Agency for Toxic Substances and Disease Registry

Agency for Toxic Substances and Disease Registry
Director:	Patrick Breysse
Deputy Director:	Donna Knutson
Administrator:	Tom Frieden
Annual budget:	$95 million (FY 2015)
Total employed:	306
Year created:	1980
Official website:	Office website

The Agency for Toxic Substances and Disease Registry (ATSDR) is a federal agency and a division of the U.S. Centers for Disease Control and Prevention, which is a part of the U.S. Department of Health and Human Services. ATSDR's work involves hazardous substances and public health and safety. The agency maintains an advisory role in federal cleanup efforts of contaminated sites and performs health assessments of sites upon request. It operates 10 regional offices and its fiscal year 2015 budget was $95 million.

History

In 1980, the United States Congress enacted the Comprehensive Environmental Response, Compensation and Liability Act, "commonly known as the 'Superfund' Act." The legislation is most well-known for having created the U.S. Environmental Protection Agency's (EPA) Superfund program, which allows the EPA to identify sites contaminated with hazardous or toxic materials and supervise the clean-up and removal of such materials.

The legislation also created the Agency for Toxic Substances and Disease Registry (ATSDR), tasked with studying certain Superfund sites for specific materials that are hazardous to human health, preventing human exposure to such hazards, and maintaining an information database about hazardous materials and their effects on human health. Subsequent legislation expanded ATSDR's responsibilities to conducting "public health assessments" of any waste site upon request by the EPA, a state or a member of the public. The agency may then advise the EPA on specific cleanup techniques, but ATSDR does not have any enforcement authority and the EPA is not required to accept the agency's conclusions.

Patrick Breysse was appointed as director of ATSDR in December 2014. The organization is based in Atlanta, Georgia.

Structure

Below is an organizational chart of the Agency for Toxic Substances and Disease Registry (ATSDR). Patrick Breysse has served as the director of ATSDR since December 2014. The agency's offices include the following:

• Office of the Director
  • Office of Communication
  • Office for Environmental Health Emergencies
  • Office of Financial, Administrative, and Information Services
  • Office of Policy, Planning, and Evaluation
  • Office of Science
  • Office of Tribal Affairs
• Division of Community Health Investigations
• Division of Toxicology and Human Health Sciences

Map of the regions served by ATSDR

ATSDR also has 10 regional offices that are housed within the U.S. Environmental Protection Agency's regional offices. These offices receive petitions for public health assessments and serve as the point of contact for the community throughout the assessment process. They are also involved in collecting data for and assisting the preparation of health consultations. Staff at regional offices are trained in disaster preparedness and may assist other agencies during emergency responses, as well as disseminate information to residents on protecting their health. Finally, regional offices lead the agency's Brownfield/Land Reuse Health Initiative by providing health information to communities seeking to redevelop formerly contaminated properties.

Mission

The mission of the Agency for Toxic Substances and Disease Registry is written on its website as follows:

“	NCEH/ATSDR protects people’s health from environmental hazards that can be present in the air we breathe, the water we drink, and the world that sustains us. We do this by investigating the relationship between environmental factors and health, developing guidance, and building partnerships to support healthy decision making.	”
—Agency for Toxic Substances and Disease Registry

Budget

For the 2015 fiscal year, the budget for the Agency for Toxic Substances and Disease Registry (ATSDR) amounted to about $95 million. This was about $20 million higher than in fiscal year 2014 due to extra appropriations provided by the Affordable Care Act. For fiscal year 2016, ATSDR requested $75 million in appropriations, a similar level to fiscal years 2013 and 2014.

Initiatives

• Toxicological profiles

The Agency for Toxic Substances and Disease Registry (ATSDR) compiles data and information from numerous studies on the health effects of common hazardous materials found at waste sites, such as sulfur dioxide and mercury. These profiles are developed mostly with health professionals in mind. From these profiles, the agency has also created ToxFAQs, two-page fact sheets that developed more with the public in mind.

• Board of Scientific Counselors

In a move meant to ensure the scientific quality and utility of the materials ATSDR produces, the agency established the Board of Scientific Counselors in 2004. The board serves as an advisory committee to research and assessments and to the dissemination of the agency's findings.

• Brownfield/Land Reuse Health Initiative

When community officials decide to redevelop brownfield properties, ATSDR performs assessments of the property to identify toxic substances and acts as a consultant on the potential health effects of such substances at the site. The agency also provides tools and guidelines for community officials to monitor residents' health after redevelopment.

Noteworthy events

In September 2008, the U.S. House of Representatives Committee on Science and Technology released a report called "Toxic Trailers - Toxic Lethargy" that was critical of the response of the Agency for Toxic Substances and Disease Registry (ATSDR) to the aftermath of Hurricane Katrina. In 2005, after Hurricane Katrina hit the Gulf Coast of the United States, the Federal Emergency Management Agency (FEMA) provided temporary travel trailers to house displaced residents. Because these types of trailers were known to have "elevated levels of formaldehyde," a preservative used for constructing plywood and particleboard, the Occupational Safety and Health Administration (OSHA) conducted testing in October 2005 on some unoccupied trailers and found high levels of formaldehyde.

In spring of 2006, the residents began reporting symptoms such as breathing difficulties, burning eyes and headaches. Upon request from FEMA, two ATSDR scientists analyzed data from air samples collected by the U.S. Environmental Protection Agency (EPA) from 96 unoccupied trailers. They measured the level of formaldehyde in the samples against a standard of 300 parts-per-billion (ppb), ATSDR's guideline for emergency response teams in the event of occupational exposure to a formaldehyde spill. They found "that if all the windows and vents were left open for four days," the level of formaldehyde in the trailers would fall below 300 ppb. "Toxic Trailers" called the selection of this standard an "indefensible" error in light of ATSDR's own standards of 8 ppb for chronic exposure of a year or more and 30 ppb for exposure lasting between 15 days and a year, in addition to publications from the EPA, National Cancer Institute, and OSHA that health effects may begin at 100 ppb.

An example of the temporary trailers provided by FEMA

ATSDR scientists clarified in their report that "the consultation is not intended to establish FEMA's future policy concerning temporary housing units." Former ATSDR Director Howard Frumkin and former Deputy Director Dr. Tom Sinks reviewed the consultation and the results were sent to FEMA in February 2007. According to "Toxic Trailers," FEMA decided to use the health consultation as guidance in its actions and interactions with trailer residents and the public:

“	FEMA Administrator David Paulison testified before the House Homeland Security Committee about FEMA's hurricane response preparedness and said, referring to the ASTDR health consultation: "We've been told that the formaldehyde does not present a health hazard."	”
—U.S. House of Representatives Committee on Science and Technology

Christopher De Rosa, then director of ATSDR's Division of Toxicology and Environmental Medicine, saw the health consultation after it had been sent to FEMA and brought up many concerns to ATSDR leadership, such as its omission that formaldehyde exposure can cause cancer. A letter written by De Rosa was sent to FEMA on March 17, 2007 that detailed his concerns and stated, "[f]ailure to communicate this issue is possibly misleading, and a threat to public health." No other actions were taken by either ATSDR or FEMA until July 2007, when the House Oversight and Government Reform committee was in the midst of hearings "on FEMA's response to the formaldehyde issue." At that point, ATSDR leadership decided to revise the health consultation, and a new report was released in October 2007. The U.S. Centers for Disease Control and Prevention (CDC) conducted new testing of occupied trailers in December 2007, and its February 2008 report found average levels of formaldehyde in the trailers to be at 77 ppb. After the release of the report, the CDC and FEMA officially recommended that trailer residents move out as soon as possible.

"Toxic Trailers" criticized ATSDR leadership for failing to flag the health consultation upon review before its release to FEMA and correct the "scientific flaws and omissions in the document." The report also criticized the agency for failing to take action to "inform trailer residents of the potential health effects they faced from exposure to formaldehyde." According to the report, leadership also downplayed their role in the development of the health consultation and attempted to push responsibility down the line to Christopher De Rosa. To read the full report, click here.

See also

• U.S. Department of Health and Human Services
• Healthcare policy in the United States
• History of healthcare policy in the United States

External links

• Agency for Toxic Substances and Disease Registry
• Federal Register, Agency for Toxic Substances and Disease Registry
• U.S. House of Representatives Committee on Science and Technology, "Toxic Trailers - Toxic Lethargy: How the Centers for Disease Control and Prevention Has Failed to Protect the Public Health"

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