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WATER GREMLIN. PUBLIC HEALTH ASSESSMENT: PUBLIC COMMENT DRAFT B. Health Study Requests M D H received many requests to conduct a "health study" that couId.determine whether exposures to TCE in air from Water Gremlin affected the health of people.who have lived near the facility. When. people refer to health studies they may mean different activities, including collecting self -reported health.inforrriatio.n, conducting medical screening or reviewing medical records, or conducting .biomonitoring.in community members. A health study may also refer to an epidemiological investigation designed to collect measures of exposure and health outcomes to determine if sufficient statistical evidence can be found to conclude an association, suggestiveof.a causal relationship, :exists betweeh.an exposure and an.effect. There :a re many reasons for wanting a health study -from documenting the health of the community,: to contributing to research about health effects of TCE, to support litigation, to: gaining information that will help address potential health concerns in the future, However, scientific health studies are often very challenging to conduct and often are disappointing because of their inability to identify a connection between.exposures and health outcomes. Major challenges to conducting a health study in the community surrounding the Water Gremlin property include the following:. The amountof TCE individuals were exposed to is unknown, in.part because historica l. data. on.air concentrations does not exist. Expos ures`were. also likely to be highly:va'riaole. depending on time. spent in different locations. TCE exposures maybe. too low to cause any observable health effects.for most if not all people who lived or were regularly near the Water Gremlin faciiity.:SIightly or moderately increased. rates.of health effects can be hard to "identify against the existing. backgrou nd rates of the same effects from all causes that affect the community. As described in the TCE Toxicity and Risk Assessment section. on page 12,.some ahirnaI studies show exposure to TCE in air may increase the risk.of: immune system and kidney effects, or heart defects in the developing fetus. However, it6ppea rs unlikely that exposures to TCE from Water Gremlin have occurred at levels sufficientto cause observable heaith.effects in the community or broader population of the area: Based on the mode led .estimates of TCE in'air from Water Gremlin, MDH expects that any increase in cancer is. un11kely to be recognized or measurable compared to the background rate of cancer tha# already.exists.from all causes. However, it is possible that past exposures to TCE. inair near the facility may have been sufficient to increase.the risk of health effects in a small number of the most exposed individuals. MDH staff were asked .to consider whether a health.study for the community near Water Gremlin is feasible, but concluded that a valid, scientificstudy is not possible given the. challenges. For more explanation of the challenges of health studies and two excellent resources for communities, please see Community Health Studies and Environmental Contamination in Appendix G. MDH is available to explore and discuss what efforts. may be feasible that help meet the goals and objectives .of the community. C. Stress When people learn the ir:comm unity's.water, soil, :or.air may not be. safe because of contamination from a nearby source, many difficult questions cah.surface. Is my health at risk? How can I protect myself and my loved ones? Is it safe .to stay in my home? Where can I get reliable information about what's happening? 48