FOREWORD

In 1980, as part of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended, also known as the Superfund law, Congress created the Agency for Toxic Substances and Disease Registry (ATSDR). The Superfund is an amount of money used to investigate and--when necessary--clean up hazardous waste sites. The US Environmental Protection Agency (EPA) works with the individual states to investigate hazardous waste sites. The EPA can place sites on the National Priorities List (NPL), thus qualifying them for cleanup with Superfund money.

Since 1986, ATSDR has been required by the Superfund law to conduct a public health assessment at each of the sites on the National Priorities List (NPL). The assessment determines whether people are being exposed to hazardous substances and, if so, whether that exposure is harmful and should be stopped or reduced. The US Navy sites under review in this public health assessment are not NPL sites. But ATSDR can conduct public health assessments at the request of concerned individuals. Such requests are initiated through an ATSDR process known as a petition. This public health assessment, and related ATSDR public health actions currently underway in Vieques result from a petition submitted by a resident of the Isla de Vieques, Puerto Rico.

Exposure: As the first step in the assessment process, ATSDR scientists review site environmental data to determine the types of contamination, their quantity and location, and how people could come into contact with them. Generally, ATSDR does not collect its own environmental sampling data; it usually reviews information provided by EPA, other government agencies, businesses, and the public. When sufficient environmental information is not available, ATSDR scientists will indicate what further sampling data is needed.

Health Effects: If, however, the environmental data shows that people have or could come into contact with hazardous substances at the site, ATSDR scientists evaluate whether any harmful effects could result from these exposures. Their report will focus on public health, or the health impact on the community as a whole, rather than on individual risks. Again, ATSDR generally makes use of existing scientific information. This can include the results of medical, toxicologic and epidemiologic studies, as well as data collected in disease registries. Because the science of environmental health is still developing, information about the health effects of certain substances is sometimes not available. When this happens, the report will suggest what further research studies are needed.

Conclusions: The report will present conclusions about the level of health threat, if any, posed by a site and will recommend ways to stop or reduce that threat. Because ATSDR is primarily an advisory agency, the report will usually identify those actions that should be undertaken by EPA, other agencies or responsible parties, or by ATSDR's research or education divisions. If, however, the health threat is urgent, ATSDR can issue a public health advisory warning of the danger. ATSDR can also authorize health education or health effects pilot studies, full-scale epidemiology studies, disease registries, surveillance studies, or research about specific hazardous substances.

Interactive Process: The health assessment process is interactive. ATSDR solicits and evaluates information from city, state, and federal agencies, from companies responsible for cleaning up the site; and from the community. ATSDR then publicly shares its conclusions. State and federal agencies review and comment on an early version of the report to make sure the data they have provided is current and accurately presented. After learning of ATSDR's conclusions and recommendations, agencies will sometimes begin to act on them--even before the final release of the report.

Community: ATSDR also wants to learn what local citizens know about the site and what concerns they have about its effect on their health. Accordingly, throughout the evaluation process ATSDR gathers information and comments from the people who live or work near a site, including area residents, civic leaders, health professionals, and community groups. To ensure the report responds to the community's health concerns, an early version is also distributed to the public for its comments. Comments received from the public are addressed in the report's final version.

Comments: If, after reading this report, you have questions or comments, we encourage you to send them to us.

Letters should be addressed as follows:

Attention: Chief, Program Evaluation, Records, and Information Services Branch, Agency for Toxic Substances and Disease Registry, 1600 Clifton Road (E-56), Atlanta, GA 30333.