The agency for Toxic Substances and Disease Registry (ATSDR) has initiated a program to design and maintain a national information management system for use in the execution of selected Superfund projects. The Federal Facilities Information Management System (FFIMS) will be used by health assessors and technical staff to gather and use data from federal, state, and external sources to make public health and emergency response decisions. Users will access the system through a customized geographical information system (GIS) in ArcInfo. Included is a graphical user interface (GUI) that allows persons without much knowledge of GIS theories or ArcInfo commands to use the system. The primary feature of the GIS is its quick display of geo-referenced sites of study. Users can choose "heads-up" display or colorplotted maps for ease of distribution. Other features of the GIS are the spatial analysis of contaminant patters, buffering of sites, plume delineation, and demographic display and analysis. These tools will simplify quick analysis for emergency response requests and complete health assessments. The FFIMS project will be updated continuously for the next few years. This paper describes the early stages of the development of the system's GIS and the prototype GUIs. Also described are the decision making processes involved in constructing this large and dynamic project.
The Agency for Toxic Substances and Disease Registry (ATSDR), a public health agency in the U.S. Department of Health and Human Services, was mandated by Congress as part of the Superfund legislation to assess the health of populations living in the impacted areas of hazardous waste sites. In order to fulfill this mandate, ATSDR conducts public health investigations that both identify potentially impacted populations and assess the health of these exposed populations. The use of geographic information systems (GISs) to integrate and manage disparate data sources has facilitated the design and analysis of health investigations and has resulted in better public health decisions. At the same time, however, it has accentuated the limitations of current databases to make those decisions. In this paper, we illustrate the importance of GIS as an epidemiological tool for cluster investigations by examining longitudinal environmental, health outcome, and population data for a Superfund site in the United States. One of the principal environmental problems identified at the site was groundwater contamination that was likely caused by activities taking place over the last thirty years at a nearby major airport. Trichloroethylene (TCE) contamination occurred in a number of public drinking water wells located in a large plume northwest of the airport. Although the public drinking water wells were closed in 1981, residents in the plume area report concerns about possible TCE exposures and increased risk of adverse health outcomes. For example, health surveys in the area have suggested increased risk of lupus, but have not verified cases or exposure status. This paper offers GIS methods to help evaluate those health concerns. The results of the data analysis highlight the strengths and limitations of making public health decisions about disease clusters within the context of available data sources.
The Agency for Toxic Substances and Disease Registry (ATSDR) has begun using Geographic Information Systems (GIS) technology as an integral tool during the development of public health assessments (PHA). GIS is particularly useful for identifying human exposure pathways and obtaining demographic information. Health assessors used GIS in the development of the Murray Smelter National Priorities List (NPL) PHA. The abandoned lead smelter facility operated in Murray, Utah, from 1902 through 1949 and contaminated the area with arsenic, cadmium, and lead. Assessors contoured data for soil lead concentrations in Murray site area and used those concentration contoured data for soil lead concentrations in the Murray site area and used those concentration contours to identify areas contaminated with soil lead concentrations of 500 to more than 5000 parts per million (ppm). Assessors identified the number of individuals living in areas where lead levels were of possible health concern by clipping census data into those areas with lead levels above 500 ppm. The results supported the need for a health investigation of residents living on the site. Assessors also compared soil lead concentrations with drinking water well locations to identify wells that might need to be tested to see whether soil contaminants have moved into groundwater. GIS also provided a map comparison that allowed assessors to determine whether the area contaminated by past smelter emissions had been identified and sampled. Use at sites such as Murray Smelter has helped ATSDR determine that GIS is a very useful tool for defining the spatial relationship between site contaminants and the people living near a site.
The role of exposure assessment in investigating and understanding environmental health issues is to provide the linkage among environmental information and analyses, consequences of exposures to toxic substances, and human health effects. In the past, the inability to link spatial and temporal distributions of chemical concentrations in the environment to potentially exposed populations efficiently and accurately made comprehensive exposure assessment analyses a difficult and time consuming. The use of GIS makes it possible to manipulate multi-layered, spatially distributed databases easily and to query topological attributes that may be unknown a priori to obtain spatial relationships of interest to environmental health scientists. An example is the relationship among environmental pollutant concentrations, socioeconomic and other demographic distributions, and the occurrence of adverse health effects for targeted populations. As part of its legislative mandate to implement the health-related portions of Superfund, the Agency for Toxic Substances and Disease Registry (ATSDR) has embarked on a program to refine the quantification of past, present, and future exposures to toxic substances in populations living near hazardous waste sites. GIS enhances the application of environmental modeling tools developed for exposure assessment analyses by providing the ability to quantify the relationships between environmental and demographic distributions and the incidence of disease patterns. By integrating GIS, environmental modeling tools, and spatial analysis techniques, environmental health scientists can co-analyze health outcome and environmental data. The process allows them to estimate the influence of nearby sources of environmental pollution on the incidence of disease patterns in surrounding populations, thereby making public health implications from exposure assessments more reliable and timely for the targeted population.