71 ip - semspub.epa.gov

S T A T E O F L O U I S I A N AD E P A R T M E N T O F H E A L T H A N D H O S P I T A L S

U I S I A N A

Edwin W. EdwardsG O V E R N O R

71it i ) : NOV 3 0 1993LJ LA i

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D e p a r t m e n t o fH E A L T H a n dH O S P I T A L SJ . Christopher P l l l e yS E C R E T A R Y

L.A. G f c P T . OFE N V I R O N M E N T _ Q U A L i T "

iAo -•: , - .-'-• 'N o v e m b e r 22, 1993

Dear P u b l i c H e a l t h Asse s sment Rec ip i en t : I Q G $ / / - 3 * & " 7 3Enclo s ed i s a c o p y ( s ) o f the Combu s t i on , I n c . P u b l i c H e a l t h Asse s sment

written by the O f f i c e o f P u b l i c H e a l t h , S e c t i o n o f Environmental E p i d e m i o l o g y . Youhave received thi s document e i ther for your own per sonal records or as a repos i tory.The P u b l i c H e a l t h Asse s sment i s open for p u b l i c comment f r o m December 3, 1993 toFebruary 3, 1994. Plea s e direct p u b l i c comments concerning the P u b l i c H e a l t hAsse s sment to:

Dr. L i n a B a l l u zH e a l t h Asse s sment S u p e r v i s o r

O f f i c e o f P u b l i c H e a l t hS e c t i o n o f Environmental E p i d e m i o l o g y

234 L o y o l a Ave., S u i t e 620New Orleans, LA 70112(504)568-8537

To have a comment inc luded in an a p p e n d i x of the f i n a l P u b l i c H e a l t h Assessmentp l e a s e send it in wri t ing to the above addres s . If you have ques t ions p l e a s e c a l l me at(504)568-8537.T h a n k You,

Laura F a d i lEnvironmental H e a l t h E d u c a t i o n C o o r d i n a t o r

144547

O F F I C E O F P U B L I C H E A L T H • E N V I R O N M E N T A L E P I D E M I O L O G YJ 3 4 J , O Y O L A A V E N U E • S U I T E 6 2 0 • N E W O R L E A N S , L O U I S I A N A 70112

PHONE - 504/568-8537 • LING 621-8537 • FAX # 504/568-7035• "AN E Q U A L O P P O R T U N I T Y EMPLOYER"

* °0439

P U B L I C H E A L T H A S S E S S M E N TC O M B U S T I O N I N C .

D E N H A M S P R I N G S , L O U I S I A N AD E C E M B E R 3, 1993

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P U B L I C C O M M E N T

P U B L I C H E A L T H A S S E S S M E N T

C O M B U S T I O N , I N C .D E N H A M S P R I N G S , L I V I N G S T O N P A R I S H , L O U I S I A N A

C E R C L I S N O . L A D 0 7 2 6 0 6 6 2 7

Prepared by

T h e Louisiana O f f i c e o f Publ i c H e a l t hunder Cooperat ive Agreement withAgency for T o x i c Subs tance s and Disease Regi s t ry


T A B L E OF CONTENTS

SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . 1B A C K G R O U N D . . . . . . . . . . . . . . . . . . . . . . . . . 3A. S i t e Descript ion and H i s t o r y . . . . . . . . . . . 3B. S i t e V i s i t . . . . . . . . . . . . . . . . . . . . 3C. Demographic s , Land Use and N a t u r a l Resource Use . . 5D. H e a l t h Outcome Data . . . . . . . . . . . . . . . . 5C O M M U N I T Y H E A L T H C O N C E R N S . . . . . . . . . . . . . . . . . . 6E N V I R O N M E N T A L C O N T A M I N A T I O N A N D O T H E R H A Z A R D S . . . . . . . . 9A. O n - S i t e Contaminat ion . . . . . . . . . . . . . . . 10B. O f f - S i t e Contaminat ion . . . . . . . . . . . . . . 13C. Qual i ty Assurance and Q u a l i t y Control ....... 14D. Physical and Other H a z a r d s . . . . . . . . . . . . 14P A T H W A Y S A N A L Y S E S . . . . . . . . . . . . . . . . . . . . . . 1 5A. Compl e t ed Exposure Pathways . . . . . . . . . . . 15B. Poten t ia l Exposure Pathways . . . . . . . . . . . . 17P U B L I C H E A L T H I M P L I C A T I O N S . . . . . . . . . . . . . . . . . 1 9A. T o x i c o l o g i c a l Evaluat ion . . . . . . . . . . . . . 19B. H e a l t h Outcome Data Evaluat ion . . . . . . . . . . 24C. Community H e a l t h Concerns Eva lua t i on . ...... 26C O N C L U S I O N S . . . . . . . . . . . . . . . . . . . . . . . . . 30R E C O M M E N D A T I O N S . . . . . . . . . . . . . . . . . . . . . . . 31A. H e a l t h A c t i v i t i e s Recommendation Panel ...... 32B. Publ i c H e a l t h A c t i o n s . . . . . . . . . . . . . . . 32PREPARERS OF REPORT . . . . . . . . . . . . . . . . . . . . . 33S E L E C T E D B I B L I O G R A P H Y . . . . . . . . . . . . . . . . . . . . 34A P P E N D I C E S . . . . . . . . . . . . . . . . . . . . . . . . . 36A p p e n d i x A. F i g u r e s . . . . . . . . . . . . . . . . . . A-lA p p e n d i x B. T a b l e s . . . . . . . . . . . . . . . . . . B-lA p p e n d i x C. H e a l t h Outcome Data Sources . ....... C-lA p p e n d i x D. Request for H e a l t h C o n s u l t a t i o n andAdvisory ..................... D-1A p p e n d i x E. Summary of Leukemia Clus t erInves t iga t i on s . ................. E-l

P U B L I C COMMENT

S U M M A R Y

Combustion, I n c . , is an inactive, abandoned waste oil recyclingf a c i l i t y in Livingston Parish, Louisiana. The site consisted ofa process area containing boiler equipment; storage tanks ho ld ingwater and o i ly wastes; a separate pond area containing addi t i onaltanks; and f o u r t e e n unlined s ha l l ow ponds containing water, o i lywastes, and sediments. Oily wastes were f o r m e r l y p i p e d from theprocess area and depos i t ed in the pond area. The site is abouttwo miles northwest of the town of W a l k e r , Louisiana. There is ares idential community of between thir ty and f o r t y householdsa d j a c e n t to the site. The nearest r e s id en t ia l house is 20 yardswest of the process area. Another re s ident ial house is locateda p p r o x i m a t e l y 200 yards southwest of the pond area.Based on in f ormat i on reviewed, the Louisiana O f f i c e of PublicH e a l t h ( L A O P H ) , S e c t i o n o f Environmental E p i d e m i o l o g y ( S E E ) h a sconcluded that the Combus t ion, I n c . site currently is anindeterminate pub l i c hea l th hazards. However, it was a pub l i cheal th hazard in the pas t . T h i s conclusion was based on theevidence of past exposure to smoke f rom the 1992 f i r e whichcaused smoke inha la t i on in some re s ident s . During the f i r e , ninere s ident s went to the h o s p i t a l s u f f e r i n g f r o m symptoms of smokeinhalation. Pos s i b l e long-term heal th e f f e c t s that could haveoccurred from these exposures would include respiratory,neurological and skin problems. However, it was d i f f i c u l t todetermine the type s and severity of these h ea l th e f f e c t s in theabsence of h o s p i t a l records and a d d i t i o n a l s tudy.Residents who live near the s i te, the former site workers andchildren who p layed on the site b e f or e the f en c e was constructedwere p o s s i b l y exposed to benzene, carbon t e t r a c h l o r i d e ,e thylbenzene , and styrene through inhala t i on and skin contact.However, adverse hea l th e f f e c t s were not l i k e l y to occur becauseof the low l eve l s of exposure. The former site workers andchildren who played on the site b e fore the f ence was constructedwere p o s s i b l y exposed to benzene, l ead , and to luene throughingestion and skin contact f r o m s o i l s on site and in the parkingarea. In add i t i on , some residents were also p o s s i b l y exposed tothese contaminants through ingestion from so i l s in the parkingarea. However, adverse heal th e f f e c t s were not l i k e l y to occurbecause of the low l eve l s of exposure. Because re s ident ial andother o f f - s i t e contamination are not well charac t er ized, thissite is an indeterminate pub l i c health hazard.Potential pathways for human exposure to smoke, PCBs, PAHs, VOCs,and heavy metal s included the f l a m m a b l e and i g n i t a b l e oil andwaste water in storage tanks and the ponds on s i t e , o f f - s i t e


sur fac e s o i l s , garden vegetables , and the local game and biotafrom the stream, Beaver Branch and West C o l y e l l Creek.Citizens raised several questions about cancers and other healthe f f e c t s f rom exposure to smoke f rom the February 1992, 1975 and1970 f i r e s on the site, and to other site-related contaminants.Detailed answers to these questions appear in the Public H e a l t hI m p l i c a t i o n s section of this pub l i c health assessment.At present, the site is being remediated. Remediation started inJ u l y , 1992, during which o i l s / s l u d g e s f r o m all the tanks andponds were incinerated, contaminated soil s and otherm a t e r i a l s / d e b r i s were trans f erred to l a n d f i l l , and thesurface water onsite is being treated (so far 11 m i l l i o n g a l l o n shas been trea t ed) currently. Ambient air is being monitored atpresent. Groundwater onsite wi l l be sampled sometime this year( 1 9 9 3 ) . Remediation wi l l be comple ted by the end of A u g u s t , 1993[Source: Louisiana Department o f Environmental Quali ty ( L D E Q ) ] .LAOPH made recommendations to (1) better characterize the s i te,and (2) conduct a f o l l o w - u p pub l i c meeting to e xp la in the resultsof the pub l i c heal th assessment to the local p e o p l e . As af o l l o w - u p to the heal th outcome data analys i s , LAOPH wi l l conducta review of area health s ta t i s t i c s , including fur therinvestigations of cancers and COPD, and wi l l fur ther investigatereported cases of smoke inhalat ion during area f i r e s , when thedata become available.

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B A C K G R O U N D

A. S i t e Description and H i s t o r yThe Combustion, I n c . , site was a small inactive waste oilrecycling f a c i l i t y in Livingston Parish, Louis iana, a p p r o x i m a t e l ytwo and one h a l f miles northeast of Oenham S p r i n g s , Louisiana,and approx imate ly two miles northwest of W a l k e r , Louisiana. Theseven- acre site consisted of a former processing area thathoused a number of h o l d i n g tanks containing o i ly wastes, and aseparate area, about one-half mile away, consisted of severaltanks and four t e en unlined shal low ponds ( S e e F i g u r e 1 . ) . Sevenof the ponds had an oil layer above o i ly water and s o l i d s . Theother ponds contained water and s o l i d s with lesser amounts ofo i ly material. A channel containing an intermittent stream ranalong the west side of the pond area. The ponds discharged intothe stream at two points . The intermittent stream runs intoBeaver Branch ju s t south of the site, which f l o w s into WestC o l y e l l Creek and f i n a l l y into the Amite River.The oil reclamation f a c i l i t y was operated as Dubose Oil Companyfrom the mid-1960s until 1977. In the mid-1970s, a p i p e l i n e wasi n s t a l l e d to transport non-reclaimable tars and p a r a f f i n s f r o mthe proces s ing plant to the pond area. A l t h o u g h at that time theland between the process and pond areas contained only trees andbrush, it is now the site of the Dubose Subd iv i s i on , are s ident ia l neighborhood of thirty-six houses. The f a c i l i t yacquired the name Combustion, I n c . , when Dubose Oil Company soldit in 1977. It continued operat ing until 1982. *

In June 1988, Combus t ion, I n c . , was p lac ed on the N a t i o n a lPriori t i e s Lis t (NPL) by the United S t a t e s EnvironmentalProtec t ion Agency (EPA) . As a result of inves t igat ions by theLouisiana Department of Environmental Q u a l i t y ( L D E Q ) and theLouisiana Department o f J u s t i c e , twenty-six p o t e n t i a l l yre spons ib le part i e s ( P R P s ) were i d e n t i f i e d . LDEQ and EPA enteredinto an enforcement agreement, d e s i g n a t i n g LDEQ as the leadagency to oversee and manage the remediation of the site by thePRPs. Remedial I n v e s t i g a t i o n act ivi t i e s concluded in A p r i l 1989.A Work Plan for Removal Act ion — Phase 1 was submitted in May1990. As a r e su l t , t h i r t y - f i v e drums were removed f rom theformer process area.At present, the site is being remediated. Remediation started inJ u l y , 1992, during which o i l s / s l u d g e s f r o m all the tanks andponds were incinerated, contaminated so i l s and otherm a t e r i a l s / d e b r i s were trans ferred to l a n d f i l l , and thesurface water onsite is being treated (so far 11 m i l l i o n g a l l o n shas been t r e a t e d ) currently. Ambient air is being monitored at

IP U B L I C C O M M E N T •

Ipresent. Groundwater onsite w i l l be s a m p l e d sometime this year( 1 9 9 3 ) . Remediation wil l be completed by the end of A u g u s t , 1993 M(Source: L D E Q ) . I

B. S i t e Vi s i t IOn November 30, 1990, members from the Louisiana O f f i c e of Publ i cH e a l t h ( L A O P H ) a n d L D E Q ' s Division o f I n a c t i v e a n d Abandoned •S i t e s (IAS) visited the site. A representative of the PRPs used |to visit the site d a i l y , and was also present during the sitevisit. The purpose of the visit was to gather s p e c i f i c _i n f o r m a t i o n about site security, land use, phys i ca l hazard s , •contamination, and environmental transport routes. The ™temperature was about s i x ty degrees , and there was a s l i g h tbreeze f r o m the northeast. •The site is in a moderately wooded rural area. The land is f l a twith some swampy areas. The nearest houses lie a p p r o x i m a t e l y •twenty yards west of the process area, and one hundred yards |southwest of the pond area.The process area ( F i g u r e 2 .) was a f e n c e d , inactive m a n u f a c t u r i n g •area that consis ted of e ighteen large , above-ground tanks and •associated p i p e s , p u m p s , and boilers. All of the tanks wererusty and show signs of age. The proce s s ing equipment was on a •concrete pad enclosed by a low cinder block w a l l . T h e r e was •evidence of oil s p i l l a g e within the concrete pad area. Theprocess area also contained a boi ler shed and a pump house •h o l d i n g drummed wastes f r o m the remedial inve s t iga t i on work. A |g a s o l i n e / d i e s e l f u e l pump area was located in s ide of the maingate. Much of the area was overgrown with v ege ta t i on at the time _of the site visit. Ther e was a strong p e t r o l eum odor in the sump •area. •The pond area ( F i g u r e 3.) was in the r igh t-o f-way for a high •voltage transmission line. The pond area was enclosed by an •e igh t - f o o t chainl ink f ence . The f en c e had two locked gat e s , andwas t o p p e d with barbed wire. Warning signs had been pos ted •throughout the area. T h e s e s igns, along with f l o o d l i g h t s on the Jsite, had been shot. W h i l e the warning signs remained l e g i b l e ,the l i g h t s were no longer f u n c t i o n a l . Acces s to the s i te was _restricted. IThe pond area was overgrown with vegetation. W a l k i n g within thef enced area was o f t e n d i f f i c u l t due to the underbrush. •I n s p e c t i o n of the ponds revealed an absence of vegetat ion around •those ponds with a s i g n i f i c a n t oil layer. At the time of the

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vi s i t , all the ponds had some area above the water l ine toaccommodate a d d i t i o n a l l iquids . The house nearest to the pondarea l i e s about two hundred yards to the southwest.There were three ponds outs ide the f enc ed area, one to thesouthwest of the f enced area, and two to the southeast. Tho s eponds were not involved in the operations that moved wastes tothe pond area.W h i l e nothing was seen at the time of the site visit to indicatethat the ponds were being used as "swimming holes ," c i t izens havereported their use as such in the pas t . In a d d i t i o n , this sitehas been visited several times since the October 1990 site visitwas conducted.C. Demographic s , Land Use and N a t u r a l Resource UseThe p o p u l a t i o n of Liv ing s t on Parish i s a p p r o x i m a t e l y 72 ,300according to a 1989 report by LAOPH. Of the re s ident s , 94.3% arewhite; 5.09% are black; 0.18% are neither black nor white. Ther eis an approx imat e ly even sex d i s t r i bu t i on , with 50.1% of thep o p u l a t i o n f e m a l e and 49.9% male. A p p r o x i m a t e l y 76% of parishresidents are younger than 45 years of age. Age d i s t r i bu t i on iss imi lar between sexes. The most common cause of death in thepari sh is heart d i s ea s e , f o l l o w e d by cancer, stroke, a c c id en t s ,and chronic obstructive pu lmonary di sease ( C O P D ) .The Combustion, I n c . , site is in a rural area in the west centralpart of the parish. The land immedia t e ly surrounding the processarea is res idential proper ty. The most recent avai lab l e count ofhouses near the site was done by EPA in J u l y 1985. It indicatedthat there were 399 p e o p l e wi thin one mi l e of the s i t e , 236p e o p l e wi thin one h a l f - m i l e , and 122 p e o p l e in 32 houses w i th inone quarter-mile of the site. Ther e are no s choo l s , churches,h o s p i t a l s , or parks within a one mile radius of the site.The pond area was more isolated than the process area, with astand of trees separating that area from the nearest residences.The pond area was in a high vol tage transmis s ion line r i g h t - o f -way. The land north and south of the pond area was part of theright-of-way. The areas to the east and west are wooded.H u n t i n g (rabbit and squ irre l s) is common in the area, though, nof i s h i n g is done.The intermittent stream on the west side of the former pond areais an unnamed tributary of the Beaver Branch of West C o l y e l lCreek. Aquatic l i f e is scant within the stream bed due to theintermit tent presence of water. Heavy algae growth on the


w a t e r ' s surface has been reported. T h i s is believed to berelated to residential discharge of septic o u t f a l l , both in thedrainage ditches that pass through the res idential areas anddrain into the stream bed, and in the stream i t s e l f .D. H e a l t h Outcome DataS t a t e and local health data were used to evaluate heal thoutcomes. Tho s e sources provided s u f f i c i e n t data to evaluate allof the cancers and some of the other health concerns expressed bythe local comunity, and included informat ion on adverse healthoutcomes p o s s i b l y related to site contaminants. However, datafor some of the heal th outcomes are not routinely co l l e c t ed inLouisiana, and there fore were not avai lab l e for evaluation.Databases used as primary sources for both state and parish datainclude:

1. Louisiana Tumor Registry, O f f i c e of Public H e a l t h , Louis ianaDepartment of H e a l t h and H o s p i t a l s , and2. Public H e a l t h S t a t i s t i c s , O f f i c e o f Public H e a l t h , LouisianaDepartment of H e a l t h and H o s p i t a l s .

T h e s e databases are described in A p p e n d i x C.

C O M M U N I T Y H E A L T H C O N C E R N S

A wide variety of health concerns have been expressed to LAOPHand to the United S t a t e s Agency for T o x i c Substances and DiseaseRegistry (ATSDR) by residents of the ad jac en t Dubose S u b d i v i s i o nand by others l iving near the site, inc luding residents ofW a l k e r , Louisiana. The major i ty of concerns have involved thep o s s i b i l i t y of exposure to site chemicals through contaminationof the air or drinking water and whether site chemicals areresponsible for cancers, respiratory problems, and rashes in thearea.On August 28, 1990, citizens Against I l l e g a l Dumping (CAID), alocal c i t i z e n s ' group formed in response to community concernsabout the site, pet i t ioned ATSDR to conduct a pub l i c healthassessment. The p e t i t i on cited concerns over u n s p e c i f i e d hea l thproblems and also reported an inaccuracy In ATSDR1 s prel iminaryhealth assessment in regard to the distance of the nearest housef r o m the site. The pe t i t ion was acknowledged by Dr. BarryJohnson o f ATSDR.

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On August 29, 1990, LAOPH Sect ion of Environmental E p i d e m i o l o g y( S E E ) s t a f f met with CAIO to l i s t en to their heal th concerns.A l s o present were representatives of the Louisiana EnvironmentalH e a l t h Network (LEHN), th e Louisiana Environmental Act ion Network( L E A N ) , a n d A T S D R ' s representative f o r Region V I . Members o fCAID were concerned about reports of cervical cancer, renal cellcarcinoma, cancer of the b l a d d e r , and re spiratory i l l n e s s e s amongthose l iv ing near the site. Medi ca l records were not prov ided .Concern was al so expressed about decreased p r o p e r t y value in thearea because of the site.On September 11, 1990, the chairperson of CAID, who was also thepe t i t ioner t o A T S D R , went t o S E E ' s o f f i c e s i n N e w Orleans t oexpress fur ther concerns about i l l n e s s e s in the area. Shereported c ompla in t s of respiratory i l l n e s s e s , rashes, kidney andbladder i n f e c t i o n s , sinus prob l ems , a l l e r g i e s , extreme f a t i g u e ,nausea and diarrhea, as well as cancers of the p r o s t a t e , colon,lungs , k idneys , bones, and b l a d d e r . She did not prov id e medicalrecords and did not know whether or not the reported cancerdiagnose s represented primary sites.On September 4, 1990, F a y a r d , H a r r i s , Roethele , and Honeycu t t , alaw f i r m representing ci t izens in a class-action suit involvingthe s i te, provided SEE with a summary of their c l i e n t s ' medicalcompla in t s based on 1651 interviews within a three-mile radius ofthe Combustion, I n c . , site. T h e y reported c ompla in t s aboutcancers, respiratory prob l ems , d ermato log i c condi t i ons ,hypertens ion, heart prob l ems , d iabe t e s , birth d e f e c t s , centralnervous system d i s order s , eye, ear, and nose prob l ems ,k i d n e y / u r i n a r y prob l ems , g a s t r o i n t e s t i n a l prob l ems ,m u s c u l a r / s k e l e t a l prob l ems , menstrual i r r e g u l a r i t i e s , sexualproblems, f a t i g u e , unexplained f ever s , immunologic problems andother i l lne s s e s . Primary sites for cancers reported includedkidney, b ladder , stomach, ga l l b l adder , pancreas, bone, leukemia,lung, pros tate , colon, breast, skin and others.On March 19, 1991, SEE s t a f f met with local community leadersf rom the W a l k e r and Denham S p r i n g s areas to organize a C i t i z e n s 'Advisory Committee to maintain contact with the community duringthe hea l th assessment process. T h o s e present included the mayorof W a l k e r , the mayor of Denham S p r i n g s , the pre s ident of theLivingston Parish Police J u r y , the po l i c e juror in whosejur i sd i c t i on the site is located, the C h i e f Sani tar ian Managerfor Livingston Parish, the Regional Admini s t ra tor of the localH e a l t h Uni t , and the Chairperson of CAID. The meeting was heldat the H e a l t h Unit in Denham S p r i n g s . Those present agreed tomeet on a regular basis to keep SEE informed about the concernsof the community related to the site and the p u b l i c hea l th


assessment. In a d d i t i o n , a p u b l i c meeting to document theconcerns of the community was scheduled for the f o l l o w i n g month.It was agreed that the c ompl e t ed p u b l i c h ea l th assessment wouldbe presented to the community at a second p u b l i c meet ing to bes cheduled a f t e r c o m p l e t i o n o f the assessment.On A p r i l 14, 1991, the f i r s t of the pub l i c mee t ings was held inW a l k e r , Louis iana. SEE s t a f f members were present as well as theC h i e f S a n i t a r i a n Manager for Liv ing s t on Pari sh , the RegionalRepre s entat ive of ATSDR, and the Environmental Consu l tan t to theLouisiana Department of H e a l t h and H o s p i t a l s (LADHH) . About twohundred res idents a t t ended. A f t e r a pre s en ta t i on of backgroundi n f o r m a t i o n and an e x p l a n a t i o n of the assessment process by LAOPHs t a f f , the meet ing was opened to the c i t i z en s for s ta t ement s o ftheir h ea l th concerns. W r i t i n g mat er ia l s were made a v a i l a b l e andwrit ten s tatements were c o l l e c t e d f r o m those who wished toexpress concerns but did not wish to speak p u b l i c l y . Localre s ident s expressed concerns about p o t e n t i a l human exposure tolead and p o l y c h l o r i n a t e d b i p h e n y l s ( P C B s ) through p o s s i b l econtamination of the soil and dr inking water, and to benzenethrough p o s s i b l e v o l a t i l i z a t i o n into the air. Many complained ofbad s m e l l i n g or bad ta s t ing water and were concerned that thep u b l i c water s u p p l y might have been contaminated by water p i p e sp a s s i n g through contaminated so i l . Others expres sed concernabout the p o s s i b i l i t y of transport of s i te contaminants during areported local f l o o d in 1977. S t i l l others s tated that they haddrunk f r o m local w e l l s and were concerned about p o t e n t i a lexposure through p o s s i b l e groundwater contamination. Somere s ident s asked about the p o t e n t i a l for exposure to toxinsthrough inge s t i on of local game and f i s h , or through v ege tab l e sf r o m local gardens. Others wanted to know if the remediat ionprocess would cause v o l a t i l i z a t i o n of toxins into the air and, ifso, whether or not local residents would be evacuated. Residentsalso raised concerns about the p o s s i b i l i t y of p o t e n t i a l pastexposure to site contaminants r e su l t ing f r o m a reported f i r e inthe process area on February 8, 1970, and a reported e x p l o s i o nf o l l o w e d by a f i r e on January 20, 1975. Residents wanted to knowwhat p l a n s had been made for the community if the site were toburn again.Some res idents expressed concern about i l l n e s s e s that theyreported to have observed in their community. The most commonlyreported i l l n e s s e s were cancers and re spiratory i l ln e s s e s . Mostof those who expressed concerns about cancer did not s p e c i f y asite for the disease. Others reported having encountered casesof cancer of the pros tate and cancer of the cervix or abnormalPap Smear results. I n d i v i d u a l cases of e sophageal cancer, renalcell carcinoma, and malignant gl ioma of the brain stem were also

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P U B L I C COMMENT

reported. In addit ion, a lawyer involved in a related class-action lawsuit claimed that six children from the WalkerElementary School and Kindergarten had developed leukemia since1979. LAOPH requested that all i n f o r m a t i o n concerning thesereports be f orwarded for f u r t h e r evaluation.Outcomes reported at least three times included rashes,a r t h r i t i s / o s t e o m y e l i t i s , kidney and urinary tract i n f e c t i o n s ,a l l e r g i e s , spontaneous abortions, headaches, nosebleeds ,g a s t r i t i s , s inus i t i s , vision prob l ems , diarrhea, f a t i g u e , and atendency for wounds to heal s l ow ly .Outcomes reported two times or f ewer included h y p e r t e n s i o n / C H D ,liver damage, f i b r o c y s t i c ovaries, irregular menstruation,diabe t e s , h e p a t i t i s / j a u n d i c e , o s t e omye l i t i s , l u p u s , brain damage,R e y e ' s S y n d r o m e , P i c k ' s d i s ease , cerebral p a l s y , learningd i s a b i l i t i e s , genetic p r o b l e m s , f e m a l e i n f e r t i l i t y , thyroiddi sorder s , a p p e n d i c i t i s , swo l l en lymph nodes, cysts, high f ever s ,ear i n f e c t i o n s , chest pains, muscle cramps, tooth los s , sorethroat, diarrhea, and f a t i g u e .

E N V I R O N M E N T A L C O N T A M I N A T I O N A N D O T H E R H A Z A R D S

T a b l e s 1-3 in A p p e n d i x B lis t the contaminants of concern. Weevaluate these contaminants in the subsequent sections of theH e a l t h Asses sment and determine whether exposure to them hasp u b l i c h e a l t h s i g n i f i c a n c e . I d e n t i f y i n g contaminants in thi ssection does not i m p l y that exposure would a c t u a l l y result inadverse hea l th e f f e c t s . Contaminant s e lec t ion considers thef o l l o w i n g f a c t o r s :

1. Concentrat ions of contaminants on and off the site.2. F i e l d data quali ty, laboratory data qual i ty , and sampledesign.3. Comparison of on-site and o f f - s i t e concentrations withhea l th assessment comparison values f or (1)noncarcinogenic endpoint s and (2) carcinogenicendpoints.4. Community health concerns.The data table s include the f o l l o w i n g acronyms:

P U B L I C COMMENT

IIICRE6 = Cancer Risk Evaluation GuideEHEG = ATSDR Environmental M e d i a Evaluat ion G u i d e IRMEG = Reference Dose Environmental M e d i a Evaluat ionGuide Ippm = parts per m i l l i o n

• ppb = parts per b i l l i o n

Compari son values for p u b l i c h e a l t h assessment are contaminant •concentrations in s p e c i f i c media that are used to selectcontaminants f or f u r t h e r evaluation. T h e s e values inc lude •Environmental Media Evaluation Guides ( E M E G s ) , Cancer Risk •Evaluat ion G u i d e s ( C R E G s ) , and other relevant g u i d e l i n e s . CREGsare estimated contaminant concentrations based on a one excess •cancer in a m i l l i o n persons exposed over a l i f e t i m e . CREGs are •ca l cu la t ed f r o m E P A ' s cancer s l o p e f a c t o r s . E P A ' s maximumContaminant Level Goal (MCLG) is a dr ink ing water h e a l t h goal .EPA believes that the MCLG represent s a level that no known or •ant i c ipa t ed adverse e f f e c t on the h ea l th of persons should occur •which a l l o w s an adequate margin of s a f e t y . Proposed MaximumContaminant Level G o a l s ( P M C L G s ) are M C L G s that are being •propo s ed . Maximum Contaminant Level s (MCLs) represent |contaminant concentrations that EPA deems protect ive of pub l i chea l th (con s id e r ing the a v a i l a b i l i t y and economics of water •treatment t e c h n o l o g y ) over a l i f e t i m e (70 year s) at an exposure •rate of 2 l i t e r s water per day. W h i l e M C L s are r egu la t oryconcentrat ions, P M C L G s a n d M C L G s a r e not. E P A ' s Ref er enc e Dose(RfD) and Reference Concentration (RfC) are e s t imate s of the •d a i l y exposure to a contaminant that is u n l i k e l y to cause adverse •health e f f e c t s .LAOPH also conducted a search of the EPA T o x i c Chemical Release |Inventory ( T R I ) f o r chemical release i n f o r m a t i o n aboutCombust ion, Inc . and other f a c i l i t i e s in the v ic ini ty. The HCombustion f a c i l i t y is not documented on TRI. However , the TRI •shows two f a c i l i t i e s in Denham S p r i n g s , Liv ing s t on Pari shreported air releases of acetone, methanol, toluene, 1,1,1-tr i ch loroe thane , methyl ethyl ketone, maleic anhydride , melamine, •f o r m a l d e h y d e , ammonia, s u l f u r i c acid, and sodium hydroxide (in •s o l u t i o n ) between 1987 and 1989. The s e f a c i l i t i e s are notlocated near the Combustion Inc. S i t e and are unl ike ly to •contribute any substantive concentrations of contaminants of |concern to the Combust ion Inc. location.

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A. On-Sit e ContaminationVarious samples of on-site environmental media were col lec ted andanalyzed between 1985 and 1990 (1-3, 5). The c o l l e c t i o n andanalyses of these s a m p l e s were in i t ia t ed by the E P A , LDEQ, andERM-Southwe s t , I n c . S p e c i f i c contaminant data are shown in T a b l e1, in A p p e n d i x B..Process AreaBoth hand-augured and d r i l l e d borings were used to characterizethe process area during the 1989 Remedial I n v e s t i g a t i o n (RI).Hand borings were t y p i c a l l y seven to eleven f e e t d e e p , while thed r i l l e d borings were c ompl e t ed t o d e p t h s o f f o r t y t o f i f t y f e e t .Trenches were dug in suspected burial areas; three monitoringw e l l s were i n s t a l l e d to characterize the groundwater.

S o i lS o i l s ampl e s taken in suspec ted s p i l l or burial areas in theprocess area ind i ca t ed lead concentrations at 3.1 to 402.0m i l l i g r a m s p e r k i logram ( m g / k g ) . T h i s range f a l l s below t h eLAOPH standard of 500 m g / k g for lead in s o i l . T o l u e n econcentrat ions , f o u n d at l e v e l s of .027 to 980 m g / k g . Thecomparison value for T o l u e n e is 400 m g / k g pica chi ld RMEG.Leve l s of benzene, f ound at .012 to .046 m g / k g are below the CREGvalue of 20 m g / k g . The areas where concentrations were highestseem to r e f l e c t s p i l l or burial areas and to coincide with theg a s / d i e s e l pump area and former waste d i s p o s a l areas.

Oils - - S t o r e d OilsS a m p l e s of the o i l s stored on site were c o l l e c t e d and a n a l y z e d .S p e c i f i c contaminant data for the o i l s are d e t a i l e d in T a b l e 1,in A p p e n d i x B.Pond AreaThe ponds were estimated to contain almost f our m i l l i o n ga l l on so f o i l , water, and s o l i d s , e x c l u d i n g p o t e n t i a l l y a f f e c t e d s o i l sbeneath the ponds. Seven of the ponds had an oil layer, composedof a f r e e oil surface layer and underlying waxy emulsion layer,above o i ly water and s o l i d s ( s e d i m e n t s ) . The remaining pondscontained water and sediments with lesser amounts of o i lymaterial.

11


Oils - - Pond S u r f a c eHeavy metal s and PCBs were detected in sampl e s of o i l s f r o m thesurface of ponds on site. S p e c i f i c contaminant data for thesur fa c e o i l s are presented in T a b l e 1, in A p p e n d i x B.

Pond W a t e rS a m p l e s of the water phase ( s u r f a c e water) of the pond s indicatedlead concentrations at 0.009 to 9.0 m g / L , and arsenicconcentrations at 0.006 to 0.010 m g / L . T h e s e data are pre s entedin T a b l e 1, A p p e n d i x B.

Pond S e d i m e n t sS a m p l e s of the Pond s o l i d s ( s e d i m e n t s ) were c o l l e c t e d andanalyzed . S p e c i f i c contaminant data are provided in T a b l e 1, inA p p e n d i x B.

W a s t e M a t e r i a l sW a s t e mat er ia l s were stored in the pond area on site. However ,no sampl ing data are avai lable for the sol id o i ly wastesmater ia l s s t i l l stored on the site.

S o i lSix borings and seven monitor ing w e l l s were made wi th in thef enc ed pond area. S o i l s a m p l e d e p t h s ranged f r o m a f o o t and ah a l f to 13.0 f e e t , with most s ampl e s taken at d e p t h s of le s s than10 f e e t . S o i l s a m p l e s taken near and between p o n d s ind i ca t econtamination outside of the ponds themselves. T h i s mayrepresent o v e r f l o w , s p i l l a g e , or p o s s i b l e migrat ion f r o m theformer ponds. Levels of lead were detected at 9.1 to 178.0m g / k g , below the LAOPH standard of 500 m g / k g for lead in so i l s .Toluene levels were detected at .006 to 34.0 m g / k g , below thecomparison value of 400 m g / k g based on the p ica ch i ld RMEG.Benzene levels were detected at 0.95 to 6.11 m g / k g , below theCREG value of 20 m g / k g . S p e c i f i c contaminant data are l i s t ed inT a b l e 1, in A p p e n d i x B.

Groundwater - - Monitoring W e l l sS a m p l i n g of the two shal low groundwater a q u i f e r s beneath thef e n c e d former pond area has been inconsi s tent. W h i l e groundwater

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monitoring w e l l s i n s t a l l e d in the pond in 1985 indicatedhydrocarbon contamination in the sha l l ow a q u i f e r s , w e l l si n s t a l l e d in the 1989 RI did not reveal any hydrocarboncontamination. In a d d i t i o n , the deeper a q u i f e r has not beenshown to be contaminated ( 1 ) . Groundwater s a m p l i n g onsite isexpected sometime this year ( 1 9 9 3 ) .

13


IIIB. O f f - S i t e ContaminationProcess Area •

Groundwater - - Moni tor ing W e l lS a m p l i n g and analyses of monitoring well M W - 2 0 3 , immedia t e ly •a d j a c e n t to the southeast f e n c e l ine , indicated 1,2-dichloroe thane in a sand and gravel layer at 15 to 20 f e e t . •Concentrations were detected at 0.011 m g / L ( T a b l e 2, A p p e n d i x B). |The s a m p l i n g well is located near the southeastern corner of theformer process area in a suspected s p i l l area and downgradient Mf r o m two of the three c o n f i r m e d f o r m a l burial areas. Regional Igroundwater f l o w d irec t ion is towards the south-southeast . Localwater level measurements indicate radial movement in alldirections* Ther e are not enough data ava i lab l e to determine the 8areal extent of the groundwater contamination. •

S o i l IO f f - s i t e so i l s in the parking area have been shown to becontaminated. That area is across the street f r o m the former «process area, and i m m e d i a t e l y ou t s id e the southeas t ern corner of Ithe proper ty. That area also coincide with the former reporteds p i l l or burial area. Benzene was de t e c t ed at 0.014 to 0.046m g / k g , below the CREG value of 20 m g / k g . T o l u e n e was de t e c t ed at H0.015 to 0.32 m g / k g , below the comparison value of 400 m g / k g •based on the p i ca chi ld RMEG ( T a b l e 2 , A p p e n d i x B).Pond Area IS u r f a c e water and sediments of the in t ermi t t ent stream in the _O f f - s i t e pond area were contaminated. The stream f l o w s f r om the •west side of the pond area to Beaver Branch. W a s t e waters f r o m ™the ponds discharged into the stream through a p e r m i t t e ddischarge point . Severe weather conditions could al so have Icaused run-o f f f r o m the ponds into the stream. •

S e d i m e n t s - - Stream •S a m p l e s of s ediments taken f r o m downstream of the stream in theo f f - s i t e pond area were ana lyzed . A n a l y s i s showed that the _sediments contained 0.005 m g / k g of benzene. T h i s level is below Ithe CREG value of 20 m g / k g . Biota in the intermit tent stream ™have not been sampled to indicate the p o s s i b i l i t y ofbioaccumulation. I

14 II

P U B L I C COMMENT

S u r f a c e Water - - FondLaboratory analyses of samples of o f f - s i t e Pond # 1 indicatedconcentrations of lead and chromium below background l eve l snormally expected for this area. S u r f a c e water f r o m O f f - s i t ePond numbers 2 and 3 have not been analyzed.

Ambient AirAir monitoring events for both the pond and the process areaswere p e r f o r m e d in J u n e , A u g u s t , and November of 1985; S e p t e m b e rof 1988; January and August of 1989; and Sep t ember of 1990 ( 1 - 5 ) ,T h e s e events were conducted by LDEQ, by EPA repre s en ta t iv e s , orby the contractor for the PRPs ( E R M - S o u t h w e s t , I n c . ) . No lead-laden dus t s or PCBs were de t e c t ed during either event. The otherEPA s a m p l i n g events, as well as those of LDEQ in S e p t e m b e r 1990,concluded that there were no u n s a f e hydrocarbon emissions f r o mthe site. S p e c i f i c contaminant data for o f f - s i t e ambient a irare presented in T a b l e 3, in A p p e n d i x B. At pre s ent , air isbeing monitored f or V O C s , PAHs, P C B s , and lead ( L D E Q ) .C. Qual i ty Assurance and Qual i ty ControlA n a l y t i c data provided to LDEQ by E R M - S o u t h w e s t , I n c . , thecontractor conducting the RI/FS, were used in p r e p a r i n g thispub l i c heal th assessment. All analyt i c result s were evaluatedusing standard Q A / Q C review. T h e i r evaluation indicated that 96%of the analyt ic results met those requirements.The results of many of the air monitoring events at the site havebeen chal l enged by state and f e d e r a l agencies. The monitoringdone in January 1989, by ERM-Southwe s t , I n c . , as well as thesampl ing by LDEQ in Sept ember 1990, were not p e r f o rmed underrepresentative weather conditions. T h e r e f o r e the comple t ene s sand r e l i a b i l i t y of the ambient air data and in f ormat i on coulda f f e c t the v a l i d i t y of conclusions related to ambient air.D. Physical and Other Hazard sIn the pas t , hazards at the Combustion Inc. S i t e due to wastes inthe tanks were comparable to those associated with warehouseswhich store f l a m m a b l e or igni table materials. In a d d i t i o n , localresidents have reported seen children p l a y i n g on the o f f - s i t emonitoring equipment.

15


IIIP A T H W A Y S A N A L Y S E SHuman exposure pathways are i d e n t i f i e d by examining environmental Iand human components that might lead to contact withcontaminants. A pathway analys i s considers f i v e e lements: asource of contaminat ion, transport through an environmental Imedium, a point of exposure, a route of human exposure, and an •exposed p o p u l a t i o n . C o m p l e t e d exposure pathways are those forwhich the f i v e e lements are evident and indicate that exposure to •a contaminant has occurred in the p a s t , is currently occurring, |or will occur in the fu ture . Potential exposure pathways arethose for which one or more of the elements is not c l e a r l y _d e f i n e d buc could be present. P o t e n t i a l pathways indi ca t e that •exposure to a contaminant could have occurred in the p a s t , could m

be occurring now, or could occur in the fu ture . T a b l e 4 inA p p e n d i x B i d e n t i f i e s both the c ompl e t ed and p o t e n t i a l exposure Ipathways. The f o l l o w i n g di scus s ion incorporates only those •pathways that are important and relevant to the site.A . C o m p l e t e d Exposure Pathways J jS o i l Pathways _P a s t , exposure pathways are p o s s i b l e f r o m contaminat ion of s o i l s ™at the former process and pond areas both on and o f f - s i t e .A l t h o u g h data presented are for surface-subsoil s a m p l e s , it is •l i k e l y that l eve l s of contaminants presented for these s a m p l e s •are s imi lar to those l eve l s in sur fac e soil horizon.Contaminat ion at the po in t s of exposure have p o s s i b l y occurredbecause of several environmental and transport mechanisms. T h e s emechanisms included transport of site contaminants by w ind ,sur fa c e r u n o f f , f l o o d i n g , a n d f u g i t i v e du s t s r e s u l t i n g f r o mvehicular t r a f f i c or construction.Exposure to soil contaminants has p o s s i b l y occurred in the pas t .On s i te , any maintenance and prop er ty or construction workers, •and children who played on the site b e f or e the f ence was •constructed were the p r i n c i p a l p o p u l a t i o n s that were l i k e l y tohave been exposed p r i m a r i l y through inge s t i on , i n h a l a t i o n and •skin contact. Since nearby o f f - s i t e s o i l s f r o m the p a r k i n g area |are shown to contain benzene and toluene, so i l s in these areasrepresent a f u t u r e exposure pathway to res idents if the area is _deve loped . However, the soil s a m p l i n g s o f f - s i t e did not extend •into residential yards. S u r f a c e soil data ( from samples 0-3 •inches d e e p ) were required to determine the degree to whichexposure was occurring. •

16 II


Ambient Air PathwaysThe E P A , LDEQ, and contractor for the PRPs (ERM-Southwe s t , I n c . )have conducted several air monitoring events at the pond and theprocess areas. The s e exercise were conducted in J u n e , Augus t ,and November of 1985, September of 1988, January and August of1989, and Sept ember o f 1990. Based on EPA's analys i s ,q u a n t i f i a b l e contaminants de t ec t ed in ambient air during theAugust 1989 s a m p l i n g included carbon t e t r a c h l o r i d e , e thylbenzene ,and styrene. Subsequent s a m p l i n g conducted by LDEQ in S e p t e m b e r1990 detec ted benzene in ambient air. An analys i s of the weatherpat t erns reveals that winds were f r o m the south-east for 40percent of the t ime, and f r o m the north-east a p p r o x i m a t e l y 25percent of the time. T h i s indicate s that neighboring residenceswere in the path of air currents that pass over the site.Releases of contaminants to ambient air at Combustion, Inc. f romformer ponds , process area and/or through f u g i t i v e emissions fromtheir processes or h a n d l i n g and other sources such as vehiculart r a f f i c p o s s i b l y resulted in past inhala t ion exposure for formerworkers on s i te , and nearby res idents . Moreover, nearbyres idents were p o s s i b l y exposed to contaminants throughinha la t i on .There has been continuous air monitoring since the remedialactivities began last year ( 1 9 9 2 ) .O i l / F i r e PathwaysLaboratory analysi s of oils in storage at the former process areaand oi l s f r om the surfaces of former ponds detected PCBs and someheavy me ta l s i n c l u d i n g l e a d , chromium, cadmium, and arsenic.Several f i r e s have been reported at the f a c i l i t y in the pas t .Two f i r e s have occurred in the former process area on the s i t e;one on February 8, 1970, and one on January 20, 1975 whi l e thesite was active. Workers on the site and any nearby re s ident swere probably exposed to smoke and contaminant gases in theburning oi l s through inhalat ion and dermal contact.The most recent f i r e occurred in the s i t e ' s pond area on February19, 1990. During the f i r e , the local S h e r i f f ' s o f f i c e evacuated30 households in the community. Nine Persons went to the nearbyhospi tal with signs and symptoms of smoke inhalation. All ninewere released shortly thereaf ter . Although there is someindication that unauthorized persons have gained access to thesite, there is no in format ion to indicate that they were incontact with the materials. Because some of the o i l s on sitewere f l a m m a b l e and ign i tab l e , f i r e remains a concern. Nearby

17

P U B L I C COMMENT

residents were the main popu la t i on p o t e n t i a l l y exposed to smokeand contaminant gases f rom the burning oils.B. Potential Exposure PathwaysFood chain PathwaysWaste water f rom the former ponds discharged into theintermittent stream at two point s . The stream runs into BeaverBranch which f l o w s into West C o l y e l l Creek and f i n a l l y emptiesinto the Amite River. There are concerns that local biota andgame may have bioaccumulated site contaminants contained in wastewater discharged into the stream. Local residents have to ld LDEQo f f i c i a l s that hunting (rabbits and squirrel s) is common in thearea. Past and present consumption of local biota and game wouldbe of some concern because of ingestion frequency. However,information is not available to determine whether local biota,game and garden produce contain site-related contaminants. Inaddit ion, there is no information about contaminantconcentrations in Beaver Branch or West C o l y e l l Creek.Private W e l l PathwaysThe LDEQ o f f i c i a l s are aware of the existence of two privateshal low w e l l s in the site vicinity. Residents s t opped usingthese w e l l s about 20 years ago when municipal water wasintroduced. The w e l l s were p o s s i b l y in use for about 5-6 yearsat the same time that the f a c i l i t y operated. However, there isconcern that contaminated groundwater contained in the sha l l owaqui f e r beneath the former process area o f f - s i t e could migrateinto ex i s t ing and any fu ture private w e l l s in re s ident ialcommunities. However, the remedial activities w i l l lessen thisp o s s i b i l i t y . Data are not available to adequately determine theextent of the groundwater contamination.Residents who used the private w e l l s b e f o r e municipal water wasintroduced were p o t e n t i a l l y exposed in the past to site-relatedcontaminants through ingestion and dermal contact. Residents whomight construct and use new we l l s in the area may be p o t e n t i a l l yexposed in the fu ture through ingestion and dermal contact.However, the site is presently being remediated which wi l l lessenthe p o s s i b i l i ty of fu ture contamination. Groundwater sampl ingwill be conducted sometime during this year ( 1 9 9 3 ) .Sediment PathwaysW h i l e there are contaminant data for pond s o l id s (s ed iment s) fromthe bottom of some of the former ponds , there is v i r tua l ly no

18

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P U B L I C COMMENT

information about sediments from the bodies of water such asBeaver Branch or the West C o l y e l l Creek or the Amite River.Since there is no in format ion indicating that former site workerswere in contact with sediments confined at the bottom of theformer ponds , the pond sediments wi l l be cal led potentialexposure pathways for any f u t u r e remedial workers. In add i t i on ,i n s u f f i c i e n t information exists for stream sediments while thereis no information on contaminant data for sediments f rom BeaverBranch, Wes t C o l y e l l Creek, and the Amite River. Although theLDEQ has information suggesting that f l o o d s have occurred in thearea in the pa s t , there is no data about surface soi l s f r omresidential areas that might indicate that former pond or streamsediments have contaminated re s idential yards. T h e r e f o r e , streamsediments w i l l also be ca l l ed po t en t ia l exposure pathways.W a s t e M a t e r i a l / W a s t e Water PathwaysSince sample s of the so l id wastes and waste water have not beencollected and analyzed, we do not know contaminant concentrationspresent in the wastes in the past. Former workers on the site whowere in close contact with the contaminanted wastes could havebeen exposed to site contaminants through inhala t ion ofcontaminated air, ingestion of contaminated par t i cu la t e s , andskin contact with contaminated materials. Future exposure to anyremedial workers could be e l iminated if such workers wearprotective equipment and comply with a p p l i c a b l e health and s a f e t yguidelines. It is unl ike ly that children who p layed on the siteb e f o r e the f ence was constructed in the past had access to thestored o i ly waste. However, the H e a l t h Consul tat ion prepared inJune 1992 ( 1 1 ) has referred to the waste and residual water insome of former tanks as f l a m m a b l e because their f l a s h po int s wereunder 37.3 degrees Cels ius while their vapor pressures were below40 pounds per square inch absolute ( p s i a ) .Present and future exposure pathways are el iminated since thesite is being remediated.Pond - -Surface WaterWater on the surface of the former site ponds were sampled andanalyzed. Lead and arsenic were detected at maximumconcentrations of 9.0 and 0.01 p p m , re spect ively. The water onthe surfaces of all the former ponds were covered by oils. It isunlikely that outsiders had access to the contaminated pond watereven before the fence was constructed. Moreover, there is noinformation to suggest that former site workers were involved inany remediation of the ponds. Future exposure to any siteremedial workers could occur unless remedial workers wear

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IP U B L I C C O M M E N T •

Ia p p r o p r i a t e personal protec t ive equipment and c o m p l y witha p p l i c a b l e h ea l th and s a f e t y gu id e l in e s . m

C. El iminat ed Exposure Pathways•Present and f u t u r e exposure to s o i l / s e d i m e n t , air, and s u r f a c ewater) through inges t ion, inhalat ion and dermal contact aree l iminated since the site is being remediated. Remediation ofthe site is expected to be comple t ed by the end of A u g u s t , 1993.

P U B L I C H E A L T H I M P L I C A T I O N S

A. T o x i c o l o g i c a l EvaluationIntroduc t ion

20

IIIT h i s section wi l l discuss the hea l th e f f e c t s in persons exposedto s p e c i f i c contaminants ( f o r comple t ed p a t h w a y s ) , discuss h e a l t h _outcome data and addres s s p e c i f i c community h ea l th concerns. To •evaluate health e f f e c t s , ATSDR has deve loped a Minimal Risk Level •(MRL) for certain contaminants commonly f o u n d at hazardous wastesites. The MRL is an e s t imate of d a i l y human exposure to a •contaminant below which non-cancer, adverse h ea l th e f f e c t s are •u n l i k e l y to occur. MRLs are d eve l oped for each route ofexposure, such as ingestion and inhalat ion, and for the l ength of •exposure, such as acute ( l e s s than 14 d a y s ) , in t e rmed ia t e (15 to |364 d a y s ) , and chronic (equal to or greater than 365 d a y s ) .Sinc e ATSDR has no m e t h o d o l o g y to determine the amount of _absorpt ion of chemicals through the skin, ATSDR does not have IMRLs for skin exposure. For this reason, it is d i f f i c u l t to •determine the heal th e f f e c t s f r o m skin exposure.ATSDR presents these MRLs in T o x i c o l o g i c a l P r o f i l e s . T h e s e |c h e m i c a l - s p e c i f i c p r o f i l e s provide i n f o r m a t i o n on h ea l th e f f e c t s ,environmental transport , human exposure, and regulatory status. HThe f o l l o w i n g discussion is based on the ATSDR T o x i c o l o g i c a l IP r o f i l e s f or benzene, carbon t e t r a c h l o r i d e , e thy lb enzene , l e a d ,styrene and toluene.LAOPH and the ATSDR have determined that residents who live near '•the site, former site workers and children who p layed on the sitewere exposed to several contaminants. Hos t of those contaminants •are l i s t ed in T a b l e 5, in A p p e n d i x B. Each contaminant wi l l be |l i s t ed by route of exposure. To estimate the exposure dose, it

II

P U B L I C COMMENT

was assumed that adul t s , non-pica children and children with picabehavior would ingest 50, 100 and 5000 mi l l igrams ( m g ) of soilper day, respect ively.SmokeExposure to smoke occurred in re s ident s through inhala t ion f romthe f i r e that occurred on the site on February 19, 1992. S i m i l a rexposures to smoke might have occurred in the past . During thef i r e , nine persons were carried to the ho sp i ta l s u f f e r i n g fromsmoke inhalation. The local S h e r i f f ' s o f f i c e also evacuated 30household in the community. The nine p e o p l e who presented to theho sp i ta l with smoke inha la t i on were released shor t ly a f t e r w a r d s( 1 1 ) . A l t h o u g h contaminant l eve l s in the smoke are notavai lable , this health outcome data indicates that the ninep e o p l e s u f f e r e d acute smoke inhalat ion from the burning oils andwastes water in the former ponds. S a m p l e s of o i l s f r om theformer ponds contain PCBs, l ead , chromium, cadmium, and arsenic( T a b l e 1, A p p e n d i x B). Sediments at the bottom of the formerponds also contain s imilar contaminants in a d d i t i o n to benzene,VOCs and P A H s ( T a b l e 1, A p p e n d i x B).Studi e s have shown that smoke inhalation can result in cyanidepo i s on ing which can be treated with hyperbaric oxygen (HBO),al though death has been reported in one pat i ent a f t e r one week ofexposure ( 1 3 ) . Several health e f f e c t s in p e o p l e exposed to smokefrom f i r e in a New J e r s e y chemical d i s p o s a l f a c t o r y containingwastes that included PCBs, benzene and other V O C s , and s l u d g ehave been reported ( 1 4 ) . S y m p t o m s included re spiratory,neurological, and skin problems. A similar ep id emio l og i ca l studyof workers p o t e n t i a l l y exposed to PCBs and other chemicals insmoke f r o m a New York t ran s f ormer f a c t o r y revealed unexp la inedweight lo s s , muscle pa in, frequent cough, skin color changes, andnervousness or s l e ep problems in the p o t e n t i a l l y exposed p e o p l ethree years later ( 1 5 ) . The s e h ea l th e f f e c t s were s imilar tothose reported in the New Jer s ey study above. According to theInternational Agency for Research on Cancer (IARC) s u f f i c i e n tevidence has been uncovered which indicate s that soot iscarcinogenic in humans ( 1 6 ) . IARC based thi s conclusion on theresults of several research in humans which indicate thatexposure to soot caused a s ta t i s t i ca l s i g n i f i c a n t increase indeath due to nonmalignant respiratory tract di sease s , chronicischemic heart disease, lung cancer, e sophageal cancer, laryngealcancer, and primary liver cancer.It is probable that the nine p e o p l e who s u f f e r e d smoke inhalationduring the February 1992 f i r e are l i k e l y to experience some formsof these heal th e f f e c t s in the future due to their exposures. In

21

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22

Ia d d i t i o n , former site workers and residents who live near thesite who may have been present during the f i r e s which occurred on «the site on February 8, 1970 and January 20, 1975 whi l e the site Iwas active are l i k e l y to experience some f o r m s of these heal the f f e c t s due to their past exposures. However, h o s p i t a l recordsand or the re sul t s of e p i d e m i o l o g i c a l s tudy may be necessary to 8c on f i rm this conclusion. •Benzene •Exposure to benzene has p o s s i b l y occurred in re s ident s who livenear the site through inhala t ion, ingest ion and skin contact f r o m _ambient air and soil . C h i l d r e n who p layed on the site b e f o r e the •f e n c e was constructed, and former site workers were al so exposed ™to benzene on site through inha la t i on , inges t ion and skin contactthrough several comple ted exposure pathways ( T a b l e 5, A p p e n d i x •B). •The inhalation exposure in residents and former workers did not •exceed ATSDR's acute MRL for benzene. In a d d i t i o n , the 0.002 ppm |benzene detected in ambient air is 20,000 times less than dosesthat caused acute problems in laboratory animals. However, the _0.0002 ppm benzene detected in ambient air is only 1,000 times •lower than doses of benzene that caused leukemia in humans a f t e r •18 months of occupational exposure ( 1 7 ) . A l t h o u g h ATSDR does nothave oral MRLs for benzene, the estimated inges t ion doses of •benzene for re s ident s , former site workers and ch i ldren who |p layed on the site are some one m i l l i o n times lower that dosesthat caused blood problems in animals. Even at these m u l t i p l e Mexposure pa thways , noncarcinogenic heal th e f f e c t s are u n l i k e l y to Ioccur in re s ident s , former site workers and the ch i ldr en whop l a y e d on the s i te b e f o r e the f e n c e was constructed.The EPA and the International Agency for Research on Cancer •(IARC) consider benzene to be a human carcinogen, based on humanand animal s tudies. We es t imate that re s ident s , f ormer site •workers and children who p layed on the site have no increased •risk of d eve l op ing cancer over a l i f e time.The estimated ingestion dose of benzene for f u tur e remedial Iworkers who might come in close contact with the pond sedimentsis between 200-700,000 times lower than doses that caused bloodproblems in laboratory animals. Potent ial exposure to benzene in •the pond sediments should not cause adverse health e f f e c t s in •fu ture site remedial workers. In add i t i on , such workers wouldhave no increased risk of d e v e l o p i n g cancer over a l i f e t i m e f r om •their po t ent ia l exposure. 8

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P U B L I C COMMENT

Carbon T e t r a c h l o r i d eResidents who live near the site were po s s ib ly exposed in thepast to carbon te trachloride in ambient air. Former siteworkers, and children who p layed on the site were p o s s i b l y alsoexposed to carbon tetrachloride in ambient air on site. Howeverthe inhalation exposure did not exceed ATSDR's intermediateinhalat ion MRL for carbon t e t rach lor ide ( T a b l e 5, A p p e n d i x B) .In add i t i on , the level of carbon te trachloride detected in air isabout 50,000 times lower than the dose that caused liver problemsin humans less than three hours of acute exposure. The level inair is also several thousand times less than doses that causedliver problems in animals a f t e r nine months of exposure ( 1 8 ) . Itis u n l i k e l y that p e o p l e who were exposed would s u f f e r anynoncarcinogenic adverse h e a l t h e f f e c t s .

•A l t h o u g h the EPA and IARC consider carbon t e t r a c h l o r i d e aspo s s i b l e carcinogens, our es t imates show that the p e o p l e who areexposed to the chemical in air have no increased risk ofdeve loping cancer over a l i f e time.EthylbenzeneExposure to e thylbenzene has p o s s i b l y occurred through inha la t i onand skin contact in residents who live near the site. C h i l d r e nwho played on the site and the former site workers were po s s i b lys i m i l a r l y exposed. However, the inhala t ion exposure in residentsand former workers d id not exceed ATSDR's in t ermedia t e inha la t i onMRL for ethylbenzene. In a d d i t i o n , the level of ethylbenzenedetected in air is several thousand times lower than doses thatcaused birth d e f e c t s in laboratory animals a f t e r short-termexposure. The level s detected in air are also several m i l l i o ntimes lower than doses that caused increased number of whiteblood c e l l s in rats a f t e r long term exposure ( 1 9 ) . It i s u n l i k e l ythat residents and former site workers would d e v e l o p adversehealth e f f e c t s f rom their exposure to ethylbenzene in air.LeadChildren who played on the site, and former site workers werep o s s i b l y exposed to lead through inges t ion and skin contact f r o msoil in the former pond and process areas on the site ( t a b l e 5,A p p e n d i x B). ATSDR does not have MRLS and the EFA has no oralR f D s for lead ( 2 0 ) . It i s d i f f i c u l t t o determine what h ea l the f f e c t s are l i k e l y to occur at soil lead values on site.However, e f f e c t s of lead in children general ly occur at lowerblood lead concentrations than in adu l t s . T h i s is because thed ev e l op ing nervous system in ch i l dr en can be a f f e c t e d adver s e ly

23


IIIat blood lead level s of les s than 10 u g / d L . The EPA has recentlydeveloped an integrated U p t a k e / B i o k i n e t i c (IU/BK) model that _examines the r e l a t i o n s h i p between environmental exposure to lead •and blood lead level s in chi ldren under the age of six years. •However, the EPA model is s t i l l being v a l i d a t e d . Level s of leadin surface soils from residential areas, other environmental •media, d i e t , paint intake, etc. are required to determine a more Im e a n i n g f u l blood lead values where actual a n a l y t i c a l values ofblood lead are unavailable. •The p o t e n t i a l exposure to lead in any f u t u r e remedial workers canbe e l iminated if the such fu tur e workers wear a p p r o p r i a t epersonal protec t ive equipment and comply with a p p l i c a b l e h ea l th •and s a f e t y g u i d e l i n e s . •Styrene . •Residents who live near the site have been p o s s i b l y exposed tostyrene through inhalat ion in ambient air. C h i l d r e n who p layed Mon the site, and former site workers were p o s s i b l y exposed to •styrene through inhalat ion in ambient air on site ( T a b l e 5,A p p e n d i x B). A l t h o u g h ATSDR does not have inha la t i on MRLs andEPA has no R f C s for styrene, the styrene in air is some 7,000 Itimes lower than doses that caused irri tat ion of the u p p e r •re spiratory track in laboratory animals. The air level is alsoabout 10,000 times lower than doses that caused EEC abnormali t i e sin humans ( 2 0 ) . It is u n l i k e l y that r e s id en t s , f ormer workersand ch i ldren who p layed on the site would s u f f e r noncarcinogenichea l th e f f e c t s f r o m their exposures. _A l t h o u g h IARC considers styrene to be a p o s s i b l e human ™carcinogen, re s ident s and workers have no increased risk ofd e v e l o p i n g cancer over a l i f e t i m e . IT o l u e n eExposure to toluene p o s s i b l y occurred in former site workers,chi ldren who p layed on the s i te , and res idents who use the o f f -site parking in the former process area. The inges t ion exposure Min non pica chi ldren and a d u l t s at the parking area and former •site workers on site did not exceed EPA's oral RfD for toluene( T a b l e 5 , A p p e n d i x B). Adverse heal th e f f e c t s are un l ik e ly tooccur because of those exposures. However, al though ATSDR does Inot have oral MRLs for toluene, the ingestion exposure in pica •citron at the former process area on site exceeded EPA's RfD fortoluene. I n f o r m a t i o n about heal th e f f e c t s in humans f o l l o w i n goral exposure to low level s of toluene is pr e s en t ly unavai lable;and there are l imi t ed animal s tudies on the e f f e c t s of oral

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P U B L I C COMMENT

exposure to toluene ( 2 1 ) . The estimated dose for pica childrenwho played on the site is about 5,000 times lower than doses oftoluene that caused behavioral toxici ty in laboratory animalsa f t e r 42 days of exposure ( 2 1 ) . It is t h er e f or e u n l i k e l y thatthe few children who practice pica who s u f f e r any adverse heal the f f e c t s from their exposures.The po t en t ia l exposure to toluene in any fu tur e site remedialworkers is in s ign i f i can t , and can also be eliminated if theworkers wear appropria t e personal protective equipment and complywith a p p l i c a b l e health and s a f e t y gu ide l ine s .In addi t ion to benzene, lead and toluene po t ent ia l exposurescenarios discussed above, po t en t ia l exposure to several othercontaminants ( T a b l e 1, A p p e n d i x B) to remedial workers can alsobe e l iminated if remedial workers wear appropr ia t e personalprotective equipment and comply with a p p l i c a b l e heal th and s a f e t yguidelines.

B. H e a l t h Outcome Data EvaluationTumor RegistryThe Louisiana Tumor Registry (LTR) contains i n f o r m a t i o n about thenumber of cases by cancer site, zip code, age, race and sex forthe f i v e regions in the state. The in format ion is complete forall f i v e regions f r om 1983 to 1987 ( A p p e n d i x C). An evaluationof da ta f r om the registry ( T a b l e 6- 24, A p p e n d i x B) detectedexcess cases of only malignant melanoma, cervical and prostatecancer. The excess pros tate cancer was s t a t i s t i c a l l ys i g n i f i c a n t . However, excesses of mal ignant melanoma andcervical cancer were not s t a t i s t i c a l l y s i g n i f i c a n t . In a d d i t i o n ,analyses of all other sites and for all sites combined indicatedno excess of cases in Livingston Parish relat ive to southernLouisiana. Human studies reviewed for the t ox i co log i ca levaluation have not linked cervical and pros tate and othercancers of community concern cancers to exposure to p a r t i c u l a t e sin smoke from burning oi l s containing chemicals detected on thesite. iHowever, the cancer data evaluation was l imited by the lack ofavailable data s p e c i f i c to the p o p u l a t i o n l iving next to thesite. The popu la t i on of Livingston Pari sJi is larger than thep o t e n t i a l l y exposed p o p u l a t i o n , and re l iab l e data exc lus ively forthe adjacent areas were not available. Cancer data by censustracts were only available for one year and, there fore , notconsidered to be representative. Cancer data by zip code areas

25


were considered unreliable because of the arbitrary di s tr ibut ionof boundaries, which crossed pari sh lines in some cases.

Public H e a l t h S t a t i s t i c sBesides cancer, the most f r e q u e n t l y reported i l l n e s s e s ofcommunity concern were chronic respiratory problems such asasthma, chronic bronchitis, emphysema, and general d i f f i c u l t y inbreathing ( d y s p n e a ) . W h i l e these conditions are not p l a u s i b l yrelated to exposure to site contaminants of concern, exposure ofresidents to smoke from three f i r e s of burning o i l s and wastescontaining PCBs, PAHs, VOCs and heavy meta l s may be r e spon s i b l efor some of the noncarcinogenic heal th e f f e c t s reported by someresidents.Based on the t ox i co log i ca l data reviewed ( 1 5 , 1 6 ) , exposure tosmoke f r o m burning o i l s and chemical wastes at the Combust ion,Inc. site is l i k e l y to cause respiratory and neurologicalsymptoms, nausea and vomiting, muscle pa in s , and skin colorchanges and irritations.Respiratory i l ln e s s e s are d i f f i c u l t to evaluate because they arenot rou t ine ly reported to a regi s try in Loui s iana. Incidencedata are there fore not available. The most severe of thesecases, however, may progress to a condi t ion known as chronicobstructive pulmonary disease ( C O P D ) . M o r t a l i t y data f or COPDa r e avai lable through t h e Louisiana O f f i c e o f Publ i c H e a l t h ' sSec t i on o f Pub l i c H e a l t h S t a t i s t i c s . T a b l e 24 ( A p p e n d i x B) showsthe S t a n d a r d M o r t a l i t y Ratio for deaths related to COPD. Theannual observed death rate is somewhat higher than the annualexpected death rate for COPD in Livingston Parish. However,since these data represent the entire pari sh p o p u l a t i o n f r o m 1983to 1987 rather than only those persons p o t e n t i a l l y a f f e c t e d bysmoke inhalat ion during the three f i r e s , the excess in Livings toncannot be so le ly attributed to the site.There are also several major l imi ta t i on s in evaluating COPD basedon mor ta l i ty data alone. Because COPD is a condit ion associatedwith m u l t i p l e f a c t o r causation, it is impo s s i b l e to a t tr ibu t emor ta l i ty rates to any s p e c i f i c exposure. A l s o , COPD is achronic condition that progress very s l owly . T h u s , moreindividuals in an area may have the disease than die f rom itduring a given period of time. F i n a l l y , . t h o s e with COPD o f t e ndie of other causes and deaths reported may not take thecondition into account as an underlying fa c t or . T h u s , mor ta l i tyrates alone may not give an accurate indication of the scope ofthe disease.

26

IIIIIIIIIIIIIIIIIII


C. Community H e a l t h Concerns EvaluationWe have addressed the community health and other concerns asf o l l o w s :1. Are residents being exposed to unsafe levels of sitechemicals through the publ i c drinking water?

No. Drinking water is not a source of human exposure tosite contaminants. The Livingston Parish H e a l t h Unit andthe O f f i c e o f Publ i c H e a l t h conduct regular s a m p l i n g of thepub l i c drinking water s u p p l y to ensure it s s a f e t y . T h i ssampl ing indicates that contamination of the drinking waterby site chemicals has not occurred. It al so provides asa f eguard against the p o s s i b i l i t y of f u t u r e contamination.On August 22, 1991, the Louisiana O f f i c e of Public H e a l t hconducted s a m p l i n g in response to community concerns thatthe drinking water was being contaminated because of waterp i p e s in the Burgess Road area pas s ing through contaminatedsoil. Water sample s f r o m the p i p e s in question wereanalyzed for the presence of site contaminants , i n c l u d i n gmetal s and hydrocarbons. The water was determined to bes a f e .

2. Are re s ident s who use private w e l l s being exposed to u n s a f elevels of contamination by drinking contaminatedgroundwater?No. S i t e contaminant level s of concern in the localgroundwater have been detected only in the shal low aqui f erbeneath the process area. No private water w e l l s contactthat aqu i f e r , and it is not otherwise used as a drinkingwater source.

3. What is the di s tance to the nearest house f r o m the site?ATSDR's preliminary health assessment o f 1989 stated thatthe house closest to the site is a p p r o x i m a t e l y 200 yardsaway. That is incorrect. There is a house a p p r o x i m a t e l y 20yards west of the process area, and one a p p r o x i m a t e l y 200yards southwest of the pond area.

27


28

III4. Were p e o p l e exposed to un sa f e level s of contamination duringthe f i r e s of 1970 and 1975 and 1992? What p lans have been •made for the community in the event of fu tur e f i r e s ? |It is not p o s s i b l e at present to determine concentrations of _contaminants v o l a t i l i z e d during the f i r e s of 1970, 1975, and I1992, because air monitoring was not conducted during or •immedia t e ly f o l l o w i n g those events.Some acute symptoms such as d i z z i n e s s and l igh t-headedne s s |may have a f f e c t e d some persons during the f i r e s . Thephys i ca l hazard of smoke inhala t i on could p o s s i b l y have •resul ted in scarring or edema of the r e sp i ra t ory system Iamong those acutely exposed to large amounts of smoke. T h a tcould p o s s i b l y lead to chronic re sp iratory prob l ems forcertain ind iv idua l s . T o x i c o l o g i c a l data reviewed indicate s Ithat p e o p l e exposed to chemical f i r e s containing s imi lar •chemicals detected in the o i l s and wastes on the site haves u f f e r e d re spiratory, neurological and skin prob l ems , muscle •pains, vomiting and nausea. However, it should be |emphasized that no cases of scarring or edema of therespiratory system re su l t ing f r o m inhala t ion of smoke f r o m •site f i r e s have been reported to LAOPH. LAOPH is p l a n n i n g •to inves t igate that p o s s i b i l i t y fur th er .

5. Have un sa f e l eve l s of contamination in the f ormer pond area •been transported of f site during area f l o o d i n g ?A l t h o u g h severe f l o o d i n g in the area has been r epor t ed , |ex i s t ing o f f - s i t e soil sampl e s indica t e concentrations o fsite chemicals are too low to produce adverse hea l th _e f f e c t s . A decrease in concentration is to be expected Ibecause any material transported during f l o o d i n g would be m

h i g h l y d i l u t e d . O f f - s i t e soil s a m p l i n g has not beenconducted in the re s ident ial area closest to the f ormer pond Iarea. I6. Are p e o p l e being exposed to unsa f e l evel s of contaminants •through ingest ion of local game and f i s h / or through |vegetables from local gardens?

S a m p l i n g data on surface soi l s from gardens or re s ident ia l •yards and local game and f i s h is needed to determine if they m

have been contaminated by si te-related chemicals in thepast. •

II


7. W i l l remediation cause unsafe levels of toxins to vo la t i l i z einto tbe air? W i l l the community have to be evacuated?Extensive air monitoring with s tate-of-the-art equipment isbeing conducted throughout the remediation process to guardagainst un sa f e releases. I f l eve l s increase s i g n i f i c a n t l y ,act ivity wil l be halted be fore an u n s a f e release occurs.Thus it is very unl ike ly that evacuation would becomenecessary. To be c omp l e t e ly prepared, however, LAOPH hasrecommended the development of an emergency evacuation p l a n ,which is in e f f e c t at present.

8. Are cancers in the area caused by chemicals f r o m the site?Local residents have reported numerous t y p e s of cancer inthe area. Most of these cancers are not related to sitecontaminants. Some of the cancers reported are associatedwith concentrations of some of the chemicals of concernunder certain conditions. T h i s would be l i k e l y for thoseresidents who were exposed to smoke from burning oils andwastes containing PCBs, PAHs, VOCs, and heavy metals.However, given the low concentrations of such chemicals inknown human pathways, and given the l i m i t e d exposure timeso f p o t e n t i a l l y exposed p o p u l a t i o n s o f f s i t e , i t i s h i g h l yunl ik e ly that the most cancers reported by the community ares i t e-re lated.

9. Are other i l lne s s e s in the area caused by exposure to sitecontaminants ?Rashes and skin irritation, respiratory, neurological andmuscles pins reported by the local p o p u l a t i o n have beenfound in p e o p l e who have been exposed to smoke f r o m burningwastes containing chemicals s imilar to those found in theburning o i l s and wastes in the former ponds at the site. Inaddi t i on, the physical hazard of smoke inhalat ion couldpo s s i b ly have resulted in scarring or edema of therespiratory system among those acutely exposed to largeamounts of smoke. T h i s could p o s s i b l y have led to chronicrespiratory problems for certain ind iv idual s . It should beemphasized that no scarring or edema of the respiratorysystem resul t ing from inhalation of smoke from site f i r e shas been reported to LAOPH. LAOPH is p l a n n i n g to f u r t h e rinvestigate this p o s s i b i l i t y .

29


III10. Has exposure to site contaminants caused a leukemia c lu s t erin the area? _SEE evaluated the LTR for p o s s i b l e leukemia cluster in the ™Walker-Denham S p r i n g s area in 1983 and again in 1991. Acancer cluster is an unusual amount of a kind of cancer in a •given area. Evaluations for the two per iod s showed that •there were many kinds of cancers involved, rather than acluster of a s ingle type of leukemia. The numbers of the •various types of cancer cases detected were not unusual •( A p p e n d i x E) .

30

IIIIIIIIIIIII


C O N C L U S I O N S

1. Based on the information reviewed, the LAOPH has concludedthat the Combustion, Inc. site is currently an indeterminatepub l i c heal th hazards. It was a pub l i c h ea l th hazard in thepast because of past exposure to smoke f r o m the February1992 f i r e which caused acute smoke inhalat ion in someresidents.2. At pre s ent , the site is being remediated. Remediat ionstarted in J u l y , 1992, during which o i l s / s l u d g e s f r o m al lthe tanks and ponds were inc inerat ed , contaminated s o i l s andother m a t e r i a l s / d e b r i s were t r a n s f e r r e d to l a n d f i l l , and thesur fac e water onsite is being treated (so far 11 m i l l i o ng a l l o n s has been t r e a t e d ) currently. Ambient air is beingmonitored at present. Groundwater onsite w i l l be sampledsometime this year ( 1 9 9 3 ) . Remediation wi l l be comple t ed bythe end of Augus t , 1993 (Source: L D E Q ) .3. Residents who live near the site, former site workers andchildren who p layed on the site be fore the fence wasconstructed were po s s i b ly exposed to benzene, carbont e trachlor ide , e thylbenzene, and styrene through inhalationand dermal contact f r om ambient air. However, adversehealth e f f e c t s are not l i k e l y to occur because of the lowlevels of exposure.4. Former site workers and ch i ldr en who p l a y e d on the site werep o s s i b l y exposed to benzene, l e a d , and toluene throughinges t ion and skin contact f r o m s o i l s in the former pond andprocess areas on the s i te , and in the park ing p la c e of theformer process area off site. Resident s were al so p o s s i b l yexposed to toluene f r o m soil in the parking area. However,adverse heal th e f f e c t s are not l i k e l y to occur because ofthe low ingest ion exposures.5. Potential pathways in the past for human exposure to smoke,PCBs, P A H s , VOCs, and heavy metals included f l a m m a b l e andignitable oils and waste water stored in former tanks, pondwater and sediments and oil s on the surfaces of the formerponds. Consumption of local f i s h and game, and contaminatedwell water were also potent ial exposure pathways. FuturePotential exposure to contaminants could be eliminated iffuture remedial workers wear appropriate personal protectiveequipment and comply with a p p l i c a b l e health and s a f e t yguidelines.

31


III6. Several h ea l th questions were received f r o m re s ident s aboutthis site. T h e s e concerns have been summarized and »addressed in the Community H e a l t h Concerns Evaluat ion Isubsection of the Publ i c H e a l t h I m p l i c a t i o n s section. m

7. Evaluat ion of hea l th outcome data showed excesses of Icervical and pro s ta t e cancers, mal ignant melanoma, and •chronic obstructive pulmonary disease (COPD) in Liv ing s t onParish. However, the cancer data for the p o p u l a t i o n nearthe site is not avai lable . COPD is a chronic condi t ion thatprogresses very s l ow ly , there fore mor ta l i ty data alone isnot an indicat ion of the disease. T h e r e f o r e a d d i t i o n a l data _and i n f o r m a t i o n are required to adequa t e ly addres s the Icommunity h ea l th concerns. •R E C O M M E N D A T I O N S •

1. Conduct a d d i t i o n a l s a m p l i n g s of the groundwater near theformer pond area, and of the s ha l l ow groundwater •contamination f r o m the f ormer process area and analyze for •s i te-related contaminants.2. Conduct soil s a m p l i n g for all r e s i d e n t i a l areas to the •southwest of the f ormer f e n c e d ponds . •

Conduct biota s a m p l i n g f r om the stream that received •di s charges f r om the f ormer ponds . T h i s stream empt i e s intoBeaver branch and West C o l y e l l Creek.A. H e a l t h A c t i v i t i e s Recommendation Panel IIn accordance with the Comprehensive Environmental Response ,Compensa t i on , and L i a b i l i t y Act ( C E R C L A ) of 1980, the data and Ii n f o r m a t i o n deve loped in the Combust ion, I n c . , H e a l t h Asses sment •have been evaluated by the H e a l t h A c t i v i t i e s Recommendation Panel(HARP) for f o l l o w - u p heal th actions. HARP concluded that a •f o l l o w up p u b l i c meeting should be held to e x p l a i n the re su l t s of |this p u b l i c h ea l th assessment. As a f o l l o w up to the h ea l thoutcome data ana ly s i s , LAOPH w i l l conduct a review of area h ea l th •s t a t i s t i c s , in c lud ing f u r t h e r inve s t igat ions of cancers and COPD, Iand w i l l f ur th er inves t igate reported cases of smoke inha la t i onduring area f i r e s .

32

III

P U B L I C COMMENT

B. Public H e a l t h Act ionsActions Undertaken:1. LAOPH w i l l recommend that local authori t i e s d e v e l o p a p l a nfor evacuation of the local community in the event of asite-related emergency.2. LAOPH wil l recommend that the appropr ia t e state agencyconduct add i t i ona l s a m p l i n g as s p e c i f i e d in the p u b l i chealth assessment, and improve site security, inc ludingre s tr i c t ing access to o f f - s i t e monitoring equipment.Actions Planned:1. L A O P H - w i l l fur ther investigate reported cases of smokeinhalat ion during past s i te-related f i r e s .2. LAOPH wil l conduct a f o l l o w - u p analys i s of local heal th datainc lud ing f u r t h e r analys i s of cancer and COPD s ta t i s t i c s .3. LAOPH wi l l recommend that the a p p r o p r i a t e s tate agencycharacterize and assess the po t en t ia l for e f f e c t s on ed ib l ebiota in the intermittent stream, Beaver Branch, and WestC o l y l e l l Creek.4. LAOPH wi l l conduct a f o l l o w - u p p u b l i c meeting to e x p l a i n theresults of the pub l i c health assessment to the localcommunity.

33


PREPARERS OF REPORT

J E F F R E Y D A V I S P U R V T S , M . P . H .Louisiana O f f i c e o f Publ i c H e a l t hEnvironmental E p i d e m i o l o g y

Y A - F E N C H A N G P U R V I S , M . S . P . H .Louisiana O f f i c e o f Publ i c H e a l t hEnvironmental E p i d e m i o l o g yS A L L Y K E N D R I C K , M . S .Louis iana O f f i c e o f Pub l i c H e a l t hEnvironmental E p i d e m i o l o g y

M U Z A F F A R U D D I N A H M A D W A H A J , M D , M P HLouisiana O f f i c e o f Publ ic H e a l t hEnvironmental Epidemio logyA T S D R R E G I O N A L R E P R E S E N T A T I V E

George Pet t igr ewRegional ServicesO f f i c e o f t h e Ass i s t an t A d m i n i s t r a t o rAgency for T o x i c Subs tance s and Disease Regis tryEPA Region VI

A T S D R T e c h n i c a l P r o j e c t O f f i c e rW i l l i a m J . GreimEnvironmental H e a l t h S c i e n t i s tDivis ion of H e a l t h Asses sment & C o n s u l t a t i o nRemedial Programs Branch

34

IIIIIIIIIIIIIIIIIII


S E L E C T E D B I B L I O G R A P H Y1. Preliminary Remedial Inve s t iga t i on Report: Combustion, I n c . ,V o l . 1, ERM-Southwe s t , I n c . , March 30, 1990.2. Preliminary Publ i c H e a l t h Evaluation and EndangermentAssessment: Combustion, I n c . , ERM-Southwest , I n c . , January 25,1990.3. Remedial Action Objec t ive s and I n i t i a l T e c h n o l o g y Screening:Combust ion, I n c . , ERM-Southwe s t , I n c . , J u l y 2 4 , 1990.4. Prel iminary H e a l t h Assessment for Combustion, I n c . , preparedby Agency for T o x i c Substances and Disease Regi s try, A p r i l 10,

1989.5. S i t e Inspe c t i on F o l l o w - u p Report for the Combustion, I n c . ,S i t e , The Earth T e c h n o l o g y Corporat ion, March, 1985.6. Community Relations P l a n , Combust ion, I n c . , S i t e , Livings tonParish, Louisiana, LDEQ-Inact ive and Abandoned S i t e s Division,June 1989.7. Memorandum, K . B . Jackson, T A T - R e g i o n VI to K. S o l a r i , OSC-EPARegion VI, W e s t o n - S p e r , August 12, 1985.8. Memorandum, P. K a f f k a , FIT Chemist to E. S i e r r a , Region VIRPO, Ecology and Environment ,Inc. , November 6, 1989.9 . Memorandum, ERM-Southwe s t , I n c . , t o S. L i n g l e , H a z a r d o u s S i t eEvaluat ion Divis ion, September 27, 1989.1 0 . Memorandum, J . C u l l i n a n e , Enviresponse, I n c . , t o J . K o p p e n ,January 27, 1986: Air Tube A n a l y s e s included in: Memorandum,P. Campagna, Environmental Response Branch to M. M. M c K e e ,Region VI, J u l y 16 , 1986.11. M u z a f f a r u d d i n Ahmad W a h a j . Leukemia Clu s t e r I n v e s t i g a t i o n ,Livingston Parish, O f f i c e o f Public H e a l t h , January, 1992.12. H e a l t h Consu l ta t i on for Combustion, I n c . , Liv ing s t on Parish,Louisiana, ATSDR, June , 1992.13. Memorandum, C.E. Wes t erman, Tox i c on "Laboratories, I n c . , toDEQ-Inactive and Abandoned S i t e s , May 22, 1985.

35


14. H a r t , GB; S t r a u s s , MB; Lennon, PA; W h i t c r a f t , DD. Treatmentof smoke inhalation by hyperbaric oxygen. J Amerg Med; Vol 3,211-5, 1985.1 5 . H a l p r i n , W ; L a n d r i g a n , P J ; A l t m a n , R ; laci A W ; Mors e , D L ;Needham LL. Chemical f i r e at toxic waste d i s p o s a l p l a n t :E p i d e m i o l o g i c study of exposure to smoke and fumes. Journalo f th e M e d i c a l S o c i e t y o f New J e r s e y , V o l . 78 , N o . 9 , 591-

594,1981.1 6 . F i t z g e r a l d , E F ; W e i n s t e i n , A L ; Y o u n g b l o o d , L G ; S t a n d f a s t , S T ;M e l i u s , J M . H e a l t h e f f e c t s three years a f t e r po t en t ia lexposure to the toxic contaminants of an e l e c t r i ca lt rans f ormer f i r e . Arch Environ H e a l t h ; Vol 44, 214-21, 1989.17. ARC monographs on the evaluation of the carcinogenic risk ofchemicals to humans, V o l . 35, po lynuc l ear aromatic compounds,part 4, bitumens, coal-tars and derived produc t s , s ha l e -o i l s ,and soot, page s 219-241, 1985.18 . T o x i c o l o g i c a l P r o f i l e f o r Benzene, ATSDR, October, 1991.1 9 . T o x i c o l o g i c a l P r o f i l e f o r Carbon T e t r a c h l o r i d e , A T S D R ,October, 19902 0 T o x i c o l o g i c a l P r o f i l e f o r E t h y l b e n z e n e , A T S D R , December, 1990.21. T o x i c o l o g i c a l P r o f i l e f or Styrene , ATSDR, December, 1989.2 2 . T o x i c o l o g i c a l P r o f i l e f o r T o l u e n e , A T S D R , December, 1989.

36

IIIIIIIIIIIIIIIIIII


4T1

A P P E N D I C E S

37


A p p e n d i x A . F i g u r e s

A-l

IIIIP A I H S l A Y / C t T C H

KCH c rCU N £ F C I X 3HIM V C C W C t PCU N E S J F r C O T

2CUJ S7C2*

WCMTCH IfT- •CnlilD H G S J 4 G

ureI . ,Pond Area . L o c a t i o n H a p

III

A-2

F i g u r e 2.;- P r o c e s s A r e a L o c a t i o n H«ip ,'

A-3

IIIIIII— -« — *• —

M f t f l r * r / a t C H

C M £

wocrss «t*SJC*»Ct UMSS

pr/0

BOI«TCI< «"•-0«».t.tB §S««:

tn>o<

I

1

I

I

I

1

I

I

I

I

f r - Y

1It

Ozrc-u

CaasK-toa

Xys


A p p e n d i x B. T a b l e s

B-l


T a b l e 1. On-site Contamination

Medium Contaminant Range inProcess Area( p p m )Range in PondArea ( p p m )

Comparison V a l u ep p m Source

S u r f a c ewater LeadArsenic

N o t T e s t e dN o t T e s t e d

0.009 - 9.00.006 - 0.010

0 . 0 5 / 00.003

M C L / M C L GR f D

Oils PCBsLeadChromiumCadmiumArsenic

27.0 - 52.0103.0 - 600.03.9 - 24.00.025 - 2.80.75 - 1.1

10.0 - 69.014.0 - 106.01.7 - 6.20.30.25

0.000050 . 0 5 / 00.05" / 1 0 b

0.0020.003

EMEGM C L / M C L GR f DEMEGR f D

S o i l BenzeneT o l u e n eLead

0.012 - 0.0460.027 - 980.0

3.1 - 402.0

0.95 - 6.110.006 - 34.0

9.1 - 178.0

20400 Picachi ldNone

CREGRMEG

Nonea - RfD for chromium +6.b - RfD for chromium +3.

B-2


T a b l e 1 ( c o n t . ) - On-site Contamination

Medium Contaminant Range in TankW a s t e s / S o l i d s( p p m )Range in PondS o l i d s / S e d i m ent s (ppm)

Comparison Valueppm Source

S o l i d s( S e d i m e n t s ) PCBsLeadChromium -T o t a lCadmiumBenzeneDi-2 ( e t h y l h e x y l )phthala t eTolueneT o t a l X y l e n e sN a p h t h a l e n ePhenanthrenePyrene

N o t Tes t edNot DetectedN o t Tes t edN o t Tes t edNot T e s t e dNot Tes t ed

Not Tes t edN o t Tes t edNot T e s t e dN o t Tes t edNot Tes t ed

1.0 - 10.016.0 - 1100.06.8 - 120.0

1.0 - 6.531.0 - 81.029.0 - 35.0

53.0 - 160.0

0.81 - 560.011.0 - 280.027.0 - 400.010.0 - 160.0

0.01NA250 a / 5 0 0 0 0 b

0.42040

400 Picachild4000N o n eNone1500

EMEGN aR f DEMEGCREGR f D

RMEG

R f DNoneNoneR f D

a - RfD for chromium +6b - RfD for chromium +3B-3


T a b l e 2 . O f f - s i t e contamination

Medium Contaminant

Groundwater 1,2 Dichloroethane

Level inProcess Area( p p m ) Level in PondArea ( p p m )Comparison Value

ppm

0.011 Not Detected 0.00038

Source

CREG

Sediment s Benzene N o t T e s t e d 0.005 20 CREG

S o i l BenzeneT o l u e n e

0.014 -0.0460.015 - 0.32

N o t T e s t e dN o t T e s t e d

20

400

CREG

RMEG

B-4


T a b l e 3. O f f - s i t e Ambient Air S a m p l e sContaminant

BenzeneCarbonTetrach lor id eEthylbenzeneStyrene

ConcentrationRange - m g / m 3

0.000650.00045

0.000515

0.00049

Date

9-908-89

8-89

8-89

Reference( Agency, #)

LDEQ222

Comparison V a l u em g / m 3

0.00010.0000671None

SourceCREGCREGR f CN o n e

B-5


T a b l e 4. Exposure Pathways at Combus t ion/ I n c .Pathway Name

S o i l s

O i l / F i r *

Ambient A i r

Exposure P a t h w a y E l e m e n t sSource

Combustion, Inc .

Combustion, I n c .

Combus t ion, I n c .

W a s t e M a t e r i a l s

S e d i m e n t s

Food C h a i n

Privat e W e l l s

Combus t ion, I n c .

Combust ion, I n c .

Combus t i on , I n c .

Combust ion, I n c .

M e d i a Point of Exposure

C o m p l e t e d Expo sur e Pathwayssoil

A i r

A i r

Process and Pond AreasOn and Off s i t e

On-si t e AreasO f f - s i t e Residences

on and o f f s i t e

Route ofExposure Exposed P o p u l a t i o n

DermalI n h a l a t i o nI n g e s t ionI n h a l a t i o nDermal

I n h a l a t i o n

P o t e n t i a l Exposure PathwaysW a s t e sA i r

S e d i m e n t s in Streamand Ponds

L o c a l b i o t ai n c l u d i n g f i s h a n dgameGroundwater( P r i v a t e w e l l )

On s i t eN e a r b y Residences

On s i t e

Residence s O f f s i t e

Residences, t apO f f s i t e

I n g e s t i onI n h a l a t i o nDermal

I n g e s t ionDermal

I n g e s t i o n

I n g e s t ion

Nearby res identsand c h i l d r e n us ingabandoned s i t e asa p l a y areaNearby ResidentsFormer workers ons i t e

F o r m e r workers ons i t eLocal re s idents

T i m e

PastPresentF u t u r ePastF u t u r e

PastPresentF u t u r e

L o c a l r e s i d e n t sFormer workers ons i t eC h i l d r e n P l a y i n gon s i t eFormer workers ons i t eL o c a l r e s i d e n t sR e s i d e n t s whogarden, hunt andf i s h in the areaResident s usingp r i v a t e w e l l wateras p o t a b l e waters u p p l y

PastF u t u r e

PastF u t u r ePastPresentF u t u r eF u t u r e

B-6


T a b l e 5. Comparison of Estimated Exposed Dose to H e a l t h G u i d e l i n e s for Residents. Foraer S i t e Workers and C h i l d r e n Who Played On the S i t e

Contaminant

BenzeneBenzene

BenzeneBenzene

Carbon T e t r a c h l o r i d eEthy lb enz eneLeadLeadS t y r e n eT o l u e n e

T o l u e n eT o l u e n e

Exposure Pathway

O f f - s i t e A i rO n - s f t e S o i l ProcessAreaQn-site S o i l Pond AreaO f f - s i t e S o i l ProcessAreaO f f - s i t e A i rO f f - s i t e A i r

On- s i t e Soi l ProcessA r e aOn- s i t e Soi l Pond AreaO f f - s i t e A i rOn- s i t e Soi l ProcessAreaOn- s i t e S o i lPond A r e aO f f - s i t e S o i l ProcessArea

H e a l t h G u i d e l i n eV a l u e

0.002 pomNone

NoneNone

0.01 pan0.3 ppm

NoneN o n eN o n e0.2 m g / k g / c t e y

0.2 m g / k g / d a y0.2 m g / k g / d a y

Source

A c u t e M R L

N o n e

N o n eNone

I n t e r * M R LI n t e r * M R L

None

N o n eN o n eR f D

R f O

R f D

Exceeded byE s t i m a t e d ExposedDoseN oN oNoneNoneN oN oNoneN o n enoneY e sP i c a O n l yN oN o

* I n t e r « I n t e r m e d i a t e .

B-7


T a b l e 6 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F E S O P H A G E A L C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

OBS. P A R I S H RATE S . L A R A T E E X P .AGE -" *< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

C A S E POP" PER00000000 .0111140100

682164386542566458176919658558374130295824982756207117011314

885489291

100,000 PER 100,0000.000.000.000.000.000.000.000.000.006.768.017.269.66

47.030.00

22.600.000.00

000000

0.20.61.75.79.6

1519.422.420.720.623.824.2

0 / EC A S E R A T I O.00.00.00.00.00.00

0.070.180.350.841.202.072.011.911.360.910.580.35

0.000.000.001.190.830.480.502.100.001.100.000.00

T O T A L 9 6 Q 7 1 f i — — — — ____ , , Q ,

S M R X 2 T E S T p - V A L U E0.76 0.67 0.25<p<0.50 A N N U A L R A T E

2 . 5 8 / 1 0 5 POP.E X P E C T E D R A T E3 . 3 9 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Par i sh ,** Data source: Louisiana O f f i c e of Publ i c H e a l t h .

B-8

IP U B L I C COMMENT

T a b l e 7 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F S T O M A C H C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A T »X V J, n tmt

S M R X 2

0.46

OBS.C A S E

000000011000120131

10

T E S T6.41

PARISH RATPOP.* PER

682164386542566458176919658558374130295824982756207117011314

885489291

69716

p - V A L U Ep < 0.01

E S. LA R A T E100,000 PER

0.000.000.000.000.000.000.003.434.840.000.000.009.66

23 .520.00

22.60122.70

68.73

ANNUAL RJ2 . 8 7 / 1 0 5

E X P .100,000

000

0.10.00.40.71.93.75.5

10.116.722.834.262.763.292.189.0

iTEPOPN

0 / EC A S E.00.00.00

0.03.000.140.230.550.760.81

.262.302.36

.914.12

.802.251.29

O1 QO4 J. . OZ

E X P E C T E D6 . 2 6 / 1 0 5

R A T I O

0.000.000.001.801.310.00

0.000.000.42

0.690.00

0.361.330.77

R A T EPOPN

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of Liv ing s t on Parish.** Data source: the Louisiana O f f i c e of Public H e a l t h .

B-9

IIIIIIIIIIIIIIIIII


T a b l e 8 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F L U N GL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987: C A N C E R FOR

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A T .

OBS.C A S E

00000012I5

17213136313010

5i Q n

P A R I S HPOP.*

682164386542566458176919658558374130295824982756207117011314

885489291

f iQ _71 I

RATE S. LAPER 100,000

0.000.000.000.000.000.003.046.854.84

33.81136.11152.39299.37423.28471.84677.97409.00343.64

S — — — — —

R A T E E X P .PER 100,000

0.400

0.30.40.42.66.4

27.655.1

114.5206.6282.8

365432.2405.3373.4235.1

0 / EC A S E0.14

.00

.000.080.120.140.861.875.708.15

14.3028.4729.2831.0428.4017.93

9.133.42

i ~7Q ni

R A T I O0.00

0.000.000.001.171.070.180.611.190.741.061.161.091.671.101.46

S M R X 2 T E S T1.06 0.67

p - V A L U E0.25<p<0.50 A N N U A L RATE

54 .51/10 5 POP.E X P E C T E D RATE5 1 . 3 6 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Pari sh ,** Data source: the Louisiana O f f i c e of Publ i c H e a l t h .

B-10


T a b l e 9 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F M A L I G N A N T M E L A N O M A F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

SMR X*1.39

OBS.C A S E

000000262132132010

23

T E S T2.51

P A R I S H R A T E S. LAPOP.* PER 100,000

682164386542566458176919658558374130295824982756207117011314

885489291

69,716

p - V A L U E0.10<p<0.25

0.000.000.000.000.000.006.07

20.569.696.76

24.0214.51

9.6635.2730.440.00

40.900.00

R A T E E X P .PER 100,000

00.10.40.51.43.55.27.46.48.59.99.5

1316.316.819.223.825.3

A N N U A L R A T E6.6C >/105 POP.

O / EC A S E.00

0.030.130.140.411.211.712.161.321.261.241.311.351.391.100.850.580.3716.55

E X P E C T E D4.75/10 5

R A T I O

0.000.000.000.000.001.172.781.510.802.431.530.742.161.810.001.720.00

R A T EPOP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Par i sh ,** Data source: the Louisiana O f f i c e of Publ ic H e a l t h .

B-ll


T a b l e 1 0 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F O T H E R S K I N C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

OBS. P A R I S H R A T E S . L A R A T E E X P . O / EAGE C A S E POP.* PER 100,000 PER 100,000 C A S E R A T I O

< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

0000000001000000001

682164386542566458176919658558374130295824982756207117011314

885489291

69,716

0.000.000.000.000.000.000.000.000.006.760.000.000.000.000.000.000.000.00

000

0.20.50.91.52.40.60.91.11.10.8

22.3

613.28.8

.00

.00

.000.060.150.31O.490.700.120.130.140.150.080.170.150.270.320.13

3.^7

0.000.000.000.000.000.007.510.000.000.000.000.000.000.000.00

— — — — — _ _ _

S M R X 2 T E S T p - V A L U E A N N U A L R A T E E X P E C T E D R A T E0.30 1.67 0.10<p<0.25 0 . 2 9 / 1 0 5 POP. 0 . 9 7 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Pari sh .** Data source: the Loui s iana O f f i c e of P u b l i c H e a l t h .

B-12

IP U B L I C C O M M E N T

T a b l e 1 1 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F P R O S T A T E C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

iwraT.

OBS.C A S E

0000000002476

23161113

6on

P A R I S HPOP.*

682164386542566458176919

. 658558374130295824982756207117011314

885489291

«Q T\

RATE SPER 100,

000000000

13325057

270243248531412

fi —

. LA,000.00.00.00.00.00.00.00.00.00.52.03.80.94.43.53.59.70.37

RATEPER 100,

0

02

123989

164238300368304

E X P .,000.10000000

.6

.8

.1

.9

.6

.1

.2

.9

.4

.4

0/EC A S E0.03

.00

.00

.00

.00

.00

.00

.000.120.41

.515.509.28

13.9615.6513.31

9.01.43

it •>•>

RAT:0.

0.4.

2.651.0.1.1.0.1.

1.35

CO00

0083276565028344

S M R X 2 T E S T p - V A L D E1.20 2.98 0.05<p<0.10

A N N U A L R A T E2 S . 2 5 / 1 0 5 POP.

E X P E C T E D R A T E21.00/10 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of Liv ing s t on Parish.** Data source: the Louisiana O f f i c e of Publ i c H e a l t h .

B-13

IIIIIIIIIIIIIIIIII

P U B L I C COMMENT

T a b l e 1 2 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F BLADDER C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

OBS.C A S E

001000111122671672

38

P A R I S HPOP.*

682164386542566458176919658558374130295824982756207117011314

885489291

69.7K

R A T E S. LAPER 100,000

0.000.003.060.000.000.003.043.434.846.76

16.0114.5157.9482.3015.22

135.59286.30137.46

R A T E E X P .PER 100,000

00

0.20.20.20.50.92.44.78.8

15.130.442.263.294.1

111.8129.9135.2

0/EC A S E.00.00

0.070.060.060.170.300.700.971.30

.89

.194.375.386.184.953.181.97T R " 7 1

R A T I O

15.290.000.000.003.371.431.030.77

1.060.48

1.371.300.161.212.201.02

SMR X* TEST1.06 0.15 p - V A L U E

p > 0.50A N N U A L RATE1 0 . 9 0 / 1 0 5 POP.

E X P E C T E D RATE1 0 . 2 5 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n P a r i s h ,** Data source: the Louisiana O f f i c e of Publ i c H e a l t h .

B-14


IIIT a b l e 1 3 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F K I D N E Y C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A / 1983-1987:

A G E< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

SMR X*0.98

O B S .C A S E

000000020323224411

24

T E S T0.01

P A R I S H R A T E S . L A R A T EPOP.* PER

682164386542566458176919658558374130295824982756207117011314

885489291

69,716

p - V A L U Ep > 0.50

E X P .100,000 PER 100,000

0.000.000.000.000.000.000.006.850.00

20.2816.0121.7719.312 3 . 5 260.8890.4040.9068.73

A N N U A L RATE6 . 8 9 / 1 0 5 POP

20.20.2

00.20.61.43.45.3

10.215.819.230.846.649.453.652.638.5

•

0 / EC A S E R A T I O0.680.060.07

.000.060.210.460.991.091.511.97

.65 13.193.963.252.371.290.5624.37

E X P E C T E D6 . 9 9 / 1 0 5

0.000.000.000.000.000.002.020.001.991.01

.130.630.501.231.690.781.79

R A T EPOP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of Liv ings t on Parish.** Data source: the Louis iana O f f i c e of P u b l i c H e a l t h .

B-15

IIIIIIIIIIIIIIII


T a b l e 1 4 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F B R A I N C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A T .

OBS.C A S E

011001101100022001

1 1

P A R I S HPOP.*

682164386542566458176919658558374130295824982756207117011314

885489291

fiQ .71 l


0.003.113.060.000.002.893.040.004.846.760.000.000.00

2 3 . 5 230.44

0.000.00

68.73K — — — — — —

R A T E E X P .PER 100,000

2.52.42.11.51.52.52.54.84.67.69.4

13.718.220.620.721.518.97.7

0/EC A S E0.850.770.690.420.440.860.821.400.951.121.171.891.881.751.360.950.460.111 1 QO

R A T I O0.001.291.460.000.001.161.210.001.050.890.000.000.001.141.470.000.008.93

S M R X 2 T E S T p - V A L U E0.61 2.67 0.10<p<0.25 A N N U A L RATE

3 . 1 6 / 1 0 5 POP.E X P E C T E D R A T E5 . 1 4 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of Liv ing s t on Parish.** Data source: the Louis iana O f f i c e of P u b l i c H e a l t h .

B-16


T a b l e I S . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O FL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

L E U K E M I A F O R

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

OBS.C A S E

200100110001233202

18

P A R I S HPOP.*

682164386542566458176919658558374130295824982756207117011314

885489291

6 9 . 7 K


5.860.000.003.530.000.003.043.430.000.000.007.26

19.3135.2745.6645.20

0.00137.46

5 — — — —

RATE EXP.PER 100,000

6.32.51.42.21.51.91.73.55.47.68.3

10.415.9

.848.263.270.762.6

0/EC A S E2.150.800.460.620.440.660.561.021.121.121.041.431.65

2.363.17

.801.730.91OA m

R A T I O0.930.000.001.610.000.001.790.980.000.000.000.701.21

1.270.95

0.720.002.20

j

S M R X 2 TEST p - V A L U E A N N U A L R A T E0.75 1.51 0.10<p<0.25 5 . 1 6 / 1 0 5 POP. E X P E C T E D R A T E

6 . 8 9 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Parish.** Data source: the Louisiana O f f i c e of Publ i c H e a l t h .

B-17

I I


O B S . P A R I S H R A T E S . L A R A T E E X P . O / EAGE C A S E POP. PER 100,000 PER 100,000 C A S E R A T I O

< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

000012612311115000

24

6821643865425664581769196585

. 58374130295824982756207117011314

885489291

69,716

0.000.000.000.003.445.78

18.223.439.69

20.288.017.269.66

11.7676.10

0.000.000.00

0000

1.14.6

88.8

10.49.99.7

12.313.210.212.615.118.923.1

.00

.00

.00

.000.321.592.632.572.151.461.211.691.370.870.830.670.460.34• j a . i f i

3.131.262.280.390.932.050.830.590.731.156.040.000.000.00

S M R X 2 T E S T p - V A L U E A N N U A L RATE E X P E C T E D RATE1.32 1.88 0.10<p<0.25 6 . 8 9 / 1 0 5 POP. 5 . 2 1 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Parish.** Data source: the Louis iana O f f i c e of Publ i c H e a l t h .

B-18


T a b l e 1 7 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F O V A R I A N C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

OBS.C A S E

000000011211231210

15

P A R I S HPOP.*

682164386542566458176919658558374130295824982756207117011314

885489291

69.711


0.000.000.000.000.000.000.003.434.84

13.528.017.26

19.3135.2715.2245.2040.90

0.005 — — — —

RATE E X P .PER 100,000

00

0.50

0.50.91.42.84.19.59.6

11.914.323.719.7

2728.830.8

0/EC A S E.00.000.16

.000.150.310.460.820.851.411.201.641.482.021.291.190.700.4514. i •*

R A T I O

0.000.000.000.001.221.181.420.830.611.351.490.771.671.420.00

S M R X 2 T E S T p - V A L U E1.06 0.05 p > 0.50 A N N U A L RATE

4 .30/10 5 POP,E X P E C T E D R A T E4 . 0 5 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of Liv ing s t on Pari sh ,** Data source: the Louisiana O f f i c e of Pub l i c H e a l t h .

B-19

1II1IIIIIIIIIIII1I


T a b l e 18 . A G E - S P E C I F I C STANDARDIZED M O R B I D I T Y R A T I O OF COLON C A N C E R FORL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987$

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84

> 84T O T A T .

O B S .C A S E

001101112355

10151012

52

74

P A R I S HPOP.*682164386542566458176919658558374130295824982756207117011314

885489291

f i Q _ 7 1 l


0.000.003.063.530.002.893.043.439.69

20.2840.0336.2896.57

176.37152.21271.19204.50137.46

K — — — — —

R A T E EXP .PER 100,000

00

0.10.20.50.82.54.9

1021.639.7

59110.4161.3

215276.2

333359.3

0/EC A S E.00.000.030.060.150.280.821.432.073.194.968.13

11.4313.7214.1312.22

8.145.23RR aa

R A T I O

30.5717.66

0.003.611.210.700.970.941.010.610.871.090.710.980.610.38

S M R X 2 T E S T p - V A L U E A N N U A L R A T E E X P E C T E D R A T E0.86 1.67 0.10<p<0.25 2 1 . 2 3 / 1 0 5 POP. 2 4 . 6 7 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Parish.** Data source: the Louisiana O f f i c e of Pub l i c H e a l t h .

B-20


T a b l « 1 9 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F R E C T A L C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

IIA G E

< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

S M R X 2

0.95

OBS.C A S E

000001011033643510

OQ4O

T E S T0.08

P A R I S H R A T :POP.* PER

682164386542566458176919658558374130295824982756207117011314

885489291

69,716

p - V A L U Ep > 0.50

E S. LA RATE100,000 PER

0.000.000.000.000.002.890.003.434.840.00

24.0221.7757.9447.0345.66

112.9940.90

0.00

A N N U A L R A T E8 . 0 3 / 1 0 5 PO

E X P .100,000

0.10

0.10

0.10.80.71.64.19.3

17.528.241.850.2

.9 486.186.3

89

P.

0 / EC A S E0.03

.000.03

.000.030.280.230.470.851.382.193.894.334.27

.40 03.812.111.2990 c%*7&y • w /

E X P E C T E D8 . 4 8 / 1 0 5

R A T I O0.000.000.003.610.002.141.180.001.370.771.390.94

.681.310.470.00

R A T EPOP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Parish.** Data source: the Louisiana O f f i c e of Public H e a l t h .

B-21

II1II1IIIIiiiiii


T a b l e 2 0 . A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O O F L I V E R C A N C E R F O RL I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A / 1983-1987:

AGE< 55-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

O B S .C A S E

000000001120132311

15

P A R I S HPOP.*

682164386542566458176919658558374130295824982756207117011314

885489291

69,716

R A T E S . LAPER 100,000

0.000.000.000.000.000.000.000.004.846.76

16.010.009.66

35.2730.4467.8040.9068.73


0.4000

0.20.20.60.7

256

1012.121.634.3

4441.948.4

0 / EC A S E0.14

.00

.00

.000.060.070.200.200.410.740.751.38

.251.842.251.951.020.7012.96

R A T I O0.00

0.000.000.000.002.421.352.670.00

0.801.630.891.540.981.42

S M R X 2 T E S T p - V A L U E1.16 0.32 p > 0.50 A N N U A L R A T E

4 . 3 0 / 1 0 5 POP. E X P E C T E D R A T E3 . 7 2 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of Liv ing s t on Par i sh ,** Data source: the Louis iana O f f i c e of P u b l i c H e a l t h .

B-22

-̂ -̂^ - • - ...=

T a b l e 21.L I V I N G S T O N

— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — ^ _____

PUBLIC COMMENT

A G E - S P E C I F I C S T A N D A R D I Z E D MORBIDITY R A T I O OF P A N C R E A S C A N C E R FORPARISH COMPARED TO S O U T H E R N LOUISIANA, 1983-1987:

OBS. PARISH RATE S. LA RATE E X P . O/EAGE C A S E POP.* PER 100,000 PER 100,000 C A S E R A T I O— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —

5-910-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84> 84

T O T A L

0000000000000100102

S M R X 2 T E S T0.07 23.11

682164386542566458176919658558374130295824982756207117011314

885489291

69,716

p - V A L U Ep < 0.01

0.000.000.000.000.000.000.000.000.000.000.000.000.00

11.760.000.00

40.900.00

000

0.10.10.10.50.83.43.8

11.922.233.345.968.299.4

105.3127.5

A N N U A L RATE0.57/10 5 POP. 7

* Parish populat ion is based on 1984** Data source: the Louisiana O f f i c e

0000000.030.030.030.160.230.700.561.493.06

.45 03.904.48

.40 02.571.8626.96

0.000.000.000.000.000.000.000.000.00

.000.260.00

.000.390.00

E X P E C T E D RATE.73/ 105 POP.

popu la t i on of Livingston Parish,of Public H e a l t h .

B-23

1I Ii111I1I11 1

III P U B L I C C O M M E N T

^I OBS. P A R I S H R A T E S . L A R A T E E X P . O / E* -— -~~ " n n "TPTS inn nnn C A S E R A T I OOtib. J f / V R X o n ««-»*— — - —— -_.AGE C A S E P O P / PER 100,000 PER 100,000 C A S E R A T 1 U

< 5 3 6821 8.80 16.6 5.66 0.535-9 3 6438 9.32 8.5 2.74 1.10

10-14 4 6542 12.23 9.4 3.07 1.3015-19 4 5664 14.12 14.3 4.05 0.9920-24 5 5817 17.19 21.1 6.14 0.8125-29 18 6919 52.03 39.8 13.77 1.3130-34 26 6585 78.97 67.9 2 2 . 3 6 1.1635-39 37 5837 126.78 118.4 34.56 1.0740-44 37 4130 179.18 197.6 40.80 0.9145-49 50 2958 338.07 323.9 47.90 1.0450-54 64 2498 512.41 501.8 62.67 1.02----- K K O T O 772.1 106.40 0.72

" " ' 1511.8 128.58 1-15re-™ 1x3 i3i4, »»•»«, lllll ll?:9i'« 1.1760.1332.66907.88

L J J . 1 j . / J - . ? « - ' - » —75-79 114 885 2576.27 2195 7 ^"?-!} ?, 81 1US:S; «"-9 32-66 !:!!.> 84 27 291T O T A L 912 69,716

IIIIIII S M R X 2 T E S T p - V A L U E A N N U A L R A T E E X P E C T E D R A T E1.00 0.02 p > 0.50 2 6 1 . 6 3 / 1 0 5 POP. 2 6 0 . 4 5 / 1 0 5 POP.

* Parish p o p u l a t i o n is based on 1984 p o p u l a t i o n of L i v i n g s t o n Parish.** Data source: the Louisiana O f f i c e of Pub l i c H e a l t h .

iiii B-24

P U B L I C COMMENT

T a b l « 23 . SUMMARY T A B L E OF A G E - S P E C I F I C S T A N D A R D I Z E D M O R B I D I T Y R A T I O OFC A N C E R S F O R L I V I N G S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A , 1983-1987:

S I T E SMR X 2 T E S T p - V A L U EE S O P H A G U SS T O M A C HL U N GM E L A N O M AO T H E R S K I NP R O S T A T EBLADDERK I D N E YB R A I NL E U K E M I AC E R V I XOVARYCOLONR E C T U ML I V E RP A N C R E A SA L L S I T E S

0.760.461.061.390.302.501.060.980.610.751.321.060.860.951.160.071.00

0.676.410.672.511.672.980.150.02.71.511.880.051.670.080.32

23.110.02

0.25<p<0.50p<0.010.25<p<0.500.10<p<0.250.10<p<0.250.05<p<0.10p>0.50p>0.500.10<p<0.250.10<p<0.250.10<p<0.25p>0.500.10<p<0.25p>0.50p>0.50p<0.01p>0.50

B-25

IIIIIIIIIIIIIIIIIII

III P U B L I C C O M M E N T

I able 24 . A G E - S P E C I F I C STANDARDIZED MORTALITY R A T I O OF C H R O N I C O B S T R U C T I V EU L M O N A R Y D I S E A S E . F O R L I V I N 6 S T O N P A R I S H COMPARED T O S O U T H E R N L O U I S I A N A ,

1983-1987:

t11I1111111111

AGE< 55-14

15-2425-3435-4445-5455-6465-7475-84> 84

D B S .C A S E

001016

172527

6

PARISH R A T E SPOP.* PER 100,

6821129801148113504

99675456482730151374

291T O T A L 83 69,716

S M R X Z T E S T p - V A L U E1.42 10.42 p < 0.01

* Parish popu la t i on is** Data source: the LOUJ

00102

2170

165393412

basedisiana

. LA000

.00

.00

.74

.00.01

.99

.44

.84

.01

.37


0.350.380.330.642.189.98

47.71138.40252.04264.59

A N N U A L RATE2 3 . 8 1 / 1 0 5 POP.

on 1984 p o p u l a t i tO f f i c e o f Public

B-26

0 / EC A S E R A T I O0.120.250.190.431.092.72

11.5120.8617.32

3.8558.34

E X P E C T E D16.74/10

an of LivirH e a l t h .

0.000.005.280.000.922.201.481.201.561.56

RATE5 POP.

igston I


A p p e n d i x C. H e a l t h Outcome Data Sources

C-l


A P P E N D I X C: HEALTH OUTCOME D A T A SOURCES

P U B L I C H E A L T H S T A T I S T I C S , O F F I C E O F P U B L I C H E A L T H , L O U I S I A N AD E P A R T M E N T O F H E A L T H A N D H O S P I T A L S :T h e O f f i c e o f Publ ic H e a l t h ' s Sec t i on o f Publ i c H e a l t h S t a t i s t i c sis re spons ib le for c ompi l ing , ana lyz ing , and report ing all vitals t a t i s t i c s in Louis iana. The section maintains a computerizeddatabase of births, dea th s , s t i l l b i r t h s , induced abortions,marriages, and divorces. The section p a r t i c i p a t e s in the nationalbirth and death regis tration system and provides s t i l l b i r t h andmarriage data to the N a t i o n a l Center for H e a l t h S t a t i s t i c s andinduced abortion data to Centers for Disease C o n t r o l .C e r t i f i c a t e s of vi tal events and repor t s of communicable d i s ease sare ca ta logued by res idence addre s s f r o m 1960 to the p r e s e n t , andare ava i lab l e upon request. In a d d i t i o n , a monograph d i s p l a y i n gtrends in disease by parish is produced annua l ly .L O U I S I A N A T U M O R R E G I S T R Y , O F F I C E O F P U B L I C H E A L T H , L O U I S I A N AD E P A R T M E N T O F H E A L T H A N D H O S P I T A L S :The Louisiana Tumor Registry (LTR) is a popula t ion-bas ed registrythat covers all h o s p i t a l s , radiation centers, and p a t h o l o g ylaboratories in the state. The LTR was e s tab l i shed in 1974 byCharity H o s p i t a l in New Orleans as a cancer registry for the NewOrleans area when LOHH f i r s t began to p a r t i c i p a t e in theSurvei l lance, Epidemiology and End Results ( S E E R ) program of theNational Cancer I n s t i t u t e (NCI). In 1979, the LTR was transferredt o the s t a t e ' s O f f i c e o f Pub l i c H e a l t h a s a p i l o t f or a s tatewideregistry. Since 1983, LTR has g r a d u a l l y expanded by region;coverage of the entire state was achieved in 1988.The LTR is composed of f i v e regional regis tries; each region isresponsible for the complete ascertainment of all cancer casesdiagnosed a n d / o r treated in its re s idents . A monograph wasproduced in 1990 that includes all cases of cancer diagnosedduring the period January 1, 1983, through December 31, 1986.The monograph l i s t s frequency of incident cases by age, a d j u s t e dincidence rates by race, sex, and region, cumulative rate (age 0- 7 4 ) , and average annual age-ad ju s t ed rates. Incidence ratesare computed with p o p u l a t i o n estimates by age, sex, and race foreach geographic region. The p o p u l a t i o n es t imates used are f romthe U.S. Bureau of the Census, and from Louisiana TechUniversity. In addit ion to the monograph, number of cases bycancer site, zip code, age, and sex are maintained in acomputerized database. That in f ormat i on is avai lab l e for all ofLouisiana from 1983 to 1987.

C-2


A p p e n d i x D. Request for H e a l t h C o n s u l t a t i o n and Advi s ory

D-l

IP U B L I C COMMENT I

A P P E N D I X D : REQUEST F O R H E A L T H C O N S U L T A T I O N A N D A D V I S O R Y :

TO: Uni t ed S t a t e s Agency for T o x i c Subs tance s and Disease ™RegistryF R O M : J e f f r e y Purvis, M . P . H . ILouis iana O f f i c e o f P u b l i c H e a l t h ,S e c t i o n of Environmental E p i d e m i o l o g y •T H R O U G H : Raoult Ratard, M . D .Dianne Dugas, M . S . W . , M . P . H .RE: Request for H e a l t h C o n s u l t a t i o n : •Combustion, I n c . , S i t eA T T N : W i l l i a m Greim |George Pe t t igr ew

T h e Louisiana O f f i c e o f P u b l i c H e a l t h ' s S e c t i o n o f EnvironmentalE p i d e m i o l o g y is requesting the Agency for T o x i c Subs tance s andDisease Registry to comment on the pub l i c heal th i m p l i c a t i o n s of •combust ib le or i g n i t a b l e material s being stored on site at the ™Combustion, I n c . , S u p e r f u n d S i t e ( C E R C L I S N O . L A D 0 7 2 6 0 6 - 6 2 7 ) . W eare concerned about the phys ical hazard presented by on-site •f i r e s and also about the p o s s i b i l i t y of r e su l t ing human exposure |to site chemicals.On February 19, 1992, at approx imat e ly 7:10 P . M . , an on-site f i r e Iwas reported to the Distric t 4 F i r e Department of L i v i n g s t o nParish. The f i r e involved a s i n g l e p o n d , Pond H, and burned andsmoldered for approx imat e ly an hour be fore it was ext inguished. •T h e local S h e r i f f ' s o f f i c e reported that i t evacuated »a p p r o x i m a t e l y 30 households f r o m the Burgess Road-Dubose Lanearea during the f i r e , and returned res idents a f t e r w a r d s . •A p p r o x i m a t e l y nine p e o p l e went to the East Baton Rouge Medica l JjCenter with symptoms of smoke inhalation and were releasedshort ly th e r ea f t e r . The Louisiana Department of Environmental •Qual i ty a n d t h e S h e r i f f ' s O f f i c e invest igated t h e f i r e . T h e f i r e •occurred in the s i t e ' s pond area, a f enced area that stores o i ly m

wastes in an interconnected series of man-made ponds. ( S e eb e l ow). The suspected cause of the f i r e is arson. flThe Combustion, I n c . , site is in Livingston Parish, Loui s iana,about two miles northwest of W a l k e r , Louisiana. A d j a c e n t to the •site is a re s ident ial community of thirty-s ix households known as gjthe Dubose Subdivi s ion. The most recent available count of houses

D-2


near the site was done by EPA in J u l y 1985. That indicated therewere 399 peop l e within one mile of the site, 236 p e o p l e withinone h a l f - m i l e , and 122 p e o p l e in 32 houses within one quarter-mile of the site. There are no schools, churches, h o s p i t a l s , orparks within a one mile radius of the site.The site consists of a former proce s s ing area that s t i l l houses anumber of h o l d i n g tanks containing o i ly wastes, and a separatearea, about one h a l f - m i l e away, consi s t ing of several tanks andfour t e en unlined s h a l l o w ponds. Oily wastes were f o r m e r l y p ipedf r o m the proces s ing area and d e p o s i t e d in the pond area. Bothareas are f enced and pos ted as dangerous. The nearest houses liea p p r o x i m a t e l y twenty yards to the west of the process area andone hundred yards to the southwest of the pond area.The process area cons i s t s of e ighteen above-ground tanks andassociated p i p e s , p u m p s , and boi lers . The area al so contains aboiler shed and pump house that h o l d s drummed wastes f r o m theremedial inve s t iga t ion work. All above-ground tanks contain somef r e e oil. On-site contamination detected during the RemedialInve s t iga t ion is d e ta i l ed in T a b l e A. Tanks 3 and 13 containcombustible or ign i tab l e l iqu id s which are a f i r e hazard. Twof i r e s have occurred in the process area: the f i r s t on February 8,1970, and the second f o l l o w i n g an exp lo s i on on January 20, 1975.The ponds are estimated to contain almost four mi l l i on gal lons ofo i l , water, and s o l id s , exc luding p o t e n t i a l l y a f f e c t e d soilsbeneath the ponds. Seven of the ponds have an oil layer, composedof a free oil surface layer and underlying waxy emulsion layer,above oi ly water and so l id s . The remaining ponds contain waterand s o l id s with lesser amounts of o i ly material. Seven of theponds have an oil layer above o i ly water and s o l id s . Theremaining ponds contain water and s o l i d s with lesser amounts ofo i ly material.In June 1988, Combustion, I n c . , was placed on the NPL by theUnited S t a t e s Environmental Protection Agency. As a result ofinvestigations by Louisiana Department Environmental Qual i ty( L D E Q ) and the Louisiana Department of J u s t i c e , twenty-sixp o t e n t i a l l y re spons ib l e par t i e s ( P R P s ) were i d e n t i f i e d . LDEQand EPA entered into an enforcement agreement, d e s i g n a t i n g LDEQas the lead agency to oversee and manage the remediation of thesite by the PRPs. Remedial I n v e s t i g a t i o n ac t iv i t i e s concluded inA p r i l 1989. A Work Plan for Removal A c t i o n —— Phase 1 wassubmitted in May 1990. To date , t h i r t y - f i v e drums have beenremoved from the process area. Removal of other material is notscheduled for the immediate fu ture .

D-3


The p o s s i b i l i t y of f i r e s is both a phys ical hazard and apo t en t ia l pathway for exposure to site contaminants. To preventf i r e s , the contents of all ponds and tanks, p a r t i c u l a r l y tanks 3and 13, should be removed f rom the site immedia t e ly , and fur therremediation should proceed in a t ime ly f a s h i o n . If removal ofthose mater ia l s is not f o r t h c o m i n g , ATSDR should issue anadvisory for emergency action.

D-4

IIIIIIIIIIIIIIIIII


A p p e n d i x E. Summary of Leukemia C l u s t e r I n v e s t i g a t i o n s

E-l


A P P E N D I X B: SUMMARY OF L E U K E M I A C L U S T E R INVESTIGATIONS:1. An early report of leukemia cluster in W a l k e r could not beconfirmed :T h i s report updat e s the 1983 inves t igat ion in l ight of add i t i onalreports of cancer in W a l k e r , Liv ings ton Parish. In 1983, theEnvironmental E p i d e m i o l o g y S e c t i o n o f th e Louis iana O f f i c e o fPublic H e a l t h (SEE/OPH) received reports of a po s s i b l e cancercluster in W a l k e r , Louisiana. Four ch i ldr en enrol l ed in akindergarten class at W a l k e r Elementary Schoo l were reported tohave been diagnosed with leukemia. OPH obtained medical recordson three of the f o u r cases. T h e y were not leukemia cases butthree d i f f e r e n t t y p e s o f cancer: one m e d u l l o b l a s t o m a , one d i f f u s emalignant l y m p h o b l a s t i c lymphoma, and one chondrosarcoma in theright ischium with me ta s ta s i s to the mas to id . Two of the threecases had moved to W a l k e r a f t e r the d i a g n o s i s was made. OPHconcluded that there was no c lu s t er because consi s t ency ofdiagnos i s and temporal as sociat ion were la ck ing .

2. I n v e s t i g a t i o n of s ixteen cancer cases reported in 1991 ;In J u n e 1991, the law f i r m of F a y a r d , H a r r i s , Roethe l e , andHoneycut t reported 16 p o s s i b l e cancer cases to O P H / S E E , in c lud ingthe three cases already investigated in 1983. Conf irmat ion ofdiagnoses in the form of medical records were not provided. Thef i r m also reported one case of an u n s p e c i f i e d immune systemde f i c i ency , and a number of individuals "very sick" with anu n s p e c i f i e d condition. S p e c i f i c d iagnose s , date o f diagnose s ,medical records, f u l l names and, in some cases, names were notprovided.Of the 16 reported cases, six involved cancers other thanleukemia: one neuroblastoma, one u n s p e c i f i e d f o r m of lymphoma,one m e d u l l o b l a s t o m a , one bone cancer, one colon cancer, and onebrain cancer.The remaining 10 cases involved some type of leukemia: one casehad no other information except for f i r s t name; one was anu n d e f i n e d "virus i n f e c t i o n with leukemoid reaction and problemwith lymph nodes". Of the eight remaining cases, three were acutelymphocytic leukemia (ALL), one was acute myelocytic leukemia andacute lymphocyt i c leukemia (AML/ALL), and three were u n s p e c i f i e dleukemia. I n f o r m a t i o n on residence at time of birth and residenceat time of diagnosis was not provided for seven of the eightremaining cases.

E-2


IIISEE conf irmed 14 cases of malignancies f r om the l i s t of 16reported cases, through O f f i c e of P u b l i c H e a l t h and Baton RougeTumor Registry. T a b l e 1 shows the d i s t r i bu t i on of these cases by •leukemia t y p e , birth p la c e , year of d iagno s i s , age at d iagno s i s , Iand residence at the time of d iagnos i s . The six cancers otherthan leukemia were c o n f i r m e d . The remaining eight cases included •f i v e ALL, one AML/ALL, one AML, one CML. T h i s included one old Icase invest igated in 1983.The evaluation of the reported cases mentioned above by the law 8f i r m was l i m i t e d by the lack of ava i lab l e data on leukemia as •well as other sites of cancers by the O f f i c e of Publ i c H e a l t h ,which provide s data f r o m 1983-1987. T h i s l i s t of s ixteen p o s s i b l e •cancers do not const i tute a cluster in i t s e l f because of the |diver s i ty of tumor s i t e s , however it led SEE to inve s t igat ef ur th er . . _3. SEE has evaluated the ava i lab l e cancer data f r o m 1983 - 1987 *for Denham S p r i n g s , and Liv ing s t on Parish :Standard iz ed Morb id i ty Ratios (SMRs) were the major measurement •used to evaluate incidence rates for leukemia. SMR is the ratioof total observed cases in the s tudy p o p u l a t i o n to to ta l expectedcases in a comparison p o p u l a t i o n . An SMR of one shows that thes tudy p o p u l a t i o n has the same rate than the comparisonpopu la t i on . An SMR greater than one shows that the study mp o p u l a t i o n has more leukemia than the comparison p o p u l a t i o n and Ian SMR lower than one shows that the study popu la t i on has less ™leukemia than in the comparison p o p u l a t i o n . C a l c u l a t i o n of SMRstakes into account the i n f l u e n c e of age, since expected cases are •ca l cu la t ed for each age group. •T a b l e 2 shows the age- sp e c i f i c leukemia rates per 100,000res idents in Denham S p r i n g s ( s t u d y p o p u l a t i o n ) and Livings t onParish (comparison p o p u l a t i o n ) from 1983 to 1987. The ages p e c i f i c morbidi ty ratios were calculated for each age group m( l e f t co lumn). A ratio lower than one shows that Denham S p r i n g s •had less leukemia than Livingston Parish in that age group. The ™overall SMR has been calculated. It summarizes the comparison forall age groups together. The SMR for leukemia was 0.77, meaning •that Denham S p r i n g s had only three quarters of the leukemia cases Ithatwould be expec ted. There was no excess of leukemia cases inDenham S p r i n g s related to Livingston Parish.The annual leukemia incidence rate for Livings ton Parish is5.1 /100,000 p o p u l a t i o n ( T a b l e 3). An incidence rate is thenumber of new cases of a disease over a s p e c i f i e d time per iod.

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provided and reviewedI

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T A B L E 1: C O N F I R M E D C A S E S OF L E U K E M I A AND O T H E R C A N C E R SREPORTEDC A S E S A G E1 062 063 074 075 096 217 318

1 052 063 064 075 156 15

B I R T HSEX P L A C EM UNKNOWNM L O U I S I A N AM B. ROUGEM UNKNOWNM UNKNOWNM B. ROUGEF U N K N O W NM ALBANY

M U N K N O W NM T H I B O D E A UM B. ROUGEF B. ROUGEM L O U I S I A N AF U N K N O W N

ALL = Acute Lymphocyt icCML = Chronic M y e l o c y t i c

•

D A T E OF DX0 4 / 7 90 6 / 8 90 8 / 8 30 6 / 8 211/900 9 / 9 01 0 / 8 9

O T H E R0 7 / 8 308/810 8 / 8 20 4 / 8 60 8 / 8 301/87LeukemiaLeukemia

L E U K E M I A T Y P EA . L . L . & A M LA . L . L .A . L . L .A . L . L .A . L . L .A . L . L .A . M . L .C . M . L .

C A N C E R SP R O S T A T E C A N C E RCHONDROSARCOMAM E D U L L O B L A S T O M AN E U R O B L A S T O M AA S T R O C Y T O M ACOLON C A N C E R

_

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P U B L I C COMMENT

REPORTEDR E S I D E N C EAT DX.

O H I OW A L K E RBATON ROUGED E N H A M S P .D E N H A M S P .W A L K E RD E N H A M S P .U N K N O W N

S L A U G H T E RW A L K E RD E N H A M S P .W A L K E RD E N H A M S P .D E N H A M S P .

•

i11111111111Il i111

I"


2 ASB S P E d F I C STANDARDIZED MORBIDITY RATIO OF LEUKBKIA FOR DEHHAK' TO L I Y I H G 8 T O M P A R I S H . W83-87:

t OBSERVEDGE C A S E S

K S I-15 0

16-17 0§8-20 0

1-24 025-44 1

— 4 5 - 5 4 0•55-59 0"60-64 1

65-74 4•> 74 1

TOTAL 8| S T A N D A R D I Z E D

111111111

D E N H A M RATE L V N G S T O N R T . E X P .POP. PER 100,000 PER 100,0003326 6.01 7.078406 0.00 0.001379 0.00 8.701956 0.00 0.002174 0.00 0.00

13968 1.43 1.724279 0.00 0.001484 0.00 7.661379 14.50 15.902034 39.33 32.841268 15.77 37.68

41,653 — — — — — — — —M O R B I D I T Y R A T I O = 0.77

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0/EC A S E R A T I O

1.18 0.850.00 0.000.60 0.000.00 0.000.00 0.001.20 0.830.00 0.000.57 0.001.10 0.913.34 1.202.39 0.4210.37 ——


T A B L E 3 . L E U K E M I A I N C I D E N C E RATE F O R L I V I N G S T O N P A R I S H , *1983 - 1987 BY AGE C A T E G O R Y :

IOBSERVED L I V I N G S T O N R A T E

AGE C A S E S P O P U L A T I O N PER 100,000 •< 55-1516-1718-2021-2425-4445-5455-5960-6465-74> 74

20100201264

5657142202299328637542319072162612251636532123

7.070.008.700.000.001.720.007.6615.9032.8437.68

T O T A L 18 70,526* 5.10

IIII

A N N U A L I N C I D E N C E R A T E I N L I V I N G S T O N P A R I S H - 5.10 / 100,000 •* P o p u l a t i o n source: Bureau of the Census , W a s h i n g t o n DC.

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P U B L I C COMMENT

TABLE 4. DISTRIBUTION OF L E U K E M I A C A S E S IN DENHAM SPRINGS AND REST OFT H E L I V I N G S T O N P A R I S H , 1983-1987 :OBS.C A S E S A G E SEX D A T E OF DX. L E U K E M I A T Y P E R E S I D E N C E

12345678

0335636572727396

F 0 5 / 8 6M 0 5 / 8 3M 08/86M 0 9 / 8 4M 0 1 / 8 3F 0 5 / 8 5M 1 2 / 8 3F 0 3 / 8 3

A. L. L.A . L . L .A . M . L .C . M . L .A . L . L .C. L. L.A . L . L .C • J_i . LJ .

D E N H A M S P .D E N H A M S P .D E N H A M S P .D E N H A M S P .D E N H A M S P .D E N H A M S P .D E N H A M S P .D E N H A M S P .

O T H E R / P L A C E S123456789

10ALL =AML =CLL =CML =

03163256616669777887

AcuteAcute

M 0 6 / 8 5M 0 8 / 8 3M 0 5 / 8 3F 0 9 / 8 6M 0 2 / 8 7M 01/83M 11/87F 0 6 / 8 5M 10/87F 10/84

Lymphocytic LeukemiaMyelocyt i c Leukemia

A . L . L .A. L. L.A . M . L .C . M . L .C . L . L .C. L. L.A . M . L .A . L . L .L. C. L.A . M . L.

A L B A N YA L B A N YL I V I N G S T O NF . S E T T L E M E N TA L B A N YHOLDENS P R I N G F I E L DS P R I N G F I E L DL I V I N G S T O NS P R I N G F I E L D

Chronic Lymphocyt i c LeukemiaChronic M y e l o c y t i c Leukemia

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