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Update on Public Health Activities August 3, 2011 Presentation to the BoRit Asbestos Site

Update on Public Health Activities August 3, 2011 Presentation to the BoRit Asbestos Site Community Action Group Dr Farhad Ahmed, Dr. Greg Bogdan, and Barbara Allerton, MPH, BSN, RN The Pennsylvania Department of Health (PADOH) Lora Siegmann Werner, MPH

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Update on Public Health Activities August 3, 2011 Presentation to the BoRit Asbestos Site

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  1. Update on Public Health Activities August 3, 2011 Presentation to the BoRit Asbestos Site Community Action Group Dr Farhad Ahmed, Dr. Greg Bogdan, and Barbara Allerton, MPH, BSN, RN The Pennsylvania Department of Health (PADOH) Lora Siegmann Werner, MPH Agency for Toxic Substances and Disease Registry (ATSDR) Edward A. Emmett, MD, MS University of Pennsylvania School of Medicine

  2. Background The Department of Health has a cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR) for the Health Assessment Program. • Prevent or reduce potential exposures and illnesses resulting from exposure to contaminants from hazardous waste sites in the commonwealth • Determine the potential human public health effects associated with any such exposures • Produce health assessment and consultation documents (e.g., TA, LHC, HC, PHA) on such sites • Provide health education to residents, health care professionals and elected officials in impacted communities (community fact sheets, public meetings, grand rounds)

  3. BoRit Asbestos Site Site includes two historical asbestos disposal areas and a water reservoir. • The facility involved manufacturing and processing of asbestos-containing material (ACM), and operated from 1897 to 1980s. • The site pile and the reservoir encompass an area of approximately 30 acres. • ACM is present in surface soils throughout the site.

  4. Site Conditions in 2008

  5. Current Conditions

  6. 1/09 Community Open House 4/09 Earth Day Community Cleanup 3/07 Grand Rounds (2) 5-6/09 Doctor Visits and Patient Poster 9/11 Nurse Association Presentation (planned) 2005 2006 2007 2008 2009 2010 7/08 Health Consultation & Community Fact Sheet 3/09 Health Consultation 8/11 Cancer Update Factsheet 12/06 – 1/07 Historical Review & Community Fact Sheet 8/08 Public Meeting 3/09 Public Meeting Public Health Activities Timeline 9/09 Grand Rounds 12/10 Nurse Association Presentation 2011 2012 6/05 Community Request 1/09 Health Consultation & Community Fact Sheet 8/10 Phase 1 Air Data Review & Spring Cleanup Flyer 2012 Public Health Assessment (planned) Documents Monthly CAG Meetings and HERS Workgroup Meetings Health Professional Education Public Meeting Community Activity

  7. Public Health Consultations Prepared two health consultation documents: 1) Environmental sampling data and concluded: • Residents in the Ambler community were not currently being exposed to asbestos at a level of health concern. • However, there was a potential public health hazard, and past exposures were unknown. 2) 2009 Cancer review found that none of the types of cancer associated with asbestos was significantly higher than expected.

  8. Public Health Recommendations (2009) • Because of the potential for exposure to the surrounding community and the level of asbestos in surface soil across the site, PADOH and ATSDR recommend immediate and sufficient containment (covering exposed areas) of asbestos-containing materials on the siteto prevent possible off-site migration of asbestos. • EPA and PADEP should continue to work with property owners to restrict access to the site. • DO NOT TRESPASS ON THE SITE! • Visitors to the site should avoid disturbing the soil.

  9. Health Outcome Data Reviews PADOH completed an initial cancer data review in 2009 to evaluate cancer incidence in the community. PADOH has now completed an update to this review. The update focused specifically on asbestos-related cancers: - mesothelioma - lung and bronchus cancers PADOH’s initial review evaluated information reported by hospitals, laboratories and physicians to the Pennsylvania Cancer Registry from 1996-2005. The updated review includes information reported to the registry from 1992-2008.

  10. Area of Review

  11. Findings of the 2011 Cancer Update • The overall cancer incidence rate (total number of all cancers per population) in ZIP code 19002 was lower than the overall rate for Pennsylvania. This lower incidence was statistically significant. • The rate of mesothelioma in ZIP code 19002 was 3.1 times higher than expected, based on statewide rates for this cancer type. Men had 2.7 times the expected rate, and women had 4.5 times the expected rate. These differences were all statistically significant. The mesothelioma rates for Blue Bell (19422) and Fort Washington (19034) were not elevated. • The rate of cancer of the lung and bronchus which has also been linked to asbestos exposure, but is more strongly related to tobacco use, was less than expected in all three ZIP codes. The low incidence rates were statistically significant compared with the rate for Pennsylvania as a whole.

  12. Conclusions of the 2011 Cancer Update PADOH and ATSDR believe the cases of mesothelioma are most likely due to exposures that occurred in the past when the asbestos facilities were operating and exposing workers, and possibly household contacts of these workers. • Most cases of mesothelioma are diagnosed 30 years or more after the first exposure to asbestos. • Air sampling results reviewed (through 2010) indicate that residents in the community are not currently being exposed to asbestos at a level of health concern. • Despite our efforts, we have been unable to confirm anecdotal reports of asbestos-related disease occurring in residents who did not work with asbestos in the past, or were not a close contact to an asbestos worker.

  13. Limitations of Health Outcome Data Reviews • This cancer data review can only determine whether there is an abnormal rate of cancer in the study area. Cause and effect relationships cannot be established because other factors may contribute to the observation (e.g., heredity, lifestyle, exposures from other sources and occupational exposures). • The cancer registry uses only the residence of the individual at the time he or she was diagnosed with the disease. Information on previous residence and length of residency are not included in the cancer registry. Population mobility and changes in population could affect the results of this analysis. • Since mesothelioma and lung cancer can take decades to develop, the current health outcome data reflect past exposures.

  14. Future Steps PADOH and ATSDR will: • Continue to share information with local health care providers. • Evaluate recent and future environmental sampling data collected by EPA and publish our finding in a public health assessment. This document is expected in early 2012. • Remain interested in learning of individuals with non-work related asbestos disease who live in the community. The University of Pennsylvania is conducting a study to determine the effects of community and occupational exposures and of household exposures in families of asbestos workers.

  15. Questions?

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