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Fetal Deaths
NPL Sites and Fetal Deaths: A Simple Correlation Issue of Census Tracts and NPL Sites.
The Purpose
The purpose of this study is to attempt to assess correlation of Infant and Fetal Mortality with hazardous waste sites, specifically Florida’s
National Priority List (NPL) sites with distance and carcinogenicity of toxicants present as a
proxy for exposure.
Outline
1. Statement of the Problem
2. Definitions
3. Introduction/Statement of the Problem
4. Project Overview
5. Procedure
6. Data/ Observations
7. Conclusion/Future Studies
Definitions (1) "Stillbirth" means the death of a fetus of more than 20 weeks gestation." (s. 467.003 Florida
Statutes, Definitions)
"Fetal death" means death prior to the complete expulsion or extraction of a product of human conception from its mother if the 20th week of gestation has been reached and the death is indicated by the fact that after such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles."
"Live birth" means the complete expulsion or extraction of a product of human conception from its mother, irrespective of the duration of pregnancy, which, after such expulsion, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, and definite movement of the voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached." (Emphasis added, s. 382.002 Florida Statutes, Definitions)
http://www.volusia.org/medicalexaminer/stillbirth.htm
Definitions (2)
Fetal death:"Stillbirth" means an unintended, intrauterine fetal death after a gestational age of not less
than 20 completed weeks.
Fetal mortality rate: The ratio of fetal deaths divided by the sum of the births (the live births + the fetal deaths) in
that year.
Fetal Deaths (Stillbirths) = Average Number of Fetal Deaths/ Average Number of Live and Still Births
http://www.medterms.com/script/main/art.asp?articlekey=3420
Infant Mortality: The death of a live born infant which occurs within the first year of life.
Infant Mortality Rate = Number of Infant Deaths /Number of Live Births
“The Fetal mortality rate is considered a good measure of the quality of health care
(and environment) in a country or a medical facility.” (Florida DOH: 2010 aims)
Definitions (3)
Definitions (4)
“National Priorities List (NPL) site” EPA's list of the most serious uncontrolled or abandoned hazardous waste sites
identified for possible long-term remedial action under Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA): Superfund . The list is based primarily on the score a site receives from the Hazard Ranking System. EPA is required to update the NPL at least once a year (National Safety Council).
“Carcinogenicity " The ability or tendency to produce cancer .
April 11, 20087
Statement of the Problem (1)
The assumption is that toxicity affects the embryo, as there is evidence in animal and human research that endorses individual Chemicals as ‘toxic’.
However, the mixture of chemicals and especially its exposure from the environment are scarce and riddled limitations.
Research
Washington State (Mueller, 2007) NO
England (Morgan, 2004); EUROHAZCON, Vrijheid) Maybe, however: ½ of the population live within ‘kilometers’ of hazardous waste sites
Middle East: Israel (Bentov, 2006): Yes, but only in the Bedouin population (intermarriage as a confounder?)
History: Dwarfs, Gnomes, one eyed monsters, two headed beasts… Beowulf: steps in ‘lighted underground lake’, and begets a monster
Introduction
Statement of the Problem (2)
“Is there a correlation between National Priority List (NPL) Sites and infant/fetal deaths in the surrounding population?”
Water:Surface Ground
Toxicants
Soil:Sludge
Sediments Flooding
AIRToxicants
Fetal Deaths?
Facts
• NPL sites:• 1641 sites in the USA
• Region 4
• Florida: 72 sites• 2 proposed (Hillsborough and Broward)
Fetal Deaths: Health Indicator 8 2010 objective 4.1 (Target 16-1a, Florida’s objective for reducing fetal deaths) 2000 Baseline 8.2 (Fetal deaths at 20 or more weeks of gestation)
National Priorities List Sites in Florida
From: EPA, Superfund
Adverse Health Effects in Population
Prototype for Diagnosis
ContaminantsVerification of
Possible Disruption
Personal Biomarker
Environmental Markers
NPL Location
Monitoring System??
Project Overview
Prototype of Diagnostic and Interference Analysis
NPL Sites:Framework
Location: Geography
Contaminant: Nature
Environmental Interactions
Fetal /Infant Death Rate vs. Distance as a
Proxy
Variables
Average Fetal/ Infant Mortality Rates Census Tracts (CHARTS): Years 1997-2001, 2002-2006
Contaminant Toxicity Types of Media Contaminated (Surface water, Groundwater, Soil, Sludge, Other) Flooding: partial, total; + sludge, + sediment, + surface water Grade Contaminant Risk Assessment (EPA list of Carcinogen Classification: A, B1,
B2, C, D, N/A)
Distance from Exposure Site 0.5, 1.1, 2.8, 7 miles with the County averages of the same year as reference
population
Fetal Deaths by Census
Tract
Ho: µ0= FD0.5 = FD1.1 =FD2.8 = FD7 = FDCounty
Ha: µ1= FD0.5 > FD1.1 >FD2.8 > FD7 > FDCounty
Distance vs. Fetal Death mortality Vs Risk/Site
Matching
Overall Site Risk Assessment
Character of Contaminants
Classification by Effects:1.Carcinogenicity2.Year of Deletion of NPL list
General Assessment Data Collection StructureHypothesis Statement
Project Overview Part 1
Classification by site:1.Geography
2.Construction Status 3.Location Characteristics
Character of Site
Character of SiteCharacter of Site
Limitations: Location: Centroid Coordinates
NPL site & Census tract fetal death rate
Toxicants: Site Contaminant Algorithm Carcinogenic Potential Classification
Exposure: Dyad fetus-mother Personalized risk assessment of environmental factors: behavior/addictions, genetics Exposure interval
Others: Missing Information _X_ sites
Research Component
The detailed analytical work on the characterization of ALL contaminants and identification of risk factors.
The next step will involve the analysis of the correlation with fetal deaths by distance from the NPL site
These then will be further analyzed by GIS through superimposition of the sites for added strength of correlation
Proceedure
Contaminants Categorized (=n) Assigned a risk value these will be added by computerized risk factor for
contaminated media, identified for flooding characteristics
Risk factors Added Toxicity Algorithm: compared with the results of the estimates of Fetal
Deaths/ Infant Deaths per thousand according to census tracts and distance (categorical variables) of the sites (0.5, 1.1, 2.8 and 7 miles).
GIS Superimposition of similar sites in magnitude of carcinogenicity for added strength
of correlation
Tools U.S. Census Bureau American FactFinder. Reference Maps:
2000 Census Tracts and Blocks EPA
National Priority List (NPL). National Priority List Sites in Florida: NPL Sites in Florida by County
Integrated Risk Information System (IRIS) Florida Charts: Community Health Assessment Resource Tool
Set. Fetal and Infant Death Indicators Computer analysis software
Geographical positioning: ArcGIS Excel (2007)
IRB: Public Data
IRB & HIPPA
Geographical Coordinates:
Plotted on Graph instead of Map
EPA ID Latitude LongitudeFLD004145140 25.8152 -80.2559FLD020536538 25.84306 -80.2565FLD981014368 25.92319 -80.2215FLD004574190 25.83958 -80.3001
GIS Analysis
Fetal Death by Census
Tract (FDOH)
CarcinogenicityFetal Mortality In Census tracts @ 0.5, 1.1, 2.8, 7 M
Soil, Water, AirFlooding NPL Status
Toxicant Risk (IRIS, ATSDR)
Exposure Route (EPA)
Project Overview: FINAL
Step 1 Step 2 Step 3
Step 4
Procedure: Step 1Fetal Deaths:
Distance as a Proxy
Fetal Death by Census Tract
Fetal Mortality In Census tracts @ 0.5, 1.1, 2.8, 7 M and County
Tracts found by entering the geographical Coordinates from the sites
Fetal Deaths by Census Tracts
# of Fetal Mortality/Tract =
(Deaths/ Mile radius)/1000 live births (?)
AIRCO PLATING CO.
FLD004145140
Average Fetal DeathsAcross
Fetal Deaths/1,000 live births
0.5 miles 10.65
1.1 miles 8.33
2.8 miles 7.85
7 miles 5.23
County 0.18
Miami Flood Oct 4 2000???SOIL AND GROUNDWATER
Procedure: Step 2Contaminants:
By Type, Media & Periculosity
1. By Type of Contaminant Inorganic Metals PAH VOC PCBs Base Neutral Acids Pesticides Radioactive Petroleum Hydrocarbon
1
2
3
4
2. By Toxicant Risk
Locate Contaminant 1. EPA NPL list
2. By County
3. Contaminated Media
4. Classify for Carcinogenicity (IRIS)
Contaminants of Concern found in the Soil CAS # Contaminant Name Contaminated
Media Area of Site Found (OU)
127-18-4 TETRACHLOROETHYLENE Groundwater/Soil RI/FS (01)
39638-32-9 CADMIUM Groundwater/Soil RI/FS (01)
57-12-5 CYANIDE Groundwater/Soil RI/FS (01)
7439-92-1 LEAD Groundwater/Soil RI/FS (01)
7440-02-0 NICKEL Groundwater/Soil RI/FS (01)
7440-47-3 CHROMIUM Groundwater/Soil RI/FS (01)
7440-50-8 COPPER Groundwater/Soil RI/FS (01)
7440-66-6 ZINC Groundwater/Soil RI/FS (01)
Procedure: Step 3Site Exposure Route
3. By Exposure Route (EPA) Contaminated Media
Air Soil Water
Groundwater Surface Water
Sludge/ Sediment/ Other
Flooding NPL Status
Site Characteristics: 1. Flooding2. Groundwater and Soil contamination3. Population within one mile: 10,001-50,000
Procedure: Step 4Site:
Toxicity Algorithm
Simulation ExampleSite Address: 3636 NW 46TH STREET
MIAMI, Florida
33142 County: MIAMI-DADE U.S. Congressional District: 18 Population within one mile: 10,001-50,000
D. CAS# Chemical Carcinogenic
Assigned Value
117-81-7 BIS(2-ETHYLHEXYL)PHTHALATE B2 50
127-18-4 TETRACHLOROETHYLENE D 1
156-59-2 CIS-1,2-DICHLOROETHYLENE D 1
39638-32-9 CADMIUM B1 5057-12-5 CYANIDE D 167-64-1 ACETONE D 1
67-66-3 CHLOROFORM N/A 7439-92-1 LEAD B2 507440-02-0 NICKEL B1 507440-47-3 CHROMIUM Ai/Do 17440-50-8 COPPER A 1007440-66-6 ZINC D 175-01-4 VINYL CHLORIDE D 175-35-4 1,1-DICHLOROETHYLENE C 2079-01-6 TRICHLOROETHYLENE N/A 327
Column A=B 411.11Assigned toxicity by chemicals
A.Assigned toxicity for Contaminated
mediaGroundwater 90
Soil 50 Flooding: partial 10 150
B.
Class Construction: complete Total values
50 150Control Year 9 41 41 191
C. Toxicants Inorganics, Metals, PAH, VOC
E. Added toxicity: Site: 191.00Toxicants 411.11
602.11
Miami Flood Oct 4 2000???SOIL AND GROUNDWATER
Data/Observations
Data/Observations:
Site Anaconda Aluminum Co./Milgo Electronics
Circlis ID FLD020536538
Air
Surface waterGroundwater 90SoilSludgeOtherFlooding: partialFlooding: total Flooding + sludgeFlooding + sedimentFlooding + surface waterTotal 90Year Exposure Controled 1994Years w/o Exposure 14Type of Contaminant
Metals
VOCsPCBs
PesticidesTotal Value 400
Conclusions
The HRS uses a structured analysis approach to scoring sites. This approach assigns numerical values to factors that relate to risk based on conditions at the site. The factors are grouped into three categories: likelihood that a site has released or has the potential to release hazardous substances into the environment; characteristics of the waste (e.g. toxicity and waste quantity); and people or sensitive environments (targets) affected by the release.
Four pathways can be scored under the HRS:
1. Ground water migration (drinking water)2. Surface water migration (drinking water, human food chain, sensitive
environments);
3. Soil exposure (resident population, nearby population, sensitive environments);
4. Air migration (population, sensitive environments).
After scores are calculated for one or more pathways, they are combined using a root-mean-square equation to determine the overall site score.
Superfund Hazard Ranking System(HRS): Quickscore
Need to get HRS SCORES!
Future Research
1. Address limitations
2. Add to the study: Mutagenicity (ATSDR) NonCA Effects (RfD, ToxFAQsTM )
3. Address Outcomes addinga. Birth defects
b. Cancer (children)
c. Adults
d. Mutagenicity
e. Non- Carcinogenic Effects (inverse RfD/10)
Butterfly Chrysalis. (Frederik Meijer Gardens & Sculpture Park,butterfly exposition March 5, 2008)
‘Life in a bud’
Most Precious Form of Life
We Do not seeDO WE CARE?
The Future
References Integrated Risk Information System (IRIS): Carcinogenicity Assessment for Lifetime Exposure.
http://www.epa.gov/iris/links.htm EPA. National Priorities List (NPL): National Priorities List Sites in Florida.
http://www.epa.gov/superfund/sites/npl/fl.htm U.S. Census Bureau: American Fact Finder. Reference Maps: 2000 Census Tracts and Blocks.
State: Florida. http://factfinder.census.gov/jsp/saff/SAFFInfo.jsp?_pageId=referencemaps&_submenuId=maps_2
Florida Charts: Community Health Assessment Resource Tool Set. Fetal and Infant Death Indicators. http://www.floridacharts.com/charts/CensusTractMap.aspx?DataType=3&Rate=Y
Mueller, B. A., Kuehn, C. M., Shapiro-Mendoza, C. K., & Tomashek, K. M. (2007). Fetal Deaths and Proximity to Hazardous Waste Sites in Washington State. Environmental Health Perspectives, 115(5), 776-780.
Bentov, Y., Kordysh, E., Hershkovitz, R., Belmaker, I., Polyakov, M., Bilenko, N. & Sarov, B. (2006). Major congenital malformations and residential proximity to a regional industrial park including a national toxic waste site: An ecological study. Environmental Health: A Global Access Science Source, 5, 1-9
Morgan, O. W., Vrijheid, M., Dolk, H. (2004). Risk of low birth weight near EUROHAZCON hazardous waste landfill sites in England. Archives of Environmental Health, 59(3),149-51.
?
Thanks Dr. Ribeiro Dr. Harris Dr. Kearney Dr. Camerom Dr. Groetsch Dr. Merchant Dr. Van Horn Ms. Rebecca Shultz Ms. Larrieux Mr. DeSousa