[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]


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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.

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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