Availability of ATSDR Decision Document Regarding the Bunker Hill, Idaho, Medical Monitoring Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Toxic Substances and Disease Registry

[ATSDR-135]

Availability of ATSDR Decision Document Regarding the Bunker

Hill, Idaho, Medical Monitoring Program

AGENCY: Agency for Toxic Substances and Disease Registry (ATSDR),

Department of Health and Human Services (HHS).

ACTION: Notice of availability for public review and comment of draft

Decision Document Regarding the Bunker Hill, Idaho, Medical Monitoring

Program.

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SUMMARY: ATSDR has reviewed scientific literature and clinical

information in order to assess the need for medical monitoring at

Bunker Hill, Idaho. ATSDR has determined that there is a definable

population at significantly increased risk of disease that will benefit

from a medical monitoring program. ATSDR has judged that the medical

monitoring program is appropriate to provide periodic medical

evaluation and referrals to improve the public health status of the

affected population. The current literature and expert panel workshop

held by ATSDR reflect that medical monitoring at Bunker Hill would be

good public health practice and of medical benefit to the affected

populations. This notice is announcing the availability of the draft

report documenting ATSDR's justification for implementing a medical

monitoring program for the population at the Bunker Hill Site: the

``ATSDR Decision Document Regarding the Bunker Hill, Idaho, Medical

Monitoring Program'', is available for public review and comment.

DATES: Comments must be received by July 9, 1998.

ADDRESSES: The report is available through Dr. Vivian Rush, MD, Medical

Officer, ATSDR-Division of Health Education and Promotion, 1600 Clifton

Road, NE., Mailstop E-33, Atlanta, Georgia 30333, E-mail address

[email protected] and telephone (404) 639-5080.

FOR FURTHER INFORMATION CONTACT: Dr. Vivian Rush, Medical Officer,

ATSDR; telephone (404) 639-5080.

SUPPLEMENTARY INFORMATION: Section 104 (i)(9) of the Comprehensive

Environmental Response, Compensation, and Liability Act (CERCLA), as

amended [42 U.S.C. 9604 (i)(9)], provides for the Administrator of

ATSDR to initiate a health surveillance program for populations at a

significant increased risk of adverse health effects as a result of

exposure to hazardous substances released from a facility. A program

ATSDR includes under health surveillance is referred to as ``Medical

Monitoring or Screening'' and is defined, as published in the Federal

Register on July 28, 1995 (60 FR 38840), in ``ATSDR's Final Criteria

for Determining the Appropriateness of a Medical Monitoring Program

under CERCLA'' as ``the periodic medical testing to screen people at

significant increased risk for disease.'' There are 7 Medical

Monitoring criteria associated with this program and they are as

follows:

(1) There should be evidence of contaminant levels in environmental

media that would suggest the high likelihood of environmental exposure

to a hazardous substance and subsequent adverse health outcomes.

(2) There should be a well-defined, identifiable target population

of concern in which exposure to a hazardous substance at a sufficient

level has occurred.

(3) There should be documented human health research that

demonstrates a scientific basis for a reasonable association between an

exposure to a hazardous substance and a specific adverse health effect

(such as an illness or change in a biological marker of effect).

(4) The monitoring should be directed at detecting adverse health

effects that are consistent with the existing body of knowledge and

amenable to prevention or intervention measures.

(5) The general requirements for a medical screening program should

be satisfied. Those requirements are:

The natural history of the disease process should be

understood sufficiently for screening.

The early detection through screening should be known to

have an impact on the natural history of that disease process.

There should be an accepted screening test that meets the

requirements for validity, reliability, estimates of yield,

sensitivity, specificity, and acceptable cost.

(6) An accepted treatment, intervention or both for the condition

(outcome or marker of exposure) must exist and a referral system should

be in place prior to the initiation of a medical monitoring program.

(7) The logistics of the system must be resolved before the program

can be initiated.

Background

The 21-square-mile Bunker Hill Superfund site includes the Bunker

Hill mining and smelting complexes and the communities of Pinehurst,

Page, Smelterville, Kellogg and Wardner in Shoshone county, in Silver

Valley of northern Idaho. Mining and mineral refining has been the

dominant industry in the Silver Valley for more than 100 years. The

mining and mineral refining activities have severely impacted the

landscape, vegetation, and the quality of the air, and soils in the

area. A population of workers and residents who have worked in and

lived surrounding the former Bunker Hill lead and zinc smelting

facility have been exposed to lead (and probably other heavy metals) in

the past at levels of public health concern (i.e., at levels where

health effects could be expected to occur). The most serious exposures

took place during the 1970's after a baghouse fire resulted in large

amounts of lead to be released into the air of towns surrounding the

smelter. Epidemiologic studies have shown adverse health effects in the

populations that were present during the past high exposure periods.

Since the smelter's closure in 1981, the exposures have markedly

decreased. In addition, the Panhandle Health District has implemented a

program to detect excess exposure in the community and provides

information and education on preventing harmful exposures and

scientific literature supports these findings.

[[Page 31497]]

Dated: June 3, 1998.

Georgi Jones,

Director, Office of Policy and External Affairs, Agency for Toxic

Substances and Disease Registry.

[FR Doc. 98-15255 Filed 6-8-98; 8:45 am]

BILLING CODE 4163-70-P