* St. Louis

La Oroya *

Study of Environmental Study of Environmental Contamination of a Mining Contamination of a Mining and Smelting Town in Peruand Smelting Town in PeruPresentation to:

St. Louis Section AIHA

February 17, 2006

By:David A. Sterling, Ph.D., CIHFernando Serrano, MSAngela Hobsen, MPHSaint Louis University School of Public Health

22

International collaboration of an environmental exposure International collaboration of an environmental exposure study in La study in La OroyaOroya, Peru & the surrounding , Peru & the surrounding MantaroMantaro River River Valley to assess biological & environmental contamination Valley to assess biological & environmental contamination

levels from a local metal mine & smelterslevels from a local metal mine & smelters

33

AcknowledgementsAcknowledgements

Saint Louis University School of Public Health

• Chris King• R Greg Evans• Volunteers

– Chris Reid– Mayan – Gale Carlson– Ryan Sterling (4)

CDC (Inorganic Toxicology Lab)

NIOSH

Peru• Archdiocese of

Huancayo• Joining Hands Network

(Consortium of NGO’s)Other• International Peace

Observers (Columbus, OH)

• Niton (now part of Thermo Electron Corp)

• Environmetrics (now part of PDC Laboratories)

ARZOBISPADO DE HUANCAYO

44

History History –– Doe Run, La Oroya PeruDoe Run, La Oroya Peru• La Oroya metallurgic complex was built in the 1920's

by a U.S. company and was known as Cerro de Pasco Copper.

• 1974 - Nationalized by the Peruvian government. Became part of the Centromin mining organization.

• 1997 - Sold to Doe Run as part of Peru's privatization of industry policy

55

Initial StudiesInitial Studies• Blood Lead Study in a Selected Population from

La Oroya”, released 1999 by the Director General of Environmental Health (DIGESA) of the Peruvian Ministry of Health. Only .9% of children BlPb<10

• “Study of Blood Lead Levels of the People of La Oroya” by DRP 2000-2001 and in 2003 by CooperAccion: Only .9% of children BlPb<10

• 2002 Report by Interamerican Association for Environmental Defense & the Peruvian Society of Environmental Law– >10ugPb/dl in 99% of children tested

• “Interior Dust Lead Levels in La Oroya, Peru”, 2004 Asociacion Civil Labor and Cooperaccion, Peru and Occupational Knowledge International, CA USA. 88% exceeded 40ug/ft2, 100% in Antigua

66

Main Research QuestionsMain Research Questions1. What are the environmental levels of heavy

metals in La Oroya and Concepcion (the control community)?

2. What are the biological (blood and urine) levels of heavy metals?

3. Is there a difference between the two communities?

4. What are the associations and factors between exposure, behaviors and biological measures?

77

Smelter

Oroya Antigua

OroyaNueva

Cuipata

88

Study Design and PreparationStudy Design and Preparation

• Minimum Statistical sample size AND reality of time frame (For power of .8 to see a difference at α=.05 for in blood lead of 8ug/dL: N= 250 subjects distributed by age group and city. Using prior information from both La Oroya and Hurculaneum, MO)

• Approvals – SLU Institutional Review Board (IRB)– Peru Ministry of Health– Provincial Minister of Health– USDA Permit to import soil– CDC letter to import blood/urine

• Getting to know the ‘lay of the land’, culture and life style (i.e. how and what to measure?)

99

MethodologyMethodologyTeam Work and International CooperationTeam Work and International Cooperation

• International team of 80 • 8 Field Teams

– 2 Recruiters– 1 Health Interviewer– 1 Doctor– 1 Medical Technician– 1-2 Environmental Scientists (SLU)– 1 International Peace Observer

• Others: – Logistics, Planning, Transportation, Security and

Administrative

1010

MethodsMethodsPopulation/Location Sample SelectionPopulation/Location Sample Selection

• Stratified Random Sampling– Random selection of city area/blocks– Random selection of starting house – Up to one subject per age group per house• 0-6, 7-12, 13-18, >18

• Inclusion Criteria– Spanish speaking– Live in city for 3 years– Live in home for 3 months

1111

MethodsMethodsSampling Instruments and MediaSampling Instruments and Media

• Biological Sampling (For Metals)– Blood & urine samples

• Questionnaire– Health behaviors and beliefs, demographics,

occupation, other exposures, ….• Environmental Sampling (For Metals)– Dust Wipes (Floor/entry/bedroom, Food prep table,

Child hands) – Modified HUD protocol– Soil – First 2-4cm core– Residential Water - Rinse 2x, 50ml collection– Mantaro River (metals and biological indicators)– Paint

1212

Analysis Of SamplesAnalysis Of Samples

• Blood (4) and Urine (13) – ICP/DRC/MS (CDC)• Water (26) – ICP EPA Method 200.7

(Environmetrix)• Dust and Soil (26) – (XRF)

(SLU and NIOSH)– Soil - dried, ground and seived

to 125um– Wipes – Niton protocol

• Paint – XRF for lead

1313

ResultsResults• 184 Homes Visited• 367 Participants (Barely expected 250)

– La Oroya – 172 + 50 at office– Concepcion – 145

• Blood – 364 samples• Urine – 344 samples• Dust Wipes – 715• Soil – 92• Water – 143 community, 13*3 Mantaro River

1414

Results Reported HereResults Reported Here

• Aggregated results of blood and urine only reported on initial 250 samples (IRB)

• Initial results of dustwipe samples

1515

Pre and Post Blood LeadPre and Post Blood Lead

00.5

11.5

22.5

33.5

44.5

5

1 2 3 4 5 6

Environmental Team Members

Blo

od L

ead

ug/d

L

Pre

Post

Ref Range*1.4 – 4.4

*50th to 95th %ile From the Third National Report on Human Exposure to Environmental Chemicals – www.cdc.gov/exposurereport

1616

Pre and Post Blood MercuryPre and Post Blood Mercury

0123456789

1 2 3 4 5 6

Environmental Team Members

Blo

od M

ercu

ry (

ug/L

)

Pre

Post

Ref Range 0.3 – 1.9

50th to 95th %ile From the Third National Report on Human Exposure to Environmental Chemicals – www.cdc.gov/exposurereport

1717

1818

1919

2020

2121

2222

2323

2424

Initial Dust Wipe Mean Loading For Initial Dust Wipe Mean Loading For La La OroyaOroya (LO) and (LO) and ConcepcionConcepcion (C)(C)

050

100150200250300350400450

LO C LO C LO C

Lead Arsenic Cadmium

Mea

n ug

/sqf

t

Inside FloorInside Food PrepOutsideHandwipes 6M-6YHandwipes 7112Y

2525

ConclusionsConclusions• Exposures to heavy metals (Pb, Cd, Cu,

As, Hg and others) are occurring in the Mantaro River Valley (La Oroya and Concepcion)

• Exposures in La Oroya are generally higher than Concepcion ~100 Km distant

• Exposures in La Oroya Antigua are higher than other areas of La Oroya

2626

WhatWhat’’s Next?s Next?• Dealing with Ethical and Communication Issues in Community

Based Participatory Research

• Translation and Dissemination– 4 Public Meetings in December on first results– Final report to be presented in July

• Additional Health Risk Communication– Participants informed about their individual results February– Education/counseling at community, family and individual levels

• Radio campaigns, public meetings, fact sheets, …• Control methods recommended – individual, community, regional…• Additional control methods being assessed

• Further Evaluation of River Valley Impact From Mining and Processing Activities?

2727

Questions ???Questions ???