[Federal Register Volume 63, Number 110 (Tuesday, June 9, 1998)]
[Notices]
[Pages 31496-31497]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-15255]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Toxic Substances and Disease Registry
[ATSDR-135]
Availability of ATSDR Decision Document Regarding the Bunker
Hill, Idaho, Medical Monitoring Program
AGENCY: Agency for Toxic Substances and Disease Registry (ATSDR),
Department of Health and Human Services (HHS).
ACTION: Notice of availability for public review and comment of draft
Decision Document Regarding the Bunker Hill, Idaho, Medical Monitoring
Program.
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SUMMARY: ATSDR has reviewed scientific literature and clinical
information in order to assess the need for medical monitoring at
Bunker Hill, Idaho. ATSDR has determined that there is a definable
population at significantly increased risk of disease that will benefit
from a medical monitoring program. ATSDR has judged that the medical
monitoring program is appropriate to provide periodic medical
evaluation and referrals to improve the public health status of the
affected population. The current literature and expert panel workshop
held by ATSDR reflect that medical monitoring at Bunker Hill would be
good public health practice and of medical benefit to the affected
populations. This notice is announcing the availability of the draft
report documenting ATSDR's justification for implementing a medical
monitoring program for the population at the Bunker Hill Site: the
``ATSDR Decision Document Regarding the Bunker Hill, Idaho, Medical
Monitoring Program'', is available for public review and comment.
DATES: Comments must be received by July 9, 1998.
ADDRESSES: The report is available through Dr. Vivian Rush, MD, Medical
Officer, ATSDR-Division of Health Education and Promotion, 1600 Clifton
Road, NE., Mailstop E-33, Atlanta, Georgia 30333, E-mail address
vcr1@cdc.gov and telephone (404) 639-5080.
FOR FURTHER INFORMATION CONTACT: Dr. Vivian Rush, Medical Officer,
ATSDR; telephone (404) 639-5080.
SUPPLEMENTARY INFORMATION: Section 104 (i)(9) of the Comprehensive
Environmental Response, Compensation, and Liability Act (CERCLA), as
amended [42 U.S.C. 9604 (i)(9)], provides for the Administrator of
ATSDR to initiate a health surveillance program for populations at a
significant increased risk of adverse health effects as a result of
exposure to hazardous substances released from a facility. A program
ATSDR includes under health surveillance is referred to as ``Medical
Monitoring or Screening'' and is defined, as published in the Federal
Register on July 28, 1995 (60 FR 38840), in ``ATSDR's Final Criteria
for Determining the Appropriateness of a Medical Monitoring Program
under CERCLA'' as ``the periodic medical testing to screen people at
significant increased risk for disease.'' There are 7 Medical
Monitoring criteria associated with this program and they are as
follows:
(1) There should be evidence of contaminant levels in environmental
media that would suggest the high likelihood of environmental exposure
to a hazardous substance and subsequent adverse health outcomes.
(2) There should be a well-defined, identifiable target population
of concern in which exposure to a hazardous substance at a sufficient
level has occurred.
(3) There should be documented human health research that
demonstrates a scientific basis for a reasonable association between an
exposure to a hazardous substance and a specific adverse health effect
(such as an illness or change in a biological marker of effect).
(4) The monitoring should be directed at detecting adverse health
effects that are consistent with the existing body of knowledge and
amenable to prevention or intervention measures.
(5) The general requirements for a medical screening program should
be satisfied. Those requirements are:
The natural history of the disease process should be
understood sufficiently for screening.
The early detection through screening should be known to
have an impact on the natural history of that disease process.
There should be an accepted screening test that meets the
requirements for validity, reliability, estimates of yield,
sensitivity, specificity, and acceptable cost.
(6) An accepted treatment, intervention or both for the condition
(outcome or marker of exposure) must exist and a referral system should
be in place prior to the initiation of a medical monitoring program.
(7) The logistics of the system must be resolved before the program
can be initiated.
Background
The 21-square-mile Bunker Hill Superfund site includes the Bunker
Hill mining and smelting complexes and the communities of Pinehurst,
Page, Smelterville, Kellogg and Wardner in Shoshone county, in Silver
Valley of northern Idaho. Mining and mineral refining has been the
dominant industry in the Silver Valley for more than 100 years. The
mining and mineral refining activities have severely impacted the
landscape, vegetation, and the quality of the air, and soils in the
area. A population of workers and residents who have worked in and
lived surrounding the former Bunker Hill lead and zinc smelting
facility have been exposed to lead (and probably other heavy metals) in
the past at levels of public health concern (i.e., at levels where
health effects could be expected to occur). The most serious exposures
took place during the 1970's after a baghouse fire resulted in large
amounts of lead to be released into the air of towns surrounding the
smelter. Epidemiologic studies have shown adverse health effects in the
populations that were present during the past high exposure periods.
Since the smelter's closure in 1981, the exposures have markedly
decreased. In addition, the Panhandle Health District has implemented a
program to detect excess exposure in the community and provides
information and education on preventing harmful exposures and
scientific literature supports these findings.
[[Page 31497]]
Dated: June 3, 1998.
Georgi Jones,
Director, Office of Policy and External Affairs, Agency for Toxic
Substances and Disease Registry.
[FR Doc. 98-15255 Filed 6-8-98; 8:45 am]
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