Media Advisory

House Subcommittee Issues Staff Report on 2007 CDC/ATSDR Health Assessments of Indoor Formaldehyde Levels in Unoccupied FEMA-Provided Travel Trailers

Report Summarizes April 1, 2008 hearing, Provides Support for CDC/ATSDR Steps and Corrective Actions

The House Subcommittee on Investigations and Oversight, Committee on Science and Technology, issued a staff report this week. The staff report provides a detailed examination of the Agency for Toxic Substances and Disease Registry’s (ATSDR) production, approval and release of a 2007 health consultation the agency did on formaldehyde levels in unoccupied travel trailers. The trailers were similar to those provided to survivors of Hurricanes Katrina and Rita. Much of the information in the report comes from an April 1, 2008, Subcommittee hearing that included testimony from Dr. Howard Frumkin, director of ATSDR and CDC’s National Center for Environmental Health (NCEH) and Dr. Thomas Sinks, ATSDR/NCEH deputy director.

It is important to note the subcommittee staff report focused only on a single study-- the 2007 ATSDR analysis of air samples from unoccupied trailers. It did not review the revised report that was released in October 2007. Nor does it encompass or include a number of other CDC and ATSDR initiatives that were undertaken in the past two years to assess formaldehyde levels or address formaldehyde exposures.

In their April testimony before the Subcommittee, Drs. Frumkin and Sinks acknowledged shortcomings in the initial ATSDR health consultation, both in terms of the processes used in the development and review of the report and in the content of the report. For example,

• The initial report should have acknowledged the potential long-term health effects of formaldehyde exposure, including cancer risk.
• Clearer, better and more frequent communication should have occurred between NCEH/ATSDR senior management and ATSDR scientists.

CDC/ATSDR recognizes that the agencies should have moved more forcefully to address the emerging concern related to formaldehyde levels in FEMA-provided trailers, particularly as it became apparent that people were living in them for longer periods of time, not as a short term solution as they had been widely considered in the past. At the April hearing, Dr. Frumkin testified that he accepted responsibility for shortfalls in the agency’s response. In addition, he took responsibility and assured members of the committee that he would work to prevent similar situations in the future.

CDC/ATSDR also shares the desire of advocates and Congressional investigators to ensure the best public health processes and science are used to understand the health effects associated with exposure to formaldehyde. Since receiving an official request from FEMA in July 2007, CDC has responded with a multi-part approach to assess actual exposures by determining whether feasible methods exist to reduce formaldehyde levels; understanding the health effects in vulnerable populations; and providing residents and health care providers health information to recognize and reduce health effects potentially related to indoor air quality issues.

Lessons Learned/Actions Taken: Hurricane Katrina presented many scientific and organizational challenges. Through this experience, we identified gaps in how scientific work is assigned, supervised, and reviewed. We have taken responsibility for correcting these gaps and have already directed all of our managers to implement several steps to address these issues. These include:

• Triaging key assignments to appropriate scientific staff depending on the content of the request and staff expertise;
• Providing appropriate scientific and supervisory oversight of all staff;
• Applying consistent peer review across all divisions;

We have also requested that our Board of Scientific Counselors examine our review and clearance process for all scientific materials, and we have commissioned an external review of management procedures to identify opportunities for improvements.

And we have asked all our staff to make sure that any contacts from other agencies are directed through the most appropriate channels to ensure consistent and correct communication.

Accomplishments to support public health:

ATSDR has conducted a reanalysis of its health consultation on unoccupied travel trailers and identified scientific limitations in the initial health consultation and issued a revised version in October 2007. The document is available at: http://www.atsdr.cdc.gov/substances/formaldehyde/pdfs/ revised_formaldehyde_report_1007.pdf

CDC has twice convened an expert panel to offer scientific insight on the topic of formaldehyde exposure. Additionally, CDC has completed several important studies that have expanded scientific knowledge about formaldehyde exposure and formaldehyde levels, including:

• a study of formaldehyde levels in 519 occupied trailers;
• a study of respiratory health among children living in Hancock County, Mississippi, before and after Hurricane Katrina;
• a study by Lawrence Berkeley National Laboratory of formaldehyde and VOC off-gassing from components used in the construction of travel trailers.

Public health work on formaldehyde and health continues:

• CDC/ATSDR is evaluating the most effective methodology for a registry of persons exposed to formaldehyde as a result of living in FEMA-supplied travel trailers or mobile homes;
• CDC/ATSDR is designing a long-term health study to evaluate the health effects to children who had lived in FEMA-supplied travel or mobile homes trailers.
• CDC/ATSDR is actively engaged in convening a multi-Agency effort to support safe and healthy use of manufactured structures, including mobile homes and travel trailers, by defining a common approach to keeping people safe and healthy in manufactured structures. This is a collaboration with the U.S. Departments of Housing and Urban Development, Education, the Federal Emergency Management Agency, and the Environmental Protection Agency, and other agencies, and will seek input from a wide variety of stakeholders including industry, environmental, community, professional, and public health groups and state and local health departments.

Other important items of note:

• No federal regulation or standard exists for formaldehyde levels in residential settings. However, in general, the higher the level of formaldehyde exposure, the greater the risk of health problems. At moderate to high levels of exposure, formaldehyde can be irritating. People can suffer symptoms such as sore throat, cough, scratchy eyes, and nosebleeds from moderate to high exposures. Some people are more sensitive than others, so an exposure that causes no problems for some people can make other people sick or uncomfortable.

In addition to causing these symptoms, formaldehyde may raise the risk of cancer. Scientific research has not demonstrated a certain level at which cancer might be caused. However, the higher the exposure, and the longer it continues, the greater the risk. Formaldehyde exposure might increase cancer risk even at levels too low to cause symptoms.

• Formaldehyde is not the only potential health issue related to living in temporary housing units. Other potential health issues for temporary housing residents relate to mold and moisture, safety concerns, mental health issues, and disruption of day-to-day lives. CDC continues to consider the range of health issues that are important to public health.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES