Next Steps

At the end of the workshop, Dr. Maureen Lichtveld presented a five-point action plan for the agency to address the issue of psychosocial effects in communities near hazardous waste sites. The actions to be taken include the following:

1. Produce a proceedings of this expert panel workshop;
2. Publish articles in the scientific literature regarding the psychosocial effects in communities near hazardous waste sites;
3. Write a training handbook for local and state public health officials on ways to minimize stress in communities exposed to hazardous substances;
4. Develop direct interventions in communities faced with exposures to hazardous substances based on disaster relief strategies; and
5. Develop and implement public health strategies designed to mitigate the psychosocial stresses that can be found in communities exposed to hazardous substances.

Since the expert panel workshop, ATSDR has moved forward with the development of a psychological effects program. Since September 1995, the agency has designed a public health strategy that combines enhancement of the public health system's capacity to respond by developing and implementing a training program for public health partners. Additionally, the agency has delivered several direct interventions in communities.

ATSDR developed a training module for health assessors and public health officers; this module is designed to enhance their awareness of the psychological responses that accompany exposures to  hazardous substances. The first training course using that module was presented on February 3-7, 1997. Several training sessions for county health officials have been conducted through the agency's partnership with the National Association of County and City Health Officials. Also, training has been held for staff in state health departments.

There have been several different projects with communities. This has involved sponsoring a 1996 educational workshop regarding ways of reducing stress caused by acute exposures to a hazardous substance and a subsequent sudden evacuation for a relocated community. A series of workshops for residents of a community permanently relocated because of environmental contamination was given on February 26-28, 1997. The series of workshops gave the residents basic information on how to cope with the stress of a relocation related to environmental contamination. Additionally, training on how to help temporarily relocated residents  as given to social workers involved with the hundreds of displaced people during the methyl parathion response on the Gulf Coast. Also, expert opinion was provided to an EPA task force that is looking at the issue of how to handle environmental relocations.

ATSDR continued to advance the public health science on this topic though a September 10 and 11, 1997, expert panel workshop entitled "The Feasibility of Measuring Stress Related to Hazardous Waste." The workshop convened in Atlanta, Georgia. The proceedings from that workshop are forthcoming.  In 1998, ATSDR worked with the Missouri Department of Health and ATSDR's Office of Regional Operations to develop a needs assessment for public health personnel to use to determine the desires and needs of a community when coping with the psychological effects of exposure to hazardous substances.

Most recently, ATSDR and EPA have joined in an initiative, ATSDR-EPA Initiative Regarding Community Stress Related to Hazardous Substances, to train EPA personnel in the area of community stress. The initiative will increase awareness and improve staff ability to respond to communities facing exposure to a hazardous substance. Public health responses  will be piloted at three sites over the next 3 years. During 1999, a community support network involving social workers will assist a community facing both permanent and temporary relocations due to environmental contamination.

A handbook, Training Handbook on Psychological Responses to Hazardous Substances, is expected to be completed by September 1999 and published in FY 2000.

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