January 14, 2010 Progress Report

ATSDR’s activities in Corpus Christi, Texas

Summary

The Agency for Toxic Substances and Disease Registry (ATSDR) and the Centers for Disease Control and Prevention’s (CDC’s) National Center for Environmental Health (NCEH) are concerned for the health of the residents of the Corpus Christi area. This progress report describes the status of current efforts and is based on internal agency reviews, site visits to Corpus Christi, and consultations with partners in the community, in state and federal government agencies, and in universities. ATSDR, in collaboration with NCEH, expects to:

• work with community leaders and residents to address key public health issues expressed to the agency,
• prepare a public health assessment that evaluates whether ambient air contaminant concentrations along Refinery Row are at levels that can impact the health of residents in the surrounding neighborhoods and if concerns are found, makes recommendations to protect public health;
• work with local and state government partners and the local medical community to encourage further discussion of elevated birth defect rates;
• conduct an exposure investigation to determine whether residents in Northern Corpus Christi along Refinery Row have high levels of benzene and other petroleum-related volatile organic compounds (VOCs) in their bodies; and
• work with Texas A&M University (TAMU) to evaluate their methods for quantifying VOCs and metabolites in blood and urine, and compare their methods with NCEH’s validated and published methods.

Background

Between 1995 and 2008, ATSDR received seven petitions related to Corpus Christi. The petitions focused on concerns about chemicals released to the air, soil and water from two landfills, chemicals released to the air from refineries and petrochemical companies, and elevated birth defect rates.

In 2001, ATSDR’s cooperative agreement state partners in Texas’ health department completed a health consultation [PDF – 4.37 MB] that addressed the landfill petition. ATSDR funds other government organizations, such as state health departments, to conduct evaluations on behalf of the agency for some sites. The health consultation [PDF – 4.37 MB] concluded that people were not exposed to harmful chemical levels from the Chula Vista and Greenwood Landfills via indoor air, surface soil, drinking water or groundwater and that the potential for current health risks from past exposures was low.

In 2003, in response to community health concerns about refineries and petrochemical facilities in the community, ATSDR agreed to evaluate the public health impact of ambient air concentrations along Refinery Row. To address this Corpus Christi Refinery Row (CCRR) petition, ATSDR began to gather available data related to air monitoring from the Texas Commission on Environmental Quality (TCEQ) and other parties. ATSDR recognizes the community’s dissatisfaction with the length of time it has taken the agency to respond to the CCRR petition. However, to adequately characterize an air-shed, several years of air monitoring data are needed.

In 2008, ATSDR received a petition requesting that the agency investigate elevated birth defect rates reported for Corpus Christi. After careful evaluation, ATSDR concluded that the limits of current scientific knowledge prevent the agency from identifying which, if any, hazardous waste sites or facilities contributed to the elevated birth defect rates presented in the Texas Department of State Health Services (DSHS) analysis. ATSDR is available to support future efforts by local and state partners, as well as provide the agency’s interpretations of additional health outcome data as they become available.

In July 2009, Congressman Solomon Ortiz requested that ATSDR obtain answers for the community. ATSDR made a commitment to complete the public health assessment in 2010 and to actively engage the community.

In November 2009, ATSDR Director Dr. Howard Frumkin, accompanied by staff, visited Corpus Christi and met with local community leaders, residents, elected officials, government partners, and industry representatives. Some of the concerns expressed to Dr. Frumkin from the community were related to the status of ATSDR’s activities, the need for community involvement in all aspects of the planning effort, the elevated birth defect rates for Corpus Christi, the lack of trust in TCEQ to lead the Corpus Christi Community Investigation (CCCI), and the community’s desire to know the final results of the collaborative pilot study conducted by TAMU, the Coastal Bend Health Education Center, and the Citizens for Environmental Justice. Based on a review of site information and in consultation with site partners, ATSDR and NCEH have committed to focus their efforts in several areas. This progress report describes those areas. They fall into five categories:

• the public health assessment,
• follow up activities for birth defect rates,
• the cross-validation of VOC biomarker methods used by TAMU,
• the exposure investigation, and
• community engagement.

Public Health Assessment

ATSDR is currently evaluating ambient (outdoor) air data for the Northern Corpus Christi area in response to the CCRR petition. The focus of the public health assessment (PHA) is to determine whether chemicals detected in ambient air are or have been at levels high enough to have potentially impacted the health of residents living in the surrounding neighborhoods. The PHA process will enable ATSDR to prioritize and identify additional steps needed to answer public health questions, and define follow-up activities needed to protect public health. ATSDR has committed to complete its PHA in 2010.

For the PHA, ATSDR has been gathering data from eight different monitoring programs that have measured outdoor air levels of volatile organic compounds, metals, and particulates near the refinery row facilities in Corpus Christi. TCEQ has been instrumental in helping the agency obtain the raw air monitoring results for the current air monitors, for providing information about the facilities of interest, and for working with the agency’s Geospatial Research, Analysis and Services Program (GRASP) analysts.

At this time, ATSDR is compiling data from two air monitoring networks currently operating in Corpus Christi: the TCEQ air monitoring network and the Corpus Christi Air Quality Project (AQP), which is run by The University of Texas (UT) at Austin. ATSDR already has air data collected through 2008, and will incorporate additional 2009 data as they become available.

Within the next six months, ATSDR will have completed its review of the following information:

• facility history and document review of background information, ownership, general manufacturing processes, periods of operation, and major changes in manufacturing process that affect emissions;
• facility emissions reported to the Environmental Protection Agency’s (EPA) Toxics Release Inventory (TRI) database as well as reports on accidental release and process upset conditions;
• environmental setting information, such as the location of the current air monitors, local climate conditions, and prevailing wind patterns;
• air monitoring data that document recent exposures (2005-2009 AQP and TCEQ data) and past data reports that focus on particular chemicals of concern (such as benzene, 1,3-butadiene, hydrogen sulfide, and sulfur dioxide);
• health effects (chemical-specific) information
  • from ATSDR toxicological profiles, the toxicology data network (TOXNET), recently published studies, and other sources,
  • for acute and chronic exposures, and chemical mixtures (to the extent health effects information exists);
• health outcome data based on available state and county data for selected cancer sites, respiratory health, and selected birth defects; and
• toxicologic evaluation, including physiologically-based pharmacokinetic (PBPK) modeling, of air monitoring data with regard to known health effects data.

ATSDR expects to complete its PHA in 2010. The PHA will contain the agency’s conclusions, recommendations, and a plan for activities to protect public health. The PHA will receive internal agency review, external peer review by outside experts, and be made available for comment by interested members of the public.

During the comment period, the public will have an opportunity to review the PHA and provide additional information and comments. After reviewing the comments and making necessary revisions, ATSDR will release a final PHA. ATSDR understands the community would like the conclusions of the PHA evaluation as soon as possible. ATSDR will keep the community updated with regard to its progress and timelines.

Birth Defects

In response to a 2008 birth defects petition, ATSDR reviewed information from several sources. To conduct this review, ATSDR coordinated with colleagues from CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD). ATSDR and NCBDDD staff reviewed Dr. Peter Langlois’ January 7, 2008 DSHS birth defect rate analysis, entitled A Case-Control Study of the Association Between Birth Defects Elevated in Nueces County and Sites of Concern to Citizens for Environmental Justice. Dr. Langlois conducted the study following a previous Texas Birth Defects Registry (TBDR) analysis that indicated birth defects rates in the Corpus Christi area were 84% higher compared to the rest of the registry. The TBDR study recommended a case-control study to examine 15 specific birth defects. Dr. Langlois stated that the case-control study would measure the association between the 15 selected birth defects and the proximity of the mother’s residence to various sites where hazardous substances were likely used and were present in the environment. The site categories were landfill, refinery or chemical manufacturing plant, military airfield, and other industrial activity.

To qualify as a “compelling association,” any connection between one of the 15 birth defect rates and one of the site categories had to have

• an odds-ratio greater than 1.5,
• statistical significance, and
• a “proximity response,” that is, an odds-ratio that increased for mothers living closer to the sites.

Dr. Langlois’ report concluded that a number of the 15 birth defect rates had some association with at least one of the site categories. That is, some birth defect-site category associations met one or two of the above criteria. However, no birth defect-site category association met all three “compelling association” criteria. Thus, whether the 84% higher incidence of birth defects in the Corpus Christi area is due to a specific site, category of sites, or some other factor or factors, remains uncertain.

During its petition request evaluation, ATSDR learned that NCBDDD is currently gathering data for a future study on gastroschisis, one of the 15 birth defects identified in the TBDR study. The center intends to pool information and results from several other epidemiological studies to identify potential risk factors associated with this birth defect. Specifically, NCBDDD will review information from maternal questionnaires and banked blood samples from the mother, father, and child as they are available. While the Corpus Christi area is not directly included in this study, the resulting information might be applicable and helpful to the Corpus Christi community.

As noted previously, ATSDR is committed to a review of available health outcome data as part of its PHA activities. The most recent data on selected birth defect rates, based on available state and county data, will be included in this review. ATSDR also plans to work with local and state government partners and the local medical community to encourage further discussion with regard to the elevated birth defect rates in Corpus Christi.

Cross-validation of Biomarker Methods

In November 2008, preliminary results of a pilot project conducted by TAMU scientists were released to the public. The pilot project was a collaborative effort by the TAMU School of Rural Public Health, the Coastal Bend Health Education Center, and the Citizens for Environmental
Justice (CFEJ). The pilot project was conducted in the Hillcrest neighborhood in Corpus Christi. The stated purpose of the pilot project was to “develop appropriate protocols for biomarkers of exposure to petroleum hydrocarbons.” Preliminary measurement of the levels of benzene in the study participants’ blood and urine were reported to be several orders of magnitude higher than benzene levels reported in other published studies. Understandably, the residents of Hillcrest are concerned.

The unpublished blood benzene levels that are described in the November 2008 preliminary report are of particular concern to ATSDR and NCEH. Initial PBPK modeling by ATSDR scientists found that the blood benzene levels in the TAMU pilot project preliminary report were not consistent with the air monitoring data collected in the Corpus Christi area. Further investigation is needed to assess the preliminary blood benzene results and expand what is currently known about environmental exposures in the Corpus Christi area.

During Dr. Frumkin’s November 2009 community meeting, the residents expressed their desire to know the final results of the pilot project. TAMU and CFEJ reported these results to the community on January 6, 2010.

Given that the stated purpose of the TAMU pilot project was to develop biomarker protocols, NCEH is working with TAMU to compare and validate biomarker methods. NCEH provided TAMU with validated protocols and materials for comparison with TAMU’s protocols and materials. Dr. Ben Blount of NCEH toured the TAMU lab on December 2, 2009, to offer further insights on VOC biomarker methods.

Exposure Investigation

In August 2009, TCEQ proposed environmental air sampling and biological sampling of residents in the Hillcrest neighborhood and allocated funding for a Corpus Christi Community Investigation (CCCI). DSHS, TCEQ, UT at Austin, EPA, ATSDR and NCEH began working with the community on the CCCI project.

At a December 1, 2009, community meeting, residents indicated that they would like to see groundwater and soil sampling included in the CCCI. TCEQ, in response to those comments, decided to shift the focus of the CCCI from biological sampling to environmental sampling only. TCEQ plans to conduct groundwater, soil, soil gas, and ambient air sampling outside resident’s homes in the community.

In response to TCEQ’s decision, ATSDR and NCEH began to explore funding options for biological sampling in Corpus Christi. The agencies believe that further investigation is needed to assess blood benzene levels in the Corpus Christi area. To provide timely information to the community, ATSDR and NCEH are proposing an exposure investigation (EI) be completed within the next six months. Specifically, ATSDR and NCEH propose

• to conduct biological sampling in Corpus Christi to evaluate VOCs in residents’ bodies,
• to incorporate personal air monitoring in the sampling plan, and
• to actively engage the Corpus Christi community (e.g., CFEJ, Hillcrest Residents Association, Sierra Club, Hispanic Chamber of Commerce, local school representatives, the local medical community, and community members) to participate up-front in the planning process.

Through both the PHA and EI activities, ATSDR and NCEH plan to work closely with the community and their partners at the local, state and federal levels to expand what is currently known about environmental exposures in the Corpus Christi area.

ATSDR’s Community Engagement

ATSDR completed interviews with community members in September 2009. ATSDR’s preliminary evaluation of the data showed that the greatest environmental health concerns relate to air emissions, air quality and health impacts. Further analysis by ATSDR will guide health education and health communication activity recommendations.

ATSDR has identified the following health promotion and community involvement actions items:

• Coordinate with DSHS, EPA, and other stakeholders on how to best develop and present a coordinated community engagement effort.
• Complete analysis of the information from the September interviews and December 1, 2009 site visit.
• Incorporate notes from community meetings and Dr. Frumkin’s meetings with federal, state, and local stakeholders, elected officials and industry representatives into the Corpus Christi Community Assessment Report (to be completed by January 28, 2010).
• Develop a draft Community Engagement Plan based on the Community Assessment and Follow-up Actions (to be completed by February 5, 2010).
• Conduct community activities based on recommendations and available funding (e.g. follow up community meetings, establishing community goals and plans, conducting informational workshops, train-the-trainer sessions, and health education courses).
• Create a webpage to provide the community and stakeholders with background information, updates, and new information concerning ATSDR’s work in Corpus Christi.

ATSDR and NCEH have a strong commitment to the health of the people of Corpus Christi. The agencies have recognized that regular communications are essential to the work they do. As the agencies move forward, ATSDR and NCEH are committed to working closely with the community and keeping the community updated on their activities.