2007 Bunker Hill Superfund Site 2007 Bunker Hill Superfund Site Coeur d’Alene BasinCoeur d’Alene BasinBlood Lead LevelsBlood Lead Levels

Idaho Department of Health and WelfareIdaho Department of Environmental Quality

Panhandle Health DistrictUnited States Environmental Protection Agency

February 27, 2008

• Public health service offered by the State

• Not a study or experiment

• Box since 1974/1985

• Basin since 1996

Lead Health Intervention Program (LHIP) Lead Health Intervention Program (LHIP) Annual Blood Lead SurveysAnnual Blood Lead Surveys

LHIP is an Interim Health Response Activity

- To identify children with high blood lead

and assist families to reduce exposure

Superfund is a Risk-based Cleanup Action

- To prevent future exposures

Panhandle Health District Panhandle Health District LHIPLHIP

No cash incentive for participants that live: within the Box and are between 6 months and 9

years of age, or

$20.00 cash incentive for participants that live: within the Coeur d’Alene River Basin and are between

6 months and 6 years of age

• Prior to blood draws, the parent/legal guardian or adult participant must sign a Consent Form and complete the appropriate Questionnaire

Panhandle Health DistrictPanhandle Health DistrictLHIP ProceduresLHIP Procedures

• Screening blood test is done by skin puncture (capillary or fingerstick - FS)

• Blood samples are collected in a lead-free ESA capillary tube and analyzed immediately using the LeadCare Analyzer

• Results of capillary test are provided to the participant or

parent immediately after analysis

Panhandle Health DistrictPanhandle Health District

LHIP ProceduresLHIP Procedures

Health Effects

Decreasing “elevated”Decreasing “elevated”blood lead levelsblood lead levels

60

40

3025

10 ??

N Engl J Med 2003;348: p1517-26.

Lead Dose Lead Dose Response ResponseObserved Effect Blood Lead g/dl

Children Adults Death 125Neurological Encephalopathy 70 100 Peripheral Neuropathy 40 40 Central Nervous System Hearing 10 Cognitive IQ <10 - Psychomotor Function 10 - Birth weight/ Term length 10 -Anemia 20 80 Heme synthesis 10 10Renal nephropathy 40 40Hypertension 25 Vitamin D < 30 Sperm count & function 40Delayed female puberty <10Adapted from Casserett & Doull’s TOXICOLOGY and ATSDR

Sub-clinicalSub-clinical

At Risk PopulationsAt Risk Populations

• Children

• Pregnant women

• Adults with cumulative exposure

• Genetically pre-disposed Individuals

Neurotoxic Effects in ChildrenNeurotoxic Effects in Children

• Neurobehavioral effects in early development persist into adolescence and young adulthood

• Neurocognative effects associated blood lead levels of 5-10 μg/dl

• A decline of 6.2 IQ points results from a blood lead change from 1 to 10 μg/dl (pooled results from 7 studies)

Cardiovascular Effects in AdultsCardiovascular Effects in Adults

• Increase in blood pressure (hypertension)

Other Organ System EffectsOther Organ System Effects• Renal effects• Immune system effects• Bone and teeth effects• Heme-synthesis effects• Reproductive and developmental effects• Adrenal effects• Liver Effects• Gastrointestinal Effects• Metabolism Effects• Genotoxic Effects• Carcinogenic Effects

Centers for Disease Control Guidance for Children with Elevated Blood Lead

blood lead concentration <10 μg/dl Re-assess or re-screen in one year.

blood lead concentration 10-14 μg/dl Provide family lead education. Provide follow-up testing. Refer for social services, if necessary.

blood lead concentration 15-19 μg/dl If blood lead levels persist or worsen proceed according toactions for blood lead concentrations in the 20-44 μg/dl range.

blood lead concentration 20-44 μg/dl Provide coordination of care, clinical management, environmental investigation, and lead- hazard

control.

blood lead concentration 45-69 μg/dl Within 48 hours, begin coordination of care clinical management,

environmental investigation, and lead- hazard control.

• blood lead concentration >70 μg/dl Hospitalize child and begin medical

treatment immediately. Begin coordination of care, clinical management, environmental investigation, and lead-hazard control immediately.

2007 EPA Lead Criteria Document Conclusion

“There is no level of Pb exposure that has yet been identified, with confidence, as clearly not being associated with possible risk of deleterious health effects.”

Bunker Hill Box Bunker Hill Box Superfund Site Remedial Superfund Site Remedial

Action ObjectiveAction Objective

• 95% of all children in each community with blood lead levels <10 µg/dl

• No children (i.e. <1%) with blood lead levels > 15 µg/dl

Coeur d’Alene BasinCoeur d’Alene BasinSuperfund Site Remedial Superfund Site Remedial

Action ObjectiveAction Objective

• 95% probability for individual children with blood lead levels <10 µg/dl

• <1% probability for any child with blood lead levels > 15 µg/dl

Bunker Hill Box Bunker Hill Box Average Blood Lead: 1974-2002Average Blood Lead: 1974-2002

**

** **

U.S. Average

**

“Elevated” blood lead level

Box Lead Health InterventionBox Lead Health InterventionSummary Statistics 1988-1994Summary Statistics 1988-1994

Number of Mean Number of children Percent children blood Pb with blood Pb (g/dl) of children

Year in survey (g/dl) >25 >15 >10 > 10 g/dl

1988* 230 9.9 7 35 105 46%

1989* 275 11.4 8 71 154 56%

1990 362 8.9 2 41 134 37%

1991 365 6.3 2 17 56 15%

1992 415 7.4 3 31 110 27%

1993 445 5.6 1 10 66 15%

1994 416 6.2 1 15 71 17%

*does not include Pinehurst

Box Lead Health InterventionBox Lead Health InterventionSummary Statistics 1995-2002Summary Statistics 1995-2002

Number of Mean Number of children Percent children blood Pb with blood Pb (µg/dl) of children

Year in survey (µg/dl) >25 >15 >10 > 10 µg/dl

1995 405 6.0 2 20 62 15%1996 397 5.8 2 13 49 12%1997 337 5.4 0 6 36 11%1998 375 4.8 0 5 31 8%1999 370 4.7 0 3 23 6%2000 320 4.3 0 5 17 5%2001 322 3.2 0 4 10 3%

2002 368 3.1 0 3 7 2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Year

% o

f C

hild

ren

wit

h B

loo

d L

ead

Ab

ove

10

g/d

l

Kellogg Pinehurst Smelterville RAO

RAO < 5%

Percent of Box Children with Blood Lead Levels > 10 μg/dl,

by City, 1988-2002

2007 Blood Lead Summary 2007 Blood Lead Summary Statistics – Box (age 0-9)Statistics – Box (age 0-9)

Total Number of Children (N) 8Minimum (μg/dl) 1.4Maximum (μg/dl) 4.8Average (μg/dl) 2.4Standard Deviation 1.3Geometric Mean (μg/dl) 2.1Geometric Standard Deviation 1.65

PercentageTotal Number of Children (N) 8Number of Children > 10 μg/dl 0 0%Number of Children > 15 μg/dl 0 0%Number of Children > 20 μg/dl 0 0%

Percent of Children with Blood Lead Levels > 10 μg/dl, Kellogg and Basin, 1988-2007

0%

10%

20%

30%

40%

50%

60%

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Year

% o

f C

hil

dre

n w

ith

Blo

od

Le

ad

Ab

ov

e 1

0 μ

g/d

l

Kellogg Basin

2007 Blood Lead Summary 2007 Blood Lead Summary Statistics – Basin (age 0-6)Statistics – Basin (age 0-6)

Total Number of Children (N) 71Minimum (μg/dl) 1.4Maximum (μg/dl) 8.6Average (μg/dl) 2.9Standard Deviation 1.5Geometric Mean (μg/dl) 2.6Geometric Standard Deviation 1.62

PercentageTotal Number of Children (N) 71Number of Children > 10 μg/dl 0 0%Number of Children > 15 μg/dl 0 0%Number of Children > 20 μg/dl 0 0%

Year 1996 1997 1998 1999 2000 2001

N 58 13 70 162 102 117

N ≥ 10 μg/dl 8 2 9 26 14 7

% ≥ 10 μg/dl 14% 15% 13% 16% 14% 6%

N ≥ 15 μg/dl 3 1 4 12 4 2

% ≥ 15 μg/dl 5% 8% 6% 7% 4% 2%

N ≥ 20 μg/dl 0 0 2 4 1 0

% ≥ 20 μg/dl 0% 0% 3% 2% 1% 0%

Basin Blood Lead Summary Basin Blood Lead Summary by Year, 1996 - 2001 by Year, 1996 - 2001 (age 0-6 only)(age 0-6 only)

Year 2002 2003 2004 2005 2006 2007

N 103 75 82 81 69 71

N ≥ 10 μg/dl 4 3 2 1 1 0

% ≥ 10 μg/dl 4% 4% 2% 1% 1% 0%

N ≥ 15 μg/dl 0 2 1 0 0 0

% ≥ 15 μg/dl 0% 3% 1% 0% 0% 0%

N ≥ 20 μg/dl 0 0 0 0 0 0

% ≥ 20 μg/dl 0% 0% 0% 0% 0% 0%

Basin Blood Lead Summary Basin Blood Lead Summary by Year, 2002 - 2007 by Year, 2002 - 2007 (age 0-6 only)(age 0-6 only)

Age 1 2 3 4 5 6

N 12 14 9 15 12 9

Min (μg/dl) 1.4 1.4 1.4 1.4 1.4 1.4

Max (μg/dl) 8.6 5.3 6.2 5.5 4.3 5.8

Ave (μg/dl) 3.3 2.9 3.3 2.7 2.2 3.2

GeoMean (μg/dl)

2.8 2.7 2.9 2.4 2.0 2.8

2007 Basin Blood Lead Summary 2007 Basin Blood Lead Summary Statistics by Age (years)Statistics by Age (years)

• Remediation is NOT based on

blood lead data.

• Remediation IS based on risk of

exposure to environmental (soils and

dust) metals concentrations.

Annual Blood Lead Surveys and Annual Blood Lead Surveys and Cleanup ActivitiesCleanup Activities

Remediation reduces health

risks to children and women

of child-bearing age currently

residing in the Basin

and for future generations.

  Consented Refused

Mullan 98% 2%

Wallace & Burke/Ninemile

97% 3%

Silverton 94% 6%

Osburn 97% 3%

Side Gulches 95% 5%

Kingston Area 89% 11%

Lower Basin 76% 24%

Total 95% 5%

Consents and refusals received from 2004 through December 2007.

Percentage of Parcels that have Percentage of Parcels that have Consented and Refused SamplingConsented and Refused Sampling

House Dust is the Primary Risk Driver

• Soil Remediation reduces exposure to outside soil lead, and

• Reduces lead in house dust from those soils

BoxHouse Dust

History

0

200

400

600

800

1000

1200

1400

1600

1800

1988 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Year

Ge

om

etr

ic M

ea

n H

ou

se D

ust

Le

ad

Co

nce

ntr

atio

n (

mg

/kg

)

Kellogg Page Pinehurst Smelterville Wardner RAO

Community Mean Vacuum Bag Dust Lead Concentration By Year and Geographic Area, 1988-2005

Community RAO <500 mg/kg

Note: Samples not available for Page in 1997, 1999 & 2001 (indicated with dashed lines).

Basin House Dust Trends

Notes:Vacuum samples were not collected in 1997, 2000, or 2001. 2002 had too little data to display. In 2005, only one vacuum sample was collected from the Lower Basin. When the number of samples is 2 or less, the results are not shown in order to maintain confidentiality.

Community Mean Vacuum Bag Dust Lead Concentration By Year and Geographic Area, 1996-2007

0

200

400

600

800

1,000

1,200

1,400

1,600

1996 1998 1999 2003 2004 2005 2006 2007

Geo

met

ric

Mea

n L

ead

Con

cent

rati

on (m

g/kg

)

Burke/Ninemile Kingston Lower Basin Mullan Osburn Side Gulches Silverton Wallace

Area Burke/Ninemile Kingston Lower Basin

Osburn

N 3 13 11 16

Min (μg/dl) 2.3 1.4 1.4 2.1

Max (μg/dl) 4.1 4.5 4.7 8.6

Ave (μg/dl) 3.0 2.1 2.0 4.0

GeoMean (μg/dl)

2.9 1.9 1.9 3.7

2007 Basin Blood Lead Summary 2007 Basin Blood Lead Summary Statistics by AreaStatistics by Area

Area Side

Gulches

Silverton Wallace

N 12 8 7

Min (μg/dl) 1.4 1.4 1.5

Max (μg/dl) 3.7 7.1 6.2

Ave (μg/dl) 2.5 2.9 3.9

GeoMean (μg/dl) 2.4 2.5 3.4

2007 Basin Blood Lead Summary 2007 Basin Blood Lead Summary Statistics by AreaStatistics by Area

1 sample from Mullan is not shown to protect confidentiality

BoxHouse Dust

History

Figure 3.8aHouse Dust Vacuum Bag Lead Concentration

Histogram - 1988

0%

10%

20%

30%

40%

50%

60%

70%

80%

0-200 200-400 400-600 600-800 800-1000 >1000

House Dust Vacuum Bag Lead Level (mg/kg)

Perc

en

tag

e o

f P

op

ula

tio

n

Figure 3.8nHouse Dust Vacuum Bag Lead Concentration

Histogram - 2002

0%

10%

20%

30%

40%

50%

60%

70%

80%

0-200 200-400 400-600 600-800 800-1000 >1000

House Dust Vacuum Bag Lead Level (mg/kg)

Perc

en

tag

e o

f P

op

ula

tio

n

Basin House Dust Trends

Basin House Dust Vacuum Bag Lead Concentration Histogram - 1996-1999

0%

10%

20%

30%

40%

50%

60%

70%

80%

0-200 200-400 400-600 600-800 800-1000 >1000

House Dust Vacuum Bag Lead Level (mg/kg)

Pe

rce

nta

ge

of

Po

pu

lati

on

Basin House Dust Vacuum Bag Lead Concentration Histogram - 2006

0%

10%

20%

30%

40%

50%

60%

70%

80%

0-200 200-400 400-600 600-800 800-1000 >1000

House Dust Vacuum Bag Lead Level (mg/kg)

Pe

rce

nta

ge

of

Po

pu

lati

on

Health Observations 2007

• No Children with Elevated Blood Lead Levels in Box or Basin

• Low Turnout in both Box and Basin

• High Cooperation with Yard Program

• Soil and Dust Exposures Decreasing in most Areas

• Higher Dust Lead Levels Persistent in Upper Basin