973, 1980, 1989, 1992, and 1997. Every flyover of Scarboro showed only natural background levels (Carden and Joseph 1998). While this does not preclude the presence of deeply buried wastes in these areas, if present, they most likely are not impacting public health in the Scarboro community because people do not have contact with deeply buried wastes.

Designated landfills on the ORR were used for disposal of hazardous wastes and radioactive materials.

7

The drinking water changes color and is sometimes cloudy.

Something in water; water was white; how much exposure can an individual have to the water before they are affected by it; things in the water; water not drinkable; problems with water; water quality (thick, milky appearance).

Oak Ridge is supplied with public water from a water treatment plant that draws surface water from Melton Hill Lake. The intake at the lake is located approximately one mile upstream of the ORR. Until May 2000, DOE owned and operated the water treatment plant at its Y-12 facility and sold drinking water to the city of Oak Ridge for distribution to residents and businesses. The city of Oak Ridge now owns and operates the water distribution system (City of Oak Ridge 2002).

Under the Safe Drinking Water Act, EPA sets health-based standards for hundreds of substances in drinking water and specifies treatments for providing safe drinking water (EPA 1999). The public water supply for Oak Ridge is continually monitored for these regulated substances. TDEC receives a copy of the monitoring report to ensure that people are receiving clean drinking water. More information about the quality of the Oak Ridge public water supply system is available at the following Web site: http://www.cortn.org/PW-html/2001WaterQualityReport.htm Exiting ATSDR Website.

To ask specific questions related to your drinking water, please call Mr. Bruce Giles, Water and Wastewater Manager, at 865-425-1875 or call EPA's Safe Drinking Water Hotline at 800-426-4791.

8

If the Joint Center cannot supply Scarboro with money they should go home.

The Joint Center should help Scarboro to write and find grant money.

The Joint Center agreement does not require them to explain any past data before 1998.

The purpose of Joint Center's Scarboro Community Environmental Study is to address community concerns about environmental monitoring in the Scarboro neighborhood.

Please contact DOE with your concerns about the Joint Center's funding as these comments are not applicable to ATSDR. More information about the Joint Center for Political and Economic Studies can be found at www.jointcenter.org Exiting ATSDR Website or by calling 202-789-3500.

9

Who makes the official health call?

ATSDR is the principal federal public health agency charged with the responsibility of evaluating the human health effects of exposure to hazardous substances. The agency works in close collaboration with local, state, and other federal agencies, with tribal governments, and with communities and local health care providers. The goal of the agency is to help prevent or reduce harmful human health effects from exposure to hazardous substances.

In 1980, the U.S. Congress created ATSDR to implement the health-related sections of the laws that protect the public from hazardous waste and environmental spills of hazardous substances. CERCLA, commonly known as the "Superfund" Act, provided a congressional mandate to clean up abandoned and inactive hazardous waste sites and to provide federal assistance in emergencies involving toxic substances. As the lead agency in the Public Health Service for implementing the health-related provisions of CERCLA, ATSDR is charged under the Superfund Act to assess the presence and nature of health hazards at specific Superfund sites, to help reduce or prevent further exposure, and to expand the knowledge base about health effects related to exposure to hazardous substances.

Under this purview, ATSDR is determining whether hazardous levels of uranium from the Y-12 plant represent a public health hazard for people living near the ORR. For additional information about ATSDR, please visit our Web site at: http://www.atsdr.cdc.gov/.

ORRHES was established in 1999, as a subcommittee of the Citizens Advisory Committee on Public Health Service Activities and Research at DOE Sites. The ORRHES provides advice and recommendations to ATSDR and Centers for Disease Control and Prevention (CDC) concerning public health activities and research conducted by ATSDR and CDC at the ORR.

10

Scarboro has a "high" background.

The monitor is in the wrong place.

They didn't sample the pond where the dump was.

They sampled my neighbor's yard, but not my yard.

The number of surface water and sediment samples taken should be increased.

Our objections in the Scarboro sampling issue include: DOE's shameless refusal to investigate particular areas suggested by Scarboro residents familiar with the DOE's legacy of contamination in their neighborhood.

Our objections in the Scarboro sampling issue include: The use of Y-12 as a control against which Scarboro soil was measured to compare contamination levels.

Our objections in the Scarboro sampling issue include: The use of the top two inches of soil as a valid sample for soil analysis; the use of only three soil samples sets for analysis.

In 2001, EPA validated the environmental sampling conducted within the Scarboro community by FAMU in 1998 (EPA 2003; FAMU 1998). ATSDR reviewed the methods and results of the environmental sampling conducted by FAMU and EPA, and found that the procedures were adequate for making public health decisions. Both EPA's and FAMU's reports are available in the DOE Information Center located at 475 Oak Ridge Turnpike, Oak Ridge, Tennessee. You can obtain documents from the Information Center at http://www.oakridge.doe.gov/info_cntr/index.html Exiting ATSDR Website or by calling 865-241-4780.

ATSDR evaluated whether the levels of uranium in the soil were significantly different in Scarboro (FAMU 1998 and EPA 2003) by comparing the levels detected in the soil in Scarboro to levels of uranium naturally occurring in the soil and to average background levels in the Oak Ridge area. ATSDR determined that the uranium concentrations in Scarboro were indistinguishable from levels occurring naturally. Please see the Current Soil Exposure Pathway discussion under Current Radiation Effects section (Section III.B.2.a.) and Figures 21, 24, and 25 for more details about this evaluation.

When conducting sampling at hazardous waste sites, ATSDR recommends that the initial evaluation of the site include an assessment of probable routes of public exposure/contaminant migration off site, and that the sampling begin at the public exposure points to determine if interim actions are needed to reduce or eliminate public exposure. Contaminated soils may expose individuals who live, play, or work near the site to contaminants at levels of health concern. Ingestion of contaminated surface soil, particularly by children, is a primary concern. Inhalation of contaminated dust and direct dermal contact with contaminated soils also can lead to adverse health effects. Generally, the public is exposed to only the top few inches of soil; therefore, ATSDR has defined surface soil as the top 3 inches. For a public health evaluation, ATSDR needs concentrations of contaminants found in surface soil reported separately from those found in subsurface soil.

11

Scarboro is adjacent to the "incinerator."

Fly ash from Y-12 settled over my car.

Contamination in air; lots of dust, air stays very smoky, smoggy. Things in air; respiratory problems; respiratory problems in children caused by air pollution from ORR; black air on mother's car after she washed it had to be from the plant; at times the air has a peculiar smell; chest pain during excitation; air pollutants building in the soils nearby; gasoline type fumes.

In 1997 and 1998, CDC, TDOH, and the Scarboro Community Environmental Justice Council conducted a study to determine whether rates of pediatric respiratory illnesses were higher in Scarboro than elsewhere in the United States and to assess whether exposure to various factors increased residents' risk for health problems. The researchers concluded the following:

No unusual pattern of illnesses emerged among the children receiving medical exams. The illnesses that were detected were not more severe than would be expected in any community. The findings of the medical exams were consistent with the findings of the community survey.

The reported prevalence rate of asthma among children in Scarboro (13%) was higher than the estimated national rate (7% in all children and 9% in black children). However, few studies have been conducted on communities similar to Scarboro, and without asthma prevalence information from these communities, it was not possible to determine whether the prevalence of asthma was higher than would be expected. The Scarboro rate was, however, within the range of rates reported in similar studies throughout the United States and internationally.

The reported rate of wheezing among children in Scarboro (35%) was also higher than most national and international estimated rates (which range from 1.6% to 36.8%).

The prevalence rates of hay fever and sinus infections in children were comparable to national estimated rates.

Because the investigation was not designed to detect associations, and a relatively small group of children was studied, it was not possible to identify causes of the respiratory illnesses.

Copies of the report on this study, An Analysis of Respiratory Illnesses Among Children in the Scarboro Community, are available in the ATSDR Oak Ridge field office at 1975 Tulane Avenue, Oak Ridge, Tennessee (telephone: 865-220-0295). This investigation is summarized in Section II.F.3. and in Appendix I.

12

What did my husband bring home from the plant?

Activities at DOE plants have led to worker health problems.

Federal regulations establish requirements for a radiological protection program. Included in the law are requirements for monitoring personnel and the workplace to ensure that contaminants are not taken outside of radiological areas. A DOE Order delineates requirements to ensure worker protection in all environment, safety, and health disciplines. The Atomic Energy Commission established worker health and safety plans through a series of orders. Worker health issues at the plants are a concern to ATSDR; however, those issues are under the purview of NIOSH. For information on NIOSH's occupational energy research program see NIOSH's Web site at www.cdc.gov/niosh/2001-133.html Exiting ATSDR Website or telephone 513-841-4400.

13

People have lived along Scarboro Road.

To address this comment, ATSDR reviewed available historical U.S. Geological Survey (USGS) maps from 1941, 1953, 1968, 1980, and 1990 to identify buildings located along Scarboro Road. In 1941, prior to ORR being established, eight unidentified buildings (potentially houses) were located along Scarboro Road. By 1953, all but one of these buildings (located at a Y intersection about 1,200 feet north of Bear Creek Road) were removed and one additional structure was added about 1,500 feet south of Bear Creek Road. Both were located west of Scarboro Road on DOE property. In 1968, the structure south of Bear Creek Road was removed, but the one at the Y intersection remained. In addition, a gas station was added north of the intersection of Scarboro Road and Bear Creek Road. No changes along Scarboro Road were noted from the 1968 map to the 1980 and 1990 maps.

In addition, ATSDR reviewed a 1945 map of the city of Oak Ridge that shows that Scarboro Road used to run north to the Oak Ridge Turnpike prior to the construction of South Illinois Avenue. According to the USGS map from 1936, seven buildings were located on this portion of Scarboro Road that no longer exists. In 1946, an additional building is shown.

14

If DOE has contaminated Scarboro land, they must buy it back.

Please contact DOE with your concerns about buying back contaminated land in Scarboro as this comment is not applicable to ATSDR.

15

The city should cover the contaminated ditches.

The springs along the north side of Pine Ridge are contaminated.

Groundwater flows from the Y-12 plant to Scarboro.

LEFPC flows through the Scarboro community; so does Scarboro Creek.

Kids play around the EFPC, when it rains water runs from the EFPC into the yards in community; son swam in the creek as a child; mercury in creek; concerned about water that flows across property; open ditches; children play in water; test the water running through the community; more frequent testing of water; lots of creeks used for drinking water when young; water glows in dark; storm water drains from reservation onto property.

Using the surface water and sediment radioactivity concentrations estimated during Task 6 of the Oak Ridge Dose Reconstruction (ChemRisk 1999), ATSDR evaluated whether past exposure to uranium in the surface water and sediment from EFPC and the floodplain would cause harmful health effects. The estimated doses were below levels of health concern for both radiation and chemical effects. Please see the Past Surface Water Exposure Pathway and the Past Soil Exposure Pathway discussions under the Past Radiation Effects section (Section III.B.1.a.) and the Past Exposure via Ingestion discussion under the Past Chemical Effects section (Section III.B.1.b) for more details about this evaluation.

In 1998 and 2001, FAMU and EPA, respectively, sampled surface water and sediment from Scarboro ditches (EPA 2003; FAMU 1998). In addition, DOE takes bi-monthly surface water samples in EFPC (DOE 1995b). ATSDR evaluated the current surface water data as it pertains to uranium contamination in the Current Surface Water Exposure Pathway and Current Soil Exposure Pathway discussions under the Current Radiation Effects section (Section III.B.2.a.) and in the Current Ingestion Exposure Pathway discussion under the Current Chemical Effects section (Section III.B.2.b.). As shown in Table 16, the mean total uranium concentrations in surface water in Scarboro and Lower EFPC are below ATSDR's EMEG and are; therefore, not of health concern. ATSDR evaluated sediment data with the soil data (see Tables 17 and 18 and Figures 21, 24, and 25). The uranium content of soils/sediment in Scarboro is indistinguishable from natural background levels and is not at a level of health concern.

16

Not allowed to eat fish or touch the water; like to fish; ate fish only to learn later they were contaminated.

Vegetables grown in Scarboro are not safe to eat and changed color.

What is in the soil? How does it get inside people's body; grass is purplish gold in color, color of flowers has changed; no information on soil testing; soil and water should be tested.

ATSDR received data on vegetable samples collected from gardens from two Scarboro residents. ATSDR calculated radiation and chemical doses following ingestion of vegetables from these gardens. As shown in Tables 21 and 24, the resulting doses are below levels of health concern–it is safe to eat vegetables from private gardens in Scarboro. Please see the Ingestion of Vegetables Grown Near the Y-12 Plants discussions in the Current Radiation Effects (Section III.B.2.a.) and Current Chemical Effects (Section III.B.2.b.) sections for more details about ATSDR's evaluation.

ATSDR compared the levels of uranium detected in Scarboro soil (EPA 2003; FAMU 1998) to the average background levels in the area around Oak Ridge and to background concentrations typically found in nature. ATSDR found that the levels of uranium that were detected in Scarboro soil were indistinguishable from background and are not a health hazard. Please see the Current Soil Exposure Pathway discussion under Current Radiation Effects section (Section III.B.2.a.) and Figures 21, 24, and 25 for more details about this evaluation.

Fish fillet samples collected from EFPC contain mercury and PCBs. However, it is ATSDR's understanding that EFPC is not a very productive fishing location and very few people actually eat fish from the creek. Regardless, in 1993, ATSDR evaluated eating fish from EFPC in a health consultation (ATSDR 1993b). ATSDR concluded that there is no acute health threat to people who eat the fish. However, if people frequently ingest contaminated fish from the creek over a prolonged period, there is a moderate increased risk of adverse effects to the central nervous system and kidneys, and of developing cancer. Copies of the health consultation, entitled Y-12 Weapons Plant Chemical Releases Into East Fork Poplar Creek, are available at the ATSDR Oak Ridge field office at 1975 Tulane Avenue, Oak Ridge, Tennessee (telephone: 865-220-0295). This investigation is summarized in Section II.F.1. and in Appendix I.

17

Check for radiation from the plant; radiation spills; radiation levels in Scarboro; should check homes for radon; a lot of people have died; skin allergy; allergies 65% have it; skin rashes on children.

DOE conducts ambient air monitoring in the environment surrounding ORR facilities, including around the Y-12 plant, to measure radiological and other parameters (DOE 1995b). One monitoring station (Station 46) is located in Scarboro, west of the Mount Zion Church on Tuskegee Drive, about 140 meters west of the Scarboro Community Center. This continuous monitoring station has been providing quarterly and annual measurements of uranium in the air since 1986 (ChemRisk 1999). The level of radiation received by Scarboro residents is not a health hazard.

18

If strontium 90 (Sr 90) were to produce health effects, how would those present themselves?

Because Sr 90 is chemically similar to calcium, it tends to deposit in bone and bone marrow (it is called a "bone seeker"). Internal exposure to Sr 90 is linked to bone cancer, cancer of the soft tissue near the bone, and leukemia (EPA 2002c). Risk of cancer increases with increased exposure to Sr 90. However, Sr 90 was not released from the Y-12 plant in high enough quantities to be a health hazard.

19

Uranium and mercury are the obvious contaminants to detect. What about other radionuclides such as beryllium? Wasn't it used at Y-12?

Is the Y-12 nuke slow cooker at Chestnut Ridge security pits included in health effects?

I also agree with attendees that the proposed surveillance, in its present proposed form, does not go far enough. Lead, thorium, beryllium, cyanide, acetonitrile, tungsten, and other materials worked at the Y-12 site have been historically "misplaced."

At the meeting it was stated by someone in the audience that Strontium-90 and Cesium-137 and other relevant radionuclides should also be measured.

The concentration of mercury in the air should be measured, so air samples should be taken also.

The concentration of mercury in plants should be measured.

Uranium, mercury, iodine, and PCBs have been detected in Scarboro.

Based on ATSDR's review and analysis of past exposures in the Phase I and Phase II screening evaluations in the State of Tennessee's Oak Ridge Health Studies, ATSDR concluded that past release of beryllium from the Y-12 plant is not a public health hazard to people living near the Y-12 plant.

ATSDR will continue to evaluate contaminants and pathways of concern to the community surrounding ORR. In addition to this evaluation of uranium from the Y-12 plant, ATSDR is evaluating uranium and fluoride from the K-25 facility, iodine 131, mercury, White Oak Creek releases in the 1950s, PCBs, the TSCA incinerator, and groundwater. ATSDR will also screen data from 1990 to the present to determine whether additional contaminants of concern need to be addressed.

Also, in 1998, FAMU collected soil and sediment from Scarboro and analyzed 10% of the samples for 150 organic and inorganic chemicals (FAMU 1998). ATSDR evaluated these data and determined that none of the chemicals that were detected (more than 100 chemicals were not detected) were at concentrations that would cause harmful health effects from exposure to the soil or sediment.

ATSDR also evaluated the gamma spectroscopy data collected by EPA in their soil sampling effort in Scarboro (EPA 2003) and concluded that other radionuclides are not of public health concern. Uranium and thorium are naturally occurring; during their decay, they produce a number of progeny that are gamma emitters. The results indicate that the progeny of uranium 238 and thorium 232 are present in the expected concentrations based on the amount of U 238 reported by EPA and FAMU (EPA 2003; FAMU 1998). Furthermore, no cobalt 60 (Co 60) was detected, and the concentration of cesium 137 (Cs 137) detected at the sampling locations averaged less than 0.3 pCi/g. In DOE's Background Soil Characterization Project (DOE 1993), the reported concentration of Cs 137 was 2 to 3 times higher than the Scarboro value. This concentration of Cs 137 is not considered to be a public health concern as the resulting radiation dose (estimated from Federal Guidance Report 13 electronic data) following the ingestion of 100 mg of soil, is orders of magnitude below the typical background dose in the Oak Ridge area.

20

The community, via SCEJOC, should be able to identify and select a contractor to accomplish the tasks needed for the characterization of pollution in the community.

Establish clearly that other affected communities in Oak Ridge are invited to sit at the table and collaborate on coordinating activities.

The community needs funding to secure its own technical assistance to ensure adequate input into this project.

DOE has primary responsibility for environmental sampling at the ORR.

21

This community needs a Sentinel Health Event evaluation performed immediately.

The community needs the data from the secret well monitoring done since the 1980s.

The community needs the data from the surface and groundwater studies at Y-12 and K-25, and this data directly impacts the surrounding residents.

This public health assessment evaluates exposure to uranium released from the Y-12 plant. All of the data that ATSDR knows of that pertains to the community is included in this report. ATSDR will evaluate uranium from the K-25 facility and the groundwater pathway in the future.

22

As the aerial studies will only reveal large releases (i.e., rare events) why is DOE spending large amounts of funding on this project?

Since the 1950s, aerial radiological surveys have been conducted at DOE facilities to provide data on the total gamma radiation emission rate found on and around its facilities (Carden and Joseph 1998). Not only do these surveys allow for the relatively rapid characterization of large land areas to determine the background levels of radiation, they are also a proven method for identifying areas where the radiation levels significantly exceed background levels of radiation. Because many of the radioactive materials used at Oak Ridge are gamma-emitting elements or decay into gamma-emitting elements, the elevated levels could be associated with Cs 137, Co 60, decay products of Sr 90, and decay products of uranium isotopes. In the case of uranium isotopes, if the soil concentrations are not significantly elevated above background levels, then the aerial survey data will be inconclusive; that is, the computer-generated results would not show the presence of elevated levels of uranium.

ATSDR has reviewed the existing flyover data for the Scarboro community and the soil survey data. While these aerial radiological surveys aid in identifying contaminated areas and the presence of relatively small amounts of contaminants (i.e., several Clinch River Cs 137 hot spots and natural uranium at the Chattanooga shale outcrop on East Fork Ridge), ATSDR does not find the surveys extremely useful in estimating doses or in making health decisions.

23

DOE has not done an adequate job of informing Scarboro, Oak Ridge, and surrounding communities of these meetings.

Our demand is that all policy debates and decisions made on the issues of environmental contamination and its effects include citizens affected by DOE-ORO operations.

Should not the result of past studies of past contaminants be more widely made available to the people of Scarboro?

ATSDR is committed to engaging the Oak Ridge community as partners in conceptualizing, planning, and implementing public health activities at ORR, in communicating and discussing results, and in determining appropriate follow-up actions. Throughout the public health assessment process, ATSDR staff have worked with the local community to identify and understand health concerns and to provide opportunities for public involvement. Please see the Summary of Public Health Activities section (specifically, Section II.F.1.) for additional information about ATSDR's community involvement activities.

The Oak Ridge Reservation Health Effects Subcommittee (ORRHES) was established in 1999, by ATSDR and CDC to provide advice and recommendations concerning public health activities and research conducted at the ORR. The subcommittee consists of 21 individuals with different backgrounds, interests, and expertise, as well as liaison members from state and federal agencies. The Subcommittee meets periodically in Oak Ridge–community members are always welcome to attend the meetings.

To promote collaboration between ATSDR and the communities surrounding the ORR, ATSDR opened a field office in Oak Ridge (located at 1975 Tulane Avenue) in 2001. This field office provides even more opportunities for community members to become involved in ATSDR's public health activities at the ORR. Please contact the ATSDR Oak Ridge field office at 865-220-0295 if you would like to be involved.

24

DOE MUST remember that many people don't attend these meetings because of fear of retaliation on their jobs.

Scarboro residents and other Afro-Americans do not participate for fear of retaliation.

All community members are encouraged to talk to any of the ORRHES members about their concerns. Perhaps it would help to know that one of the members is a Scarboro resident and a number of other members are active in the Scarboro community. Please visit the following Web site for more information about the ORRHES and its members: http://www.atsdr.cdc.gov/HAC/oakridge/index.html.

Additionally, community members can fill out an anonymous Community Health Concerns sheet in ATSDR's field office, located at 1975 Tulane Avenue in Oak Ridge (telephone: 865-220-0295). All concerns are entered into the ATSDR Community Health Concerns Database to ensure that all health concerns are brought to ATSDR's attention and are included in ATSDR's evaluation of potential public health impacts from exposures related to the ORR.

25

Is ozone concentration monitored? What health effects from ozone?

ATSDR is unaware of any ozone monitoring in Scarboro or the city of Oak Ridge. EPA's Clean Air Act Web site may provide some useful information: http://www.epa.gov/air/oaq_caa.html Exiting ATSDR Website.

Cancer Health Effects

26

There is a high rate of cancer deaths in Scarboro.

Over 80% of people die from cancer; grandfather has spot on lung; husband passed of leukemia; cancer from the plant or the water; husband died of cancer in 1996, worked 39 years at ORR: Everybody around here dies with cancer; Did living here have anything to do with it? Cancer killed 2 brothers, mother, and husband; high rate of breast cancer; cancer possibly due to vegetable garden.

The Public Health Assessment Work Group, as part of the ORRHES, is currently evaluating cancer issues with the TDOH Cancer Registry. For more information about the work group's efforts, contact members of ORRHES or the ATSDR Oak Ridge field office (located at 1975 Tulane Avenue, Oak Ridge, Tennessee; telephone: 865-220-0295).

Noncancer Health Effects

27

A lot of deformed and retarded babies were born in Oak Ridge.

Uranium is not known to cause these kinds of health effects. The level of exposure to uranium from the Y-12 plant is not expected to cause these problems in pregnant women. However, ATSDR will also be evaluating the effects from exposure to iodine 131, mercury, White Oak Creek releases in the 1950s, PCBs, fluorides, the TSCA incinerator, and groundwater. Please contact the TDOH with your concerns about a high rate of deformed and retarded babies being born in Oak Ridge.

28

Scarboro children suffer from too much asthma.

Asthma; Check people with respiratory problems; 65% of residents have asthma, child up the street has trouble breathing; man had to leave Scarboro because his two boys had trouble breathing.

In 1997 and 1998, CDC, TDOH, and the Scarboro Community Environmental Justice Council conducted a study to determine whether rates of pediatric respiratory illnesses were higher in Scarboro than elsewhere in the United States, and whether exposure to various factors increased residents' risk for health problems. The researchers concluded the following:

No unusual pattern of illnesses emerged among the children receiving medical exams. The illnesses that were detected were not more severe than would be expected in any community. The findings of the medical exams were consistent with the findings of the community survey.

The reported prevalence rate of asthma among children in Scarboro (13%) was higher than the estimated national rate (7% in all children and 9% in black children). However, few studies have been conducted on communities similar to Scarboro, and without asthma prevalence information from these communities, it was not possible to determine whether the prevalence of asthma was higher than would be expected. The Scarboro rate was, however, within the range of rates reported in similar studies throughout the United States and internationally.

The reported rate of wheezing among children in Scarboro (35%) was also higher than most national and international estimated rates (which range from 1.6% to 36.8%).

The prevalence rates of hay fever and sinus infections in children were comparable to national estimated rates.

Because the investigation was not designed to detect associations, and a relatively small group of children was studied, it was not possible to identify causes of the respiratory illnesses.

Copies of the report on this study, An Analysis of Respiratory Illnesses Among Children in the Scarboro Community, are available in the ATSDR Oak Ridge field office at 1975 Tulane Avenue, Oak Ridge, Tennessee (telephone: 865-220-0295). This investigation is summarized in Section II.F.3. and in Appendix I.

Health Concerns/Procedural

29

Scarboro was left out of the flyovers because it is contaminated.

DOE conducted eight aerial radiological surveys of the ORR between 1959 and 1997. Such flyovers are performed at major DOE facilities nationwide and follow specific procedures. "Broad Area" flyovers cover the entire ORR, while "Focused Area" flyovers cover the three plants and specific areas of interest due to DOE activities in the area, such as White Oak Creek remediation. Areas off the ORR that show only natural background levels of radiation are not surveyed in Focused Area flyovers. The community of Scarboro was included in five Broad Area flyovers, and because every flyover showed only background readings, it was not included in two Focused Area flyovers. About a third of the Scarboro community was included in the Focused Area flyover of White Oak Creek only because it was on the flight-path for the White Oak Creek survey. Scarboro was not included in Focused Area flyovers because it was "not contaminated."

Copies of the full report summarizing all radiological flyovers, Aerial Radiological Surveys of the Scarboro Community, are available from the Information Center by visiting the following Web site http://www.oakridge.doe.gov/info_cntr/index.html Exiting ATSDR Website or by calling 865-241-4780.

Because of this concern, FAMU and EPA performed independent soil sampling of Scarboro. The results of both sampling campaigns confirmed that the levels of uranium would not result in harmful health effects for the people living in Scarboro. For every exposure pathway evaluated, the levels were too low to be of health concern for both radiation and chemical health effects.

30

The DOE Background Soil Study was done on contaminated soils.

During this evaluation of uranium from the Y-12 plant, ATSDR reviewed Scarboro soil data (EPA 2003; FAMU 1998), the Background Soil Characterization Project (DOE 1993), and natural background levels. As shown in Figures 21, 24, and 25, there was no significant difference between them. Please see the Current Soil Exposure Pathway discussion under Current Radiation Effects section (Section III.B.2.a.) for more details about this evaluation. Furthermore, ATSDR compared the results of the Scarboro sampling and the DOE Background Characterization Project to values typically found throughout the country and found no significant difference among the values reported.

31

The Scarboro cancer data supplied by the state is incomplete.

The Public Health Assessment Work Group, as part of ORRHES, is currently evaluating cancer data in counties surrounding the ORR. For more information about the work group's efforts, contact members of ORRHES or the ATSDR Oak Ridge field office (located at 1975 Tulane Avenue, Oak Ridge, Tennessee; telephone: 865-220-0295).

32

What experiments were run on us?

What secrets are still being kept?

Any DOE-controlled study will lack credibility.

For several decades, DOE and its predecessor agencies have conducted research and production activities at a number of sites across the country, including ORR. These activities involved development and production of nuclear weapons and materials, as well as other nuclear energy-related research. People in communities near and downwind from these sites became increasingly concerned about whether site activities might be affecting their health. In response to these concerns, DOE asked the U.S. Department of Health and Human Services (DHHS) to independently investigate the public health implications of its nuclear energy-related activities. DOE formally delegated responsibility for this work to DHHS in two memorandums of understanding issued in 1990.

Under a memorandum of understanding between DOE and DHHS, CDC became responsible for analytic epidemiologic research concerning the potential impacts of DOE's energy-related activities. This memorandum of understanding also recognized that ATSDR would be responsible for all public health activities mandated by Superfund. These activities include conducting public health assessments at DOE sites, in addition to other follow-up activities, as appropriate.

The ORRHES was established in 1999, as a subcommittee of the Citizens Advisory Committee on Public Health Service Activities and Research at DOE Sites. ORRHES provides advice and recommendations to ATSDR and CDC concerning public health activities and research conducted at ORR. The subcommittee consists of 21 individuals with different backgrounds, interests, and expertise, as well as liaison members from state and federal agencies.

33

The Scarboro community should influence the choice of the contractor that will perform the sample collections.

Because ATSDR did not perform environmental sampling in the Scarboro community, this comment is not applicable to ATSDR.

34

ORHASP has recognized that mercury speciation is still a problem, but is not going to address it. We must have independent analysis and research performed by both minority and majority universities.

ATSDR will evaluate exposures to mercury during a separate public health assessment, expected to be conducted during 2004.




18 The Task 6 values (based on 52 years of exposure) were multiplied by 1.35 (70 years/52 years) for comparison with ATSDR's MRL, which is based on a 70-year exposure.

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