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The Effects of Great Lakes Contaminants on Human Health

FOREWORD

The Great Lakes basin comprises one-fifth of the total fresh water on the earth's surface; it is valuable natural resource for both the United States and Canada. For over 200 years, the Great Lakes basin has been used as a resource for industry, agriculture, shipping, and recreation. Approximately 10 percent of the United States population lives within the Great Lakes basin. Researches have identified 362 contaminants in the water, sediment, and biota in quantifiable amounts, approximately one- third have been evaluated for their potential toxic effects. Many of these chemicals have known adverse effects on humans. Critical Great Lakes pollutants identified by the International Joint Commission are polychlorinated biphenyl (PCBs), dichlorodiphenyl trichloroethane (DDT), dieldrin, toxaphene, mirex, methylmercury, benzo[a]pyrene, hexachlorobenzene (HCB), furans, dioxins, and aklylated lead. All eleven substances tend to accumulate in aquatic organisms eaten by Great Lakes fish. Because of the persistence and widespread contamination of these Great Lakes pollutants in the environment, toxic effects in wildlife have been demonstrated and results from epidemiological investigations suggest that adverse human health effects, (i.e., reproductive, developmental, behavioral, neurologic, endocrinologic, and immunologic) are associated with exposure to Great Lakes pollutants.

Exposure assessment studies indicated that humans are the final biological receptors for many toxic substances. There is limited information on the effects associated with the consumption of Great Lakes fish. Given the implications of the association between contaminants in the Great Lakes and adverse human health outcomes, further research is necessary to illuminate the relationship between exposure, contaminant levels in human biological tissues and fluids, and the potential for adverse human health effects in these exposed populations.

In accordance with the responsibilities under the Great Lakes Critical Programs Act of 1990, the USEPA transferred funds to the Agency for Toxic Substances and Disease Registry (ATSDR), which has developed a research program to address human health effects from exposure to contaminants in the Great Lakes. Much of the historical data used in this report was obtained from information and prior research performed by state health departments and universities. Federal agencies other than the USEPA and ATSDR, such as the Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health, and state agencies have all participated in preliminary reviews of this report. This report reflects comments made by those agencies as well as those made by the principal researchers whose work is contained within the report.

Because this research program is still in its early phases, there are no results of these new studies presented in this report. However, preliminary results support earlier reports of an association between the consumption of contaminated Great Lakes fish and body burdens of persistent toxic substances, including PCBs, organochlorines, and heavy metals such as mercury and lead. These body burdens, identified in the fluids and tissues of consumers of Great Lakes fish appear to be higher than those in the general population. Research studies are ongoing to assess any effects of these contaminants on human health. The health studies are investigating neurobehavioral and developmental deficits potentially associated with the consumption of contaminated fish. In the meantime, the potential human health effects in at-risk populations associated with documented exposures and body burdens remain a potential public health concern. In those instances of documented exposures and associated body burdens, the research community supported by this program is pursuing appropriate public health interventions and communication efforts for defined at-risk populations in the basin with an emphasis on disease prevention. Results from all studies will be summarized in a supplement to this document, upon completion of the studies.

Executive Summary

In 1990, Congress passed the Great Lakes Critical Programs Act, amending the Federal Water Pollution Control Act. This amendment requires the U.S. Environmental Protection Agency (USEPA), in consultation with the Agency for Toxic Substances and Disease Registry (ATSDR) and the Great Lakes states, to submit to Congress a report assessing the adverse effects of water pollutants in the Great Lakes basin on the health of persons in the Great Lakes states and the health of fish, shellfish, and wildlife in the Great Lakes system. In support of this directive, Congress authorized funds not to exceed $3 million to carry out research to support this report for each of the fiscal years 1992, 1993, and 1994. The USEPA received earmarked appropriations of $2 million for fiscal year 1992 and $3 million per year for fiscal years 1993 and 1994 to support human health effects studies in the Great Lakes basin. These funds were transferred by the USEPA's Health Effects Research Laboratory to the ATSDR to conduct these studies. This report focuses on adverse human health effects as opposed to fish, shellfish, and wildlife for two reasons. First, this was done because there are few if any comprehensive reports addressing human health in the Great Lakes. Conversely, there are a number of reports addressing the effects of Great Lakes pollutants on fish and wildlife including the USEPA's 1994 Report to Congress on the Great Lakes Ecosystem, (pages 11 to 25) and the U.S. Fish and Wildlife Service (USFWS) Annual Report to Congress required by the Great Lakes Fish and Wildlife Restoration Act of 1990. Second, from discussions between USEPA and Congressional staff it was apparent that the Congressional intent of this report was to address human health impacts. The Congressional intent was also for the USEPA to take responsibility for the report preparation and transferring funds to the ATSDR. ATSDR's responsibility is to oversee the technical human health research program.

Although this report presents no results, it summarizes the existing literature on Great Lakes human health studies related to contaminants, as well as research progress made by the ATSDR's Great Lakes Human Health Effects Program during fiscal year 1992. Final results and conclusions are expected to be submitted as a supplement to this document upon completion of the studies.

ATSDR's mission is to prevent exposure and adverse human health effects and diminished quality of life associated with exposure to hazardous substances from waste sites, unplanned releases, and other sources of pollution present in the environment. The activities described in this report support this mission and are consistent with achieving the health promotion and disease prevention objectives of Healthy People 2000, a national strategy put forth by the U.S. Department of Health and Human Services for significantly improving the health of the Nation during the next decade.

ATSDR made significant progress in implementing its Great Lakes Human Health Effects Research Program in fiscal year 1992. The ATSDR research program is designed to investigate and characterize the association between the consumption of contaminated Great Lakes fish and short- and long-term harmful health effects. The objectives of the research program are to:

Toward this end, ATSDR developed a Great Lakes Health Effects Research Strategy. The goal of this strategy is to identify human populations residing in the Great Lakes basin that may be at greater risk of exposure to chemical contaminants present in one or more of the Great Lakes and to help prevent any adverse health effects. This strategy is built upon the five traditional elements of disease prevention: identification, evaluation, control, dissemination, and infrastructure. This strategy has been endorsed by the Council of Great Lakes Research Managers and has been endorsed by the International Joint Commission as a framework for the study of human health and other ecosystem effects in the Great Lakes basin.

For fiscal year 1992, the USEPA through ATSDR funded nine research grants to study the potential adverse human health effects from consumption of contaminated Great Lakes fish. These studies include eight epidemiologic investigations in presumed susceptible populations, (i.e., Native Americans, sport anglers, the urban poor, pregnant females, and fetuses and nursing infants of mothers who consume contaminated Great Lakes fish). The ninth study focuses on developing more sensitive methods to detect persistent and bioaccumulative Great Lakes contaminants such as polychlorinated biphenyls, dioxins, alkylated lead, mirex, and methylmercury in human biologic tissues and fluids. The 10 grants funded by ATSDR for fiscal year 1993 included nine continuation awards for the studies initiated in 1992 and one new award that established an interlaboratory-based quality assurance/quality control program for the ATSDR research program. The fiscal year 1994 funds were used to continue funding the previously mentioned ten projects.

The impact of this research program will be felt most directly by the communities within the Great Lakes basin. Collectively, these 10 research projects will

Additionally, the research conducted by this program will help delineate the relationships among contaminant levels in the environment, exposure pathways, tissue levels, and potential human health effects; allow for evaluation and interpretation of data across all human health studies to facilitate a basin-wide analysis on the pollution problem in the Great Lakes; and provide a model for other ecosystem-level studies intended to determine human health impacts of hazardous waste.


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