Communities exposed to toxic chemicals from industrial pollution struggle to get answers about whether the pollution has caused the health problems in their community. Groups organize to pressure the government to stop the pollution and to clean up the contamination. But these agencies have few answers and often little is done. Frequently states ask the Agency for Toxic Substances and Disease Registry (ATSDR) to investigate the health problems reported in a community. Initially, ATSDR is welcomed because people think that someone is finally going to provide some answers about the health problems in the community.

The Agency for Toxic Substances and Disease Registry (ATSDR) was created in 1980 to address health problems at Superfund sites. Their mission is to protect communities from harmful health effects related to exposure to both natural and man-made hazardous substances. ATSDR is the right agency to evaluate health complaints in a community and they have been doing so for more than 30 years. And for most of this time, the agency has repeatedly failed to answer the questions people raise about whether there’s a link between health problems and the pollution in the community. CHEJ has written much about ATSDR over the years¹.

Last month an investigative report by the news service Reuters took an extensive look at ATSDR’s work. The report, “How a US health agency became a shield for polluters,” analyzed 428 reports issued by the agency from 2012 to 2023. Those reports contained 1,582 conclusions about potential harms at contaminated sites. Reuters found that in 68% of its findings, the ATSDR declared communities safe from hazards or did not make any determination at all. That record of finding little harm “strains credulity,” said one former EPA official quoted in the report.

Other key findings included:

• The agency’s frequent declarations of no harm often are rooted in faulty research. At least 38% of the time, agency reports show, its researchers relied on old or flawed data.
• At least 20 times from 1996 to 2017 the agency declared that a potential hazard posed no health risk – only to be refuted later by other government agencies or the ATSDR itself. The errors impact communities in Alabama, California, Missouri, New York and North Carolina.
• Despite decades of criticism, the agency continues to publish research that relies upon practices its own review board called “virtually useless.”
• The agency’s common practice of publishing inconclusive reports feeds a long-standing corporate strategy of using scientific uncertainty to deflect regulation and liability for polluted sites.

How is it possible that ATSDR has operated like this for so long? Some answers come from a symposium hosted by ATSDR in 2012 on the Future of Science at ATSDR²:

“In conducting its core work of assessing health risks at contaminated sites, ATSDR has faced a large workload with limited authority and resources to collect needed data. Moreover, concerned communities have voiced legitimate public health questions that ATSDR could not answer fully with existing scientific tools and knowledge.

This meeting documented many scientific limitations and challenges facing the agency. ATSDR’s Board of Scientific Counselors hired a consultant who reviewed the agency’s scientific work and came to these conclusions and observations:

• An alarming gap persists between public expectations and the limited tools available to scientists to assess the public health effects of hazardous waste sites and uncontrolled releases. This gap is due, in part, to the inherently complex and uncertain relationship between diseases and chemicals emanating from hazardous waste sites and uncontrolled releases. Many substances commonly found at hazardous waste sites and in uncontrolled releases may also emanate from other sources and are routinely detected at low levels in air, water, food, consumer products, or other media. No field-based methods are readily available for measuring the portion of a particular ambient exposure or internal dose that is attributable to a specific hazardous waste site or uncontrolled release.
• In the absence of scientific methods for assessing the unique contribution of releases from hazardous waste sites and uncontrolled exposures to disease, ATSDR scientists rely upon surrogate methods and designs (e.g., comparing exposures to disease rates in communities with a hazardous waste site with “background” levels). Such approaches, although squarely within the mainstream of environmental science, typically are not robust enough to detect adverse health effects caused by site-specific exposures to toxic chemicals.
• EPA and ATSDR scientists calculate theoretical risk estimates based on a host of assumptions about contaminant concentrations, exposure duration, characteristics of the exposed population, acute and long-term health risks and other factors.
• ATSDR relies predominately on environmental data collected by other agencies (primarily EPA and state agencies) for its health assessments. Such data often are not adequate or appropriate for addressing specific questions about current exposures and pathways.

Without good tools to evaluate the impact of chemical exposures on people, ATSDR, EPA and other government agencies will continue to struggle to address pollution and contamination in communities. It’s time to recognize and to acknowledge that scientists know very little about how exposures to toxic chemicals, especially to low level mixtures, lead to adverse health outcomes.

Instead of trying to link cause and effect (the agencies default approach), which is virtually impossible to achieve because of the inherently complex and uncertain relationship between disease and chemical exposure and the limited tools to evaluate health effects, isn’t it time to consider whether there’s enough information and evidence about exposure and adverse health problems in a community to take action to protect people exposed to toxic chemicals?

Until there is a change in how government approaches health problems in a community, you can expect ATSDR to continue to investigate health problems in communities using the same approach that’s reflected in the Reuters article.

Acrylamide is a clear, odorless chemical. It has many industrial uses, including treating waste water
discharge from water treatment plants. It is also used in the production of industrial products like dyes,
paper pulp, grout, plastics, and construction materials. Many consumer products are also produced
using acrylamide, such as contact lenses, cosmetics, fabrics, textiles, and sugar. When acrylamide enters
the environment, people are most likely to be exposed to it by drinking contaminated water. Acrylamide
can enter drinking water through the water treatment process or through improper disposal from
industrial facilities that use it to manufacture products.

Exposure to acrylamide can have serious effects on the brain, causing numbness in the hands and feet,
disorientation, loss of balance, and muscle weakness. Skin contact with acrylamide can cause irritation,
dermatitis, and nerve damage. Studies in laboratory animals have found that acrylamide exposure can
also cause defects in the male reproductive system, but it is unknown if it has the same effects in
humans. Based on studies in laboratory animals, the US Environmental Protection Agency classifies
acrylamide as probably causing cancer in humans. The International Agency for Research on Cancer
classifies it as likely causing cancer in humans.

In 2002, acrylamide was discovered to form when foods rich in starch are grilled, baked, or fried above
250°F. This includes foods like potato chips, French fries, and breakfast cereals. The resulting acrylamide
can be found in the dark brown or burnt areas of these foods. Since this discovery, many regulatory and
public health agencies across the world have called for more research into whether this dietary
exposure to acrylamide increases the risk for cancer. The American Cancer Society says that based on
existing studies in humans, dietary acrylamide exposure is unlikely to be linked to increased cancer risk.
However, the ACS says that more research on this topic is needed to fully know if dietary acrylamide
poses a cancer risk. This research will be crucial in understanding how widespread cancerous acrylamide
exposure may be.

Styrene is a chemical compound that can be linked together with itself or other compounds to create strong, flexible polymers that make up plastics, rubbers, and resins. Many products such as foodware containers, printer toner, shoes, plastic pipes, carpeting, fiberglass insulation, and automobile parts contain styrene.

Styrene can enter the air, water, and soil through manufacturing and disposal of styrene-containing products. Styrene is a colorless liquid but it readily evaporates, so a large portion of styrene that enters water or soil ends up in the air. While manufacturing and disposal can cause exposure, most people are exposed to styrene through their use of styrene-containing products.  For example, people inhale it indoors because styrene-containing building materials and printers release styrene vapors. In addition, the styrene in foodware containers can migrate into the food they hold, causing people to ingest styrene.

Once inhaled or ingested, styrene can have many adverse effects on the body. Many of these effects are in the brain, such as impaired vision, impaired hearing, loss of coordination, slowed reaction time, fatigue, and difficulty concentrating. Studies in laboratory animals have found that styrene exposure can also cause damage to the liver, though it is unknown if it has this effect in humans. The US Department of Health and Human Services classifies styrene as being reasonably anticipated to cause cancer. The International Agency for Research on Cancer classifies styrene as probably causing cancer. The pervasiveness of styrene-containing plastics in consumer and industrial products makes these adverse health effects particularly concerning. Decreasing the reliance on plastics – through government regulation, scientific innovation, and consumer education – would help protect people from styrene exposure and its associated health effects.