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ATSDR's Child Health Initiative recognizes that the unique vulnerabilities of infants and childrendeserve special emphasis with regard to exposures to environmental contaminants. Infants, youngchildren, and the unborn might be at greater risk than adults from exposure to particularcontaminants. Exposure during key periods of growth and development might lead to malformationof organs (teratogenesis), disruption of function, and even premature death. In certain instances,maternal exposure, via the placenta, could adversely effect the fetus. After birth, children mightreceive greater exposures to environmental contaminants than adults. Children are often more likelyto be exposed to contaminants from playing outdoors, ingesting food that has come into contact withhazardous substances, or breathing soil and dust. Pound-for-pound of body weight, children drinkmore water, eat more food, and breathe more air than adults. For example, in the United States,children in the first 6 months of life drink 7 times as much water per pound as the average adult.29The implication for environmental health is that, by virtue of children's lower body weight, giventhe same exposures, they can receive significantly higher relative contaminant doses than adults.

The scientific literature was reviewed to evaluate the likelihood of adverse reproductive ordevelopmental health effects as a result of exposure to the site-related contaminants of concern.Estimated exposures were well below levels observed to cause adverse reproductive ordevelopmental health effects for all of the contaminants evaluated.


Health outcome data are investigated when the concentrations of the chemicals of concern are atlevels where we might expect to find adverse health effects. WDOH evaluated all of theenvironmental sampling data collected to date at the Cenex site to assess the likelihood that personsliving near the site would experience higher rates of disease. In high-dose animal studies, some of thecontaminants of concern have been associated with specific cancers, such as renal pelvis cancer,thyroid tumors, and bladder cancer (see the Discussion section). However, under very conservativeexposure scenarios (assuming exposure to the highest detected concentrations of all of thecontaminants of concern at the site over many years), the total estimated increased lifetime cancerrisk for children and adults was low; less than one additional cancer in a population of 100,000persons exposed for many years. Using a more realistic exposure scenario (i.e., using surface soilcontaminant concentrations instead of subsurface soil contaminant concentrations, where the levelswere usually lower, and shorter, more realistic exposure durations), the potential for developingcancer is substantially less. There was no evidence that exposure to the chemicals at this site wouldresult in other chronic health conditions.

Given the very low likelihood that anyone around the site would have experienced any long-termlasting adverse health outcomes, and the relatively small number of people potentially exposed to thesite, it was not feasible to accurately assess any health impacts for this immediate area by usingexisting data sources such as the Washington State Cancer Registry. However, some residents haveexpressed strong concerns about cancer. For example, at a WDOH-sponsored Open House inQuincy in 1997, a number of residents were concerned that the population living near the site hadexperienced higher rates of cancer of the brain, breast, lymph, throat, colon, liver, kidney, bladder,lung and thyroid. Other noncancer health concerns were expressed by some area residents, and wereaddressed by WDOH in the Community Health Concerns section of the health assessment.

In response to the cancer concerns, data from the Washington State Cancer Registry were evaluatedto determine if there were more cases of cancer among Quincy area residents (i.e., ZIP code 98848)than would be expected. To calculate the number of cases of each type of cancer that would beexpected to occur in Quincy if the rate in Quincy was the same as the state as a whole, we calculatedstatewide cancer rates for each type of cancer within specific age groups for each gender. We thenmultiplied these rates by the number of people in Quincy in each of these gender and age groups.Finally, we added the results for all the gender and age groups together to obtain a total number ofexpected cases of that cancer. This analysis was carried out for the 24 major sites of cancer using allseven years of available data (i.e., 1992-1998). The cancer sites included: bladder, brain, breast(female), cervix, colorectal, endometrium, esophagus, Kaposi's sarcoma, kidney and renal pelvis,larynx, leukemia, liver, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, lung, melanoma of theskin, multiple myeloma, oral cavity and pharynx, ovary, pancreas, prostate, stomach, testes, andthyroid. In addition, we examined cancers of unknown primary site (i.e., cancers diagnosed at anadvanced stage for which it was impossible to determine the site where the cancer began), all othercancers, and all cancers combined.

In a small community such as Quincy, the number of cancer cases from a specific site will berelatively small and will vary considerably from year to year. Even when several years ofinformation are used, the observed number of cases will rarely be exactly equal to the expectednumber of cases. For some cancer sites there will be more cases than expected, for other sites therewill be fewer cases than expected. These differences are sometimes due to the random variation inthe number of cases seen each year. However, in other instances, the difference might indicate thatthere actually is a higher or lower rate of new cancer cases in the community than would beexpected.

To determine whether the difference between the observed and expected number of cancer cases wasdue to random variation, we conducted statistical tests and computed p-values. The statistical testassesses how likely it is to have the observed number of cancer cases if the actual cancer rate inQuincy was the same as the state as a whole. The resulting p-value is an estimate of the probabilityof having the observed number of cases, or a number of cases which is even further from theexpected number of cases based on the overall state average. If the p-value is 0.05 or less, we say thecomparison is statistically significant, meaning there is evidence of a difference between the incidence of cancer in Quincy and the state average. If the p-value is largerthan 0.05, we say there is no evidence of a difference in the cancer incidence.

By chance alone, we expect to see a p-value of 0.05 or less in about 1 out of every 20 statisticaltests. Therefore, when we conduct many statistical tests, as in this analysis, we expect to see some"significant" p-values even if there is no real difference between cancer incidence in Quincy and therest of the state. The smaller a p-value is, the stronger the evidence that there is a real differencebetween Quincy and the state average.

Overall, there were fewer total reported cases of cancer in Quincy during the 1992 to 1998 timeperiod than would be expected in a community in Washington of the same size and age structure(Table 1). There were a higher number of cancers of "unknown primary site." These are cancersdiagnosed at an advanced stage for which it was impossible to determine the site where the cancerbegan. Since these were different types of cancer, it is very unlikely that they would have had acommon underlying cause. Many other cancer sites had fewer cases than expected, includingKaposi's sarcoma, liver, lung and bronchus, melanoma of the skin, and testes. Cancer rates for theother sites did not appear to be different than would be expected on the basis of Washington Staterates.

This analysis used data for all residents living in the 98848 ZIP code, and, as such, the results do notspecifically apply to just those residents living near the Cenex facility. Including residents who werenot exposed to site contaminants can affect the analysis in two ways. First, the inclusion ofunexposed persons in the study population might obscure an otherwise measurable cancer increasein the exposed population. However, measuring cancer in only the population who were potentiallyexposed (i.e., those living very close to the facility) greatly reduces the number of people in theanalysis, making it very difficult to accurately estimate the expected number of cases or to interpretthe comparison of the observed cases to the expected number. For example, in very small areas, it isdifficult to accurately estimate the population for non-census years, and even one case of cancer mayrepresent a statistically significant increase. Secondly, when people who do not live in the area ofpotential exposure have cancer risk factors not found in the exposed population, then an increase incancer may be observed that is not related to exposure to the site. Given the low likelihood thatanyone exposed to the site would have experienced any adverse health outcomes, and the problemsin assessing cancer risk in situations where the potentially exposed population is very small, we donot feel that it is useful to conduct these analyses for an area smaller than the Quincy ZIP code.

Table 1.

Cancer incidences reported and expected for the Quincy area (1992-1998)
Cancer Incidence for Quincy, WA
(Zip Code 98848)
Observed # of Cases Expected # of Cases p-values*
Primary Site Category19921993199419951996199719981992-981992-19981992-98
All Cancers29392931353535233275.50.01
Breast (female)572848104442.50.74
Kaposi's Sarcoma000000001.00.74
Hodgkins Lymphoma000100011.70.99
Kidney and Renal Pelvis1102033106.00.09
Lung and Bronchus44534152638.10.05
Melanoma of the Skin0401111815.30.06
Multiple Myeloma010011033.01.0
Non-Hodgkins Lymphoma01113411110.30.68
Oral Cavity and Pharynx101100036.50.22
Unknown Primary Site2231211125.60.01
All Other Sites11113231215.20.50

* Two-sided p-values


An Open House was hosted by the Washington State Department of Health (WDOH) on April 23,1997, to gather community health concerns related to the site. WDOH received comments fromapproximately 20 residents, including four whose primary language was Spanish. A Spanish-speaking interpreter documented concerns from those residents. Several residents attended thesession, but did not comment. The following health concerns were heard:

1. Resident expressed concern about asthma. The resident also knows of three or fourchildren with brain cancer and requested a door-to-door health survey.

A number of causative agents are known or suspected to trigger asthma, although the specificreasons can vary from person to person. Common triggers include infections, lung irritants, inheritedfactors, allergens, sinusitus, cigarette smoke, cold weather, and occupational and environmentalirritants. Although exposures to some environmental contaminants might trigger a preexistingasthma condition, WDOH found nothing in the scientific literature that suggests exposure to thedetected concentrations of site contaminants, in and of themselves, would cause asthma.

Brain cancers can have both environmental and nonenvironmental etiologies (causes). There isevidence to suggest a link between adult workers exposed to chemicals used in certain industries(vinyl, rubber production, oil refining, and chemical manufacturing), and an increased risk ofdeveloping brain cancer. Considerably less information exists about the causes of childhood braincancers, particularly from environmental exposures. Some studies have suggested an associationbetween increased incidences of certain brain cancers and exposure to pesticides by pesticideapplicators, and in children living in agricultural areas.30, 31 After careful evaluation of the potentialhealth effects from past exposure to Cenex site contaminants, brain cancer would not be expected.WDOH also studied the Washington State Cancer Registry to observe whether there was an increasein the number of brain cancers reported for the Quincy area compared to the number expected.Review of those data indicate that the number of brain cancers reported for the Quincy area werewithin the range expected for this time period (see Table 1).

On the basis of its evaluation of all available site-specific environmental and community healthoutcome data, WDOH determined that the site posed a low health risk and is not recommending adoor-to-door health survey. At the request of one area resident, WDOH provided an applicationform for a health study shortly after the April 1997 WDOH-sponsored Open House. To date,ATSDR has no record of having received such an application.

2. A resident living on a farm indicated that aerial pesticide spraying occurs on fieldssurrounding his home, and is concerned about their cumulative effects on health. Theresident had breast cancer and surgery in 1990. The resident's daughter and son-in-law alsolive on the property. The resident's daughter's baby was born with Rubinstein-TaybiSyndrome. The resident also stated that their homes are ½ mile from the city's wastedisposal area. The resident is also concerned that waste and urine from a feedlot might becontaminating the groundwater.

The primary purpose of this health assessment was to evaluate the potential health effects fromexposure to site-specific contaminants. WDOH concluded that the site posed a low health risk dueto previously elevated levels of some herbicides and pesticides in soil at the Cenex site. The risk wasfor persons assumed to be exposed through ingestion, skin contact, and inhalation to the mostcontaminated soil over many years. The site does not currently pose a health hazard.

The cause of Rubinstein-Taybi Syndrome (RTS) is unknown.32 Although some type of geneticorigin is possible, no definite genetic pattern has been identified. There have been no consistentchemical or other environmental exposures reported during pregnancy for children born with RTS.

Exposures to pesticides from aerial application have the potential to pose a health risk, depending onthe duration, type, and concentration of pesticides one is exposed to. WDOH was not providedspecific information on the aerial pesticide exposures in question, and did not evaluate the associatedhealth implications. The purpose of this health assessment was to evaluate potential health risksassociated with exposure to contaminants from the Cenex facility, not to evaluate health risks relatedto areawide aerial pesticide spraying. For additional information concerning pesticide poisoningissues, contact Lynden Baum, manager of the WDOH Pesticide Investigation and Surveillance Unit(360-236-3361, or toll-free at 1-888-586-9427) can be contacted. The Washington StateDepartment of Agriculture, Pesticide Management Compliance Unit, Yakima Branch (509-225-2640) and the Washington State Department of Labor and Industries Compliance Unit (509-886-6505) can be contacted for issues relating to pesticide application regulations and worker health andsafety issues, respectively.

If the resident suspects the nearby feedlot or city waste disposal area are impacting the groundwater,WDOH recommends contacting the Grant County Health District to request an inspection. Ifresidential wells are at risk, follow-up testing of the wells should be considered. WDOH is availableto evaluate the results of any such testing.

3. Resident is concerned about the possibility of ambient chemicals in the air causing lungdisease. The resident also asked whether there would be enough time to move people awayfrom the site if there was a major problem. The resident asked about the types of chemicalsin the ground. Resident is also concerned that the schools are too close to the surroundingchemical plants and if the plants can be moved away from the schools.

Lung disease can be caused by many factors (see WDOH response to question # 1, above). Ambientair sampling at the Cenex site, prior to installation of the soil vapor extraction (SVE) system, waslimited. Only 1,2-dichloropropane and a small number of other volatile organic compounds (VOCs)of concern that were present in Cenex site soil gas were tested. Air sampling conducted after theSVE system became operational has not detected 1,2-dichloropropane. Potential contribution ofairborne contaminants originating from other facilities was not part of this health assessment. Ifadditional ambient air sampling is conducted at the site, WDOH is available to evaluate the results.For the reasons described previously, WDOH recommended follow-up air sampling at the highschool. This additional air sampling was done in August 2000, and no site-related contaminants, orother contaminants at levels of health concern, were detected. A follow-up indoor air samplinginvestigation was conducted inside the high school in fall 2001, the results of which also will beevaluated by WDOH.

In general, it is prudent to zone public institutions, such as schools and residences, away fromindustrial areas. WDOH recommends contacting the local or state agency responsible for emergencyresponse in your area (most likely the Fire Department or Department of Ecology) regardinginquiries about the readiness of adjacent facilities to respond to accidental releases. Staff with theDepartment of Ecology's Hazardous Waste and Toxics Reduction Program routinely inspecthazardous waste generation and storage facilities. They can also be contacted for additionalinformation, or to request a facility inspection.

The types and concentrations of contaminants detected in the ground, and the respective healthcomparison values, are listed in Appendix A of this report.

4. A resident stated that his wife and daughter have a recurring cough and that one of hisdaughters has asthma. Their young son has behavior problems. The resident wants to knowwhat materials were dumped at the site, at what concentrations, and from what sources.Resident is concerned that Cenex built the site poorly and illegally and its record keepingand materials tracking was poor.

Based on the limited information provided by the commenter, WDOH cannot assess the reasons forthe recurring coughs or behavioral problems. WDOH recommends asking your primary carephysician about these conditions. The primary contaminants of concern released at the Cenex sitewere fumigants (primarily Telone), solvents, and pesticide/herbicide compounds. The reader canrefer to the Background section of this report for a brief description of activities at the site thatresulted in the contamination. The types and concentrations of contaminants detected are located inthe data tables in Appendix A. The References section lists the primary documents availableregarding the site investigation and cleanup, which are available for public review.

Cenex has acknowledged that past site activities have resulted in the release of hazardous chemicalsinto the environment. Cenex, with Ecology oversight, continues to evaluate and clean up the site.Guy Gregory, site manager with the Department of Ecology (509-456-6387), can be contacted foradditional information about Cenex's past practices and record keeping.

5. Resident used to live near the Cenex site, has no health problems, and thought theannouncement was alarming. Resident has no concerns and has seen no health effects.

Comment has been noted.

6. Resident has lived in Quincy for 30 years and used to live upriver from the Hanfordreservation. Her husband died of cancer and a friend had lymph and kidney cancer. Shewants to know if there is a connection with those cancers and site contaminants. Residentwants to know if there is a large number of cancers in the area.

After careful review and evaluation of all available site environmental sampling data, WDOHconcluded that exposure to contaminants detected at the Cenex site are unlikely to result in chronicadverse health effects. Under a very conservative exposure scenario (ingestion, inhalation, and skincontact with the most contaminated soil over many years), WDOH estimated a low increased cancerrisk. The reader can refer to the Discussion and Conclusion sections of this report for a morecomplete analysis of the health risks.

The reader can refer to the Health Outcome Data Evaluation for Quincy section of this report fora summary of cancers reported for the Quincy area, compared to the number of cancers expected.

This health assessment was intended to summarize the potential health impacts from exposure toCenex site contaminants only. The Department of Health's Hanford Health Information Network(HHIN) was created to provide information on the known and potential health effects of theradioactive releases from the Hanford Nuclear Reservation, located in south central WashingtonState. Although HHIN no longer exists, information and related links can be obtained by accessingtheir Web site at . A December 2000 report summarizing theHanford Individual Dose Assessment Project titled "Final Report" is also available from WDOH'sDivision of Radiation Protection.

There were a number of concerns expressed by some area residents about the possible health impactsas a result of contaminants detected at the Cenex site. This (the Community Health Concernssection) is a summary of all of the concerns, and WDOH's responses to the concerns.

7. Resident's office has been located 200 feet southeast of the site for the past 15 years. Hehas had sinus problems for the past 4 to 5 years and wants to know if dust exposure from thesite could be the cause. The resident is also concerned about health risks of his employees,whether his property is contaminated, and is concerned that the contaminated soil piles atthe site were not adequately covered.

After evaluating all available site environmental sampling data, WDOH concluded that the siteposed a low health risk. WDOH noted the contaminated soil piles stockpiled on site after excavationoccurred in 1997, and the fact that the cover was not 100% effective. The soil piles were taken to alicensed hazardous waste landfill in Roosevelt, Washington, in May 1997. Although concentrationsof some contaminants in the excavated soil piles were elevated, they were only moderately elevated,and in and of themselves, would not be expected to result in sinus problems to exposed individuals.WDOH estimated dust exposures using an EPA particulate model. The results of this modelingeffort indicated that exposure to contaminated dust generated at the site would not have posed ahealth hazard.

Cenex, under Ecology supervision, has investigated some properties to the south and southeast of thesite, particularly to determine the nature and extent of off-site groundwater and subsurface soil gascontamination originating from the Cenex site. Groundwater contamination is the most seriousenvironmental problem associated with the site, although there are currently no known exposures tothe contaminated groundwater.

WDOH has evaluated the results of numerous soil, soil gas, groundwater, and air samples collectedat various offsite locations, including the adjacent school property, Desert Electric facility, and abackground site. WDOH is not recommending further off-site soil testing. However, because ofcommunity concerns, the presence of elevated levels of VOCs in the groundwater underneath thehigh school property, and the limited scope of the 1998 Quincy high school air samplinginvestigation, WDOH recommended more comprehensive follow-up air sampling at the highschool. A more comprehensive indoor air quality study was performed at the high school in August2000 using passive air sampling canisters (EPA Method TO-14). Method TO-14 is the standardprocedure used for detecting and analyzing VOCs in air at low concentrations. No 1,2-DCP or otherchemicals were detected in the samples at levels of health concern. WDOH and ATSDRrecommended another round of indoor air sampling inside the high school to verify that site-relatedVOCs are not present at levels of health concern. This additional sampling was conducted inNovember 2001, the results of which will be evaluated in a separate health consultation.

8. Resident has worked at Quincy Junior High and is concerned that students and teachersare affected by the site. He wants to know what is being done and what the timeframes arefor site cleanup?

Guy Gregory, site manager with the Department of Ecology, can be contacted for informationconcerning current site clean-up activities, and timelines for cleanup.

WDOH understands that the rinsate pond spray evaporation system, which operated at the site for ashort time in the late 1980s, reportedly generated overspray which occasionally drifted onto theneighboring junior high school. Since no air sampling of the overspray was conducted during theoperation of the spray system, measurement of the school exposures is not possible. However, basedon the limited number of herbicide/pesticide compounds reported for the sludge (five), theirgenerally low concentrations, the limited timeframe in which exposure would have occurred, a long-term health risk would not be expected. However, if junior high school students or staff haveongoing health concerns they feel are related to exposures from the overspray, WDOH recommendsconsulting with their primary care physicians. WDOH also can consult with Occupational Healthphysicians who specialize in the medical evaluation of environmental and occupational exposures todetermine if a follow-up medical evaluation should be considered.

In early 1998, WDOH spoke with an employee of the junior high school regarding concerns heexpressed about air quality there. Specific concerns included exposures to the rinsate pondoverspray, the possibility of pesticides in the school's ventilation system, and diesel fume exhaustodors. The conversation was followed up with a letter in January 1998. Included with the letter wasa list of Washington State private air quality consulting firms, indoor air quality guides, an exposurehistory guidance form, an Environmental Health Resource Directory, an application for additionalAir Quality Tools for Schools kits, and additional indoor air quality references. WDOH alsoreferred the employee to our program's indoor air quality specialist and the Washington StateDepartment of Labor and Industries consultative branch for additional information. WDOH hasrecommended follow- up ambient air sampling at the high school. Follow-up testing was conductedin August 2000, and no site-related chemicals were detected. ATSDR evaluated those results in aseparate health consultation report, which was provided to the school, agency representatives,consultants, and others. Copies were also sent to the Quincy public library and city hall. Additionalindoor air sampling was conducted at the high school in fall 2001.

9. Resident is concerned that little has been done, yet the site has been a known problem fora long time.

Numerous activities have occurred at the site since the early 1990s. The commenter can refer to theBackground section of this report for a detailed list of those activities. Most recently (summer 2001),Cenex prepared a Remedial Action Workplan and Engineering Design documents which describethe cleanup actions, standards, and other requirements to be met at the site. Guy Gregory, theEcology site manager, can be contacted at (509-456-6387) for information on current activities andtimelines for cleanup.

10. Resident wants to know whether chemicals at the site could have caused his throatcancer. Wants to know if there is an exposure pathway and whether the site is currently safe.Resident is concerned about possible higher-than-normal cancer rates among potato plantworkers near the Cenex site.

Exposure pathways were evaluated as part of the health assessment process, and are discussed indetail in the Discussion section of this report.

On the basis of the types and concentrations of contaminants detected at the site, throat cancer wouldnot be expected to result from exposure. Since removal of the rinsate pond, fumigant tanks, and themost heavily contaminated soil, the site currently does not pose a health threat to site workers orresidents.

WDOH was not provided the details of the potato plant workers' cancers, nor was WDOH providedany information about chemicals used at the potato plant to which employees might have beenexposed. A detailed discussion of reported and expected cancer incidences for the Quincy area forvarious cancers is located in the Health Outcome Data Evaluation section of this report.

11. Resident expressed concerns about dust exposure to surrounding schools and residences.Resident is also concerned about whether there are adequate school evacuation plans due tothe surrounding chemical plants. Resident is concerned about contaminated mist from site-spraying operations and about contaminated sludge spread onto a farm. Resident isconcerned about EDB-contaminated water at the Nielson Trailer Park water system.Resident wanted to know which lab would analyze subsequent groundwater samples, andwants a door-to-door survey.

The commenter can refer to the WDOH response to

-- comment # 7 regarding estimated dust exposures from the Cenex site. Undoubtedly, windblowndust is generated from the Cenex site and numerous other area sources, including surroundingfields. This health assessment focused only on potential exposures to Cenex site-relatedcontaminants.

-- comment # 3 concerning recommendations on contacts for inquiries about evacuation/emergencyresponse. In general, it is prudent to have appropriate notification and evacuation plans in place inthe event of an unplanned hazardous chemical release(s), particularly for facilities located near at-risk populations, such as residences and schools. WDOH recommends contacting the local firedepartment, school administrator, and/or Grant County Health District for facility-specificinformation.

- comment # 8 regarding the spray system that operated at the site for a short time in the late 1980s.Two case investigation reports were prepared by the Washington State Department of Agriculture;one in July 1991, and one in May 1992. The reports summarized the Department of Agriculture'sinvestigation of Cenex sludge disposal on the farm property and are listed in the Reference section.

- comment # 14 in the Response to Comments section later in this report for information on theNielson Trailer Park (now Country Corner) well. EDB was used extensively in the past as a soilfumigant and as a leaded-gasoline additive, and is occasionally detected in domestic well water inareas where it was used. Examples in Washington state include Thurston and Whatcom county.

Ecology can be contacted for information on the labs used to analyze the water samples. Thecommenter can refer to WDOH response to comment # 1 regarding the request for a health survey.

12. Resident is concerned about her health. She has colon and liver cancer and thyroidproblems. Resident used to work at nearby potato plant. She wants to know the healthproblems of others in the area and local cancer rates compared to national rates.

The commenter can refer to Table 1 and the Health Outcome Data Evaluation section of this healthassessment for a detailed discussion of specific Quincy area cancer incidences, compared to expectedcancer incidences.

No information was provided to WDOH regarding potential chemical exposures of potato plantemployees. Occupational exposures are regulated by the Department of Labor and Industries,although WDOH is available to assist in evaluating the results of any such exposure monitoring.

Cancer is the most common cause of death in Washington adults, aged 45 to 74. Be it breast, lung,or prostate, cancer of some form will likely strike 1 in 3 Washington residents in their lifetime.WDOH's 1997 Cancer in Washington report, released in late October 1999,summarizesdata onthe state's 24 most common types of cancer. In 1997, there were 26,517 new cases of cancer overall.Breast cancer is the most common type of cancer, followed by prostate, lung, and colorectal cancerand melanoma.Lung cancer accounts for almost 30% of all cancer deaths in Washington State.

13. Resident's 28-year-old child has chronic fatigue syndrome and attended local schools.Resident's second child (18 years old) has chronic headaches, chronic fatigue syndrome, andhas twice had mono. He was tested and had elevated levels of aluminum. Their drinkingwater was tested and was high in nitrates, but not high in aluminum.

Currently, there is no known cause or a specific biological indicator for the illness commonlyreferred to as chronic fatigue syndrome. An estimated 90% of mononucleosis cases are caused by theEpstein-Barr virus (EBV), a member of the herpesvirus group. Most of the remaining cases arecaused by certain other herpesviruses, particularly cytomegalovirus.33 Exposure to environmentalchemicals is not a likely cause of mononucleosis. WDOH was not provided specific informationabout the elevated aluminum levels, although aluminum was not a contaminant of concern at thesite.

Ingestion of drinking water containing nitrate at or above the federal drinking water standard(maximum contaminant level, or MCL) of 10 ppm might pose a health hazard for infants due to therisk of methemoglobinemia. A risk also exists for pregnant women drinking water that containsnitrate above the MCL. Although high nitrate levels were found in the shallow groundwaterunderneath the site, WDOH is not aware of any exposures to the contaminated groundwater.

14. Resident stated her horses became sick and died as a result of eating hay that was grownon the field where the Cenex rinsate pond sludge was spread. Resident had a bad cough whilehandling the hay and was diagnosed with chronic fatigue syndrome.

WDOH has reviewed two reports prepared by the Washington State Department of Agriculture,which included a discussion of crop impacts after field application of the rinsate pond sludge (seeWDOH response to comment # 11). Although one of the reports concluded that "the contents of theCenex waste pond applied to the 100-acre circle had deleterious effects on plant growth," noevaluation was made on the potential impact the sludge application might have had on the horses.The reports are listed in the Reference section, and should be available for public review. Residualcontaminants detected in the field soil samples included atrazine, chlorpyrifos, ethalfluralin,propachlor, dichlobenil, and trifluralin. The residual levels of these contaminants measured in thefield soil at the time of the sampling were low (levels ranged from 0.001 ppm to 0.17 ppm--belowhealth comparison levels for soil ingestion). Administrative penalties were issued to Cenex as aresult of the sludge application.

WDOH was not provided with specific information (i.e., the levels of pesticides/herbicides in thehay), whereby an estimation of health risk could be made. As noted above, the residual levels ofpesticides and herbicides measured in the field after the sludge application were quite low,suggesting that exposure would unlikely have resulted in adverse health effects. If the resident is stillconcerned about the health effects he or she feels might be related to handling of the hay, WDOHrecommends contacting the resident's primary health care physician. The commenter can refer to theresponse to comment # 13 regarding chronic fatigue syndrome.

15. Resident wants to know when the site will be contained and cleaned up and feels there has been inadequate community responsiveness. Resident owns house "downwind" of the site and notes that a friend who passes by the site is losing his hair. Resident does not like the groundwater testing procedures and wants to know
-- if the tests were for specific chemicals;
-- the source of the "elevated levels of beryllium" found on the site;
-- about winter runoff from the site.
Resident feels there is insufficient information available to the public and wants a health survey conducted, especially for the migrant population and a mobile home park near the high school. The resident also is concerned about Hanford wastes in Quincy.

Ecology's site manager can be contacted for an update on current site activities and timeframes forcleanup. Since 1997, there have been numerous community Open Houses and meetings to updatearea residents about site investigation and cleanup activities. WDOH presented the findings of thepreliminary health assessment at a public meeting in 1998. Notices were mailed out well in advanceof the meeting.

WDOH could not find anything in the scientific literature which suggests that exposure to the typesof contaminants found at the site would result in hair loss.

The groundwater testing procedures were conducted in accordance with an Ecology-approvedsampling plan. The testing included the analysis of a broad range of chemicals that were known orsuspected to be present at the site.

There were no elevated levels of beryllium detected at the Cenex site. An initial sample analysisreport prepared in early 1996 indicated an elevated level of beryllium in a site soil sample. In a letterfrom Cascade Analytical (the lab that conducted the analysis) to the Department of Ecology datedMarch 14, 1996, the lab indicated there had been an error in the initial analysis. The error resultedfrom an electronic failure with the instrument used to analyze the sample batch. Subsequent analysiswas conducted that indicated that the beryllium concentration was much lower than the initialanalysis had reported. The corrected results were submitted to Ecology on May 15, 1996. WDOHevaluated all sample results, including the beryllium results. The highest concentration was from asample collected by EPA in 1993. The concentration (1.39 mg/kg) was within the range of naturalbackground concentrations for the area and does not pose a health threat.

The commenter can refer to WDOH's response to comment # 1 regarding the health survey. WDOHis not aware of Hanford wastes in the Quincy area in general, or at the Cenex site, in particular.WDOH evaluated the results of all environmental samples collected during the site investigation.This report summarizes the public health findings.

16. Resident has lived in Quincy since 1956, has no health problems, wants to know if there isstill a problem with the site, and the status of the cleanup.

Comment noted. Since removal of the fumigant storage tanks, rinsate pond, and contaminatedsoil/sludge, the site has not posed a direct contact health threat. Most of the remaining contaminationis in the shallow groundwater underneath the site, where exposure is not occurring. A public healthhazard would exist only if people were to become chronically exposed to the contaminatedgroundwater. Groundwater cleanup is being addressed as part of the overall site cleanup plan. Thecommenter can contact the Ecology site manager regarding the status of the cleanup. Because of thelimited scope of the 1998 high school air sampling investigation, WDOH has recommended morecomprehensive follow-up air sampling investigations there. The first of these samplings wasconducted at the high school in August 2000, and no site-related contaminants were detected. Asecond follow-up indoor air investigation occurred in late 2000. The results of this investigation willbe evaluated by WDOH.

17. Resident is concerned about pesticides getting into the drinking water and is concernedabout soil and air exposure to pesticides. Also, the resident wants to know how contaminatedthe site is, why the site is so close to the school, how long it will take to clean it up, and howthe site might affect the family.

Per requirements of the Washington State Model Toxics Control Act (MTCA), Ecology directedCenex to investigate and clean up the site because of the threat to human health and theenvironment. Pesticide contamination was one of the concerns, and was evaluated during theRemedial Investigation. Although numerous pesticide/herbicide compounds were detected in sitesoil and rinsate pond sludge samples, none were detected in the shallow groundwater (although othercontaminants were detected in groundwater). WDOH determined that, on the basis of the types andconcentrations of some elevated pesticides/herbicides detected in site soil samples prior to the 1997soil removal, a theoretically very low increased cancer risk existed for persons assumed to bechronically exposed. The reader can refer to the Discussion section of this report for a detailedsummary of the health risks.

On the basis of the types and concentrations of contaminants detected in site soil, WDOH is notrecommending air sampling for pesticides. Since the last version of the health assessment, WDOHconservatively estimated pesticide exposures using a dust inhalation model (see Appendix A), andconcluded that exposures would have been below levels of health concern (see previous responsesregarding dust). WDOH has offered to review and evaluate any air sampling plans, air dispersionmodel results, or air sampling test results which Cenex, other agencies, or individuals might wish todevelop and collect.

WDOH does not know the reasons for citing the schools in their current locations. Quincy'sPlanning/Zoning Department is probably the best source of information on this.

No VOCs (the primary class of contaminants of concern detected in site groundwater) were detectedin the most recent Quincy well samples. The owner/operator of the resident's water system can becontacted for the most current water testing information. WDOH is available to evaluate the resultsof such tests.

18. Resident wants to know whether the rash on her daughter's neck is related to the site.The resident also wants to know the concentration of contaminants in the groundwater and ifher son, who attends the school, might be exposed to the site contamination. The residentwants the site cleaned up and wants to be assured that her family will not be harmed.

Maximum groundwater contaminant concentrations are summarized in Table A5 of this report.Groundwater testing since then has revealed similar contaminant concentrations.

Some laboratory studies have shown that rodents exposed to high concentrations (much higher thanlevels detected at the site) of some of the detected contaminants developed redness and/or skinsensitization. Trifluralin, for example, might produce allergic reactions in certain people at highconcentrations. However, skin contact with even the highest levels of contaminants found at the sitewould not be expected to result in skin rashes.

Although it is possible that exposure to site contaminants occurred by means of periodic fugitivedust emissions from the Cenex site, on the basis of the results of the particulate model discussedpreviously, WDOH does not believe a health threat existed.

Since 1997, under an Ecology Order, the site has undergone extensive investigation and cleanup.The Remedial Action Workplan addresses additional planned site remedial actions.

19. Resident is concerned that his school-aged children are being exposed to the site and thatchemicals from the site could contaminate the drinking water.

Past releases of chemicals at the site did contaminate the groundwater, although the groundwater inthe area of contamination is not believed to be used as a source of drinking water. Residents in thearea obtain their water from Quincy municipal wells, which, to date, have not been impacted by thesite. Under an Ecology Order, Cenex has been directed to clean up the site, including thecontaminated groundwater. The commenter can refer to WDOH's previous responses concerningexposures at the adjacent schools. Groundwater, soil gas, and indoor air samplings have beenconducted on the high school property. The initial, limited 1998 air sampling investigation revealedthe chemical 1,2-DCP in the staff lounge, and was evaluated in this health assessment. Because ofthe limited scope of that investigation, WDOH recommended more comprehensive air sampling atthe high school. A more complete indoor air quality study was performed at the high school inAugust 2000, and no 1,2-DCP was detected. A similar, follow-up indoor air investigation wasconducted in November 2001.

20. Resident wants to know if her renal problems are related to site contaminants, wants toknow the levels of site contaminants, and wants to know whether her drinking water iscontaminated. She also wants to know if her family's health is at risk from site contaminantsand whether the contaminants could affect pregnancies. She has had two miscarriages andwants the site cleaned up and moved out of the area.

The levels of site contaminants are summarized in Appendix A of this report. Those contaminantsfound at levels that required further evaluation by WDOH are highlighted in the data tables, and arediscussed in the report.

WDOH was not provided with a water sample analysis report for the commenter's well, so cannotevaluate the results. Extensive groundwater testing in the immediate vicinity of the Cenex site hasrevealed substantial shallow groundwater contamination (predominantly volatile organiccompounds and nitrate). However, after extensive records searches, followed by field investigations,WDOH and the Grant County Health District were unable to locate any private wells being used fordomestic purposes in the impacted area. If the commenter is concerned about possible wellcontamination, WDOH or the Grant County Health District can provide the names of certifiedtesting laboratories. WDOH is available to evaluate the results of any such tests.

After careful evaluation of available environmental sampling results, WDOH concluded thatchronic noncancer health effects (such as kidney or liver disease) are unlikely to result fromexposure. Adverse reproductive or developmental health effects also would not be expected. Under avery conservative exposure scenario (assuming long-term ingestion, skin contact, and inhalation ofthe most contaminated soil), WDOH estimated there was a theoretically slight increased chance ofdeveloping cancer.

The site is being cleaned up under the provisions of Washington state's hazardous waste cleanuplaw (MTCA). Although WDOH can recommend actions to protect public health, WDOH has noregulatory authority regarding Cenex's future plans.

21. Resident lived in Quincy from 1969-96, including locations near the site, and has renalcell carcinoma. She currently works at Simplot and feels there are an unusually high numberof rare cancers in the community.

The commenter can refer to previous WDOH responses and the Health Outcome Data Evaluationsection of this report concerning cancer incidences reported for the Quincy area. The Ecology sitemanager can be contacted to request any available environmental sampling information for theSimplot facility.

22. A resident is concerned about a substance he and school kids ran through and inhaled.The substance had a salty/acidic taste and was on their arms, face, and clothing. He isconcerned that the school's ventilation system lets in diesel fumes and is concerned about thedrinking water.

A rinsate pond spray evaporation system operated for a short period of time at the Cenex site in thelate 1980s. Reportedly, overspray from that system periodically migrated toward the school andcame into contact with staff and students for a short period of time during track. Although a singlerinsate pond sample was collected and analyzed, rinsate spray samples were not. As a result, WDOHcannot measure the exposures to which the commenter refers. The commenter can refer to WDOHresponse to question # 8 for further discussion.

The Department of Labor and Industries can be contacted if there is reason to believe there is achronic indoor air problem at the school. If vehicles are responsible for the diesel exhaust, the schoolshould consider simply having the vehicles park in a different location. (i.e., further from ventilationintakes). Tim Hardin, an indoor air specialist with the Department of Health (360-236-3363), canbe contacted for additional information. Indoor Air Quality: Tools for Schools Action Kit providesuseful information and additional contacts on indoor air quality issues. Tim Hardin can be contactedfor information on how to obtain copies.

State drinking water regulations require the school's drinking water to be tested periodically. It isWDOH's understanding that the school uses water supplied by the city's municipal wells. To date,there is no evidence that these wells have been impacted by the Cenex groundwater plume.

23. Resident's father has liver problems, Alzheimer's disease, bladder cancer, nerve andheart damage, bronchial asthma, and a hernia. He worked at the site for about 1 year in1976. Resident cannot find records of chemicals her father was exposed to while he cleanedthe inside of pesticide tanks. He had a chemical injury in 1976, but resident states that manyof her father's medical records are gone.

WDOH is not routinely provided with employee medical records, nor has WDOH been providedwith the details of the employee's workplace exposure. Employers are required to provide access toemployee medical records. Without proper respiratory and skin protection, the potential forsignificant chemical exposures while cleaning the inside of pesticide tanks is significant. Underexisting state and federal Occupational Health and Safety, and Employee Right-to-Know laws,employees are entitled to know the types and hazards of the chemicals they are exposed to in theworkplace. Chemical-specific Material Safety Data Sheets are one such source of information. If thepotential exists for significant workplace exposures, employers are also required to provideemployees with appropriate personal protective equipment. The employee should contact theWashington State Department of Labor and Industries (Compliance Branch), if he feels there werehealth and safety violations. If more detailed occupational exposure data is provided that suggests aworkplace hazard exists(ed), WDOH can work with the Department of Labor and Industries andconsult with occupational health physicians who specialize in the medical evaluation ofenvironmental and occupational exposures to determine if a follow-up medical evaluation should beconsidered.

WDOH evaluated all Cenex site environmental sampling data, and concluded that exposures to sitecontaminants were not at levels expected to result in the kinds of health effects the residentdescribed.

24. Resident's family is healthy and feels there is unsubstantiated blame by the media andinaccurate information being communicated by the media and some residents about the site.

Comment noted.


  1. Current conditions at the Cenex site are not likely to cause adverse health effects or disease, and do not pose a public health hazard.

  2. After careful evaluation of all available environmental sampling data, WDOH determinedthat no apparent public health hazard existed for adults and children assumed to be exposedin the past, through ingestion, skin contact, or inhalation, to contaminants found in soil at theCenex site. Contaminants were not at levels expected to result in adverse noncancer healtheffects, although a theoretically slight increased cancer risk was estimated for personsassumed to be exposed continuously, over many years.

  3. Potential health risks from exposure to contaminants in dust generated at the Cenex site wereevaluated using EPA's particulate emission model, and were estimated to be below a level of health concern.

  4. Exposure to the level of 1,2-dichloropropane detected in one room during a limited-scale,1998 high school indoor air sampling event is not expected to result in chronic healthproblems for most people. A more comprehensive air quality study conducted at the highschool in August 2000 found no 1,2-DCP or other site-related VOCs. Some chemicals weredetected during this air sampling investigation, but below levels of health concern. A similarindoor air investigation was conducted inside the high school in November 2001, the resultsof which will be evaluated in a separate health consultation.

  5. Contaminated groundwater at the Cenex site does not represent a public health hazard, since it is not being used for domestic purposes.

  6. Past exposure of students and staff at the junior high school to overspray from the formerCenex rinsate pond spray system represents an indeterminate public health hazard. No airsampling of the overspray mist was conducted during its brief operation, so measurement ofstaff and student exposures is not possible. However, on the basis of the limited number andconcentrations of chemicals detected in a rinsate pond sample, and the limited timeframe in which exposures would have occurred, a long-term health risk is not expected.

  7. Using all available data (1992-1998), WDOH evaluated the 24 major cancer types, cancerswith unknown primary site, all other cancers, and all cancers combined that were reportedfor Quincy during this time period. The analysis indicates the total number of reportedcancer cases is significantly less than would be expected in another Washington State community of the same size and age structure."Unknown primary site"was the only category for which there was a statistically significant excess number of cancercases than would be expected. Since these cases were different types of cancer, it is very unlikely that they would have had a common underlying cause.


  1. Cenex should continue to remediate and monitor the site per Ecology's requirements.

  2. To verify that chemicals are not present at levels of health concern, another round of indoor airsampling (similar to the August 2000 round) should be conducted inside Quincy high school.The indoor air samples should include analysis for 1,2-dichloropropane and other VOCs thatwere identified as contaminants of concern in the groundwater at the Cenex site. The samplingshould occur during the winter season, to evaluate conditions different, and potentially "worse" than those in August. Results of any such testing should be provided to WDOH or ATSDR for evaluation.
  3. Follow-up indoor air sampling was conducted in November 2001. The results will be evaluatedin a separate health consultation.

  4. WDOH should be notified in the event any domestic water supply wells are identified that couldbe threatened by the contaminated groundwater plume originating from the Cenex site.


The Public Health Action Plan (PHAP) outlined below for the Cenex site is a description of actionsalready taken, and actions planned. The purpose of the PHAP is to ensure that this health assessmentnot only identifies public health hazards, but provides a plan of action designed to prevent ormitigate adverse human health effects resulting from exposure to hazardous substances in theenvironment.

Actions taken by Cenex, Ecology, and EPA

  1. Since 1993, the U.S. Environmental Protection Agency, Ecology, and Cenex have conductedextensive on-site and off-site environmental sampling in soil, soil gas, groundwater, and air.

  2. From August 1994 to February 1995, Cenex contractors, with Ecology oversight,decontaminated and removed all tanks of the former fumigant storage facility.

  3. A total of 360 tons (277 cubic yards) of soil and concrete removed from the rinsate pond was transported to the Rabanco Landfill on May 1 and 2, 1997. The site was wet down, and clean gravel was placed over the site to suppress dust emissions.

  4. Ecology and Cenex have sponsored numerous Open Houses and meetings to update thecommunity about the status of the site investigation and clean-up activities.

  5. In February 1998, a limited-scale air sampling investigation was conducted by Cenex in andaround the Quincy high school, followed by more comprehensive indoor air samplinginvestigations in August 2000 and November 2001.

  6. Cenex and Ecology entered into an Agreed Order in 1998 to clean up contamination near theCenex site rinsate pond and storage facility.

  7. In cooperation with Ecology, Cenex conducted various interim actions, including theinstallation of a soil vapor extraction system, field scale testing of air sparging technology,and installation of additional monitoring wells.

  8. In May 2000, a Feasibility Study was finalized that describes the results of the interimactions and evaluates the remedial alternatives that address cleanup of the site.

  9. In early 2001, Ecology selected the final clean-up action based upon MTCA criteria. Cenexand Ecology entered into a Consent Decree to perform the clean-up actions.

  10. In August 2001, Cenex prepared a draft Remedial Action Workplan, including engineeringdesign documents. The documents summarize the following proposed actions; (1) asphaltcapping of on-property soils, (2) installation of various on-property soil vapor andgroundwater treatment systems, (3) monitoring and institutional controls to preventexposures to off-property contaminated groundwater, and (4) air monitoring at Quincy highschool. These documents were available for public comment.

Actions taken by WDOH and ATSDR

  1. On April 23, 1997, WDOH sponsored an Open House to meet with area residents, and todocument their health concerns.

  2. On June 5, 1997, WDOH sponsored a meeting with representatives of Cenex, Ecology,Grant County, and Washington State University to review site information, and to assess theexistence of private wells in the vicinity of the Cenex site that could potentially be affectedby the contaminated groundwater plume.

  3. In October 1997, WDOH prepared a letter summarizing all site activities since earlysummer 1997, and activities planned for the future. The letter was mailed to attendees of theQuincy Open House, Cenex, area residents, and agency representatives.

  4. On December 16, 1997, WDOH attended an Open House in Quincy to share the results ofthe preliminary health assessment, to provide site-specific chemical information, and toaddress questions from the community, media, and agencies.

  5. In April 1998, WDOH mailed update letters to area residents summarizing the findings ofthe preliminary health assessment.

  6. On August 18, 1998, WDOH presented the findings of the preliminary health assessment atan Ecology-sponsored public meeting in Quincy.

  7. On April 11, 2000, WDOH attended a Quincy Concern-sponsored meeting held in Quincyto address questions about the preliminary health assessment.

  8. In August 2000, ATSDR evaluated the results of indoor air samples collected inside QuincyHigh School. The results of the agency's evaluation are presented in a health consultationreport, copies of which were sent to Quincy High School, agency representatives, QuincyCity Hall, the Quincy public library, and others. Follow-up indoor air testing at Quincy highschool was conducted in November 2001. The results of this testing will be evaluated byWDOH.

  9. In early 2002, WDOH released the final public health assessment for the Cenex site, alongwith a fact sheet summarizing the findings of the health assessment. The health assessmentand/or fact sheet was mailed to Ecology, Grant County, Cenex, area residents,representatives, the local library, and others.


Paul Marchant
Washington State Department of Health
Office of Environmental Health Assessments
Site Assessment Section

Designated Reviewer

Robert Duff, Manager
Site Assessment Section
Office of Environmental Health Assessments
Washington State Department of Health

ATSDR Technical Project Officer

Debra Gable
Division of Health Assessment and Consultation
Agency for Toxic Substances and Disease Registry


  1. Agency for Toxic Substances and Disease Registry. Interim Guidance on the Structure ofPublic Health Assessments. Atlanta: US Department of Health and Human Services; 1998June.

  2. Cenex Supply and Marketing Inc. Background data evaluation report for rinsepond/fumigant plant. Quincy, Washington: Cenex Supply and Marketing Inc. 1995 Jul.

  3. West Coast Environmental Consultants. Remedial Investigation report for Cenex SupplyandMarketing: Quincy rinsate pond and fumigant storage facility. Quincy, Washington: WestCoast Environmental Consultants # 96-1409-90; 1997 Oct.

  4. Washington State Department of Ecology. Chronological summary of Cenex/Quincy site.Olympia, Washington: Washington State Department of Ecology; 1997 May.

  5. Cenex Supply and Marketing Inc. Cenex-Quincy site assessment report. Vols 1-5. Quincy,Washington: Cenex Supply and Marketing Inc.; 1997.

  6. Washington State Department of Agriculture. Case investigation report: disposal ofpesticide/fertilizer waste from rinsate pond onto Dennis DeYoung's farm property, andsample results: Case 86Y-92. Olympia, Washington: Washington State Department ofAgriculture; 1992 May.

  7. Washington State Department of Agriculture. Case investigation report: disposal ofpesticide/fertilizer waste from rinsate pond onto Dennis DeYoung's farm property, andsample results: Case 157Y-91. Olympia, Washington: Washington State Department ofAgriculture; July 1991.

  8. US Environmental Protection Agency. Western Farmers/Cenex site assessment. WashingtonDC: US Environmental Protection Agency; 1993 Oct.

  9. Cenex Supply and Marketing Inc. Revised site assessment plan for rinsate pond andfumigant plant. Quincy, Washington: Cenex Supply and Marketing Inc.; 1995 Apr.

  10. Washington State Department of Ecology. Model Toxics Control Act clean-up levels andrisk calculations (CLARC II), update. Olympia, Washington: Washington State Departmentof Ecology; 1996 Feb.

  11. Agency for Toxic Substances and Disease Registry. Soil and drinking water comparisonvalues. Atlanta: US Department of Health and Human Services; 2001.

  12. US Environmental Protection Agency. Region III risk-based concentration table. 1998 Oct.

  13. American Cancer Society. Facts and figures: 1998 cancer statistics. American CancerSociety; 2000.

  14. West Coast Environmental Consultants. Ambient air monitoring report for Quincy HighSchool, Quincy, Washington. Morris, Minnesota: West Coast Environmental Consultants;1998 Apr.

  15. West Coast Environmental Consultants. Soil vapor extraction workplan for Cenex Supply &Marketing, Quincy, Washington. Morris, Minnesota: West Coast EnvironmentalConsultants; 1998 Sep.

  16. Agency for Toxic Substances and Disease Registry. Toxicological profile for 1,2-dichloropropane. Atlanta: US Department of Health and Human Services; 1989 Dec.

  17. US Environmental Protection Agency. Integrated risk information system (IRIS).Washington DC: US Environmental Protection Agency; 2001 Oct update.

  18. US Environmental Protection Agency. Guidance for the registration of pesticide productscontaining trifluralin as the active ingredient. Washington DC: US Environmental ProtectionAgency; 1987 Apr.

  19. US Environmental Protection Agency. Trifluralin. Unified air toxics web site. WashingtonDC: US Environmental Protection Agency;

  20. Agency for Toxic Substances and Disease Registry. Toxicological profile for disulfoton.Atlanta: US Department of Health and Human Services; 1995 Aug.

  21. Agency for Toxic Substances and Disease Registry. Fact sheet: disulfoton. Atlanta: USDepartment of Health and Human Services; 1996 Sep.

  22. US Department of Agriculture, Extension Toxicology Network, Extension Service/NationalAgricultural Pesticide Impact Assessment Program. Vernolate. Washington DC: USDepartment of Agriculture; 1994.

  23. Weed Science Society of America. 1994. Vernolate. Herbicide Handbook--7th Ed. p. 302-303.

  24. Agency for Toxic Substances and Disease Registry. Toxicological profile for chlorpyrifos.Atlanta: US Department of Health and Human Services; 1997 Sep.

  25. Agency for Toxic Substances and Disease Registry. Toxicological profile for cadmium.Atlanta: US Department of Health and Human Services; 1997 Sep.

  26. Agency for Toxic Substances and Disease Registry. Toxicological profile for chromium(update). Atlanta: US Department of Health and Human Services; 1998 Aug.

  27. Agency for Toxic Substances and Disease Registry. Toxicological profile for beryllium.Atlanta: US Department of Health and Human Services; 1993 Apr.

  28. Washington State Department of Ecology. Natural background soil metals concentrations inWashington State. Olympia, Washington; 1994 Oct.

  29. Agency for Toxic Substances and Disease Registry. Guidance on including child healthissues in Division of Health Assessment and Consultation documents. Atlanta: USDepartment of Health and Human Services; 1998 Jul.

  30. Living near agriculture increases brain cancer risk.Am J Public Health 86(9):1289-1296.

  31. Italian pesticide applicators have high brain cancer rate. Intl J Epidemiol 22(4):579-583.1993.

  32. Stevens CA, Carey JC. 1991. Rubinstein-Taybi syndrome: a book for families. MedicalCollege of Virginia, Virginia Commonwealth University, and University of Utah.

  33. National Institutes of Health. Chronic fatigue syndrome fact sheet. Washington DC:National Institutes of Health; 1995 Mar.

  34. Cenex Supply and Marketing Inc. Summary of analytical results for SVOC, pesticides,phenoxyherbicides in rinsate pond samples collected by EPA on May 11, 1993. Quincy,Washington: Cenex Supply and Marketing Inc.

  35. Cenex Supply and Marketing Inc. Quarterly monitoring report for June 1998, Quincy,Washington: Cenex Supply and Marketing Inc.; 1998 Sep.

  36. Cenex Supply and Marketing Inc. Revised results of Cenex site samples (including theberyllium soil sample result). Quincy, Washington: Cenex Supply and Marketing Inc. 1997.

  37. City of Quincy (Washington). Quincy municipal well sampling results. 1997-2001.

  38. West Coast Environmental Consultants. Remedial Investigation report appendices for CenexSupply and Marketing, Quincy rinsate pond and fumigant storage facility, Quincy,Washington. Morris, Minnesota: West Coast Environmental Consultants; 1997 Oct.

  39. West Coast Environmental Consultants. Supplement to the Remedial Investigation report forCenex Supply and Marketing rinsate pond and fumigant storage facility, Quincy,Washington. Morris, Minnesota: West Coast Environmental Consultants; 1997 Nov.

  40. West Coast Environmental Consultants. Feasibility Study for Cenex Harvest States fumigantstorage facility, Quincy, Washington. Morris, Minnesota: West Coast EnvironmentalConsultants; 2000 Feb.

  41. Envirometrics Inc. Indoor air sampling: Quincy High School. Seattle: Envirometrics Inc.;2000 Aug 31.

  42. US Environmental Protection Agency, Region 10. Resource Conservation and RecoveryAct, Risk Assessment Guidance for Superfund, particulate emission model. Washington DC:US Environmental Protection Agency.

  43. US Environmental Protection Agency. Health Effects Assessment Summary Table (1997update).Washington DC: US Environmental Protection Agency.

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