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WATER GREMLIN PUBLIC .HEALTH ASSESSMENT: PUBLIC COMMENT DRAFT Community members living with environmental contamination may experience. chronic stress for various reasons (e.g., health concerns, uncertainty, and community conflict), which can .be compounded by feeling diismissed.., powerless, unheard,- or. unsupported. It's hard to wait for answers, especially if you don't know who to trust. And people may not agree about how to handle the situation; even among farriily and friends. Stress is a normal reaction. to environmental contamination; :it is not a. mental health disorder. However, chronic stress can pose physiological health risks on top of the health risks that may be associated with .expos ure to.contaminants (ATSDR., 2021). Resources A7SDR's online Community Stress. Resource Center (ww.w.atsdr.tdc.gov/stress/comMunity_merribers.htmi) was.created to acknowledge stress and worry related to environmental coritamination and offer ideas for managing stress. MDH's webpage offers an information sheet created for people in the community concerned about the Water Gremlin contamination: Coping, with the stress that environmental contamination can cause www.health.state,mn.us communities environment hazardous`docs steesscontsit6s. d . D. CumulativeRisks Cumulative risk assessment (CRA) is a concept that aims to consider the many factors, both chemical and non -chemical, that may. affect health in a community. At its, Mrn plest, CRA attempts. to add risks from.multiple environmental chemical exposures and includes all the exposure pathways (ingestion,. inhalation;. dermal,.etc.) in multiple media (drinking water, air, soil, etc.) from all sources (other facility emissions, naturally occurring contaminants, traffic emissions, etc.) over time. This approach of adding health risks of single chemicals may overestimate or underestimate risks, although risk assessment 'is intended to take into account that certain individuals or populations can be more sensitive to the effects of.ch.e:micais than others.. Real -world chemical mixtures are complex and data from either animal or human studies .on .combined effects of exposures to mixtures is.generally lacking.. A.multitude of other, non -chemical stressors can.also affect health. These factors caninclude noise, poor :nutritiion, stress, crime,. etc. Of particular importance are factors that make populations more vulnerable to contamination due to health disparities --such as lack of access to health care, poverty,: education :inequity, etc. The complexity of accounting for all th ese:. factors. makes it. difficult to.quantify.risk or create a single approach to assessing health risk. The U.S. EPA is.expected to release: an updated CRA guidance. document in the:coming.months. M D H staff will review this document and look for ways to incorporate its concepts to further.acknowledge all the factors that.may affect health in a community. This Public Health Assessrnent.reviews all the possible exposure pathways in all environmental media affected by known contamination from the Water Gremlin facility. Ongoing t-DCE air exposure adds additional risk to that from past TCE air exposures. Workers at Water Gremlin experienced high levels of solvent and lead exposures, and may also face health disparlties..FinMly, other chemical exposures from all sources people may encounter and non -chemical stressors that .could impact individuals' health also. are expected to. exist. within this community. 49