NCD980602163_19821019_Warren County PCB Landfill_SERB C_Levine letter re Monitoring-OCR

Ronald H. Levine, M.D., M.P.H.
DIVISION OF HEALTH SERVICES
P.O. Box 2091
Raleigh, N.C. 27602-2091
October 19, 1982
ST A TE HEAL TH DIRECTOR
Mr. Joseph S. Lennon
Health Director
OC1 2 0 1%2
Warren County Health Department
540 W. Ridgeway Street
Warrenton, NC 27589
Dear Joe:
Thank you for the opportunity to get together with Warren County
officials as well as yourself to discuss environmentBl and clinical
monitoring in Warren County. I felt that the session was extremely
worthwhile and plan to meet again with you very soon to develop a more
specific monitoring protocol.
The material provided me by Dr. Greg Smith of ml)' staff regarding
blood testing for PCB's follows:
-CurrenJ1no lab is certified or licensed to do clinical testing
for PCB's. Those currently doing PCB analysis do so only
for research purposes and agreements are signed with the
promise not to use the results of the tests for clinical pur-
poses.
-The cost for PCB serum analysis for research purposes is
approximately $100 per analysis. Monitoring a population
of 5,000 persons with before and after samples (e.g., now
and 5 years from now) would cost $1 million.
-The Centers for Disease Control in Atlanta presently have 6
contract 1 abs doing PCB analysis. A report sch'edul ed to be re-
l eased in the December issue of ENVIRONMENTAL HEALTH PERSPECTIVES
will apparently reveal significant variability in both interlab
and intralab quality control. There are significant problems
with reliability (reproducibility) of results. In addition, the
sensitivity and specificity of results leave much to be desired,
based on the fact that ODE, a metabolite of DDT, ubiquitous in
the environment and in the human population, produces a spike
in gas chromatography where spikes for PCB's oacur, therefore
increasing the chance for false positive and false negative inter-
pretations. There are apparently one or two labs that have fairly
good reproducibility and sensitivity/specificity (e.g., Raltech,
Inc., of Madison, Wisconsin).
Jomes B Hunt, Jr/ Sarah T Morrow MD MPH STATE OF NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES . ' . ' . GOVERNOR SECRET ARY
Mr. Joseph S. Lennon
October 19, 1982
Page Two
Interpretation of the results again would be difficult. Should
increases be seen in later samples (one would expect this to
occur), it must be determined if the increases ,are artifactual
(due to improved analytic methods, quality control, etc.) or
real. If real, do they represent a shift of POB's from the
fat to the serum due to weight loss, change in hormone level,
or other physiologic factors due to age, race, sex, stress,
etc. Finally, if serum increases are real and they represent
increased body burdens of PCB I s, where did these increases come
from-the environment, where PCB's are ubiquitous and we will
all continue to absorb small amounts; or from the landfill,
from which the chance of exposure is negligible. The burden
of proof will probably rest with the state, and the only way
to obtain a defensible argument that the increases did not
come from the landfill is to design a prospective, controlled
clinical epidemiologic study involving millions of dollars
in resources and extensive scientific manpower.
Please give me a call if you would like further ·information prior to our
next meeting.
RHL:hg
cc: Dr. Sarah T. Morrow
Ms. Lucy Bode
Sincfely,
Rona~ine, M.D., M.P.H.
State Health Director
bee: Mr. 0. W. Strickland thru Mr. Stamey
-11r. John Freeman & Staff thru Dr. Hines
Mr. Bryant Haskins