PERSON COUNTY
2011 COMMUNITY HEALTH ASSESSMENT
Volume Two: Environmental Data
October, 2011
Person County Community Health Assessment – Volume Two Table of Contents
Table of Contents
Introduction ...... 5
Chapter One: Water Quality ...... 6 Water Resource Agencies in North Carolina ...... 7 Surface Water ...... 7 River Basins and Watersheds ...... 8 Roanoke River Basin ...... 8 Biological Parameters of Water Quality ...... 9 Chemical and Physical Parameters of Water Quality . . . . . 10 Whole Effluent Toxicity ...... 11 Lake and Reservoir Water Quality ...... 11 Impaired Water Bodies in the Roanoke River Basin . . . . . 14 Neuse River Basin ...... 15 Tar-Pamlico River Basin ...... 16 Fish Kills ...... 16 Fish Consumption Advisories ...... 17 Groundwater ...... 18 Aquifers ...... 18 Surficial Aquifer ...... 18 Fractured Bedrock Aquifer ...... 18 Groundwater Incidents ...... 19
Chapter Two: Air Quality ...... 20 Outdoor Ambient Air ...... 20 Criteria Air Pollutants ...... 20 Annual CAP Maxima ...... 22 Air Quality Index ...... 23 Sources of Criteria Air Pollutants ...... 24 EPA Air Quality Non-Attainment Areas ...... 25 Vehicle Inspection Mandates ...... 25 Vehicle Miles Driven ...... 25 Vehicles Powered by Alternative Fuels ...... 26 Mass Transportation ...... 27 Hazardous Air Pollutants ...... 28 Caveats Using HAP Data ...... 28 Cancer and Noncancer HAP Risks ...... 29 Indoor Ambient Air ...... 30 Carbon Monoxide ...... 31 Carbon Monoxide Poisoning Deaths ...... 31 Radon ...... 32 Health Risks of Radon ...... 32 Environmental Tobacco Smoke ...... 33 Other Health Effects of Air Pollution ...... 35 Sick Building Syndrome/Building-Related Illness ...... 35
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Person County Community Health Assessment – Volume Two Table of Contents
Asthma ...... 36 Cardiovascular Events ...... 37
Chapter Three: Toxic Chemical Releases ...... 39 Toxic Release Inventory ...... 39 Land Contamination ...... 52 Superfund Sites ...... 52 Brownfields ...... 52 Inactive Hazardous Sites ...... 53 Hazardous Substances Emergency Events ...... 53
Chapter Four: Lead Hazards ...... 54 Where Lead is Found ...... 54 Health Effects of Lead Exposure ...... 55 Assessing Lead Risk ...... 55 Housing Units at Risk ...... 55 Childhood Blood Lead Levels ...... 56
Chapter Five: Agricultural Pollution ...... 59 Person County Agricultural Census ...... 59 Pesticides ...... 60 Pesticides Used on Crops ...... 61 Health and Environmental Risks of Pesticides ...... 63 Agricultural Animal Waste ...... 65
Chapter Six: Waste Management ...... 68 Solid Waste Management ...... 68 County-Level Solid Waste Collection ...... 68 Town-Level Solid Waste Collection ...... 69 County-Level Recycling ...... 69 Town-Level Recycling ...... 69 Landfill Capacity ...... 69 Wastewater Management ...... 70 County-Level Wastewater Management ...... 70 On-Site Wastewater Management ...... 70 Permitted Wastewater Discharges ...... 71
Chapter Seven: Drinking Water ...... 73 Water Usage ...... 73 Drinking Water Systems ...... 74 Community Drinking Water Systems ...... 74 Community Drinking Water Systems SDWIS Violations ...... 74 Municipal Drinking Water Systems ...... 75 Private Wells ...... 76
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Person County Community Health Assessment – Volume Two Table of Contents
Chapter Eight: Food-, Water-, and Vector-Borne Disease ...... 78 Food-Borne Diseases ...... 79 Water-Borne Diseases ...... 80 Vector-Borne Diseases ...... 80 Arboviral Diseases ...... 80 West Nile Virus ...... 80 Eastern Equine Encephalitis ...... 81 LaCrosse Encephalitis ...... 82 Other Arthropod Transmitted Diseases ...... 82 Rocky Mountain Spotted Fever ...... 82 Lyme Disease ...... 82 Rabies ...... 83
References ...... 84
Appendices ...... 97 Appendix A: 2011 Person County CHA Volume Two Summary ...... 97
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Person County Community Health Assessment – Volume Two Introduction
Introduction
This volume presents an overview of data describing major features of the natural environment of Person County. It is intended to complement the Person County Community Health Assessment Volume One by describing the environmental context in which the people of Person County are living.
The information in this report is based on the Center for Disease Control’s list of environmental public health indicators (EPHIs). These indicators identify specific areas that should be evaluated in order to track environmental exposures and adverse health effects within a community. The report describes in general terms the quality of water, air, and land in Person County, using data from the public domain. It lists the major contaminants and pollutants affecting ambient and drinking water quality and outdoor ambient and indoor air quality in the County, and names the sources of the pollutants where they are known. It describes chemicals and wastes affecting the County’s land and soil, and describes municipal waste management and water and wastewater facilities and sanitation practices. Finally, it contains data on environment-related health issues such as water-, food- and vector-borne diseases.
It is important to note that this report contains data retrieved directly from sources in the public domain. In some cases the data is very current; in other cases, while it may be the most current available, it may be several years old. Note also that the names of organizations, facilities, geographic places, etc. presented in the tables and graphs in this report are quoted exactly as they appear in the source data. In some cases these names may not be those in current or local usage; nevertheless they are used so readers may track a particular piece of information directly back to the source.
Data in this report may raise concern that the health of the citizens of Person County is being adversely affected by environmental pollutants. While the report does discuss the possible health effects of some of the pollutants entering air and water in the county, it does not—and cannot—assess any particular population’s or individual’s actual risk of experiencing adverse health effects. While the quantifiable presence of a pollutant is one element of the risk calculation, another essential element is the measurement of exposure, and exposure assessment is well beyond the scope of this report.
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Person County Community Health Assessment – Volume Two Water Quality
Chapter One: Water Quality
One measure of a community’s environmental health is the status of its natural waters. Water is a renewable resource, but clean water is in limited quantity, and as the population continues to grow, the demand for clean water rises every year.
In order to understand water quality issues in North Carolina (NC) it is necessary first to understand the terminology of the ecological and hydrogeological principles that apply.
Surface water - A geographic area’s surface waters are its fresh flowing waters (rivers, streams and creeks), and its fresh standing waters (lakes, ponds and reservoirs). Also included among surface waters are the estuaries, bays and coasts of oceanic environments, which, of course, do not pertain to Person County. Surface waters serve many purposes that affect the quality of life in a community: sources of water for human and industrial consumption, sources of food, sites for recreation, routes for transportation and commerce, and sites for disposal of byproducts and wastes of manufacturing and sewage treatment.
Watershed - A watershed is a geographic land area with elevations and topographical features that cause water to drain into a given body of water such as a creek, stream, river, lake, bay, or sound. A watershed may vary in size from several acres for a small stream or pond, to thousands of square miles for a major river system. Every river, stream and creek belongs to a particular watershed, and smaller watersheds can join together naturally to become larger watersheds, called river basins, which represent the drainage areas of major river systems. North Carolina contains a portion of 58 different watersheds that drain into 17 river basins. Water moves downstream in a watershed, so any activity that affects the water at the head, or anywhere else upstream, can also affect the characteristics of the downstream waters. The most downstream points in a watershed may, in fact, bear and demonstrate the cumulative results of upstream affects.
As of June 1, 2011 the state of NC conducted its water quality assessment and planning on a river- basin basis, with each of the state’s existing 17 river basins being monitored once in a five-year rotation.
Every watershed in the country is identified according to a national uniform hydrologic unit system sponsored by the US Geological Survey and the Water Resources Council. This system divides the country into regions, subregions, accounting units and cataloging units, designation of each of which contributes two digits to create an eight-digit numeric cataloging unit (CU). There are 54 eight-digit CUs in NC. These units have been further subdivided into 11- and 14- digit hydrologic units (HUs), to designate local-scale watersheds.
Subbasin – A subbasin is a designated subunit or sub-watershed area of a major river basin. Subbasins typically encompass the watersheds of significant streams or lakes within a river basin. Each of NC’s 17 river basins is subdivided into subbasins, ranging from one subbasin in the Watauga River basin to 24 subbasins in the Cape Fear River basin. There are 133 subbasins statewide that range in size from approximately 100 to 1,200 square miles. Each subbasin is identified by a six-digit code that was developed independently from the hydrologic unit codes, in an entirely different numbering system. Subsequent to their creation, the subbasin boundaries have been modified to be coincident with the hydrologic unit boundaries. Water quality data is cataloged variously by different source agencies; consequently data in this is this report is sometimes presented on the basis of subbasin and at other times on the basis of hydrologic unit.
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Person County Community Health Assessment – Volume Two Water Quality
Groundwater - Groundwater is the water basin beneath the soil surface that can be collected by wells and pumps and other man-made devices, or that flows naturally to the surface via seeps or springs. Groundwater is the primary source of water for 50% of the population in NC and the US, with heavier dependency in rural areas. Despite the visual prominence of surface waters, the vast majority of the earth’s freshwater—97%—is located underground. The term aquifer describes an underground layer of water-bearing permeable rock or unconsolidated materials (gravel, sand, silt, or clay) from which groundwater can be usefully extracted using a water well (1).
Water Resource Agencies in North Carolina
In NC as of June 1, 2011, there are two primary agencies responsible for monitoring and managing the state’s natural water resources: the Division of Water Resources (DWR), and the Division of Water Quality (DWQ), both located in the NC Department of Environment and Natural Resources (NCDENR). (At the time this report was being prepared, the NC General Assembly was considering changes in the structure and function of NCDENR.)
The DWR administers programs for river basin management, water supply assistance, water conservation, and water resources development. It conducts special studies on in-stream flow needs and serves as the state liaison with federal agencies on major water resources related projects. The DWR also administers environmental education outreach programs (2).
The DWQ, with a central office in Raleigh and seven regional offices located across the state, issues pollution control permits, monitors permit compliance, evaluates environmental quality, and carries out enforcement actions for violations of environmental regulations. The DWQ regional office serving Person County is located in Raleigh, NC, in Wake County (3).
Generally speaking, water bodies in NC and throughout US have become cleaner over time because of pollution controls on industrial discharges and sewage treatment plants, but extensive water quality problems remain. The Federal Clean Water Act requires surface water quality to be high enough to support fish and wildlife populations, protect drinking water sources, and allow for human recreation. According to the pollution information organization, Scorecard, nationwide 36% of rivers and streams, 39% of lakes and reservoirs, and 38% of estuaries still are not supporting at least one of these uses (4).
Surface Water
In response to the stipulations of the Clean Water Act, DWQ is charged with submitting a biennial report to the US Environmental Protection Agency (EPA) that assesses water quality in NC according to standards set by the state. This report traditionally describes (a) the quality of surface waters, groundwaters, and wetlands according to how well they support a series of best designated uses (e.g., for swimming, fishing, or drinking water supply); (b) what might be causes and sources of impairment for those designated uses; and (c) what standards and regulations protect those uses. The Environmental Sciences Section (ESS) of DWQ is responsible for water quality assessment in NC.
To help conduct this assessment work, DWQ operates the Ambient Monitoring System (AMS), which was established to provide site-specific, long-term water quality information on significant rivers, streams, and estuaries throughout the state. At the time this report was prepared the system operated a total of 323 active AMS stations spread among 95 of the state’s 100 counties. Stations are visited at
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Person County Community Health Assessment – Volume Two Water Quality
least monthly for the collection of a variety of physical, chemical and microbial samples and measurements (5).
The AMS' primary objectives are: to monitor water bodies of interest for determination of levels of chemical, physical, and bacterial pathogen indicators for comparison to a selection of the state's water quality standards and action levels; to identify locations where exceedances of water quality standards and action levels for physical and chemical indicators occur in more than 10% of samples/measurement (20% for Coliform bacteria); and to identify long-term temporal or spatial patterns.
NC AMS data are made available to the public through the US EPA STORET data management system, but the detailed nature of that data is beyond the scope of this report. NC AMS data (and other water quality data) is also summarized by basin on a rotating five-year cycle and reported as part of ESS’s Basin Assessment Report mechanism (5); that is the data that will be used for this report.
While DWQ’s Ambient Monitoring System is the primary source of chemical, physical and microbial water quality assessment data, other sources for these sorts of data include the US Geological Survey, local governments and environmental groups, industry, and municipal and university coalitions. Submitted data is accompanied by a Quality Assurance Project Plan (QAPP) to assure that “external” data were collected in a manner consistent with agency data (6).
Biological parameters, especially benthic macroinvertebrates and fish, are also assessed by ESS at a series of stations some of which are different from the AMS stations.
River Basins and Watersheds
The major watersheds of Person County are the Middle Roanoke, the Upper Neuse, the Upper Tar- Pamlico, and the Lower Dan watersheds. The majority of Person County lies in the Roanoke River Basin. The Roanoke River Basin is divided into 10 subbasins; of these, Person County contains a portion of Subbasins 04, 05 and 06. In terms of the hydrological units of the Roanoke River Basin, Person County is within HU 03010104.
Smaller parts of Person County also lie in either the Neuse River Basin (specifically Subbasin 01 in the southern third of the county) or the Tar-Pamlico River Basin (specifically Subbasins 01 and 02 in the eastern part of the county) (6).
Roanoke River Basin
The Roanoke River basin extends from its source in the Blue Ridge Mountains of VA to the Albemarle Sound in NC, encompassing mountainous, piedmont, and coastal topography as it flows generally east- southeastward. As the sixth largest river basin in the state, the Roanoke River carries more water and has the widest floodplain of any river in the state. The basin’s five eight-digit hydrologic units (Figure 1) constitute 3,503 square miles of drainage area and approximately 2,389 miles of streams and rivers in NC. Major tributaries to the Roanoke River include the Dan River, Mayo River, Smith River, County Line Creek, Hyco Creek/River, Cashie River and Conoho Creek. Priority watersheds in the Roanoke River Basin are the Mayo and Dan Rivers. Fifteen counties and 42 municipalities are also included in the basin.
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Person County Community Health Assessment – Volume Two Water Quality
Figure 1. Roanoke River Basin and Associated Hydrologic Units
Source: NC DENR, Division of Water Quality, Environmental Sciences Section, December 2010; Basinwide Assessment Report Roanoke River Basin. Available at: http://portal.ncdenr.org/c/document_library/get_file?uuid=e3dd1d8b-bbc5-42c9-9999- 1d99dd4c7455&groupId=38364 (accessed June 15, 2011).
The Roanoke River Basin has been sampled by NC DWQ ESS four times for basinwide monitoring: 1994, 1999, 2004, and 2009. The ESS collects a variety of biological, chemical, and physical data that can be used in a myriad of ways for basinwide-planning. In some program areas there may be adequate data to allow a fairly comprehensive analysis of ecological integrity or water quality. In other areas, data may be limited to one program area, such as only benthic macroinvertebrate data. Such data may or may not be adequate to provide a definitive assessment of water quality, but can provide general indications of water quality (7). The 2009 assessment data for the Roanoke River Basin were summarized in a series of separate program area reports released in December 2010. Primary program areas from which data were drawn for the 2009 assessment include benthic macroinvertebrate and fish communities, ambient chemistry (AMS data), aquatic toxicity, and lakes.
At the present time water quality data are organized and coded on the basis of hydrologic units (HUs); Person County lies primarily within the 03010104 hydrologic unit.
Following is a summary of the biological, chemical/physical, and effluent toxicity water quality indicators in the part of the Roanoke River Basin that includes Person County (HU 03010104).
Biological Parameters of Water Quality
The DWQ gives each creek, stream, lake and river a bioclassification, based on the number of intolerant, or sensitive species, particularly macroinvertebrates, present in the water. The presence of intolerant species indicates higher quality water than can support such sensitive organisms, while their absence signifies possible water quality or habitat problems. Excellent, good, and good-fair waters are fully supportive of benthic macroinvertebrates; fair waters are partially supportive; and poor waters are
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not supportive of such life. Loss of canopy, increase of stream temperature, and increased nutrients, toxicity or sedimentation all can affect the benthic (bottom dwelling) community.
There are two benthic macroinvertebrate sampling sites and six fish community sampling sites in HUC 03010104; one of each of these sites is in Person County. Table 1 lists the bioclassification data for all eight sites for both 2004 and 2009. Most streams in the western and central portion of this HUC have very sandy substrates and show evidence of nonpoint source sediment runoff, yet most of the biological communities rate at least Good-Fair or Good. At one site, County Line Creek in Caswell County, the classification of the benthic community improved from Good to Excellent between 2004 and 2009. The benthic macroinvertebrate community in Marlowe Creek in Person County, the watershed for which includes the City of Roxboro and which receives the treated effluent from the Roxboro wastewater treatment plant, declined from Good-Fair to Fair between 2004 and 2009. (In three of the four monitoring cycles over the past 15 years, the benthic macroinvertebrate community at the Marlowe Creek site has rated Fair or Poor.) The fish community in South Hyco Creek in Person County (a tributary to Hyco Reservoir) at the US 158 bridge is affected by prolonged droughts due to its location bracketed by Lake Roxboro and Hyco Reservoir. By 2009 the fish community there seemed not to have recovered yet from the 2007-2008 droughts (8).
Table 1. Bioclassification of HUC 03010104 Sampling Sites (2004 and 2009)
Bioclassification Site County Location Indicator Organism 2004 2009 County Line Creek Caswell NC 57 Benthic macroinvertebrates Good Excellent Marlowe Creek Person SR 1322 Benthic macroinvertebrates Good-Fair Fair Hogans Creek Caswell SR 1301 Fish --- Good-Fair Hogan’s Creek Caswell SR 1330 Fish Good Good-Fair Moon Creek Caswell SR 1511 Fish Good Good Rattlesnake Creek Caswell SR 1523 Fish Good Good South Hyco Creek Person US 158 Fish Good Fair Aaron’s Creek Granville SR 1400 Fish Good Good
Source: NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Reports and Publications, Basin Wide Reports, Roanoke Basin 2010, Basin Wide Assessment Report, Roanoke River Basin, December 2010. Available at: http://portal.ncdenr.org/c/document_library/get_file?uuid=e3dd1d8b-bbc5-42c9-9999-1d99dd4c7455&groupId=38364
Chemical and Physical Parameters of Water Quality
The DWQ lists three long-established AMS stations in Person County, all in the Roanoke River Basin: one is on the Hyco River below the Afterbay Dam near McGhee’s Mill, the second is on Marlowe Creek at State Road (SR) 1322 near Woodsdale, and the third is on Mayo Creek at SR 1501 near Bethel Hill.
Table 2 presents a summary of AMS stations located in Person County that had at least some measures of assessed parameters of physical characteristics, chemicals, nutrients or coliforms that exceeded AMS evaluation levels (standards or action levels) during the period from 2005 through 2009.
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Table 2. AMS Stations in Person County Not Meeting Evaluation Levels (EL) (2005-2009)
Site Parameter Not Meeting EL
Hyco River below Afterbay Dam near McGhees Mill Low pH Marlowe Creek at SR 1322 near Woodsdale High turbidity, presence of Fecal Coliforms Mayo Creek at SR 1501 near Bethel Hill Presence of Fecal Coliforms
Source: NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Reports and Publications, Basin Wide Reports, Roanoke Basin 2010, Roanoke Basin Ambient Monitoring Report, September 2010. Available at: http://portal.ncdenr.org/c/document_library/get_file?uuid=c9a59811-634c-490b-b566-6a8ebc00554d&groupId=38364
Whole Effluent Toxicity
Certain manufacturing and wastewater and water treatment facilities are permitted by the state to discharge wastes of production to surface waters. DWQ ESS performs acute and/or chronic toxicity tests to determine the toxicity of these discharges to sensitive aquatic species (usually fathead minnows or the water flea Ceriodaphnia). Results of these tests have been shown to be predictive of discharge effects on receiving stream populations, and may be used in permit renewal decisions (9).
Twenty-seven facility permits in the Roanoke River Basin require whole effluent toxicity (WET) testing; four of these facilities are in Person County. An additional three facilities require monitoring rather than testing; one of these facilities is in Person County (9). Table 3 lists the results of effluent toxicity testing and monitoring for Person County permitted discharge sites in Roanoke River Basin HUC 03010104.
Of the permitted facilities in Person County, the Primary Energy discharge site had repeated failures between May and July of 2006 and was deemed non-compliant by the state, resulting in an enforcement action. After July 2006, follow-up tests showed no apparent toxicity (9).
Table 3. Whole Effluent Toxicity (WET) Results for Permitted Dischargers in Person County (2005-2009)
WET Results, 2005-2009 Facility Receiving Stream No. Passes No. Fails Primary Energy LLC UT Mitchell Creek 25 4 CP&L [now Progress Energy] Mayo Steam Plant Mayo Reservoir 21 0 Progress Energy – Roxboro Hyco Lake (1) 20 0 Progress Energy - Roxboro Hyco Lake (2) Monitoring only Roxboro Wastewater Treatment Plant Marlowe Creek 21 1
Source: NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Reports and Publications, Basin Wide Reports, Roanoke Basin 2010, Roanoke River Basin Whole Effluent Toxicity Report; Roanoke River Basin Basinwide Assessment Report, Whole Effluent Toxicity Program, 2005-2009, May 2010. Available at: http://portal.ncdenr.org/c/document_library/get_file?uuid=ed270110-42db-49a6-8a0f-0bf3ef2657d8&groupId=38364
Lake and Reservoir Water Quality
There are four lakes and/or reservoirs in the Roanoke River Basin located at least partially in Person County (Hyco Lake, Lake Roxboro, Mayo Reservoir, and Lake Isaac Walton) that are assessed by NCDWQ (10).
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Person County Community Health Assessment – Volume Two Water Quality
Hyco Lake. Hyco Lake is located on the Hyco River approximately three miles south of the NC-VA state line in Person and Caswell Counties. This reservoir was constructed in 1965 to provide cooling water for the Carolina Power and Light Company (currently Progress Energy) Roxboro Steam Plant. The drainage area for Hyco Lake is characterized by rolling hills and land use along the 159 mile shoreline is primarily residential, forested, and agricultural.
In 2009 water clarity in Hyco Lake was good, and surface physical parameters (dissolved oxygen, pH and water temperature) were similar to measurements observed in previous sampling years. Total suspended solids and turbidity values also were similar to those observed in previous years, and nutrient concentrations generally ranged from low to moderate (10).
In 2008, Progress Energy notified the Raleigh Regional Office (RRO) of DWQ that the flue gas desulfurization wastewater settling basin at the Roxboro Steam Plant was seeping and at risk of failure. (Flue gas desulfurization [FGD] is technology used for removing sulfur dioxide from the exhaust flue gases in power plants that burn coal or oil to produce steam for the steam turbines that drive their electricity generators.) Despite the efforts of the company to solve the problem, on February 27, 2008, Progress Energy notified RRO staff that a failure occurred, allowing water from the settling pond to discharge into an adjacent ash pond. As a result, the RRO requested Progress Energy to conduct additional sampling of both lake surface water and adjacent ground water in an effort to determine changes or effects on the waste streams as a result of the treatment unit failure, bypass, and changes in the treatment capacities of the settling basin. This sampling effort was conducted eight times in March and April of 2008. Data from this monitoring effort revealed elevated levels of thallium, selenium, copper, beryllium, silver, mercury and antimony in an effluent stream in Hyco Lake and in a non-potable well located within 500 feet of the FGD settling basin. At the request of the RRO, staff from DWQ’s Intensive Survey Unit collected water and sediment samples on July 21, 2008 from various lake sites near the FGD wastewater treatment system along with two additional sites located upstream and downstream of the facility. Results of the summer sampling indicated that elevated metals detected by Progress Energy in the spring were by this time at very low levels or below DWQ laboratory detection levels (10).
Progress Energy monitors the limnology and fisheries in Hyco Lake. The primary objective of this program is to provide an assessment of the effect of the operation of the Roxboro Steam Electric Plant on the water and aquatic life in Hyco Lake. The most recent monitoring effort was conducted in 2008. No significant changes in the physical parameters and nutrient concentrations of the lake were observed at that time. In 2008, increases in the annual mean concentrations of hardness, some ions and in specific conductance were observed in the vicinity of the power plant discharge. These increases were attributed to operations of the new FGD system. Although slight increases in arsenic and selenium were observed near the power plant outfall, these values were not greater than the applicable state water quality standards (10).
Lake Roxboro. Lake Roxboro is located in Caswell and Person Counties near the community of Hester’s Store. The 195-acre lake, which is an impoundment of South Hyco Creek, was filled in 1978. Land uses in the watershed include agriculture, forest, and residential areas. Lake Roxboro is classified WS-II B HQW (High Quality Water).
DWQ staff sampled this lake once a month from May through September in 2007 and twice a month from May through September in 2009. In 2007, measures of water clarity were the best they would be over the entire sampling period, meaning water clarity deteriorated. Over the sampling period sited dissolved oxygen concentrations frequently were hypoxic, total phosphorous concentrations ranged from moderate to elevated, and total nitrogen concentrations were elevated. Chlorophyll a values ranged from moderate to elevated. Concentrations greater than the state water quality chlorophyll a
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Mayo Reservoir. Mayo Reservoir is located on Mayo Creek in Person County, just south of the VA border, and covers 2,800 acres. Owned by Progress Energy, the reservoir was completed in 1983 to provide cooling water for the Mayo Electric Generating Plant. The drainage area is characterized by rolling hills with forests and agriculture.
Assessment efforts in 2009 indicated good water clarity in Mayo Reservoir. Surface physical parameters (dissolved oxygen, pH and water temperature) in 2009 were similar to those values observed in this reservoir since it was first monitored by DWQ in 1983. Total phosphorus, nitrite plus nitrate, and ammonia concentrations were very low in 2009, and chlorophyll a values were also low in 2009. Based on these data, Mayo Reservoir was determined to exhibit very low biological productivity in May, August and September, and moderate productivity (i.e., was mesotrophic) in June and July (10).
Progress Energy monitored the water, sediments and fisheries of this reservoir in 2008 as required by the National Pollutant Discharge Elimination System (NPDES) Permit No. 003837. Nutrient concentrations in 2008 were relatively low and similar among all of the sampling stations with the exceptions of phosphorus and total organic nitrogen. The concentrations for these nutrients were found to be higher in the upper reservoir. Chlorophyll a concentrations were less than the state water quality standard at all of the lake sampling sites. Trace elements were low or below laboratory detection levels (10).
Lake Isaac Walton. Lake Isaac Walton (also called City Lake) is located in Person County near the City of Roxboro and is the primary water supply for the town. The lake was built in the 1930's. Satterfield and Storys Creek are the main tributaries. The watershed is comprised of agricultural land, pastures, and residential areas.
DWQ collected samples monthly from May through September in 2009. Samples collected early during this time period indicated good water clarity at the dam, but clarity deteriorated significantly over time at sites upstream from there. In September, clarity was poor throughout the lake, perhaps associated with the fact that the water level of Lake Isaac Walton had dropped by three feet by September (10).
In 2009, pH values at the lake surface were within state water quality standards. Total phosphorus concentrations were low near the dam and the middle of the lake, but elevated further upstream. Total nitrogen was elevated, and chlorophyll a values ranged from low to elevated, with the highest chlorophyll a value observed near the dam in August, when a green film was observed along the shoreline near the upper end of the lake. Analysis of a water sample taken at this bloom determined that the alga Euglena sp. was responsible for this bloom. Based on these 2009 data, Lake Isaac Walton was determined to be very biologically productive (i.e., was eutrophic). This lake has been eutrophic since it was first monitored by DWQ in 1988 (10).
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Impaired Waters in the Roanoke River Basin
Although comprehensive river basin reports are developed only every five years, the state must report “impaired” waters to the EPA every two years, usually in the form of the “303(d) List”. This document, named for the part of the Clean Water Act of 1972 that requires it, is a list of the most impaired waters in the state at the time of the report.
At the present time, the EPA uses a system of five Integrated Reporting Categories (IRCs) to describe water body impairment. IRCs represent varying levels of water quality standards attainment, ranging from Category 1, where all the water’s designated uses are met, to Category 5, where a pollutant impairs a water body and a total maximum daily load (TMDL) is required. (A TMDL is a calculation of the maximum amount of a pollutant that a water body can receive and still safely meet water quality standards.) Each water body in NC that has been assessed is assigned at least one of the following IRCs (11).
Category 1: Attaining the water quality standard and no use is threatened. This category consists of those waters or assessment units where all applicable use support categories are rated "Supporting." Data and information are available to support a determination that the water quality standards are attained and no use is threatened. Future monitoring data will be used to determine if the water quality standard continues to be attained.
Category 2: Attaining some of the designated uses; no use is threatened; and insufficient or no data and information is available to determine if the remaining uses are attained or threatened. This category consists of those waters where at least one of the applicable use support categories is rated “Supporting" and the other use support categories are rated "Not Rated." Also included in this category are waters where at least one of the applicable use support categories, except Fish Consumption, are rated "Supporting," the remaining applicable use support categories except Fish Consumption are rated "Not Rated," and the Fish Consumption category is rated "Impaired-Evaluated." Data and information are available to support a determination that some, but not all, uses are attained. Attainment status of the remaining uses is unknown because there is insufficient or no data or information. Future monitoring data will be used to determine if the uses previously found to be in attainment remain in attainment, and to determine the attainment status of those uses for which data and information was previously insufficient to make a determination.
Category 3: Insufficient or no data and information to determine if any designated use is attained. This category consists of those waters where all applicable use support categories except Fish Consumption are rated "Not Rated" or “No Data” and the Fish Consumption category is rated "Impaired-Evaluated." Measured data or information to support an attainment determination for any use is not available. Supplementary data and information, or future monitoring, will be required to assess the attainment status.
Category 4: Impaired or threatened for one or more designated uses but does not require the development of a TMDL. This category contains three distinct subcategories:
Category 4a: TMDL has been completed. This category consists of those waters for which EPA has approved or established a TMDL and water quality standards have not yet been achieved. Monitoring data will be considered when evaluating Category 4a water bodies for potential delisting, although the TMDL strategy will remain in place.
Category 4b: Other pollution control requirements are reasonably expected to result in the attainment of the water quality standard in the near future. This category consists of those waters
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for which TMDLs will not be attempted because other required regulatory controls (e.g., National Pollutant Discharge Elimination System [NPDES] permit limits, Storm Water Program rules, buyout programs, etc.) are expected to attain water quality standards by the next regularly scheduled listing cycle. Future monitoring will be used to verify that the water quality standard is attained as expected.
Category 4c: Impairment is not caused by a pollutant. This category consists of waters that are impaired by pollution, not by a pollutant. EPA defines pollution as "the man-made or man-induced alteration of the chemical, physical, biological and radiological integrity of the water." EPA believes that in situations where the impairment is not caused by a pollutant, a TMDL is generally not the appropriate solution to the problem. EPA staff has verbally stated that this category is intended to be used for impairments related to water control structures (i.e., dams). Future monitoring will be used to confirm that there continues to be no pollutant-caused impairment and to support water quality management actions necessary to address the cause(s) of the impairment.
Category 5: Impaired for one or more designated uses by a pollutant(s), and requires a TMDL. This category consists of those waters that are impaired by a pollutant and the proper technical conditions exist to develop TMDLs. As defined by the EPA, the term pollutant means "dredged soil, solid waste, incinerator residue, sewage, garbage, sewage sludge, munitions, chemical wastes, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal, and agricultural waste discharged into the water." In most cases, data are available to support a determination that a water quality standard is not attained. When more than one pollutant is associated with the impairment of a single assessment unit in this category, the assessment unit will remain in Category 5 until TMDLs for all listed pollutants have been completed and approved by the EPA.
The state’s 303(d) List of Impaired Waters includes only Category 5 impaired waters that require a TDML (11).
There were two water bodies in Person County that were classified as impaired according to the 2010 NC 303(d) List (Table 4), both are sections of Marlowe Creek.
Table 4. Person County Water Bodies in HU 03010104 Classified as Impaired Under the CWA, 2010
Year Impaired Subbasin/Watershed Waterbody First Reason for Listing Miles Use Listed Dan River Subbasin/ Marlowe Creek from Aquatic 1998 “Fair” 6.6 Hyco River Watershed source to Mitchell Creek life bioclassification Dan River Subbasin/ Marlowe Creek from Aquatic 2008 Standard violations: 4.5 Hyco River Watershed Mitchell Creek to Storys life copper, zinc Creek
Source: NC Department of Environment and Natural Resources, Division of Water Quality, Planning, Water Quality Data Assessment, 2010 Final 303(d) List; http://portal.ncdenr.org/c/document_library/get_file?uuid=8ff0bb29-62c2-4b33-810c-2eee5afa75e9&groupId=38364
Neuse River Basin
As noted previously, part of Person County lies within the Neuse River Basin. The Neuse River Basin is one of only three river basins located entirely within NC. It originates just northwest of Durham in Person and Orange Counties. The first 22 miles of the Neuse River now are impounded behind the
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Falls of the Neuse Reservoir Dam near Raleigh, creating Falls Lake. After the dam, the river flows southeast for 185 miles past Raleigh, Smithfield, Goldsboro, and Kinston before reaching tidal waters near Street’s Ferry. Once reaching these tidal waters, the river broadens and changes into an estuary that empties into the Pamlico Sound. For assessment and monitoring purposes the entire river basin is divided into 14 subbasins; Person County contains portions of Subbasin 01.
Subbasin 01 consists of the Flat, Little, and Eno River watersheds. Person County contains the northern half of the subbasin where the land use is mostly agricultural and forest. The lower half of the subbasin includes the town of Hillsborough, the City of Durham, and Falls Lake Reservoir and its tributary streams. The middle of Subbasin 01 includes Ledge, Robertsons, Beaverdam, Ellerbe, and Lick Creeks.
The most recent comprehensive assessment of the Neuse River Basin available at the time this report was prepared had been conducted in 2005 and published in 2006. Findings from that Neuse River Basin assessment were discussed in the 2007 Person County Community Health Assessment (CHA) Volume Two: Environmental Data (12). As noted in the 2007 CHA, there are no AMS or bioclassification monitoring sites for Subbasin 01 water bodies in Person County, so no AMS or bioclassification data are available.
As also noted in the 2007 Person County CHA, no water bodies in the Person County reaches of Subbasin 01 appeared on the 2006 303(d) list of impaired waters. A recent examination of the 2010 303(d) list revealed the same result (11).
Tar-Pamlico River Basin
The Tar-Pamlico River originates in the eastern piedmont, in Person County, and flows southeast for 180 miles to the coastal plain, entirely within the state of NC. Priority watersheds in the Tar-Pamlico River Basin are the Fishing Creek and Swift Creek watersheds and the Upper Tar River. Beginning in Person County and until reaching US Highway 17 in the Town of Washington in Beaufort County, the river is called the Tar River. From Washington to Pamlico Sound it is called the Pamlico River. The names actually differentiate the type of water flowing in the river: the Tar River is primarily freshwater and the Pamlico River is entirely estuarine. For assessment and monitoring purposes the entire river basin is divided into eight subbasins. Person County contains portions of Subbasins 01 and 02; this same region is identified as HUC 03020101.
The 2007 Person County CHA discussed findings from the 2002 Tar-Pamlico River Basin assessment that was published in 2003 (12). The most recent assessments of the Tar-Pamlico River Basin were published in 2008. As noted previously in this report, and consistent with previous assessments, there are no AMS or bioclassification monitoring sites in the portion of the Tar-Pamlico River Basin that is located in Person County.
Fish Kills
Fish kills and fish disease events in NC often involve a host of factors and underlying causes, so it is important to gather as much information as possible surrounding an event from all involved parties. In 1996 the DWQ staff, in consultation with Wildlife Resources biologists and Division of Marine Fisheries (DMF) personnel, instituted a new fish kill investigation procedure to be used by the DWQ Regional
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Offices, Response Teams and other agencies to collect and track information on fish kills throughout the state. Fish kill and fish health data are recorded via standardized methods (for example, trained investigators must confirm that at least 25 fish were affected) and sent to the Division for review. Fish kill investigation reports and supplemental information are compiled in a central database where the data can be managed, retrieved, and reported to state officials, scientists, and other concerned parties. Fish kill data is also reviewed as part of the DWQ efforts to monitor water quality trends across the state (13).
There was only one fish kill event reported in Person County between January, 2007 and June, 2011. In May 2009, a fish kill of 100 specimens occurred in a shallow pond near Roxboro in a surface water system known as Pine Lakes. This pond, which had been filling with sediment over the years, was at the time of the kill receiving sewage from a leaking septic system that was implicated as the probable cause of the kill (14).
Fish Consumption Advisories
Fish from the vast majority of the state’s waters are safe to eat. However certain fish in some NC waters contain high levels of contaminants that may pose a risk to human health. The NC Department of Health and Human Services ( NC DHHS) issues fish consumption advisories for those fish, telling people to either limit consumption or avoid eating those kinds of fish. Unborn children and young children are often more susceptible to developing problems as a result of contact with contaminants; that’s why advisories are often more stringent for women of childbearing age and children (15).
The Epidemiology Section of the NC Division of Public Health (DPH) maintains an Internet website listing current fish consumption advice and advisories (16). In April 2008, the Section listed a statewide advisory against women of childbearing age (15-44 years), pregnant women, nursing mothers, and children under age 15 eating any fish high in mercury; the Section further advised all other persons to consume fish high in mercury no more than one meal a week and fish low in mercury no more than four meals per week. The fish with high mercury levels are primarily ocean species, and include: albacore (white) tuna (fresh or canned), almaco jack, banded rudderfish, cobia, crevalle jack, greater amberjack, south Atlantic grouper (gag, scamp, red, and snowy), king mackerel, ladyfish, little tunny, marlin, orange roughy, shark, Spanish mackerel, swordfish, tilefish, and tuna (fresh or frozen). There are eight freshwater species on the “avoid” list: blackfish (bowfin), black crappie, catfish (caught wild), jack fish (also called chain pickerel), largemouth bass, walleye from Lake Fontana and Lake Santeetlah, warmouth, and yellow perch. Freshwater fish with the highest mercury levels have been found primarily south and east of Interstate 85. At the present time here are no fish consumption advisories specific to Person County.
In addition, the website also lists site-specific advisories regarding consumption of species with high levels of other chemicals such as polychlorinated biphenyls (PCBs) and dioxins. None of the referenced sites are in Person County; most are located in the coastal plain of northeastern NC. Advisories were made for consumption of catfish and carp, particularly for children and women of childbearing age; all other persons were advised to eat no more than one meal per month of carp and catfish from these areas. Swimming, boating, and other recreational activities in these waters present no known significant health risks.
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Groundwater
Much less is known generally about groundwater than surface waters, despite the facts that over 95% of all freshwater is groundwater, and that half the population in NC relies on groundwater as its primary source of drinking water.
In NC, DWR is responsible for monitoring and managing the state’s groundwater resources. The agency maintains a library of databases on various groundwater topics that was the source of the information in this section (17).
Aquifers
As noted previously, aquifers are hydraulically connected geologic materials (sands, limestone, and fractured rock) that provide water through a properly constructed well opening. The aquifers in NC are highly varied in their character and water producing capabilities. Several of them can be traced over large geographic areas and form principal aquifers, which are significant sources of groundwater for drinking water supplies, agriculture, and industries. Other aquifers provide less significant amounts of water and cover smaller areas of the state (18).
There are eight principal aquifers in NC: the Lower Cape Fear, Upper Cape Fear, Castle Hayne, Yorktown, Surficial, Black Creek, Peedee, and Bedrock aquifers. The three minor aquifers in the state include the Lower Cretaceous, Beaufort, and Pungo River aquifers. The Upper and Lower Cape Fear, Black Creek, Peedee, and Castle Hayne aquifers are regional aquifers, with substrates so well connected that withdrawals from one site can cause pressure reductions many miles from the pumping center (18).
None of the primary regional aquifers, which are located primarily in the eastern portion of NC, serves Person County. Person County lies in the piedmont region of the state that is served primarily by the surficial and fractured bedrock aquifers, which tend to interact with one another (18).
Surficial Aquifer
The Surficial (or “unconfined”) aquifer is widely used throughout NC for individual home wells. It is the shallowest aquifer, and most susceptible to contamination from septic tank systems and other pollution sources. The Surficial aquifer is also very sensitive to variations in rainfall amounts, and wells tapping this aquifer are the first to dry-up in a drought. Commonly, large diameter wells (up to 3 feet in diameter) are drilled up to 60 feet deep to store large quantities of water in the well casing. Wells tapping this aquifer typically yield 25-200 gallons per minute (18).
Fractured Bedrock Aquifer
This aquifer is widely used for home water supply in the western coastal plain, Piedmont, and Blue Ridge regions of NC. Usually six inch wells are drilled to intercept water bearing fractures which are more common in valleys or draws. Thick overlays of the surficial aquifer above fractured bedrock can improve yields to 200 gallons per minute or more. Industries and county or municipal well fields look for these higher yielding bedrock wells. Wells typically yield 5-35 gallons per minute (18).
Drinking water – from both private wells and public water systems – in Person County is covered in Chapter Seven of this report.
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Groundwater Incidents
The DWQ Incident Management Office keeps track of leaks and spills of chemicals that present risks to health. While the Incident Management System database previously was accessible to the public, DWQ has changed its policy and restricted access to only approved users. Consequently, recent groundwater incident data cannot be included in this report. The 2007 Person County Community Health Assessment, Volume Two reported that no groundwater incidents occurred in the county between 2001 and 2006 (12).
Chapter Seven of the present report discusses violations and contaminations in groundwater used for community drinking water.
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Chapter Two: Air Quality
Outdoor Ambient Air
Parts of the central piedmont region of NC, where Person County is located, can have significant air quality problems, due to emissions from polluting industries and Interstate highway traffic. In order to understand Person County air quality issues it is first helpful to understand some of the underlying air science. Nationally, air quality is the responsibility of the Environmental Protection Agency (EPA); most of the following information and data originate with that agency. In NC, the agency responsible for monitoring air quality is the Division of Air Quality (DAQ) in DENR.
The EPA categorizes outdoor air pollutants as “criteria air pollutants” (CAPs) and “hazardous air pollutants” (HAPs).
Criteria Air Pollutants
Criteria air pollutants (CAPS) are six chemicals that can injure human health, harm the environment, or cause property damage: carbon monoxide, lead, nitrogen oxides, particulate matter, ozone, and sulfur dioxide. The EPA has established National Ambient Air Quality Standards (NAAQS) that define the maximum legally allowable concentration for each CAP, above which human health may suffer adverse effects (19). Table 5 (following page) lists the current NAAQS.
Following are descriptions of the sources of the six CAPs (20).
Carbon Monoxide (CO) - Nationwide, 77% of carbon monoxide emissions are from transportation sources, primarily highway motor vehicles, but other sources include wood-burning stoves, incinerators and industrial outputs.
Lead (Pb) – Lead enters the atmosphere primarily from gasoline additives, non-ferrous smelters, and battery plants. The proportion of atmospheric lead from cars and trucks has decreased dramatically over a generation due primarily to a shift to lead-free gasoline.
Nitrogen dioxides (NOx) – Nitrogen oxides are formed when fuels are burned at high temperatures, such as in transportation vehicles, and stationary combustion sources like electric utilities and industrial furnaces. They play an important role in the reactions that create ozone and acid rain.
Particulate matter (PM) – Particulate matter is usually categorized on the basis of size, and includes dust, dirt, soot, smoke, and liquid droplets emitted directly into the air by factories, power plants, construction activity, fires and vehicles.
Ozone (O3) – Ozone, the major component of smog, is not usually emitted directly but rather formed through chemical reactions in the atmosphere. Precursor compounds like volatile organic compounds (VOC) and oxides of nitrogen (NOx) react to form O3 when stimulated by ultraviolet radiation and temperature, so peak O3 levels typically occur during the warmer and sunnier times of the day and year. VOCs are chemicals that play a role in forming ozone and are emitted from a variety of sources, including automobiles, chemical and paint manufacturing plants, dry cleaners, and other facilities that use solvents and paint.
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Sulfur dioxide (SO2) - This pollutant is released primarily by burning sulfur-containing fuels like coal, oil and diesel fuels, and is emitted from power plants, steel mills, refineries, pulp and paper mills and smelters.
Table 5. Primary National Ambient Air Quality Standards (2011)
Pollutant Primary Standard Averaging Times Notes 9 ppm (10 mg/m3) 8-hour Not to be exceeded > 1/year Carbon monoxide (CO) 35 ppm (40 mg/m3) 1-hour Not to be exceeded > 1/year
Rolling 3-month Lead 0.15 µg/m3 n/a average
The official level of the annual NO2 Annual (arithmetic standard is 0.053 ppm, equal to 53 ppb, 53 ppb average) which is shown here for the purpose of clearer comparison to the 1-hour standard Nitrogen dioxide To attain this standard, the 3-year average of the 98th percentile of the daily maximum 100 ppb 1-hour 1-hour average at each monitor within an area must not exceed 100 ppb Particulate matter Not to be exceeded > 1/year on average 150 μg/m3 24-hour (PM10) over 3 years
To attain this standard, the 3-year average of the weighted annual mean PM2.5 Annual (arithmetic 15.0 µg/m3 concentrations from single or multiple average) community-oriented monitors must not exceed 15.0 µg/m3 Particulate matter ) (PM2.5 To attain this standard, the 3-year average of the 98th percentile of 24-hour 35 μg/m3 24-hour concentrations at each population-oriented monitor within an area must not exceed 35 μg/m3 To attain this standard, the 3-year average of the fourth-highest daily maximum 8-hour Ozone (O3) 0.075 ppm 8-hour average ozone concentrations measured at each monitor within an area over each year must not exceed 0.075 ppm Annual (arithmetic 0.03 ppm average) 0.14 ppm 24-hour Not to be exceeded > 1/year Sulfur Dioxide Final rule signed June 2, 2010. To attain this standard, the 3-year average of the 99th 75 ppb 1-hour percentile of the daily maximum 1-hour average at each monitor within an area must not exceed 75 ppb
Source: Environmental Protection Agency. Air and Radiation. National Ambient Air Quality Standards (NAAQS). http://www.epa.gov/air/criteria.html.
Table 6 lists some of the environmental and health effects of CAPS and their precursors.
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Table 6. Health and Environmental Effects of Criteria Air Pollutants
Pollutant Effect CO Reduces delivery of oxygen to the body’s organs and tissues Pb Affects nervous, reproductive, digestive, cardiovascular systems and the kidney
NOx Effects ecosystems on land and in water; plays a role in the formation of acid rain Affects breathing, aggravates existing respiratory and cardiovascular disease; damages lung PM tissue O3 Damages lung tissues, reduces lung function and sensitizes lungs to other irritants VOC Contributes to ozone formation; may cause cancer and have reproductive toxicity SO2 Affects breathing and may aggravate existing respiratory and cardiovascular disease
Source: Scorecard. Pollution Locator. Description of Criteria Air Pollutants. Available at: http://www.scorecard.org/env- releases/cap/pollutant-desc.tcl
Annual CAP Maxima
Person County is in the Raleigh Region of the NC DAQ Monitoring and Emissions Data System, along with 15 other counties (Chatham, Durham, Edgecombe, Franklin, Granville, Halifax, Johnston, Lee, Nash, Northampton, Orange, Vance, Wake, Warren and Wilson Counties) (21).
At the present time there is only one air quality monitor located in Person County, in Bushy Fork; this monitor measures only ozone. (Multiple monitors tend to be located in urban population centers.)
Table 7 shows the number of daily exceedances in 8-hour and 1-hour ozone standard maxima at the Bushy Fork monitoring site for the years 2007 through 2010. There were eight exceedance days out of a total of 843 monitored days for 8-hour ozone during the period, and no exceedances for 1-hour ozone. The exceedances that did occur tended to be very small. For instance, in 2010 the exceedances in 8-hour ozone ranged between 0.076 and 0.079 ppm compared to the standard of 0.075 ppm (22).
Table 7. Daily Exceedances in 8-hour and 1-hour Ozone Maxima at the Bushy Fork Air Quality Monitoring Site in Person County, 2007-2010.
8-hr Ozone Avg 1-hr Ozone Avg Year Valid Days Exceedance Valid Days Exceedance Monitored Days Monitored Days 2010 214 3 214 0 2009 214 0 214 0 2008 204 5 211 0 2007 211 0 214 0
Source: NC Department of Environment and Natural Resources, Division of Air Quality, Ambient Monitoring Program, Monitoring Data, Archival Data, Data Archives & Statistical Summaries, Air Quality Data Analyses, Ozone. Available at: http://daq.state.nc.us/monitor/data/o3design/
The EPA produces an Annual Report of Criteria Air Pollutants for each state that shows the annual CAP maxima data for each county that has one or more monitoring stations. Table 8 presents 2008 NC annual maxima for each CAP and identifies the county in which it was measured. Concentrations noted in bold type exceed the NAAQS standard.
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Table 8. North Carolina Annual High Levels of Criteria Air Pollutant Emissions, 2008
Highest Recorded Pollutant NAAQS Standard County Concentration Carbon monoxide 1-hour average max 35 ppm 3.1 ppm Wake 8-hour average max 9 ppm 2.2 ppm Forsyth Nitrogen dioxide Annual mean 53 ppb 0.0011 ppb Forsyth, Mecklenburg PM-10 24-hour average max 150 μg/m3 45 μg/m3 Mecklenburg PM-2.5 Annual mean 15 µg/m3 41.6 μg/m3 New Hanover Ozone 1-hour average max 0.12 ppm 0.115 ppm Lincoln 8-hour average max 0.075 ppm 0.093ppm Mecklenburg1 Sulfur Dioxide 24-hour average max 0.14 ppm 0.028 ppm New Hanover Annual mean 0.03 ppm 0.006ppm Forsyth, New Hanover
Source: US EPA. Air and Radiation. AirData Criteria Air Pollutants, County Air Quality Report, North Carolina; http://www.epa.gov/air/data/geosel.html. 1 Other counties where 8-hr O3 exceeded NAAQS by significant amounts (and frequently) were: Alexander, Caswell, Durham, Forsyth, Franklin, Graham, Granville, Guilford, Haywood, Pitt, Rockingham, Rowan, Union, Wake, and Yancey counties.
Historically, NC has fared poorly in national rankings of states based on emissions of CAPs. According to 1999 data from Scorecard, the state ranked among the 20% of states with the highest emissions of carbon monoxide and volatile organic compounds, and among the 30% of states with the highest emissions of nitrogen oxides, sulfur dioxide, and small particulate matter (PM 2.5). It also ranked among the 30% of states with the most person days in exceedance of the 8-hour NAAQS standard for ozone (23). From the data presented in Table 8, it is clear that NC still experiences exceedances for particulate matter and ozone, especially in the populous metropolitan areas and along Interstate Highway corridors.
Air Quality Index
The impact of CAPs in the environment is described on the basis of emissions, exposure, and health risks. A useful measure that combines these three parameters is the Air Quality Index (AQI), which was formerly called the Pollutant Standards Index (PSI).
The AQI is an information tool to advise the public. The AQI describes the general health effects associated with different pollution levels, and public AQI alerts (often heard as part of local weather reports) include precautionary steps that may be necessary for certain segments of the population when air pollution levels rise into the unhealthy range. The AQI measures concentrations of five of the six criteria air pollutants and converts the measures to a number on a scale of 0-500, with 100 representing the NAAQS standard. An AQI level in excess of 100 on a given day means that a pollutant is in the unhealthy range that day; an AQI level at or below 100 means a pollutant is in the “satisfactory” range (24). Table 9 defines the AQI levels.
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Table 9. General Health Effects and Cautionary Statements, Air Quality Index
Index Value Descriptor Color Code Meaning
Air quality is satisfactory, and air pollution poses little or no Up to 50 Good Green risk.
Air quality is acceptable; however, for some pollutants there 51 to 100 Moderate Yellow may be a moderate heath concern for a very small number of people who are unusually sensitive to air pollution. Unhealthy Members of sensitive groups may experience health effects. 101 to 150 for sensitive Orange The general public is not likely to be affected. groups
Everyone may begin to experience health effects; members 151 to 200 Unhealthy Red of sensitive groups may experience more serious health effects.
Very Health alert: everyone may experience more serious health 201-300 Purple unhealthy effects.
Health warnings of emergency conditions. The entire 301-500 Hazardous Maroon population is more likely to be affected.
Source: AIRNow, Air Quality Index (AQI) – A Guide to Air Quality and Your Health; http://airnow.gov/index.cfm?action=aqibasics.aqi
In 2008 (the most recent data available at the time this report was prepared), Person County registered no “unhealthy” AQI days, five days with an AQI in the “unhealthy for sensitive groups” category, and 35 days in the “moderate” AQI category. In all 40 of these less-than-good daily AQI ratings in Person County the offending pollutant was ozone. Statewide, there were only a few counties that experienced days with “unhealthy” AQI measurements in 2008: Mecklenburg County (3 days), and Chatham, Durham, Guilford, Lincoln, Martin, New Hanover, Pitt and Wake Counties (1 day each) (25).
Sources of Criteria Air Pollutants
The sources of criteria and other air pollutants are categorized as mobile, area, or point sources, each of which is described below.
Mobile sources include on-road vehicles like cars, trucks and busses as well as off-road equipment like airplanes, construction and agricultural equipment. Mobile sources are the primary source of criteria air pollutants in the US (60.2% of the total tonnage). Nationally, mobile sources provide most carbon monoxide (77.1%), nitrogen oxides (55.5%), and large particulate matter (40.3%) CAPs (26).
Area sources are defined as sources that emit less than 10 tons per year of a criterion or hazardous air pollutant or less than 25 tons per year of a combination of pollutants. Such sources include dry cleaners, gas stations and auto body paint shops, and heating and cooling units in residential and commercial buildings. Waste disposal in the form of open burning, landfills and wastewater treatment also are significant area sources. Nationally, area sources account for only 21.6% of criteria air pollutants, and are not the source for the majority of any of these pollutants (26).
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Point sources are those facilities that emit 10 tons a year of any of the criteria or hazardous air pollutants or 25 tons per year of a mixture of air toxics. Such sources include major industrial facilities like chemical plants, steel mills, oil refineries, power plants and hazardous waste incinerators. Nationwide point sources contribute the majority (90%) of sulfur dioxide emissions, and account for about 40% of total nitrogen oxide releases (26).
EPA Air Quality Non-Attainment Areas
As of April 21, 2011, the EPA had designated seven NC counties (Cabarrus, Gaston, Iredell, Lincoln, Mecklenburg, Rowan and Union) as “moderate/non-attainment” counties regarding ozone standards. The determination was based on air quality monitoring data that shows ozone levels exceed the 8-hour ozone standard in these parts of NC (especially during the warmer months). Additionally, the EPA designated three NC counties (Catawba, Davidson, and Guilford) as “non-attainment” regarding small particulate matter (PM 2.5) (27). The State is required to develop remediation plans for the non- attainment counties that include proposals for curbing ozone by reducing emissions from vehicles, industries and power plants (28).
The EPA has not designated any NC counties as “non-attainment” for carbon monoxide, nitrogen dioxide, ozone (1 hour), sulfur dioxide, large particulate matter, or lead (27).
Person County is not on any CAP non-attainment list, nor is it adjacent to any counties that are.
Vehicle Emission Inspection Mandates
The state of NC is fighting an on-going battle against ozone-forming emissions from gasoline-operated cars and light duty trucks. Since 2002, licensed inspection stations have been required to conduct inspections using a vehicle’s on-board diagnostic (OBD) system, computerized equipment installed on all new vehicles since 1996. Though they are still required to obtain a safety inspection, diesel- operated vehicles are exempt from the annual emissions inspection (29).
Special emissions inspections currently are required in 48 counties: Alamance, Brunswick, Buncombe, Burke, Cabarrus, Caldwell, Carteret, Catawba, Chatham, Cleveland, Craven, Cumberland, Davidson, Durham, Edgecombe, Forsyth, Franklin, Gaston, Granville, Guilford, Harnett, Haywood, Henderson, Iredell, Johnston, Lee, Lenoir, Lincoln, Mecklenburg, Moore, Nash, New Hanover, Onslow, Orange, Pitt, Randolph, Robeson, Rockingham, Rowan, Rutherford, Stanly, Stokes, Surry, Wake, Wayne, Wilkes, Wilson and Union (29). Note that Person County is not on this list; most of these counties are in major population centers or along the major Interstate highway corridors crossing the state.
Vehicle Miles Driven
Since most CAPs are emitted by mobile sources, it is instructive to examine the patterns and trends in vehicle miles driven (VMD). While state and local data are difficult to obtain, a recent national study by the US Department of Transportation reveals some interesting information about a continuing decline in VMD.
Figure 2 shows the annual change in the rolling 12-month average of VMD in the US for the period from January 1972 through January 2008. (The researchers used the rolling average statistical technique to
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remove data “noise” and seasonality.) According to this graph, vehicle miles driven were off 3.6% Year-over-Year (YoY) between 2007 and 2008. This decline in miles driven is larger than declines during the early '70s and the 1979-1980 oil crisis (as denoted by the overall length of the respective line segments into negative values) (30). This trend, along with improved auto emissions and an increase in the number of hybrid- and electric vehicles on the road, as well as recent spikes in the cost of gasoline may be affecting (i.e., decreasing) mobile CAPs nationally.
Figure 2. Vehicle Miles Driven in the US as Year-over-Year Change (1972-2008)
Source: Calculated Risk, Finance and Economics, Thursday, February 19, 2009, US Vehicle Miles Driven Off 3.6% in 2008. Available at: http://www.calculatedriskblog.com/2009/02/us-vehicle-miles-driven-off-36-in-2008.html
Vehicles Powered by Alternative Fuels
One way to overcome air pollution from the combustion of gasoline is to power automobiles by alternative, lower-polluting fuels. According to data from the US Census Bureau presented in Table 10 (following page), the total number of vehicles in the US powered by alternative fuels increased every year from 2004 through 2007 (31).
It must be noted, however, that the data in this table excludes perhaps the fastest-growing segment of alternatively-fueled vehicles: gasoline-electric (or diesel-electric) hybrids. Up until now the US Census Bureau has excluded vehicles in this category because the input fuel in these vehicles is gasoline or diesel rather than a totally alternative transportation fuel.
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Given the recent influx of hybrid vehicles on the automotive market, it may be necessary to provide an accounting of these types in future Census counts of alternative fueled vehicles. For example, according to one source, there were 308,001 hybrid cars sold in the US in 2008, and 290,272 sold in 2009. In 2009 the total number of hybrid cars registered in the US was estimated at 1.6 million (32). J.D. Power and Associates, an automotive research company, expects the number of hybrid cars on the road will triple by year 2015, to a vehicle market share of approximately ten percent (33).
Table 10. Number of Vehicles in the US Powered by Alternative Fuels, 2004-2007
Number of Alternative Fueled Vehicles Fuel Type 2004 2005 2006 2007 Compressed Natural Gas (CNG) 118,532 117,699 116,131 114,391 Electric (all electric) 49,536 51,398 53,526 55,730 Ethanol, 85 percent (E85) 211,800 246,363 297,099 364,384 Hydrogen 43 119 159 223
Liquefied Natural Gas (LNG) 2,717 2,748 2,798 2,781 Liquefied Petroleum Gas (LPG) 182,864 173,795 164,846 158,254 Other fuels -- 3 3 3 TOTAL 565,492 592,125 634,562 695,766
Source: US Census Bureau. The 2010 Statistical Abstract. Transportation: Motor Vehicle Registrations, Alternative Fuel Vehicles. Table 1061. Alternative Fueled Vehicles and Estimated Consumption of Vehicle Fuels by Fuel Type: 2004 to 2007. Available at: http://www.census.gov/compendia/statab/2010/tables/10s1061.pdf
Mass Transportation
The Public Transportation Division (PTD) of the NC Department of Transportation (DOT) was created in 1974 by the NC General Assembly to foster the development of intercity, urban and rural (now referred to as "community") public transportation in the state. This agency administers federal and state transportation grant programs, provides safety and training opportunities for transit professionals; and makes planning and technical assistance available. According to PTD, community, regional community, urban, and regional urban transportation systems in NC serve more than 62 million passengers each year via intercity bus, rail, air and ferry services (34).
According to the NC DOT Statewide Local Transit Information Site and associated local links (35), Person County is served by Person Area Transportation System (PATS), a curb-to-curb paratransit transportation system, providing appointment-based dial-a-ride services. Transportation is provided for purposes of in-county work, recreation, human service appointments, or shopping. Out-of-county transportation trips are provided for medical purposes only. PATS operates Monday through Friday, but not on weekends or on holidays. The system operates a total of 15 vehicles, including buses, passenger vans, mini-vans, and lift vans that can accommodate wheelchairs or other mobility aids. PATS maintains contracts to provide transportation services on behalf of a number of human service agencies in the county including the Departments of Public Health and Social Services.
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Hazardous Air Pollutants
Hazardous Air Pollutants (HAPs) refer to over 188 chemicals that can cause adverse effects on human health and the environment. They include substances that can cause cancer, neurological, respiratory, and reproductive effects in humans. HAPs are ranked by a method that combines exposure data from the EPA National-Scale Air Toxics Assessment (NATA) with toxicity data to estimate the health risks posed by chemical pollutants in ambient air. The exposure estimates used in determining risk are based on 1996 emissions data. (It is necessary to rely on exposure estimates rather than actual monitoring because there are fewer than 50 monitoring stations measuring outdoor levels of HAPs in the entire country. NATA currently provides the only data available for assessing the extent of exposures to hazardous air pollutants across the entire US.) Scorecard, the source of much of the following data, uses conventional risk assessment methods to produce a screening-level health risk assessment, which offers valuable information about the magnitude and sources of hazardous air pollution problems (36). Although it is useful and interesting to identify problem-level HAPs in the local environment, the use of this “applied” statistical data comes with some important cautions.
Caveats in Using HAP Assessment Data
Effect of Using 1996 Exposure Estimates. EPA cautions against "using the results of the National- Scale Air Toxics Assessment modeling exercise alone to draw real-world conclusions about current local conditions" because of the limitations involved in modeling exposures using 1996 emissions data. There clearly have been changes in emissions since 1996 in pollution sources and quantities that may affect the reliability of EPA's exposure estimates. For example, some pollution sources have come under substantial regulatory controls since 1996, and others have grown in importance. Nevertheless, EPA comparisons among 1996 monitoring data, NATA estimates and current monitoring data found that modeled estimates are generally consistent with current concentrations (37).
Effect of Focusing of Small Geographic Areas or Individual Sources. Uncertainties in the accuracy of exposure data and source apportionment increase as the scale of geographic analysis decreases to the census tract or source-specific level. EPA recommends the county level of resolution because emissions inventory data for some pollutants and sources are only available at the county level and there are large uncertainties regarding exposure modeling parameters at the tract level (37).
Effect of Uncertainty on Health Risk Assessment. Scorecard applies conventional health risk assessment methods to characterize potential cancer and noncancer risk. Note that risk estimates are calculations based on models; hence they are useful for ranking purposes but are not necessarily predictive of any actual individual's risk of getting cancer or other diseases. Risk assessment methods rely on the use of assumptions to address gaps in scientific understanding and data. Some assumptions err on the side of health protection (e.g., presuming animal carcinogens are potential human carcinogens) and may result in overestimation of health risk. Other assumptions may result in underestimated health risk (e.g., presuming all people have equal susceptibility to toxicants) (37).
Note that NATA includes only chronic health effects from inhalation exposure to outdoor sources of air toxics. Effects from less-than-lifetime exposures (e.g., accidental chemical releases) and total exposure to air toxics (e.g., including indoor air pollution sources) require further evaluation. In addition, because EPA's methodology only considers inhalation, exposures to HAPs which are persistent or bioaccumulative may be significantly underestimated by NATA. For example, ingestion of contaminated food, water or soil is likely to result in substantially greater human exposures than inhalation for lead, mercury, cadmium, polychlorinated biphenyls, dioxin, hexachlorobenzene, polycyclic
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Person County Community Health Assessment – Volume Two Air Quality aromatic hydrocarbons, and polycyclic organic matter. Other HAPs exposures that may be significantly underestimated by NATA for various technical reasons include formaldehyde, acetaldehyde, acrolein, and lead (37).
Effects of Limitations in Emissions Inventories. Limitations in available emissions inventories for mobile sources may impact the accuracy of NATA results. In its assessment of on-road emissions, EPA uses population data as a surrogate to project vehicle miles traveled. This method results in underestimation of on-road emissions in more suburban counties, while largely overestimating on-road emissions in urban counties. In its assessment of off-road emissions, EPA uses economic measures of construction activity as a surrogate to project emissions from off-road engines. This method distorts the relative contribution of off-road diesel sources in urban counties where housing and commercial building prices are extremely high (37).
Cancer and Non-Cancer HAP Risks
Risk due to HAPs is estimated by two measures: added lifetime cancer risk for carcinogenic HAPs, and cumulative hazard indices for chemicals with non-cancer effects.
Added Cancer Risk. Added cancer risk is the estimated individual risk of getting cancer due to a lifetime exposure to outdoor HAPs. The goal of the Clean Air Act is to reduce lifetime cancer risk from HAPs to 1 in 1,000,000, so added cancer risk is expressed as a multiple of this measure. For example, an added risk of 550 per 1,000,000 is 550 times higher than the Clean Air Act goal (38).
According to EPA data accessed via Scorecard, Mecklenburg County is the NC county with the highest added cancer risk to individuals from hazardous air pollutants; its added cancer risk score is 800 (39). It also has the greatest population living in proximity to such risk (40). The primary offending HAP in Mecklenburg County is diesel emissions (41). Of the 100 counties in NC, Person County ranked 17th in terms of an individual’s added cancer risk (39). The estimated added cancer risk for the Person County population is 360; i.e., it is 360 times the goal set by the Clean Air Act (39). The primary HAP contributing to the added cancer risk is diesel emissions (42).
The cancer risk from diesel emissions in Person County comes primarily from both mobile sources (49%) and point sources (46%), with area sources contributing only 5% to the problem (43). The mobile sources of diesel emissions include on-road vehicles such as cars, buses and trucks, and off- road equipment, such as boats and agricultural and construction equipment. Point sources for diesel emissions traditionally include major industrial facilities like chemical plants, steel mills, oil refineries, power plants, and hazardous waste incinerators. Point sources are defined as those that emit 10 tons per year of any of the criteria pollutants or hazardous air pollutants or 25 tons per year of a mixture of air toxics (44). In Person County the primary point sources of diesel emissions are power plants.
Health Effects of Diesel Emissions. The microscopic particles in diesel exhaust are small enough to penetrate deep into the lungs, where they contribute to a range of health problems. Diesel exhaust and many individual substances contained in it (including arsenic, benzene, formaldehyde and nickel) have the potential to contribute to mutations in cells that can lead to cancer. In fact, long-term exposure to diesel exhaust particles poses the highest cancer risk of any toxic air contaminant evaluated by the California Office of Environmental Health Hazard Assessment (OEHHA). In its comprehensive assessment of diesel exhaust, OEHHA analyzed more than 30 studies of people who worked around diesel equipment, including truck drivers, railroad workers and equipment operators. The studies showed these workers were more likely to develop lung cancer than workers who were not exposed to
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diesel emissions. These studies provide strong evidence that long-term occupational exposure to diesel exhaust increases the risk of lung cancer (45).
While cancer resulting from long-term exposure to diesel emission can take years to develop, short- term exposure can have immediate health effects. Diesel exhaust can irritate the eyes, nose, throat and lungs, and it can cause coughs, headaches, lightheadedness and nausea. In studies with human volunteers, diesel exhaust particles made people with allergies more susceptible to the materials to which they are allergic, such as dust and pollen. Exposure to diesel exhaust also causes inflammation in the lungs, which may aggravate chronic respiratory symptoms and increase the frequency or intensity of asthma attacks (45).
Cumulative Hazard Index. Non-cancer hazard from HAPs is measured by the Cumulative Hazard Index (CHI), which is calculated as the concentration of a HAP divided by its safe exposure level. Therefore, if a hazard index exceeds 1, the resulting exposure level may pose non-cancer risks such as neurological, respiratory, reproductive, developmental or other adverse health effects. The goal of the Clean Air Act is to attain an “ample margin of safety to protect public health”, or an index of less than 1. A cumulative hazard index of 55, for example, is 55 times higher than the Clean Air Act goal (38).
According to data from Scorecard, Person County ranks 10th out of all NC counties for non-cancer CHI with a score of 2.2, more than double the Clean Air Act goal of 1.0. Mecklenburg County, which is ranked as the NC county with the highest risks of any kind, has a CHI of 3.5 (46).
The sources of the pollutants that contribute to non-cancer health risks are not as easy to pinpoint as those leading to higher cancer risks, and they vary much more from county to county. However the most significant non-cancer hazardous air pollutant in both Mecklenburg and Person Counties is acrolein (47, 48). This chemical is ranked among the worst 10% of compounds hazardous to ecosystems and human health, and is on at least 10 federal regulatory lists. Acrolein is produced in high volume (exceeding 1 million pounds annually in the US); it is found in consumer products, building materials or furnishings, and pesticide products, and contributes to indoor air pollution. Acrolein is suspected of being a carcinogen, a cardiovascular or blood toxicant, a developmental toxicant, a gastrointestinal or liver toxicant, a neurotoxicant, a respiratory toxicant, and a skin or sense organ toxicant (49). In Person County, area sources contribute 38% to the cumulative hazard index while mobile and point sources each contribute 31% to the CHI (50).
Indoor Ambient Air
The quality of the air inside buildings has received greater attention in recent years than in the past. Indoor ambient air pollutants can have both short-term and long-term health effects. Immediate effects may show up after a single exposure or after repeated exposures. Health effects from indoor air pollutants include irritation of the eyes, nose, and throat, headaches, dizziness, and fatigue. Such immediate effects are usually short-term and treatable. Sometimes the treatment is simply eliminating the person's exposure to the source of the pollution, if it can be identified. Symptoms of some diseases, including asthma, may also show up soon after exposure to some indoor air pollutants (51).
Other health effects may show up either years after exposure has occurred or only after long or repeated periods of exposure. These effects, which include some respiratory diseases, heart disease, and cancer, can be severely debilitating or fatal (51).
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The primary cause of indoor air quality problems in homes is the release of gases or particles into the air, from sources including: combustion (oil, gas, kerosene, coal and wood as well as tobacco products); wet, damp or deteriorated insulation or carpet; cabinetry and furniture made of certain pressed wood products; chemical products for cleaning, personal care, or hobbies; and central heating and cooling systems and humidification devices. Also of concern are gases from the outside such as radon, pesticides, and outdoor air pollution that seep into homes. Inadequate ventilation can increase indoor pollutant levels by not bringing in enough outdoor air to dilute emissions from indoor sources and by not carrying indoor air pollutants out of the home (51). Specific indoor ambient air pollutants of concern include carbon monoxide, radon, and tobacco smoke.
Carbon Monoxide
Carbon monoxide (CO) is an odorless, colorless and toxic gas. It is impossible to see, taste or smell the toxic fumes of CO, and it does not irritate the skin, eyes, or lungs. Called the “silent killer”, CO can cause death before the exposed person becomes aware of its presence. The effects of CO exposure can vary greatly from person to person depending on age, overall health and the concentration and length of exposure (52).
At low concentrations, health effects of CO exposure include fatigue in healthy people and chest pain in people with heart disease. At higher concentrations, exposure effects include impaired vision and coordination, headaches, dizziness, confusion, and nausea. Moderate exposures can cause angina, impaired vision, and reduced brain function, but can also result in flu-like symptoms that may clear up after leaving the vicinity of the source. At very high concentrations, death can occur due to the formation of carboxyhemoglobin in the blood, which inhibits oxygen intake (52).
The sources of CO include: unvented kerosene and gas space heaters; leaking chimneys and furnaces; back-drafting from furnaces, gas water heaters, wood stoves, and fireplaces; worn or poorly maintained gas stoves; generators and other gasoline powered equipment; automobile exhaust in attached garages; and tobacco smoke. Auto, truck, or bus exhaust from attached garages, nearby roads, or parking areas can also be a source (53).
Carbon Monoxide Poisoning Deaths
CO may be the cause of more than one-half of the fatal poisonings reported in many countries. Because fatal cases are believed to be grossly under-reported or misdiagnosed by medical professionals, the precise number of individuals who have suffered from CO intoxication probably is not known (53).
According to data compiled by the CDC, unintentional CO exposure accounts for an estimated 15,000 emergency department visits and 500 unintentional deaths in the US each year. During the period 1999-2004, an average of 439 persons died annually from unintentional, non-fire-related CO poisoning, and the national average annual death rate was 1.5 per 1 million persons. However, rates varied by demographic subgroup, month of the year, and state. Rates were highest among adults aged >65 years, men, non-Hispanic whites, and non-Hispanic blacks. The average number of deaths was highest during the month of January (54).
In 2009 in NC, there were 15 deaths attributable to accidental exposure to non-organic gases and vapors including carbon monoxide (ICD 10 Code X47) and an additional 33 deaths due to intentional
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Radon
Radon is a naturally occurring, invisible, odorless gas that comes from soil, rock and water. It is a radioactive decay product of radium, which is in turn a decay product of uranium; both radium and uranium are common elements in soil. Radon usually is harmlessly dispersed in outdoor air, but when trapped in buildings it can be harmful. Most indoor radon enters a home from the soil or rock beneath it, in the same way air and other soil gases enter: through cracks in the foundation, floors, hollow-block walls, and openings around floor drains, heating and cooling ductwork, pipes, and sump pumps. The average outdoor level of radon in the air is normally so low that it is not a problem (57).
Trace amounts of uranium are sometimes incorporated into construction materials such as concrete, brick, granite and drywall. Although these materials have the potential to produce radon, they are rarely the main cause of elevated radon levels in buildings (57).
Radon may also be dissolved in water as it flows over radium-rich rock formations. Dissolved radon can be a health hazard, although to a lesser extent than radon in indoor air. Homes supplied with drinking water from private wells or from community water systems that use wells as water sources generally have a greater risk of exposure to radon in water than homes receiving drinking water from municipal water treatment systems. This is because well water comes from ground water, which has much higher levels of radon than surface waters. Municipal water tends to come from surface water sources which are naturally lower in radon, and the municipal water treatment process itself tends to reduce radon levels even further (58).
Elevated levels of radon have been found in many counties in NC, but the highest levels have been detected primarily in the upper Piedmont and mountain areas of the state where the soils contain the types of rock (gneiss, schist and granite) that have naturally higher concentrations of uranium and radium (59). Eight counties in NC appear to have the highest levels of radon, exceeding, on average, 4 pCi/L (pico curies per liter). These counties are Alleghany, Buncombe, Cherokee, Henderson, Mitchell, Rockingham, Transylvania and Watauga. There are an additional 31 counties in the central and western Piedmont area of the state with radon levels in the 2-4 pCi/L range; the remaining 61 NC counties, mostly in the piedmont and eastern regions of the state and including Person County, have predicted indoor radon levels of less than 2 pCi/L (60).
According to county-level data provided by the NC Radon Program, the average radon level among 15 Person County air samples reported in 2004 was 2.43 pCi/L (61), slightly outside the expected range.
Health Risks of Radon
There are no immediate symptoms to indicate exposure to radon. The primary risk of exposure to radon gas is an increased risk of lung cancer (after an estimated 5-25 years of exposure). Smokers are at higher risk of developing radon-induced lung cancer than non-smokers. There is no evidence that other respiratory diseases, such as asthma, are caused by radon exposure, nor is there evidence that children are at any greater risk of radon-induced lung cancer than are adults (62).
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In 2003, the EPA worked with the National Academy of Science (NAS) to update the estimates of lung cancer risks from indoor radon. The EPA’s updated best national estimate of annual lung cancer deaths from radon is about 21,000 (63). Table 11 shows the lifetime risk of lung cancer death per person from radon exposures of certain levels in homes.
Table 11. Lifetime Risk of Lung Cancer Death (per person) from Radon Exposure in the Home1
Radon Level Never Smokers Current Smokers General Population (pCi/L) 20 36 out of 1,000 260 out of 1,000 110 out of 1,000
10 18 out of 1,000 150 out of 1,000 56 out of 1,000 8 15 out of 1,000 120 out of 1,000 45 out of 1,000
4 73 out of 10,000 620 out of 10,000 230 out of 10,000 2 37 out of 10,000 320 out of 10,000 120 out of 10,000 1.25 23 out of 10,000 200 out of 10,000 73 out of 10,000 0.4 73 out of 100,000 640 out of 100,000 230 out of 100,000
Source: US Environmental Protection Agency, Air, Indoor Air Quality, Radon, Health Risks, Report: Assessment of Risks from Radon in Homes; http://www.epa.gov/radon/risk_assessment.html 1 Assumes constant lifetime exposure in homes at these levels.
Environmental Tobacco Smoke
Tobacco smoking has long been recognized as a major cause of death and disease, responsible for hundreds of thousands of deaths each year in the US. Smoking is known to cause lung cancer in humans, and is a major risk factor for heart disease. However, it is not only active smokers who suffer the effects of tobacco smoke. In 1993, the EPA published a risk assessment on passive smoking and concluded that the widespread exposure to environmental tobacco smoke (ETS) in the US presented a serious and substantial public health impact (64).
ETS is a mixture of two forms of smoke that come from burning tobacco: sidestream smoke (smoke that comes from the end of a lighted cigarette, pipe, or cigar) and mainstream smoke (smoke that is exhaled by a smoker). When non-smokers are exposed to secondhand smoke it is called involuntary smoking or passive smoking. Non-smokers who breathe in secondhand smoke take in nicotine and other toxic chemicals just like smokers do. The more secondhand smoke that is inhaled, the higher the level of these harmful chemicals will be in the body (65).
Secondhand smoke causes harm in many ways (65). In the US alone, each year it is responsible for:
an estimated 46,000 deaths from heart disease in non-smokers who live with smokers; about 3,400 lung cancer deaths in non-smoking adults; other breathing problems in non-smokers, including coughing, mucus, chest discomfort, and reduced lung function;
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50,000 to 300,000 lung infections (such as pneumonia and bronchitis) in children younger than 18 months of age, which result in 7,500 to 15,000 hospitalizations annually; increases in the number and severity of asthma attacks in about 200,000 to 1 million children who have asthma; more than 750,000 middle ear infections in children; and pregnant women exposed to secondhand smoke are also at increased risk of having low birth- weight babies.
In 2006 the US Surgeon General issued a report (66) with a number of significant conclusions:
Secondhand smoke causes premature death and disease in children and in adults who do not smoke. Children exposed to secondhand smoke are at an increased risk of sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more severe asthma. Smoking by parents causes breathing (respiratory) symptoms and slows lung growth in their children. Secondhand smoke immediately affects the heart and blood circulation in a harmful way. Over a longer time it also causes heart disease and lung cancer. The scientific evidence shows that there is no safe level of exposure to secondhand smoke Many millions of Americans, both children and adults, are still exposed to secondhand smoke in their homes and workplaces despite a great deal of progress in tobacco control. The only way to fully protect non-smokers from exposure to secondhand smoke indoors is to prevent all smoking in that indoor space or building. Separating smokers from non-smokers, cleaning the air, and ventilating buildings cannot keep non-smokers from being exposed to secondhand smoke.
There are four places where exposure to second-hand smoke is prevalent: at work, in public places, at home, and in the car. Through the relatively recent intervention of federal, state and local governments, as well as some health-conscious businesses, smoking is increasingly prohibited in workplaces and restaurants, and in schools and government properties of all kinds, by policy or by law. In NC, entire school campuses and government offices are now smoke-free, as are most restaurants and bars. Nevertheless, smoking is still popular among state residents, and exposure to second-hand smoke remains a problem.
According to the 2010 NC Behavioral Risk Factor Surveillance System (BRFSS) Survey results, 20% of respondents statewide self-identified as “current smokers” (67). This figure represents a 13% decrease from the comparable 2006 BRFSS figure of 23% (68) that was reported in the 2007 Person County CHA. No comparable county-specific 2006 or 2010 BRFSS data exist that is specific for Person County, but smoking habit questions were part of the 2007 and 2011 Person County Community Health Surveys. According to results of the 2007 survey, 20% of respondents reported being “current smokers” (69); according to results from the 2011 survey, 14% of respondents (n=108) self-reported as current smokers (see Volume I of this report, Chapter Four: Community Health Survey). This data demonstrates an apparent 30% decrease in the smoking population. Approximately 19% of the current smokers (n=20) say they do not want to quit smoking.
A recent UNC poll revealed that smoke-free policies are supported by large majority of NC citizens (70). On January 2, 2010, NC became the first tobacco-producing state in the nation to ban smoking in restaurants and bars. The poll, conducted after the law went into effect, shows that the ban is supported by 72.2% of adults in the state. The poll also found 25.8% of the population opposed the
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ban, and 2.1% were undecided. Proponents were more likely to be nonsmokers (85.5% vs. smokers 30.7%), women (80.3% vs. men 63.5%), and more highly educated (82.1% vs. lower education 60.2%).
In addition, a large majority–72.1%–said they would support a law that requires all indoor workplaces and public places to be smoke-free, while 25.8% opposed such a measure and 2.1% were undecided.
Concern was voiced during the debate on the legislation that it would have a deep, negative economic impact on restaurants and bars. However, the new poll suggests the opposite may be true. Despite the challenging economic times, 38.8% of adults said they dine out more since the ban took effect, 50.4% said it has made no difference, and only 10.6% said they go out less often.
Other Health Effects of Air Pollution
Air pollutants besides radon and tobacco smoke pose health risks that include respiratory problems, exacerbated allergies, asthma, and increased incidence of cardiovascular disease. This is especially true for vulnerable populations such as children, the elderly, pregnant women, those with heart or lung disease, and people with weakened immune systems.
Sick Building Syndrome/Building Related Illness
According to the EPA, the term "sick building syndrome" (SBS) is used to describe situations in which building occupants experience acute health and comfort effects that appear to be linked to time spent in a building, but for which no specific illness or cause can be identified. The complaints may be localized in a particular room or zone, or may be widespread throughout the building. In contrast, the term "building related illness" (BRI) is used when symptoms of diagnosable illness are identified and can be attributed directly to airborne building contaminants (71).
Indicators of SBS include:
Building occupants complain of symptoms associated with acute discomfort, such as headache; eye, nose, or throat irritation; dry cough; dry or itchy skin; dizziness and nausea; difficulty in concentrating; fatigue; and sensitivity to odors. The cause of the symptoms is not known. Most of the complainants report relief soon after leaving the building.
Indicators of BRI include:
Building occupants complain of symptoms such as cough; chest tightness; fever, chills; and muscle aches. The symptoms can be clinically defined and have clearly identifiable causes. Complainants may require prolonged recovery times after leaving the building.
It is important to note that complaints may result from other causes. These may include an illness contracted outside the building, acute sensitivity (e.g., allergies), job related stress or dissatisfaction, and other psychosocial factors. Nevertheless, studies show that symptoms may be caused or exacerbated by indoor air quality problems (71).
A number of factors have been cited as causing or contributing to SBS, among them:
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inadequate ventilation; chemical contaminants from indoor sources (adhesives, carpeting, upholstery, manufactured wood products, copy machines, pesticides, and cleaning agents, especially those emitting volatile organic compounds; environmental tobacco smoke; respirable particulate matter; and combustion products such as carbon monoxide and nitrogen dioxide from unvented kerosene and gas space heaters, woodstoves, fireplaces and gas stoves); chemical contaminants from outdoor sources (pollutants from motor vehicle exhausts; plumbing vents, and building exhausts that enter buildings through poorly located air intake vents, windows, and other openings or garages); and biological contaminants (bacteria, molds, pollen, and viruses that may breed in stagnant water in ducts, humidifiers and drain pans, or where water has collected on ceiling tiles, carpeting, or insulation; also in insect or bird droppings) (71).
In order to establish a cause-and-effect relationship between the symptoms of an illness and a contaminant of an indoor environment it is necessary to conduct an investigation that demonstrates both (a) the presence of a contaminant in the environment and, and (b) that the physical or mental complaint is actually caused or exacerbated by that contaminant. Proving such relationships is exceedingly difficult. There are no public statistics in NC cataloging SBS or BRI.
Asthma
Asthma is a chronic respiratory disease that inflames and narrows the airways of the lungs, causing recurring periods of wheezing, chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. Asthma attacks can vary from mild to life-threatening. Asthma affects people of all ages, but it most often starts in childhood. In the US, more than 22 million people are known to have asthma; nearly 6 million of these people are children (72).
The exact cause of asthma isn't known. Researchers think a combination of factors (family genes and certain environmental exposures) interact to cause asthma to develop, most often early in life. These factors include: an inherited tendency to develop allergies (called atopy); parents who have asthma; certain respiratory infections during childhood; and contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing (72).
Air Pollution Asthma Triggers. Sources of indoor and outdoor air pollution can trigger asthma attacks. Some of the most common indoor asthma triggers include secondhand smoke, dust mites, mold, cockroaches and other pests, pet dander, and combustion byproducts. In addition, even low levels of exposure to nitrogen dioxide (as a byproduct of fuel-burning appliances such as gas stoves, gas or oil furnaces, fireplaces, wood stoves and unvented kerosene or gas space heaters) may cause increased bronchial reactivity in people with asthma, and make young children more susceptible to respiratory infections. Long-term exposure to high levels of NO2 can lead to chronic bronchitis (73).
Outdoor asthma triggers include high levels of ozone and particulate pollution, which have been associated with 10-20% of all respiratory hospital visits and admissions (74).
Asthma Prevalence among Adults. According to CDC data based on the national BRFSS Survey, in 2008, 13.3% of the adult respondents in the US and 11.7% of the respondents in NC reported having been diagnosed with asthma at some point in their lifetime (lifetime prevalence). These percentages
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extrapolate to approximately 30.9 million lifetime asthma diagnoses nationally and 803,000 diagnosis in NC (75).
As noted in Volume One of this report, the NC BRFSS regional population sample that includes Person County is too large and diverse to yield county-specific data. Both the 2007 and 2011 Person County Community Health Surveys attempted to estimate the lifetime prevalence of asthma in the community. In response to the question, “Have you ever been told by a doctor, nurse, or other health professional that you had asthma”, 13% of respondents to the 2007 survey answered “yes” (69). In 2011, 11% (n=85) of survey respondents answered “yes” to the same question (see Volume I of this report, Chapter Four: Community Health Survey). Interestingly, of the 85 Person County residents who self- reported having asthma, 11 (13%) also self reported being current smokers. According to the 2010 NC Behavioral Risk Factor Surveillance System (BRFSS) Survey results, 13% of respondents statewide reported having been told they had asthma (76). This figure represents an 18% increase from the comparable 2006 BRFSS figure of 11% (77).
Estimates of current prevalence of asthma among US adults are somewhat lower than estimates of lifetime prevalence. According to data from the National Center for Health Statistics (78), 7.3% of non- institutionalized adults in the US (a total of 16.4 million) currently have asthma.
Asthma Prevalence among Children. With regard to childhood asthma, CDC data from the 2008 National BRFSS survey indicates that 13.3% of children referenced in the survey sample had been diagnosed with asthma; this lifetime prevalence rate translates to approximately 7.6 million lifetime diagnoses of childhood asthma (79). The 2006 and 2010 NC BRFSS surveys did not implement the childhood asthma question module, so no comparable state data is available.
According to recent (2009) data from the National Center for Health Statistics, the current prevalence rate of childhood asthma in the US is 9.4% (7.0 million children) (78).
Asthma Mortality. According to preliminary national data for 2008, there were 3,395 deaths in the US attributable to asthma, yielding a corresponding age-adjusted death rate of 1.0 per 100,000 population (80). Asthma deaths among children are relatively rare; in 2006, 131 of the 3,613 asthma deaths nationally (4%) were among children under the age of 15 (81).
In 2009, there were 94 deaths statewide in NC attributed to asthma; two of these deaths occurred in children under the age of 15 (82). In Person County between 2006 and 2009 there was a total of five deaths (all adults) attributed to asthma (83).
Cardiovascular Events
During the last decade, epidemiological studies conducted worldwide have shown a consistent, increased risk for cardiovascular events, including heart and stroke deaths, in relation to short- and long-term exposure to outdoor air pollution, especially particulate matter. Elderly patients, people with underlying heart or lung disease, populations of lower socioeconomic status and diabetics may be at particularly increased risk.
In 2004, the American Heart Association (AHA) issued a scientific statement on “Air Pollution and Cardiovascular Disease,” concluding that exposure to particulate matter (PM) air pollution contributes to cardiovascular morbidity and mortality. Since then, numerous studies expanded understanding of this association and further elucidated the physiological and molecular mechanisms involved. In 2010, the
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AHA updated its original statement, citing the following findings regarding exposure to small particulate matter in air (84):
Exposure to small particulate matter (PM2.5) over a few hours to weeks can trigger cardiovascular disease–related mortality and nonfatal events. Longer-term exposure (e.g., a few years) to PM increases the risk for cardiovascular mortality to an even greater extent than exposures over a few days and reduces life expectancy within more highly exposed segments of the population by several months to a few years. Overall evidence is consistent with a causal relationship between PM2.5 exposure and cardiovascular morbidity and mortality. Reductions in PM levels are associated with decreases in cardiovascular mortality within a time frame as short as a few years.
And concluding the following: PM2.5 exposure is deemed a modifiable factor that contributes to cardiovascular morbidity and mortality (84).
A 2009 study that examined hospital records for 9.3 million Medicare enrollees as well as air pollution levels gathered between 1999 and 2005 in 126 urban counties around the US found that levels of ambient carbon monoxide (CO) in the air well below accepted environmental standards are associated with an increased risk of hospital admissions for “heart problems” among the elderly. Specifically, a 1 part per million (ppm) increase in daily one-hour exposure was associated with a 0.96 percent increase in the risk of hospitalization for cardiovascular disease (CVD) outcomes (including ischemic heart disease, heart rhythm disturbances and heart failure, as well as cerebrovascular disease and total CVD) among people over the age of 65. According the study’s authors, the increased risk persisted at extremely low CO levels of less than 1 ppm, suggesting that the detrimental effects of even short exposure to low levels of CO or other traffic- related pollutants pose an under-recognized health risk to seniors (85).
Admittedly, a person’s relative cardiovascular risk due to air pollution is small compared with the impact of established cardiovascular risk factors such as smoking, obesity, or high blood pressure. However, it is fair to conclude that cardiovascular risk from air pollution is a serious public health problem because an enormous number of people are exposed over an entire lifetime.
At the present time there is no simple mechanism for linking cardiovascular events to air pollution at the county level.
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Person County Community Health Assessment – Volume Two Toxic Chemical Releases
Chapter Three: Toxic Chemical Releases
Toxic Release Inventory
Over 4 billion pounds of toxic chemicals are released into the nation’s environment each year. The US Toxic Releases Inventory (TRI) program, created in 1986 as part of the Emergency Planning and Community Right to Know Act, is the tool the EPA uses to track these releases. Approximately 20,000 industrial facilities are required to report estimates of their environmental releases and waste generation annually to the TRI program office. Their reports estimate the facilities’ releases of any of approximately 650 toxic chemicals to air, water, and land, as well as the quantities of chemicals they recycle, treat, burn or dispose of in any way on-site or off-site. These reports do not cover all toxic chemicals, and they omit pollution from motor vehicles and small businesses. Note that because TRI facilities in NC and most other states are not required to report the quantities of toxic chemicals actually used (inputs), but rather to report only estimates of emissions, TRI data may not be entirely realistic (86).
The EPA makes TRI data available through downloadable files and data access tools in order to provide communities with information about toxic chemical releases and waste management activities, and to support informed decision making at all levels by industry, government, non-governmental organizations, and the public (87).
TRI release data is available for 85 NC counties for 2009 (the most recent year). According to a February 2010 update of the 2009 EPA data, Person County was the NC county on the list with the largest quantity of TRI releases (total of on- and off-site disposal or other releases): 4,552,769 pounds; Davie County had the smallest quantity of releases: 27 pounds. Several of the 85 NC counties listed (Caswell, Clay, Greene, Macon, Pasquotank and Warren) had zero TRI releases (88).
Table 12 lists in alphabetical order the nine facilities in Person County that filed a TRI “Form R Report” with the EPA in 2009. The table shows for each facility the total pounds of chemicals released and whether the chemicals were released or disposed on- or off-site. (Note that the current name of Carolina Power and Light Company [CP&L] cited in the tables below is Progress Energy, and that Loxcreen Co., Inc. has closed since this data was reported.)
Table 12. EPA TRI Facility Report: Person County: Total Releases (Pounds), 2009
Total Pounds On- Total Pounds On- Total Pounds Off- and Off-Site Facility Site Disposal or Site Disposal or Disposal or Other Other Releases Other Releases Releases Aleris Rolled Products Inc., 4,328 0 4,328 Roxboro
Carolina Power & Light Co. Mayo Electric Generating 1,600,490 139,618 1,740,108 Plant, Roxboro
Carolina Power & Light Co. Roxboro Steam Electric 2,736,475 200 2,736,675 Plant, Semora
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Total Pounds On- Total Pounds On- Total Pounds Off- and Off-Site Facility Site Disposal or Site Disposal or Disposal or Other Other Releases Other Releases Releases CPI USA North Carolina LLC, 5 717 723 Roxboro
Eaton Corp., Roxboro 0 538 538
Georgia-Pacific Wood 635 0 635 Products LLC, Roxboro
Louisiana Pacific Corp., 31,530 0 31,530 Roxboro O OSB, Roxboro
Loxcreen Co Inc., Roxboro 807 2,374 3,181
US Flue Cured Tobacco 399 34,653 35,052 Growers Inc., Timberlake
TOTAL 4,374,669 178,100 4,552,769
Source: US Environmental Protection Agency, Toxic Release Inventory (TRI) Program, TRI Explorer, Reports, Facility Report, 2009, Select a State, North Carolina, Select from a List of Counties, Person, http://www.epa.gov/triexplorer/facility.htm
Table 13 presents details on the ten TRI chemicals released in greatest quantity in Person County in 2009, listed in descending order of pounds of chemical released regardless of release mode (89). (See the primary reference for the entire list.)
Table 13. TRI Chemical Releases in Person County, 2009
Total Pounds Pounds Disposed On- Facilities Releasing Chemical Chemical Off-Site/ Chemical per Facility Released CP&L Roxboro Plant 868,411 Barium compounds 1,146,225 CP&L Mayo Plant 277,814
CP&L Mayo Plant 670,000 Hydrochloric acid 679,300 CP&L Roxboro Plant 9,300
CP&L Mayo Plant 270,000 Sulfuric acid 540,000 CP&L Roxboro Plant 270,000 CP&L Roxboro Plant 331,842 Vanadium compounds 439,832 CP&L Mayo Plant 107,990
CP&L Roxboro Plant 272,6991 Manganese and manganese CP&L Mayo Plant 74,789 347,973 compounds Eaton Corp., Roxboro 538 Loxcreen Co. Inc., Roxboro 27
CP&L Roxboro Plant 196,813 Zinc compounds 261,891 CP&L Mayo Plant 65,078
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Total Pounds Pounds Disposed On- Facilities Releasing Chemical Chemical Off-Site/ Chemical per Facility Released
CP&L Roxboro Plant 180,601 Copper and copper 238,974 CP&L Mayo Plant 58,350 compounds Loxcreen Co. Inc., Roxboro 23
CP&L Roxboro Plant 159,168 Chromium and chromium 209,678 CP&L Mayo Plant 50,431 compounds Loxcreen Co. Inc., Roxboro 79
CP&L Roxboro Plant 151,629 Nickel and nickel compounds 202,745 CP&L Mayo Plant 50,649 Loxcreen Co. Inc., Roxboro 467
CP&L Roxboro Plant 92,833 Arsenic compounds 121,833 CP&L Mayo Plant 29,523
Source: US Environmental Protection Agency, Toxic Release Inventory (TRI) Program, TRI Explorer, Reports, Facility Report, 2009, Select a State, North Carolina, Select from a List of Counties, Person, http://www.epa.gov/triexplorer/facility.htm
For purposes of relating chemical releases to the health of the public, Scorecard categorizes TRI chemicals as having “cancer risks” or “noncancer risks”. The ranking system, based on pounds of releases, uses a weighting factor so chemical releases can be compared on a common scale that takes into account both exposure and toxicity. The weighted result, referred to as a Toxic Equivalency Potential (TEP), is a relative measure of human health risk associated with a release of one pound of subject chemical compared to the risk posed by the release of one pound of a reference chemical. All releases of carcinogens are converted to pounds of benzene equivalents; all releases of chemicals that cause noncancer health effects are converted to pounds of toluene equivalents. Each chemical’s TEP is multiplied by its release quantity (in pounds) to determine the chemical’s local risk score (90).
The most recent data available from the TRI risk hazards section of Scorecard describes 2002 TRI releases. At that time, Person County ranked 1st among 80 NC counties listed for total environmental releases (19,125,859 pounds) (91). In 2002 the overall cancer risk and non-cancer risk scores in Person County were related primarily to releases of arsenic and mercury compounds, respectively (92). Of these, only arsenic was among the 10 chemicals released in greatest quantity in Person County in 2009, ranking 10th (see following section). The two CP&L (now Progress Energy) plants cited in Table 12 reported releasing an estimated total of 121,833 pounds of arsenic and 1,389 pounds of mercury compounds in 2009 (89).
Possible uses, origins and health effects of the primary TRI release chemicals in Person County listed previously in Table 13 are described below in Table 14 (in decreasing order of pounds released in the county). The site-specific uses of the materials in the list were retrieved from the Form R Reports submitted by the facilities to the EPA and viewed via links on the EPA TRI Explorer website (89). Sources of health effects information are cited separately for each compound. It should be noted that the health effects information described cannot be used to predict specific health effects in any particular community or individual since exposure data, a critical determinant of ultimate health effects, is unavailable for communities and individuals.
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Barium compounds – In Person County barium compounds are produced as byproducts of coal combustion. They are captured primarily in on-site surface impoundments or reservoirs, although smaller quantities are released to the air.
Barium occurs in nature in many different compounds. These compounds are solids, existing as powders or crystals, and they do not burn well (which is why they are byproducts of coal combustion). Two forms of barium, barium sulfate and barium carbonate, are often found in nature as underground ore deposits. Barium is sometimes found naturally in small quantities in drinking water and food.
The length of time that barium will last in air, land, water, or sediments following release depends on the form of barium released. Barium compounds that do not dissolve well in water, such as barium sulfate and barium carbonate, can persist for a long time in the environment. Barium compounds that dissolve easily in water, such as barium chloride, barium nitrate, or barium hydroxide, usually do not last in these forms for a long time in the environment; however, the barium in these compounds that is dissolved in water quickly combines with sulfate or carbonate that are naturally found in water and become the longer lasting forms (barium sulfate and barium carbonate). Barium sulfate and barium carbonate are the barium compounds most commonly found in the soil and water. If barium sulfate and barium carbonate are released onto land, they will combine with particles of soil.
Background levels of barium in the environment are very low. For example, in the US the air that most people breathe contains about 0.0015 parts of barium per billion parts of air (ppb). Most surface water and public water supplies contain on average 0.030 parts of barium per million parts of water (ppm) or less, but can average as high as 0.30 ppm in some regions of the US. The amount of barium found in soil ranges from about 15 to 3,500 ppm. The amount of barium found in food and water usually is not high enough to be a health concern. However, information is still being collected to determine if long- term exposure to low levels of barium causes any health problems.
People with the greatest known risk of exposure to high levels of barium are those working in industries that make or use barium compounds and who breathe air that contains barium sulfate or barium carbonate. Sometimes they are exposed to one of the more harmful barium compounds (for example, barium chloride or barium hydroxide) by breathing the dust from these compounds or by getting them on their skin. Hazardous waste sites containing barium compounds may be a source of exposure for people living and working near them. Exposure near hazardous waste sites may occur by breathing dust, eating soil or plants, or drinking water that is polluted with barium.
The health effects associated with exposure to different barium compounds depend on how well the specific barium compound dissolves in water or in the stomach. For example, barium sulfate does not easily dissolve in water and causes few harmful health effects. Barium compounds such as barium acetate, barium chloride, barium hydroxide, barium nitrate, and barium sulfide that dissolve in water can cause harmful health effects. Barium carbonate does not dissolve in water, but does dissolve in the stomach, where it can have harmful health effects. Eating or drinking very large amounts of barium compounds that dissolve in water or in the stomach can cause changes in heart rhythm, paralysis or even death in humans. People who eat or drink smaller amounts of barium for a short period may experience vomiting, abdominal cramps, diarrhea, difficulties in breathing, increased or decreased blood pressure, numbness around the face, and muscle weakness. There is no information about the ability of barium to affect reproduction in humans, but a study in experimental animals did not find reproductive effects. Some studies of humans and experimental animals exposed to barium in the air have reported damage to the lungs, but other studies have not found these effects. There is no reliable information about the health effects in humans or experimental animals that are exposed to barium by direct skin contact. Barium has not been shown to cause cancer in humans or in experimental animals
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drinking barium in water, and the EPA has noted there is insufficient current information to determine whether it will be carcinogenic to humans following inhalation exposure (93).
Hydrochloric acid – In Person County hydrochloric acid is produced as a byproduct of coal combustion and is released entirely as stack or point air emissions.
Hydrochloric acid occurs as a colorless, nonflammable aqueous solution or as a gas. It has an irritating, pungent odor and is corrosive to the eyes, skin, and mucous membranes. Acute (short-term) inhalation exposure may cause eye, nose, and respiratory tract irritation (e.g., coughing and hoarseness), inflammation and ulceration of the respiratory tract, chest pain, and pulmonary edema (fluid build-up in the lungs) in humans. Acute oral exposure may cause corrosion of the mucous membranes, esophagus and stomach, with nausea, vomiting and diarrhea reported in humans. Skin contact may produce severe burns, ulceration, and scarring. Chronic (long-term) occupational exposure to hydrochloric acid has been reported to cause gastritis, chronic bronchitis, dermatitis, and photosensitization in workers. Prolonged exposure to low concentrations may also cause dental discoloration and erosion.
No information is available on the reproductive or developmental effects of hydrochloric acid in humans, nor is there information on the carcinogenic effects. The EPA has not classified hydrochloric acid for carcinogenicity (94).
Sulfuric acid – In Person County sulfuric acid is produced as a byproduct of coal combustion and is released entirely as stack or point air emissions.
Sulfuric acid is a clear, colorless, oily liquid that is very corrosive. Exposure to concentrated sulfuric acid in air will cause nasal irritation and lead to the perception of a pungent odor. Sulfuric acid can be found in the air as small droplets or it can be attached to other small particles in the air.
Much of the sulfuric acid in the air is formed from sulfur dioxide released when coal, oil, and gas are burned. The released sulfur dioxide slowly forms sulfur trioxide, which reacts with water in the air to form sulfuric acid. Sulfuric acid dissolves in the water in air and can remain suspended for varying periods of time; it is removed from the air as rain. Sulfuric acid in rain contributes to the formation of acid rain. Sulfuric acid in water separates to form hydrogen ions and sulfate. The ability of sulfuric acid to change the acidity (pH) of water is dependent on the amount of sulfuric acid and the ability of other substances in the water to neutralize the hydrogen ions (buffering capacity).
In occupational settings, breathing small droplets of sulfur trioxide or sulfuric acid or touching it with skin are the most likely sulfuric acid exposure routes. Among the general public, the most likely route of sulfuric acid exposure is likely breathing outdoor air containing the compound. Breathing small droplets of sulfuric acid at levels that might be in the air on a day with high air pollution may make it more difficult to breathe. This effect is more likely to occur in people who have been exercising, or have asthma. This effect may also be more likely to occur in children than adults. Breathing sulfuric acid droplets may affect the ability of the respiratory tract to remove other small inhaled particles.
Studies in people who breathed high concentrations of sulfuric acid at work have shown an increase in cancers of the larynx. However, most of the cancers were in smokers who were also exposed to other acids and other chemicals. There is no information that exposure to sulfuric acid by itself is carcinogenic. The carcinogenicity of sulfuric acid has not been studied in animals. The EPA and the US Department of Health and Human Services (US DHHS) have not classified sulfur trioxide or sulfuric
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Person County Community Health Assessment – Volume Two Toxic Chemical Releases acid for carcinogenic effects. Based on very limited human data, the International Agency for Research on Cancer (IARC) believes that evidence is sufficient to state that occupational exposure to strong inorganic acid mists containing sulfuric acid is carcinogenic to humans. IARC has not classified pure sulfuric acid for its carcinogenic effects (95).
Vanadium compounds – In Person County vanadium compounds are produced as byproducts of coal combustion. These releases are captured primarily in on-site surface impoundments or reservoirs, although smaller quantities are released to the air.
The element vanadium occurs naturally in soil, water, and air. Natural sources of atmospheric vanadium include dust, marine aerosols, and volcanic emissions. Vanadium is found in about 65 different minerals. Releases of vanadium to the environment are associated mainly with industrial sources, especially oil refineries and power plants using vanadium rich fuel oil and coal. Global human- made atmospheric releases of vanadium have been estimated to be greater than vanadium releases due to natural sources. Natural releases to water and soil are far greater overall than human-made releases to the atmosphere.
Vanadium cannot be destroyed in the environment; it can only change its form or become attached or separated from airborne particulate, soil, particulate in water, and sediment. Vanadium particles in the air settle to the ground or are washed out of the air by rain. Smaller particles, such as those emitted from oil-fueled power plants, may stay in the air for longer times and are more likely to be transported farther away from the site of release. The transport and partitioning of vanadium in water and soil is influenced by many factors including the acidity of the water or soil and the presence of particulates. Vanadium can either be dissolved in water as dissolved ions or may become adsorbed to particulate matter.
Most people take in very little vanadium from breathing. However, populations in areas where use of residual fuel oils for energy production is high may be exposed to above-background levels of airborne vanadium through inhalation, and they also may be exposed via increased particulate deposition upon food crops and soils in the vicinity of power plants.
Occupational inhalation exposures to vanadium compounds, particularly vanadium pentoxide, can result in coughing which can last a number of days after exposure. Studies in animals exposed to vanadium during pregnancy have shown that it can cause decreases in growth and increases in the occurrence of birth defects; these effects are usually observed at levels which cause effects in the mother. It is not known whether vanadium can cause birth defects in humans. Lung cancer has been found in mice exposed to vanadium pentoxide, and the IARC has determined that vanadium is possibly carcinogenic to humans (96).
Manganese and manganese compounds – In Person County manganese and manganese compounds are produced as byproducts of coal combustion. These releases are captured primarily in on-site surface impoundments or reservoirs, although smaller quantities are released to the air.
Manganese is a metal that occurs naturally in the environment in many types of rock, and is also naturally present at low levels in water, air, soil and food. It is essential for normal physiologic functioning in humans and animals, and exposure to low levels in the diet is considered to be nutritionally essential in humans. Manganese can also be released into the air by iron and steel production plants, power plants, and coke ovens. Metallic manganese is used primarily in steel production to improve hardness, stiffness, and strength. It is also used in carbon steel, stainless steel,
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Person County Community Health Assessment – Volume Two Toxic Chemical Releases and high-temperature steel, along with cast iron and superalloys. Manganese forms compounds in the environment with chemicals such as oxygen, sulfur, and chlorine. The resulting manganese compounds are solids that do not evaporate; however, small dust particles can become suspended in air and can dissolve in water. Manganese compounds have a variety of uses. For example, manganese dioxide is used in the production of dry-cell batteries, matches, fireworks, and the production of other manganese compounds.
People who work in factories where manganese metal is produced from manganese ore or where manganese compounds are used to make steel or other products are most likely to be exposed through inhalation to higher than normal levels of manganese. Chronic (long-term) exposure to high levels of manganese by inhalation in humans may result in central nervous system effects. Visual reaction time, hand steadiness, and eye-hand coordination were affected in chronically-exposed workers. A syndrome named manganism may result from chronic exposure to higher levels; manganism is characterized by feelings of weakness and lethargy, tremors, a mask-like face, and psychological disturbances. Respiratory effects have also been noted in workers chronically exposed by inhalation. Impotence and loss of libido have been noted in male workers afflicted with manganism. No reports of effects in humans following acute (short-term) effects of exposure to manganese are available.
Several animal studies reported an increased incidence of thyroid gland follicular cell adenomas and hyperplasia, or increased incidence of pancreatic tumors, but oral human and animal studies on manganese are inadequate to indicate a causal relationship to any cancer. The EPA has classified manganese as a Group D, not classifiable as to carcinogenicity in humans (97).
Zinc compounds – In Person County zinc compounds are produced as byproducts of coal combustion. These chemicals are released primarily to landfills and surface impoundments, although smaller quantities may be released as air emissions or discharged to water bodies.
Zinc is one of the most common elements in the earth's crust. It is found in air, soil, and water, and is present in all foods. Zinc has many commercial uses: as coatings to prevent rust, in dry cell batteries, and mixed with other metals to make alloys like brass, and bronze. A zinc and copper alloy is used to make US pennies. Zinc combines with other elements to form zinc compounds. Common zinc compounds found at hazardous waste sites include zinc chloride, zinc oxide, zinc sulfate, and zinc sulfide. Zinc compounds are widely used in industry to make paint, rubber, dyes, wood preservatives, and ointments.
Some zinc is released into the environment by natural processes, but most comes from human activities like mining, steel production, coal burning, and burning of waste. It attaches to soil, sediments, and dust particles in the air. Rain and snow remove zinc dust particles from the air. Most of the zinc in soil stays bound to soil particles and does not dissolve in water. However, depending on the type of soil, some zinc compounds can move into the groundwater and into lakes, streams, and rivers where It builds up in fish and other organisms, but not in plants.
Low levels of zinc are essential for maintaining good health. Too little zinc can cause problems, but too much zinc is also harmful. Exposure to high levels of zinc occurs mostly from eating food, drinking water, or breathing workplace air that is contaminated. Zinc exposure can cause stomach cramps, nausea, vomiting, anemia, and changes in cholesterol levels. Harmful effects generally begin at levels 10-15 times higher than the amount needed for good health. Inhaling large amounts of zinc (as dusts or fumes) can cause a specific short-term disease called metal fume fever. The long-term effects of breathing high levels of zinc are not known.
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It also is not known if high levels of zinc affect reproduction in humans, but rats that were fed large amounts of zinc became infertile. Putting low levels of zinc acetate and zinc chloride on the skin of rabbits, guinea pigs, and mice caused skin irritation; skin irritation will probably occur in people.
The US DHHS and the IARC have not classified zinc for carcinogenicity. Based on incomplete information from human and animal studies, the EPA has determined that zinc is not classifiable as to its human carcinogenicity (98).
Copper and copper compounds – In Person County copper and copper compounds are produced as byproducts of coal combustion. They are released primarily to on-site landfills or surface impoundments, although smaller quantities are released as air emissions or discharged to water bodies.
Copper is a metal that occurs naturally in rock, soil, water, sediment, and, at low levels, in air. Copper also occurs naturally in all plants and animals, where at low levels it is an essential element for health. At much higher levels, toxic effects can occur. (The term copper in this profile not only refers to copper metal, but also to compounds of copper that may be in the environment.)
Copper is extensively mined and processed in the US where it is used primarily as the metal or alloy in the manufacture of wire, sheet metal, pipe, and other metal products. Copper compounds, both natural and manufactured, are most commonly used in agriculture to treat plant diseases, like mildew, or for water treatment and as preservatives for wood, leather, and fabrics.
Copper can enter the environment through releases from the mining of copper and other metals, and from factories that make or use copper metal or copper compounds. Copper can also enter the environment through waste dumps, domestic waste water, combustion of fossil fuels and wastes, wood production, phosphate fertilizer production, and natural sources (for example, windblown dust from native soils, volcanoes, decaying vegetation, forest fires, and sea spray). Copper is often found near mines, smelters, industrial settings, landfills, and waste disposal sites.
When copper is released into soil, it can become strongly attached to the organic material and other components (e.g., clay, sand, etc.) in the top layers of soil and may not move very far when it is released. When copper and copper compounds are released into water, the copper that dissolves can be carried in surface waters either in the form of copper compounds or as free copper or, more likely, copper bound to particles suspended in the water. Even though copper binds strongly to suspended particles and sediments, there is evidence to suggest that some water-soluble copper compounds do enter groundwater. Copper that enters water eventually collects in the sediments of rivers, lakes, and estuaries. Copper is carried on particles emitted to the air from smelters and ore processing plants, and is then carried back to earth through gravity or in rain or snow. Copper is also carried into the air on windblown metallurgical dust. Indoor release of copper comes mainly from combustion processes (for example, kerosene heaters).
Humans may be exposed to copper by breathing air, drinking water, eating food, and by skin contact with soil, water and other copper-containing substances. Most copper compounds found in air, water, sediment, soil and rock are strongly attached to dust and dirt or imbedded in minerals. In the general population, the soluble copper compounds most commonly used in agriculture are more likely to pose health threats than the bound copper compounds. When soluble copper compounds are released into lakes and rivers, they generally become attached to particles in the water within approximately 1 day, lessening their exposure threat depending on how strongly the copper is bound to the particles and how much of the particulate settles into lake and river sediments.
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Copper can enter the body when humans drink water or eat food, soil, or other substances that contain copper; copper can also enter the body via inhalation of air or dust containing copper. Copper rapidly enters the bloodstream and is distributed throughout the body after it is ingested; however, the human body is very good at blocking high levels of copper from entering the bloodstream, and the amount of copper in the human body tends to remain constant. It is not known how much copper enters the body through the lungs or skin.
Exposure to high doses of copper can be harmful to humans. Long-term exposure to copper dust can irritate the nose, mouth, and eyes, and cause headaches, dizziness, nausea, and diarrhea. Drinking water that contains higher than normal levels of copper may cause nausea, vomiting, stomach cramps, or diarrhea. Exceptionally high intakes of copper can cause liver and kidney damage and even death. It is not know if copper can cause cancer in humans. The EPA does not classify copper as a human carcinogen because there are no adequate human or animal cancer studies (99).
Chromium and chromium compounds – In Person County chromium and chromium compounds are produced as byproducts of coal combustion or used as a component in the manufacture of metals. They are released primarily to on-site landfills and surface impoundments, with smaller quantities released as air emissions or to water bodies.
Chromium is a naturally occurring element in rocks, animals, plants, soil, and volcanic dust and gases; it is also produced by industrial processes. One form of chromium, called chromium (III) or trivalent chromium, is essential to normal glucose, protein, and fat metabolism in humans and thus is an essential dietary element. Air emissions of chromium are predominantly of trivalent chromium, and in the form of small particles or aerosols. The metal chromium is used mainly for making steel and other alloys. Chromium compounds are used for chrome plating, the manufacture of dyes and pigments, leather and wood preservation, and treatment of cooling tower water. Smaller amounts are used in drilling muds, textiles, and toner for copying machines.
The most important industrial sources of chromium in the atmosphere are those related to ferrochrome production. Ore refining, chemical and refractory processing, cement-producing plants, automobile brake lining and catalytic converters for automobiles, leather tanneries, and chrome pigments also contribute to the atmospheric burden of chromium.
The general population is exposed to chromium (generally chromium [III]) by eating food, drinking water, and inhaling air that contains the chemical. Skin exposure to chromium may occur during the use of consumer products that contain chromium, such as wood treated with copper dichromate or leather tanned with chromic sulfate. Occupational exposure to chromium occurs from chromate production, stainless-steel production, chrome plating, and working in tanning industries; occupational exposure can be two orders of magnitude higher than exposure to the general population. People who live in the vicinity of chromium waste disposal sites or chromium manufacturing and processing plants have a greater probability of elevated chromium exposure than the general population.
Some forms of chromium are more toxic than others. For example, chromium (VI) is much more toxic than chromium (III), for both acute and chronic exposures. The respiratory tract is the major target organ for chromium (VI) toxicity, for acute (short-term) and chronic (long-term) inhalation exposures. Shortness of breath, coughing, and wheezing were reported from a case of acute exposure to chromium (VI), while perforations and ulcerations of the septum, bronchitis, decreased lung function, pneumonia, and other respiratory effects have been noted from chronic exposure.
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Limited information on the reproductive effects of chromium (VI) in humans exposed by inhalation suggest that exposure to chromium (VI) may result in complications during pregnancy and childbirth. Human studies have clearly established that inhaled chromium (VI) is a human carcinogen, resulting in an increased risk of lung cancer.
Chromium (III), on the other hand, is much less toxic. Although data from animal studies have identified the respiratory tract as the major target organ for chronic chromium exposure, these data do not demonstrate that the effects observed following inhalation of chromium (VI) particulates are relevant to inhalation of chromium (III). Acute animal tests have shown chromium (III) to have moderate toxicity from oral exposure. No information is available on the reproductive or developmental effects of chromium (III) in humans.
No data are available on the carcinogenic potential of chromium (III) compounds alone. The EPA has classified chromium (III) as a Group D, not classifiable as to carcinogenicity in humans, but has stated that "the classification of chromium (VI) as a known human carcinogen raises a concern for the carcinogenic potential of chromium (III)" (100).
Nickel and nickel compounds – In Person County nickel and nickel compounds are produced as byproducts of coal combustion or used as a component in the manufacture of metals. They are released primarily to on- and/or off-site landfills and surface impoundments, with smaller quantities released as air emissions or to water bodies.
Pure nickel is a metal with properties that make it very desirable for combining with other metals to form mixtures called alloys. These alloys are used in making metal coins and jewelry, and in industry for making items such as valves and heat exchangers. Most nickel is used to make stainless steel. There are also compounds consisting of nickel combined with many other elements, including chlorine, sulfur, and oxygen. Many of these nickel compounds are water soluble and have a characteristic green color. Nickel and its compounds have no characteristic odor or taste. Nickel compounds are used for nickel plating, to color ceramics, to make some batteries, and as substances known as catalysts that increase the rate of chemical reactions.
Nickel combined with other elements occurs naturally in the earth's crust. It is found in all soil, is emitted from volcanoes, and found in meteorites and on the ocean floor. Nickel is released into the atmosphere during nickel mining and by industries that make or use nickel, nickel alloys, or nickel compounds. These industries also might discharge nickel in waste water.
Nickel is also released into the atmosphere by oil-burning power plants, coal-burning power plants, and trash incinerators. The nickel that comes out of the stacks of power plants attaches to small particles of dust that settle to the ground or are taken out of the air in rain or snow. It usually takes many days for nickel to be removed from the air. If the nickel is attached to very small particles, it can take more than a month to settle out of the air. Nickel can also be released in industrial waste water. A lot of nickel released into the environment ends up in soil or sediment where it strongly attaches to particles containing iron or manganese. Under acidic conditions, nickel is more mobile in soil and might seep into groundwater. Nickel does not appear to concentrate in fish. While studies show that some plants can take up and accumulate nickel, it apparently does not accumulate in small animals living on land that has been treated with nickel-containing sludge.
Nickel normally occurs at very low levels in the environment, so very sensitive methods are needed to detect nickel in most environmental samples. Food is the major source of exposure to nickel, but humans may also be exposed to nickel by breathing air, drinking water, or smoking tobacco containing
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nickel. Skin contact with soil, bath or shower water, or metals containing nickel, as well as, metals plated with nickel can also result in exposure. Exposure of an unborn child to nickel is through the transfer of nickel from the mother's blood to fetal blood. Likewise, nursing infants are exposed to nickel through the transfer of nickel from the mother to breast milk. However, the concentration of nickel in breast milk is either similar or less than the concentration of nickel in infant formulas and cow's milk.
Much of the nickel found in air, soil, sediment, and rock is so strongly attached to dust and soil particles or embedded in minerals that it is not readily taken up by plants and animals and, therefore, cannot easily affect health. In water and waste water, nickel can exist either dissolved in water or attached to material suspended in water. The highest concentrations of nickel in soil are found near industries that release it into the air during processing, where it settles on the ground.
Food containing nickel is the major source of nickel exposure for the general population. Foods naturally high in nickel include chocolate, soybeans, nuts, and oatmeal. People who work in industries that process or use nickel likely are exposed to higher levels than the general public. Nickel can enter the body via inhalation of air containing nickel, or by drinking water or eating food that contains nickel. A small amount of nickel can enter the bloodstream from skin contact. After nickel enters the body, it can go to all organs, but it mainly goes to the kidneys.
The most common harmful health effect of nickel in humans is an allergic reaction. Approximately 10- 20% of the population is sensitive to nickel. A person can become sensitive to nickel when jewelry or other items containing nickel are in direct contact and prolonged contact with the skin. Once a person is sensitized to nickel, further contact with the metal may produce a reaction. The most common reaction is a skin rash at the site of contact. In some sensitized people, dermatitis may develop in an area of the skin that is away from the site of contact. Some workers exposed to nickel by inhalation can become sensitized and have asthma attacks, but this is rare. Some sensitized individuals react when they eat nickel in food or water or breathe dust containing nickel. More women are sensitive to nickel than men (thought to be a result of greater exposure of women to nickel through jewelry and other metal items).
The most serious harmful health effects from exposure to nickel, such as chronic bronchitis, reduced lung function, and cancer of the lung and nasal sinus, have occurred in people who have breathed dust containing certain nickel compounds while working in nickel refineries or nickel-processing plants. Exposure to high levels of nickel compounds that dissolve easily in water may also result in cancer when less soluble nickel compounds are also present, or when other chemicals that can produce cancer are present. The US DHHS has determined that nickel metal may reasonably be anticipated to be a carcinogen, and nickel compounds are known human carcinogens. The IARC has determined that some nickel compounds are carcinogenic to humans and that metallic nickel may possibly be carcinogenic to humans. The EPA has determined that nickel refinery dust and nickel subsulfide are human carcinogens. These cancer classifications were based on studies of nickel workers and laboratory animals (101).
Arsenic compounds – In Person County arsenic compounds are produced as a byproduct of coal combustion. They are released primarily to on-site landfills or surface impoundments, with smaller quantities released to an on-site waterbody (Hyco Lake) and as air emissions.
Arsenic is a naturally occurring element that is widely distributed in the earth’s crust. Arsenic is classified chemically as a metalloid, having both properties of a metal and a nonmetal; however, it is frequently referred to as a metal. Arsenic is usually found in the environment combined with other elements such as oxygen, chlorine, and sulfur. Most arsenic compounds have no smell, and most have
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no special taste. Inorganic arsenic occurs naturally in soil and in many kinds of rock, especially in minerals and ores that contain copper or lead. When these ores are heated in smelters, most of the arsenic goes up the stack and enters the air as a fine dust. Smelters may collect this dust and take out the arsenic as a compound called arsenic trioxide. However, arsenic is no longer produced in the US; all of the arsenic used in the US is imported.
Presently, about 90% of all arsenic produced is used as a preservative for wood to make it resistant to rotting and decay. The preservative is copper chromated arsenate (CCA) and the treated wood is referred to as “pressure-treated.” In 2003, U.S. manufacturers of wood preservatives containing arsenic began a voluntary transition from CCA to other wood preservatives that do not contain arsenic in wood products for certain residential uses, such as play structures, picnic tables, decks, fencing, and boardwalks. This phase-out was completed on December 31, 2003; however, wood treated prior to this date could still be used and existing structures made with CCA-treated wood would not be affected. CCA-treated wood products continue to be used in industrial applications. It is not known whether, or to what extent, CCA-treated wood products may contribute to exposure of people to arsenic.
In the past, inorganic arsenic compounds were predominantly used as pesticides, primarily on cotton fields and in orchards. Inorganic arsenic compounds can no longer be used in agriculture. However, organic arsenic compounds, namely cacodylic acid, disodium methylarsenate (DSMA), and monosodium methylarsenate (MSMA), are still used as pesticides, principally on cotton. Some organic arsenic compounds are used as additives in animal feed. Small quantities of elemental arsenic are added to other metals to form metal mixtures or alloys with improved properties. The greatest use of arsenic in alloys is in lead-acid batteries for automobiles; another important use of arsenic compounds is in semiconductors and light-emitting diodes.
Arsenic occurs naturally in soil and minerals and it therefore may enter the air, water, and land from wind-blown dust and may get into water from runoff and leaching. Volcanic eruptions are another source of arsenic. Arsenic is associated with ores containing metals, such as copper and lead, and may enter the environment during the mining and smelting of these ores. Arsenic also may be released into the atmosphere from coal-fired power plants and incinerators because coal and waste products often contain some arsenic.
Arsenic cannot be destroyed in the environment; it can only change its form, or become attached to or separated from particles. It may change its form by reacting with oxygen or other molecules present in air, water, or soil, or by the action of bacteria that live in soil or sediment. Arsenic released from power plants and other combustion processes is usually attached to very small particles. Arsenic contained in wind-borne soil is generally found in larger particles. These particles settle to the ground or are washed out of the air by rain. Arsenic that is attached to very small particles may stay in the air for many days and travel long distances. Many common arsenic compounds can dissolve in water, releasing arsenic into lakes, rivers, or underground water by dissolving in rain or snow or through the discharge of industrial wastes. Some of the arsenic will stick to particles in the water or sediment on the bottom of lakes or rivers, and some will be carried along by the water. Ultimately, most arsenic ends up in the soil or sediment. Although some fish and shellfish take in arsenic, which may build up in tissues, most of this arsenic is in an organic form called arsenobetaine (commonly called "fish arsenic") that is much less harmful.
Since arsenic is found naturally in the environment, people can be exposed to some arsenic by eating food, drinking water, or breathing air. Children may also be exposed to arsenic by eating soil. The concentration of arsenic in soil varies widely; however, soils in the vicinity of arsenic-rich geological deposits, some mining and smelting sites, or agricultural areas where arsenic pesticides had been applied in the past may contain the highest levels of arsenic. The concentration of arsenic in natural
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surface and groundwater is generally low, but may be many times higher in contaminated areas or where arsenic levels in soil are high. Groundwater is far more likely to contain high levels of arsenic than surface water.
Humans normally take in small amounts of arsenic in air, water, and food. Of these, food is usually the largest source of arsenic. The predominant dietary source of arsenic is seafood, followed by rice/rice cereal, mushrooms, and poultry. Children are likely to eat small amounts of dust or soil each day, so this is another way they may be exposed to arsenic. Children also may be exposed to small amounts of arsenic from hand-to-mouth activities from playing on play structures or decks constructed out of CCA-treated wood. The potential exposure that children may receive from playing in play structures constructed from CCA-treated wood is generally smaller than that they would receive from food and water. Hand washing can reduce the potential exposure of children to arsenic after playing on play structures constructed with CCA-treated wood, since most of the arsenic on the children’s hands is removed with water.
In the past, several kinds of products used in the home (rat poison, ant poison, weed killer, some types of medicines) had arsenic in them. However, most of these uses of arsenic have ended, so the general public is not likely to be exposed from home products any longer.
Inorganic arsenic has been recognized as a human poison since ancient times, and large oral doses can result in death. Ingestion of lower levels of inorganic arsenic may cause irritation of the stomach and intestines, with symptoms such as stomachache, nausea, vomiting, and diarrhea. Other effects that might result from swallowing inorganic arsenic include decreased production of red and white blood cells (which may cause fatigue), abnormal heart rhythm, blood-vessel damage resulting in bruising, and impaired nerve function causing a "pins and needles" sensation in the hands and feet.
Perhaps the single-most characteristic effect of long-term oral exposure to inorganic arsenic is a pattern of skin changes. These include patches of darkened skin and the appearance of small "corns" or "warts" on the palms, soles, and torso, and are often associated with changes in the blood vessels of the skin. Skin cancer may also develop. Swallowing arsenic has also been reported to increase the risk of cancer in the liver, bladder, and lungs. The US DHHS, IARC and EPA all have determined that inorganic arsenic is known to be carcinogenic to humans.
Breathing high levels of inorganic arsenic is likely to cause a sore throat and irritated lungs, as well as some of the skin effects mentioned above. The exposure level that produces these effects is uncertain. Longer exposure at lower concentrations can lead to skin effects, and also to circulatory and peripheral nervous disorders. There is some data suggesting that inhalation of inorganic arsenic may also interfere with normal fetal development, although this is not certain. An important concern is the ability of inhaled inorganic arsenic to increase the risk of lung cancer. This has been seen mostly in workers exposed to arsenic at smelters, mines, and chemical factories, but also in residents living near smelters and arsenic-using or producing chemical factories. People who live near waste sites with arsenic may have an increased risk of lung cancer as well.
Almost no information is available on the effects of organic arsenic compounds in humans. Studies in animals show that most simple organic arsenic compounds are less toxic than the inorganic forms (102).
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Person County Community Health Assessment – Volume Two Toxic Chemical Releases
Land Contamination
Superfund Sites
The EPA National Priorities List (NPL), commonly known as the Federal “Superfund” Program List, catalogues some of the nation’s worst toxic waste sites, made eligible by law for long-term remediation. As of June 13, 2011, there were 1,288 Superfund sites nation-wide; NC currently has 36 Superfund sites scattered statewide in 21 counties. The current list identifies one Superfund site in Person County: the now defunct GMH Electronics facility in Roxboro; this facility was first listed in 2009 (103).
The GMH Electronics site is located at the intersection of Halifax Road and Virgilina Road in Roxboro. The approximate size of the property is 0.5 acres. GMH Electronics produced electronic parts, including printed circuit boards. Parts were washed with chlorinated solvents in three industrial washing machines on site. The washing solution was then run through carbon filters and discharged to the onsite septic system.
The contaminants of concern are volatile organic compounds (VOCs), which include 1,1- dichloroethene, 1,1-dichloroethane, 1,1,1-trichloroethane, chloromethane, and vinyl chloride. The site is on the list because ground water contaminated with VOCs above EPA's Safe Drinking Water Act maximum contaminant levels (MCLs) was detected in 17 private drinking water wells in the area. In response to the finding, sixteen private homes and one business were provided bottled water as an emergency response action by EPA. Seven of the homes were also provided whole-house carbon filtration systems.
The state referred the site to EPA because of the large number of contaminated residential wells and because the state does not have the resources to remediate the site. NPL listing would support remediation of the contaminated ground water and mitigate the spread of the contamination. EPA received a letter of support for placing this site on the NPL from the State (104).
According to the 2010 Person County State of the County Health Report, since the NPL listing of the site and the provision of bottled drinking water and/or whole-house filtration systems, a water line for municipal water has been extended to 42 affected homes; their wells are no longer in use. Next steps include a Remedial Investigation to study the extent of the groundwater contamination and a plan for remediation of the site (159).
Brownfields
The EPA began the Brownfields Initiative in 1995 to encourage the clean-up and reuse of abandoned contaminated properties. A Brownfields site is any real property that is abandoned, idle or underutilized where environmental contamination, perceived or real, hinders redevelopment. Loans are very difficult to obtain when property comes with potential environmental cleanup liability; the NC Brownfields program aims to alleviate that liability for possible developers.
The NC Brownfields Program, authorized by the state statute known as the Brownfields Property Reuse Act, provides a mechanism to treat prospective developers of brownfield sites differently than the parties responsible for contaminating them. Prospective developers negotiate a brownfields agreement with the program that defines activities needed to make the site suitable for reuse, rather than cleaning up the site to regulatory standards (which responsible parties are required to do) (105).
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As of September 30, 2010, 173 Brownfields Agreements had been negotiated in NC; there were 119 active eligible projects and 26 more pending. One negotiated project was listed for Person County: the Bromma Property II, an 11.6 acre site in Roxboro. There were no active eligible sites listed for Person County, but there was one pending Brownfields project (the J.G. Harrison site in Roxboro) at that time (106).
Inactive Hazardous Sites
In 1987 the NC General Assembly enacted The NC Inactive Hazardous Sites Response Act, establishing a program to protect the public and the environment from uncontrolled and unregulated hazardous waste sites that are not addressed by other environmental programs. The Inactive Hazardous Site Branch (IHSB) of DENR was created to deal with any site where hazardous substance or waste contamination existed that wasn’t already under the jurisdiction of another program. An organizational change within DENR in 2007 consolidated oversight of contaminated site remediation into the Division of Waste Management (DWM).
The Inactive Hazardous Sites Branch, within the Superfund Section of the DWM, is responsible for oversight and approval of the assessment and remediation of all historical and any recent accidental releases of hazardous substances and pollutants (with a number of specific exceptions). The Branch oversees remedial actions, conducts any necessary enforcement of assessment and remediation at sites deemed to be a priority, and conducts the work itself at orphaned sites when state resources are available (107).
As of April 8, 2011 there were 1,896 inactive hazardous sites across NC listed by DWM. Eight of these sites were in Person County: Atec Industries (Roxboro), Country Club Lane Contamination site (Roxboro), Eaton Corporation (Roxboro), Halifax Road/Virgilina Road DCE site (Roxboro), Oscar Holloway property (Roxboro), Loxcreen Co. Inc. (Roxboro), Republic Services of NC (Rougemont), and Southern States – Roxboro (Roxboro) (108).
Hazardous Substances Emergency Events
In 1990, the Agency for Toxic Substances and Disease Registry (ATSDR) established an active, state- based Hazardous Substances Emergency Events Surveillance (HSEES) system to describe the public health effects associated with releases of hazardous substances such as ammonia, chlorine, acids, pesticides, paints, and dyes (but not petroleum products). The NCDPH joined the federally funded project in 1991, but that iteration of the project ended in 2009 (109). Data available from 1998–2001 was excerpted in the 2007 Person County Community Health Assessment, Volume Two (12).
In 2009, NCDPH was awarded a new grant from ATSDR that builds on the surveillance data collected in the HSEES program. The new program name is the National Toxic Substance Incidents Program (NTSIP), and its goal is to reduce illnesses and deaths from acute toxic substance incidents. In order to meet this goal the program objectives include: (1) maximizing coordination among federal, state, and local agencies involved in toxic substance activities, (2) incorporating multiple levels of surveillance and outreach, (3) conducting public health investigations of highly significant incidents, (4) generating maps to identify chemical vulnerabilities in communities, and (5) promoting green chemistry. To achieve these objectives program staff will interact with stakeholders including, but not limited to, government officials, responders, and industry personnel who are working to achieve a safer environment for the people of NC. Subsequent HSEES event reports should emanate from this new program (110).
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Person County Community Health Assessment – Volume Two Lead Hazards
Chapter Four: Lead Hazards
Lead is a highly toxic metal found in small amounts in the earth’s crust. Because of its abundance, low cost, and physical properties, lead and lead compounds have been used in a wide variety of products including paint, ceramics, pipes, solders, gasoline, batteries, and cosmetics. Since 1980, federal and state regulatory standards have helped to minimize or eliminate the amount of lead in consumer products and occupational settings. Today, the most common sources of lead exposure in the US are lead-based paint in older homes, contaminated soil, household dust, drinking water, lead crystal, and lead-glazed pottery (111).
People can get lead in their body if they put their hands or other objects covered with lead dust in their mouths; ingest paint chips, soil, or water that contains lead; or breathe in lead dust, especially during renovations that disturb painted surfaces.
Where Lead is Found
Paint
Lead-based paint is the most common source of lead poisoning (especially for children) because it was widely used in most oil-based paints prior to 1950. Children are exposed to lead when they eat paint chips or chew painted surfaces. Lead-containing paint is most dangerous when it is peeling, chipping, chalking, or cracking, or is located on a surface that is subject to damage from repeated impacts such as door frames. Improper renovation of homes with-lead based paint can generate lead in the air, dust, and soil (112).
Soil and Dust
Soil and dust can be major sources of lead-contamination around the home as a result of peeling and chipping paint and remodeling activities, such as sanding and scraping of paint. Industries such as lead ore mining, milling, or smelting, municipal solid waste incinerators, and lead-acid battery recycling facilities can contaminate soil with lead. Lead-contaminated soil is a potential source of exposure, directly through hand-to-mouth activity, and indirectly as a contributor to indoor floor dust when tracked into the home (112).
Air
Sources of airborne lead include emissions from gasoline combustion, smelters, and battery manufacturers, among others. Due to the federal Clean Air Act, there is less lead in motor fuels and tighter emission controls on industrial activities. This has driven air emissions of lead down nearly 90 percent during the last 25 years (112).
Water
Industrial facilities, urban runoff and atmospheric deposition are sources of lead in the aquatic environment. Lead solder used in plumbing installations also can contaminate drinking water (112).
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Person County Community Health Assessment – Volume Two Lead Hazards
Health Effects of Lead Exposure
Childhood lead poisoning remains a major environmental health problem in the US, but adults also can be affected by exposure to lead.
Chronic lead exposure in adults can lead to decreased fertility in both men and women, high blood pressure and hypertension, nerve disorders, memory and concentration problems, and muscle and joint pain, and memory and concentration problems (112). In adults, a “normal” blood lead level is less than 20 µg/dL (micrograms per deciliter). Adults who have been exposed to lead should have blood lead levels below 40 µg/dL. Treatment is recommended if there are symptoms of lead poisoning, or if the blood lead level is greater than 60 µg/dL (113).
Lead is more dangerous to children than adults because babies and young children often put their hands and other objects in their mouths, children's growing bodies absorb more lead, and children's brains and nervous systems are more sensitive to the damaging effects of lead. While extreme lead exposure in children can cause a variety of neurological disorders such as slowed growth, lack of muscular coordination, convulsions and coma, much lower lead levels have been associated with measurable changes in children’s mental development and behavior. These changes include hyperactivity; deficits in fine motor function, hand-eye coordination, and reaction time; hearing problems; and lowered performance on intelligence tests (111, 112). Among children, a “normal” blood lead level is less than 10 µg/dL. A blood lead level greater than this threshold requires further testing and monitoring, and the source of lead must be found and removed. A blood lead level greater than 45 µg/dL in a child's blood usually indicates the need for treatment (113).
Assessing Lead Risks
Housing Units at Risk
One way to estimate the potential burden of lead hazards is to examine local housing and demographic indicators to identify areas with housing at high risk of lead hazards. Studies have demonstrated that housing built prior to 1950 and households with income below the poverty threshold have an elevated risk of lead contamination. Scorecard, via 2000 US Census data, ranks counties by overall lead hazard risk in housing to help estimate potential lead hazards in housing. Person County was not among the 50 NC counties listed in terms of any of the housing-related parameters of high lead hazard risk (114). Details of that risk are shown below in Table 14.
Table 14. Person County Lead Hazard Indicators, 2000 US Census
Housing Units at High Housing Units Built Housing Units with Children < 5 Living Risk for Lead Hazards Before 1950 Low Income Below Poverty Level No. % No. % No. % No. % 300 2 2,300 n/a 1,800 13 580 25
Source: Scorecard, Pollution Rankings. Lead Hazards. County Report. Person County; http://scorecard.goodguide.com/env- releases/lead/county.tcl?fips_county_code=37145
The figures in Table 14 are relatively low compared to figures for largely urban communities in NC that were developed earlier and more densely than the communities in Person County. For example,
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Mecklenburg County and Guilford County lead the state in terms of housing units built before 1950; in each there are an estimated 22,000 homes built prior to 1950 (114). Note that data from the soon-to- be-released 2010 Census is unlikely to change any of the housing-related lead risk figures since they describe past events (i.e. housing built before 1950).
Lead risks in Person County are not related exclusively to housing factors, however. The county is subject to significant releases of lead compounds related to power generation. According to the 2009 EPA TRI Facility Report for Person County, the Mayo and Roxboro power generating plants released a total of 112,842 pounds of lead compounds. The bulk of these compounds was impounded or landfilled on-site, but some was released as air emissions or into waterbodies (89). Some fraction of these chemical releases could pose at least a theoretical risk to human health, depending on chemical form and level of exposure.
Childhood Blood Lead Levels
The Children’s Environmental Health Branch of DENR, via its Lead Poisoning Prevention Program, catalogues data on the results of blood lead level screenings and testing among children (115). Results for the period from 2005 through 2009 are presented in Tables 15 and 16.
Table 15 presents results of routine screening data for children ages 1 and 2. (These are the ages for which universal blood lead screening is recommended.) Note that statewide, the number and percentage of children in this age group testing positive for blood lead levels ≥ 10µg/dL declined every year during the period cited, even as the number tested was rising. The pattern in Person County is not as clear, although the percentage testing positive at a level ≥ 10µg/dL in 2009 was lower than the comparable percentage in 2005.
Table 15. County Childhood Lead Screening Results, Ages 1 and 2 years
Target No. No. ≥10 % ≥10 Year Location % Tested Population1 Tested2 µg/dL µg/dL Person County 960 491 51.1 2 0.4 2009 Granville County 1,249 646 51.7 3 0.5 (Draft) State of NC 261,644 129,267 49.4 581 0.4 Person County 950 476 50.1 4 0.8 2008 Granville County 1,286 622 48.4 7 1.1 State of NC 258,532 121,023 46.8 654 0.5 Person County 923 369 40.0 2 0.5 2007 Granville County 1,289 718 55.7 7 1.0 State of NC 250,686 112,556 44.9 706 0.6 Person County 899 395 43.9 4 1.0 2006 Granville County 1,248 716 57.4 1 0.1 State of NC 242,813 103,899 42.8 867 0.8
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Target No. No. ≥10 % ≥10 Year Location % Tested Population1 Tested2 µg/dL µg/dL Person County 881 362 41.1 4 1.1 2005 Granville County 1,247 663 53.2 9 1.4 State of NC 238,065 96,623 40.6 873 0.9
Source: NC Department of Environment and Natural Resources, Children’s Environmental Health Branch, Lead Poisoning Prevention Program, Surveillance Data Tables (2009 [Draft], 2008, 2007, 2006, 2005 Lead Surveillance Data); http://www.deh.enr.state.nc.us/ehs/Children_Health/Lead/Surveillance_Data_Tables/surveillance_data_tables.html 1 “Target Population” is based on the number of live births in preceding years. 2 “Number Tested” is an unduplicated count of children tested for lead poisoning within the calendar year. Note: Children are counted as being tested for lead poisoning in successive years until they are confirmed to have a lead level ≥ 10µg/dL. Confirmation is based on a child receiving two consecutive blood lead test results ≥ 10µg/dL within a six-month period. “Confirmed” lead levels are based on the confirmation data and are classified according to the highest level confirmed during the calendar year.
Table 16 presents testing results for children ages six months to six years for the same period. These children were tested because a lead poisoning hazard had been identified in their residential housing unit or their child-occupied facility (e.g., daycare facility). The numbers of children with high blood lead levels (10-19 µg/dL) in Person and Granville Counties are low and likely unstable, and therefore unsuitable for trending or comparing. Statewide, the number of children with confirmed blood lead levels in the 10-19 µg/dL range decreased every year even as the number tested increased. The number of children statewide with blood lead levels greater than or equal to 20µg/dL remained approximately constant (36-38) from year to year over the last four years of the overall period cited.
Table 16. County Childhood Lead Testing Results, Ages 6 Months to 6 years
No. No. No. Year Location Confirmed Confirmed Tested 10-19 µg/dL ≥20 µg/dL
Person County 660 0 0 2009 (Draft) Granville County 771 0 0 State of NC 160,563 143 38 Person County 625 0 0 2008 Granville County 687 2 0 State of NC 152,222 181 36 Person County 524 1 0 2007 Granville County 802 1 0 State of NC 143,972 232 38 Person County 622 2 0 2006 Granville County 805 1 0 State of NC 135,595 255 38
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No. No. No. Year Location Confirmed Confirmed Tested 10-19 µg/dL ≥20 µg/dL
Person County 593 3 1 2005 Granville County 761 4 1 State of NC 128,249 299 53
Source: NC Department of Environment and Natural Resources, Children’s Environmental Health Branch, Lead Poisoning Prevention Program, Surveillance Data Tables (2009 [Draft], 2008, 2007, 2006, 2005 Lead Surveillance Data); http://www.deh.enr.state.nc.us/ehs/Children_Health/Lead/Surveillance_Data_Tables/surveilla nce_data_tables.html Note: “Confirmed 10-19” and “Confirmed ≥ 20” are mutually exclusive.
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Person County Community Health Assessment – Volume Two Agricultural Pollution
Chapter Five: Agricultural Pollution
Growing crops successfully involves the application of a variety of chemicals, some of which have environmental effects beyond their intended use. Unfortunately, most of these effects are deleterious. Livestock production also requires chemicals, mostly in the form of food additives and antibiotics. Another major environmental issue connected with livestock production is the generation of animal waste. In order to understand the effect of a county’s agricultural production on the environment, it is first necessary to understand the nature of the crops being grown and livestock being raised. One aid in this task is the US Census of Agriculture, which is conducted every five years by the US Department of Agriculture. The most recent Census of Agriculture was completed in 2007; the data were released in February, 2009 and updated in December 2009. The following section presents Person County data from the 2007 US Census of Agriculture, and compares some of it to data from the 2002 Census of Agriculture.
Person County Agricultural Census
From the 2007 US Census of Agriculture (116):
In 2007, Person County was home to 403 farms (up from 374 in 2002), involving a total of 98,521 acres, 31.2% of which (30,696 acres) was in harvested cropland. The average size of a farm in Person County in 2007 was 244 acres, down 4% from the average size in 2002.
In terms of the total market value of agricultural products sold, Person County ranked 78th out of 100 counties statewide in 2007. The per-farm market value of products sold was $47,857 in 2007, down 1% from a comparable value of $48,454 in 2002. The average government payment received by each Person County farm in a government program in 2007 was $6,826, up 62% from the comparable figure in 2002. With average per farm production expenses of $49,224 in 2007, average per farm net cash farm income of operation was only $7,799.
Fewer than half of the Person County farm operators (170 out of 403) listed farming as their primary occupation in 2007. The average age of the principal operators of Person County farms (18% of whom were female) in 2007 was 57.1 years.
The NC Department of Agriculture’s Agricultural Statistics Division catalogues annual estimates on the production of crops and livestock throughout the state on a county basis. However, the Division imposes numeric thresholds for the data it releases. For instance, information regarding livestock raised is not reported for counties with fewer than 1,000 hogs, 500 total cattle, 200 beef or milk cows, 500,000 broilers or turkeys, or 50,000 other chickens.
Table 17 summarizes Person County crop data for 2009; Table 18 summarizes livestock data. The crop data will be used subsequently to describe chemicals (pesticides and herbicides) that may be used in the county, and the livestock data will be used to calculate animal waste production estimates.
Soybeans are the crop in Person County with the most acres harvested, but flue-cured tobacco is the leader in terms of the monetary value of production (Table 17). The primary livestock raised in Person County is cattle; the county ranks 42nd in NC in the production of this commodity (Table 18).
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Table 17. Person County Crop Data, 2009
Yield Acres State Crop per Production Harvested Rank Acre Corn for Grain (Bu.) 3,100 98 305,000 50 Cotton (Lbs); Production in 480 Lb. Bales n/a n/a n/a n/a Hay, Other (Tons) 9,200 1.65 15,000 41 Peanuts (Lbs.) n/a n/a n/a n/a Soybeans (Bu.) 10,300 24.0 247,000 52 Sweet Potatoes (Cwt.) n/a n/a n/a n/a Tobacco, Burley (Lbs.) 200 2,310 462,000 3 Tobacco, Flue-Cured (Lbs.) 3,260 2,385 7,776,000 18 Wheat (Bu.) 6,900 35.0 240,000 38 Nursery, Greenhouse, Floriculture, Christmas Trees (Dollars) 1,110,000 53
Source: NC Department of Agriculture and Consumer Services, Agricultural Statistics Division, 2010 Annual Statistics Book, County Summary: Person; http://www.ncagr.gov/stats/2010AgStat/index.htm Note: “n/a” signifies a value below the threshold for reporting.
Table 18. Person County Livestock Data, 2010
State Livestock Number Rank Broilers Produced (2009) n/a n/a Cattle, All (Jan. 1, 2010) 7,500 42 Beef Cows (Jan. 1, 2010) 3,400 43 Milk Cows (Jan 1, 2010) n/a n/a Chickens, Excluding Broilers (Dec. 1, 2009) n/a n/a Hogs and Pigs (Dec. 1, 2009) 5,000 47 Turkeys Raised (2009) n/a n/a
Source: NC Department of Agriculture and Consumer Services, Agricultural Statistics Division, 2010 Annual Statistics Book, County Summary: Person; http://www.ncagr.gov/stats/2010AgStat/index.htm Note: “n/a” signifies a value below the threshold for reporting.
Pesticides
A pesticide is any substance or mixture of substances intended for preventing, destroying, repelling, or mitigating any pest. Though often misunderstood to refer only to insecticides, the term pesticide also applies to herbicides, fungicides, and various other substances used to control pests. Under US law, a pesticide also is any substance or mixture of substances intended for use as a plant regulator, defoliant, or desiccant (117).
By their very nature, most pesticides create some risk of harm to humans, animals, or the environment because they are designed to kill or otherwise affect living organisms.
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Pesticides Used on Crops
To provide an example of the number and variety of pesticides that may be used on a particular crop, Table 19 list the agricultural chemicals possibly applied to the largest non-forage crop (by acres harvested) grown in Person County: soybeans. The list of chemicals is based on recommended kinds and rates of application of insecticides, herbicides, fungicides (and other disease control agents), and plant growth regulators for specific crops as described in the NC Cooperative Extension Service 2011 Agricultural Chemicals Manual (118).
It is not possible to calculate the precise volume of each chemical applied because although there are recommended application rates, it is the individual farm operator’s choice for which plants, how much and how often to apply crop chemicals. The list as presented here denotes only what might be being applied to soybeans, and for what purpose, in Person County.
Table 19. Agricultural Chemicals Commonly Applied to Soybeans
Chemical (and Trade Name) Used to Control Insecticides Acephate (Orthene 97) Bean leaf beetle, grasshopper, stink bug, velvetbean caterpillar, grape colaspis blister beetle and others Bacillis thuringiensis (Dipel, Javelin and others) Green cloverworm, soybean looper Carbaryl (Sevin XLR and others) Corn earworm, velvetbean caterpillar, grape colaspis blister beetle and others Chlorpyrifos (Lorsban) Bean leaf beetle, corn earworm, grasshopper, green cloverworm, velvetbean caterpillar Chlorpyrifos + gamma-cyhalothrin )(Cobalt) Bean leaf beetle Cyfluthrin (Baythroid XL) Bean leaf beetle, corn earworm Encapsulated methyl parathion (Penncap-M) Stink bug Esfenvalerate (Asana XL) Corn earworm Flubendiamide (Belt SC) Corn earworm, soybean looper Gamma cyhalothrin (Prolex, Declare) Corn earworm, stink bug Imidacloprid + beta cyfluthrin (Leverage 360) Corn earworm Indoxacarb (Steward SC) Beet armyworm, corn earworm, green cloverworm, soybean looper, velvetbean caterpillar Lambda-cyhalothrin (Karate Z, Warrior II) Bean leaf beetle, corn earworm, stink bug, grape colaspis blister beetle and others Lambda-cyhalothrin + thiamethoxam (Endigo) Bean leaf beetle Methomyl (Lannate LV) Beet armyworm, corn earworm Methoxyfenozide MOA 18A (Intrepid) Beet armyworm, soybean looper Methyl parathion Stink bug Permethrin (Pounce 25 WP) Corn earworm Spinetoram (Radiant SC) Soybean looper Spinosad (Tracer) Beet armyworm, corn earworm, green cloverworm, soybean looper, velvetbean caterpillar Spinosad + gamma cyhalothrin (Consero) Soybean looper Thiodicarb (Larvin) Beet armyworm, corn earworm, green cloverworm, soybean looper, velvetbean caterpillar Zeta cypermethrin (Mustang Max EX) Corn earworm, stink bug Zeta cypermethrin + bifenthrin (Hero) Corn earworm, stink bug, grape colaspis blister beetle and others
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Herbicides 2,4-D, MOA 4 (numerous brands) Cutleaf evening primrose, wild radish, vetch, horseweed, and others 2,4-DB, MOA 4 (various brands) Cocklebur, morningglory Acifluorfen, MOA 14 (Ultra Blazer) Annual broadleaf weeds Acifluorfen, MOA 14 + bentazon, MOA 6 Annual broadleaf weeds (Storm) Alachlor, MOA 15 (Intrro, Micro-Tech) Annual grasses Bentazon, MOA 6 (Basagran) Annual broadleaf weeds, nutsedge Carfentrazone, MOA 14 (Aim) Annual broadleaf weeds Chlomazone, MOA 13 (Command 3 ME) Annual grasses, annual broadleaf weeds Chloransulam-methyl, MOA 2 (FirstRate) Annual broadleaf weeds Chlorimuron ethyl, MOA 2 (Classic) Annual broadleaf weeds, nutsedge Chlorimuron ethyl, MOA 2 + thifensulfuron Annual broadleaf weeds, nutsedge methyl, MOA 2 (Synchrony XP) Clethodim, MOA 1 (Select, Select Max)) Annual grasses and broadleaf weeds Dicamba, MOA 4 (Clarity) Horseweed and others Dimethenamid-P, MOA 15 (Outlook) Annual broadleaf weeds, annual grasses Ethalfluralin, MOA 3 (Sonalan) Annual grasses Fluazifop-p-butyl, MOA 1 (Fusilade DX) Annual grasses Flumetsulam, MOA 2 (Python) Annual broadleaf weeds Flumichlorac pentyl ester, MOA 14 (Resource) Annual broadleaf weeds Flumioxazin,MOA 14 (Valor SX) Annual broadleaf weeds, horseweed and others Fomesafen, MOA 14 (Flexstar, Reflex, Others) Annual broadleaf weeds Glyphosate, MOA 9 (numerous brands) Emerged grass and broadleaf weeds, cutleaf eveningprimrose, wild radish, vetch, horseweed, Italian ryegrass, wheat, barley, rye and others Glyphosate, MOA 9 + fomesafen, MOA 14 Emerged grass and broadleaf weeds (Flexstar GT) Glyphosate, MOA 9 + thifensulfuron, MOA 2 Curly dock, vetch, Carolina geranium and others (Harmony SG) Glufosinate, MOA 10 (Ignite 280) Horseweed and others Imazamox, MOA 2 (Raptor) Annual broadleaf weeds Imazaquin, MOA 2 (Scepter) Annual broadleaf weeds Imazethapyr, MOA 2 (Pursuit) Annual broadleaf weeds Lactofen, MOA 14 (Cobra) Annual broadleaf weeds Linuron, MOA 7 (Linex) Annual broadleaf weeds Metolachlor, MOA 15 (Parallel, Parrlay, others) Annual grasses, annual broadleaf weeds Metribuzin, MOA 5 (Sencor) Annual broadleaf weeds Metribuzin, MOA 5 + S-metolachlor, MOA 15 Annual grasses and broadleaf weeds (Boundary) Paraquat, MOA 22 (Gramoxone Inteon) Emerged grass and broadleaf weeds Pendimethalin, MOA 3 (Prowl) Annual grasses Pyraflufen-ethyl, MOA 14 (ET) Annual broadleaf weeds, cutleaf eveningprimrose, wild radish, vetch and others Qizalofop p-ethyl, MOA 1 (Assure II) Annual grasses S-metolachlor, MOA 15 (Brawl, Cinch, others) Annual grasses, annual broadleaf weeds S-metolachlor, MOA 15 + fomesafen, MOA 14 Annual grasses and broadleaf weeds (Prefix) Saflufenacil, MOA 14 (Sharpen) Horseweed and others Sethoxydim, MOA 1 (Poast) Annual grasses Sulfentrazone, MOA 14 + metribuzin, MOA 5 Annual broadleaf weeds (Authority MTZ) Thifensulfuron methyl, MOA 2 (Harmony) Annual broadleaf weeds
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Trifluralin, MOA 3 (Treflan) Annual grasses Disease Control Agents Abamectin (Avicta) Root-knot, Columbia lance, lesion nematode Aldicarb (Temik) Sting, Columbia lance nematode Azoxystrobin (Strobis, Quadris) Frogeye leaf spot, target spot, Asiatic soybean rust Captan + PCNB + thiabendazole (Rival) Damping-off, seed decay Chlorothalonil (various brands) Frogeye leaf spot, target spot, Asiatic soybean rust Cyproconazole (Alto) Asiatic soybean rust Dichlorophene (Telone II) Root-knot, Columbia lance nematode Fluoxastrobin (Evito) Frogeye leaf spot, target spot, Asiatic soybean rust Flutriafol (Topguard) Asiatic soybean rust Mefenoxam (Ridomil Gold, Apron) Phytophthora root rot, phytophthora or pythium damping-off, downy mildew on seed Mefenoxam + fludioxonil (Apron Maxx RTA) Damping-off complex, phytophthora or pythium,. And rhizoctonia Metalaxyl + PCNB + carboxin (Prevail) Damping-off complex, phytophthora or pythium,. And rhizoctonia Metconazole (Caramba) Asiatic soybean rust Myclobutanil (Laredo) Asiatic soybean rust Propiconazole (Tilt, Propimax, Bumper) Asiatic soybean rust Prothioconazole (Proline) Asiatic soybean rust Pyraclostrobin (Headline) Frogeye leaf spot, target spot, Asiatic soybean rust Tetraconazole (Folicur, Orius, Uppercut) Asiatic soybean rust Thiophanate-methyl (Topsin M) Frogeye leaf spot, target spot Thiram + carboxin (Vitavax 200) Damping-off, seed decay Triflozystrobin + propiconazole (Stratego) Frogeye leaf spot, target spot
Source: NC State University, College of Agriculture and Life Sciences, NC Cooperative Extension Service. 2011 NC Agricultural Chemicals Manual. Available at: http://ipm.ncsu.edu/agchem
Noteworthy from Table 19 is the extensive range of chemicals possibly being used on soybeans and therefore possibly being introduced into the natural environment. Further, note that the above list covers only pesticides used on soybeans; pesticides used on other crops in Person County 9e.g., wheat, tobacco and corn) might be different.
Health and Environmental Risks of Pesticides
The effects of pesticides on human health depend on the type of pesticide, the concentration, and the length of exposure. Some types of pesticides, such as the organophosphates and carbamates, affect the nervous system. Others may irritate the skin or eyes. Some pesticides may be carcinogens; others may affect the hormone or endocrine systems in the body (119).
Human exposures to agricultural chemicals can occur through air, water, and direct contact. Sprayed pesticides can be carried in droplets into the air, and it is possible for pesticides and their degradation products to run off into surface waters and leach into groundwater. The greatest effects of agricultural chemicals may be borne by the people who mix and apply pesticides, thus possibly coming into direct, repeated contact with them. The NC State Center for Health Statistics reports a total of five pesticide poisoning deaths statewide in the period from 2004 through 2009, none of which occurred in Person County (120). Data on illness due to pesticide exposure is far more elusive than the number of deaths. Although state- and county-level data is available listing hospital discharges due to poisoning and other accidental injury, this data does not separate poisonings by source.
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To provide examples of the environmental and health risks and health effects of chemicals applied to crops, Table 20 presents data from the Pesticide Action Network of North America (121) on some of the insecticides, herbicides, fungicides and other chemicals that may be being applied on Person County soybeans (from Table 19).
Table 20. Health and Environmental Risks of Chemicals Possibly Used on Crops in Person County
Developmental Cholin- Ground Acute Carcino- or Endocrine Chemical esterase Water 3 Toxicity genicity 1 Reproductive. Disruptor Inhibitor Contaminant 2 Toxicity Insecticides Acephate Slight Possible Yes Potential Unknown Suspected Carbaryl Moderate High Yes Potential High Suspected Chlorpyrifos Moderate Not likely No Unknown Unknown Unknown Cyfluthrin Moderate Not likely No Unknown Unknown Unknown Cypermethrin Unknown Possible No Unknown Unknown Suspected Esfenvalerate Moderate Not likely No Unknown Unknown Suspected Flubendiamide Unknown Not likely No Unknown Unknown Unknown Gamma cyhalothrin Unknown Not likely No Unknown Unknown Suspected Indoxacarb Moderate Not likely No Unknown Unknown Unknown Lambda-cyhalothrin Unknown Unknown No Unknown Unknown Unknown Methyl parathion High Unclassifiable Yes Potential Unknown Suspected Permethrin Moderate High No Unknown Unknown Suspected Spinetoram Unknown Not likely No Potential Unknown Unknown Spinosad Slight Not likely No Unknown Unknown Unknown Thiodicarb Moderate High Yes Unknown Unknown Unknown Zeta-cypermethrin High Possible No Unknown Unknown Suspected Herbicides 2,4-D, 2-ethylhexyl ester Slight Possible No Potential High Suspected 2,4-D, dimethyaminel salt High Possible No Potential Unknown Suspected Acifluorfen Slight Unknown No Unknown Unknown Unknown Alachlor Slight High No High High Suspected Bentazon Slight Not likely No Unknown Unknown Unknown Carfentrazone-ethyl No Not likely No Unknown Unknown Unknown Chloransulam-methyl Slight Not likely No Unknown Unknown Unknown Chlorimuron ethyl Slight Not likely No Unknown Unknown Unknown Clethodim Moderate Not likely No Potential Unknown Unknown Dicamba Slight Unclassifiable No Potential High Unknown Dimethenamid Moderate Possible No Unknown Unknown Unknown Ethalfluralin Moderate Possible No Unknown Unknown Unknown Flumetsulam Slight Note likely No Unknown Unknown Unknown Flumiclorac-pentyl Slight Not likely No Unknown Unknown Unknown Flumioxazin Unknown Not likely No Unknown Unknown Unknown Fomesafen Slight Possible No Unknown Unknown Unknown Glyphosate Slight Not likely No Potential Unknown Unknown Glufosinate Slight Unknown No Unknown Unknown Suspected Imazamox Slight Not likely No Unknown Unknown Unknown Imazaquin Slight Not likely No Unknown Unknown Unknown Lactofen Unknown High No Unknown Unknown Unknown Linuron Slight Possible No Potential High Suspected Metolachlor Slight Possible No High Unknown Suspected
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Developmental Cholin- Ground Acute Carcino- or Endocrine Chemical esterase Water 3 Toxicity genicity 1 Reproductive. Disruptor Inhibitor Contaminant 2 Toxicity Metribuzin Moderate Unclassifiable No Potential High Suspected Paraquat High Not likely No Potential Unknown Suspected Pendimethalin Slight Possible No Unknown Unknown Suspected Pyraflufen-ethyl Unknown High No Unknown Unknown Unknown S-Metolachlor Slight Possible No High Unknown Suspected Saflufenacil Unknown Not likely No Unknown Unknown Unknown Sethoxydim Slight Not likely No Potential Unknown Unknown Thifensulfuron methyl Unknown Unknown No Unknown Unknown Unknown Trifluralin Slight Possible No Unknown Unknown Suspected Disease Control Agents Aldicarb High Unclassifiable Yes High Unknown Suspected Azoxystrobin Not acute Not likely No Potential Unknown Unknown Chlorothalonil High High No Potential Unknown Unknown Cyproconazole Slight High No Unknown Unknown Unknown Dichlorophene Moderate Possible No Unknown High Unknown Fluoxastrobin Unknown Not likely No Unknown Unknown Unknown Flutriafol Slight Not likely No Potential Unknown Suspected Mefanoxam High Not likely No Potential Unknown Unknown Metconazole Slight Not likely No Unknown Unknown Unknown Myclobutanil Slight Not likely No Unknown High Suspected Propiconazole Moderate Possible No Potential High Suspected Pyraclostrobin Unknown Not likely No Potential Unknown Unknown Pyraclostrobin Unknown Not likely N o Potential Unknown Unknown Tetraconazole Moderate High No Potential Unknown Unknown
Source: Pesticide Action Network North America (PANNA), Pesticide Action Network (PAN) Pesticide Database, Search Alphabetized Chemical List, Alphabetical List of All Chemicals in the PAN Database; http://www.pesticideinfo.org/List_ChemicalsAlpha.jsp
1 Proper functioning of the nervous system requires an enzyme called cholinesterase (ChE), which facilitates the transmission of nerve impulses. ChE-inhibiting pesticides disable this enzyme, resulting in symptoms of neurotoxicity: tremors, nausea, and weakness at low doses; paralysis and death at higher doses. Most of these pesticides are insecticides with a similar mechanism of action in both insects and humans. Exposure to cholinesterase-inhibiting pesticides has been linked to impaired neurological development in the fetus and in infants, chronic fatigue syndrome, and Parkinson's disease. 2 Causing birth defects, infertility, sterility and impairment of normal growth and development. 3 Substance that interferes with the synthesis, secretion, transport, binding, action, or elimination of natural hormones in the body that are responsible for the maintenance of normal cell metabolism, reproduction, development, and/or behavior.
What is noteworthy from Table 20 is how much is not known about the environmental and health effects of the agricultural chemicals being used on crops.
Agricultural Animal Waste
Animal waste from livestock sometimes finds its way into surface and/or groundwater, with the amounts depending on the waste collection and treatment practices being implemented by individual farmers, or “corporate” farms. At farms where animals are allowed to graze on pasture, much—if not all—of their manure is excreted directly onto the land, serving as a fertilizer and recycling nutrients back into the soil.
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On industrial livestock farms, however, animals drop their manure in the houses where they live. From there, the manure must be cleaned out, transported, and stored, each step of which can negatively affect the environment. Manure is usually stored for many months, often in giant outdoor pits known as lagoons. As it decomposes, the manure emits potentially harmful gases such as ammonia and hydrogen sulfide. These lagoons can leak or rupture, polluting the surrounding soil and water systems. Even without leaks, manure lagoons are so fragile that major storms often result in overflows. Perhaps most famously, in 1999 the majority of NC’s manure lagoons in the eastern part of the state spilled over into waterways during Hurricane Floyd, leading to widespread water contamination (122).
Since manure is produced on factory farms in excess of what can safely be absorbed by the farm's soil, it is often shipped to neighboring farms for use as fertilizer. Once the manure arrives at its destination, it is sprayed onto farm fields. Under the current system of animal production, however, there is often more manure available than can be absorbed by the soil as fertilizer. This practice can result in contamination of human drinking water through leaching and/or run-off. In addition, factory livestock facilities release over 400 separate gases, mostly due to the large amounts of manure they produce. The principal gases released are hydrogen sulfide, methane, ammonia, and carbon dioxide (122).
Among the many nutrients usually present in high concentrations in animal waste are phosphorous and nitrogen, which are beneficial to the soils when the manure is added in small concentrations. However, the volume of manure usually found in lagoons and storage systems, and subsequent very high concentrations of nutrients, can cause a range of ecological problems like fish kills or a loss in biodiversity when released into the environment, and can affect human health when leached into drinking water (122).
Table 21 shows the extent of livestock farming among the 403 farms in Person County farms in 2007. Beef cattle ranching/farming composes the largest proportion of livestock operations in Person County (94 farms). Note that no cattle raising operations in the county classify as “feedlot” operations.
Table 21. Person County Farms by North American Industry Classification System, 2007
Number of Type of Livestock Farming Farms Beef cattle ranching and farming 94 Cattle feedlots 0 Dairy cattle and milk production 3 Hog and pig farming 3 Poultry and egg production 11 Sheep and goat farming 33 Animal aquaculture and other animal production 47
Source: US Department of Agriculture, National Agricultural Statistics Service, 2007 Census of Agriculture, Volume I, Chapter 2, County Level Data, North Carolina, Table 45. Farms by North American Industry Classification: 2007; http://www.agcensus.usda.gov/Publications/2007/Full_Report/Volume_1,_Chapter_2_County_Level/ North_Carolina/st37_2_045_045.pdf
Table 22 offers a profile of animal waste production in Person County in 2009, using as its base the livestock production data from Table 18. The waste computation uses per-head waste production estimates, by animal source, that were developed in 2002 by NC State University researchers and personnel from the NC Department of Agriculture and Consumer Services+ (123). According to these
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Person County Community Health Assessment – Volume Two Agricultural Pollution calculations, an estimated 71,750 tons of animal waste were produced by Person County livestock in 2009.
Table 22. Estimated Livestock Waste Production in Person County, 2009
Feces and Urine Total Feces and Livestock Number of Production Urine Produced Category Head (tons/year/head) (tons/year) Cattle All cattle 7,500 8.31 62,250 Swine Hogs and Pigs 5,000 1.9 9,500
Source: NC State University, 2002 North Carolina Agricultural Chemicals Manual, Livestock Manure Production Rates and Nutrient Content; http://agrienvarchive.ca/bioenergy/download/barker_ncsu_manure_02.pdf
1 Because the livestock category “cattle” is not subdivided into beef and dairy, the waste rate for beef cattle was applied. Note that the annual per head waste produced by dairy cattle is 22.3 tons/year, or almost three times the rate for beef cattle; therefore, the total waste production estimate for cattle in the table is likely low, since the actual cattle census contains both beef and dairy cattle.
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Chapter Six: Waste Management
Solid Waste Management
Table 23 presents figures summarizing tonnage of solid waste disposed in Person County, Granville County and NC for the period FY2005-06 through FY2008-09. In FY2008-09, Person County managed 32,203 tons of municipal solid waste (MSW) for a rate of 0.86 tons per capita. This tonnage represented an increase of 7% from the per capita rate for FY1991-92 (the period customarily used for the base rate). During the same 2008-09 period Granville County reduced its per capita rate by 31%, and the overall state per capita solid waste management rate was the same as the FY1991-92 base per capita rate. According to the NC Division of Waste Management (DWM), the tonnage disposed statewide in FY2008-09 was an all-time low, due primarily to the national recession, a resulting decline in construction waste, and increased costs for disposal (124).
Table 23. Solid Waste Disposal, FY2005-06 through FY2008-09
MSW Tons Base Year Per Capita % Cha nge MSW Tons Disposed Location Managed Per Capita Rate Base Year to 1991-1992 2005-06 2006-07 2007-08 2008-09 (1991-1992) 2008-2009 Current
Person County 24,249 34,837 37,856 38,464 32,203 0.80 0.86 +7% Granville County 54,548 74,764 71,823 62,550 54,204 1.39 0.96 -31% State of NC 7,257,428 11,765,855 11,837,104 11,284,712 9,910,031 1.07 1.07 0%
Source: NC Department of Environment and Natural Resources, Division of Waste Management, Solid Waste Program, NC Solid Waste Management Annual Report, Fiscal Year 2008-2009, Appendix B: County Population, Waste Disposal, Per Capita Rate and Percent Reduction, FY2008-2009; http://wastenot.enr.state.nc.us/swhome/AR08_09/AR08_09.pdf
County-Level Solid Waste Collection
The one active public solid waste facility in Person County is the Upper Piedmont Regional Municipal Solid Waste (MSW) Landfill, located between Roxboro and Oxford NC, in Rougemont NC (125). This landfill, which began accepting waste in 1997, is owned by Republic Services of NC, LLC, and is operated by Upper Piedmont Environmental. The landfill currently accepts municipal solid waste from counties within 60 statute miles of Person County. This is a Subtitle D, lined municipal solid waste landfill (126). Residential and commercial waste is collected in the County through a subscription service with private haulers, who transport the collected waste to the landfill (127).
In addition to the municipal solid waste facility, there is an active industrial waste landfill and an active land clearing and inert debris (LCID) landfill, both in Semora and both operated by Progress Energy. There are no active permitted construction and demolition (CD) landfills in Person County (125).
In July, 2007, Upper Piedmont Regional Landfill received a permit from the NC Division of Solid Waste to operate Cell 4B of its landfill. With the opening of cell 4B, the facility applied for a Title V permit for modifications related to the installation of a landfill gas collection and control system. The modifications were intended to prevent the release of hazardous air pollutants and odiferous gases (126). Nevertheless, a review of actions and requests related to the Upper Piedmont Regional Landfill operational permit indicates the facility periodically has ignited community controversy, most commonly over odor emissions or expansion plans (128).
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Town-Level Solid Waste Collection
City of Roxboro. The City of Roxboro provides curbside residential solid waste collection (garbage and trash) once a week and commercial solid waste collection in front loaders as needed to local businesses (127). Yard waste is also eligible for collection providing it is properly bagged, boxed or containerized in city-approved containers; the City mulches this yard waste. The City does not collect construction, remodeling or demolition materials; disposed white goods will be picked up by appointment (129). The City does not charge any fee for residential garbage collection, but charges a monthly fee for commercial garbage collection services based on a monthly rental fee for dumpsters and a charge for each time the dumpster is emptied (130).
County-Level Recycling
In June, 2009, the Person County Recycling Center opened, operated by clients and staff of Person Industries, a Community Rehabilitation Program (CRP) in Roxboro and a department within Person County Government. This facility supplanted a manned drop-off recycling center that collected nearly 440 tons during FY2007-2008 (127). The new Person County Recycling Center, available only to residents anywhere in Person County, receives single stream recyclables from individuals, businesses, schools and waste carriers. The Center currently operates a drop-off materials recovery facility (MRF) that accepts newspaper, mixed paper, and corrugated cardboard; clear, brown and green glass bottles and food jars; aluminum and steel cans; and plastics #1 through #7 (131).
Town-Level Recycling
City of Roxboro. The City of Roxboro does not operate its own government-sponsored recycling center, but residents of the City can use the services of the County-sponsored Person County Recycling Center.
Landfill Capacity
As noted previously, municipal solid waste in Person County is collected at the Upper Piedmont Regional MSW Landfill. In FY2008-09 the regional landfill reported collecting 32,203 tons of municipal solid waste (132).
The projected life of landfills is of regional and local concern. The Upper Piedmont Regional MSW Landfill was opened in 1997; in 2009 it was estimated to have a remaining capacity of approximately 3.012 million tons and a projected lifetime of approximately 13 years at current disposal rates (133).
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Wastewater Management
According to 1990 Census data (data are not available for the 2000 Census, and 2010 Census data had not yet been released by the time of this report), 3,861 Person County housing units (30.8%) were on a year-round public sewer system and 8,045 (64.1%) residences had septic tanks. An additional 642 housing units (5.1%) had some other form of sewage disposal, including individual sewer pipes into creeks, rivers and streams (straight pipes) or outhouses. The comparable percentages in Granville County in 1990 were 36.0%, 58.4%, and 5.6% respectively, and statewide the corresponding figures were 49.8%, 48.4%, and 1.8%, respectively (134).
Municipal Wastewater Management
There is only one wastewater treatment in Person County. It was constructed in 1964 and enlarged in 1982. Its present treatment capacity is 5.0 million gallons of sewage per day (MGD). The Wastewater Treatment Plant is located at 902 Cavel-Chub Lake Road just outside the City of Roxboro.
The sewage collection system consists of over 100 miles of sewer lines, manholes, ten lift stations and the Wastewater Treatment Plant. Both the collection system and the Wastewater Treatment Plant are part of the City of Roxboro's Public Services Department. The system serves primarily residents of the City of Roxboro and some additional customers outside the city limits (135).
On-Site Wastewater Management
According to the 1990 Census data sited above, only approximately 31% of Person County residences were connected to year-round public sewer, meaning 69% had septic tanks or some other mechanism of sewage disposal. Many individual residences rely on septic tanks for on-site sewage treatment, but some communities and commercial and government facilities outside of the sanitary sewer district depend on on-site wastewater treatment systems, or “package plants” for wastewater treatment.
Package treatment plants are usually constructed and maintained by developers to service residential subdivisions and commercial projects. These systems carry some community risk: unless a package treatment plant is properly maintained and continuously monitored, it can break down, inconvenience the property owners who depend on it, and threaten public health. As a result, local governments usually seek financially and legally binding assurances from developers and homeowners associations that package treatment plants will be properly managed and maintained so they do not become a public burden.
On July 1, 2011, the On-Site Water Protection Section of DENR listed 12 “large wastewater systems” (package plants) in Person County (136). Represented among them are numerous types of systems, some combining multiple wastewater treatment modalities. Communities served by these systems include the airport, trailer parks, a church, a car wash, government entities, and private property.
The focus of the On-Site Water Protection Section of DENR is not on assuring adequate operations of large wastewater systems (which are the responsibility of the Environmental Health Division of the local health department) but rather on protecting surface and groundwater from degradation. The Section’s work includes: evaluating and documenting appropriate innovative and alternative systems from both public health and water quality perspective; documenting potential effects of on-site wastewater systems and community wastewater systems on coastal water quality; evaluating and documenting the
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extent of water quality impacts from high-density on-site wastewater systems and by designing measures to mitigate water quality impacts; evaluating potential programs (rules) for improved life cycle management of on-site wastewater systems, advanced wastewater treatment and disposal systems; coordinating and facilitating educators and technology transfer to government agencies and to the public; and encouraging local governments, interstate or intrastate agencies, public and private nonprofit organizations and institutions to participate in this program through federal, state and/or local funding. Grants that support the Section’s work are allocated by the EPA (137).
As noted previously, local health departments are charged with permitting and inspecting on-site wastewater facilities. Table 24 presents a summary of selected Person County Health Department (PCHD) On-Site Wastewater activities for 2007-2010. The decrease in new permits noted over the period cited may be a reflection of the recent economic downturn and its effect on local development.
Table 24. PCHD Environmental Health Section On-Site Wastewater Activity Summary 2007-2010
Activity 2007 2008 2009 2010
Site Evaluations (including repairs) 298 166 114 177 Permits Issued New/Repair 229 208 138 124 Building Additions/Mobile Home Replacement 93 79 69 63 Sewage Complaint Investigations n/a n/a n/a 32
Source: Harold Kelly, Person County Health Department, Environmental Health Section, personal communication to LeighAnn Creson, Health Educator, Person County Health Department, July 21, 2011.
Permitted Wastewater Discharges
The US Clean Water Act of 1972 initiated strict control of wastewater discharges with the responsibility of enforcement given to the EPA. The EPA then created the National Pollutant Discharge Elimination System (NPDES) to track and control point sources of pollution in surface waters. The primary method of control is the issuance of permits to dischargers with limitations on wastewater flow and constituents. The EPA delegated permitting authority to the State of NC in 1975 (138).
In NC, the NPDES Unit in DENR’s DWQ is responsible for issuing wastewater discharge permits. This process includes determining the quality and quantity of treated wastewater that the receiving stream can assimilate, incorporating input from stream modeling, collaborating with Regional Office staff, and evaluating the discharger’s location. In addition to administering the NPDES program throughout the state, the NC NPDES unit is also responsible for enforcing discharge limitations. The penalty for discharging without a permit is a fine of up to $25,000 per day (138).
Table 25 lists the Person County facilities permitted to discharge wastewater to surface waters as of July1, 2011.
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Table 25. Person County NPDES-Permitted Wastewater Discharges (Accessed July 1, 2011)
Permitted Flow Owner Facility Discharge Destination (Gal/Day)
Progress Energy Carolinas, Inc. Mayo Steam Electric Power Plant Mayo Creek Not limited Progress Energy Carolinas, Inc. Roxboro Steam Electric Power Plant South Hyco Creek (Lake Roxboro) Not limited Person County Schools Woodland Elementary School South Hyco Creek 6,000 City of Roxboro Roxboro Water Treatment Plant Marlowe Creek Not limited City of Roxboro Roxboro Wastewater Treatment Plant Marlowe Creek 5,000,000 CPI USA North Carolina LLC Roxboro Plant Mitchell Creek Not limited CertainTeed Gypsum NC, Inc. Gypsum Wallboard Plant Hyco Lake 5,000 Eaton Corporation Roxboro Plant North Flat River 22,000
Source: NC Department of Environment and Natural Resources, Division of Water Quality, Surface Water. NPDES Wastewater Permitting and Compliance Program, Permit Info, List of Active Individual Permits as of 5/2/11; http://portal.ncdenr.org/web/wq/swp/ps/npdes/
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Chapter Seven: Drinking Water
According to the 1990 Census (data is not available for the 2000 Census and not yet available for the 2010 Census), 4,482 year-round housing units in Person County (35.6%) were on a water source supplied by a city or county water department, a water district, a private water company, or a well serving six or more housing units. Another 7,807 units (62.2%) had an individual well as the primary source of water. A smaller number of units – 259 or 2% – obtained water from some other source, such as springs, creeks, rivers, lakes, ponds or cisterns. The comparable percentages in Granville County in 1990 were 40.5%, 57.9%, and 1.6% respectively, and statewide the corresponding figures were 65.4%, 32.4%, and 2.2%, respectively (139).
Water Usage
Table 26 details the annual average rate of water usage in Person County for 1995, 2000 and 2005. For the purposes of this table, domestic water usage includes withdrawal of fresh water from individual wells for domestic uses. Municipal/community water usage is defined as the withdrawal of fresh water from surface and ground water sources by public water supply systems for municipal and commercial uses. Industrial usage is the withdrawal of fresh water from surface and ground water sources or purchases from a water supplier for industrial uses. Irrigation usage refers to water withdrawn from surface and ground sources for agricultural and golf course irrigation, and livestock usage refers to use of surface and groundwater for watering livestock. The total water use is the average annual rate of withdrawal of fresh water from surface and ground water sources for all uses. All figures are reported in millions of gallons per day (MGD) (140).
As illustrated in Table 26, total water usage in Person County increased by 56% from 1995 to 2000, and decreased by a miniscule 0.2% from 2000 to 2005. By far the largest proportion of water used in Person County is utilized for thermoelectric power generation, which in 2005 accounted for 99% of all water usage in the county.
Table 26. Average Annual Rate of Water Usage in Person County, 1995, 2000 and 2005 (Millions of gallons per day)
Thermo- Municipal and electric Domestic Industrial Irrigation Livestock Total Year Community Power Usage Usage Usage Usage Usage Usage Generation Usage 1995 1.46 4.15 0.71 1.73 0.24 670.00 678.29
2000 1.47 3.64 0.00 1.36 0.14 1,052.20 1,058.81
2005 1.79 5.21 0.00 1.51 0.15 1,047.62 1,056.28
Source: Log Into North Carolina (LINC) Database Search. Topic Group: Environment, Recreation and Resources. Data Items 1307, 1308, 1309, 1310, 1311, 1312, 1313; http://data.osbm.state.nc.us/pls/linc/dyn_linc_main.show (accessed July 1, 2011).
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Drinking Water Systems
Community Drinking Water Systems
Groundwater and aquifers have been discussed in Chapter One of this report. Although private wells draw from groundwater, most of the community drinking water systems in Person County source surface water.
As of April 14, 2011, the EPA Safe Drinking Water Information System (SDWIS) lists four active community water systems in Person County (114) that together serve 13,715 people (Table 27). Based on this figure and the 2010 population of 39,464, 34.8% of county residents receive drinking water from community water systems. A community water system is one that serves at least 15 service connections used by year-round residents or regularly serves 25 year-round residents. This category includes municipalities, subdivisions and mobile home parks.
Table 27. Person County Active Community Water Systems (April, 2011)
Number Primary Water Source Water System Name Served Type Bridgewater S/D 30 Groundwater Flat River Mobile Home Community 50 Groundwater Roxboro, City of 13,477 Surface water Timberlake Mobile Home Park 158 Groundwater TOTAL 13,715
Source: US Environmental Protection Agency, Envirofacts Warehouse, Safe Drinking Water Information System (SDWIS). Query: North Carolina, Person County, All Populations, Active; http://www.epa.gov/enviro/html/sdwis/sdwis_query.html#geography
Community Drinking Water System SDWIS Violations
The EPA records violations of drinking water standards reported to it by states in its SDWIS. It records violations as either health-based (contaminants exceeding safety standards or water not properly treated) or monitoring- or reporting-based (system failed to complete all samples or sample in a timely manner, or had another non-health related violation). Table 28 cites only the health-based violations for SDWIS Community Water Systems in Person County for the period from January 2005 through December 2010. There were six health-based violations during the period cited, all for the City of Roxboro Water System. All the noted violations were for total trihalomethane (TTHM) levels in excess of the maximum contaminant level (MCL). The repetitive nature of the violations would seem to indicate an on-going problem, which was acknowledged by the City of Roxboro in its 2010 Annual Drinking Water Quality Report (142). The City is investigating methods to remove organic materials (which are connected with the TTHM problem; see below) from the source water.
Trihalomethanes are byproducts formed during the chlorination process from organic compounds already present in water. The presence of the organic precursor materials usually is more common in surface water than in ground water. Some people who drink water containing trihalomethanes in excess of the Maximum Contaminant Level (MCL) over many years may experience problems with their liver, kidneys, or central nervous systems, and may have an increased risk of getting cancer (143).
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There were numerous citations for monitoring and/or reporting violations at all four community water systems listed in Table 27 during the period cited; these non-health related violations are not presented here.
Table 28. Person County Community Drinking Water Systems SDWIS Health-Based Violations, 2005-2010
System Name Dates Type of Violation Contaminant Roxboro, City of July-Sept, 2010 MCL1, Average TTHM2 Roxboro, City of April-June, 2010 MCL, Average TTHM Roxboro, City of Jan-March, 2010 MCL, Average TTHM Roxboro, City of Oct-Dec, 2009 MCL, Average TTHM Roxboro, City of July-Sept, 2009 MCL, Average TTHM Roxboro, City of Jan-Mar, 2009 MCL, Average TTHM
Source: US Environmental Protection Agency, Envirofacts Warehouse, Safe Drinking Water Information System (SDWIS). Query: North Carolina, Person County, All Populations, Active (click on water system name for violations list); http://www.epa.gov/enviro/html/sdwis/sdwis_query.html#geography (accessed July 1, 2011)
1 MCL=Maximum Contaminant Level 2 TTHM=Total trihalomethanes.
In addition to the Community Water Systems described in the section above, there are 48 transient, non-community water systems in Person County. Transient, non-community water systems are those that do not consistently serve the same people (e.g., rest stops, campgrounds, gas stations, marinas, churches, etc.). Together these systems, all of which tap groundwater, serve an estimated 3,915 people (141).
A third category of water systems, non-transient, non-community water systems, are those that serve the same people, but not year-round (e.g., schools that have their own water system). There are five water systems of this type listed for Person County as of April 14, 2011: North End School, Oak Lane Elementary School, Woodland Elementary School, the Roxboro Steam Plant, and Zion Christian Center. Together these systems serve an estimated 1,317 people. With the exception of Progress Energy’s Roxboro Steam Plant, which uses surface water, all the water systems in this category utilize groundwater (141).
Municipal Drinking Water System
The City of Roxboro operates the one drinking water treatment plant in Person County. The present Water Treatment Plant was constructed in 1954 and enlarged in 1964. It has the capacity to treat 8 million gallons of water per day (144).
The City of Roxboro has two drinking water supply lakes: Lake Isaac Walton (City Lake) and Lake Roxboro. Lake Isaac Walton was constructed in 1924 and enlarged to its present size in 1954 when the current water plant was built; Lake Roxboro was constructed in 1978. Together the lakes can provide over 11 million gallons of water (145).
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NC DENR, Public Water Supply (PWS) Section, Source Water Assessment Program (SWAP) conducted assessments for all drinking water sources across NC. The purpose of the assessments was to determine the susceptibility of each drinking water source (well or surface water intake) to Potential Contaminant Sources (PCSs). Assessment results appear as a relative susceptibility rating of Higher, Moderate or Lower for each drinking water source. The relative susceptibility rating of the sources for the City of Roxboro’s drinking water was determined by combining the contaminant rating (number and location of PCSs within the assessment area) and the inherent vulnerability rating (i.e., characteristics or existing conditions of the well or watershed and its delineated assessment area). In a SWAP report issued in February 2010, City Lake and Lake Roxboro were each assigned a susceptibility rating of “Moderate” (142).
Private Wells
Unlike public water systems in NC, which are required to undergo mandatory periodic sampling and quality assessment, the water in private wells usually is sampled only at the request of the owner. The county health department is responsible for permitting all new wells, which undergo initial testing when they are installed. After that, any requested water quality tests are conducted by the NC State Laboratory for Public Health, through a process that must be facilitated by Environmental Health personnel from the local health department.
The Environmental Microbiology Unit of the NC State Laboratory for Public Health performs bacteriological analyses on water samples from both public and private water systems. Samples are examined for the presence of the Coliform group of bacteria, which are indicators of fecal contamination. Water is not examined specifically for pathogenic bacteria, as the prospect of isolating them from water is very remote. The State Laboratory also analyzes water samples, both public and private, for the presence of certain inorganic and organic chemicals (146).
Samples from existing private wells will be analyzed for Coliform bacteria only if the sample is submitted through a local health department. In most counties, an Environmental Health Specialist from the local health department goes to the property and personally draws the water to be analyzed. (There are two reasons for health department involvement: one is to ensure that the sample is collected and stored properly, and the other is that the well should be inspected at the time the sample is collected, and well inspections are the responsibility of the local health department.) For new private well water analysis, collection kits may be purchased by the public from the State Laboratory.
According to State Laboratory rules, no sample for sanitary analysis should be submitted from an open well, an unprotected spring, or from any source where there is visible evidence of contamination. Such supplies are unsafe for drinking purposes, regardless of laboratory findings. The State Laboratory will analyze samples of non-drinking water, such as those from lakes, streams, rivers, and ponds for total and fecal Coliform bacteria providing they are submitted by a local health department (146).
Table 29 summarizes PCHD Environmental Health Section activities related to wells and well testing for 2007 through 2010. Comparing Table 24 with Table 29 it is obvious that there are far fewer well activities than on-site wastewater activities. This is a reflection of a public water system that is more extensive throughout the county compared with a fairly limited public sewage system; that is, fewer people depend on wells for drinking water and more people depend on septic systems for wastewater disposal.
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Table 29. PCHD Environmental Health Section Well Activity Summary, 2007-2010
Activity 2007 2008 2009 2010
Site Evaluations n/a n/a n/a 65 Well Site Consultative Visits n/a n/a n/a 325 Well Permits New 140 100 74 65 Water Samples Collected Bacterial n/a n/a n/a 211 Chemical n/a n/a n/a 128
Source: Harold Kelly, Person County Health Department, Environmental Health Section, personal communication to LeighAnn Creson, Health Educator, Person County Health Department, July 21, 2011.
Table 30 presents data from the NC State Laboratory of Public Health on private well water samples submitted by Person County residents that were assayed during the period from January 1, 2008 through June 29, 2011. The State Laboratory processed 211 water samples from Person County for microbiological analysis during the period cited. Of those, 77 (36.5%) showed the presence of bacteria according to analysis for “total coliforms”. Each sample returning a positive result for total coliforms was also tested for the presence of E. coli, a specific fecal contaminant. Fecal contamination was confirmed in 4 of the 77 coliform-positive samples (5.2%).
Table 30. Person County Private Well Test Results, 2008-2011
No. No. Positive % Positive No. Coliforms % Coliforms Year Samples Total Coliforms Total Coliforms as E. coli As E. coli 20111 21 7 33.3 1 14.3 2010 82 28 34.1 1 3.6 2009 70 24 34.3 2 8.3 2008 38 18 47.4 1 5.6
Source: NC Division of Public Health, State Laboratory of Public Health, Environmental Microbiology, Relevant Links, Water Sample Test Results; http://slphreporting.ncpublichealth.com/EnvironmentalSciences/Micro/Default.aspx 1 2011 data includes January 1 through June 29 only
For a discussion of a specific well contamination issue of significance, see also the section, Land Contamination: Superfund Sites, in Chapter Three of this report.
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Chapter Eight: Food-, Water-, and Vector-Borne Diseases
A number of human diseases and syndromes are caused or exacerbated by microbial contaminants or by animal vectors in the natural environment. Several of these conditions are among the illnesses that must be reported to health authorities. A number of food-, water-, and vector- borne diseases are of increasing importance because they are either rare but becoming more prevalent, or spreading in geographic range, or becoming more difficult to treat. Among these diseases are Shiga toxin producing E. coli, salmonellosis, Lyme disease, West Nile virus infection, Eastern equine encephalitis, and rabies. Table 31 lists the number of cases of major reportable food-, water- and vector-borne diseased reported among Person County residents from 2002 to 2005, the most recent data available from the state. Comparable data for NC are provided for 2005 only.
Table 31. Reported Cases of Food-, Water-, and Vector- Borne Diseases, 2002-2005
Person County NC Disease 2002 2003 2004 2005 2005 Campylobacter 6 0 4 6 672 Cryptosporidiosis 0 0 0 0 92 E. coli O157 0 0 0 0 -- E. coli (Shiga toxin-producing) 0 0 7 1 64 Ehrlichiosis (monocytic) 0 0 0 0 29 Encephalitis, California group 0 0 0 0 23 Encephalitis, Eastern equine 0 0 0 0 1 Encephalitis, West Nile Virus 0 0 0 0 2 Hepatitis A 0 0 0 1 84 Listeriosis 0 0 0 0 34 Lyme disease 1 0 1 0 49 Rocky Mountain spotted fever 5 2 3 6 625 Salmonellosis 7 7 7 7 1,701 Shigellosis 0 0 1 0 202
Source: NC Division of Public Health, Epidemiology Section, General Communicable Disease Branch. Communicable Disease Control. Statistics. County Tables: Reported Cases, North Carolina, 2002-2005, County of Residence by Diseases and Year of Report. Available at http://www.epi.state.nc.us/epi/gcdc.html. Note: The table is limited to the primary food-, water-, and vector borne diseases found in NC and is not the comprehensive list of diseases catalogued by the source cited above.
The Person County Health Department Division of Nursing has provided updated local data on the occurrence of these food-, water-, and vector-borne diseases for the period 2006-2010 (147). The list shows the total Person County reports for the period cited.
Salmonellosis - 9 Campylobacter infection - 3 Hepatitis A - 1 Shigellosis - 1
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At both the county and state levels, salmonella and campylobacter infections are among the most common of all reported diseases.
Food-Borne Diseases
The disease causing the largest number of reports cited in Table 31 (and the following data update) in Person County and NC was salmonellosis. Salmonellosis, or salmonella infection, is one of the most common food-borne diseases. Salmonellosis may occur in small, contained outbreaks in the general population or in large outbreaks in hospitals, restaurants, or institutions housing children or the elderly. Every year, the CDC receives reports of 40,000 cases of salmonellosis in the US. Children are the most likely to get salmonellosis. The elderly, infants, and those with compromised immune systems and especially people with AIDS are more likely to have severe and/or recurring illness (148).
Salmonella bacteria can be found in food products such as raw poultry, eggs, and beef, and sometimes on unwashed fruit. Food prepared on surfaces that previously were in contact with raw meat or meat products can, in turn, become contaminated with the bacteria (cross-contamination). In recent years, the CDC has received reports of several cases of salmonella from eating raw alfalfa sprouts grown in contaminated soil. It is also possible to get salmonella after handling pets, particularly reptiles like snakes, turtles, and lizards. The disease can be spread from infected persons to other people through poor sanitary practices (such as a lack of hand washing before preparing food) (148).
The PCHD, as all health departments throughout NC, plays a major role in preventing outbreaks of food-borne illnesses, and in investigating any that do occur.
On the prevention side of the equation, the health department is responsible for inspecting food and lodging establishments to enforce state and local government regulations designed to protect the health of the public. The establishments under this purview include: restaurants, food stands, push carts, school lunchrooms, limited food stands, lodging, summer camps, bed and breakfast homes, bed and breakfast inns, meat markets, nursing homes, child day care facilities, school buildings, local confinements, elderly nutrition sites, residential facilities, swimming pools, and tattoo parlors. Table 32 summarizes data on PCHD food, lodging and institutional sanitation activities for 2007-2010.
Table 32. PCHD Food, Lodging and Institutional Sanitation Activities Summary, 2007-2010
Activity 2007 2008 2009 2010
Inspections 293 312 309 322 Permits Issued n/a n/a n/a 46 Investigations Complaint n/a n/a n/a 29 Facility Inspection n/a n/a n/a 94 Plan Review n/a n/a n/a 29
Source: Harold Kelly, Person County Health Department, Environmental Health Section, personal communication to LeighAnn Creson, Health Educator, Person County Health Department, July 21, 2011.
On the investigation side of the equation, the health department conducts routine surveillance of food- borne and other diseases as they are diagnosed by health professionals in the community and
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reported, as required, to the health department. When the surveillance staff of the PCHD detects a suspicious pattern or unexpected recurring incidence of a disease, they muster medical, nursing and environmental health staff to conduct an outbreak investigation in order to pinpoint the cause and identify the population at risk.
In 2007 the PCHD conducted a comprehensive food-borne outbreak investigation related to illness among 76 people that attended a catered luncheon at the opening of a new industry. Although neither an infectious organism nor the source of the contamination was identified, the investigation did conclude that food temperature regulations were violated. As a result, PCHD and Person County Economic Development planned to collaborate on ensuring compliance with all food safety regulations at catered events (149, 150).
Water-Borne Diseases
Water can be the primary source of transmission of a number of the diseases listed in Table 31. Cryptosporidiosis (caused by a protozoan), camplyobacteriosis, E. coli infections, and Legionellosis (all caused by bacteria) are examples. Outbreaks of water-borne diseases would be noted and investigated by the PCHD. No water-borne disease investigations have been conducted in Person County between 2006 and 2010.
Vector-Borne Diseases
Vectors are the transmitters of disease-causing organisms that carry the pathogens from one host to another. While most vectors are invertebrate animals, especially arthropods (notably insects and ticks), vertebrates can also act as vectors, as for examples foxes, raccoons, and skunks that can all transmit the rabies virus to humans via a bite. The most significant mode of vector-borne disease transmission is by biological transmission by blood-feeding arthropods. The pathogen multiplies within the arthropod vector, and the pathogen is transmitted when the arthropod takes a blood meal. Mechanical transmission of disease agents may also occur when arthropods physically carry pathogens from one place or host to another, usually on body parts.
Arboviral Diseases
Arboviral diseases are viral diseases transmitted from an animal host to humans (and sometimes other animals) by the bite of an arthropod, usually a tick, or a biting fly such as a mosquito. Mosquito-borne diseases are of particular significance in communities where there is a lot of water, since that is the environment in which they breed.
Historically, several mosquito-transmitted diseases, most notably Eastern Equine Encephalitis and LaCrosse Encephalitis are endemic in NC. West Nile Virus is a relatively new arboviral disease.
West Nile Virus
West Nile virus (WNV) is a disease normally found in Africa, West Asia and the Middle East. It first appeared in the US in 1999, and by 2001 it had spread to 28 states. The first NC appearance of WNV
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was in 2000 in Chatham County, where it was detected in a dead crow. The virus is believed to be carried by migrating flocks of birds and transmitted to other vertebrates and humans via mosquito bites.
Symptoms of WNV occur five to 15 days after infection and may include fever, headache and body aches, which may be accompanied by skin rashes and swollen lymph glands. In more severe cases, disorientation, coma, tremors and paralysis can occur. This disease is rarely fatal; the elderly are most at risk. There is no vaccine for West Nile Virus (151).
The NC Division of Environmental Health’s Public Health Pest Management (PHPM) Section manages the state’s WNV surveillance program, which is focused on mosquitoes, wild birds and other animals. Because the reservoir for WNV appears to be avian, “sentinel” flocks of birds, primarily chickens, are used as a kind of early warning system. (When the virus first appeared in the US, NC was among many states that were able to get valuable information from the collection and testing of dead, wild birds. Now that the virus has become established within the wild bird population, testing dead birds is no longer necessary) (151).
According to PHPM data, there were only four positives statewide among sentinel flock chickens for the period from 2006-2009; none were in Person County. State veterinary surveillance resulted in the identification of eight positives between 2004 and 2007; none were in Person County or any of its neighboring counties. NC reported four “positive” (i.e. confirmed, probable or suspect) human cases of WNV in 2005, one case in 2006, four cases in 2007, and three cases in 2008. None of the human cases during this period was from Person County (151).
Eastern Equine Encephalitis
Eastern equine encephalitis (EEE) is a rare disease that can affect both humans and horses. The virus normally occurs in birds, but when mosquito populations grow very large, the virus is more likely to spread to non-avian species. NC averages about one human case of EEE annually. Approximately half of human EEE cases are fatal, with young children and the elderly most at risk. In NC, this disease is more likely to occur in coastal or eastern Piedmont areas, usually late in the summer or in early fall (152).
Symptoms develop a few days to two weeks after being bitten by an infected mosquito and include rapid onset of fever and headache. The symptoms of EEE resemble flu symptoms, but survivors of EEE infections may suffer from long-term effects to the nervous system. Therapy is limited to treating the symptoms of the disease; there is no specific cure. There is an EEE vaccine for horses but not for humans (152).
The presence of EEE is monitored by the sentinel flock method. There were 35 positive sentinel flock cases in NC in 2006, 21 in 2007, 23 in 2008, and 53 in 2009; none of the sentinel cases were in Person County. Veterinary surveillance statewide over the same period discovered five cases in 2006, no cases in 2007, 13 cases in 2008, and 23 cases in 2009; none of the veterinary surveillance cases were in Person County. In 2005 there were no positive human cases statewide; there was one in 2006, none in 2007, and one in 2008. None of the positive human cases during this period was in Person County (152).
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LaCrosse Encephalitis
La Crosse Encephalitis (LAC) is the most common arboviral disease affecting NC, where it appears mainly in the western part of the state. LaCrosse encephalitis (LAC) is associated with small mammals like squirrels and chipmunks. Transmission occurs most frequently after being bitten by an infected mosquito. There is no sentinel surveillance program for LAC in NC (153).
Symptoms occur a few days to two weeks after the mosquito bite. They include fever, headache, nausea and vomiting. In more severe cases, convulsions, tremors and coma can occur, but the disease is rarely fatal in humans. Young children and the elderly are the most susceptible to the disease (153).
From 2005-2008, there were 70 positive cases of LAC reported in NC (32 in 2005, 18 in 2006, 11 in 2007 and 9 in 2008), all in the western-most region of the state. No positive cases of LAC occurred in Person County (153).
Other Arthropod-Transmitted Diseases
Rocky Mountain Spotted Fever
Rocky Mountain Spotted Fever (RMSF) is a seasonal disease that occurs throughout the US, primarily from April through September. Over half of the cases occur in the south-Atlantic region of the country (Delaware, Maryland, Washington D.C., Virginia, West Virginia, North Carolina, South Carolina, Georgia, and Florida). The highest incidence rates have been found in NC and OK. Although this disease was first discovered and recognized in the Rocky Mountain area, relatively few cases are reported from that area today. RMSF is caused by a species of bacteria, Rickettsia rickettsii, which is spread to humans through tick bites (154). The disease can be very difficult to diagnose, and so likely is under-reported.
RMSF generally requires an incubation period of about five to 10 days after the tick bite. The early clinical presentation of the disease is often nonspecific and may resemble many other infectious and non-infectious diseases. Initially, patients may report fever, nausea, vomiting, severe headache, muscle pain and/or a lack of appetite. Later symptoms may include rash, abdominal pain, joint pain or diarrhea. RMSF can be a severe illness, and the majority of patients are hospitalized (154).
As noted in Table 31 and the subsequent update cited previously, there were 16 cases of RMSF in Person County over the period from 2002 through 2005, and no cases between 2006 and 2010.
Lyme Disease
Lyme disease, an infection caused by the bacterium Borrelia burgdorferi, is on the rise in NC, after first becoming endemic in the northeastern region of the US. In the Northeast, the bacterium normally occurs in mice, squirrels and other small animals, and can be transmitted to humans through the bite of a black-legged tick. The ticks that transmit Lyme disease can occasionally transmit other tick-borne diseases as well. In the southeastern US, the transmission cycle is not as clearly defined or understood (155).
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Typical symptoms of Lyme disease include fever, headache, fatigue, and a characteristic, circular skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful in the later stages of disease. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics (156).
As noted in Table 31 cited previously, there were two cases of Lyme disease in Person County over the period from 2002-2005. The PCHD did not report any cases of Lyme disease in the period 2006-2010.
Rabies
Rabies is a deadly viral disease that attacks the central nervous system of warm-blooded animals, particularly mammals. In NC, the most common type of rabies is raccoon-variant rabies. It is found commonly in raccoons, skunks, red and grey foxes, coyotes, wolves, groundhogs and beavers. Bats can also transmit rabies but have their own bat-variant rabies virus. Any mammal can become infected with rabies. The virus can infect domestic pets, agricultural animals such as cows and horses, and people when they are exposed to rabid wildlife (157).
In NC, rabies law requires that all owned dogs, cats and ferrets must be vaccinated against rabies by four months of age (NCGS 130A-185). One shot is not enough; rabies vaccinations must be kept current. In 2009, the NC General Assembly updated the state’s rabies laws to conform to recommendations of the Centers for Disease Control and Prevention and the National Association of Public Health Veterinarian’s Compendium of Animal Rabies Prevention and Control, 2008 (157).
Rabies is not frequently reported in Person County. For the entire period from 2006 through 2010, there were 18 positive rabies test results; two positives were from bats, ten were from raccoons, and six were from skunks (158).
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References
1. NC Department of Environment and Natural Resources, Division of Water Resources, Education and Technical Assistance, Groundwater, Aquifer Characteristics, North Carolina Aquifers; http://www.ncwater.org/Education_and_Technical_Assistance/Ground_Water/AquiferCharacteristi cs/ (accessed June 15, 2011)
2. NC Department of Environment and Natural Resources, Division of Water Resources, About DWR; http://www.ncwater.org/About_DWR/ (accessed June 15, 2011).
3. NC Department of Environment and Natural Resources, Division of Water Quality, About DWQ; http://portal.ncdenr.org/web/wq/home/about (accessed June 15, 2011).
4. Scorecard, Investigate Pollution Topics, Water, Clean Water Act; http://scorecard.goodguide.com/env-releases/water/ (accessed June 15, 2011).
5. NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences, Ecosystems, Ambient Monitoring System (AMS); http://portal.ncdenr.org/web/wq/ess/eco/ams (accessed June 15, 2011).
6. NC Department of Environment and Natural Resources, Division of Water Quality, Planning, Water Quality Data Assessment; http://portal.ncdenr.org/web/wq/ps/mtu/assessment (accessed June 15, 2011).
7. NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Reports and Publications, Basin Wide Reports, Roanoke Basin 2010; http://portal.ncdenr.org/web/wq/ess/reports (accessed June 15, 2011).
8. NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Reports and Publications, Basin Wide Reports, Roanoke Basin 2010, Basin Wide Assessment Report, Roanoke River Basin, December 2010; http://portal.ncdenr.org/c/document_library/get_file?uuid=e3dd1d8b-bbc5-42c9-9999- 1d99dd4c7455&groupId=38364 (accessed June 15, 2011).
9. NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Reports and Publications, Basin Wide Reports, Roanoke Basin 2010, Roanoke Basin Whole Effluent Toxicity Report; Roanoke River Basin Basinwide Assessment Report, Whole Effluent Toxicity Program, 2005-2009, May 2010. Available at: http://portal.ncdenr.org/c/document_library/get_file?uuid=ed270110-42db-49a6-8a0f- 0bf3ef2657d8&groupId=38364 (accessed June 15, 2011).
10. NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Reports and Publications, Basin Wide Reports, Roanoke Basin 2010, Roanoke Basin Lake and Reservoir Assessments; Lake & Reservoir Assessments, Roanoke River Basin, March 2010. Available at: http://portal.ncdenr.org/c/document_library/get_file?uuid=5d9ab9be- d0cd-47d5-bbcf-b00c21f31cff&groupId=38364 (accessed June 15, 2011).
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11. NC Department of Environment and Natural Resources, Division of Water Quality, Planning, Water Quality Data Assessment, 2010 Final 303(d) List; http://portal.ncdenr.org/c/document_library/get_file?uuid=8ff0bb29-62c2-4b33-810c- 2eee5afa75e9&groupId=38364 (accessed June 16, 2011).
12. NC Institute for Public Health. 2007. Person County Community Health Assessment, Volume Two: Environmental Data. Final Technical Report, October, 2007 (accessed June 16, 2011).
13. NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, North Carolina Fish Kill Activity; http://portal.ncdenr.org/web/wq/ess/fishkillsmain (accessed June 16, 2011).
14. NC Department of Environment and Natural Resources, Division of Water Quality, Environmental Sciences Section, Fish Kill Events; http://portal.ncdenr.org/web/wq/ess/fishkills (accessed June 16, 2011).
15. NC Division of Public Health, Epidemiology, Topics A-Z, Fish Consumption Advisories; http://www.epi.state.nc.us/epi/fish/ (accessed June 16, 2011).
16. NC Division of Public Health, Epidemiology, Topics A-Z, Fish Consumption Advisories, Current Fish Consumption Advisories in North Carolina; http://www.epi.state.nc.us/epi/fish/current.html (accessed June 16, 2011).
17. NC Department of Environment and Natural Resources, Division of Water Resources, Ground Water, Ground Water Database Access; http://www.ncwater.org/Data_and_Modeling/Ground_Water_Databases/ (accessed June 17, 2011).
18. NC Department of Environment and Natural Resources, Division of Water Resources, Education and Technical Assistance, Groundwater, Aquifer Characteristics, North Carolina Aquifers; http://www.ncwater.org/Education_and_Technical_Assistance/Ground_Water/AquiferCharacteristi cs/ (accessed June 17, 2011).
19. US Environmental Protection Agency, Air and Radiation, National Ambient Air Quality Standards (NAAQS); http://www.epa.gov/air/criteria.html (accessed June 17, 2011).
20. Scorecard. Pollution Locator. Smog and Particulates. Criteria Air Pollutant Descriptions; http://scorecard.goodguide.com/env-releases/cap/pollutant-desc.tcl (accessed June 17, 2011).
21. NC Department of Environment and Natural Resources, Division of Air Quality, Regional Offices and Local Programs; http://daq.state.nc.us/about/regional/ (accessed June 17, 2011)
22. NC Department of Environment and Natural Resources, Division of Air Quality, Ambient Monitoring Program, Monitoring Data, Archival Data, Data Archives & Statistical Summaries, Air Quality Data Analyses, Ozone, Detailed Raw Ozone Data, 8-hour Averages, 2010; http://daq.state.nc.us/monitor/data/files/o3data_2010.pdf (accessed June 17, 2011).
23. Scorecard. Pollution Locator, Smog and Particulates, Criteria Air Pollution, Criteria Air Pollution Report: North Carolina; http://scorecard.goodguide.com/env- releases/cap/state.tcl?fips_state_code=37 (accessed February, 2011).
85
Person County Health Assessment – Volume Two References
24. AIRNow, Air Quality Index (AQI) – A Guide to Air Quality and Your Health; http://www.airnow.gov/index.cfm?action=aqibasics.aqi (accessed June 17, 2011).
25. US Environmental Protection Agency, AirData, Air Quality Index Report, North Carolina, 2008; http://www.epa.gov/oar/data/monaqi.html?st~NC~North%20Carolina (accessed June 17, 2011).
26. Scorecard, Pollution Locator, Definitions of Air Pollution Source Categories; http://scorecard.goodguide.com/env-releases/def/air_source.html (accessed June 17, 2011).
27. US Environmental Protection Agency, Green Book, Currently Designated Nonattainment Areas for Criteria Air Pollutants, as of April 21, 2011; http://www.epa.gov/oaqps001/greenbk/ancl.html (accessed June 17, 2011).
28. US Environmental Protection Agency, Air and Radiation, Six Common Air Pollutants, State Implementation Plan Status and Information; http://epa.gov/air/urbanair/sipstatus/index.html (accessed June 17, 2011).
29. NC Department of Transportation, Division of Motor Vehicles, Vehicle Registration, Registration and Plate Renewal, Vehicle Emissions and Safety Inspection; http://www.ncdot.gov/dmv/vehicle/registration/inspection/ (accessed June 17, 2011).
30. Calculated Risk, Finance and Economics, Thursday, February 19, 2009, US Vehicle Miles Driven Off 3.6% in 2008; http://www.calculatedriskblog.com/2009/02/us-vehicle-miles-driven-off-36-in- 2008.html (accessed June 17, 2011).
31. US Census Bureau. The 2010 Statistical Abstract. Transportation: Motor Vehicle Registrations, Alternative Fuel Vehicles. Table 1061. Alternative Fueled Vehicles and Estimated Consumption of Vehicle Fuels by Fuel Type: 2004 to 2007; http://www.census.gov/compendia/statab/2010/tables/10s1061.pdf (accessed June 17, 2011).
32. NumberOf.net., Number of Hybrid Cars in the US; http://www.numberof.net/number-of-hybrid- cars-in-the-us/ (accessed June 17, 2011).
33. How Many Hybrid Cars Are On the Road?; http://greenliving.lovetoknow.com/How_Many_Hybrid_Cars_Are_on_the_Road (accessed June 17, 2011).
34 NC Department of Transportation, Division of Public Transportation; http://www.ncdot.org/nctransit/ (accessed February, 2011).
35. NC Department of Transportation, Division of Public Transportation, Statewide Local Transit Information, Person County; http://www.ncdot.org/nctransit/localtransit.html?Counties=*Person*&Cities=* (accessed June 17, 2011).
36. Scorecard, Pollution Locator, Hazardous Air Pollution – A National Overview; http://scorecard.goodguide.com/env-releases/def/hap_gen.html (accessed June 23, 2011).
37. Scorecard, Pollution Locator, Caveats on Scorecard's Hazardous Air Pollution Data; http://scorecard.goodguide.com/env-releases/def/hap_caveats.html (accessed June 23, 2011).
86
Person County Health Assessment – Volume Two References
38. Scorecard, Pollution Locator, Definitions of Risk Measures for Hazardous Air Pollutants; http://scorecard.goodguide.com/env-releases/def/hap_risk_measures.html#cancer (accessed June 23, 2011).
39. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, by County, Average Individual’s Added Cancer Risk; http://scorecard.goodguide.com/env-releases/hap/rank- counties.tcl?how_many=100&drop_down_name=Average+individual%27s+added+cancer+risk&fi ps_state_code=37&rank_source_type=all (accessed June 23, 2011).
40. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, by County, Population in Areas Where Cancer Risk Exceeds 1 in 1,000; http://scorecard.goodguide.com/env- releases/hap/rank- counties.tcl?how_many=100&drop_down_name=Population+in+areas+where+cancer+risk+excee ds+1+in+1%2C000&fips_state_code=37&rank_source_type=all (accessed June 23, 2011).
41 Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, County Report: Mecklenburg, Cancer Risks from Hazardous Air Pollutants; http://scorecard.goodguide.com/env- releases/hap/county.tcl?fips_county_code=37119 (accessed June 23, 2011).
42. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, County Report: Person, Cancer Risks from Hazardous Air Pollutants; http://scorecard.goodguide.com/env- releases/hap/county.tcl?fips_county_code=37145 (accessed June 23 2011).
43. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, County Report: Person, Sources Contributing to Health Risks from Hazardous Air Pollutants, Contribution to Added Cancer Risk; http://scorecard.goodguide.com/env- releases/hap/county.tcl?fips_county_code=37145#sources (accessed June 23, 2011).
44. Scorecard, Pollution Locator, Definitions of Air Pollution Source Categories; http://scorecard.goodguide.com/env-releases/def/air_source.html#point (accessed June 23, 3011).
45. California Office of Environmental Health Hazard Assessment, Air Toxicology and Epidemiology, Health Effects of Diesel Exhaust; http://oehha.ca.gov/public_info/facts/dieselfacts.html (accessed June 23, 2011).
46. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, by County, Noncancer Cumulative Cancer Index; http://scorecard.goodguide.com/env-releases/hap/rank- counties.tcl?how_many=100&drop_down_name=Noncancer+cumulative+hazard+index&fips_stat e_code=37&rank_source_type=all (accessed June 23, 2011).
47. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, County Report: Mecklenburg, Non-Cancer Hazards from Hazardous Air Pollutants; http://scorecard.goodguide.com/env-releases/hap/county.tcl?fips_county_code=37119 (accessed June 23, 2011).
48. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, County Report: Person, Non-Cancer Hazards from Hazardous Air Pollutants; http://scorecard.goodguide.com/env- releases/hap/county.tcl?fips_county_code=37145 (accessed June 23, 2011).
87
Person County Health Assessment – Volume Two References
49. Scorecard, Chemical Profiles, Chemical Profile for Acrolein; http://scorecard.goodguide.com/chemical-profiles/summary.tcl?edf_substance_id=107-02-8 (accessed June 23, 2011).
50. Scorecard, Pollution Locator, Hazardous Air Pollutants, North Carolina, County Report: Person, Sources Contributing to Health Risks from Hazardous Air Pollutants, Contribution to Cumulative Hazard Index; http://scorecard.goodguide.com/env- releases/hap/county.tcl?fips_county_code=37145#sources (accessed June 23, 2011).
51. US Environmental Protection Agency, Indoor Air Quality, An Introduction to Indoor Air Quality (IAQ); http://www.epa.gov/iaq/ia-intro.html (accessed June 23, 2011).
52. US Environmental Protection Agency, Indoor Air Quality, An Introduction to Indoor Air Quality (IAQ), Carbon Monoxide; http://www.epa.gov/iaq/co.html (accessed June 23, 2011).
53. US Environmental Protection Agency, National Center for Environmental Assessment, Carbon Monoxide Poisoning, a Public Health Perspective; http://cfpub2.epa.gov/ncea/cfm/recordisplay.cfm?deid=65703 (accessed June 23, 2011).
54. Centers for Disease Control and Prevention, MMWR Weekly, December 21, 2007, 56(50), 1309- 1312; http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5650a1.htm (accessed June 23, 2011).
55. NC State Center for Health Statistics, County Level Data, Detailed Mortality Statistics Report, 2009,North Carolina, ICD 10 Codes X47 and X67 http://www.schs.state.nc.us/SCHS/deaths/dms/2009/northcarolina.pdf (accessed June 23, 2011).
56. NC State Center for Health Statistics, County Level Data, Detailed Mortality Statistics Report (years as noted) Person County, ICD 10 Codes X47 and X67; http://www.schs.state.nc.us/SCHS/data/county.cfm (accessed June 23, 2011).
57. NC Department of Environment and Natural Resources, NC Radon Program, Basic Radon Information, Facts About Radon; http://www.ncradon.org/Facts.htm (accessed June 23, 2011).
58. NC Department of Environment and Natural Resources, NC Radon Program, Basic Radon Information, Radon in Water; http://www.ncradon.org/water.htm (accessed June 23, 2011).
59. NC Department of Environment and Natural Resources, NC Radon Program, Basic Radon Information, Radon and Geology; http://www.ncradon.org/Geology.htm (accessed June 23, 2011).
60. NC Department of Environment and Natural Resources, NC Radon Program, Basic Radon Information, Radon and Geology, EPA Radon Zone Map of NC; http://www.ncradon.org/zone.htm (accessed June 23, 2011).
61. NC Department of Environment and Natural Resources, NC Radon Program, Radon Research and Data, County Information Regarding Radon Levels; http://www.ncradon.org/countydata/weballcounty_1.html (accessed June 23, 2011).
62. NC Department of Environment and Natural Resources, NC Radon Program, Health Risks of Radon; http://www.ncradiation.net/Radon/Health.htm (accessed June 23, 2011).
88
Person County Health Assessment – Volume Two References
63. US Environmental Protection Agency, Air, Indoor Air Quality, Radon, Health Risks, Report: Assessment of Risks from Radon in Homes; http://www.epa.gov/radon/risk_assessment.html (accessed June 23, 2011).
64. US Environmental Protection Agency, Air, Indoor Air Quality, Smoke-free Homes Program, Fact Sheet: Respiratory Health Effects of Passive Smoking; http://www.epa.gov/smokefree/pubs/etsfs.html (accessed June 23, 2011).
65. American Cancer Society, Tobacco and Cancer, Secondhand Smoke; http://www.cancer.org/Cancer/CancerCauses/TobaccoCancer/secondhand-smoke (accessed June 23, 2011).
66. US Department of Health and Human Services, The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Washington, DC: Department of Health and Human Services; 2006; www.surgeongeneral.gov/library/secondhandsmoke/ (accessed June 23, 2011).
67. NC State Center for Health Statistics, Behavioral Risk Factor Surveillance System (BRFSS) Calendar Year 2010 Results, North Carolina Statewide, Tobacco Use, Current Smoker; http://www.epi.state.nc.us/SCHS/brfss/2010/nc/all/_rfsmok3.html (accessed June 23, 2011).
68. NC State Center for Health Statistics, Behavioral Risk Factor Surveillance System (BRFSS) Calendar Year 2006 Results, North Carolina Statewide, Tobacco Use, Current Smoker; http://www.schs.state.nc.us/SCHS/brfss/2006/nc/all/_rfsmok3.html (accessed June 23, 2011).
69. NC Institute for Public Health. 2007. Person County Community Health Assessment, Volume One: Demographic, Socioeconomic and Health Data. Final Technical Report, October, 2007. Chapter Three: Survey Results (accessed June 23, 2011).
70. The University of North Carolina at Chapel Hill, News, Health and Medicine, UNC poll: N.C. smoke-free policies supported by large majority; http://uncnews.unc.edu/content/view/3766/107/ (accessed June 23, 2011).
71. US Environmental Protection Agency, Air, Indoor Air Quality (IAQ), Publications, Sick Building Syndrome, Indoor Air Facts No. 4 (revised) Sick Building Syndrome; http://www.epa.gov/iaq/pubs/sbs.html (accessed June 23, 2011).
72. US Department of Health and Human Services, National Institutes of Health, National Heart, Lung and Blood Institute, Diseases and Conditions Index, Asthma; http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html (accessed June 23, 2011).
73. US Environmental Protection Agency, Air, Indoor Air Quality, Asthma., Basic Information, Important Asthma Triggers; http://www.cdc.gov/asthma/triggers.html (accessed June 23, 2011).
74. US Environmental Protection Agency, Air, Indoor Air Quality, Asthma, Basic Information, Important Triggers, Outdoors; http://www.cdc.gov/asthma/triggers_outdoor.html (accessed June 23, 2011).
89
Person County Health Assessment – Volume Two References
75. Centers for Disease Control and Prevention, Asthma, Data and Surveillance, Asthma Surveillance Data, Behavioral Risk Factor Surveillance System Prevalence Data, 2008. Adult Self-Reported Lifetime and Current Asthma Prevalence, Table 1.1, Overall by State or Territory; http://www.cdc.gov/asthma/brfss/08/lifetime/tableL1.htm (accessed June 23, 2011).
76. NC State Center for Health Statistics, Behavioral Risk Factor Surveillance System (BRFSS) Calendar Year 2010 Results, North Carolina Statewide, Asthma; http://www.schs.state.nc.us/SCHS/brfss/2010/nc/all/asthma2.html (accessed June 23, 2011).
77. NC State Center for Health Statistics, Behavioral Risk Factor Surveillance System (BRFSS) Calendar Year 2006 Results, North Carolina Statewide, Asthma; http://www.schs.state.nc.us/SCHS/brfss/2006/nc/all/asthma2.html (accessed June 23, 2011).
78. Centers for Disease Control and Prevention, National Center for Health Statistics, FastStats, State and Territorial Data, Asthma Morbidity; http://www.cdc.gov/nchs/fastats/asthma.htm (accessed June 23, 2011).
79. Centers for Disease Control and Prevention, Asthma, Data and Surveillance, Asthma Surveillance Data, Behavioral Risk Factor Surveillance System Prevalence Data, 2008, Child Lifetime and Current Asthma Prevalence, Table 1.1, Overall by State or Territory; http://www.cdc.gov/asthma/brfss/08/child/lifetime/tableL1.htm (accessed June 23, 2011).
80. Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics Reports, Vol. 59, No. 2, December 9, 2010, Table 2: Deaths, Death Rates, and Age- Adjusted Death Rates from 113 selected causes and Enterocolitis due to Clostridium difficile, by Age: United States, 2007 and Preliminaty 2008, Asthma (ICD 10 Codes J45 and J46); http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_02.pdf (accessed June 23, 2011).
81. Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics Reports, Vol. 57, No. 14, April 17, 2009, Table 11: Death rates for 113 selected causes and Enterocolitis due to Clostridium difficile, by Age: United States, 2006, Asthma (ICD 10 Codes J45 and J46); http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf (accessed June 23, 2011).
82. NC State Center for Health Statistics, County Level Data, Detailed Mortality Statistics Report, 2009, North Carolina, ICD 10 Codes J45 and J46; http://www.schs.state.nc.us/SCHS/deaths/dms/2009/northcarolina.pdf (accessed June 23, 2011).
83. NC State Center for Health Statistics, County Level Data, Detailed Mortality Statistics Report (years as noted), Person County, ICD 10 Codes J45 and J46; http://www.schs.state.nc.us/SCHS/data/county.cfm (accessed June 23, 2011).
84. American Heart Association, Particulate Matter Air Pollution and Cardiovascular Disease: An Update to the Scientific Statement from the American Heart Association. Circulation, 2010; 121; 2331-2378; http://circ.ahajournals.org/cgi/reprint/CIR.0b013e3181dbece1 (accessed June 23, 2011).
85. American Heart Association, News Releases, Low levels of carbon monoxide increase heart- related hospitalizations in elderly; http://www.newsroom.heart.org/index.php?s=43&item=807 (accessed June 23, 2011).
90
Person County Health Assessment – Volume Two References
86. Scorecard, Pollution Locator, Toxic Chemical Releases; http://scorecard.goodguide.com/env- releases/us-map.tcl (accessed June 23, 2011).
87. US Environmental Protection Agency, Toxic Release Inventory (TRI) Program; http://www.epa.gov/tri/ (accessed June 23, 2011).
88. US Environmental Protection Agency, Toxic Release Inventory (TRI) Program, TRI Explorer, Reports, Geography Report, 2009, Select a State, North Carolina, Releases: Geography County Report; http://www.epa.gov/triexplorer/geography.htm (accessed June 23, 2011).
89. US Environmental Protection Agency, Toxic Release Inventory (TRI) Program, TRI Explorer, Reports, Facility Report, 2009, Select a State, North Carolina, Select from a List of Counties, Person, http://www.epa.gov/triexploUSrer/facility.htm (accessed June 23, 2011).
90. Scorecard, Pollution Locator, Risk Scoring System; http://scorecard.goodguide.com/env- releases/def/tep_gen.html (accessed June 23, 2011).
91. Scorecard, Pollution Locator, Toxic Chemical Releases, North Carolina, By County (Sort on Total Environmental Releases); http://scorecard.goodguide.com/ranking/rank- counties.tcl?fips_state_code=37&type=mass&category=total_env&modifier=na&how_many=100 (accessed June 23, 2011).
92 Scorecard, Pollution Locator, Toxic Chemical Releases, Reports, Environmental Release Report: Person County, NC; http://scorecard.goodguide.com/env- releases/county.tcl?fips_county_code=37145 (accessed June 23, 2011).
93. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Toxicological Profile for Barium and Barium Compounds; http://www.atsdr.cdc.gov/ToxProfiles/tp24.pdf (accessed June 24, 2011).
94. US Environmental Protection Agency, Technology Transfer Network, Air Toxics Website, Hydrochloric Acid (Hydrogen Chloride); http://www.epa.gov/ttn/atw/hlthef/hydrochl.html (accessed June 24, 2011).
95. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Toxic Substances Portal, Sulfur Trioxide and Sulfuric Acid, Public Health Statement for Sulfur Trioxide and Sulfuric Acid; http://www.atsdr.cdc.gov/phs/phs.asp?id=254&tid=47 (accessed June 24, 2011).
96. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Toxic Substances Portal, Vanadium and Compounds, Public Health Statement for Vanadium; http://www.atsdr.cdc.gov/phs/phs.asp?id=274&tid=50 (accessed June 24, 2011).
97. US Environmental Protection Agency, Technology Transfer Network, Air Toxics Website, Manganese Compounds; http://www.epa.gov/ttnatw01/hlthef/manganes.html (accessed June 24, 2011).
98. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Toxic Substances Portal, Zinc; http://www.atsdr.cdc.gov/substances/toxsubstance.asp?toxid=54 (accessed June 26, 2011).
91
Person County Health Assessment – Volume Two References
99. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Toxic Substances Portal, Copper, Public Health Statement for Copper; http://www.atsdr.cdc.gov/phs/phs.asp?id=204&tid=37 (accessed June 26, 2011).
100. US Environmental Protection Agency, Technology Transfer Network, Air Toxics Website, Chromium Compounds; http://www.epa.gov/ttn/atw/hlthef/chromium.html (accessed June 26, 2011).
101. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Toxic Substances Portal, Copper, Public Health Statement for Nickel; http://www.atsdr.cdc.gov/phs/phs.asp?id=243&tid=44 (accessed June 26, 2011).
102. US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, Toxic Substances Portal, Arsenic, Toxicological Profile for Arsenic; http://www.atsdr.cdc.gov/toxprofiles/tp.asp?id=22&tid=3 (accessed June 26, 2011).
103. US Environmental Protection Agency, National Priorities List, Final Sites (as of June 13, 2011), by State; http://www.epa.gov/superfund/sites/query/queryhtm/nplfin.htm (accessed June 26, 2011).
104. US Environmental Protection Agency, National Priorities List, NPL Site Narrative for GMH Electronics; http://www.epa.gov/superfund/sites/npl/nar1797.htm (accessed June 26, 2011).
105. NC Department of Environment and Natural Resources, Division of Waste Management, Brownfields Program, Project Eligibility; http://portal.ncdenr.org/web/wm/bf/projectinventoryhttp://portal.ncdenr.org/web/wm/bf/projectinven tory (accessed June 26, 2011).
106.. NC Department of Environment and Natural Resources, Division of Waste Management, Brownfields Program; NC Department of Environment and Natural Resources, Division of Waste Management, Brownfields Program, Brownfields Program Site Summaries and Inventory of Projects as of September 30, 2010; http://portal.ncdenr.org/c/document_library/get_file?uuid=8674a10f-aa55-407d-987c- 9a92f1a8ef2b&groupId=38361 (accessed June 26, 2011).
107. NC Department of Environment and Natural Resources, Division of Waste Management, Inactive Hazardous Sites Program, Overview; http://portal.ncdenr.org/web/wm/sf/ihshome (accessed June 26, 2011).
108. NC Department of Environment and Natural Resources, Division of Waste Management, Inactive Hazardous Sites Program, List of Sites by County, Inactive Hazardous Sites and Pollutant-Only Sites, Inventory By County; http://portal.ncdenr.org/c/document_library/get_file?uuid=bc36cebd- 0da1-4199-be4c-1044a7f1343c&groupId=38361 (accessed June 26, 2011).
109. NC Division of Public Health, Epidemiology Branch, Toxic Substances, Hazardous Substances Emergency Events Surveillance Program (HSEES); http://www.epi.state.nc.us/epi/oee/hsees.html (accessed June 26, 2011).
110. NC Division of Public Health, Epidemiology Branch, Toxic Substances, National Toxic Substance Incidents Program; http://www.epi.state.nc.us/epi/oee/ntsip.html (accessed June 26, 2011).
92
Person County Health Assessment – Volume Two References
111. US Department of Health and Human Services, National Institutes of Health, National Institute of Environmental Health Sciences, Health and Education, Environmental Health Topics, Environmental Agents, Lead; http://www.niehs.nih.gov/health/topics/agents/lead/ (accessed June 28, 2011).
112. US Environmental Protection Agency, Chemical Safety and Pollution Prevention, Pollution Prevention and Toxics, Lead in Paint, Dust and Soil, Basic Information; http://www.epa.gov/lead/pubs/leadinfo.htm#health (accessed June 28, 2011).
113. National Institutes of Health, US National Library of Medicine, Medline Plus, Lead Levels – Blood; http://www.nlm.nih.gov/medlineplus/ency/article/003360.htm (accessed June 28, 2011).
114. Scorecard, Pollution Rankings, Lead Hazards by County, Counties with Potential Lead Hazards, North Carolina, Number of Housing Units with a High Risk of Lead Hazards; http://scorecard.goodguide.com/env-releases/lead/rank- counties.tcl?how_many=50&drop_down_name=Number+of+housing+units+with+a+high+risk+of+ lead+hazards&fips_state_code=37 (accessed June 28, 2011).
115. NC Department of Environment and Natural Resources, Children’s Environmental Health Branch, Lead Poisoning Prevention Program; http://www.deh.enr.state.nc.us/ehs/Children_Health/Lead/lead.html (accessed June 28, 2011).
116. US Department of Agriculture, National Agricultural Statistics Service, The Census of Agriculture, 2007 Census Publications, State and County Profiles, North Carolina: Person County; http://www.agcensus.usda.gov/Publications/2007/Online_Highlights/County_Profiles/North_Caroli na/cp37145.pdf (accessed June 28, 2011).
117. US Environmental Protection Agency, Pesticides, About Pesticides; http://www.epa.gov/pesticides/about/index.htm#not (accessed June 28, 2011).
118. NC State University, College of Agriculture and Life Sciences, NC Cooperative Extension Service. 2011 NC Agricultural Chemicals Manual. Available at: http://ipm.ncsu.edu/agchem (accessed June 27, 2011).
119. US Environmental Protection Agency, Pesticides, Health and Safety, Human Health Issues; http://www.epa.gov/pesticides/health/human.htm (accessed June 29 2011).
120. NC State Center for Health Statistics, County Level Data, Annual Publications Containing County Level Data, Detailed Mortality Statistics Report, North Carolina Resident Deaths, 2004, 2005, 2006, 2007, 2008, 2009, North Carolina; Person County, ICD 10 Code X48, X68 and X87; http://www.schs.state.nc.us/SCHS/data/county.cfm (accessed June 29, 2011).
121. Pesticide Action Network of North America (PANNA); http://www.panna.org/ (accessed June 29, 2011).
122. Sustainable Table, The Issues: Waste; http://www.sustainabletable.org/issues/waste/ (accessed February, 2011).
93
Person County Health Assessment – Volume Two References
123. NC State University, 2002 North Carolina Agricultural Chemicals Manual, Livestock Manure Production Rates and Nutrient Content; http://agrienvarchive.ca/bioenergy/download/barker_ncsu_manure_02.pdf (accessed June 29, 2011).
124. NC Department of Environment and Natural Resources, Division of Waste Management, Solid Waste Program, NC Solid Waste Management Annual Report, Fiscal Year 2008-2009; http://wastenot.enr.state.nc.us/swhome/AR08_09/AR08_09.pdf (accessed June 30, 2011).
125. NC Department of Environment and Natural Resources, Division of Waste Management, Solid Waste Program, Facility List, Permitted Solid Waste Facilities by County; http://portal.ncdenr.org/web/wm/sw/facilitylist (accessed June 30, 2011).
126. NC Department of Environment and Natural Resources, Division of Air Quality, Air Permit Review; http://www.ncair.org/permits/permit_reviews/UPRLf_rev_11192008.pdf (accessed June 30, 2011).
127. Solid Waste Management Plan, Person County Planning Area (Three Year Update), July 1, 2009 – June 30, 2019. Person County and City of Roxboro. Available at: http://www.personcounty.net/LinkClick.aspx?fileticket=3Kl1wwAShqk%3D&tabid=156&mid=595 (accessed June 30, 2011).
128. NC Department of Environment and Natural Resources, Division of Waste Management, Solid Waste Program, Solid Waste Documents, Public, Permit 7304-MSWLF-1997; http://acp.ncdenr.org/pls/apex/f?p=2136:25:3430279559591639:::CIR:IR_PERMITID:7304- MSWLF-1997 (accessed June 30, 2011).
129. City of Roxboro, Departments, Public Works, Garbage Collection; http://www.cityofroxboro.com/departments/public_works/public_works.html (accessed June 30, 2011).
130. City of Roxboro, Departments, Finance, FAQs, Garbage Collection Fees; http://www.cityofroxboro.com/departments/finance/finance.html (accessed June 30, 2011).
131. NC Pride, New Recycling Center in Person County, Leasburg Road. Available at: http://www.pcpride.org/page5.html (accessed June 30, 2011).
132. NC Department of Environment and Natural Resources, Division of Waste Management, Sections and Programs, Solid Waste Section, Annual Reporting; Solid Waste Data, Plans, Statistics and Reports; Statistics, Solid Waste County Disposal 2008-09, Person County; http://www.wastenotnc.org/swhome/AR08_09/County%20Waste%20Disposal%20Report_2008- 2009.pdf (accessed June 30, 2011).
133. NC Division of Waste Management, Sections and Programs, Solid Waste Section, Annual Reporting; Solid Waste Data, Plans, Statistics and Reports; Statistics, Municipal Solid Waste Landfill Capacity, 2008-09, (Upper Piedmont Regional Landfill); http://www.wastenotnc.org/swhome/AR08_09/AR08_09_AppendixD.pdf (accessed June 30, 2011).
134. Log Into North Carolina (LINC) Database Search. Topic Group: Environment, Recreation and Resources. Data Items 6218, 6219, 6220; http://data.osbm.state.nc.us/pls/linc/dyn_linc_main.show (accessed July 1, 2011).
94
Person County Health Assessment – Volume Two References
135. City of Roxboro, Departments, Public Utilities, Wastewater Plant; http://www.cityofroxboro.com/departments/public%20utilities/public_utilities.html (accessed July 1, 2011).
136. NC Department of Environment and Natural Resources, On-Site Water Protection Section, Large Wastewater Systems, Large Systems Database, System Information (search Person County entries); http://www.deh.enr.state.nc.us/osww_new/new1//largewwsys.htm (accessed July 1, 2011).
137. NC Department of Environment and Natural Resources, On-Site Water Protection Section, Non- Point Source Pollution Program - Goals; http://www.deh.enr.state.nc.us/osww_new/new1/NPS_goals.htm (accessed July 1, 2011).
138. NC Department of Environment and Natural Resources, Division of Water Quality, Surface Water, Point Source, NPDES Wastewater, NPDES History; http://portal.ncdenr.org/web/wq/swp/ps/npdes/history (accessed July 1, 2011).
139. Log Into North Carolina (LINC) Database Search. Topic Group: Environment, Recreation and Resources. Data Items 6113, 6216, 6217; http://data.osbm.state.nc.us/pls/linc/dyn_linc_main.show (accessed July 1, 2011).
140. Log Into North Carolina (LINC) Database Search. Topic Group: Environment, Recreation and Resources. Data Items 1307, 1308, 1309, 1310, 1311, 1312, 1313; http://data.osbm.state.nc.us/pls/linc/dyn_linc_main.show (accessed July 1, 2011).
141. US Environmental Protection Agency, Envirofacts Warehouse, Safe Drinking Water Information System (SDWIS). Query: North Carolina, Person County, All Populations, Active; http://www.epa.gov/enviro/html/sdwis/sdwis_query.html#geography (accessed July 1, 2011).
142. City of Roxboro, Departments, Public Utilities, Water Treatment Plant, 2010 Annual Drinking Water Quality Report, City of Roxboro; http://www.cityofroxboro.com/assets/pdf/NC_CCR_Water%20Quality%20Report%202010.pdf (accessed July 1, 2011).
143. US Environmental Protection Agency, Envirofacts Warehouse, Safe Drinking Water Information System (SDWIS), Drinking Water Contaminants, TTHMs; http://www.epa.gov/enviro/facts/sdwis/water_contaminants.html#tthmstotaltrihalomethanes (accessed July 1, 2011).
144. City of Roxboro, Departments, Public Utilities, Water Treatment Plant; http://www.cityofroxboro.com/departments/public%20utilities/public_utilities.html (accessed July 1, 2011).
145. City of Roxboro, Departments, Public Utilities, Raw Water; http://www.cityofroxboro.com/departments/public%20utilities/public_utilities.html (accessed July 1, 2011).
146. NC Division of Public Health, State Laboratory for Public Health, Environmental Microbiology, http://slph.state.nc.us/environmentalsciences/microbiology/default.asp (accessed July 1, 2011).
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Person County Health Assessment – Volume Two References
147. LeighAnn Creson, Health Educator, Person County Health Department, personal communication to Sheila Pfaender, July 1, 2011.
148. US Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Health and Research A to Z, Salmonellosis; http://www.niaid.nih.gov/topics/salmonellosis/pages/default.aspx (accessed July 1, 2011).
149. Person County Health Department, Person County 2008 State of the County Health Report.
150. Person County Health Department, Person County 2009 State of the County Health Report.
151. NC Department of Environment and Natural Resources, Public Health Pest Management Section, Data and Maps, Mosquito-Transmitted Diseases in North Carolina, West Nile Virus, Health Issues; http://www.deh.enr.state.nc.us/phpm/healthissues_WNV.htm (accessed July 1, 2011).
152. NC Department of Environment and Natural Resources, Public Health Pest Management Section, Data and Maps, Mosquito-Transmitted Diseases in North Carolina, Eastern Equine Encephalitis, Health Issues; http://www.deh.enr.state.nc.us/phpm/healthissues_EEE.htm (accessed July 1, 2011).
153. NC Department of Environment and Natural Resources, Public Health Pest Management Section, Data and Maps, Mosquito-Transmitted Diseases in North Carolina, LaCrosse Encephalitis, Health Issues; http://www.deh.enr.state.nc.us/phpm/healthissues_LAC.htm (accessed July 1, 2011).
154. Centers for Disease Centers for Disease Control and Prevention, Tickborne Rickettsial Diseases, Rocky Mountain Spotted Fever; http://www.cdc.gov/ticks/diseases/rocky_mountain_spotted_fever/faq.html (accessed July 1, 2011).
155. NC Department of Environment and Natural Resources, Public Health Pest Management Section, Data and Maps, Health Issues: Lyme Disease; http://www.deh.enr.state.nc.us/phpm/Lyme_Disease.htm (accessed July 1, 2011).
156. Centers for Disease Control and Prevention, Division of Vector-Borne Infectious Diseases, Lyme Disease; http://www.cdc.gov/ncidod/dvbid/lyme/index.htm (accessed July 1, 2011).
157. NC Division of Public Health, Epidemiology Branch, Veterinary Public Health, An Introduction to Rabies in North Carolina; http://www.epi.state.nc.us/epi/vet.html (accessed July 1, 2011).
158. NC Division of Public Health, Epidemiology Branch, Veterinary Public Health, Rabies Data, Maps and Other Information; http://www.epi.state.nc.us/epi/rabies/state.html (accessed July 1, 2011).
159. Person County Health Department, Person County 2010 State of the County Health Report.
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Person County Health Assessment – Volume Two Appendix
Appendix
Appendix A
2011 Person County CHA Volume Two Summary
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Why Environmental Assessment Person County 2011 • Health happens (or not) in a context Community Health Assessment • The natural environment is part of that context –Air VlVolume T wo S ummary: – Water Environmental Data – Land – Climate/weather October, 2011 • The built environment is also part of that context • Environmental data in Volume Two complements health data in Volume One
Environmental Assessment Data Focus Resources and Contaminants • Included in accreditation benchmarks for community assessment • Water • Relatively new concept to many health agencies – Surface water and Healthy Carolinians coalitions – Ground water – Unfamiliar terminology – Drinking water – Un famili ar in forma tion an d da ta sources • AiAir – Often a baseline process (with no previous data for comparison) – Outdoor air – Data more technical in nature – Indoor air – Requires inclusion of definitions and explanations • Agriculture – More data-driven than opinion-drive – Crops •Is not the same as risk assessment, because it –Livestock lacks exposure assessment. • Man-made environments
1 Water Quality Water Quality
• Surface Waters • Person County Waterbodies in the Roanoke River Basin (2009 Basinwide Report, HUC03010104) – Fresh flowing and standing waters – Subbasin 04 – Monitored by NC DWQ against standards set by state • No impaired waterbodies listed to determine impairment (process complies with • All waterbodies classified as good or fair FdFederal lCWA) CWA) – Surface waters used for: – Subbasin 05 • Sources of water for human and industrial consumption • 1 impaired waterbody listed (Marlowe Creek) • Sources of food • All waterbodies classified as good or fair • Sites for recreation • Routes for transportation and commerce – Subbasin 06 • Sites for disposal of byproducts and wastes of manufacturing • No impaired waterbodies listed and sewage treatment. • All waterbodies classified as good or fair
Water Quality Water Quality
• Person County Waterbodies in the Roanoke River • Person County Waterbodies in the Roanoke River Basin (2009 Basinwide Report) Basin (2009 Basinwide Report)
Bioclassifications (Two monitoring stations in Person Ambient Monitoring System (AMS) Stations Not County) Meeting Evaluation Levels (EL), 2005-2009
– Marlowe Creek: rated “fair” for benthic – Hyco Creek: low pH macroinvertebrates (down from “good-fair” in 2004. – Marlowe Creek: high turbidity; presence of fecal – South Hyco Creek: rated “fair” for fish (down from coliforms “good” in 2004) – Mayo Creek: presence of fecal coliforms
2 Water Quality Water Quality
• Person County Waterbodies in the Roanoke River • Person County Waterbodies in the Roanoke River Basin (2009 Basinwide Report) Basin (2009 Basinwide Report)
Whole Effluent Toxicity (WET) Failures for NPDES- Problems Detected through Lake Monitoring Permitted Dischargers, 2005-2009 – Hyco Lake: none – Primary Energy, LLC: 4 “fails” – Lake Roxboro: eutrophic in 2007 and 2009; – Roxboro Wastewater Treatment Plant: 1 “fail” degrading since 2007
– Progress Energy, Mayo Steam Plant: 0 “fails” – Lake Isaac Walton: eutrophic since 1988
– Progress Energy, Hyco Lake: 0 “fails” – Mayo Reservoir: mesotrophic; unchanged
Water Quality Water Quality
• Person County Waterbodies in the Neuse River • Ground Water Basin (2006 Basinwide Report; no updates)
– Subbasin 01 – Aquifers • No bioclassification or AMS stations in the Person County • Person Countyyg utilizes ground water from the part of the subbasin. Surficial aquifer and the Fractured Bedrock aquifer. • Both these aquifers are shallow and therefore • Person County Waterbodies in the Tar-Pamlico River subject to septic and other leachate contamination Basin (2003 Basinwide Report; no updates) and are affected by drought – Subbasins 01 and 02 • No bioclassification or AMS stations in the Person County parts of the subbasins
3 Water Quality Air Quality
• Ground Water • Outdoor Ambient Air Quality – Criteria Air Pollutants (CAPs) – Bacteria in Well Water (2008-2011) • Carbon monoxide – 75% from transportation sources • 36% (77) of 211 well water samples submitted to • Lead – mostly from gasoline additives the State Public Health Laboratory were positive • Nitrogen oxides – transportation and combustion for coliforms • Ozone – chemical reactions involving VOC and NOx • 6% (5) of the 77 coliform-positive samples were • Particulate matter – vehicles, factories, power plants • Sulfur dioxide – burning sulfur-containing fuels also positive for fecal coliforms – Human health effects: compromise breathing and – Ground Water Incidents (2001-2006) lung function; toxic to organs and systems; may • No leak/spill incidents were reported; no update cause cancer available.
Air Quality Air Quality
• Outdoor Ambient Air Quality • Outdoor Ambient Air Quality Monitoring Station Results Air Quality Index (AQI) Results (2003, for Ozone only) – There is one air qqyuality monitorin g station in Person
County (at Brushy Fork); it measures only ozone (O3). – “Hazardous” (code maroon): 0 days – From 2007-2010 there were 8 exceedance days out – “Very unhealthy” (code purple): 0 days – “Unhealthy” (code red): 0 days of 843 days monitored for 8-hr 03; the exceedances were very low – “Unhealthy for sensitive groups” (code orange): 5 days – “Moderate” (code yellow): 35 days – No exceedances for 1-hr 03 over the same period. Person County is not one of 48 NC counties with DOT-required emissions testing.
4 Air Quality Air Quality
• Outdoor Ambient Air Quality • Outdoor Ambient Air Quality – Hazardous Air Pollutants (HAPs) HAPs in Person County with Added Cancer Risk (Goal = 1) • 200 chemicals that can have adverse effects on human health and the environment – Overall score: 360 ((g;g360 times the goal; NC average = • Some are know carcinogens 480) • Some have respiratory, neurological and – Overall state rank: 17th reproductive effects in humans • Mecklenburg ranks 1st (Overall score = 800) • Described as contributing to either “added lifetime – Primary cancer risk pollutant in Person County cancer risk” for carcinogenic CAPs or “cumulative • Diesel emissions (carcinogenic with long-term exposure; hazard index” for chemicals with non-cancer short term exposure causes ENT irritation, lung inflammation, effects cough, headache and nausea.) – 49% from mobile sources (transportation) • Exposure ultimately is a factor in an individual’s – 44% from point sources (power plants) risk; this report cannot assess exposure – 5% from area sources
Air Quality Air Quality
• Outdoor Ambient Air Quality • Indoor Ambient Air Quality HAPs in Person County with Added Non- – Carbon Monoxide Cancer Risks (Goal = <1) • Released in heater and car exhaust – Overall Cumulative Hazard Index (()CHI) score: 2.2 • No intentional or unintentional deaths from CO in (NC average = 2.0) Person C oun ty i n 2006-2009 th – Overall state rank: 10 – Radon • Mecklenburg ranks 1st (CHI = 3.5) • Harmful when trapped in buildings – Primary non-cancer risk pollutant in Person County • Acrolein (in cigarette smoke, auto exhaust, burning plants • Major health effect = increased risk of lung cancer and oil, pesticides; toxic to various organ systems) • Elevated in upper Piedmont and mountains – 38% from area sources • Average level in Person County in 2004 = 2.43 – 31% from mobile sources pCi/L (EPA action level = 4 pCi/L) – 31% from point sources
5 Air Quality Toxic Chemical Releases
• Indoor Ambient Air Quality • US Toxic Release Inventory Environmental Tobacco Smoke – Inventory in existence since 1986 • 2010 Statewide BRFSS Results – Monitors 650 chemicals – 20% o f par tic ipan ts se lf-iden tifie d as “curren t – Based on industry-reported estimates of smokers” (down 12% from 2006) emissions to air, water and land • 2011 Person County CHA Survey Results – Person ranked 1st (worst) of 85 NC counties – 14% of respondents (108/761) self-identified as listed for total emissions in 2009 (4,552,769 “current smokers” (down 30% from 2007) pounds, down from ~20,000,000 pounds in 2002, when it also ranked first in total TRI – 19% of respondents who smoke (20/108) are emissions.) not interested in quitting
Toxic Chemical Releases Toxic Chemical Releases
Person County TRI Emitting Facilities and Total Primary Person County TRI Releases, Total Pounds Pounds On/Off Site Disposal or Other Releases On/Off Site Disposal or Other Releases (Primary (2009) Emitters), 2009 – Barium – 1,146,225 lbs (power plants) – Aleris Rolled Products, Inc. (Roxboro) – 4,328 – Hydrochloric acid – 679,300 (power plants) – Mayo Electric Generating Plant (Roxboro) – 1, 740, 108 – Sulfuric acid – 540,000 (power plants) – Roxboro Steam Electric Plant (Semora) = 2,736,675 – Vanadium compounds – 439,832 (power plants) – CPI USA NC, LLC (Roxboro) – 723 – Manganese compounds – 347,973 (power plants, Eaton Corp., – Eaton Corporation (Roxboro) – 538 Loxcreen) – Georgia Pacific Wood Products (Roxboro) – 635 – Zinc compounds – 261,891 (power plants) – Louisiana Pacific Corporation (Roxboro) – 31,530 – Loxcreen, Inc. (Roxboro) – 3,181 [this facility has since closed] – Copper and compounds – 238,974 (power plants, Loxcreen) – US Flue-Cured Tobacco Growers (Timberlake) – 35,052 – Chromium and compounds – 209,678 (power plants, Loxcreen) – Nickel compounds – 202,745 (power plants, Loxcreen) – Arsenic compounds – 121,833 (power plants)
6 Land Contamination Lead Hazards
• Superfund Sites (EPA) • Source: deteriorating lead-based paint, lead- – Nation’s worst toxic waste sites; federal help with cleanup contaminated dust and lead-contaminated soil – 1 in Person County (defunct GMH Electronics facility in • Most common in housing built before 1950 Roxboro, listed in 2009 for VOCs in residential wells) • Most commonly involve residents with income below the • Brownfield Sites (()EPA) poverty level – Properties where contamination hinders development; program alleviates liability for developers • Children are at greatest risk from lead contamination, – 1 negotiated site (Bromma property II, Roxboro) and 1 pending especially children in poverty site (J.G. Harrison property, Roxboro) in Person County • Estimated Person County housing units at high risk for • Inactive Hazardous Sites (State) lead contamination: 300 (2%) (1999) – For sites not covered by other programs; state oversees • Elevated (>g/dL) blood lead level screening results remediation for Person County 1- and 2-year olds (2009): n=2 (0.4% – 8 sites in Person County (7 in Roxboro, 1 in Rougemont) of all children screened)
Agricultural Pollution Agricultural Pollution
• Person County Agricultural Census • Possible Pesticide Usage – Farms (2007) • 403 farms (up from 374 farms in 2002) – Soybeans • Average size = 244 acres (down from 254 acres in 2002) • Insecticides – 24 chemicals • 42% of operators list farming as primary occupation • Herbicides – 43 chemicals – Main Crops (2009) • Disease control agents – 21 chemicals • Soybeans – 10,300 acres (down from 12,900 acres in 2005) • Potential acute toxicity of these chemicals ranges • Wheat – 6,900 bushels (up from 6,000 bushels in 2005) from “unknown” to “high”; other environmental and • Tobacco – 3,460 acres (up from 2,315 acres in 2005) • Corn – 3,100 acres (up from 2,300 acres in 2005) health effects are possible. – Main Livestock (2010) • Animal Waste (2009): 71,750 tons produced • Hogs and pigs – 5,000 head (down from 9,890 head in 2002) • All cattle – 7,500 head (down from 7,589 head in 2002)
7 Waste Management Wastewater Management • Solid Waste Management • Wastewater Systems (1990 Census; no – FY2008-09 Person County per capita solid waste management rate = 0.86 tons (8% increase over the update available) FY1991-92 reference base of 0.80, but 9% decrease – 3,861 (31%) housing units on public sewer from the FY2004-05 rate of 0.94.) – 8,045 housing units (64%) on septic systems – The Upper Piedmont Regional Landfill (UPRL) in – 642 housing units (5%) on “other” (e. g., straight pipe Rougemont collects within a 60-mile radius of Person systems and outhouses) County • 32,203 tons municipal solid waste collected in FY2008-09 • Remaining capacity in 2009 = 3.012 million tons (~13 years) • City of Roxboro WWTP • Community controversy over expansion plans and odor – Can treat 5.0 MGD; current utilization is 2.1 MGD issues – Discharges to Marlowe Creek, where there have been – CP&L operates one industrial landfill and one land ongoing water quality problems. clearing/inert debris landfill in Person County.
Total Water Usage Drinking Water
• Water Usage (total used from surface and • Drinking Water Systems (1990 Census; no ground water sources) update available) – Total water usage in Person County – 4,482 (36%) year-round housing units on water from • Increased 56% from 1995 to 2000 a municipal water department, a water district, a • Decreased 0.2% from 2000 to 2005 pppy,grivate water company, or a well serving six or more – Domestic, municipal/community, and irrigation use all housing units increased from 2000 to 2005 – 7,807 (62%) on water from individual wells – The largest proportion of water (99%) in Person County is used for thermoelectric power generation – 259 (2%) on “other” (springs, creeks, cisterns) • Use increased 57% from 1995 to 2000 • Use decreased 0.4% from 2000 to 2005. • In 2011 the EPA listed 4 active “community water systems” that together serve 13,715 people (35% of 2010 Person County population)
8 Drinking Water Food-, Water-, and Vector-Borne Disease • Community Water Systems (2011 EPA SDWIS Data) • Most Common Food- and Water- and Vector-Borne Diseases in Person County – Bridgewater S/C (serving 30 people) – Salmonellosis (primarily food) • No health violations 2005-2010 – Camplyobacter (primarily food) – Flat Ri ver M obil e H ome C ommunit y (50 peop le ) – Rocky Mountain Spotted Fever (tick vector) • No health violations 2005-2010 – There were no cases of West Nile Virus, Eastern Equine Encephalitis or LaCrosse Encephalitis in Person County – Timberlake Mobile Home Park (158 people) between 2005 and 2010 • No health violations 2005-2010 • Rabies in Person County – City of Roxboro (13,477 people) – 18 positive rabies tests among animals 2006-2010 • Multiple health violations 2009-2010 for presence of total • Raccoons – 10 trihalomethanes (TTHM) exceeding the acceptable average • Skunks - 6 for maximum contaminant level (MCL) •Bats –2
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