The Agency for Toxic Substances and

                 Disease Registry (ATSDR): Problems in

                  the Past, Potential for the Future?

                  Report by the Majority Staff of the
              Subcommittee on Investigations and Oversight
                  Committee on Science and Technology
                     U.S. House of Representatives
                  to Subcommittee Chairman Brad Miller

                             March 10, 2009

Introduction

    Last April the Subcommittee on Investigations and Oversight held a 
hearing on the Agency for Toxic Substances and Disease Registry 
(ATSDR), a sister agency of the Centers for Disease Control and 
Prevention (CDC). The hearing looked at how the Agency produced a 
scientifically flawed and misleading health consultation on the health 
hazards of potential formaldehyde exposures by survivors of Hurricanes 
Katrina and Rita living in travel trailers provided by the Federal 
Emergency Management Agency (FEMA).1 Last September the Subcommittee 
issued a detailed staff report on our investigation which found that: 
``The leadership of ATSDR obfuscated their role in reviewing and 
approving the February 2007 health consultation and attempted to 
abdicate their own responsibility for the Agency's fundamental failure 
to protect the public's health. Most disturbingly, as the Agency's 
troubled response to the formaldehyde fiasco unraveled, the leadership 
of ATSDR attempted to shift blame for the inappropriate handling of the 
incident to others, primarily [whistleblower Dr. Chris] De Rosa and his 
staff.'' 2 Unfortunately, the poor scientific integrity of ATSDR's 
formaldehyde health consultation and the weak leadership at the Agency 
that permitted the production of this misleading report which went 
uncorrected for so long--keeping the public in harm's way for a year 
longer than necessary--was not an isolated incident.
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    1 ``Toxic Trailers: Have the Centers for Disease Control Failed 
to Protect Public Health?,'' Hearing before the Subcommittee on 
Investigations and Oversight, Committee on Science and Technology, U.S. 
House of Representatives, April 1, 2008, available here: http://
science.house.gov/publications/
hearings-markups-details.aspx?NewsID=2133
    2 ``Toxic Trailers--Toxic Lethargy: How the Centers for Disease 
Control and Prevention Has Failed to Protect the Public Health,'' 
Majority Staff Report, Subcommittee on Investigations and Oversight, 
Committee on Science and Technology, U.S. House of Representatives, 
September 2008, available here: http://democrats.science.house.gov/
Media/File/Commdocs/
ATSDR-Staff-Report-9.22.08.pdf
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    The Agency's mission ``is to serve the public by using the best 
science, taking responsive public health actions, and providing trusted 
health information to prevent harmful exposures and disease related to 
toxic substances.''3 On paper, according to ATSDR, the Agency is 
deeply involved with the local communities it is intended to help 
protect, it makes independent, objective health decisions based on the 
best science available, it conducts exposure investigations to assess 
health impacts of environmental toxins and it provides and explains the 
results of their evaluations, medical consultations and investigations 
to local communities and tribes.4 In reality, across the Nation local 
community groups believe that ATSDR has failed to protect them from 
toxic exposures and independent scientists are often aghast at the lack 
of scientific rigor in its health consultations and assessments. The 
studies lack the ability to properly attribute illness to toxic 
exposures and the methodologies used by the Agency to identify 
suspected environmental exposures to hazardous chemicals are doomed 
from the start.
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    3 ``Statement of Mission,'' Agency for Toxic Substances and 
Disease Registry, undated, available here: http://www.atsdr.cdc.gov/
about/mission.html
    4 ``What You Can Expect From ATSDR,'' Agency for Toxic Substances 
and Disease Registry, May 2002, available here: http://
www.atsdr.cdc.gov/COM/expect.pdf
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    The Subcommittee staff is not suggesting that ATSDR find problems 
where none exist or that ATSDR should or can identify the sources of a 
possible cancer cluster, disease or other health hazard in every 
instance or where the potential source of toxic exposures are ambiguous 
or elusive. Yet time and time again ATSDR appears to avoid clearly and 
directly confronting the most obvious toxic culprits that harm the 
health of local communities throughout the Nation. Instead, they deny, 
delay, minimize, trivialize or ignore legitimate concerns and health 
considerations of local communities and well respected scientists and 
medical professionals.
    Many independent scientists, medical professionals, local 
environmental groups and public health advocates believe that rather 
than objectively and aggressively trying to identify the source of 
reported health problems, ATSDR often seeks ways to avoid linking local 
health problems to specific sources of hazardous chemicals. Instead, 
says one current ATSDR scientist who spoke to the Committee on the 
condition of anonymity: ``It seems like the goal is to disprove the 
communities' concerns rather than actually trying to prove exposures.'' 
None of these problems are new to ATSDR but it will require a new will 
and desire to fix them on the part of ATSDR's leadership.