ATSDR staff members get communities involved and respond to community concerns about hazardous substances and chemicals in the environment. They produce several types of reports that analyze available environmental data to determine any possible harm to the public’s health.

Community involvement and health education are an important part of ATSDR’s work, especially when community members and local health professionals need to protect the community’s health. Activities in these areas include:

Public Health Assessments

A public health assessment (PHA) evaluates a hazardous waste site for hazardous substances, health outcomes, and community concerns. A PHA also looks at whether people could be harmed by coming into contact with site-related substances. Public health assessments are often the evaluation tool of choice when a site contains multiple contaminants and multiple, potential pathways of chemical exposure. ATSDR and other agencies use PHAs to identify whether a health study is appropriate or whether some other public health action is warranted, such as community health education. But for every site that is on or is proposed for the National Priorities List, the Superfund law requires that ATSDR conduct a public health assessment. Public health assessments evaluate.

• Levels (or concentrations) of hazardous substances.
• Whether people might be exposed to contamination and how they may come in contact with it (that is, through “exposure pathways” such as breathing, eating, or skin contact with contaminated air or soils).
• What levels of a toxic substance might cause harm to people.
• Whether working or living near a hazardous waste site might affect people’s health.
• Other dangers to people, such as unsafe buildings, abandoned mine shafts, or other physical hazards.

Public Health Consultations

If a specific health question or issue arises about a potential environmental hazard, ATSDR conducts a public health consultation. A consultation differs from a public health assessment in that the consultation focuses on a specific question and provides a more rapid response. A consultation can address public health issues such as a chemical or radiological contamination, epidemiology, or provide technical advice on sampling and remediation plans. Public health consultations are not medical examinations, community health studies, or public health assessments.

Exposure Investigations

Sometimes, critical data needed for a health assessment or consultation are missing or not available. In such cases, ATSDR might conduct an exposure investigation. Exposure investigations involve the collection and analysis of environmental contamination data and biologic tests (when appropriate). The goal is to determine whether people have been exposed to hazardous substances. An exposure investigation is one approach used to better characterize past, current, and possible future human exposures to hazardous substances and to evaluate both existing and possible exposure-related health effects.

Exposure investigations may include:

• Biomedical testing (urine and blood samples), which can show current and possibly past exposure to a contaminant, or
• Environmental testing of soil, water, or air. Testing is done where people live, spend time, play, or might come in contact with contamination.

Exposure dose reconstruction analyses use environmental sampling and computer models to estimate contamination levels that people may have been exposed to in the past, or may be exposed to in the future. Modeling helps in estimating potential exposures and assisting in conclusions on how exposures might affect a person’s health.

Public Health Advisories

An advisory is an official notice that ATSDR gives to U.S. EPA or to a state regulatory agency. The advisory identifies an immediate threat to human health from a hazardous substance. The advisory also includes a recommendation to reduce exposure and any threat to human health. In the advisory ATSDR also notifies appropriate state and local health and environmental agencies about any public health problems.

Public Health Advisories include:

• What the levels or concentrations of a hazardous substances are.
• Whether people might be exposed to contamination and how they might come into contact with it (breathing, drinking, eating).
• What harm the substance might cause to people (the toxicity).
• Whether working or living near the site might affect people’s health.
• Other dangers such as unsafe buildings, abandoned mine shafts, or other physical hazards.