Public Health Assessment. Cayuga County Groundwater Contamination Towns of Aurelius, Fleming & Springport, Cayuga County, New York.

Transcription

1 Public Health Assessment Cayuga County Groundwater Contamination Towns of Aurelius, Fleming & Springport, Cayuga County, New York. EPA Facility No.: NYN Prepared under a Cooperative Agreement with U.S. Department of Health & Human Services Public Health Service Agency for Toxic Substances and Disease Registry

2 1

3 TABLE OF CONTENTS SUMMARY BACKGROUND AND STATEMENT OF ISSUES A. Site Description and History B. Site Visit C. Demographics DISCUSSION A. Environmental Contamination B. Exposure Pathways C. Toxicological and Epidemiological Evaluation for Adult and Children s Health Issues D. ATSDR Child Health Considerations E. Health Outcome Data COMMUNITY HEALTH CONCERNS CONCLUSIONS RECOMMENDATIONS PUBLIC HEALTH ACTION PLAN REFERENCES PREPARERS OF REPORT CERTIFICATION APPENDIX A--TABLES APPENDIX B--FIGURE APPENDIX C--NYS DOH PROCEDURE FOR EVALUATING POTENTIAL HEALTH RISKS FOR CONTAMINANTS OF CONCERN APPENDIX D--INTERIM PUBLIC HEALTH HAZARD CATEGORIES APPENDIX E. SUMMARY OF PUBLIC COMMENTS AND RESPONSES APPENDIX F. ATSDR GLOSSARY OF TERMS

4 0

5 SUMMARY The Cayuga County Groundwater Contamination site was proposed to the National Priorities List (NPL) on September 13, 2001 and added to the list on September 4, The site is a plume of contaminated groundwater in a deep bedrock aquifer, stretching from the City of Auburn to the Village of Union Springs. The Union Springs Public Water Supply wells have been contaminated with low levels of volatile organic compounds since at least November A comprehensive private well sampling program, begun by the Cayuga County Department of Health (CCDOH) and the New York State Department of Health (NYS DOH) in December of 2000, found that many private wells were also contaminated. All known private wells in a broad corridor between Union Springs and Auburn were sampled. Contaminants found in private or public well water include cis- and trans-1,2-dichloroethene, trichloroethene and vinyl chloride. About 800 people live within the area of potential private well contamination; about 1100 live within the Village of Union Springs. A source or sources of the contamination have not been determined. The United States Environmental Protection Agency (US EPA) is continuing efforts to find the source or sources. Homeowners and farmers with wells found to be contaminated at levels above the federal maximum contaminant levels (MCLs) were provided with treatment systems by the US EPA to remove contaminants and reduce their exposure to chemicals in their water. A grant from New York State was used by the CCDOH to provide granular activated carbon filter systems to anyone in the plume area with a well contaminated with volatile organic compounds below the federal MCLs. The Village of Union Springs installed an air stripping treatment system on its public water supply in May 2001 to reduce people's exposure to drinking water containing volatile organic compounds. Based on extensive sampling data and the ATSDR's health hazard category classification, the Cayuga County Groundwater Contamination was a public health hazard in the past. This classification is used because people were exposed in the past to contaminants in drinking water from private wells at concentrations exceeding public health comparison values and/or drinking water standards and there is evidence from studies in animals and humans that exposure to elevated levels of vinyl chloride (a known human carcinogen) can increase the risk of adverse cancer and noncancer health effects in humans. Because of the pattern of contamination and the contaminants found, the exposures may have occurred for some time, with people nearer to Auburn potentially exposed the longest. Due to the measures taken to reduce people's exposure to VOC contamination in their drinking water to levels below public health concern, the contaminated groundwater plume in the Aurelius, Fleming, and Springport area currently is no apparent public health hazard. However, proper operation, maintenance and monitoring of some existing treatment systems is not assured and a long-term remedy for the contaminated drinking water is not currently available for the entire area. 1

6 Cis-1,2-dichloroethene and trichloroethene were detected in the Village of Union Springs public water supply wells. Water treatment measures were undertaken to minimize people's exposure to contaminated drinking water; the health risks associated with current levels of exposure are minimal or very low. Community health concerns have been expressed at public meetings and meetings with local elected officials, through correspondence to government agencies and telephone calls to the county and state health departments. The primary concern expressed is about the possible health effects from the exposures and what, if any, medical monitoring would be appropriate. Some residents believe that illnesses were caused by exposure to the contaminated groundwater. Whether these contaminants or some other factor caused the symptoms or illnesses mentioned is not known. In general, medical tests are not specific to these VOC exposures. Biological tests such as urinalysis or blood chemistry analyses are useful tools for finding health problems early. Residents may wish to tell their physician about their exposure to VOCs because he or she considers personal health history when deciding the types of tests needed and how frequently their patients need to be seen. The NYS DOH conducted site-specific health care provider outreach to 36 local physicians identified by the CCDOH. The county mailed NYS DOH and ATSDR-prepared educational materials on site conditions, site-specific chemicals and exposure to chemicals. The Cayuga County Groundwater Contamination site has been selected as one of the sites for inclusion in the NYS VOC Exposure Registry. Residents of households who were exposed in the past to VOCs from private well drinking water supplies are being asked by the NYS DOH to participate. The exposure registry allows long-term follow-up on the health status of persons with documented exposures to VOCs from this site as well as persons exposed to VOCs at other selected sites in New York State. An exposure registry such as this one is a resource for research that may help us learn whether exposures to VOCs are related to health effects. People who are enrolled in the Registry will be kept informed of any research results that come from the Registry data. Data gathered for the Registry will be kept confidential. The primary recommendation of this Public Health Assessment is to minimize exposure to contaminated water in the community by providing alternative sources of potable water. Treatment systems with proper operation, maintenance and monitoring should be available for all contaminated wells, and the feasibility of providing a long-term remedy to affected wells should be evaluated. The NYS DOH will continue to work with the Cayuga County Water and Sewer Authority, the Cayuga Lake Intercommunity Water Board and other state and local agencies to find a permanent alternative source of potable water for the entire affected area. 2

7 BACKGROUND AND STATEMENT OF ISSUES The Agency for Toxic Substances and Disease Registry (ATSDR) produced this Public Health Assessment in response to a petition by a resident in the subject area who requested an evaluation of the public health implications of exposure to volatile organic compounds found in private drinking water wells. In addition, this public health assessment fulfills the congressional mandate for a public health assessment for each site proposed for inclusion in the National Priorities List (NPL). The Cayuga County Groundwater Contamination site was proposed to the NPL on September 13, 2001 and was added to the NPL on September 4, Under a cooperative agreement with ATSDR, the New York State Department of Health (NYSDOH) prepared this public health assessment. A. Site Description and History The Union Springs Public Water Supply wells have been known to contain low levels of volatile organic compounds since November 1988, when routine organic chemical monitoring was initiated for public water systems in New York State. While contamination was closely monitored, investigations near the Village of Union Springs failed to locate a likely potential source or sources of the contaminants. A broader investigation was begun in September of 2000 with the sampling of 28 private wells in the Town of Springport in the countryside surrounding the Village. Detections of the same chemicals as those found in the Village wells prompted another round of sampling to the northeast in the Towns of Fleming and Aurelius. The discovery of additional affected wells, with higher levels of contamination, prompted a comprehensive private well sampling program performed by the Cayuga County Department of Health (CCDOH) and the New York State Department of Health (NYS DOH ), begun in December of All known private wells in a broad corridor between Union Springs and Auburn were sampled. A plume of contaminated groundwater in the deep bedrock stretches from the edge of the City of Auburn to the Village of Union Springs, with the highest levels of volatile organic compounds found near the City in the vicinity of Pinckney and Overbrook Roads. The New York State Department of Environmental Conservation (NYS DEC) referred the site to the United States Environmental Protection Agency (US EPA) for further actions. US EPA is continuing efforts to find the source or sources of the contamination. Homeowners and farmers with wells contaminated at levels above the federal maximum contaminant levels (MCLs) were provided with treatment systems by the US EPA to remove contaminants and reduce their exposure to chemicals in their water. A grant from New York State was used by the CCDOH to provide granular activated carbon filter systems to anyone in the plume area with a well contaminated with volatile organic compounds below the federal MCLs. The Cayuga County Water and Sewer Authority and Cayuga Lake Intercommunity Water Board are working to provide permanent alternative water supplies to affected areas. 3

8 B. Site Visit Since contamination was found in the Union Springs wells, NYS DOH staff Ronald Heerkens and Henriette Hamel visited the area many times. The countryside is rural with scattered residences and dairy farms in rolling terrain. There is a relatively new subdivision of single family residences on Overbrook Drive, within the impacted area. On December 14 th, 2000, Ms. Hamel and Mr. Heerkens visited the affected area (see Appendix B, Figure 1) and later spoke at a public meeting. About 175 people attended the meeting. Fact sheets with a statement of the problem, background, information on the chemicals found, advice to minimize exposures, and numbers to call for more information were prepared and distributed by the NYS DOH. Staff from the various concerned agencies (NYS DOH, CCDOH, NYS DEC and the US EPA) reported their activities to date and explained their roles in addressing the problem. Most recently, Ms. Hamel visited the area on June 5 th, 2002 to discuss site investigations with the US EPA, CCDOH and NYS DEC. 4

9 C. Demographics Demographics for contamination plume area outside of the Village of Union Springs The NYS DOH estimated, from the 2000 Census (US Bureau of the Census 2001), that approximately 802 people live within the area of environmental contamination. There are 167 females of reproductive age (ages 15-44) in the area. Detailed socioeconomic information for 2000 has not yet been made available by the Census; therefore, income estimates are based on the 1990 Census (US Bureau of the Census 1992). The following chart compares area demographics with statewide averages. There are no schools and no nursing homes within the plume area. New York State Contamination Plume Area Age Distribution <5 7% 7% % 24% % 54% >64 13% 15% Race Distribution White 68% 98% Black 16% <1% Native American <1% <1% Asian 6% <1% Pacific Islander <1% <1% Other 7% <1% Multi-Racial 3% 1% Ethnicity Distribution Hispanic 15% 2% Income 1989 Median Income $32,965 $34,033 % Below Poverty Level 13% 7% 5

10 Demographics for Village of Union Springs The NYS DOH estimated, from the 2000 Census (US Bureau of the Census 2001), that 1,074 people live within the Village of Union Springs in Cayuga County. There are 209 females of reproductive age (ages 15-44) in the area. Detailed socioeconomic information for 2000 has not yet been made available by the Census; therefore, income estimates are based on the 1990 Census (US Bureau of the Census 1991). The following chart compares area demographics with statewide averages. There are five schools and no nursing homes within the Village. New York State Village of Union Springs Age Distribution <5 7% 5% % 23% % 55% >64 13% 17% Race Distribution White 68% 98% Black 16% 1% Native American <1% <1% Asian 6% <1% Pacific Islander <1% <1% Other 7% <1% Multi-Racial 3% <1% Ethnicity Distribution Hispanic 15% <1% Income 1989 Median Income $32,965 $30,813 % Below Poverty Level 13% 7% 6

11 DISCUSSION A. Environmental Contamination Private Wells Private wells were sampled beginning in September 2000, when the NYS DEC began a state superfund preliminary site assessment in response to the low level solvent detections in the Union Springs wells. Four of the twenty-eight wells sampled in the first round to the northeast of Union Springs were contaminated. Wells sampled in the next round were chosen over a more widespread area, reaching towards the City of Auburn. Fourteen more wells were found to contain one or more of the following volatile organic compounds: cis-1,2-dichloroethene, trans-1,2-dichloroethene, trichloroethene, and vinyl chloride. Samples were then taken from all private wells in an area approximately seven and one-half miles long and two miles wide lying between the Village of Union Springs and the City of Auburn. In total, sixty-eight wells appear impacted by this plume of contaminated groundwater. Not all of the impacted wells have all of the contaminants. The affected groundwater is in bedrock; all but one of the impacted wells are greater than 122 feet deep. No contamination was found in shallow wells. Levels of cis-1,2-dichloroethene ranged from non-detect to 980 micrograms per liter (mcg/l) with an average concentration of 253 mcg/l in the sixty-five wells where it was found. Trans-1,2-dichloroethene was detected in fifty-three wells and concentrations ranged from nondetect (ND) to 20 mcg/l, with an average concentration of 6.1 mcg/l. The detection limit was 0.5 mcg/l. Trichloroethene concentrations ranged from ND to 62 mcg/l; it was present in fifty-four wells with an average concentration of 22.5 mcg/l. Vinyl chloride was found in twenty-five wells, ranging from ND to 42 mcg/l, with an average of 9.6 mcg/l. Cis- and trans-1,2-dichloroethene and vinyl chloride are breakdown products of trichloroethene. Sampling data are summarized in Appendix A, Table 1. The pattern of contaminants (primary plus breakdown products) suggests an old plume and extensive bedrock involvement since the area of the plume is large (greater than 7 miles long and 2 miles wide) and all impacted wells are in bedrock. The fact that the highest levels were found in the Auburn area, with decreasing levels to the southwest, may suggest a source or sources somewhere near Auburn. Village of Union Springs Wells The Village of Union Springs draws water from two wells, both of which are contaminated. Since the contamination was discovered, the level of cis-1,2-dichloroethene has ranged from not detectable to 12 mcg/l (average of detects was 3.6 mcg/l) and the level of trichloroethene ranged from not detectable to 1.6 mcg/l (average of detects was 0.6 mcg/l). An air-stripper treatment system to reduce volatile organic compounds in the water was added to the Village of Union Springs water supply in May

12 B. Exposure Pathways In this Public Health Assessment, the NYS DOH and ATSDR evaluated exposure to contaminants in private drinking water supplies. This is the pathway of exposure that the petitioner requested be evaluated. Past exposures to contaminants in the public drinking water supplies of the Village of Union Springs are also evaluated here. Another pathway, exposure to contaminants by drinking milk from cows that drink contaminated water, was previously evaluated by ATSDR (ATSDR 2001). Homeowners with contaminated water can be exposed in several ways to the chemicals in their water including: ingestion - consuming the water by drinking it and cooking with it; inhalation - chemicals evaporating into the air may be breathed in during bathing, showering, or using hot water in household chores; and by direct contact with the skin. Because the source or sources of the contamination have not been identified and we have limited historical sampling data, we do not know for how long people have been using contaminated drinking water. However, because of the pattern of contamination and the contaminants found, the contaminants may have been present for some time, with people nearer to the source area potentially exposed the longest. Over time, however, the kinds and concentrations of contaminants may have changed with levels of breakdown products, such as vinyl chloride, appearing and increasing over time. C. Toxicological and Epidemiological Evaluation for Adult and Children s Health Issues To evaluate the public health implications (potential health risks) from exposure to contaminants in the groundwater at the Cayuga County groundwater contamination plume, the NYS DOH assessed the risks for cancer and noncancer health effects. Health effects are related primarily to contaminant concentration, exposure pathway, exposure frequency and exposure duration. Long term exposure to chemicals in drinking water is possible by ingestion, dermal contact and inhalation from water uses such as showering, bathing and cooking. Although exposure varies depending on an individual's lifestyle, each of these exposure routes can contribute to the overall daily intake of contaminants and may increase the risk for long term health effects. In our evaluation of volatile organic chemicals in drinking water we doubled the measured concentration in drinking water to account for additional exposure through inhalation which may take place during showering, bathing or other household activities. For additional information on how the NYS DOH determined health risks applicable to this public health assessment refer to Appendix C. Private Wells For an undetermined period of time, private water supply wells have been contaminated with chlorinated volatile organic compounds (VOCs). Therefore, we chose an exposure duration of 30 years to evaluate the risks. This is the US EPA s recommended 95 th percentile value for residence time (i.e., the amount of time people live in one residence) (US EPA 1999). Exposure to high levels of VOCs was reduced when US EPA and the County installed carbon filters in 8

13 2001. The remaining wells without carbon filters contain either no detectable VOCs or levels below health comparison values. The highest concentrations and the average concentrations, respectively, of cis-1,2-dichloroethene (980 mcg/l and 253 mcg/l), trans-1,2-dichloroethene (20 mcg/l and 6.1 mcg/l), trichloroethene (62 mcg/l and 22.5 mcg/l), and vinyl chloride (42 mcg/l and 9.6 mcg/l) measured in the private wells exceed New York State public drinking water standards and public health assessment comparison values (see Appendix A, Table 2); therefore, these chemicals have been selected for further evaluation. However, many of the wells tested had concentrations much less than the health comparison values. Cancer health effects An estimated increased excess lifetime cancer risk is not a specific estimate of expected cancers. Rather, it is a plausible upper bound estimate of the probability that a person may develop cancer sometime in his or her lifetime following exposure to that contaminant. Several studies of workers exposed to elevated levels of vinyl chloride in air (at levels much higher than that detected in the well water in this area) reported an increased risk for angiosarcoma, a relatively rare type of liver cancer (ATSDR 1997a). Other human cancers associated with vinyl chloride exposure include cancer of the brain, central nervous system, lung, respiratory tract, and lymphatic and blood forming organ systems. Based on the increased risk for liver angiosarcomas found among vinyl chloride workers, vinyl chloride is considered a known human carcinogen (ATSDR 1997a). Studies of workers exposed to trichloroethene and other chemicals show an association between exposure to high levels (much higher than that detected in the well water of this area) of trichloroethene and increased risks of certain forms of cancer including kidney, liver and non- Hodgkin's lymphoma (ATSDR 1997b). Chance is not likely to be responsible for these associations; however, the role of other factors in causing these cancers, including exposures to other potential cancer-causing chemicals, is not fully known. These data suggest, but do not prove, that trichloroethene causes cancer in humans. Other studies show that people living in communities with drinking water supplies contaminated by mixtures of chemicals, including trichloroethene, have higher risks of certain types of cancer (e.g., non-hodgkin's lymphoma) than do people living in communities with uncontaminated drinking water. However, these studies are weaker than those of the workers largely because we do not know for certain whether the people who got cancer actually drank the contaminated water for long periods of time before they got cancer. Trichloroethene causes cancer in laboratory animals given large oral doses or exposed to high levels in air over their lifetimes (ATSDR 1997b). The animal cancers caused by trichloroethene include liver, kidney, testes, lymphoma, and lung cancer. Chemicals that may cause cancer in workers and do cause cancer in laboratory animals may also cause cancer in people who are exposed to lower levels over long periods of time. Toxicological data are inadequate to assess the carcinogenic potential of cis-1,2-dichloroethene and trans-1,2-dichloroethene (ATSDR 1996). 9

14 A total of 319 samples was analyzed for vinyl chloride. Most of the sampling (over 90%) either did not detect vinyl chloride or indicated that vinyl chloride was present, but at levels below the method detection limit. Most of the sampling (86% of all the samples) for trichloroethene either did not detect the chemical or indicated that trichloroethene was present, but at levels below the method detection limit. If people were exposed to trichloroethene levels up to 62 mcg/l (the highest level detected) for 30 years, they are estimated to have a low increased risk of getting cancer (about 13% of all the samples). If people were exposed to these levels for less than 30 years, their risk of getting cancer is reduced. The following table summarizes our cancer risk estimates for the Cayuga County Groundwater Contamination Site. Estimated Cancer Risks for Exposure to Contaminants in Private Wells Cayuga County Groundwater Contamination Site For individuals exposed for 30 years at specific concentrations (Actual concentrations over the past 30 years are not known) Chemical Concentration Percentage of Samples * Estimated Cancer Risk** vinyl chloride < 2.7 mcg/l 96.5% very low to low vinyl chloride 2.7 to 26 mcg/l 2.5% moderate vinyl chloride 27 to 42 mcg/l 1% high trichloroethene < 3.7 mcg/l 87% very low trichloroethene 3.7 to 62 mcg/l 13% low *A total of 319 samples were analyzed. For vinyl chloride and trichloroethene, 93% and 86% of the samples, respectively, either did not detect the chemical or indicated it was present but at levels below the method detection limit. **An estimated increased excess lifetime cancer risk is not a specific estimate of expected cancers. Rather, it is a plausible upper bound estimate of the probability that a person may develop cancer sometime in his or her lifetime following exposure to that contaminant. The actual increase in cancer risk from vinyl chloride and trichloroethene in drinking water cannot be estimated because we have little information on how long or to what levels people were exposed prior to the time the contamination was discovered. However, because of the pattern of contamination and the contaminants found, the exposures may have occurred for some time, with people nearer to the source area potentially exposed longer. Over time, however, the 10

15 specific kinds of contaminants may have changed, with levels of breakdown products, such as vinyl chloride, appearing and increasing over time. Non-cancer health effects Exposure to high levels of cis-1,2-dichloroethene, trans-1,2-dichloroethene, trichloroethene and vinyl chloride is also known to produce noncancer health effects, primarily on the liver, kidneys and the blood (ATSDR 1996, 1997a,b). Most of the sampling for cis-1,2-dichloroethene (over 90% of the samples) either did not detect the chemical or showed that the chemical was present at levels below the method detection limit. Although the risks for noncarcinogenic effects from past exposures to cis-1,2-dichloroethene in drinking water are not completely understood, the existing information suggests that they could be low for people exposed to levels from 175 mcg/l to 874 mcg/l (about 6% of all the samples) or moderate for people exposed to levels from 875 mcg/l to 980 mcg/l (about 1% of all the samples). The risks for noncancer health effects for exposure to the highest levels of trans-1,2-dichloroethene (20 mcg/l), trichloroethene (62 mcg/l) and vinyl chloride (42 mcg/l) would be minimal. Again, we do not know how long or to what levels of these contaminants people may have been exposed prior to the time the contamination was discovered. Village of Union Springs Wells Cis-1,2-dichloroethene and trichloroethene were detected in the Village of Union Springs s public water supply wells. The contamination was discovered in 1988, and some of the levels of cis-1,2-dichloroethene (as high as 12 mcg/l) exceeded the state's public drinking water standard of 5 mcg/l. The highest levels of cis-1,2-dichloroethene did not exceed its public health comparison value for noncancer effects (Table 2). The highest levels of trichloroethene did not exceed its public drinking water standard (5 mcg/l) or any of its health comparison values (Table 2). Exposure to these levels of cis-1,2-dichloroethene and trichloroethene is estimated to pose a minimal risk of noncancer health effects. Exposure to these levels of trichloroethene is also estimated to pose a very low risk for developing cancer. Toxicological data are inadequate to assess the carcinogenic potential of cis-1,2-dichloroethene (ATSDR 1996). D. ATSDR Child Health Considerations The ATSDR Child Health Initiative emphasizes the on-going examination of relevant child health issues in all of the Agency s activities, including evaluating child-focused concerns through its mandated public health assessment activities. The ATSDR and NYS DOH consider children when we evaluate exposure pathways and potential health effects from environmental contaminants. We recognize that children are of special concern because of their greater potential for exposure from play and other behavior patterns. Children sometimes differ from adults in their susceptibility to hazardous chemicals, but whether there is a difference depends on the chemical. Children may be more or less susceptible than adults to health effects and the 11

16 relationship may change with developmental age. The possibility that children or the developing fetus may have increased sensitivity to cis-1,2-dichloroethene, trichloroethene and vinyl chloride (the primary contaminants detected in the Cayuga County groundwater plume) was taken into account when evaluating the potential health risks associated with the groundwater contamination. However, studies on the reproductive and developmental toxicity of cis-1,2-dichloroethene in animals or humans are not available (ATSDR 1996). Vinyl chloride is a known human carcinogen, based on several studies of workers that show an association between exposure to elevated air levels of vinyl chloride and an increased risk for liver cancer. Animal studies suggest that children could be more sensitive to the carcinogenic effects of vinyl chloride than adults. For example, studies of partial lifetime exposures in animals suggest that the lifetime cancer risk may depend on the age of the animals at the time of exposure, with higher risks being attributed to exposures at younger ages. Furthermore, newborn rats exposed to vinyl chloride have a greater and more varied carcinogenic response (i.e., a higher incidence of tumors and more tumor types) than similarly-exposed adult rats. Finally, vinyl chloride has been shown to bind to genetic material (i.e., DNA) in the liver cells of newborn or young rats to a greater degree than similarly treated adult rats. We do not know if the same agesensitivity to the carcinogenic effects of vinyl chloride demonstrated in animals exists in human beings. The estimated exposures to vinyl chloride in drinking water in the private wells (based on the highest detected levels) are about 83,000 times lower than the lowest exposure levels that cause developmental effects in the offspring of animals. The potential for vinyl chloride to cause adverse effects in the offspring of laboratory animals has been assessed in several studies. When pregnant animals are exposed by inhalation to large amounts of vinyl chloride, adverse effects on the normal development of the offspring are observed (ATSDR 1997a). In these studies, the high amounts of vinyl chloride also caused adverse health effects on the parent animal. Adequate studies for evaluating the reproductive and developmental toxicity of vinyl chloride in humans are not available. The estimated exposures to trichloroethene in drinking water in the private wells (based on the highest detected levels) are about 50 times lower than the lowest exposure levels that cause developmental effects in the offspring of animals. When pregnant animals are exposed by ingestion and/or inhalation to large amounts of trichloroethene, adverse effects on the normal development of the offspring are observed (ATSDR 1997b). In most, but not all of these studies, the high amounts of the chemicals also caused adverse health effects on the parent animal. In one study, abnormal fetal heart development was observed in the offspring of rats exposed to trichloroethene in drinking water before and during pregnancy (Dawson et al. 1993). Human studies suggest that exposure to mixtures of volatile organic compounds (including trichloroethene) in drinking water during pregnancy may increase the risk of birth defects (e.g., 12

17 neural tube defects, oral cleft defects, and congenital heart defects) and/or childhood leukemia (ATSDR 1997b). In each of these studies, however, there are uncertainties about how much contaminated water the women drank during pregnancy and about how much trichloroethene was in the water the women drank during pregnancy. Moreover, the role of other factors in causing these effects is not fully known. The most important of the factors was the potential exposure during pregnancy to other chemicals in drinking water. These studies suggest, but do not prove, that the developing fetus may have increased sensitivity to the effects of trichloroethene. E. Health Outcome Data The Cayuga County Groundwater Contamination site has been selected as one of the sites for inclusion in the NYS VOC Exposure Registry. Residents of households who were exposed in the past to VOCs from private well drinking water supplies are being asked by the NYS DOH to participate. Eligible potential registrants are asked to complete a mailed questionnaire seeking information about exposures during the time period before contamination was detected and before intervention occurred to prevent exposure. Information about other health risk factors such as alcohol and tobacco use, detailed information about registrant health status before and after potential exposure, and basic demographic information such as age, education and occupation will be collected. Health status questions seek information about cancer as well as respiratory, neurological, cardiovascular, gastrointestinal, musculo-skeletal, endocrine and reproductive symptoms and diseases. Enrollees will be contacted approximately every two years regarding their health status. The exposure registry allows long-term follow-up on the health status of persons with documented exposures to VOCs from this site as well persons exposed to VOCs at other selected sites in New York State. An exposure registry such as this one is a resource for research that may help us learn whether exposures to VOCs are related to health effects. People who are enrolled in the Registry will be kept informed of any research results that come from the Registry data. Data gathered for the registry will be kept confidential. The New York State Cancer Registry collects, processes and reports on information about every New York resident diagnosed with cancer. The reporting of cancer incidence to the Registry is mandatory and enforced through a Public Health Law. In December 2000, a medical consultant for CCDOH requested information from the New York State Cancer Registry regarding the incidence of hepatic angiosarcoma in Cayuga County since scientific information shows an increased risk for liver angiosarcomas in vinyl chloride workers. The New York State Cancer Registry reported that from 1990 to 1997, there were no reported cases of hepatic angiosarcoma in the Western/Central portion of the state. 13

18 COMMUNITY HEALTH CONCERNS Community health concerns have been expressed at public meetings and meetings with local elected officials, through correspondence to government agencies and telephone calls to the county and state health departments. The CCDOH, in conjunction with the NYS DEC, established a telephone hotline for people to call with community health concerns. In addition, the public was invited to review a draft of this public health assessment during the public comment period which ran from November 13, 2002 to December 15, Our responses to the comments we received can be found in Appendix E. Concern: The primary concern expressed is about the possible health effects the exposed individuals may have suffered. Part of this concern is the uncertainty about the length of time they may have been exposed and whether the levels of contaminants have varied (increased or decreased) during that time. Answer: Potential health effects from past exposure to contaminants in drinking water are evaluated and discussed in the Toxicological and Epidemiological Evaluation for Adult and Children s Health Issues and ATSDR Child Health Initiative sections. Until a source or sources is confirmed, the extent and the duration of the chemical release is uncertain. Concern: Individuals who have been exposed to the contaminated water are interested in what, if any, medical monitoring would be indicated for themselves and their families. Answer: General medical tests are not specific to these VOC exposures. Biological tests such as urinalysis or blood chemistry analyses are useful tools for finding health problems early. Individual s physicians may have already used these routine tests when giving periodic checkups in the past. Physicians evaluate test results in comparison to normal ranges for your sex and age. A wide range of medical conditions can cause abnormal findings in these tests. Each physician also interprets an individual s results in relation to individual medical histories. Residents may wish to tell their physician about their exposure to VOCs because he or she considers personal health history when deciding the types of tests needed and how frequently their patients need to be seen. If your physician would like to talk with a NYS DOH environmental health nurse or physician, he or she should contact the NYS DOH at , extension The NYS DOH conducted site-specific health care provider outreach to 36 local physicians identified by the CC DOH. The County mailed to the health care providers NYS DOH and ATSDR-prepared educational materials on site conditions, site-specific chemicals and exposure to chemicals. Concern: Some residents suspect that illnesses were caused by exposure to the contaminated groundwater (e.g. cancer, miscarriages, dizziness, stomach complaints, etc.). Answer: Potential health effects are discussed in the Toxicological and Epidemiological 14

19 Evaluation for Adult and Children s Health Issues and the ATSDR Child Health Initiative sections. CONCLUSIONS Based on extensive sampling data and the ATSDR's health hazard category classification, the Cayuga County Groundwater Contamination was a public health hazard in the past. This classification is used because people were exposed in the past to contaminants in drinking water from private wells at concentrations exceeding public health comparison values and/or drinking water standards and there is evidence from studies in animals and humans that exposure to elevated levels of vinyl chloride (a known human carcinogen) can increase the risk of adverse cancer and noncancer health effects in humans. Because of the pattern of contamination and the contaminants found, the exposures may have occurred for some time, with people nearer to Auburn potentially exposed the longest. Cis-1,2-dichloroethene and trichloroethene were detected in the Village of Union Springs public water supply wells. Water treatment measures were undertaken to minimize people's exposure to contaminated drinking water; the health risks associated with current levels of exposure are minimal or very low. Given these data and ATSDR s categories, the exposures to volatile organic compounds in the Village drinking water represents no apparent public health hazard. Based on the measures taken to reduce people s exposure to VOC contamination in their drinking water to below levels of public health concern, the Cayuga County Groundwater Contamination site is currently no apparent public health hazard (Appendix D). However, proper operation, maintenance and monitoring of some existing treatment systems is not assured. Furthermore, though a water main extension was installed southwest of Auburn, no long-term remedy for the contaminated drinking water is currently available for the entire area affected by the groundwater plume. RECOMMENDATIONS Based on the potential for adverse health effects from exposure to contaminated groundwater in private wells, the primary recommendation of this Public Health Assessment is to minimize exposure to contaminated water in the community by providing alternative sources of potable water. The affected private drinking water supply wells and treatment systems should continue to be monitored at frequent intervals to help ensure that a continuous supply of potable water is provided. The treatment systems should remain in use until the raw groundwater quality in the affected wells consistently meets the state drinking water standards or until such time that an acceptable permanent alternate drinking water supply is provided. The feasibility of providing a long-term remedy to the entire affected area should be evaluated. 15

20 If new private drinking water wells are installed within the area of the contaminant plume, the new wells need to be sampled and analyzed for site-related contamination. If a new well is contaminated, a treatment system should be installed and maintained if a permanent alternate drinking water supply system has not been identified and implemented. Other recommendations: 1. Continue to provide information such as sampling and source investigation results to the public as soon as data become available. 2. Continue to provide toxicological information/advice to local physicians to assist them in responding to their patients questions and concerns. 3. Continue investigations to locate the source or sources of the chemicals in the plume to reduce further contaminant contribution to the plume and to obtain possible clues to exposure duration. 4. NYS DOH, in consultation with CCDOH, should continue to evaluate the monitoring program analysis results. This will help to ensure that possible changes in the plume location and concentration will be detected and appropriate and timely measures will be taken to minimize potential new exposures. PUBLIC HEALTH ACTION PLAN The Public Health Action Plan (PHAP) for the Cayuga County Groundwater Contamination contains a description of actions already taken or to be taken by the NYS DOH and/or Cayuga County Health Department following completion of this public health assessment. The purpose of the PHAP is to ensure that this Public Health Assessment identifies public health hazards and provides a plan of action designed to mitigate and prevent adverse human health effects resulting from the past, present and/or future exposures to hazardous substances in contaminated groundwater in this area. Included is a commitment on the part of the NYS DOH to follow-up on this plan to ensure that it is implemented. The public health actions are as follows: Actions already taken: 1. Several actions have been taken to provide alternative sources of water to families with contaminated wells. Upon receipt of private well data, the NYS DOH and NYS DEC requested the US EPA to provide relief under the Federal Superfund program. Bottled water, and subsequently, household granular activated-carbon filter systems were provided to those families with wells where contamination exceeded federal drinking water MCLs. Affected farms were also provided treatment. 16

21 2. The Village of Union Springs installed air stripping treatment systems to the public water supply to reduce people s exposure to drinking water containing volatile organic compounds. 3. The Cayuga County Health Department and Emergency Management Office arranged to have supplies of bulk water made available at local fire stations for those who did not qualify for US EPA assistance. 4. The Cayuga County legislators, in conjunction with the CCDOH, sought and obtained a New York State grant, administered by the CCDOH, to provide household treatment systems. The grant is being used by the CCDOH to provide granular activated carbon filter systems to anyone in the plume area with a well contaminated with volatile organic compounds below the federal MCLs. 5. The NYS DOH conducted site-specific health care provider outreach to 36 local physicians identified by the CCDOH. The County mailed to health care providers NYS DOH and ATSDR prepared educational materials on site conditions, site-specific chemicals and exposure to chemicals. 6. In January 2002, a waterline was extended and put in service to provide water from the City of Auburn to the areas most highly contaminated (Overbrook Drive, Experimental Road and Pinckney Road). The Cayuga County Legislature worked to obtain grant funding to provide the waterlines to these areas. 7. In November 2001, the Cayuga County Board of Health passed a resolution recommending any new wells being dug or wells on property changing ownership be tested for VOCs. Additionally, the resolution recommends all privately owned wells be tested yearly for VOC. This information is passed out through the Cayuga County Health Department and through well drillers. Actions planned or ongoing: 1. The NYS DOH will coordinate with the US EPA, CCDOH and other appropriate environmental and health agencies to continue to provide community health education activities to people living in and near the affected area. Activities thus far have included public meetings, fact sheets, and information mailed to local physicians to assist them in addressing their patients concerns. 2. The NYS DOH and CCDOH will continue to work with the US EPA in their efforts to locate the source or sources of the contaminated groundwater plume. 17

22 3. The CCDOH and the NYS DOH initiated and will continue a private well monitoring program in the vulnerable area. Wells that will be sampled include those impacted but at levels below US EPA s limits, wells that have incidental contaminants unrelated to the larger plume, and those that have not been impacted, but are located near ones that have been impacted. 4. The NYS DOH has distributed information and enrollment forms for the NYS Volatile Organics Exposure Registry to residents with contaminated wells. Enrollees will be contacted every two years to update their medical histories. Results of any new research that become available will be shared with Registry program participants. The NYS DOH and ATSDR will evaluate whether additional health studies of people exposed to volatile organics at this site are warranted. 5. The NYS DOH will continue to work with the Cayuga County Water and Sewer Authority, the Cayuga Lake Intercommunity Water Board and other state and local agencies to find a permanent alternative source of potable water for the affected area. 6. The NYS DOH will provide follow-up to this PHAP, as needed, outlining the actions completed and those in progress. This report will be placed in repositories, as they are established, and provided to people who request it. ATSDR/NYS DOH will reevaluate and expand the PHAP when needed. New environmental, toxicological, or health outcome data, or the results of implementing the above proposed actions, may determine the need for additional actions at this site. 18

23 REFERENCES Agency for Toxic Substances and Disease Registry (ATSDR) Toxicological Profile for 1,2-Dichloroethene. Atlanta, Georgia: U.S. Department of Health and Human Services. Public Health Service. Agency for Toxic Substances and Disease Registry (ATSDR). 1997a. Toxicological Profile for Vinyl Chloride. U.S. Department of Health and Human Services. Atlanta, Georgia: U.S. Public Health Service. Agency for Toxic Substances and Disease Registry (ATSDR). 1997b. Toxicological Profile for Trichloroethylene. U.S. Department of Health and Human Services. Atlanta, Georgia: U.S. Public Health Service. Agency for Toxic Substances and Disease Registry (ATSDR) Health Consultation for the Union Springs Groundwater Contamination, Springpost, Cayuga County, NY. Atlanta, Georgia: U.S. Department of Health and Human Services. Public Health Service. Dawson, V., P.D. Johnson, S.J. Goldberg and J.B. Ulreich Cardiac teratogenesis of halogenated hydrocarbon-contaminated drinking water. J. Am. Coll. Cardiol. 21: New York State Department of Health New York State Cancer Surveillance Improvement Initiative. US Environmental Protection Agency (US EPA) Exposure Factors Handbook (EFH). Office of Research and Development. Washington, DC. EPA/600/C-99/001. US Bureau of the Census Census of population and housing summary file 1(SF1). US Department of Commerce. US Bureau of the Census Census of population and housing summary tape file 3A CD-ROM. US Department of Commerce. September. 19

24 20

25 PREPARERS OF REPORT New York State Department of Health Authors Henriette M.J. Hamel Regional Toxics Coordinator Northeastern Region/Central Field Office Thomas Johnson Research Scientist Bureau of Toxic Substance Assessment Sharlin Liu Research Scientist Bureau of Toxic Substance Assessment Donald W.R. Miles ATSDR Grant Coordinator Bureau of Environmental Exposure Investigation Steven P. Forand Research Scientist Bureau of Environmental and Occupational Epidemiology Agency for Toxic Substances and Disease Registry ATSDR Regional Representative Arthur Block Senior Regional Representative Region 2 Office of Regional Operations ATSDR Technical Project Officer Greg Ulirsch Environmental Health Engineer Superfund Site Assessment Branch Division of Health Assessment and Consultation 21

26 22

27 CERTIFICATION The Public Health Assessment for the Cayuga County Groundwater Contamination was prepared by the New York State Department of Health under a cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR). It is in accordance with approved methodology and procedures existing at the time the Public Health Assessment was initiated. Technical Project Officer, SPS, SSAB, DHAC The Division of Health Assessment and Consultation (DHAC), ATSDR, has reviewed this Public Health Assessment and concurs with its findings. Chief, SPS, SSAB, DHAC, ATSDR 23