epidemiologic study. Following are examples of health
studies or investigations that ATSDR conducted or
blood-lead levels.
supported in Missouri.
Census activities started in February 2000 in the
Hazardous Substances Emergency Events
Joplin area and in March 2000 in areas outside of
Surveillance System (HSEES)--HSEES was
Joplin. More than 9,000 households were visited
established by ATSDR in 1990 to collect and
during the census; 847 households were found to
analyze information about releases of hazardous
have children aged 6 to 72 months living near the
Jasper County Superfund Site at least 60 days
substances that need to be cleaned up or
neutralized according to federal, state, or local law,
before the beginning of the study. Blood samples
as well as threatened releases that result in a public
were obtained from 216 children in the original
health action, such as an evacuation. The goal of
study area and 71 children in the expanded area.
HSEES is to reduce the morbidity and mortality of
Environmental sampling was conducted. A parent
first responders, employees, and the general public
or guardian of each of the children involved in
resulting from hazardous substances emergencies.
the study responded to questions about behavioral
Fifteen state health departments, including
risk factors associated with blood-lead levels.
Missouri, currently participate in HSEES. HSEES
Study results indicated that interventions to reduce
captures data on over 5,000 events annually. Of
blood lead levels of children living in the mining
these, 80% occur at fixed facilities, and 20% are
waste and smelter area of Jasper County have been
transportation-related events. Most events occur
effective. Only 2% of the children tested in 2000
between 8:00 AM and 5:00 PM on Monday through
had blood lead levels greater than 10 micrograms
Friday. Persons most often injured are employees.
per deciliter. A final study report was published
September 2002.
Multiple Sclerosis and the Amoco Refinery in
Sugar Creek--Residents of Sugar Creek, a small
Determining the Prevalence of MS and
Amyotrophic Lateral Sclerosis (ALS) in
community near Kansas City that is adjacent to an
Communities Living Around Hazardous
Amoco oil refinery, have indicated their concern
Waste Sites--In fiscal year 2002, ATSDR
about the rate of multiple sclerosis (MS) in their
community. Anecdotal information suggested a
twofold to fourfold elevation in MS prevalence
a cross-sectional prevalence study and a cluster
above the U.S. figures. The Jackson County
investigation in Herculaneum and Jefferson
Health Department (JCHD) entered into a
County to address community concerns of excess
ALS and MS and to define the epidemiologic
2000 to more fully explore MS prevalence in
characteristics of cases. MDHSS will analyze
the area. This research activity includes the
medical records to ascertain all MS and ALS
development of methods for case ascertainment
cases treated since January 1, 1998. Medical
and case confirmation and the estimation of MS
records of cases will be abstracted by professional
prevalence for Sugar Creek and the surrounding
abstractors and verified by a neurologist consultant.
community of Independence. These two
Prevalence estimates for ALS and MS will be
communities have a combined population of
calculated and the possibility of clustering will be
almost 120,000 persons.
evaluated using geographical statistical techniques.
Study of Childhood Blood-Lead Levels
Following Environmental Cleanup--MDH
was awarded a grant to conduct a follow-up
study of childhood blood-lead levels following
environmental cleanup. The objective of the
study was to evaluate whether interventions (soil
remediation and community and professional
For more information, contact ATSDR toll-free
health education) in the area since 1991 reduced
at 1-888-42ATSDR (1-888-422-8737) or visit the
the mean blood-lead levels of all children, thereby
ATSDR Web page at www.atsdr.cdc.gov.
December 2003
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