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The Palmerton Zinc Pile site is listed on the U.S. Environmental Protection Agency's (EPA) National Priorities List (NPL). The site is located in the Borough of Palmerton, Carbon County, Pennsylvania. Previous studies, as well as the Remedial Investigation (RI), have shown that the metals of concern (cadmium, lead, arsenic, and zinc) have been found in the soils around the Palmerton area. The highest concentrations are around the East and West Plants. The contamination is a result of the smelter activities that were conducted in the area for over 90 years. Some current sources may be contributing to the contamination, but none have been identified to date.

Organized citizens groups are concerned about possible health effects that may be attributable to exposure to these metals. They have expressed particular concern about the health effects that may occur as a result of exposure to lead. They requested that health studies be conducted for the people in the area. An exposure study was begun in the Palmerton area prior to completion of the public health assessment. The exposure health study, entitled Biological Indicators of Exposure to Cadmium and Lead, Palmerton, Pennsylvania, will be final in 1994.

A health consultation, prepared by the Agency for Toxic Substances and Disease Registry (ATSDR) in April 1993, evaluated the public health threat based on environmental data for Palmerton. The health consultation will be presented as part of the exposure health study. The health consultation indicated that the levels of lead, cadmium, zinc, and arsenic found in the Palmerton areas sampled may pose a health threat, particularly to young children. (See Health Consultation in Appendix for related discussion, conclusions, and recommendations.)

People can be exposed to contamination in the off-site soils through ingestion of the soil or through inhalation and swallowing of the particulate (a suspension of small soil particles in air). People can also be exposed through ingestion of contaminated surface water, groundwater, fish, game animals, and local vegetables.

PADOH and ATSDR conclude that this site is a Public Health Hazard because people are exposed to contaminants at concentrations that may result in adverse human health effects. People exposed to low levels of cadmium over a long period of time are the primary concern at the site. Adverse health effects, particularly on the kidney, have been associated with cadmium exposure. However, evaluation of available health outcome data (mortality data) did not indicate that the site has adversely impacted the health of people in the community.

The data and information developed in the Public Health Assessment for the Palmerton Zinc site, Palmerton, Pennsylvania, have been evaluated by ATSDR's Health Activities Recommendation Panel for appropriate follow-up with respect to health activities. The Panel determined that the on-going biological indicators of exposure study, conducted by ATSDR's Division of Health Studies in association with the Pennsylvania Department of Health (PADOH), is appropriate for the site. In addition, HARP determined that community and health professionals education is needed.

The Public Health Action Plan (PHAP) for the Palmerton Zinc Pile site contains a description of actions to be taken by ATSDR and/or the Pennsylvania State Department of Health (PADOH) at and in the vicinity of the site prior to or subsequent to the completion of this public health assessment. The purpose of the PHAP is to ensure that this public health assessment not only identifies public health hazards, but provides a plan of action designed to mitigate and prevent adverse human health effects resulting from exposure to hazardous substances in the environment. Actions that have been implemented include:

The Pennsylvania Department of Health (PADOH) distributed educational materials on cadmium and lead to the general community. These educational materials included methods of preventing any unnecessary exposures to these toxic materials. PADOH will prepare additional educational materials on arsenic and zinc if deemed necessary.

ATSDR's Division of Health Education (DHE) is providing health education in the Palmerton area. DHE has provided information and health education programs on lead and cadmium for physicians, nurses, and other health care providers. Staff from DHE have met with members of the Community Task Force and the Community Assistance Panel and has provided information about lead and cadmium toxicity for members of the community. Upon release of the Biological Indicators of Exposure to Cadmium and Lead, Palmerton, Pennsylvania study, additional health education may be necessary. If so, additional educational activities will be conducted by DHE in conjunction with the local medical community.

The biological indicators of exposure study has been completed and will be released in 1994. The study focuses on two target areas in Palmerton and in a comparison community (East Jim Thorpe) and should provide further insight into sources of lead dust.

A health consultation has been completed and is included in Appendix B of this document. The health consultation was included as part of the exposure study and assesses exposures to lead, cadmium, zinc, and arsenic present in the environment.

Indoor dust samples were collected as part of the exposure study. That information is evaluated in the 1993 health consultation.

Other activities completed at the site are outlined in the Background section of this document.

Actions that are planned include:

The second part of the exposure study is to be released late in 1994. That part of the study addresses a set of medical test batteries, which were obtained from study participants, that assess immune, kidney, and liver function.

ATSDR will reevaluate and expand the Public Health Action Plan when needed. New environmental, toxicological, or health outcome data, or the results of implementing the above proposed actions may determine the need for additional actions at this site.


A. Site Description and History

The Palmerton Zinc Pile site is listed on EPA's National Priorities List (NPL). The site is in the Lehigh Valley, along the Aquashicola Creek, in Palmerton, Carbon County, Pennsylvania. The Palmerton Zinc Pile industrial complex consisted of two separate zinc smelting plants, one east and one west of town. The site was used for primary zinc smelting from 1898 until 1980. In 1980, the plant began a secondary metal refining and processing operation (4), and in 1987, the West Plant closed (3).

The East Plant is on the southern bank of Aquashicola Creek, and the West Plant is on the Lehigh River, north of the where the Lehigh River joins Aquashicola Creek. According to the EPA remedial project manager (RPM), the smelters are no longer in existence. The east smelter has been demolished, although the plant building is now operating as a Resource Conservation and Recovery Act of 1976 (RCRA) recycling facility. The west smelter is being demolished.

Contamination of the valley likely resulted from massive tailing piles left from metal refining processes and from smelter stack emissions. Lead, cadmium, and zinc left in the tailing piles and emitted from the stacks traveled through the air and were deposited in soils and on vegetation throughout the 40-50 square-mile study area, which includes parts of Carbon, Lehigh, and Northampton counties that surround the two zinc smelting plants. Soil samples have been collected as far as 5 miles from the Borough of Palmerton (4). The north slope of Blue Mountain could not support vegetation as a result of heavy metals concentrating in that area. Therefore, heavy metals present in surface water runoff from the denuded mountain and waste piles have been transported into area streams (5).

The Palmerton area consists of a series of deep, narrow valleys. The town of Palmerton is in a valley where Stony Ridge lies north of the town, Aquashicola Creek, a trout-stocked stream, runs the length of the valley, and Blue Mountain borders the valley on the south. Lehigh Gap cuts through Blue Mountain south of Palmerton on the east side of the West Plant. Winds blow predominantly northeast and southwest through Lehigh Gap and northeastward up the Aquashicola Creek valley (2). The Palmer Water Company, which supplies water to the towns of Palmerton and Aquashicola, has four wells at the base of Blue Mountain at depths of 200 to 400 feet (3).

Studies have shown that heavy metals have been detected in soils in and around the Palmerton area, with the highest concentrations found in soils immediately surrounding the East and West Plants. Because of the elevated levels of heavy metals in soil in the Palmerton area, EPA included the Palmerton site on the NPL in 1982.

EPA divides the site into four operable units (see Figure 1). Operable Unit (O.U.) #1 is the defoliated north slope of Blue Mountain (part of the Appalachian Mountains). O.U. #2 is the Cinder Bank (Slag Pile) at the East Plant. O.U. #3 consists of a 45-square mile portion of the Lehigh Valley, and more specifically, the off-site soil contamination believed to have resulted from the emission and deposition of heavy metals generated during the smelter operation. O.U. #4 focuses on surface water and groundwater (1). Remedial Investigations (Ris) are being conducted on the four operable units designated by EPA.

O.U. #1, the defoliated north slope of Blue Mountain, has undergone an RI. Cadmium (maximum 1,300 mg/kg), lead (maximum 6,475 mg/kg), and zinc (maximum 35,400 mg/kg) were found in soils on Blue Mountain. The slope has been covered with a mixture of fly ash and waste water treatment sludge as part of Phase 1 of O.U. #1 to vegetate the mountain. The goal is to minimize erosion and heavy metal runoff into the surface waters (6).

O.U. #2, the Cinder Bank at the East Plant, has undergone an RI. A remediation action plan is being developed. Contamination of the groundwater and surface water, O.U. #4, was documented by this RI. The estimated volume of the Cinder Bank is 33,000,000 tons of waste. The amounts of the various contaminants of concern in the Cinder Bank are estimated as follows: zinc - 881,000 tons, cadmium - 8,250 tons, and lead - 118,800 tons. The Record of Decision (ROD) recommended the following remedial actions for the Cinder Bank: (1) slope contouring, (2) construction of surface water diversion channels, (3) cap construction, (4) a vegetative cover and (5) pre-design studies to determine the best method to control internal fires. Additional studies will be conducted to evaluate various cap scenarios, evaluate the fires within the Cinder Bank, and to evaluate recycling the Cinder Bank (3).

The RI tasks for O.U. #3 (the valley) were accomplished in 1985 and 1986, and the draft report and risk assessment were completed in January 1988. The RI for O.U. #3 includes a separate study by Pennsylvania State University on the Prediction of Cadmium in the Food Chain from Garden Vegetables Grown on Soils Contaminated with Zinc and Cadmium in the Vicinity of Smelters at Palmerton, Pennsylvania, as well as a review of death certificates from the Palmerton Hospital. O.U. #3 is the focus of this public health assessment.

All of the environmental studies conducted at the site since 1971 are summarized in the current RI. Additionally, in May 1991 EPA did a limited soil and dust investigation in the residential areas of Palmerton. This investigation suggested the possibility of elevated lead in the soil and dust of a few homes. A comprehensive investigation was indicated and was completed as part of ATSDR's/PADOH's study in the fall of 1991. This investigation also suggested that another current source of lead is a possibility, but the source is not yet determined.

Historically, the Centers for Disease Control and Prevention (CDC) and ATSDR have been involved with the Palmerton Zinc Pile site since 1975. Some activities conducted by these agencies include:

  1. CDC participated with EPA in 1975 with an epidemiology study of heavy metals around smelters (Dallas Study), which indicated that children in Palmerton did have elevated cadmium in the blood and hair, elevated lead in the hair, and an elevated blood erythrocyte protoporphyrin.

  2. CDC conducted a health consultation and review of environmental data and other documents in 1983. CDC recommended that a Pilot Health Study be considered.

  3. CDC reviewed the cancer mortality rates around Palmerton in 1985. The report contained a brief overview of groundwater, surface water, air, soil and crop, household dust, and plant and fish contamination in addition to the cancer mortality rate evaluation. CDC concluded that rectal cancer mortality was elevated; however, the mortality rate for this type of cancer is also elevated for the State. Other Carbon County data were not statistically significant (7).

  4. ATSDR performed a public health assessment on O.U. #1 in 1987. The recommendations included that the proposed remediation (revegetation) should take place to decrease future contamination in area streams and that fish from streams in the immediate area of Blue Mountain should be consumed only on a limited basis (no more than once per week) (5).

  5. ATSDR consulted in April 1988 with EPA concerning the need for an exposure study in the Palmerton area. ATSDR recommended that a public health assessment for the off-site area be conducted first (2). This report is the recommended public health assessment.

  6. ATSDR performed a health consultation on November 16, 1990, concerning health impact along the Appalachian Trail on Blue Mountain. ATSDR concluded that concentrations of heavy metals were elevated in soil on the trail, but concentrations were not a public health threat because people were not likely to be exposed at levels and durations of time that would result in adverse health effects (8).

  7. PADOH and ATSDR began a Cadmium and Lead Exposure Study in Palmerton and East Jim Thorpe (selected as a comparison community) in August/September of 1991. The study results will be available in 1994. A health consult for the Palmerton environmental data was provided to EPA by ATSDR in 1993 (Appendix B). An overview of the study design and purpose follows.

    PADOH, with technical assistance from ATSDR, conducted a cadmium and lead exposure study in 1991 to determine whether residents in the target area of Palmerton had been exposed to excess amounts of cadmium and lead. The purpose of the proposed study was to:

    1. Measure blood lead and urine cadmium levels among a representative group of Palmerton residents living in neighborhoods near the two plant sites.

    2. Compare the levels of lead and cadmium found in residents of the two target areas to levels found in a comparison community (East Jim Thorpe) while controlling for other factors which may influence exposure to these heavy metals.

    3. Perform medical tests on all three groups to evaluate liver function, kidney function, and other body systems.

    4. Compare medical test results found in residents of the two target areas to levels found in the comparison community and correlate these results to blood lead and urine cadmium levels.

    Mail and door-to-door canvases of the target area and a nearby comparison town, East Jim Thorpe, were conducted to determine a sampling frame. A total of 504 randomly selected residents, from 6 months to 75 years of age, participated from both towns. A standardized questionnaire was used to collect information on socio-demographics, smoking, hobbies, occupations, and behaviors which may be related to heavy metals. Blood and urine specimens were collected at the time of the interview. Urine cadmium and blood lead analyses were conducted by a CDC laboratory. In addition, EPA provided dust, paint, soil, and water testing for all consenting participants.

  8. The 1993 health consultation of the Palmerton Zinc site environmental data is summarized as follows:

      EPA asked ATSDR to evaluate public health threats posed by exposures to metals detected in areas surrounding the Palmerton Zinc Pile site in Palmerton, Pennsylvania and to comment on their proposed removal response action levels in residential surface soil and dust within homes where children 6 years old and younger and where pregnant women reside. The samples were collected in August and September 1991 as part of the Biological Indicators of Exposure to Cadmium and Lead, Palmerton, Pennsylvania study. Many outdoor activities would potentially increase exposure to cadmium and lead in soil occur during the summer, thus the study was conducted at that time. Among the consult's conclusions were that the levels of lead, cadmium, zinc, and arsenic detected in the Palmerton areas sampled may pose a health threat, particularly to young children. EPA's removal action levels of both 1,500 mg lead/kg and 100 mg cadmium/kg residential soil or interior dust may not be protective of the health of children and pregnant women. Recommendations in the consult included: (1) consider lowering the removal action levels for lead and cadmium in areas such as sandboxes, day care centers, interior dusts, and park areas where there are no protective barriers between the contamination of environmental medium and people, and where frequency and duration of exposure are likely to be high for sensitive populations; (2) consider having independent removal actions for lead and cadmium rather than requiring both to be elevated before removal action will be taken. (See Appendix B for data tables, discussion and all conclusions and all recommendations in this health consult).

B. Site Visit

On May 14, 1990, PADOH conducted a visit to the off-site area (O.U. #3) that lasted about four hours. Doctors Fox and Logue and Mr. Bertovich represented PADOH, and Tony Koller represented EPA. Representatives from the Pennsylvania Department of Environmental Resources (PADER), the remedial investigation contractor (REWAI), and the Zinc Corporation of America were also present.

The group met initially at the Horsehead Research Building in Palmerton. After the meeting, PADOH, PADER, and EPA representatives toured the greater Palmerton area.

They spent much time on top of Stony Ridge, which overlooks the East Plant and gives an excellent panoramic view of the area. PADOH representatives noted with concern the proximity of homes to the plant. They could see Aquashicola Creek, defoliated Blue Mountain, the town of Palmerton, Lehigh Gap, and the Lehigh River from this ridge. The group had a good view of the East Plant, including the large waste piles. They could see some workers active at the site.

ATSDR has conducted other site visits and has noted similar observations.

On December 8, 1993, Thomas Hartman of PADOH met an EPA official and discussed different areas of the site. Mr. Hartman then spent considerable time in several areas of Stony Ridge. He observed the features previously described. Some areas still appeared stark, with dead trees and no ground cover on parts of the mountain. He visited both east and west plant sites as well as the village of Aquashicola. On a driving tour of Palmerton, he noted housing, school, and business locations. Later he visited Jim Thorpe, a control town for the exposure study. He noticed the similarity to the Palmerton area in types and ages of homes as well as topography.

C. Demographics, Land Use and Natural Resource Use


The Palmerton off-site (residential) study area that is discussed in this report is predominantly comprised of rural and semi-rural areas in the southern portion of Carbon County, Pennsylvania. A small area, consisting of the northeastern corner of Lehigh County and the northwestern corner of Northampton County, is also included. This defined area has a population of approximately 13,000 people, of which 5,394 live within Palmerton Borough, and an approximate 300 persons live in the adjacent community of Aquashicola. Approximately 850 people live within 1 mile of the site. The 1990 Census indicates that Palmerton has an older population than the Pennsylvania State population distribution.


% < Age 18 % Age 18-64 % Age 65 AND
Carbon County
Palmerton Borough

The increased age of the Palmerton residents is the most dominant demographic parameter, and it is reflected both in percent of the population over 65 years of age (20.4) and the median age (36.2). An older population will be of great importance in assessing the chronic health of the community.

Land Use

Approximately 50 percent of the land in the entire study area consists of moderate to dense forests, and shrub and brushland. Of the remaining 50 percent, 21 percent is agricultural, 9 percent is residential, 1.5 percent is industrial, and 18.5 percent is classified as other uses. About 900 Palmerton families have residential gardens out of a total number of families that live in 2,400 homes (3).

In the Palmerton area, land is used mostly for residential and industrial purposes. In the Aquashicola Creek Valley near Palmerton, both managed and abandoned agricultural land exists; however, the agricultural land beyond Blue Mountain north of Palmerton is managed (4).

Natural Resource Use

Natural resources in the study area include: recreational areas for boating, fishing, and camping; forested state game lands for hunting and wildlife observation; forest resources; and mineral resources. About 17 percent of the land in the study area is presently used for farming. However, about 2,000 acres of land adjacent to the site have been defoliated. A large, man-made lake, about 4 miles north of Palmerton, is heavily used for fishing, boating, and camping by both the local and regional population.

Aquashicola Creek, which runs past the East Plant, is used for trout fishing by the local community. This creek, a tributary of the Lehigh River, flows through the valley with Blue Mountain (elevation 1,500 feet) on the south and Stony Ridge (elevation 900 feet) on the north. The Appalachian Trail, a popular hiking trail, runs along the top of Blue Mountain.

The Palmer Water Company supplies drinking water to the area. The water company maintains 4 wells. The wells are at the base of Blue Mountain and range from 200 to 400 feet deep.

D. Health Outcome Data

Mortality data, which are presented and discussed in the Public Health Implications section, are the most reliable public health indicator available in Pennsylvania that is applicable to the Minor Civil Division (MCD) level, a geographic area that includes communities in the study area. PADOH maintains vital records of deaths, live births, fetal deaths, and reports of induced termination of pregnancy; however, with the exception of deaths and live births, the use of these data for geographic areas smaller than the county level is difficult because recordings of exact place of residence are not as accurate as mortality and natality records.

The Pennsylvania Cancer Registry (PCR) now collects cancer data for all areas of Pennsylvania. The types of data available, and the limitations of those data, are discussed further in the Health Outcome Evaluation section of the document. Field representatives interact with local hospitals to audit the accuracy of all reporting. However, the mobility of the patients, the variance in compliance rates among hospitals, and the newness of the program create difficulty in analyses of geographic areas smaller than the county level. The most recent report, published in June 1993, is entitled Cancer Incidence and Mortality in Pennsylvania, 1986-1990. The report presents data only applicable at the county level (smallest geographic area for which data are available).

The comprehensive study, Biological Indicators of Exposure to Cadmium and Lead, Palmerton, Pennsylvania will be released in 1994. A health consultation (see Appendix B), prepared by ATSDR, evaluated public health threats posed by exposure to metals detected in areas surrounding the Palmerton site. That health consultation is part of the comprehensive study.


Historically, the community has been concerned about the environmental devastation and the negative image the barren mountain projects. Widespread soil contamination exists because of the deposition of heavy metals from past air emissions from the smelter. The public has been concerned about the potential health effects that may result from contact with contaminated soil. The community has become more active through the years.

The Palmerton Citizens for a Clean Environment (PCCE), was the first citizens group to organize in the 1990s. The group is concerned with, among other things, the off-site contamination of lead, zinc, and cadmium in the soil and in groundwater. This group requested PADOH to conduct the health study to include lead screening, which has been done, of the people in the area.

A second organized group of concerned citizens, the Pro-Palmerton Coalition (PPC), has been formed. This group promotes Palmerton as a healthy place to live and work and attempts to counter negative publicity that the area receives in relation to having an NPL site in the Borough. This group became active in early 1991 and met on June 4, 1991. The same day another group, the Citizens Advisory Panel (CAP), later referred to as Community Advisory Panel, met for the first time.

The Citizens Advisory Panel (CAP) was appointed to coordinate communications related to the health effects/exposure study conducted in Palmerton and East Jim Thorpe in August/September of 1991. The primary purpose of the CAP is to facilitate effective communication between local officials, residents of the community, and ATSDR/PADOH staff. Community group members were to advise ATSDR staff of community concerns and inform the community as issues are discussed by the group. The CAP discussed study plans, announced meetings, answered questions about the study, and increased awareness and participation in the study. This group met as necessary (6-7 times annually during the study period). The most recent meeting was held in May 1993. The completion of the health study activities has reduced the need for the CAP. The study, Biological Indicators of Exposure to Cadmium and Lead, will be available in 1994. The study will evaluate blood lead testing and urine cadmium testing for Palmerton and East Jim Thorpe and relate the findings to environmental sampling test results.

The Palmerton Environmental Task Force (PETF) was established in May 1992 and meets monthly. The purpose of the 10 person group, with two co-moderators, is to gather information on what is happening at the site and to disseminate information to the public and the news media.

A more recent group to form is an Ad Hoc Committee on the Environment, which is affiliated with the Chamber of Commerce. This committee evaluates the impact that EPA actions have on business in the community.

An additional concern of the citizens is the possibility of on-going contamination of the community by the recycling facility presently in operation. EPA is investigating this possibility. The community concerns are further discussed in the Community Health Concerns Evaluation section of this document.

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