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WATER GREMLIN PUBLIC HEALTH AsSE55MENT: PUBLIC COMMENT DRAFT ■ This analysis of cancer rates does not:speciifically:address potential health risks from environmental exposures to. TCE. Because TCE is commonly used; it is not unusual for people to frequently encounter small amounts of TCE'in air from many.s.ources. Cancersurveillance data by itself is not enough to establish the extent that an .environmental exposure m.ay be contributing to cancer .occurrence. The estimates of expected.cases are based only.on age and gender distribution of the -study area population. The rates do not accountfoethe many other risk.factors = such as family history, smoking.history, occupation, and diet —that affect whether cancer rates are high or low in a community at a point in time. The MCRS only collects information ❑n residence at the time of diagnosis, The location recorded for place of residence does not necessarily indicate an exposure.causing the.illness. also occurred. at or nearthat location. For example, .6 person diagnosed with cancer who previously lived near the Water Gremlin facility and left, would not be identified in the selected geographies if they moved. outside.the study area. Likewise, a person who moved into the area before a dlagnosis, may be counted as living in the.study area. This would contribute to the observed cancer rates, even though potential exposures to..many cancer risk factors likely occurred before living in the .studyarea. In addition, people may be exposed to hazards that affect their health at workplaces or other locations that are distant from their place.of residence. The full report, Cancer Occurrence Report for White Bear Township; White Bear Lake and Gem Lake Area Five'Census,Tracts, 2007.2016, is in Appendix F. M D H does not expect to see. meaningful changes in cancer patterns and trends in this community in the future; especially.ovei- the short term.. Nevertheless, M D H would consider a reanalysis of Minnesota Cancer Reporting System data at a later time (e.g.,1n 10 years). if the situation warrants and community interest remains high. B. Birth Defects TCE from the Water Gremlin facility was released i.n the southern part of zip code 55110: Because of Potential exposures to residents in this area and the. potential link between TCE and cardiac birth defects in animal studles, M D H reviewed available data from .the Minnesota Birth Defects Information System (B015). Since monitoring birth defects among babies born 1n Minnesota began in May200.5, the earliest available population=based:.data on Congenital heart defects is for babies born in :2006. For the: purposes of this evaluation, the mother's residence: in zip code. 55110 at the time she delivered her baby was chosen as a.proxy for possible exposure to TCE 1n air. This geography most closely corresponds to the area where people who were most:] 1 kely to be exposed regularly to airborne TCE dispersed from the Water Gremlin facility would live..5maIler geographical units were.not available in the BDIS for this analysis. The frequency of congenital heart defects diagnosed an.d re ported: for births. to mothers living in zip code 55110 were compared to the frequency of the same defects that occurred in other parts of the state from.the 2006 to 2019 birth cohorts. MDH conducted an analysis of the. 2006 to.20W birth cohorts in.201.9; the analysis was updated in 2021 to include births through 2019=-the period when pregnant women were potentially exposed to TCE from the Water Gremlin facility. The addition of 2018 and 2019 birth cohorts did not change the results -of the analysis, Based on the timeline. of reported TCE emissions: from the Water Gremlin facility, about 400 infants were born annually to women living in this area at the time of delivery for the 2006 to 2019 birth cohorts (recall that congenital he defects data were. not recorded before 2006). Of these, about 3 4.3