several surveillance activities, including the
clinical evaluations and screenings. ATSDR
surveillance of hazardous spills and releases in
also conducts health education and promotion
a number of states.
activities that have a nationwide focus, such as
its case study program on environmental
One large-scale project initiated during the past
medicine.
year was the medical evaluation of residents
and former residents of Libby, Montana.
These activities are conducted with the assis-
Vermiculite mined in the area was found to
tance of numerous partners with whom the
have been contaminated with asbestos, and
people had been potentially exposed for a
states, American Indian tribal nations or
number of years. More than 6,000 people were
groups, and national organizations. ATSDR
tested for signs of asbestos-related disease. The
also expanded its network of pediatric environ-
program offered chest x-rays and a test for
mental health specialty units in fiscal year 2000
breathing capacity. About 5% of those tested
to eight units across the country. ATSDR and
were immediately referred for a follow-up
its partners performed health education and
examination of health conditions that were
promotion activities at approximately 300 sites.
found. Results of the medical testing are to be
One example of a site where ATSDR and its
analyzed and reported in fiscal year 2001.
partners implemented an extensive health
ATSDR has collaborated with other agencies of
promotion activity was in Ottawa County,
the Department of Health and Human Services
Oklahoma, where ATSDR worked with Ottawa
to have additional medical services provided in
County public health officials to create a lead
Libby. The Health Resources and Services
poisoning prevention program. The Tar Creek
Administration designated the community as
site there is inside Oklahoma's portion of the
being medically underserved and provided a
Pitcher Field mining region, an area that had
grant for a nurse to work with residents. The
extensive lead and zinc mining.
National Cancer Institute is providing informa-
The program used a mobile education and
tion to the community on clinical trials and
blood-testing unit that visited Head Start
current therapies for treating asbestos-related
centers and kindergartens, where about 250
illnesses.
children were screened. In addition, 600 blood
level screenings of children and pregnant
Preventing Health Effects Related
women were performed through the county's
Women, Infants, and Children clinics. Fifty
to Hazardous Substances
children had blood lead levels that were above
ATSDR draws on its resources in health
the level of health concern and are being
education, risk communication, environmental
rechecked every 3 months. A database was
medicine, and health promotion to prevent or
created to track blood lead levels and interven-
reduce the harmful health effects of exposure to
tions and to provide information to EPA for
hazardous substances in communities. ATSDR
pathway analysis and cleanup, when necessary.
provides such preventive measures as training
Additionally, parents of children identified with
local physicians about the health concerns
elevated blood lead levels received referrals and
educational materials.
communities with information about the health
effects of hazardous substances, and providing
Executive Summary 3