NCD980602163_19820505_Warren County PCB Landfill_SERB C_Memo to Charles Gregory Smith MD re Proposed Clean-up-OCR

Ronald H. Levine, M.D., M.P.H.
ST ATE HEAL TH DIRECTOR
DIVISION OF HEALTH SERVICES
P.O. Box 2091
Raleigh, N.C. 27602-2091
M~y 5, 1982
MEMORANDUM
TO: Ronald H. Levine, M.D., M.P.H.
State Health Director
FROM: Charles Gregory Smith, M.D.
Environmental Epidemiologist/Toxicol~gist
As per your request to keep you informed regarding any new developments pertaining
to the proposed PCB clean-up and necessary precautions, I am prov iding you with
the following information.
l. The Solid and Hazardous Waste Management Branch received a request from
Dr. Kirkman, Geneticist at NCMH to sample the well water at the residence
of Mickie Hewlin, a 16-year-old mother, who gave birth on March 17, 1982,
to a male infant, Charl Hewlin (NCMH chart #55-03-09) who had the following
abnormalities:
Gastroschisis (Frequency approximately l in 7,000 births)
Hypoplasia of the right foot
Shortening of the fingers and toes
Flexion contractures of the fingers and elbows
Questionable mental capacity
Chromosome studies were normal (i.e. abnormalities probably not
genetic in origin).
Ms. Hewlin informed Dr. Kirkman her well is app roximately 20 feet f~om a PCB
_road spill; Address: Rt, l, Box 158, Hollister , NC 27844.
2. Approximately two years ago, Dr. Ernest Kraybill, (Pediatric Neonatology,
NCMH) informed me that a surgery student or resident noted two cases of
gastroschisis born to mothers who lived proximate to PCB spills in North
Carolina.
3. Ray Greenberg, M.D., a student at UNC-SPH, on information from Jim Thulien, M.D.,
Pediatric Neonatologist at Wake Medical Center, is conducting with Roger
Grimson, Ph.D., (Biostatics, UNC-SPH) a case-control study of some interesting
time-space clustering of gastroschisis over the last several years in central
North Carolina counties.
4. A physician in Michigan is conducting a similar 'case-control study involving
time-space clustering of gastroschisis that occ ~rred in 1974 and 1975 and 1976
after the PBB contamination of dairy cattle feed in 1973.
James B. Hunt, Jr/ _ . Sarah T. Morrow M .D. M.PH .... STATE OF NORTH CAROLINA GO ER OR DEPARTMENT OF HUMAN RESOURCE I ' . ' V N . SECRET ARY
., MEMO: Dr. Levine
May 5, 1982
Page Two
In light of this information, I feel my original recommendation for protective
clothing, etc., in the PCB spill clean-up, be adhered to, so that the potential
for transport of the material home by workers on deir dusty, conta-11inated
clothing is minimized.
In addition, I suggest the following be done by the Division of Health Services
in conjunction with the UNC School of Medicine and School of Public Health:
1. Run a CSIN computer search on birth defects and congenital malformations
in animal models and humans for PCBs and PBBs .. Also, cross-referenced with
mutagen icity ,tera to gen i city aid embryotoxic ity.
2. a. Resample the original PCB spill site in front of Ms. Hewlin's home.
b. Sample well water, soil around house, and a1ny garden plot.
c. Obtain topographical sketch of spill site, house, incline or slope from
spill site to house, well, etc.
3. Request from Dr .. Kraybill (NCMH) location of the two other cases reportedly
born to mothers who lived proximate to PCB spill sites.
4. Provide county road maps with spill sites identified on them to Ray Greenberg,
M.D., and Roger Grimson, Ph.D., (SPH).
5. Obtain a maternal blood sample and if still lactating, a breast ailk sample
for analysis of PCBs. If she has stopped lactating, attempts show:ld be made
to restart lactation manually. Discovery of a body burden of PCB is of
paramount importance. Perhaps this could and should be arranged through
Greenville, N.C., PCB breast milk analysis progtam. (Walt Rogan, M.D., at
NIEHS has apparently refused, in the past, requests for outside analysis}.
NOTE: Analysis of breast milk takes approximately six weeks and there are
only two or three good labs in the country producing reliable results.
CGS, M. D. : n s
cc: 0. W. Strickland
James F. Stamey