Transcript Kingston TVA Coal Fly Ash Spill

Kingston TVA Coal Ash Spill
David Kirschke, MD
Deputy State Epidemiologist
Tennessee Department of Health
Regional Epidemiology Meeting
3/30/09
Slough Off Emory River
Outline
• Tennessee Department of Health role
• Environmental investigation
– Water, air, soil, fish
• Exposure routes
• Health survey
• Surveillance
• Recommendations
Situation
• December 22 a retaining wall failed at the TVA
Kingston Fossil Plant
• >5.4 million cubic yards of coal ash spilled from an
on-site holding pond to cover >300 acres
• No immediate injuries
• Physical and natural environment has been
dramatically impacted
• “Citizens’ lives have been disrupted, water quality
has been impaired, and aquatic habitat has been
destroyed.”
Tennessee Department of
Environment and Conservation
Tennessee Department of Health
(TDH)
• Working with other federal/state/local
agencies:
– Environmental sampling plan
– Environmental testing at state laboratory
– Interpreting environmental test results for
potential impact on human health
– Providing public health recommendations
– Surveillance at hospital emergency departments
for associated illnesses
– Neighborhood health survey with CDC
Fly Ash Material Safety Data
Sheet
• Contains silica and trace metals
• “Short term exposure presents little to no
hazard”
– Eye / respiratory irritation
• Chronic exposure – silicosis
– Depends on duration and level of exposure
• Chronic exposure – heavy metals
– No current evidence for chronic exposure
Sampling Plan
• Comprehensive sampling plan to address
surface water, ground water, drinking water,
soil and air monitoring to better inform
communities and citizens while ensuring full,
complete clean up
• Ongoing water quality monitoring and
assessment within the major waterways
impacted by the ash slide – Emory River,
Clinch River and Tennessee River
Tennessee Department of
Environment and Conservation
Air Monitoring
• Oversight of TVA will be accomplished in several
ways:
– Splitting samples collected by TVA to independently analyze
their makeup
– Quality assurance of the TVA operated monitors by TDEC
staff
– Installing co-located TDEC air monitor at a TVA monitoring
site
– TDEC already operates a continuous air monitoring site in
Harriman (approximately 2.5 miles from the ash spill)
• More than 2,600 mobile air monitoring samples have
been collected
• All sample results have been within the National
Ambient Air Quality Standards for Particulate Matter
- except one
Tennessee Department of
Environment and Conservation
Particulate Matter (PM)
• Studies have linked particle pollution exposure to:
– increased respiratory symptoms, such as irritation of the airways,
coughing, or difficulty breathing, for example;
– decreased lung function;
– aggravated asthma;
– development of chronic bronchitis;
– irregular heartbeat;
– nonfatal heart attacks; and
– premature death in people with heart or lung disease.
• People with heart or lung diseases, children and older adults
are the most likely to be affected
• However, even if you are healthy, you may experience
temporary symptoms from exposure to elevated levels of
particle pollution
EPA
Tennessee Wildlife Resources
Agency (TWRA)
• Potential impacts to aquatic habitats will be
tracked
• Monitoring of rivers and the collection of fish
• Exceedences of Tennessee’s clean water goals
have been noted
• Parameters of concern include arsenic, lead,
thallium, and mercury
• Fish tissue samples will be tracked for the
metals associated with the ash
Tennessee Wildlife Resources
Agency (TWRA)
Fish
• TWRA advises until further notice that
fishing and boating should be avoided in the
lower section of the Emory River
• Existing advisories for Watts Bar, which
would include the lower Emory River:
– Fish consumption advisory against eating striped
bass and a precautionary advisory for catfish and
sauger.
– A precautionary advisory means that children,
pregnant women, and nursing mothers should not
consume the fish species named. All other
persons should limit consumption of the named
species to one meal per month.
Tennessee Wildlife Resources
Agency (TWRA)
Heavy Metal Exposure
• Routes: ingestion, inhalation
• Factors:
– Toxicity
– Amount
– Duration
– Frequency
• Skin contact not an exposure route
unless ingested
Public Health Recommendations
• Avoid contact
– Especially important for children
• Wash hands / clothes
• Don’t drink untested well water
• Heed fish advisories
• Follow air pollution recommendations if
issued
Human Laboratory Screening
Not Recommended
• Because tests of environmental samples
have not shown levels of substances in
ranges that would adversely affect human
health, the Department of Health is not
currently recommending human testing for
any particular substance.
• Residents / providers may contact the
Tennessee Poison Control Center (800-2221222) for advice
Screening Pitfalls
• Quality control
– Some labs unreliable
– Skin/specimen contamination
• What to do with results?
– In absence of known exposure, results likely
reflect past/ongoing unrelated exposures
• Occupational
• Environmental
• Dietary / smoking
Recommended Laboratory
Testing
• If known or suspected toxic exposure
to particular substance
• If illness presentation consistent with
toxic exposure
• Tennessee Poison Control (800-2221222)
• ATSDR toxicologist
Health Survey
• 5 teams of 2 person X 1 week
• Visited 324 residences
– 170 (52%) households interviewed
• 368 persons
• Average household 2.6 persons
• Age distribution
– <18 (24%), 18-64 (59%), ≥65 (17%)
Preliminary Results: Exposure
• 47% said fly ash in yard
• 4% said involved in cleaning it up
• 13% said skin contact
• 33% said ash on clothes
• 1% ate fish since spill
• 8% said pet tracked in ash
Preliminary Results: Behaviors
• 83% aware of public health messages
– Only 66% of people with ash on hands said they
washed afterwards
• Persons drinking bottled water more than
doubled (9 to 25%)
• 4 persons reported drinking well water
before and only 1 afterwards
• 18% said they spend no time outdoors
currently compared to 5% before
Preliminary Results: Health
• 12% with asthma
• 6% with COPD
• 5% with history of MI
– 7% with angina or coronary artery disease
• 45% with history of smoking
– 18% current smokers
Preliminary Results: Health
• Most had no change in health status
– 27% said cough is worse
– 14% said wheezing / SOB worse
– 25% said headache worse
• Some persons had complaints that may
warrant increased attention to mental health
issues
– 25% said difficulty sleeping
– 46% worried or anxious
Surveillance
• No diseases reported to health department
associated with incident
• Syndromic surveillance at 5 area hospitals
– No spikes attributable to incident
– 19 children seen in ED at children’s hospital
investigated; none appeared associated; no
admissions
• Active surveillance at one local hospital
– Several visits with respiratory complaints
investigated but none determined to be related to
incident
Toxicology Consultation
• Tennessee Poison Control Center
– 800-222-1222
• Pediatric toxicologist
– Robert Geller, MD; 404-616-6652
• ATSDR toxicologist
– 770-488-7100
• Tennessee Department of Health
– To notify of reportable illnesses: 800-404-3006
Thank You
David Kirschke, MD
Deputy State Epidemiologist
Tennessee Department of Health