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1. ATSDR > Public Health Assessments & Consultations

PUBLIC HEALTH ASSESSMENT

Bloomington PCB Sites
Bloomington, Monroe County, Indiana
and
Spencer, Owen County, Indiana

HEALTH OUTCOME DATA

This section identifies the relevant, available databases; their evaluation occurs in the Public Health Implications section. Cancer may be a plausible health outcome from long-term exposure to at least one of the contaminants of concern. The ISDH maintains a statewide cancer registry; however, data regarding cancer incidence by city and county are not yet available. In addition, the ISDH maintains a mortality database by county. Mortality data on Monroe and Owen Counties' cancer deaths are available (1950-1979).

This section of this report contains an evaluation of Community Health Concerns, Health Outcome Data, Health Studies, and a Toxicological Evaluation of all chemicals of concern found in completed and potential pathways. This data will be grouped together for the six Consent Decree sites under the Public Health Implication section of this report.

Several health studies have been performed on populations residing in and around the Bloomington area. The following studies will be evaluated further in the Public Health Implications section:

• Centers for Disease Control (CDC) study on the health effects of individuals who used PCB-contaminated sewage sludge on their gardens (Baker et al. 1980)

• National Institute of Occupational Safety and Health (NIOSH) study of the metabolic and health consequences of occupational exposures to PCBs (Smith et al. 1982)

• CDC/ISDH studies of exposure to PCBs by residents living near three waste sites (Lemon Lane Landfill, Neal's Landfill, and Bennett Stone Quarry)

  - Health effects associated with serum PCB levels (Stehr et al. 1986)
  - Serum PCB levels in persons at high risk of exposure in residential and occupational environments (Stehr et al. 1986)
  - Effects of PCBs and lipemia on serum analysis (Steinberg et al. 1986)

• Study of higher and lower chlorinated serum PCB congeners in individuals who used contaminated PCB sludge in their gardens and capacitor manufacturing workers (Steele et al. 1986)

• NIOSH/ISDH follow-up health study of workers occupationally exposed to PCBs (NIOSH. HETA 84-339. 1990)

• ISDH/NIOSH study to evaluate the mortality experiences of a cohort of Westinghouse Electric Corporation workers occupationally exposed to PCBs (NIOSH. HETA 89-116-2094. 1991)

• ISDH/NIOSH study of proportional hazards model to examine the variations between cumulative PCB exposure and site-specific cancer mortality (Sinks et al. 1992)

• CDC/ISDH study to evaluate the potential for using domestic animals in the surveillance of environmental exposures (Schilling et al. 1988)

• ISDH/ATSDR study to evaluate the health implications of general community exposures to PCBs (Steele & Richter. 1992)

• NIOSH study of serum PCB concentrations in 50 workers at the Westinghouse plant (Phillips et al. 1989)

COMMUNITY HEALTH CONCERNS

The community health concerns were derived from numerous interviews conducted with the Monroe and Owen County Health Departments and local residents. The most recent interviews were conducted on January 19, 1993, during a Citizens Information Committee meeting, and a Public Meeting on February 18, 1993, in Bloomington, Indiana conducted by the staff from ATSDR in Atlanta, Georgia. There were approximately 100 people present at the public meeting with 25 percent expressing the health concerns listed below. The concerns listed below are related to the possible impact on public health of PCB contamination in the Bloomington area.

1. Will the health study look at any chemicals other than PCBs? Will it look at chemicals such as dioxins, furans, and heavy metals?

2. What about other sites besides those listed in the Consent Decree?

3. Why is the health study being done now?

4. Have any studies been done before?

5. Are copies available of studies conducted at similar sites?

6. What happens after the health study and expert panels are concluded?

7. Is the purpose of the study to find out if PCBs are hazardous? What is to be gained?

8. How long with the health study go on?

9. How will the public health assessment be used? Will a risk assessment be involved? Are they the same?

10. Did the ATSDR Toxicological Profile on PCBs consider only cancer?

11. Will the health study point out correlations such as cancer and miscarriages due to PCBs?

12. Will you look at the potential health effects of the proposed ash landfill?

13. How will you get a true picture of the health effects when limited to only the Consent Decree sites? What about ABB (formerly Westinghouse) and Fell Iron & Metal Inc., which are located in heavily populated areas?

14. Will the Lemon Lane Landfill springs be looked at?

15. I am concerned that my physician is not aware of the literature regarding the toxicity of exposure to PCBs.

16. What about former and current workers at the Westinghouse/ABB plant? Many of the former workers have stated that they feel their health is deteriorating. Current workers are concerned that they are still being exposed to PCBs (from residual contamination) while working in the plant.

17. Will the public health assessment address all of the sites where scavenging of discarded capacitors occurred, or where PCB-contaminated sewage sludge was used?

In addition, community concerns were gathered from the January 19, 1993, Citizens Information Committee meeting. There were 40-50 people present. The issues discussed during this meeting were:

• the IDEM deadline to complete a written Report of Comparative PCB Technologies;

• the Dean Little Biodegradation of PCB project; and

• the proposed Westinghouse Incinerator to destroy PCB-contaminated soil.

The Monroe and Owen County Health Departments were contacted for any additional health concerns. Health officials reported cancer rates as the primary community health concern.

These concerns will be addressed in the Public Health Implication Section of the this report.

PUBLIC HEALTH IMPLICATIONS

In this section we will discuss the health effects of persons exposed to specific contaminants, evaluate state and local health databases, if available, discuss the results of numerous health studies on populations residing in and around the Bloomington area, and address any existing community health concerns.

A. Toxicological Evaluation

This subsection of the report assesses the public health implications of contaminants that are associated with a past, present, and future exposure pathway that have not been eliminated in the Pathways Analyses section.

Assumptions are used to determine the estimated dose by any route for all exposed and potentially exposed individuals. These assumptions include the following:

• The highest concentration of a chemical found in any media was used to calculate the estimated dose.

• 100% of ingested contaminated sediment is available for absorption

• Length of on-site exposure to media on landfill:
  Child - 5 days/week, 30 weeks/year for 10 years
  Scavengers/landfill workers - 5 days/week, 30 weeks/year for 10 years

• Daily ingestion of water (only source of water):
  Adult - 2 liters/day
  Child - 1 liter/day

• Soil ingestion rate:
  Adult - 50 mg/day
  Child - 100 mg/day

• Average fish consumption:
  Adult male - 16 oz./meal
  Adult female - 11 oz./meal
  Child - 9 oz./meal

• Inhalation rate:
  Adult male - 23 mm³
  Adult female - 21 mm³
  Child - 15 mm³

Although the chemical of major interest in this document is polychlorinated biphenyls, there were other chemicals found at the six sites that are considered in this evaluation. These chemicals are aluminum, arsenic, bis(2-ethylhexyl)phthalate, boron, cadmium, chromium, chloroethane, cobalt, dioxins, heptachlor, lead, naphthalene, sodium, tetrachloroethene, 1,1,1-trichloroethene, trichloroethylene, vanadium, vinyl chloride, and zinc. Table 50 contains a list of the chemicals of concern by site, media, and location.

Table 50. Summary of Chemicals of Concern by Site and Media

To assist in evaluating the potential occurrence of noncancer health effects, ATSDR has developed a Minimal Risk Level (MRL) for chemicals commonly found at hazardous waste sites. The MRL is an estimate of daily human exposure to a chemical below which non-cancer, adverse health effects are unlikely to occur. MRLs are developed for each route of exposure such as ingestion, inhalation, and for the length of exposure such as acute (less than 14 days), intermediate (15-364 days), and chronic (greater than 365 days). In lieu of sufficient human data, MRLs are typically based on the results of animal studies in which the most sensitive adverse effect level (LOAEL) or the no observed adverse effect level (NOAEL) has been identified. To derive the MRLs, the LOAEL or NOAEL is divided by levels of uncertainty ranging from 10 to several thousand to account for species differences and human variability in response.

ATSDR presents these MRLs in toxicological profiles. These chemical-specific profiles provide information on health effects, environmental transport, human exposure, and regulatory status. In the following discussion, where ever possible, ATSDR Toxicological Profiles have been used for the chemical evaluation.

The discussions that follow for individual substances are evaluated based on their potential, though highly unlikely, to contaminate private wells. Based on the dye tracer studies performed at Lemon Lane Landfill and Neal's Landfill, the flow of water from these two sites is primarily toward each site's associated springs or streams. Sample analysis of private wells within a 5,000-foot radius revealed no PCBs, and organic and inorganic chemicals were below the maximum contaminant level for drinking water. Contaminants found in springs and streams fed by groundwater originating under the site suggest the possibility that residential wells in the area may also become contaminated. The chemicals detected in site associated streams or springs are therefore considered potential contaminants of private wells and are presented below along with the other chemicals of concern.

Aluminum

Aluminum is a natural element in the earth's crust. It is used in the manufacturing of deodorants, cooking and eating utensils, appliances, building materials, and for the treatment of water.

When aluminum is ingested, very little is absorbed into the bloodstream; most of it will leave the body through the feces and urine. Exposure to this chemical is usually not harmful. However, in animal studies, ingestion of large amounts of soluble aluminum have been shown to cause harm in the unborn and developing animals. Very little aluminum enters the body through inhalation and dermal contact. (ATSDR Toxicological Profile for Aluminum)

Aluminum was found in the Lemon Lane Landfill off-site springs surface water at 2,300 ppb, and the off-site stream surface water for Neal's Landfill at 49,000 ppb. Because aluminum is not readily inhaled or absorbed through the skin, the only route of exposure remaining is ingestion. This water is not used for drinking. Aluminum is a potential contaminant of private wells at both of these landfills.

Arsenic

Inorganic arsenic has been determined to be a cancer causing agent. The single most characteristic effect of long-term oral exposure to inorganic arsenic is a pattern of skin changes. This includes a darkening of the skin and the appearance of small "corns" or "warts" on the palms, soles, and torso. While these skin changes are not considered to be a health concern, a small number of the corns may ultimately develop into skin cancer. Swallowing arsenic has also been reported to increase the risk of cancer in the liver, bladder, kidney, and lung. (ATSDR Draft Toxicological Profile for Arsenic)

Arsenic was found in the off-site streams surface water associated with Neal's Landfill. The estimated daily dose for arsenic potentially found in private wells, and the estimated incidental ingestion dose of this water, was higher than the EPA Reference Dose (RfD) and the chronic oral MRL. This presents a low increased risk of cancer. No observed adverse health effects have been observed in humans exposed to arsenic at the estimated daily dose level.

Boron

Boron is a solid substance that widely occurs in nature. It usually does not occur alone, but it is often found in the environment combined with other substances to form compounds called borates. Boron does not evaporate easily, but it does bind to soil particles. Over half of the boron taken by mouth can be found in urine within 24 hours. (ATSDR Toxicological Profile for Boron)

Boron was found in Neal's Landfill off-site stream surface water at 9,400 ppb. The estimated daily exposure dose was calculated based on the potential for private wells to be contaminated at the specified levels. The dose was higher than the RfD and the intermediate MRL for boron. The estimated daily exposure dose was lower than the level at which adverse health effects were noted in animal studies. Based on this information, adverse health effects are not expected from exposures at the detected levels.

Cadmium

Cadmium is an element that occurs naturally in the earth's crust. Pure cadmium is a soft, silver-white metal; however, cadmium is not usually found in the environment as a metal. It is found as a mineral combined with other elements such as oxygen, chlorine, or sulfur. These compounds are solids that may dissolve in water but do not evaporate or break down in the environment.

Cadmium can enter the body from food consumed or particles breathed in. Very little cadmium enters through the skin. If the body does not receive enough iron or other nutrients, it will likely take up more cadmium than usual from food. Another source of cadmium is cigarette smoke. Cadmium that enters the body stays in the liver and kidneys, and very little leaves the body. The body keeps most of the cadmium in a form that makes it not harmful, but too much of it can overload the kidneys' storage system and cause health damage. (ATSDR Draft Toxicological Profile for Cadmium)

Cadmium was found in the off-site groundwater monitoring wells at 8 ppb, and at 9 ppb in the off-site springs and streams surface water of Lemon Lane Landfill. An estimated daily dose exposure was calculated assuming the migration of contamination to the off-site private wells. The calculated exposure dose was lower than the level of lowest observed adverse health effects for less serious health effects in humans and animals. It was also lower than the MRL for this chemical. Cadmium is a potential contaminant of private residential wells. Adverse health effects are not expected at the levels detected.

Chloroethane

Chloroethane, which is also called ethyl chloride, is a colorless gas at room temperature and pressure, with a characteristic, sharp odor. Chloroethane is a manmade compound, and human activity is responsible for almost all the chloroethane released to the environment. Most chloroethane released to the environment ends up as a gas in the atmosphere, but small amounts may enter groundwater as a result of filtration through soil. Once in the atmosphere, chloroethane breaks down fairly quick by reacting with substances in the air. (ATSDR Toxicological Profile for Chloroethane).

Chloroethane will most often enter the body by being inhaled, although it may also enter the body through contaminated drinking water. Because this chemical was found at Neal's Landfill in the on-site groundwater at 5 ppb, there is a potential for private wells to be contaminated as well. The health effects resulting from long-term human exposure to water containing specific levels of chloroethane are not known. It is not known if chloroethane produces cancer in humans. There is no chronic ingestion MRL for this chemical.

Chromium

Chromium is a naturally occurring element that is found in soil and in volcanic dust and gases. Chromium compounds produced by the chemical industry are used for chrome plating, the manufacture of pigments, leather tanning, wood treatment, and water treatment.

For most persons, exposure to small amounts of chromium results from breathing air and ingesting drinking water and food containing chromium. Because small amounts of chromium occur in many foods, most chromium enters the body from dietary intake. Chromium is a required element in the diet for carbohydrate function and is found in most vitamin supplements. Long-term exposure of workers to airborne levels of chromium higher than those in the natural environment has been associated with lung cancer.

There are three major forms of chromium, which differ in their effects on health; however, chromium (VI) is the form responsible for most adverse health effects. The naturally occurring mineral chromite, in the Chromium III form, is used as brick lining for high-temperature industrial furnaces for making metals, alloys, and chemical compounds. Chromium VI is irritating, and short-term high-level exposure can result in adverse effects at the site of contact, such as ulcers of the skin, irritation of the nasal mucosa and perforation of the nasal septum, and irritation of the gastrointestinal tract. It may also cause adverse effects in the kidney and liver. (ATSDR Draft Toxicological Profile for Chromium)

Chromium was found at a concentration of 76 ppb in the off-site streams surface water associated with Neal's Landfill. The estimated daily exposure dose was lower than the RfD for chromium VI. Further, the data we have are for total chromium, which is a combination of all three forms of this chemical. Adverse health effects are not expected at the detected levels.

Cobalt

Cobalt has both beneficial and harmful effects on human health. It is found in sewage sludge from cities sometimes at high levels. Cobalt is mostly used to make mixtures of metals, a drier for paint and porcelain enameling. Small amounts of cobalt are added to or naturally occur in foods.

Cobalt is beneficial for humans because it is part of vitamin B₁₂, which is essential to maintain human health. It has been used as a treatment for anemia, particularly in pregnant women as it causes production of red blood cells. It has not been found to cause cancer in humans or in animals following exposure in the air or in food or water.

The amount of cobalt that enters the body from food or water depends on many things including an individual's state of health; the amount of food or drink consumed; and the number of days, weeks, or years food or drinks containing cobalt are consumed. If there is not enough iron in the body, more cobalt is absorbed from the foods consumed. After cobalt enters the body, it can go into all tissues, but mainly the liver, kidney, and bones. Cobalt leaves the body slowly, mainly through the urine. (ATSDR Toxicological Profile for Cobalt)

Cobalt was found in the off-site streams surface water associated with Neal's Landfill. The estimated daily exposure dose, based on the assumption that this chemical could be found in private wells, was much lower than the level at which no health effects were observed in humans exposed to cobalt orally.

Dioxins

Chlorinated dibenzo-p-dioxins are a class of compounds that are referred to as dioxins. There are 75 different dioxins which are referred to as congeners. The dioxin which is most toxic has four chlorines attached; it is 2,3,7,8-dibenzo-d-dioxin (2,3,7,8-TCDD). TCDD is a congener of major concern. The toxicity of other dioxins and furans are reported in terms of TCDD equivalents. This chemical is a colorless solid with no known odor. It is released from herbicides, wood preservatives, pulp and paper manufacturing plants, burning wood, exhaust from automobiles, and from transformer/capacitor fires.

No studies are available on the inhalation toxicity of 2,3,7,8-TCDD. Chloracne is the only health effect shown to be produced by dioxins in humans. Dermal exposure to dioxins has been associated with an increase in soft tissue sarcomas and lymphomas. However, incidental ingestion and inhalation could not be ruled out as potential routes of exposure. (ATSDR Toxicological Profile for 2,3,7,8-Tetrachlorodibenzo-p-dioxin)

A toxic equivalency factor is a number that has been assigned to a chemical that represents its relative degree of toxicity. This number is then multiplied by the comparison value of its chemical congener. The product is the toxic equivalency factor.

As certain chemicals share similar properties, they are assumed to produce similar health effects. Furans and dioxins are such chemicals. There is currently no health value for furans, although they appear to be less potent than 2,3,7,8-TCDD. For this report, however, the MRL for 2,3,7,8-TCDD was used for all dioxin and furan congeners. Air concentrations for dioxins and furans are reported as toxic equivalency factor concentrations for 2,3,7,8-TCDD.

Dioxins and furans were found in the on-site subsurface soil of Neal's Landfill at a maximum concentration of 0.11 ppb (TEFC). An estimated daily exposure dose was calculated using the worst-case scenario for human exposure. All exposure doses were below the MRL for 2,3,7,8-TCDD. Dioxins were found in the on-site soil boring samples at Neal's Landfill at a maximum concentration of 0.8 ppb (TEFC). The estimated daily exposure dose for scavengers and/or trespassers was above the MRL for 2,3,7,8-TCDD.

The hepta-chloro dibenzofuran congener was found in the on-site groundwater wells at Anderson Road Landfill at 5 ppt. The estimated daily exposure dose of this chemical was greater than the MRL for 2,3,7,8-TCDD. We have no information on the health effects of this chemical at the detected levels.

Heptachlor

Heptachlor is a manmade chemical that was used in the past for killing insects in homes, buildings, and on food crops. This chemical binds to soil very strongly and evaporates into the air. It does not dissolve easily in water. Heptachlor in soil can be taken up by plant roots. Animals that eat plants containing heptachlor can also absorb it. (ATSDR Toxicological Profile for Heptachlor/Heptachlor Epoxide)

Heptachlor was found in the on-site groundwater and the off-site springs surface water of Neal's Landfill at 0.1 ppb. The estimated daily exposure dose was calculated assuming off-site contamination of private wells. The dose was less than the RfD for this chemical. There is an insignificant increased risk of cancer due to exposure to this chemical at the specified levels.

Lead

Lead is found in the earth's crust as a naturally occurring metal. Due to human activities (use of leaded gasoline), lead has spread to the air, drinking water, rivers, lakes, oceans, dust, soil, and thus animals and plants. Lead can enter the body through inhalation (lead dust), ingestion (lead contaminated foods), and only small portions will absorb through the skin.

Lead is partitioned first in the soft tissues (liver, kidneys, lungs, brain, spleen, muscles, and heart). After several weeks it travels to and is stored in bone and teeth. Symptoms associated with lead exposure include possible decrease in memory; weakness in the fingers, wrists, or ankles; and anemia.

Children are more sensitive to the effects of lead than adults. Lead exposure can cause premature birth, smaller babies, decreased intelligent quotient scores (IQ) and reduced post-natal growth. High lead exposure may cause abortion and damage to the male reproductive system in adults, and brain and kidney damage in both children and adults. (ATSDR Draft Toxicological Profile for Lead)

Lead was found at 122 ppb in the off-site stream surface water associated with Neal's Landfill. The EPA has established an MCL for lead in drinking water at 50 ppb. ATSDR has not derived an MRL for lead. An RfD does not exist for lead because no thresholds have been demonstrated for the most sensitive effects in humans. The RfD is an estimate of daily human exposure to a contaminant for a lifetime below which noncancer health effects are unlikely to occur.

A quantitative estimate of the carcinogenic risk from oral and inhalation exposure to lead has not been determined. Quantifying lead's cancer risk involves many uncertainties, some of which may be unique to lead. Age, health, nutritional state, body burden, and exposure duration influence the absorption, release, and excretion of lead. There is currently only a potential threat of exposure to this chemical.

Naphthalene/2-Methyl Naphthalene

Naphthalene is a white solid substance with the characteristic odor of tar or mothballs. It is released into the air from the burning of fuels such as coal and oil and from the use of naphthalene-containing mothballs. Naphthalene evaporates easily. When it is released into the air, humidity and sunlight cause it to break down within a few hours.

The primary health concern for humans exposed to naphthalene for either short or long periods of time is Hemolytic Anemia (a condition involving the breakdown of red blood cells). Other effects commonly found include nausea, vomiting, diarrhea, kidney damage, jaundice (yellowish skin or eyes), and liver damage. These effects can occur from either breathing or eating naphthalene. Cancer has not been seen in humans or animals exposed to naphthalene. (ATSDR Toxicological Profile for Naphthalene/2-Methyl Naphthalene)

Naphthalene and methylnaphthalene were found at 1 ppm in the off-site springs sediment associated with Lemon Lane Landfill. There is currently no health comparison value for both of these chemicals. Based on a calculated ingestion dose for a trespasser/scavenger exposed to these chemicals on a daily basis for a lifetime, there are no expected health effects. Animals exposed daily to similar concentrations for long or short periods of time have shown no health effects.

Polychlorinated Biphenyls (PCBs)

Polychlorinated biphenyls (PCBs) are a family of 209 chemicals with varying numbers of chlorine atoms. Commercial PCB products are always mixtures of PCBs and are usually contaminated with small amounts of polychlorinated dibenzofurans (furans). Contamination by furans is a concern because their toxicity is generally much greater than that of PCBs.

PCBs have caused elevated liver enzyme levels and chloracne in humans, and may be associated with reproductive effects. They cause cancer in animals and may cause cancer in humans. PCBs are environmentally persistent and concentrate upward in the food chain. The chemical stability of PCBs accounts for their persistence in the environment. Another important reason for their persistence is their resistance to biodegradation.

Fetuses and neonates are potentially more sensitive to PCBs than adults. Fetuses and neonates lack enzymes which are normally found in the adult liver that make the breakdown and excretion of PCBs easier.

Because PCBs accumulate in breast milk, nursing infants are at additional risk of exposure to PCBs. Furthermore, PCBs would tend to accumulate in the neonate since human milk contains a chemical that blocks the normal breakdown and excretion of PCBs. Excretion of PCBs is slow, so accumulation occurs even at low exposure levels. The higher the chlorination, the longer it takes to be excreted by the body. Antibiotics, tobacco smoke, and alcohol consumption increase a person's susceptibility to adverse health effects caused by PCB exposure. (ATSDR Draft Toxicological Profile for Selected PCBs)

PCBs are stored in the fat of the body. As exposure continues, PCBs can accumulate in the body. PCBs have been associated with increases in the low-density lipoprotein fraction of cholesterol and a decrease in the high-density lipoprotein in cholesterol. PCBs have also been shown to cause elevations in blood fats, increases in certain liver and kidney enzymes, irritation of the skin and eyes, and have been associated with certain types of cancers in individuals occupationally exposed.

Cancer and reproductive effects of PCBs in humans have not been adequately studied, but there is some suggestion that PCBs are associated with malignant melanoma; leukemia; and cancers of the liver, gall bladder, brain, and the biliary tract in individuals occupationally exposed. (ATSDR Draft Toxicological Profile for Selected PCBs)

Low levels of PCBs can be found throughout the world. PCBs in water or on soil surfaces evaporate and return to earth by rainfall or settling of dust particles. Because PCBs strongly adsorb to soil particles, significant leaching from soil and translocation to plants does not occur. Although PCBs are widespread in the aquatic environment, their low water solubility helps to prevent high concentrations in drinking water supplies.

Humans may be exposed to PCBs from various sources. Generally, most people are exposed either at their job through the ingestion of contaminated food stuffs, or through exposure to PCBs in the environment.

With the exception of those occupationally exposed, food is the major source of PCB exposure, usually from fish and animal fat. PCBs preferentially separate from water and adsorb to sediment. The food chain starts from small biota feeding on bottom sediments and progresses upward to increasing larger predator fish, then to the final level, which is consumption of fish by man. Individuals eating sport fish more frequently than people who occasionally eat marketed fish might be exposed to higher PCB concentrations. The FDA mandates tolerances of 0.2 to 3 ppm PCBs for all foods, with a tolerance level in fish of 2 ppm.

The ISDH advises that only limited amounts of PCB-contaminated fish be consumed. The FDA action levels were formerly used as guidelines for developing fish consumption advisories for Indiana waters.

As noted in Table 51, the estimated daily exposure dose for individuals eating fish taken from the waterways associated with Neal's Landfill, and the Winston-Thomas facility were above the FDA permissible level. These doses were calculated for men, women, and children eating fish every day of the week, and once a week. Although the estimated daily ingestion exposure dose may not exceed the MRL, based on the methodology used to develop State fish consumption advisories, the ISDH recommends that individuals not consume fish from designated waterways with PCB levels higher than 2 ppm.

Table 51. Comparison of Estimated Exposure Dose to Health Guidelines
for PCBs in Fish

The fish advisory for Indiana waterways has been in existence since 1988. Sampling has been on-going at the mentioned sites since 1989. Since the safety of consuming contaminated fish remains unclear in some cases, the best way to protect the health of individuals is to limit the amount of fish they consume that are known to be contaminated with PCBs or other lipophilic chemicals. This risk can be reduced further by preparing fish as skinless fillets, trimming off all fat, and by baking or broiling the fish so the fat can drip off while cooking. Preparing potentially contaminated fish in this manner can reduce the amount of consumed contamination by nearly 50 percent.

A group 2 fish advisory was placed on Richland Creek and Clear Creek by the ISDH in 1983. A group 2 fish advisory means that women of child-bearing age and children under the age of 18 should not eat a particular species of fish. All other adult men and women are encouraged not to eat any more than 1 meal per week consisting of up to 1/2 pound of flesh from the designated fish species on the advisory. Currently, there is a group 2 fish advisory for Clear Creek; however, the advisory on Richland Creek was lifted as the fish did not show contamination above the FDA guideline.

Based on the molecular structure of PCBs, it can be anticipated that PCB behavior in soil would be similar to the chlorinated hydrocarbon pesticides which have been used extensively in the past for controlling soil-borne insects.

Pesticide research has shown that there is minimal uptake of these compounds by crops and little translocation of the chemical into the aerial part of the plant. The results of a study of carrots grown in PCB-contaminated soils indicate that small amounts of PCBs were found only in the peelings of the carrot and not in the interior of the root. Surface absorption appeared to be the major mechanism whereby PCBs accumulated in the crop. Analysis of leaf samples indicated that small amounts of PCBs were present, but it was not clear whether this was due to uptake and translocations of the PCBs, or merely surface contamination via dust fall on the surface of the leaves. (Sommers, LE. Memorandum to ISDH. Agronomy, Purdue University. July 7, 1976.)

PCB-contaminated sludge was spread on gardens and pasture lands in the Bloomington area. This resulted in the contamination of garden vegetables and cattle. Vegetables grown in gardens with PCB-contaminated soil should be washed thoroughly and peeled before eating as the chemical is not taken up in large amounts through the root system, but more so from dust landing on the foliage.

Aroclors (PCBs) were found at levels of health concern in groundwater, soil, sediment and surface soil. Table 52 presents the site-specific media and a comparison to the MRL for PCBs. All doses were calculated using children, daily exposure, and maximum contamination levels found at the site in an effort to evaluate the worst-case scenario.

Table 52. PCB Multi-Media Ingestion Exposure Dose and Cancer Risk Summary
Table For All Consent Decree Sites

* Estimated Ingestion Exposure Dose

Scavengers are the population most likely to have had frequent contact with PCB-contaminated oils and heavily contaminated surface soils. Frequent contact under these conditions where exposures were to the raw PCB oil increases the likelihood of absorption of PCBs into the body. Studies in Bloomington have shown that exposure to PCB-contaminated soils did not result in significantly increased body burdens of PCBs compared to populations thought to have less contact with PCBs. Furthermore, studies show that PCBs tend to have a greater affinity for the organic matrix in soils which tends to restrict dermal absorption.

When we calculated the estimated cancer risk by multiple routes of exposure (i.e., incidental ingestion and dermal contact), the results indicated a change in the cancer risk. There is a high increased risk of cancer for individuals coming into contact with contaminated sediments associated with Neal's Dump, and a moderate to low increased risk of cancer at Bennett Stone Quarry, Neal's Landfill, and Lemon Lane Landfill.

In calculating the estimated cancer risk, we assumed that the exposed population was children and that they were exposed five days per week. We also assume that 100 percent of the contaminated sediment that is ingested is available for absorption by the gastrointestinal tract and that 100 percent of the contaminated sediments are absorbed through the skin. All cancer risks were based on the highest concentration of PCBs found in sediments at each site. These assumptions provide for the worst-case scenario and maximize the actual cancer risk.

No human and/or animal studies link dermal exposure to PCBs with the following adverse health effects: neurological, developmental, or reproductive. No animal studies link dermal exposure to PCBs with adverse health effects in the blood, liver, kidney, or the immune system. The long-term effects of human exposure to PCBs have not been fully determined. PCBs may produce harmful effects, however, if consumed over a long period of time. PCBs are currently only a potential contaminant of private wells surrounding the six sites. Recent sampling indicates that there are currently no exposures to PCBs in drinking private well water.

The other probable route of exposure for scavengers and trespassers was inhalation. Exposure scenarios used for estimated inhalation dose were scavenger exposure of 5 days per week and trespassers at 1 day per week. All exposures were assumed to be for 30 weeks per year for 10 years. Doses were calculated for children and adults. There is no inhalation MRL for PCBs. Dose levels were compared to the lowest level that adverse health effects (LOAEL) have been observed in animal studies (LOAEL = 3 µg/m³), and the National Institute of Occupational Safety and Health (NIOSH) 10-hour time-weighted average of 1 µg/m³. One sample of PCBs in the on-site ambient air at Lemon Lane Landfill was above the LOAEL for animals. The levels found in the on-site ambient air at Neal's Landfill were predominantly higher than the LOAEL.

It is important to note that these air samples were all taken prior to the interim remediation, which included the removal of leaking capacitors, the excavation of PCB-stained soil, the removal of PCB-contaminated water and sediments, restriction of access to the sites, and capping of all sites. These remediation steps reduce the risk of the surrounding community being exposed through ambient air to levels of PCBs that could be harmful to their health.

Sodium

Elevated sodium intake has been associated with the prevalence of hypertension in various populations throughout the world. Long-term ingestion of high concentrations of sodium are believed to be associated with the development of hypertension and would complicate clinical treatment of hypertensive patients on salt-restricted intakes.

Sodium was found in elevated levels in the off-site streams surface water associated with Lemon Lane Landfill and Neal's Landfill. Sodium is a potential contaminant of private wells within 5,000 feet of Lemon Lane Landfill.

Tetrachloroethene

Tetrachloroethene (PCE) is a manmade substance that is used for dry cleaning purposes, and for metal degreasing operations. It is also used as a building block in the manufacturing of other chemicals.

The levels of PCE in city or industrial areas, especially around dry cleaner shops, are higher than in rural areas. The use of products which contain PCE is another means of exposure. Products that may contain PCE include water repellents, lubricants, suede protectors, spot removers, and wood cleaners. (ATSDR Draft Toxicological Profile for Tetrachloroethylene)

PCE was found at 32 ppb in the off-site springs surface water of Lemon Lane Landfill. The most common route of exposure to this media is through dermal contact. An estimated ingestion exposure dose was calculated due to the potential for off-site private wells to be sharing the same aquifer as the springs. All doses were considerably lower than the MRL for PCE. Based on the estimated cancer risk, there is a low increase risk for adults and a moderate increase risk for children if private wells were contaminated with PCE at the levels found in the springs.

1,1,1-Trichloroethane

1,1,1-Trichloroethane is a colorless manmade chemical which does not occur naturally. It is often used as a solvent to dissolve other substances. It is used in homes in such products as spot cleaners, glues, and aerosol sprays. Regardless of how 1,1,1-trichloroethane enters the body, nearly all of it leaves the body through exhaled air. (ATSDR Toxicological Profile for 1,1,1-Trichloroethane)

This chemical was found in the on-site groundwater at Neal's Landfill at 890 ppb. An estimated daily exposure dose was calculated. The results were considerably less than the no observed adverse health effect level found in human research. The health effects resulting from long-term human exposure to water containing specific levels of 1,1,1-trichloroethane are not known.

Trichloroethylene

Trichloroethylene is a manmade chemical that does not occur naturally in the environment. It is a nonflammable, colorless liquid at room temperature with an odor similar to ether or chloroform. It is mainly used as a solvent to remove grease from metal parts.

Trichloroethylene can easily enter the body through ingestion, inhalation, or dermal contact. This chemical is not likely to build up in the body. Exposure to high levels of trichloroethylene in air can cause dizziness, sleepiness, and damage to some of the nerves of the face. It has caused rashes in some individuals who were exposed dermally. It is not known if this chemical causes cancer or will affect human reproduction. (ATSDR Draft Toxicological Profile for Trichloroethylene)

Trichloroethylene was found in the off-site groundwater and off-site springs surface water at Lemon Lane Landfill at 61 and 45 ppb respectively. The intermediate MRL for trichloroethylene is 100 µg/kg/day, which assumes exposure for longer than 14 days, but less than 1 year. The estimated daily ingestion dose for children and adults is considerably higher than the intermediate MRL. Using this water for drinking purposes for an extended period of time increases the risk of cancer.

The dye tracer study done on the springs at Lemon Lane Landfill suggests that water flows from under the site toward the springs instead of residential wells. It is important to note that the residential wells surrounding Lemon Lane Landfill have been tested for PCBs and priority pollutants. All wells were non-detect for PCBs and below the maximum contaminant level for all priority pollutants. This chemical currently is a potential contaminant of private drinking wells.

Trichloroethylene was found in the on-site groundwater of Neal's Landfill at 25,700 ppb, and in the off-site streams surface water associated with Neal's Landfill at 56 ppb. The estimated daily exposure dose, assuming the residential wells could potentially be contaminated, was higher than the MRL for this chemical. There is a low increase cancer risk if this chemical were to contaminate private wells at the specified levels.

Vanadium

Vanadium, a metal, is considered nontoxic. Headache, dry mouth, and irritated eyes have been seen in workers exposed to vanadium compound dust. The usual signs of exposure are irritated mucous membranes and/or lungs. (ATSDR Toxicological Profile for Vanadium)

Vanadium was found in the off-site streams surface water associated with Neal's Landfill at elevated levels. The estimated ingestion exposure dose was higher than the intermediate oral MRL for this chemical. This chemical is considered a potential contaminant of the private wells within 5,000 feet of Neal's Landfill.

Vinyl Chloride

Vinyl chloride is a colorless vapor with a mild, sweet odor. It can exist in liquid form if it is kept under high pressure. Almost all vinyl chloride is manmade, or can occur from the breakdown of TCE. Most of the vinyl chloride produced in the United States is used to make polyvinyl chloride (PVC). PVC is used to make a variety of plastic products including pipes, wire and cable coatings, and packaging materials. Other uses include furniture and automobile upholstery, wall coverings, housewares, and automotive parts.

The most likely way to be exposed to vinyl chloride is by breathing it. Vinyl chloride does not enter the body by passing through the skin. Most of the vinyl chloride is gone from the body a day after either breathing it in or swallowing it. The liver, however, makes some new substances that do not leave the body as rapidly. A few of these substances are more harmful than vinyl chloride because they react with chemicals inside of the body and interfere with the way the body uses or responds to these chemicals. It takes more time for the body to get rid of these changed chemicals, but eventually it will remove them as well. (ATSDR Draft Toxicological Profile for Vinyl Chloride)

Based on animal studies, it has been determined that vinyl chloride is a known carcinogen. Studies of long-term exposure in animals show that increases in cancer may occur at very low levels of vinyl chloride in the air. Vinyl Chloride was found in the on-site groundwater of Neal's Landfill at 2,360 ppb. The estimated daily ingestion dose for this chemical is higher than the MRL. This chemical is currently a potential contaminant of private wells in the Neal's Landfill area.

Zinc

Zinc is the 24th most common element in the earth's crust. It is found in air, soil, and water, and is present in all foods. Taking in too little zinc is at least as important a health problem as taking in too much zinc. Without enough zinc in the diet, individuals may experience loss of appetite, decreased sense of taste and smell, slow wound healing, and skin sores. (ATSDR Draft Toxicological Profile for Zinc)

Zinc was found in the off-site streams surface water associated with Neal's Landfill at 112,000 ppb. The estimated daily exposure was calculated assuming individuals could potentially be exposed to this chemical through private well use. The exposure dose was above the RfD for zinc. It was also higher than the LOAEL for less serious blood associated health effects in humans.

B. Health Outcome Data Evaluation

Using State health databases, it may be possible to determine whether certain health effects are observed more frequently than expected in Monroe and Owen Counties.

Data from the National Cancer Institute, CDC, and the American Cancer Society were reviewed through the State Cancer Control Map and Data Program. The data were standardized to the U.S. 1970 standard. All data were adjusted for gender, race, and age. Information was reviewed by decade for the period 1958-1987. (National Cancer Institute. State Cancer Control Map and Data Program).

Because white females were the only population that showed statistically significant increases in cancer, the discussion that follows will focus on all cancers found in white females. Table 53 contains the cancer statistics for white females who live in Monroe or Owen County. The asterisk beside the years and cancer types indicates that the specific cancer type was not due to random chance (statistically significant). All cancers statistically significant in one county were listed in the other county for comparison purposes. The rank in the State is based on there being 92 counties in Indiana with the first county being the county with the highest reported level of a specific cancer.

The standardized mortality ratio (SMR) is determined by dividing the observed number of cases by the expected number of cases. It can be used as a first cut to identify problem areas. If the SMR is 100, it indicates that the expected and observed number of cases are the same. If the SMR is less than 100, this indicates that the observed number is less than the expected. When the SMR is greater than 100, it suggests that the observed is greater than the expected. In most cases, increases in the SMR above 100 are due to chance since the number of cancer cases can fluctuate from year to year.

Table 53. Cancers (White Females) in Monroe and Owen Counties

* = Statistically Significant

The number of women dying from ovarian cancer in Monroe County was statistically significant for the years 1958-1967. Ovarian cancer is considered a disease of older age. The actual cause of Ovarian cancer is unknown. Suggestive environmental causes of ovarian cancer are diet, occupation, alcohol, smoking, talc, and asbestos. (Daly, MB. The Epidemiology of Ovarian Cancer, August 1992.)

The mortality rate for ovarian cancer in Monroe County was similar to that observed from 1958-1987. Death records were reviewed for the period 1970-1990 for all white females in Monroe County who died of ovarian cancer. The rate of mortality did not change significantly for these years. The age adjusted incidence of ovarian cancer was also reviewed; it was lower than the national average for 1987-1990.

The number of women dying from cervical/uterine cancer in Monroe and Owen Counties was statistically significant for the years 1958-1967. These data do not suggest an environmental component to these cancers. If there was a relationship between an exposure and an increase in cancer incidence, we would expect to see a consistent increase of any one particular type of cancer. (EPA, U.S. Cancer Mortality Rates and Trends 1959-1979)

The ISDH has maintained a Birth Problems Registry from 1987-1991. This registry contains information on infants born with congenital anomaly(ies), low birth weight, and fetal deaths. The registry is categorized by race of mother, and the county and birth year of the infant. Data do exist for Monroe and Owen Counties and the State of Indiana (ISDH. Birth Problems Registry, March 1993).

A review of the data of all fetal deaths in Monroe and Owen Counties was done. The definition of a fetal death in this database is any pregnancy of five months or more. It is important to note that these data have a gap of missing information for all miscarriages occurring prior to a five-month gestation.

Statistical analysis of data for the period 1987-1991 did not show any statistical significant trends in the occurrence of miscarriages in Owen or Monroe County.

If an area has very few births, the observed birth defect rate or miscarriage rate may be very different from the true rate. Thus, if two areas are compared in a given year and one (or both) of the area's rates is based on a small number of births, it would not be unusual to find the comparison reversed the following year. (Kleinman, JC. Infant Mortality, Healthy People 2000 Statistical Notes, Vol. 1, No. 2, Winter 1991)

The ISDH Birth Problems Registry is relatively new, thus the information it contains is not capable of showing any indication of significant trends of concerns or problems that may be as a result of site-related chemicals. A large number of years and birth per years are required to determine if the occurrence of a birth defect is statistically significant (not due to random chance).

C. Health Studies

Several health studies have been performed on populations residing in and around the Bloomington area. The following is a summary of the findings from these studies. Environmental health data is presented to make the information more complete and understandable in this section. The studies are categorized as general community health studies, occupational health studies, and other health studies.

General Community Health Studies

In Bloomington, Indiana, the municipal sewage treatment plant has made sewage sludge available to local residents for use as fertilizer since the mid-1960s. Much of this sludge was used in organic gardens by persons who wished to minimize their exposure to agricultural chemicals. From 1972 through 1976, approximately 500 to 1,000 persons had obtained sludge at the plant. In the 1970s, however, Bloomington residents began to suspect that their sludge might be contaminated with waste PCB discharge into the sewage system by an electrical capacitor manufacturing plant.

The factory had been discharging waste PCBs into the Bloomington municipal sewage system throughout the 18 years of its operation. Further environmental testing through August 1976 confirmed the presence of PCBs in raw sewage, sewage sludge, sludge-treated soil, and in vegetables grown in treated soil (see Table 54). (Baker et al. 1980)

Among the toxic materials found in mixed industrial and domestic sewage have been metals including cadmium, lead, zinc, nickel, copper, molybdenum, selenium, chlorinated hydrocarbons, and pesticides. With repeated application, these materials may accumulate in soils and may have the potential to be absorbed by plants, eventually to reach foodstuffs. (Baker et al. 1980)

In 1976, then Mayor Francis X. McCloskey, asked the CDC to evaluate the health effects of exposure to PCBs in individuals who used this contaminated sludge in their gardens. (Baker et al. 1980)

PCB levels in vegetable samples (see Table 54) were generally much lower than those in the soils in which they were grown. Root crops such as beets and carrots appeared to absorb PCBs from soil more efficiently than leafy vegetables. This apparent difference may have been a result of adherence of PCB-contaminated soil to the exterior surfaces of root vegetables. (Baker et al. 1980)

In this study, mean serum PCB levels were 71.7 ppb in the 18 individuals occupationally exposed, 33.6 ppb in the 129 members of these workers' families, 17.6 ppb in 91 persons exposed to the sludge, and 23.8 ppb in 23 persons who were believed not to have any exposure to PCBs. Forty-nine percent (45) of the sludge users had less than two years of exposure to PCBs. The maximum exposure was for four years. No chloracne or systemic symptoms of PCB toxicity were noted. Serum levels of gamma-glutamyl transpeptidase (GGTP) increased with PCB concentrations. There were no other correlations found between PCB levels and tests of hepatic or renal function. Plasma triglyceride levels increased with serum PCB concentrations. The authors stated that these data suggest that PCBs may impair liver function and alter metabolism at exposures insufficient to cause overt symptoms. (Baker et al. 1980)

Table 54. PCB Concentrations in Environmental Samples
Taken During 1976 Study of Sludge Users (Baker et al. 1980),
Bloomington, Indiana

In late 1983, the ISDH asked the CDC for assistance in studying exposure to PCBs among residents living near three waste sites (Lemon Lane Landfill, Neal's Landfill, and Bennett Stone Quarry) in the Bloomington area. A pilot study was conducted to evaluate persons at high risk of exposure to these waste sites and determine if any of these individuals had abnormally elevated serum PCBs, and to determine which environmental pathways among those containing PCBs might have contributed most to producing abnormally elevated levels of PCBs in human sera. Based on the results of a screening survey of 995 individuals who lived in proximity to these three sites, a total of 114 individuals were selected to participate in the full study. Of the 20 individuals with serum PCB levels greater than 20 ppb, seven had known occupational exposures, five were in the highest risk group, and nine were from the randomly selected at risk group. Twenty percent of the 61 individuals in the highest risk group had elevated serum PCB levels while 16.3 percent of the randomly selected at risk group had elevated serum PCB levels. No specific environmental pathway, with the exception of occupational exposures and scavenging of capacitor parts, could be identified. One explanation given was that exposures in the community were actually taking place from a combination of pathways, although they could not be individually implicated. No statistically significant differences between the highest risk group and either of the two comparison groups (unexposed group and the randomly selected at risk group) were detected for any of the general specific diagnostic categories as elicited from the health effects survey questionnaire or from the clinical chemistries results. There was, however, a statistically significant dose-response relationship between serum PCB levels and the occurrence of self-reported high blood pressure; this relationship remained statistically significant when the data were controlled for the possible confounding effects of age or smoking. The authors recommended further study of the population to ascertain which exposure pathways were responsible for the increased levels of serum PCBs identified, and recommended a larger epidemiologic study investigating the effect of serum PCBs on measured blood pressure (Stehr-Green, Welty, and Steele. 1986; Stehr, Welty, Steele, and Steinberg. 1986; Steinberg et al. 1986.)

Table 55. Exposure Assessment Results, January & March 1984

Exposed Population	Number Exposed	PCB Concentration (ppb)
		Mean	Range
Workers	58 (34 Westinghouse)	31.7	15-75
Scavengers	37	15.7	4-51
Diggers	81	11.7	4-42
Fish Eaters	352	9.1	4-18
Game Eaters	193	8.0	5-12
Playing On-site	220	8.2	5-12
Swimmers	200	11.4	3-23
Non-Exposed	263	6.3	4-13
Randomly Selected	-	11.1	2-47
Living Near Sites	-	8.6	3-13
Total	995

Five individuals who had participated in the 1977 NIOSH study and six individuals who had participated in the sludge users study participated in the study (Stehr et al. 1986) previously mentioned. Changes in their higher and lower chlorinated serum PCB congeners were evaluated by reviewing the results of their serum PCB assays conducted in the late 1970s and comparing them to the results of their serum PCB analyzed in 1984. Assuming no continuing exposure in 1977 and a log-linear relation to serum PCB levels over time, which is consistent with first-order kinetics of PCB metabolism, the half-life for the lower chlorinated congeners was estimated to be six to seven months while the half-life for the higher chlorinated congeners was determined to be 33 to 34 months (Steele et al. 1986).

In 1987, the ISDH requested assistance from ATSDR in evaluating the health implications of exposures to PCBs. This study was a follow-up study to the study conducted by CDC and ISDH staff in 1983 and 1984. The goals of this study were to: (1) ascertain if the population in Monroe County from 18 through 65 years of age with serum PCB levels being greater than 20 ppb was similar to what was observed in other cross-sectional studies of populations putatively exposed; (2) evaluate whether there was an association between PCBs and hypertension, and if so, evaluate the strength and nature of the relationship; (3) evaluate the potential of PCBs to induce microsomal enzymes; and (4) to identify those exposure pathways which lead to elevated serum concentrations.

The mean total PCB level was 8.1 ppb for males and 7.8 ppb for females. Approximately 3.6 percent of the study population had serum PCB levels greater than 20 ppb. The range for all study participants was from approximately 1 to 76 ppb. There were statistically significant trends between increasing systolic and diastolic blood pressures and PCB levels in the univariate analyses. After adjustment for other variables in the multivariate regression analysis models, PCB exposure was not associated with either diastolic or systolic blood pressure. There was no association between high-density or low-density cholesterol levels and PCB levels. No statistically significant differences among the liver function enzymes were found with serum PCB levels greater than 20 ppb. No statistically significant associations between PCBs and gender, race, educational level, employment status, dietary consumption of games and vegetation, or recreational activities were identified. Eating homegrown vegetables, however, was the only variable associated (though not significantly) with increased concentrations of serum PCBs. The results of this study indicated that, in spite of the potential for exposure to PCB-contaminated media, individuals living in the general community were generally not at risk of exposure, based on the results of their serum PCB levels (Steele and Richter. 1992).

Occupational Health Studies

In 1975, NIOSH was in the process of identifying capacitor manufacturing facilities that could be used in an industry-wide study of PCB exposures in capacitor manufacturing workers.

The Bloomington Westinghouse plant was chosen for study because the concurrent epidemiological study by Baker investigating human exposures to PCB-contaminated sewage sludge provided background data on serum PCB concentrations. Data gathering began in 1977.

Serum PCB concentrations were many times greater among workers employed in power capacitor manufacturing than among the general population, even comparing employees never assigned to work in PCB exposed areas. Statistically significant correlations of symptoms suggestive of mucous membrane and skin irritation, of systemic malaise, and altered peripheral sensation were noted with increasing concentrations of serum PCBs. No clinical abnormalities attributable to exposure to PCBs were observed. Serum PCB concentrations were positively and significantly correlated with glutamic-oxalacetic transaminase (SGOT), serum gamma-glutamyl transpeptidase (GGTP), and plasma triglyceride, and were inversely correlated with plasma high-density lipoprotein cholesterol. The authors stated that these findings were indicative of PCBs' physiological effect on the liver, whose long-term health significance was unknown. Concerns were raised regarding the long-term cardiovascular effects of exposure to PCBs evidenced by the association of PCBs with plasma triglyceride and the negative association with plasma HDL cholesterol (Smith et al. 1982).

In May of 1984 the ISDH requested assistance from NIOSH to follow-up workers occupationally exposed to PCBs. These workers had participated in a cross-sectional medical study conducted by NIOSH in 1977. Serum log PCB concentrations were quantified as lower chlorinated biphenyls and higher chlorinated biphenyls. Workers were stratified into higher and lower exposed groups based on their 1977 serum PCB concentrations. By 1985 the concentration of the lower chlorinated congeners in the low exposure PCB group decreased by an average of 85 percent of the 1977 values. Serum PCB lower chlorinated congener concentrations in the high exposure group decreased by an average of 90 percent. By 1985 the level of higher chlorinated PCB congeners in the low exposure and the high exposure groups had decreased by 39 percent and 58 percent respectively of the 1977 values. No clinical abnormalities attributable to exposure to PCBs were observed. Serum PCB concentrations were positively and significantly correlated with triglycerides, cholesterol, total bilirubin, conjugated bilirubin, beta glucuronidase, 5-prime nucleotidase, serum apolipoprotein A1, serum apolipoprotein B, urinary creatinine, and urinary alanine aminopeptidase. When the prevalence of symptoms and overt clinical disease were investigated by exposure group, no differences between the groups could be ascertained except for a positive association with GGTP and a negative association with urinary creatinine. The authors state these findings are indicative of PCBs physiological effect on lipid metabolism, liver function, and kidney function.

Also in 1984, the ISDH and NIOSH began to evaluate the mortality experience of a cohort of Westinghouse Electric Corporation workers who were occupationally exposed to PCBs. The primary interest was to determine if this cohort had experienced any increased mortality from cancers previously associated with exposure to PCBs. These included malignant melanoma, liver and biliary tract cancer, cancer of the rectum, hematopoietic malignancies, and lung cancer. It was also intended to examine mortality as a function of job-specific exposures to PCBs and to control for other known exposures in the workplace. The cohort was comprised of 3,588 persons who had ever worked at the Westinghouse facility during the time which PCBs were used. Although overall mortality and deaths due to all cancers combined were less than expected, this study indicated that there was a moderate, though not statistically significant, increase in the risk of dying from cancer of the brain, and a significant increase in deaths due to malignant melanoma, a form of skin cancer. These findings applied to all individuals who were employed at this facility from January 1, 1957, through March 31, 1977. This study provides some evidence for an association between PCB exposure in an occupational environment and mortality from malignant melanoma. The brain cancer finding suggests that this outcome be carefully observed in further follow-up of this cohort, which is currently underway (NIOSH. HETA 89-116-2094, 1991.)

To follow-up on these findings, the authors conducted a proportional hazards model to examine the association between cumulative PCB exposure and site-specific cancer mortality. All-cause mortality and total cancer mortality were lower than expected. More deaths were observed than expected for malignant melanoma and cancer of the brain and nervous system. The average estimated cumulative dose for the cases of brain cancer was greater than for other workers, but the 95 percent confidence intervals around this difference were broad. The risk of malignant melanoma was not related to cumulative PCB exposure (Sinks et al. 1992.)

In 1977 and 1985, serum PCB concentrations were determined for 58 workers at the Westinghouse plant. Less chlorinated PCBs were quantitated as Aroclor 1242, and the more highly chlorinated PCBs were quantitated as Aroclor 1254. The median half-life was 2.6 years for Aroclor 1242 and 4.8 years for Aroclor 1254. The half-life, however, varied inversely with the initial serum concentration. This pattern may be a result of continued low-level exposure, variation in the time of exposure, or enzyme induction by PCBs. The authors recommended further studies incorporating greater numbers of data points and congener specific analyses in order to more fully understand the dynamics of PCBs in humans (Phillips et al. 1989)

Other Health Studies

In 1986 the ISDH along with the CDC decided to evaluate the potential for using domestic animals in the surveillance of environmental exposures. Dog owners who lived near the three major PCB waste sites were identified. Each dog owner was identified to obtain information on the dog's age, sex, breed, length of residence in the area, weight, height at the shoulder, confinement (indoors, yard, or leash), and activities outdoors (retrieving and digging). Whenever possible, older dogs that had lived in the area before the 1983 remedial actions limited access to the waste sites and dogs that had been allowed to run free frequently were selected. After selecting nine dogs from Monroe County, a similar questionnaire was used to identify nine comparison dogs owned by CDC employees in Atlanta. Dogs that were similar in weight, height, and age to the Monroe County dogs were selected. The results of the study indicated that canine serum PCB levels in contaminated areas tend to be greater than those in uncontaminated areas. The findings suggested that pet dogs may serve as sentinels of human exposure to PCBs (Schilling et al. 1988)

D. Community Health Concerns Evaluation

1. Will the health study look at any chemicals other than PCBs? Will it look at chemicals such as dioxins, furans, and heavy metals?

   The ISDH is performing an analysis of the environmental data, and human exposure pathways. ATSDR will incorporate this report into their public health assessment at these sites. This project is not a health study. The health assessment evaluates the potential for people to be exposed to site-related contaminants and the possibility for adverse health outcomes resulting from those exposures. Generally, the public health assessment helps determine the need for a future health study; however, there have already been many health studies performed on individuals exposed to PCBs in this community.

   The public health assessment will look at all site-related contaminants that are currently in the soil, air, surface water, and groundwater.

2. What about other sites besides those listed in the Consent Decree?

   Only the six sites listed in the Consent Decree will be addressed in this report and in the public health assessment. Concerned citizens can request a health consultation or health assessment by petitioning ATSDR to perform a public health assessment at any non-Superfund site, or those sites not specifically covered by the Consent Decree.

3. Why is the health study being done now?

   As previously stated, a public health assessment not a health study is being performed. Congress mandated that a public health assessment be performed at every Superfund site. Public health assessments are usually done on old existing sites when new site-related activities take place, or when a special need arises. In this instance, Congress asked ATSDR to specifically look at the six sites addressed by the Consent Decree and the health risks associated with the methods used to destroy the site-related contaminants.

4. Have any studies been done before?

   Several health studies have been performed on individuals exposed to PCBs in the Bloomington area. Copies of these studies are available for your review in the Monroe County and Ellettsville Libraries, as well as the Indiana University Library. Copies of these studies can also be obtained from the Environmental Epidemiology Section of the Indiana State Department of Health.

5. Are copies available of studies conducted at similar sites?

   Copies are available and will be placed in the repositories in the libraries mentioned above.

6. What happens after the health study and expert panels are concluded?

   ATSDR will incorporate the findings of the expert panels into the public health assessment. The public health assessment will be discussed with the community. The final public health assessment will be provided to the community and all Consent Decree parties for their review and use.

7. Is the purpose of the study to find out if PCBs are hazardous? What is to be gained?

   We already know that PCBs are hazardous, and additional work in this area is not needed. The purpose of the public health assessment is to determine the current potential for individuals to be exposed to site-related contaminants at these six sites and if they are exposed, what the potential is for those exposures to result in adverse health effects.

8. How long will the health study go on?

   The entire ATSDR Bloomington PCB Project will be completed by the fall of 1994.

9. How will the public health assessment be used? Will a risk assessment be involved? Are they the same?

   A public health assessment and a risk assessment are not the same. The public health assessment is not done to determine clean-up levels, assign risk levels associated with specific activities, or to determine violation of state and/or federal regulations. The public health assessment makes a qualitative assessment of the routes by which individuals can be exposed to site-related contaminants and whether those exposures would result in adverse health outcomes. The public health assessment can also be used to make recommendations for additional environmental sampling, as well as recommend actions to prevent human exposures. The public health assessment also helps prioritize future health related activities at the site or in the potentially affected community. A risk assessment will not be used or developed in this project.

10. Did the ATSDR Toxicological Profile on PCBs consider only cancer?

    No, the ATSDR Toxicological Profile considers all potential health effects from each potential route of exposure (such as breathing PCBs, ingesting PCBs in food or water, or adsorption through the skin). The health effects included in the profile range from conditions that appear soon after high levels of exposure such as skin rashes to health conditions that appear months or years after exposure to lower levels. They involve the effects of PCBs on every organ system of the body including but not limited to cancer and reproductive effects.

11. Will the health study point out correlations such as cancer and miscarriages due to PCBs?

    One section of the public health assessment involves the review of existing health outcome data. In this section, cancer mortality data as well as adverse reproduction outcomes are reviewed.

12. Will you look at the potential health effects of the proposed ash landfill?

    The potential adverse health effects from the ash landfill will not be addressed in this preliminary report. As part of the Bloomington PCB project, ATSDR will evaluate the public health implications of incinerating the PCB-contaminated soil associated with these sites. In that context, potential health effects of the proposed ash landfill may be addressed.

13. How will you get a true picture of the health effects when limited to only the Consent Decree sites? What about ABB (formerly Westinghouse) and Fell Iron & Metal Inc., which are located in heavily populated areas?

    It is true the public health assessment will focus on only the Consent Decree sites; however, there are ongoing studies of former and current workers at the former Westinghouse plant. Further, individuals who reside near the Fell Iron and Metal site have been included in other studies already performed prior to the discovery of this site. If additional health studies are shown to be needed by the public health assessment, ATSDR will work with the ISDH to undertake those studies.

14. Will the Lemon Lane Landfill Springs be looked at?

    These springs are included in the preliminary report (see page 51 through 72).

15. I am concerned that my physician is not aware of the literature regarding the toxicity of exposure to PCBs.

    It is difficult for physicians to keep abreast of the latest toxicity data regarding chemical exposures. We will, therefore, recommend that ATSDR develop and implement a medical education program for the local nurses and physicians.

16. What about former and current workers at the Westinghouse/ABB plant? Many of the former workers have stated that they feel their health is deteriorating. Current workers are concerned that they are still being exposed to PCBs (from residual contamination) while working in the plant.

    Although the Westinghouse/ABB plant site is not a part of the Consent Decree, residual PCB contamination has been documented at the plant. ATSDR will notify NIOSH and the Occupational Safety and Health Administration (OSHA) of the workers' concerns and request that they look into those concerns.

17. Will the public health assessment address all of the sites where scavenging of discarded capacitors occurred, or where PCB-contaminated sewage sludge was used?

    Although the assessment of those sites is not within the scope and purpose of this document, the ISDH is aware of the fact that capacitor scavenging and the spreading of PCB-contaminated sewage sludge in gardens and pastures occurred in approximately 180 different areas of Bloomington. The PCB soil levels have been measured at 27 percent of these sites. At the scavenge sites, where we have data, 50 percent of the sites had soil PCB levels greater than 50 ppm. At the sludge sites, only 10 percent of those sampled had soil PCB levels greater than 50 ppm. Based on these data, we will recommend that Federal and State environmental agencies continue to investigate the level of PCB contamination at these sites.

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