A, T, S, D, What?

My first task as Director of the National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry (NCEH/ATSDR) was to master the use of an awkward acronym. I also quickly realized that many people have either never heard of ATSDR or don’t really understand what we do; however, I learned very quickly what we do.

Within my first few months, we faced an oil spill in Wyoming’s Yellowstone River, a train derailment in West Virginia, and pesticide exposure in the U.S. Virgin Islands. I witnessed firsthand just how important it is to have a federal agency focused on environmental health. And every day that I’ve worked here since reinforces this belief.

Environmental health is complex and means different things to different people. Tackling the environmental health challenges we face today requires a wide variety of skills, and NCEH/ATSDR’s extensive work has an enormous impact on people’s lives and health.

A Few Founding Facts

In response to the environmental disasters at Love Canal and Times Beach, Missouri, Congress passed the Comprehensive Environmental Response, Compensation, and Liabilities Act (CERCLA or “Superfund” law) in 1980. This law created ATSDR, which was formally organized in 1985. Superfund and the Superfund Amendments and Reauthorization Act of 1986 (SARA)  gave the U.S. Environmental Protection Agency (EPA) the responsibility for identifying, investigating, and cleaning up sites on the National Priorities List and created ATSDR as a non-regulatory public health agency to

• Conduct health assessments,
• Conduct health consultations,
• Produce toxicological profiles,
• Conduct epidemiological studies, and
• Establish registries and conduct health surveillance.

At first, ATSDR focused on evaluating toxic exposure just for communities near Superfund sites. As time went on, the agency began to assess requests from EPA; state, tribal or local agencies; residents; and communities. In total, we’ve addressed health concerns about chemical exposure in more than 6,000 communities. In 2014 alone, we worked in about 600 communities across the country, evaluating toxic exposure for close to one million people.

A Different Kind of Fed: Up Close and Local

Most of our work in communities focuses on understanding whether people are or have been exposed to harmful chemicals. ATSDR does not respond to all requests. Once a request is received, we review existing environmental and health information to find out if people are at risk because of their exposures. And when appropriate, we make recommendations to EPA; state, regulatory and health agencies; and other organizations for preventing the harmful exposures. Sometimes our assessments identify important missing information that keep us from answering questions about health risks, so we conduct or recommend further investigation.

We evaluate environmental health issues that differ widely in scope, size, and exposure type, including

• Large projects with many steps and reviews, such as public health assessments
• Long-term studies of possible environmental health effects in a larger population, such as our investigations of asbestos exposure in Libby, Montana, and ongoing investigations of exposure to contaminated drinking water at Camp Lejeune, North Carolina.
• Studies of connections between exposures and health, such as our study of exposure to uranium and other metals and pregnancy outcomes in the Navajo Nation.
• Much smaller projects, like helping to determine whether one or two families with private wells can safely drink their well water.

ATSDR works closely with local residents, setting us apart from many other federal agencies. At exposure sites, we

• Talk to individual community members to find out how environmental exposures affect them.
• Establish community assistance panels to help guide our work when we conduct more detailed investigations.
• Hold public meetings to explain our findings and recommendations.
• Work with health providers near exposure sites to help them answer patients’ questions and provide effective treatment.

We have staff at ATSDR’s headquarters in Atlanta, Georgia, at EPA headquarters in Washington, D.C., and in 10 regional offices. We also fund 25 state health departments to do the same types of work our staff members do: evaluate hazards, make recommendations, and educate residents.

We Even Help With Emergency Response

Although much of ATSDR’s work focuses on assessing community exposures, our toxicologists, medical officers, and other scientists also respond to environmental emergencies, like the oil pipeline breech near the Yellowstone River in Montana.

Our Assessment of Chemical Exposures (ACE) program provides resources and technical help to rapidly assess health effects from toxic spills or releases.  ACE can quickly assemble a team of experts to help state and local health departments either from Atlanta or at the scene.

Don’t Forget Our World-Class Toxicology Resources

ATSDR is known world-wide for its research and contributions to scientific and technical knowledge, including the latest information about toxicology, environmental science, and environmental medicine.

• Our toxicological profiles (ToxProfiles^TM) are used by scientists, health providers, and regulators around the world. We now have a total of 173 profiles on more than 350 substances available in our Toxic Substances Portal. In 2014, more than 1,700 scientists cited the Tox profiles in their research articles.
• Also available in the portal are short summaries of the profiles (ToxFAQs^TM) that answer major questions about the health risks of hazardous substances.

In addition, we offer support for healthcare providers nationwide to diagnose and treat environmentally linked health concerns, including

• Pediatric Environmental Health Specialty Units (PEHSUs) for clinical consultations to physicians;
• Case Studies in Environmental Medicine online, plus continuing education courses for diagnosing and treating environmental exposures; and
• Medical Management Guidelines to help emergency departments and health providers manage acute exposures from chemical incidents, plus comprehensive evaluation and treatment guidelines.
• Other technical resources include geospatial analyses to identify contamination and estimate how many people are exposed; computational toxicology; exposure modeling, and biomonitoring.

ATSDR’s partnership with NCEH allows the agency to use CDC resources to protect communities. We often rely on NCEH’s state-of-the-art environmental laboratory to evaluate biological samples, such as children’s blood for lead and other metals, like we did at the Colorado Smelter site.

It’s in Our Name: Disease Registries

ATSDR designs and conducts surveillance and registry programs and manages the nation’s only population-based registry, collecting information to help scientists learn more about who gets amyotrophic lateral sclerosis (ALS) and what causes it. Our National ALS Registry provides information on medical studies and other resources for persons with ALS and their families. ATSDR has also created registries for specific populations and specific events, like the World Trade Center Registry for people exposed to toxic substances on and after 9/11.

Tools for Communities

We also develop tools and resources for local communities, including

• “Don’t Mess with Mercury,” an award-winning website for middle school children, including student activities and tools for teachers, administrators, and school custodians that explains how to safely remove mercury and clean up after a spill, as well as whom to contact.
• A brownfields toolkit for bringing health into discussions about reusing possibly contaminated properties.

A Closing Affirmation about ATSDR

NCEH/ATSDR confronts environmental health challenges and addresses the risks we face from chemicals in our environment. Our work advances the science of environmental health and translates that science into practice by developing tools, conducting research, and partnering with local health departments, officials, and practitioners. And most important, we make a difference in people’s lives and health.