VIII. Public Health Action Plan

The Public Health Action Plan for Vieques contains a description of actions taken and those to be taken by ATSDR, the Navy, EPA, PREQB, and PRDOH. The purpose of the Public Health Action Plan is to ensure that this PHA not only identifies public health hazards, but also provides a plan of action to mitigate and prevent adverse human health effects resulting from exposure to hazardous substances in the environment. The public health actions that are completed, planned, or recommended are as follows:

Actions Completed:

• Drinking water and groundwater sampling was carried out by various agencies, including EPA, PRDOH, PREQB, USGS, and the Navy.
• In August 1999, ATSDR conducted an initial site visit to Vieques to meet with the petitioner, tour the island and bombing range, and gather available environmental data. As a result of this site visit, ATSDR accepted the resident's petition and initiated the PHA process.
• In September 2000, ATSDR met with various agencies including PRDOH, PREQB, EPA, USGS, and the Navy to gather data and to discuss the scope and nature of ATSDR investigations. ATSDR also met with the petitioner to tour various sites on Vieques and provide an update on ATSDR efforts.
• In June and October 2000, ATSDR discussed with local health care providers their concerns about public health and provided training about how to medically assess environmental exposures. During these visits ATSDR met with numerous residents of the island to discuss health concerns.
• In September 2001, ATSDR conducted additional community involvement activities to inform participants of the scope of ATSDR investigations and seek additional community input. Continuing education-public health training was held for the nurses of Vieques and environmental health instruction was given to area parents and high school students.
• ATSDR held a public availability session on March 14, 2001 to be available to meet individually with community members about the findings of the evaluation of drinking water on Vieques.

Actions Planned:

• ATSDR will continue to identify and analyze potential and completed pathways as data become available and will impart the findings to the residents of Vieques in additional focused PHAs.

Recommendations for Further Action:

• Because the levels of nitrate and nitrite in Well 3-7 is a public health hazard and because there may be other similar shallow domestic drinking water wells in use that have not been identified, ATSDR recommends that when such wells are identified that PRDOH or PREQB sample those wells to ensure that the well water is safe to drink.
• It is known that some rainfall collection systems are installed on Vieques. The available information indicates that most of these systems are used to provide an emergency water supply. However, some rainfall collection systems may be used for a more continuous drinking water supply. ATSDR recommends that PRDOH or PREQB identify examples of such collection systems and perform sampling to evaluate if these systems deliver tap water that is safe to drink. If the storage tanks associated with these collection systems contain bottom sediments, it is recommended that those sediments be sampled to provide an indication of potential past water quality.
• ATSDR recommends that PRDOH or PREQB, in coordination with Compania de Aguas, take the necessary steps to ensure that backup water supply systems are available during emergency situations.

Other Public Health Assessment Activities

Completed or Ongoing Actions:

• ATSDR will continue to identify and analyze potential pathways as data become available and will impart the findings to the residents of Vieques in additional focused PHAs. Efforts are ongoing to assess potential pathways of contaminant transport through the air, soil, and food chain. Reports on these evaluations will be made available for public comment when they are completed.
• ATSDR requested that the Navy sample soil on the LIA for use in our assessment of the air and soil pathways. This sampling has been completed and was received by ATSDR in early January 2001. Evaluation of those data is underway.
• ATSDR is continuing to meet with various community members and organizations to gather concerns and exchange information. This effort will continue throughout the PHA process.
• ATSDR has and will continue to meet with local health care providers to discuss health concerns for the community and to provide educational materials for addressing the community's health needs.
• ATSDR will review cancer registry information and data gathered by the PRDOH. The information will be evaluated as it relates to potential pathways of environmental exposure and general health status of the communities.
• PRDOH is working on Vieques to gather information about recent cancer cases on the island. The information gathered will be added to the current cancer registry information.