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Moderator: Von Roebuck, April 30, 2008, 12:00 p.m. ET

OPERATOR:  Good afternoon and thank you all for holding.  At this time your lines have been placed on listen only until we open up for questions and answers.  Please be advised today′s conference is being recorded.  If you have any objections, you may disconnect at this time.  I would now like to turn the conference over to Mr. Von Roebuck.  Please go ahead sir.

VON ROEBUCK, CDC:  Thank you Laura.  Welcome everyone to the CDC media availability.  I′m Von Roebuck in CDC′s main press office in Atlanta.  Today the Agency for Toxic Substances and Disease Registry, ATSRD, is issuing a revised report for public comment and what is known about environmental contaminates in human health in the Great Lakes Region.

The report is being posted today on the ATSCR CDC Web site.  Dr. Henry Falk, Director of Coordinating Center for Environmental Health and Injury Prevention at the CDC joins us today to talk about this report.  Dr. Falk′s last name is spelled, F as in Frank, A-L-K.  Dr. Falk will make a few brief comments about this report.  Then we′ll take your questions.  Dr. Falk, please proceed.

HENRY FALK, DIRECTOR OF COORDINATING CENTER FOR ENVIRONMENTAL HEALTH AND INJURY PREVENTION, CDC:  Thank you very much and welcome.  I just want to provide a few background comments with regards to ATSDR and the nature of this report and where we are and where we′re going subsequently.

So this report is from ATSDR, the Agency for Toxic Substances and Disease Registry, which is closely linked with CDC, Centers for Disease Control.  ATSDR is an agency that was created as part of the superfund legislation to work on health related aspects of toxic chemicals, releases and hazardous waste, and ATSDR is committed to protecting public health from chemical contaminations since its founding over 20 years ago.

In particular, ATSDR has had long standing commitment to working in the Great Lakes area, both internally in terms of reviewing data about exposure at hazardous waste sites in the Great Lakes States, but also working with State Health Departments in the area and the work they do in this area, as well as ATSDR, has had a long standing extramural grants program to support work at the Great Lakes states Health Departments and Universities in this area.

In 2001, the International Joint Commission asked ATSDR for assistance in evaluating the public health implications of environmental contamination in Great Lakes areas of concern.  Those areas of concern are ecologically degraded places in the region, and in particular, they asked ATSDR to focus on public health implications of the environmental contaminants in the area.

So the report that′s being released today is a public comment draft, which means that the report is being released today and will be open for public comments for the next 60 days and as Von said, it′ll be up on the web site for all to see.  Simultaneously, this draft, together with earlier drafts of this report, is being reviewed by the Institute of Medicine at our request.

And so we hope that we will have broad input on this public comment draft from prestigious scientific groups like the Institute of Medicine from scientists in the Great Lake states and elsewhere in the area from state and local Health Departments and particularly from the public and all of those who are interested in this.

I just want to briefly describe this report.  The report primarily provides a compilation of environmental data in the counties where these areas of concern are included.  The data includes material from ATSDR reports and investigations over the years.  It includes publicly available information from a variety of EPA databases, in particular, the toxic release inventory.

In addition to providing this information by county and by site, there are a series of maps and tables and other information, which help portray this large body of environmental data.  So we think there′s a value to pulling together the various streams of environmental data, which will help people consider public health implications going forward.

And earlier drafts of this report had included county health data.  You will see when you look at this draft that we have not included the county health data.  In large part this draft was worked on by a wide variety of people at ATSDR, multiple divisions.

And the consensus feeling was that the county health data are not informative and valid in terms of trying to project what the health concerns are at these geographically distinct focused and limited sites in terms of the areas of concern and hazardous waste sites.

The particular-- the conclusions of this report are largely saying that when dealing with these very specific areas, the readily collected available health information is not specific enough.  And really going forward there is a need to get better focused health information for these sites.  And in the recommendations and conclusions section  points to a number of different kinds of information that would be helpful in the future.

We are hoping, that as a result of the public comment period and the reviews by IOM and others, that we will get really good feedback on this draft document and that within two months, by the end of June, we’ll have the IOM comments, as well as the public comments on this draft, and we’ll work towards finalizing this report at that point.

We have because, as you know, there’s been considerable discussion and controversy over the Agency’s holding back an earlier draft, we′ve tried very hard to be as transparent as we can.  All of the earlier drafts, all of the comments on the earlier drafts, the current draft, all of that is up on the ATSDR Web site.  All of that is being reviewed by the IOM.  All of that is available to the public.

And we look forward to good dialogue and response to the materials and are seeking broad input on this draft.  As I’ve said before, we want to conclude this draft and we have this strong commitment to work in the great lakes area.

We want to be able to follow up on this report as well, in the most appropriate way and we look forward to the public comment on this draft.  So I hope, you know, that’s a good introduction, and we’d be eager to answer any questions that you have.

ROEBUCK:  Thank you Dr. Falk.  Laura, please, we’ll take questions at this point.

OPERATOR:  Thank you.  At this time, if you would like to ask a question please press star followed by one on your touch tone phone.  To withdraw your request, you may press star two.  And once again, to ask a question please press star followed by one.  Our first question comes from James Janega, Chicago Tribune, please go ahead.

JAMES JANEGA, CHICAGO TRIBUNE:  Hello.  I had the mute button on, sorry about that.  Dr. Falk, first as a point of clarification, will there be no health data in this or no county health data?

FALK:  The county health data has not been included.  When you go through the document, there’s very detailed discussions of the areas of concern and the health sites by the Great Lakes over a course of five chapters and that really is the largest part of the report.

And in that compilation of information about each of those areas of concern it includes information a lot ATSDR work over the previous 15 years at assessing hazardous waste sites in their area and it includes, up to date information on that.

So if ATSDR concluded that particular hazardous waste sites within or adjacent to areas of concerning were a public health concern or were not a public health concern, that information is in the body of the report.

So we haven’t included the county health data.  And I guess what I’m trying to say is that the readily available data, such as county health data, state health data, that information is hard to apply to the individual sites, but whatever information we do have on the individual sites from past work, we have included there.

ROEBUCK:  Thank you, Dr. Falk.  We’ll take our next question.

OPERATOR:  Thank you.  Once again, as a reminder, to ask a question please press star followed by one.  Our next question comes from Todd Zwillich, Capitol News Connection Public Radio, please go ahead.

TODD ZWILLICH, CAPITOL NEWS CONNECTION PUBLIC RADIO:  The Tribune just asked my question almost word for word.  Thanks.

FALK:  Thank you.

ROEBUCK:  OK, thank you, we’ll take our next question.

OPERATOR:  Thank you, again, as a reminder, to ask a question please press star one.  Our next question will come from John Flesher, Associated Press, please go ahead.

JOHN FLESHER, ASSOCIATED PRESS:  Thank you.  I wonder, Dr. Falk, if you could talk a little bit about the period of time it took to put these reports together?  There′s been some, as you know, some criticism from Congress about that time period and some suggestion that the reports were being withheld or suppressed somehow.  Can you just talk about the amount of time it took to do this and why it took as long as it did?

FALK:  Right.  So the request from the International Joint Commission came in 2001, the original draft, which appeared in 2004, therefore was prepared over a period of three years.  It went out for peer review comment in 2004 as well as was circulated at various times in 2004, -05 and -06 to other groups, such as to EPA.

And so, comments were received between 2004 and 2007 and then the draft that was sent forward to the ATSDR leadership in 2007 was the one that was held back because of questions, you know, in terms of scientific concerns.  So, yes, that′s – that is, in terms of process, less than ideal though it′s longer than we would like.

It was held back even after that amount of time because we felt it needed to be strengthened.  We also feel strongly about having – this draft has had stronger participation from within ATSDR, the multiple divisions of ATSDR.

And because we know that, you know, there has been discussion and concern and controversy we wanted to make sure that we did the best, most complete, most open job of evaluating this current draft which is why we included the Institute of Medicine and why we have this public comment draft up on the website and available to everyone.

So I share, you know, the concern about the length of time it took to do this and, you know, we are evaluating our systems and we hope to make sure that, you know, in the future we′ll be able to do this in a more timely way.

As part of – I think the greater transparency when we receive public comments and the IOM comments, all of which is due by the end of June, we will try to in a very expeditious way, assemble all of those comments, collate them, summarize them and utilize them in putting together a final draft relatively rapidly.

ROEBUCK:  Thank you Dr. Falk, we′ll take our next question please.

OPERATOR:  Thank you.  Our next question comes from Molly Davis, Inside Washington Publishing, please go ahead.

MOLLY DAVIS, INSIDE WASHINGTON:  Hi, Dr. Falk.  This is Molly, writing for Inside EPA.  Last time we talked you told me about this sort of three-part approach for it′s internal investigations at the ATSDR to address some of the science and general management concerns but that some of it still hadn′t been entirely developed yet.  So, can you sort of articulate how those three, sort of, internal flash independent reviews are going to go forward?

FALK:  Sure, and the first of those is a very thorough scientific review of this draft report, and as you know, we asked the Institute of Medicine to review, not just the draft we′re giving them today but the whole series of drafts, the ‘04, the ‘07, as well as today′s, as well as the various review comments that have been in on that.

The Institute of Medicine has established a committee; they are meeting tomorrow (May 1) and Friday (May 2) and as I said, they have promised to report by the end of June.

And that′s a group of about I believe 10 very quality scientists from around the country who have expertise in areas such as epidemiology, toxicology, risk assessment and statistics, health communication and so on.  And so that was the first step to deal as openly and transparently and as rigorously as we could in terms of getting strong scientific input.

And I think as many of you probably know the earlier draft arrived in mid ′07 to ATSDR leadership in a sense unannounced and we were, it was sort of a rapid decision that was made at that time.

So we have asked the board of scientific counselors of ATSDR to work with us on reviewing clearance and peer review processes within ATSDR so again, so that that system works as smoothly as possible.

And the third area which I mentioned which is also important to us is that the – we are, we will and it hasn′t yet started but hopefully in the near future a management review so that, you know, our procedures and processes will be as strong as possible.

So the scientific review of this document is the first of those three and is moving very rapidly both with this public common draft and with the IOM input.

ROEBUCK:  Thank you, Dr. Falk.  Laura, we′ll take our next question.

OPERATOR:  Thank you.  Our next question comes from Alison Young, Atlanta Journal-Constitution.

ALISON YOUNG, ATLANTA JOURNAL-CONSTITUTION:  Hi, Dr. Falk.  Thanks for taking our calls.  Can you explain a little bit more what peer review this report has gone to prior to this point and a little bit about what kind of feedback the agency received, whether there was consensus or dissent on the earlier inclusion of the county level data?

FALK:  Sure.  I′m happy to do that.  So the 2004 draft went to three peer reviewers and their comments are up on the website and you can see them.  And I think those peer reviewers in general felt that it was important to make the compilation of environmental data available and, you know, I would rank those as relatively positive feedback.

Now, they also pointed out to the limitations of the health data and you should recognize that the county health data as they were utilized in the 2004 draft were done very differently than in the 2007 draft.  So those peer reviewers saw the 2004 draft and their response, you know, the three of them, was that it was important to get the environmental data of this compilation out.

And I just want to reiterate - no new data generated for this report.  It′s a compilation of previously existing publicly available information.  The value is having it in one place, distributed by particular sites so that, you know, there is an ease of having assembled the data for the interested reader.

Over the course of 2004 to early 2007 as I mentioned, the document was at various stages, was sent to probably over 200 people and I think the great bulk of those people did not reply.  They weren′t formal peer reviewers and so perhaps 80 percent or more of those and 80 to 90 percent of those didn′t actually formally reply.  Those that did reply, some portion of them replied to a specific point in the report.  They might have said, well, in talking about this site in this state, you know our records suggest something different than what you have.

So, there were comments there that are not comprehensive reviews of the document, but they relate to a specific point of interest to the person who received the document.  Of the remainder, I think there are, you know, I would say that there are two strands among people who′ve reviewed this.  There are those who say the compilation of environmental data is very helpful.  It′s good to have this, important to prepare this information and utilize it.

And there are others, in particular, and you′ll see those comments on the Web site, whether they′re from the EPA or from others, where they felt that the utilization of the county health data was, in a sense inappropriate, that people, you know, might draw conclusions, which were not really valid and the way the county health data, in particular, were utilized.

And I think even after the material that′s on the Web site, there′ve been three letters, for example, that have come in from State Health Departments, which also express concern about that in terms of how people would interpret that information.

So I think those broader number of reviews try to emphasize the value of compiling the environmental data, which we agree with and are of varying levels of concern.  So I′m very concerned about the utilization of the county health data and the way it was done.  So in working on this draft at the present time, we haven′t included the county health data.

And of course we′ll be open to hearing what the IOM and other scientists who review this think and whether we have some consensus in response to what we′ve done.  We′ve also tried to be very close to the original intent of the document, which was the compilation of the environmental data.

And what we tried to do in this document, is in this current draft, is to update that data as much as possible to make sure that all the information is correct, to make sure the methodology is clearly stated.  And we′ve provided more specificity and precision to some of that environmental data.

So for example, if you look at the maps and the appendices which summarize the EPA TRI data as well as the AOC data, you′ll see much more information on those maps.  The method, hopefully will be clearer.  We′ve updated, say for example, EPA data on which sites have been cleaned up and which ones have not been remediated so you have the current information.

So we want the compilation to be as useful as possible and we want to have that data as current and as precise as it can be.

ROEBUCK:  Thank you, Dr. Falk.  We′ll take our next question, Laura?

OPERATOR:  Thank you.  Our next question comes from Tracy Samilton, Michigan Radio.  Please go ahead.

TRACY SAMILTON, MICHIGAN RADIO:  Yes, thank you.  I wanted to clarify this.  It sounds like there really are no conclusions you were able to make about the areas of concern and their effects on public health based on the existing data.

And if that′s true, then what kind of data would have to be collected so that scientists could draw some kind of conclusions?

FALK:  I think where we have data on individual sites, as I said, from previous ATSDR work, we′ve included that.  And I want to emphasize that previous work, which has been done with support from ATSDR to scientists at universities and Health Departments in the Great Lakes, have significantly added to our knowledge, for example, about the effects of particular chemicals, you know, the effects of PCB′s for example, on the young and the elderly.

In some areas there have good information on the exposure levels to those chemicals.  So, we do have information on specific sites and related to specific chemicals.  I think what the report is trying to say is that in terms of broad readily available data that there are limitations.

And so the logical extension of that is that to really look at focused areas where there are specific kinds of chemicals and very specific kinds of exposure patterns you actually have to look at those areas themselves in more detail, try to understand exactly what chemicals, exactly what the exposure patterns are, who has been significantly exposed and what specific effects you would find in those very discreet and local and circum square populations.

So, the broader counter state data doesn’t really answer that question for you.  So, there are various ways in which one could assemble help data but it really has to be focused on those specific areas.

ROEBUCK:  Thank you Dr. Falk, we′ll take the next question please.

OPERATOR:  Thank you.  Our next question comes from James Lynch, Detroit News, please go ahead.

JAMES LYNCH, DETROIT NEWS:  Dr. Falk, just following up on that last question I think the key to the people who live out in these areas is they were really interested in knowing what sort of health risks they′re at for being near these sites?

And I think you just touched on the type of information that′s available right now.  But I think I would be remiss if I didn’t ask what sort of—are there any sort of studies in the works to follow up on that?  To take that sort of more specific look that needs to be done to get at those questions?  To be able to tell somebody who lives near a plant out here that the reason you′re having complication, you know, A, B, or C is because of your exposure?

FALK:  Right, so, you know, the answers to that are very specific to each individual site.  I—when one thinks about hazard waste sites or areas of concern the key issue is that they′re not all the same. They have different chemicals.  They have different routes of exposure.  Exposures occurred at different times in the past.

Many of these sites, you know, the current exposure is not currently continuing but the question is whether exposures in the past might have led to effects they′re currently having.  But I guess the point is it′s not easy to just look at broad health data and say well because of this we expect the following.

One really has to know because all these sites are different.  You have to know the history of the site.  You have to know what chemicals, who was exposed, how were they exposed, the intensity of exposure, whether the chemicals were the long acting or the short acting, and then look at the relevant kind of health data at those sites.

So, and as I′ve said, a number of those sites, at least the hazard waste sites that have been looked at by EPA and ATSDR and have been assessed but one looks broadly at the areas of concern.  One has to develop a comparable database of health data that is very specific to those areas of concerns and it′s—unfortunately you can′t, you know, one has to actually look at those specific places and develop the appropriate database for those individual sites.

ROEBUCK:  Thank you, Dr. Falk.  We′ll take our next question.

OPERATOR:  Thank you.  Our final question comes from Katie Boyle of Greenwire.  Please go ahead.

KATIE BOYLE, GREENWIRE: Well just again kind of following up on the last two questions.  So basically I know that this report has now been about eight years in the works.  And one of its major conclusions is that other data is needed.

Lacking that data are there any new judgments from the existing compilation of environmental data in the report about the health effects of pollutants in the region or, is this just kind of repeating things from previous studies?

FALK:  I think the main value, this-- let me just reiterate.  This report, even in its earlier drafts, was not an epidemiologic study looking at an analytic approach to linking environmental health data.  Even the earlier drafts, which utilize the County Health data, were very clear that this was not a traditional epidemiological, analytic study.

The report also did not generate new environmental data.  It assembled and compiled data from elsewhere.  So, to be-- I think to summarize this study, I would say that this is a sold base on which we′ve assembled a lot of information, which, I think, would be helpful, in terms of planning the future work that needs to be done.

And, I think that′s its main value and, so, I′m hoping that this information, which has been very carefully assembled, will be valuable to people in health departments, universities, to citizens and others thinking about the future work that needs to be done.

And, it does include information on which sites, which of the hazardous waste sites in areas, have been already remediated, which ones have been previously studied by ATSDR.  So, there is a base of information here that, I think, is helpful to build on, in terms of thinking of future work.

But this study, the way it was constructed, was not intended to be the ultimate answer in terms of public health implications and, as I said, it′s a very complex issue because all of these sites are so different.

One has to really think about which are the ones that are most likely, you know, to be of concern.  And, the ATSDR information in the report is helpful on that score.  And, so, we see this as not, in some sense, the end of our work, but as an important step in planning future work.

ROEBUCK:  Thank you, Dr. Falk.  Laura, we′ll take one more question.

OPERATOR:  We have no further questions at this time, sir.

ROEBUCK:  OK, thank you, Laura.  And, thank you all for joining us today on this brief.  Please note that the report that Dr. Falk discussed today is available on the internet at http://www.atsdr.cdc.gov/grtlakes/.  The report is open for public comment, for 60 days.

If you have additional questions from today′s briefing, please contact the CDC′s main press office.  And, as a reminder, a written transcript of this briefing will be posted on the CDC′s website later today.  Thank you all, and have a good day.

OPERATOR:  Thank you, and this does conclude today′s conference call.  We thank you for your participation.  You may now disconnect your line.

END

####

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