[Federal Register Volume 63, Number 110 (Tuesday, June 9, 1998)] [Notices] [Pages 31496-31497] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 98-15255] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Toxic Substances and Disease Registry [ATSDR-135] Availability of ATSDR Decision Document Regarding the Bunker Hill, Idaho, Medical Monitoring Program AGENCY: Agency for Toxic Substances and Disease Registry (ATSDR), Department of Health and Human Services (HHS). ACTION: Notice of availability for public review and comment of draft Decision Document Regarding the Bunker Hill, Idaho, Medical Monitoring Program. ----------------------------------------------------------------------- SUMMARY: ATSDR has reviewed scientific literature and clinical information in order to assess the need for medical monitoring at Bunker Hill, Idaho. ATSDR has determined that there is a definable population at significantly increased risk of disease that will benefit from a medical monitoring program. ATSDR has judged that the medical monitoring program is appropriate to provide periodic medical evaluation and referrals to improve the public health status of the affected population. The current literature and expert panel workshop held by ATSDR reflect that medical monitoring at Bunker Hill would be good public health practice and of medical benefit to the affected populations. This notice is announcing the availability of the draft report documenting ATSDR's justification for implementing a medical monitoring program for the population at the Bunker Hill Site: the ``ATSDR Decision Document Regarding the Bunker Hill, Idaho, Medical Monitoring Program'', is available for public review and comment. DATES: Comments must be received by July 9, 1998. ADDRESSES: The report is available through Dr. Vivian Rush, MD, Medical Officer, ATSDR-Division of Health Education and Promotion, 1600 Clifton Road, NE., Mailstop E-33, Atlanta, Georgia 30333, E-mail address [email protected] and telephone (404) 639-5080. FOR FURTHER INFORMATION CONTACT: Dr. Vivian Rush, Medical Officer, ATSDR; telephone (404) 639-5080. SUPPLEMENTARY INFORMATION: Section 104 (i)(9) of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended [42 U.S.C. 9604 (i)(9)], provides for the Administrator of ATSDR to initiate a health surveillance program for populations at a significant increased risk of adverse health effects as a result of exposure to hazardous substances released from a facility. A program ATSDR includes under health surveillance is referred to as ``Medical Monitoring or Screening'' and is defined, as published in the Federal Register on July 28, 1995 (60 FR 38840), in ``ATSDR's Final Criteria for Determining the Appropriateness of a Medical Monitoring Program under CERCLA'' as ``the periodic medical testing to screen people at significant increased risk for disease.'' There are 7 Medical Monitoring criteria associated with this program and they are as follows: (1) There should be evidence of contaminant levels in environmental media that would suggest the high likelihood of environmental exposure to a hazardous substance and subsequent adverse health outcomes. (2) There should be a well-defined, identifiable target population of concern in which exposure to a hazardous substance at a sufficient level has occurred. (3) There should be documented human health research that demonstrates a scientific basis for a reasonable association between an exposure to a hazardous substance and a specific adverse health effect (such as an illness or change in a biological marker of effect). (4) The monitoring should be directed at detecting adverse health effects that are consistent with the existing body of knowledge and amenable to prevention or intervention measures. (5) The general requirements for a medical screening program should be satisfied. Those requirements are:The natural history of the disease process should be understood sufficiently for screening. The early detection through screening should be known to have an impact on the natural history of that disease process. There should be an accepted screening test that meets the requirements for validity, reliability, estimates of yield, sensitivity, specificity, and acceptable cost. (6) An accepted treatment, intervention or both for the condition (outcome or marker of exposure) must exist and a referral system should be in place prior to the initiation of a medical monitoring program. (7) The logistics of the system must be resolved before the program can be initiated. Background The 21-square-mile Bunker Hill Superfund site includes the Bunker Hill mining and smelting complexes and the communities of Pinehurst, Page, Smelterville, Kellogg and Wardner in Shoshone county, in Silver Valley of northern Idaho. Mining and mineral refining has been the dominant industry in the Silver Valley for more than 100 years. The mining and mineral refining activities have severely impacted the landscape, vegetation, and the quality of the air, and soils in the area. A population of workers and residents who have worked in and lived surrounding the former Bunker Hill lead and zinc smelting facility have been exposed to lead (and probably other heavy metals) in the past at levels of public health concern (i.e., at levels where health effects could be expected to occur). The most serious exposures took place during the 1970's after a baghouse fire resulted in large amounts of lead to be released into the air of towns surrounding the smelter. Epidemiologic studies have shown adverse health effects in the populations that were present during the past high exposure periods. Since the smelter's closure in 1981, the exposures have markedly decreased. In addition, the Panhandle Health District has implemented a program to detect excess exposure in the community and provides information and education on preventing harmful exposures and scientific literature supports these findings. [[Page 31497]] Dated: June 3, 1998. Georgi Jones, Director, Office of Policy and External Affairs, Agency for Toxic Substances and Disease Registry. [FR Doc. 98-15255 Filed 6-8-98; 8:45 am] BILLING CODE 4163-70-P