Butte CTEC Seeks to Gauge Public Health Perceptions with New Study

On October 30th, Butte’s Citizen’s Technical Environmental Committee hosted the second in a series of public meetings seeking to incorporate the concerns of area residents in a Health Study and Biomonitoring Assessment. This assessment is required every five years by Butte-Silver Bow’s Residential Metals Abatement Program, and they are in the preliminary stages of the second of these studies. The meeting was to be a mix of community discussion and presentations from people involved in the process.

Around fifty people attended the meeting, with agency personnel and other folks associated with Superfund outnumbering the general public. A wide cross section was achieved with people ranging in age from their twenties to their seventies, some life-long residents and some recent transplants. At the table I sat at there were five health care professionals, but experience and expertise varied widely amongst the crowd.

The meeting was kicked off by facilitator by Steve Akerlund, a member of the health study working group, a consultant for CTEC, and a risk communication expert.

SA: “My name is Steve Ackerlund, I’m a private consultant and I’ve worked for CTEC on and off over the years on the Superfund project as a technical advisor for EPA’s Technical Assistance Grant program, which provides funds to the citizen groups to both help them understand the issues and to have their voice heard in the Superfund process. The main purpose of tonight’s meeting is to gain insight into resident’s health concerns here in Butte. And then to talk about a rigorous process for taking that information and moving it forward in terms of conducting a health study that truly responds to the needs and interests of the broader public.”

He explained that they were there to gather the concerns of citizens, not to dispel beliefs or provide information, but to listen.

SA: We’re trying to move forward with a process that’s transparent, that’s trusted, that’s useful to both you all and the decision makers in terms of what do we need to do to move forward, to improve the health and vitality of this community. And all concerns are valid, we’re not here to debate that one concern is more valid than another, we just want to make sure people get heard.”

First to present was professor emeritus and CTEC board member Bill Macgregor. Bill was there to talk about a separate study that he and others have started.

BM: “It’s a one-year pilot study funded by NIH through Montana INBRE program run out of Montana State. We got funded to pursue a hypothesis, to explore a hypothesis, that a significant gap exists between the perceptions of Butte residents, about health risks living in Butte, is it safe, and the record of risk reduction associated with environmental cleanup, reclamation and restoration work undertaken over the last thirty plus years.”

The study consists of two components, a systematic survey of the perceptions of members of the community and a compilation of documentation of remedial actions and effects. The survey is in the form of a mailed questionnaire that will go out soon. The other data is being collected currently.

BM: “So, we’re surveying to see where the gap between reality and perception is, but also between the official assessments of risk and anecdotal reports that contradict those. We want to get that out on the table, so they are taken seriously.”

This study is not directly related to the EPA mandated biomonitoring study, but it will help inform the working group as they plan and scope this and future studies.

And with that, the meeting moved on to roundtable discussions of the health concerns of the citizens in attendance. Each table was asked to provide their opinion on the top priorities for potential health studies. Members of the health study working group were at each table and they took notes and delivered a summary.

Concerns included ailments such as mental health, cancer, neurological diseases, and autoimmune diseases. Several brought up recent studies showing elevated mortality rates and exposures. They wondered about the safety of gardening, as well as soil in general and action levels. People brought up the possibility of synergistic effects of the contaminants, the way these toxics might amplify the effects of each other. People were concerned about dust and the possibility of toxins in the dust.

People were also concerned about specific areas of town: the organic contaminants at the Pole Plant and the dust in the Greeley neighborhood. They mentioned the conflict between economic development and having an honest look at health outcomes. Some mentioned the lack of an accessible repository of information on Superfund.

Other common themes included the need for a comprehensive health study, one that looks beyond lead and beyond the impacts of historic mining. And all in the crowd seemed to agree.

The meeting then moved on to presentations from a few agency representatives, starting with the local health department talking about the Community Health Needs Assessment:

JR: “Hi, I’m John Rolich from the environmental health department, and this is Karen Maloughney, our communicable disease nurse, and what I’m here to talk to you guys about is the Community Health Needs Assessment that is done every three years. St James leads it and we work in conjunction with St. James on this health needs assessment.”

These health needs assessments are required of nonprofit hospitals. The assessment was based on phone surveys of members of the community as well as online surveys of key informants such as healthcare providers and social service providers. They identified the eight main concerns raised in the surveys:

JR: “It was access to health care, cancer, injury and violence, mental health, nutrition/physical activity/weight, potentially debilitating conditions, substance abuse, and tobacco use.”

It was pointed out that the assessment does not even mention metals and it was conceded that exposure is not really on the radar of healthcare providers or the public, in general.

Next Laura Williamson, the state epidemiologist, was tasked with explaining how the health study will move forward.

LW: The agencies that stood up and introduced themselves at the beginning, we will be getting together and reviewing this list and collectively thinking about how we can answer these questions. So what I wanted to do is give you a brief synopsis of some of the thought process that we will be going through as we look at these ideas and assess whether or not our agencies can answer these questions, or perhaps they are better suited for academia, or some other group to try to answer, or perhaps for some of these the science just isn’t there yet and we can’t answer.”

She explained how they will start by looking at the health outcomes that are directly linked to exposure to heavy metals. They will also look for evidence of exposure, with data such as the blood-lead sampling that has been collected. She stressed the limitations of these narrowly defined health studies, that they are restricted to existing disease registries and data sources that may not be able to answer the community’s questions and concerns.

She faced pointed questions about how the public’s concerns would be integrated. When I pressed her on if the current health study would be limited to the contaminants of concern and diseases that can be directly linked to those contaminants, she differed to the EPA. Remedial project manager Nikia Green answered that yes, by the letter of the law, the responsible party was only required to examine these aspects, and further they only needed to assess existing biomonitoring data. At this point the only biomonitoring data is blood-lead data collected mostly from children. The previous health study looked exclusively at these data, and found levels were dropping on par with national averages.

This was discouraging to many attendees who had come to share their broad concerns with hope they might finds answers. Steve Ackerlund jumped in to express the working group’s willingness to look deeper. He said they were committed to tackling these questions, even if the EPA could not compel the responsible parties to expand the study, and it is possible the health department or DPHHS could pursue such studies. But he cautioned that it is a complicated problem and any study will face limitations.

SA: “Moving forward we will be trying to sort out of all the concerns that folks have, everything we’ve heard, what is answerable, what can we tease out, based on many factors: the size of the population, the statistical power, the database that we have, in terms of incidence and mortality, and so on and so forth.”

Attendees did not seem to be comforted by this outcome, but Steve encouraged everyone to attend the next meeting where they will lay out a plan of action. Stay tuned as we cover that meeting, and the future of this and other health studies happening here and in Anaconda.

I’m Dave Hutchins reporting for KBMF.