Enviro-Health Tracs Profile Sample 2

8/3/2019 Enviro-Health Tracs Profile Sample 2

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(EHELP)

Environmental Health Exposure

Life Profile

Sample 2

January 10, 2012

by David Lincoln


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SUMMARY

Client is an 83 year old white female diagnosed with Alzheimers disease in hereighties. She has no history of previous chronic health problems and no history ofchronic diseases (including cancer) in her family. She has never smoked and herparents never smoked, but she was subjected to secondhand smoke from herspouse for thirty years during late teens through middle age exclusively. It shouldbe noted that her spouse died recently of Chronic Obstructive Pulmonary Disease(COPD) which could have partly been the result of decades of smoking, breathingLos Angeles area smog-filled air, or both.

The subject only lived in three residences during her entire lifetime. Fortunately forher, the first residence was located on the outskirts of Oklahoma City in thewestern suburbs of Bethany OK. This location was essentially undeveloped duringthe 1930s and 40s. There is no indication of any significant toxic exposures fromthe pre-natal period through her teenage years with the possible exception of leadpaint in the home. The prevalence ofAlzheimers Disease in her large family

could potentially be partly a result of eating lead paint flakes near the windows inearly childhood. Parental lifestyle choices (non-smokers, non-drinkers, etc.) and nofamily history of cancer pre-disposed her to a relatively low risk of cancer. Lowcancer risks for white females are present in Oklahoma County to this day.

Despite this strong beginning, the next housing choice had the oppositecharacteristics and presents a higher risk for development of cancer and otherchronic diseases. The house was located near a major freeway through the easternsuburbs of Los Angeles in the midst of the heavily developed post-WWII erahousing boom. Moreover, the residence was ringed by a highly pollutingpetrochemical complex.

Since the Norwalk, CA residence was at least two miles away from the nearestsuperfund site or toxic release facilities, soil and groundwater contamination are notsignificant issues in this area. However, air pollution was and is a real problem inthe Norwalk area. Particulate matter and exhaust fumes from the nearby highwaywith 10% benzene and 50% formaldehyde releases from the refineries andfactories in the vicinity could have had major health impacts. Benzene is a knownhuman carcinogen and has been linked to leukemias (especially chronicmyeloid leukemia) as has formaldehyde exposure.

The latency period for the Benzene effects may be as long as 40 years. The highestrisks of nasopharyngeal cancer were found for individuals with the highestformaldehyde exposure levels (assessed as cumulative exposure, exposure level, or

exposure score). Risks were also significantly elevated for individuals with longertime since first exposure or who died at an older age. Risk was increasedfourfold for individuals who died after the age of 68 and were probablyexposed to high levels of formaldehyde for at least 20 years before death.

In particular, the American Cancer Society recently found that people living in thesmoggiest cities [like Los Angeles] for more than 20 years were 30 percent


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more likely to have succumbed to lung diseases such as chronic bronchitis,

emphysema and pneumonia.

One of the major pollutants in Los Angeles in the post-war era was 1,3-Butadiene.Butadiene was primarily found in synthetic rubber in tires and is known to be ahuman carcinogen. Three studies have shown an association between occupationalexposure to 1, 3-butadiene and excess mortality from cancer of the blood cells,

especially leukemia.

These occupational exposure studies are particularly relevant because the subjectwas employed by Firestone Tire And Rubber Company manufacturing tires for 5years in the early 1960s. The client remembers working the night shift putting rimson tires and airplane fuel tanks while coping with strong odors with no masks.This represents the third chemical exposure associated with a higher risk ofleukemia.

Air pollution from local refineries in the Santa Fe Springs petrochemical complex

consisted largely ofBenzene, Toluene, Ethylbenzene and Xylene or BTEXchemicals. Both Benzene and Ethylbenzene have been associated with high risks forleukemia. One study concluded that the increased risk of leukemia from breathingAmbient BTEX could be as high as 3 in 10,000.

Smoking is also thought to be the main cause in 14 percent of all United Statesadult leukemia cases, which amounts to about 3,600 cases per year. Secondhandsmoke can contribute to and a 20% increase in risks of lung cancer and probablyleukemia as well. In a recent Canadian study the risks of developing chroniclymphocytic leukemia were more than doubled for those with the longest exposuresto secondhand smoke.

Altogether during the Los Angeles period, exposure to the Benzene andFormaldehyde found in Los Angeles smog, the Ethylbenzene emitted from thelocal refinery, the occupational exposure to 1, 3-Butadiene and the secondhandsmoke total five different chemical sources associated with higher risks fordeveloping leukemia.

In general, white females in Los Angeles during the past decade have experiencedrelatively higher mortality rates for All Malignant Cancers as well as stomachcancer, cervical cancer, liver, gallbladder and other biliary tract cancer.

Given the long history of pollution in the Los Angeles area from petrochemicalsources and vehicle emissions, there is no reason to expect that past trends for

cancer would have been significantly less than current trends. Therefore, thesubject who lived in this setting for 42 years should expect about the same cancerrisks from environmental exposure as those who have lived in Los Angeles over thepast two decades.

Since 1988, the subject has lived in the presently pristine environment of MountainHome in Baxter Co. Arkansas. Yet, there are two historical risk factors which shouldbe considered.


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The first chemical exposure is from the relatively high concentration of boatbuilding operations in the area which have been emitting huge amounts ofstyrene in past decades. These emissions peaked at several hundred thousandpounds of styrene released into the air per year about five years after the subjectmoved here.

Since Styrene has recently been declared a probable human carcinogen, thesehistorical emissions take on greater significance than they would have warranted atthe time of the pollution releases. It is impossible to determine from the availabledata what the levels of styrene might have been in the ambient air in the regionduring this period. However, we can examine the death rates in the countiesnearest to the operations. While we do not know that the boat building industry inArkansas is the cause of these high cancer rates, it is reasonable to assume thatthey may be a contributing factor.

Baxter County over the past decade has shown elevated mortality rates for AllMalignant Cancers for white females. These cancers included pancreatic cancer,

lung cancer and ovarian cancer. The county also showed an elevated age adjusteddeath rate for stroke among white females.

While there is little or no mortality data for bladder cancer among females in theregion, the same mortality data for males shows that the county has some of thehighest mortality rates in the country for bladder cancer. Recent studies haverevealed that men are nearly 3-4 times more likely to develop bladder cancer thanwomen. However, women present with more advanced disease and have worsesurvival. There is no reason to suspect that nationally these comparisons would notbe consistent across counties. Therefore, it is certainly worth monitoring earlysymptoms of bladder cancer in white females in addition to males.

The Second potential exposure source which much be evaluated in the MountainHome residence is radon. The subject is advised that houses in the region nearledge or basement should be tested for indoor radon gas. If the gas tests areelevated, then the house should be treated and fixed to reduce risks of lungcancer.

Other recommendations for the client involve the overall safety of the drinkingwater. The water well should be tested periodically to determine the levels of heavymetals, volatile organic compounds and pesticides. Given the changing levels ofaquifer access, no water should be considered safe until it is thoroughly tested.

Client should inform her doctor that she has likely been exposed to moderately high

levels of benzene and formaldehyde during middle age. The doctor should beinformed that the latency period for Benzene exposure can be up to 40 years andthat she has been removed for 24 years after an exposure period of 42 years.

Environmental Health tracking is most useful if used as a risk indicator. Obviously,if the subject plans to relocate, she is going to want an environmental assessmentof the future residence. For past toxic exposures, she will need to work with her


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doctor to assist in diagnosing chronic illnesses and determining the risks of

treatment options.

Our approach utilizes actual residences and proximity to Superfunds and toxicrelease sites. We analyze exposure based on the chemicals and amounts estimatedat the time of residence. Based on this county exposure data we determine therelative risk of developing specific chronic diseases known to be associated with

these chemicals at these levels of exposure in the latest medical journals. This isthe only scientifically valid and defensible approach to assessing the risk of

developing chronic disease from past exposure to environmental toxins.


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EARLY YEARS

Town: BETHANY OK.

Years of Occupation: 1928-1945

Subject was born on May 18, 1928 where she spent her pre-natal period through toher teenage years (up to 1946) at 610 N Muller St.

Bethany Aerial Photo 1990

(Showing approx., location of 610 N. Muller St on oldest known air photo)


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2011 Satellite Image of Bethany Address

Expansion of School has resulted in new homes being built since client moved.

Satellite Image of Bethany OK and Toxic Release Sites


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Bethany Area Toxic Release Sites

Overlain by Death Rates for All Malignant Cancers for White Females

(Green colors are lowest risk)

Bethany Oklahoma has no superfund sites within 10 miles and no leaking

underground storage tanks. The address has two Toxic Release sites within five

miles but the chemicals are commonly less than 10,000 pounds/year. Two of these

companies are emitters of Styrene to the air. The Athenian Marble Corp is located

two miles from the residence, but was not established until 1969.


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The other polluter in the area is Xerox Corp in Yukon OK just two miles from the

residence. This company emits styrene and butadiene, but the date of first

operation could not be determined. Based on a report by USA today called The

Smokestack Effect,it appears the neither the subjects residence nor her schools

were significantly impacted by these emissions. No adverse health effects would be

anticipated. Between 2004 and 2009 the death rate for all cancers in the area was

extremely low for white females compared to all US counties. Given the distance to

older Superfund sites there is no reason to expect that cancer rates would have

been higher in the past.


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There is a very high rate ofAlzheimers Disease in the subjects own large family.

At least half of her 13 brothers and sisters developed Alzheimers Disease and

many of them died from this progressive killer. This could simply be the result of

genetics or it could be compounded by environmental exposure.

On closer scrutiny, we find that both parents lived until about 90 with no

accelerated signs of cognitive impairment. Furthermore, the youngest of the

children suffered most from Alzheimers in old age; although they all lived in the

same house. It turns out that the older children shared rooms in the basement

while the younger childrens rooms were upstairs. This suggests an

environmental cause within the house.

Scientists dont yet know exactly how Alzheimers develops, but research is turning

up important clues. For instance, researchers know that a protein called amyloid-

beta is very important in Alzheimers prognosis. People with higher levels of this

protein appear more likely to develop Alzheimers.

While specific genes do influence how much amyloid-beta is in the brain, they arent

the only factor. Studies show that certain chemicals, such as lead, can increase

amyloid-beta accumulation in the brain. This frightening effect is worse when the

exposure to lead happens early in life because the brain is less developed and thus

more influenced by changes in the environment.

Since lead paint was common at the time, and it was more likely to flake along the

window sills on the upper floors; this is one possible source of exposure. The

possible effect is magnified since only the younger children spent their earliest

childhoods in that house. It could be informative to examine lead levels in teeth or

bone to augment any genetic studies.


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CALIFORNIA

Los Angeles County

Calif. Map of All Malignant Cancer Incidences Relative to US Counties

(Higher incidences shown in darker brown color)

Note that Los Angeles County in the Southwestern part of the state has some of the

highest incidences of Malignant Cancer for white females in the US.


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Town: Norwalk CA

Address: 11713 Arlee Ave

Years of Occupation: 1946-1988

Norwalk CA Aerial Photo 1994 (Oldest known air photo available)

As shown above, the Norwalk residence was located less than mile from the

Santa Ana Freeway in Los Angeles County. The Santa Ana Freeway in Norwalk

began as a part of the US Route 101 Bypass in 1941 which extended to Anaheim.

Formal construction of the Santa Ana Freeway was initiated in 1947, but wasnt

completed until 1956.

Smoke and fumes have been known in the Los Angeles Area since the beginning of

the 20th Century. However, smog first arrived in Los Angeles in 1943. The Los

Angeles Times reported that a pall of smoke and fumes descended on downtown,cutting visibility to three blocks. Striking in the midst of a heat wave, the "gas

attack" was nearly unbearable, gripping workers and residents with an eye-

stinging, throat-scraping sensation. It also left them with a realization that

something had gone terribly wrong in their city, prized for its sunny climate.

The following day, city officials pointed the finger at the Southern California Gas

Co.'s. Aliso Street plant, which manufactured butadiene, an ingredient in synthetic


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rubber. Public pressure temporarily shuttered the plant, but the gas attacks

persisted, proving that it was not the prime culprit.

First recorded photo of smog in Los Angeles, 1943

(Photo courtesy of Los Angeles Times Collection, Department of Special Collections,UCLA Library).

World War II dramatically increased the region's industrial base and resulting airpollution. The city's population and motor vehicle fleet grew rapidly as well. As a

result, according to weather records, visibility declined rapidly from 1939 to 1943.

Angelenos grew increasingly alarmed at the smoke that clouded their vision and thefumes that filled their lungs. In 1947, more than 300,000 backyard trashincinerators puffed out white plumes -- and black soot -- across the city. In October1954, the heavy smog in Los Angeles was so bad that it shut down schools and

industry for most of the month. More than a decade after the problem was firstidentified, trash collection programs were established and backyard incinerators

were finally banned in 1958.

Smog contains ground-level ozone, sulfur dioxide, nitrogen dioxide and carbonmonoxide are especially harmful for senior citizens, children, and people with heartand lung conditions such as emphysema, bronchitis, and asthma. It can inflamebreathing passages, decrease the lungs' working capacity, and cause shortness ofbreath, pain when inhaling deeply, wheezing, and coughing. It can cause eye andnose irritation and it dries out the protective membranes of the nose and throat andinterferes with the body's ability to fight infection, increasing susceptibility to

illness.

A 2009 American Cancer Society study found that people living in the smoggiestcities for more than 20 years were 30 percent more likely to havesuccumbed to lung diseases such as chronic bronchitis, emphysema and

pneumonia.


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In 2004, ScoreCard ranked Los Angeles as one of the Dirtiest Counties in the UnitedStates. With potentially serious health problems resulting from extremely high

levels of ozone, particulates, oxides and volatile organic compounds such as

formaldehyde.

For the Norwalk area there are numerous sources of airborne emissions as shown

below.


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Air Pollution and Air Emissions Sources In Relation to the Norwalk Residence

In particular, samples of pollution in the area contain over 10% Benzene and more

than 50 % formaldehyde. Long-term exposure to benzene can cause cancer of the

blood-forming organs or bone marrow. This condition is called leukemia. Benzene

is a known human carcinogen and has been linked to the following cancers

and leukemias;

Acute or Chronic Myelogenous Leukemia (AML/CML)

Acute or Chronic Lymphocytic Leukemia (ALL/CLL)

Chronic Myelogenous Leukemia (CML)

Hairy Cell Leukemia (HCL)

Non-Hodgkin's Leukemia (NHL)

Multiple Myeloma

Myelodysplastic Syndrome (MDS)

Benzene toxicity may present as an acute illness or as a chronic disease. There is

a latency period associated with the effects of benzene exposure ranging

from 7 to 40 years from the first exposure for the effects to show.


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On 10 June 2011, the US National Toxicology Program described formaldehyde as

"known to be a human carcinogen" associated with nasal sinus cancer and

nasopharyngeal cancer. Studies found the highest risks of nasopharyngeal cancer

for individuals with the highest formaldehyde exposure levels (assessed as

cumulative exposure, exposure level, or exposure score). Risks were also

significantly elevated for individuals with longer time since first exposure or who

died at an older age. Risk was increased fourfold for individuals who died

after the age of 68 and were probably exposed to high levels of

formaldehyde for at least 20 years before death. Recent studies have also

shown a positive correlation between exposure to formaldehyde and the

development of leukemia, particularly myeloid leukemia.

One of the major pollutants in Los Angeles in the post-war era was 1, 3-Butadiene.

Butadiene was primarily found in synthetic rubber in tires and is known to be a

human carcinogen. Three studies have shown an association between occupational

exposure to 1, 3-butadiene and excess mortality from cancer of the blood cells,

particularly leukemia. These include an increased risk of lymphosarcoma and

reticulosarcoma in workers who manufactured 1,3-butadiene monomer, a study of

styrene-butadiene rubber workers in eight plants in the United States and Canada

showing increased risk of leukemia among production workers, and a case-control

study of styrene-butadiene rubber workers showing a large excess of

leukemia associated with exposure to 1,3-butadiene.

Occupational exposure to 1,3-butadiene may occur through inhalation and, to a

lesser extent, dermal contact. The National Occupational Exposure Survey

(conducted from 1981 to 1983) estimated that about 52,000 workers at 2,201

facilities, including 1,410 women, potentially were exposed to 1,3-butadiene.

An earlier estimate of about 66,000 to 70,000 workers at 3,086 facilities was

reported in the National Occupational Hazard Survey (conducted from 1972 to

1974). This suggests that workers exposed actually decreased from the 1970s to

the 1980s. We can only suppose that even more women were exposed during the

1950s and 1960s.

These occupational exposure studies are particularly relevant because the subject

was employed by Firestone Tire And Rubber Company manufacturing tires


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for 5 years in the early 1960s. The client remembers working the night shift

putting rims on tires and airplane fuel tanks while coping with strong odors with

no masks. This represents the third chemical exposure associated with a higher

risk of leukemia.

The subject was married to a smoker in 1946 who smoked continually until the

1970s. While never a smoker herself, she was a victim of secondhand smoke for 25

years. The National Toxicology Program has found an overall increase in risk of lung

cancer of 20% for exposure to environmental tobacco smoke from a spouse who

smokes. Increased risk of lung cancer appears to be most strongly related to

exposure to secondhand or environmental tobacco smoke from spousal smoking or

exposure in an occupational setting. This is the fourth separate chemical exposure

in Los Angeles which could increase the risks of leukemia

The Norwalk residence is surrounded by at least 10 toxic release sites and one

Superfund Site as shown above. The Waste Disposal Inc. Superfund site is located

over two miles from the subjects home and while it was in operation during her

residence until the 1960s, it is mainly responsible for localized water and soil

pollution.


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The Toxic Release sites form a ring around a petrochemical complex shown by the

satellite image below.

Norwalk CA, Satellite Image from 2011 with Toxic Release Inventory Sites

The largest of the Toxic Release sites is Cosby Oil Co Inc. in Santa Fe Springs. This

company established in 1939 is a petroleum refiner, blender, distributer and

trucking company. Its toxic BTEX emissions are typical of petrochemical companies

in the area. In addition to Benzene, the site emits significant amounts ofToluene,

Ethylbenzene and Xylene into the atmosphere. Ethylbenzene has been classified as

a possible carcinogen while the other two chemical are not classifiable due to

limited data. A 2010 study in Lisbon Portugal concluded that the increased risk of

leukemia from breathing Ambient BTEX could be as high as 3 in 10,000.This is the

fifth source of chemical exposure associated with higher risks of leukemia.


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Motor vehicles emit particulate matter < 2.5 m in diameter (PM2.5), and as a

result, PM2.5 concentrations tend to be elevated near busy streets. A 2000

Canadian study found exposure to PM2.5 has a significant effect on hospital

admission rates for a subset of respiratory diagnoses (asthma, bronchitis, chronic

obstructive pulmonary disease, pneumonia, upper respiratory tract infection), with

a relative risk of 1.24 (95% confidence interval, 1.051.45) for a log10 increase in

exposure.

In 2010, the Health Effects Institute in Boston, Massachusetts, summarized the

available evidence on exposure to traffic generated air pollution and negative health

effects. They find strong evidence for a causative role for traffic related air pollution

and premature death, particularly from heart attacks and strokes. PM2.5 is emitted

directly, and it is also produced by secondary formation, as sulfur dioxide (SO2)

and nitrogen oxide (NOx) emissions contribute to the formation of sulfate and

nitrate particles. Exposure to PM2.5 also causes other health effects such as asthma

attacks, and other respiratory illnesses. They identified an exposure zone within a

range of up to 300 to 500 m from a highway [approx. distance from Santa AnaFrwy to Norwalk residence] or a major road as the area most highly affected by

traffic emissions (the range reflects the variable influence of background pollution

concentrations, meteorological conditions, and season).

The data presented may help to explain the relatively high rates of malignant

cancer in Los Angeles County. The maps below present the mortality rates for

specific cancers for white females in the Los Angeles area.


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LOS ANGELES CO. STOMACH CANCER MORTALITY RATE FOR WHITE FEMALES

(darker blue colors are higher mortality rates)

LOS ANGELES CO. LIVER CANCER MORTALITY RATE FOR WHITE FEMALES



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LOS ANGELES CO. CERVICAL CANCER MORTALITY RATE FOR WHITE FEMALES


Given the long history of pollution in the Los Angeles area from petrochemical

sources and vehicle emissions, there is no reason to expect that past trends for

cancer would have been significantly less than current trends. Therefore, the

subject who lived in this setting for 42 years should expect about the same cancer

risks from environmental exposure as those who have lived in Los Angeles over the

past two decades.


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Town: Mountain Home Ark

Address: 1391 Robinson Pt. Rd

Date of Occupation: Jan 10, 1988 PRESENT

The subject moved to the Mountain Home residence in Jan. 1988 when she was 60years old and has lived there continuously for the past 24 years. The house is

located at the peak of a recreational peninsula approx. 5 miles east of the town.

Robinson Point AR Aerial View 1994 (oldest known air photo available)

The photo above shows the area essentially undeveloped with few residences

nearby. As can be seen by the recent satellite image below little has changed to

present day.

Mountain Home Satellite Image with Closest Toxic Release Sites in 2009


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However, a larger view of the region paints a very different picture of the past

environmental exposure.

MOUNTAIN HOME TOXIC RELEASE INVENTORY SITES

As shown by the Toxmap above, the area is dominated by boat building

operations and these comprise the three largest toxic release sources

(especially styrene) on the map. While each of these companies has made

substantial progress in reducing their styrene emissions in recent years, it is the

peak volumes over the last two decades which determine the maximum

environmental exposure. Since Styrene has recently been declared a probable

human carcinogen and the boat companies have released remarkably high levels

of styrene into the air, we will begin our investigation with these operations.

Styrene inhalation over longer periods of time such as in the boat buildingoccupations may cause central nervous system effects including headache, fatigue,

weakness, and depression. Exposure may also damage peripheral nerves and causechanges to the kidneys and blood.

The chart below shows the products in a boat building operation which containstyrene along with the percentage styrene content.


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Chart showing Hazardous Air Pollutant Styrene fromthe Boat Building Industry

Ranger Boats is one of the largest Boat Builders in the region. The Toxic ReleaseInventory shows that nearly 95 % of their emissions are Styrene and theyreleased about a quarter million pounds of styrene per year in 2008.


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In previous years Ranger Boats have released even more styrene as shownbelow (in red): This shows a peak styrene emissions rate of nearly 300,000pounds/yr. in 1995 which made it one of the largest styrene emitters inthe country. Over time this level of source pollution could have dispersed overlarge distances.

Ranger Boats

Ranger Boats Annual Toxic Emissions (pounds/yr.)

Ranger Boats also submitted an emissions permit request in Arkansas in 2003

which stated,

The major components of the laminations are styrene based resins andgel coats. The facility exceeds 100 tons per year of VOC [including styrene] andover 25 tons per year of combined hazardous air pollutants (HAPs).

Air dispersion modeling was performed on the estimated hourly emissions fromsources, in order to predict ambient concentrations beyond the propertyboundary. The Presumptively Acceptable Impact Level (PAIL) for each compoundwas deemed by the Department to be one one-hundredth of the Threshold LimitValue, as listed by the ACGIH.

The chart below shows the amount of materials consumed at Ranger Boats.

Chemical 2008 2007 2006 2005 2004 2003 2002

Methylmethacrylate 14,179 15,922.30 18,708.20 19,511 25,172 21,040 21,137.80

Styrene 238,967 296,685 293,008.90 273,195 247,802 245,278 230,683.20 2

Toluene - - - - - 13,725 -

Chemical 1998 1997 1996 1995 1994 1993 1992

Methylmethacrylate 5,121 4,974 8,416 - - - -

Styrene 85,125 78,905 81,396 299,422 272,751 40,809 61,446

13,736 17,896 13,631 14,141 9,681 - -


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The use of over a half million pounds per month of resin which consists of morethan 30% styrene suggests that even the high levels of styrene emissions reportedat the plant may have understated the problem. Other Boat Builders in the areamight also have underreported their styrene emissions. Bass Cat Boats shows a

peak emissions rate of more than 50,000 pounds/yr. of styrene.

Bass Cat Annual Toxic Emissions (pounds/yr.)

Legend Boats emissions history is similar although only about half the output isreported.

The models indicate that the boat builders were aware of their emissions

beyond their property boundaries and over the years they have installed

equipment and adopted new processes and procedures to reduce those impacts.

Yet for many, the damage has already been done.


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Therefore we have to ask, What have been the long term health impacts to

these rural communities of the use of hundreds of thousands of pounds per

month of toxic resins and gel coats by these facilities?

One way to begin to answer this question is to examine the death rates in the

counties nearest to the operations. While we do not know that the boat buildingindustry in Arkansas is the cause of these high cancer rates, it is reasonable to

assume that they may be a contributing factor,

BAXTER CO. ALL MALIGNANT CANCERS DEATH RATES FOR WHITE FEMALES

(Higher death rates are in darker blue)

Two surprising additional risks must be evaluated in the region. The first is BaxterLabs which has had remarkable success in recent years in reducing their totalemissions.


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The TRI data above shows that Baxter Labs in the past emitted over 500,000pounds per year of Freon and released about 100,000 pounds per year of ethyleneoxide in 1988, through 1990. Then emissions were reduced dramatically. Ethyleneoxide has been used for sterilization but it is a proven carcinogen. A 2003 study of7,576 women exposed while at work in commercial sterilization facilities in the U.S.suggests ethylene oxide is associated with breast cancer incidence. Since ethyleneoxide degrades in air within a few days it would not be expected to be a risk severalmiles away. However, occupational exposure for a large number of workers couldpotentially impact county breast cancer rankings.

Another major pollutant from Baxter Labs is phthalate which peaked at nearly100,000 pounds per year in 1991. The plasticizer Di-2-(ethylhexyl) phthalate,commonly abbreviated DEHP, is an organic compound which has been associatedwith birth defects in boys. Fortunately, it should be of little concern to a womanbeyond child-bearing years.


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In 2002 Scorecard ranked Baxter Labs as one of the dirtiest facilities in the US interms total waste and reproductive toxicants (like Phthalates).

Phthalate is also the major pollutant at the last toxic release site investigatedMountain Home; Epoxyn Products LLC. Here the peak year of production was 1997at nearly 20,000 pounds of phthalic anhydride per year. This plasticizer has similarhealth impacts to the previous one.


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This laboratory supply company also produced close to 20,000 pounds per year of1-1-1 Trichloroethane until 1992. 1,1,1-trichloroethane, also known as methylchloroform was used as a solvent and in PVC but has been phased out nationally asa greenhouse gas. Chloroform was recently declared to be reasonablyanticipated to be a human carcinogen. One study in 2007 found a significantlyelevated risk of urinary-bladder cancer associated with high levels of chloroform indrinking water.

Although there is considerable distance between the Mountain Home residence andthis toxic release site in town, there may be other sources and the groundwater

recharge patterns are not well known. It would worthwhile to consider having thedrinking water tested for Chloroform and other harmful substances.

Baxter County as a whole was evaluated in 2002 by ScoreCard and the cancer risks

are shown below:


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In all of the Cancer Risk and Disease Risk maps below, the darker blue

counties in Arkansas represent the highest risk for cancer relative to the

rest of the counties in the US.

BAXTER CO STYRENE TOXIC RELEASE INVENTORY SITES

BAXTER CO. ALL CANCERS MORTALITY FOR WHITE FEMALES


BAXTER CO. STROKE MORTALITY FOR WHITE FEMALES



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BAXTER CO. PANCREATIC CANCER MORTALITY FOR WHITE FEMALES


BAXTER CO. OVARIAN CANCER MORTALITY FOR WHITE FEMALES



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BAXTER CO. LUNG CANCER MORTALITY FOR WHITE FEMALES


Finally, since Baxter Co is considered by the EPA to be at risk for radon gas further

investigation is warranted.

N ARK RADON MAP

Radon Map Legend


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The Radon Map above clearly shows Baxter County and surrounding counties in

Northern Arkansas in Zone 2 indicating a moderately high radon level. Radon is

the number one cause of lung cancer among non-smokers, according to EPA

estimates. Overall, radon is the second leading cause of lung cancer. Radon is

responsible for about 21,000 lung cancer deaths every year. About 2,900 of these

deaths occur among people who have never smoked.

On January 13, 2005, Dr. Richard H. Carmona, the U.S. Surgeon General, issued a

national health advisory on radon. EPA recommends having homes tested because

there is no known safe level of exposure to radon. EPA also recommends that

Americans consider fixing their home for radon levels between 2 pCi/L and

4 pCi/L.

The client would be wise to follow the EPA advice and have their home tested,

especially due to the proximity to ledge or basement near the residence. If tests

confirm moderate potential for lung cancer risk she should definitely have the

house fixed professionally by having basement sealed against outgassing.

In conclusion, the client is advised to have her well water tested for volatile organic

compounds and heavy metals. She should inform her doctor that she has likely

been exposed to moderately high levels of benzene and formaldehyde during

middle age. The doctor should be informed that the latency period for Benzene

exposure can be up to 40 years and that she has been removed for 24 years after

an exposure period of 42 years. This places her at greater risk for Chronic

Myeloid Leukemia or Chronic Lymphocytic Leukemia (CML/CLL). Proximity

to a petrochemical complex emitting BTEX could increase the risk of

leukemia from breathing the ambient air as high as 3 in 10,000. Prolonged

exposure to styrene in her later years increases the risks of leukemia and

lymphoma. She should have her blood tested regularly and any anomalous tests of

blood cells should be considered cause for concern; not a fluke.

Formaldehyde exposure at this time also adds to the risk of myeloid leukemia and

nasal sinus cancer and nasopharyngeal cancer. These risks were significantly

elevated for individuals with longer time since first exposure or who died at an older

age. Risk was increased fourfold for individuals who died after the age of

68 and were probably exposed to high levels of formaldehyde for at least

20 years before death.


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In addition, prolonged exposure to high levels of smog during this periodsuggests that she is 30 percent more likely to succumb to lung diseasessuch as chronic bronchitis, emphysema and pneumonia. Upper chest

congestion should be a cause for thorough testing.

Living next to a major freeway during this period means exposure to particulatematter (especially PM2.5) which could increase susceptibility to respiratory

infections including pneumonia. Recent studies have shown a relationship betweentraffic related air pollution and death from heart attack and stroke. The doctorshould be informed that White Females in Los Angeles over the past decade havehad an unusually high death rate from Stomach Cancer as well as Liver, Gallbladderand other Biliary Tract Cancer.

Lung Cancer as a secondhand smoker cannot be ruled out and these chances areincreased if it is determined that an unsafe level of radon is in the house. The U.S.Surgeon General estimates that living with a smoker increases a nonsmokerschances of developing lung cancer by 20 to 30 percent. No one knows what the risk

is after smoking ceases. The doctor should definitely not rule out lung cancer as alikely possibility just because she has never smoked.

The local doctor should already be aware that there is little or no mortality data forbladder cancer among females in the region However, the same mortality data formales shows that the county has some of the highest mortality rates in the countryfor bladder cancer. The doctor should also know that the region generally had anelevated mortality rate for all malignant cancers among females. This can partly beexplained by the relatively high smoking rate and poor diet, but other

environmental factors may also be involved.

On the basis of mortality rates alone in the county, the doctor should be told to beon the lookout for early signs of stroke, pancreatic cancer, ovarian cancer and lung

cancer.

Environmental Health tracking is most useful if used as a risk indicator. Obviously,if the subject plans to relocate, she is going to want an environmental assessmentof the future residence. For past toxic exposures, she will need to work with herdoctor to assist in diagnosing chronic illnesses and determining the risks oftreatment options.

Environmental Health tracking is a fact-based, evidenced-based tool for assessingthe risks of chronic disease over a persons lifetime. We use only toxic exposuredata in the places of residence and estimate exposure only at the time of residence.We take into account the actual distance from the residences to the toxic sourcesand estimate amounts of discharge or emissions of specific chemicals known to behazardous during the time of residence. Based on this exposure data we analyzethe relative risk of developing specific chronic diseases known to be associated withthese chemicals at these levels of exposure in the latest medical journals.


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Only epidemiological data appropriate to the gender and race of the subject ispresented. All of this exposure information is compared directly to the relativemortality rates over the past decade for specific chronic conditions in the countiesof residence. This is the only scientifically valid and defensible approach toassessing the risk of developing chronic disease from past exposure to

environmental toxins.

We do not claim that environmental exposures cause chronic diseases, only that itpotentially contributes to the development of the diseases and therefore increasesthe risks of certain chronic diseases. Of course, multiple exposures to chemicalsknown to be associated with specific chronic diseases (as these historicalinvestigations might reveal) increases the risks further.

These relative risk assessments, in consultation with the subjects doctors, could aidin early diagnosis and treatment of chronic disease. If environmental tracking isapplied to assess toxic risks at potential future residences or workplaces underconsideration, it could also help to reduce the risks of future development of chronic

diseases.

Enviro-Health Tracs Profile Sample 2

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Transcript of Enviro-Health Tracs Profile Sample 2