Sustained Outrage

WVTAP pulls some punches in review of CDC

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Commercial Photography Services of West Virginia

It’s probably fair to say that West Virginians who have become distrustful of the state and federal government’s handling of the continuing water crisis have been hopeful and optimistic about the work being conducted by the team at the West Virginia Testing Assessment Project.

One of the WVTAP leaders, University of South Alabama environmental engineer Andrew Whelton, built up a lot of credibility when he and some of his students drove to Charleston in January on their own dime to test home water supplies and help people properly flush their plumbing systems.  Dr. Whelton reached out to and welcomed input from various citizen groups, and most of his public comments have shown respect for residents — and a willingness to clearly define the unknowns in this situation, and not try to sugarcoat those unknowns just to quell public outrage.

The release a week ago of WVTAP’s results from its pilot home water testing effort was a groundbreaking example of how public pressure can force public officials — in this case Gov. Earl Ray Tomblin — to do things they really don’t want to do  — in this case test the water residents were actually being exposed to, rather than just sample at the water plant and neighborhood hydrants. The question now, of course, is whether Gov. Tomblin will cough up the money needed for a larger study that could actually characterize the levels of MCHM that are still in our region’s drinking water.

But this week’s release of a preliminary report from the WVTAP Health Effects Panel didn’t go nearly as well — and raises some significant questions about the way this part of the WVTAP effort is being handled.

When we did our print story about the panel’s public meeting on Monday, we described the preliminary report as saying that the 1.0 part per million screening level set back in January by the U.S. Centers for Disease Control was “too weak.”

But when I look back at that now, it’s more clear to me that while the report’s results made clear the CDC figure was way off — the CDC figure is 1,000 parts per billion, and WVTAP’s is 120 ppb —  the WVTAP preliminary report never really came out and said so. In fact, whoever is writing WVTAP’s press releases went to great efforts to make it look like the panel was what the CDC did was just fine. For example, the press release opined:

The panel concluded that the CDC used traditional methods and reasonable assumptions to develop their screening levels.

It was a statement like that which allowed West Virginia Department of Health and Human Resources Secretary Karen Bowling to say in her own press release that the WVTAP work was “clearly an affirmation that our water is safe and the CDC’s calculation at the time of the incident was appropriate.”

The problem with the WVTAP press release and Secretary Bowling’s comment is that they simply aren’t supported by the facts as they were laid out by the WVTAP Health Effects Panel. For one thing, the WVTAP panel decided that the appropriate assumption was that the most exposed population was formula-fed infants, not an older child weighing 10 kilograms. This is a big difference. And it’s an assumption that the CDC initially made that the WVTAP team decided was inappropriate.


Now, if you’re not completely familiar with these assumptions, or the math that the WVTAP panel used to spit out its 120-ppb number, that’s because the chair of that panel, a consultant named Michael Dourson (pictured above) apparently didn’t think that was something the public needed to see at the moment. When I asked for the exact formula, he did send it to me, though. Here it is:

— Use the No Observed Effect Level (NOEL) of 100 mg/kg-day from the 4 week study of MCHM dated April 3, 1990 by Eastman Kodak;

— Adjust this NOEL to 71 mg/kg-day by multiplying by a factor of 5/7 to account for the fact that the rats were only dosed for 5 days per week;

— Divide this adjusted NOEL by a 1000-fold uncertainty factor to estimate a safe dose of 0.07 mg/kg-day; this factor consists of multiples of 10 for within human variability, 10 for experimental animal to human extrapolation, and 10 for an incomplete database (e.g., missing developmental and reproductive toxicology studies);

— Divide this safe dose by consumption of 0.285 liters of water per kg of body weight per day, which represents a 95% upper intake of formula-fed infants (the most exposed population), to develop a water-only safe concentration of 250 ppb;

— Multiply this water-only concentration by 0.5 to allow for other possible sources of exposure, such as inhalation, to develop a safe level of 120 ppb.

Got all that? Well, really, at this point, the main thing to keep in mind to understand whether the CDC did an appropriate job is to look at that last line:

— Multiply this water-only concentration by 0.5 to allow for other possible sources of exposure, such as inhalation, to develop a safe level of 120 ppb.

Remember all those people who reported adverse reactions from being exposed to the MCHM fumes from their hot water taps? Well, this is where the WVTAP panel did something that the CDC never bothered to even try to do: Take into account the fact that residents were going to be exposed to MCHM not only from drinking the water, but from inhaling volatilized chemicals from steam from their hot water.

Now, it’s a good thing that the WVTAP panel tried to tackle this and take it into account. It’s not clear yet whether they did so in an appropriate manner. But what is clear is that the WVTAP panel was really dodging the truth when it said that taking these inhalation exposures — and the reactions they could have caused — into account was something the CDC couldn’t have done, because the CDC didn’t have data to show that was a potential problem. Dourson made that clear, telling residents and the public:

We had more information than the Centers for Disease Control, so we were able to use that information.

The truth is the CDC knew — or should have known — that inhalation was a central risk from MCHM contamination of our water supply. The CDC made it clear that it based its initial screening level calculations, all done by 9 .m. the night of the Jan. 9 spill, on the MSDS that Eastman Chemical published about MCHM. That document warns on its first page:


When this was pointed out to them, the folks from WVTAP said that they believed the reports of hospital visits by residents seeking treatment for the very kind of exposures warned of in the MSDS.  Actually, the truth is that reports of hospital visits and these kinds of reactions were being reported on local media — and disclosed in a daily count by DHHR — starting at least on Saturday, Jan. 11 — a point in the event at which CDC had yet to explain its actions publicly, and at a time when the agency was still finalizing its preliminary screening level calculations.

It doesn’t do anyone in West Virginia any good to whitewash the errors that the CDC made. And doing that certainly won’t help anyone improve this process for the next community that has to deal with a chemical exposure and counts on the federal government to come up with a safe screening level. Hopefully, the folks running WVTAP will remedy this when they issue a final report on the health effects issues. While they’re at it, WVTAP might instruct the panel to go back and take a look at the important analysis by Jennifer Sass of the Natural Resources Defense Council, in which the CDC’s initial use of the Eastman study is questioned.

Meanwhile, I know that some members of the public I talked to where concerned about some of the platitudes about chemical safety — this business about a part per billion being one drop in a swimming pool or everything in life being toxic at the right dose — that were suddenly being thrown around by some folks involved in Monday’s WVTAP event.

Perhaps Richard Denison at the Environmental Defense Fund had some explanation for that sort of rhetoric with his blog post called Conflicted West Virginia chemical spill panel is repeating many of CDC’s mistakes. Denison explains that Dourson is president of a consulting firm called Toxicology Excellence for Risk Assessment, or TERA, and writes:

TERA has a long history of working with the petrochemical and related industries.  Acknowledged sources of industry funding noted on its website include the American Petroleum Institute, PPG Industries, Eli Lilly, the American Cleaning Institute (formerly called the Soap and Detergent Association), Procter & Gamble, and the Nickel Producers Environmental Research Association … At the press conference, a reporter asked Dourson whether he or TERA had worked for Eastman Chemical, Dow Chemical (the maker of the other chemicals that spilled on January 9) or trade associations that represent their interests.  Dourson’s response to this question was apparently the first public disclosure of his affiliations with these companies.

I was the reporter who asked Dourson that question. His response was that TERA had not recently worked for Eastman Chemical, but had done recent work for Dow. He didn’t answer the part about trade associations, but both Dourson and WVTAP officials kind of wrote of the issue, saying there would be “conflict of interest” statements in their final report. But why didn’t WVTAP make these possible conflicts public from the start themselves? Here’s what WVTAP said about Dourson it its press release announcing his involvement in the MCHM project:

Since 1995, Dr. Dourson has served as President for Toxicology Excellence for Risk Assessment. Dr. Dourson will Chair the Expert Panel and has over 30 years experience in toxicology, risk assessment and derivation of risk values. While with the US Environmental Protection Agency (EPA) he chaired the EPA’s Reference Dose (RfD) Work Group, was a charter member of the US EPA’s Risk Assessment Forum, and chief of the group that helped create the Integrated Risk Information System (IRIS). Dr. Dourson received his Ph.D. in Toxicology from the University of Cincinnati and is a Diplomate of the American Board of Toxicology and a Fellow of the Academy of Toxicological Sciences. He has served on or chaired many expert panels in the US EPA, Food and Drug Administration (FDA), National Sanitation Foundation International, and independent organizations. He served as President of the American Board of Toxicology and Secretary for the Society for Risk Analysis, and has published more than 100 papers on risk assessment methods.

Here’s what EDF’s Denison had to say:

The fact that an individual and company that have done work directly for the companies that make the spilled chemicals were selected not only to convene the expert panel, but to chair it and serve as its spokesperson, points to a clear conflict of interest.  And the fact that the conflict was only revealed because a reporter happened to ask the right question is even more troubling.