This e-manual is an update to ATSDR’s 2005 Public Health Assessment Guidance Manual, also referred to as “PHAGM.” The updated manual uses a dynamic web-based format, which offers options for user navigation, enhances readability, and facilitates the ability for ATSDR to make as-needed content updates. This revised manual builds upon the process described in the 2005 manual with updates to reflect ASTDR’s most current scientific approaches. This manual presents detailed guidance on how to perform ATSDR’s PHA process, outlining many of the procedures used to identify potential public health hazards and pinpoint recommended public health actions. ATSDR welcomes comments from users of the manual, and will continue to make periodic updates to this online version of the manual so that it aligns with current science and the most up-to-date ATSDR guidance. The PHAGM website provides links to useful tools and resources to aid health assessors when performing the various PHA process steps.

This e-manual is just one tool available to those involved in the PHA process. It is not intended to take the place of professional judgment or discretion of the health assessor in compiling and analyzing data, drawing conclusions, and making public health recommendations. The e-manual is intended to serve as a uniform tool to provide a logical, step-by-step, and consistent approach to use when evaluating the public health implications of sites. ATSDR acknowledges that some sites may pose unique challenges, which require varying degrees of site-specific evaluation. In these cases, the health assessor may need to seek assistance from additional specialists (such as toxicologists) to follow approaches that are scientifically defensible.

Page last reviewed: April 14, 2022