Agency for Toxic Substances and Disease Registry

Did You Know?

• ATSDR was created as an advisory, nonregulatory agency and cannot provide or fund medical treatment for exposed individuals.
• ATSDR has seven goals, including promoting environmental justice and reducing health disparities associated with environmental exposures.

History

Congress passed the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), known as the Superfund legislation, after the environmental disasters at Love Canal and Times Beach, Missouri. CERCLA authorized the establishment of ATSDR to assess health hazards near Superfund sites and expand knowledge about health effects from hazardous exposures. A 1982 lawsuit by the Chemical Manufacturers Association and the American Petroleum Institute forced the agency's creation, and ATSDR was established under the Department of Health and Human Services on April 19, 1983, with James O. Mason as its first administrator. The Hazardous and Solid Waste Amendments of 1984 to the Resource Conservation and Recovery Act gave ATSDR additional authority regarding hazardous waste storage facilities. The agency was formally organized on June 11, 1985. The Superfund Amendments and Reauthorization Act of 1986 broadened ATSDR's responsibilities in public health assessments, toxicological databases, information dissemination, and medical education. In 2003, the assistant administrator position was replaced with a director shared with the National Center for Environmental Health.

Organization

The CDC Director, currently Jay Bhattacharya, serves as ATSDR administrator and heads the Office of the Administrator; this appointment is made by the president and does not require Senate approval. Aaron Bernstein serves as director of NCEH/ATSDR, heading the Office of the Director, and is appointed by the ATSDR administrator. The Office of the Director is joint with that of the National Center for Environmental Health and contains seven functional units, five offices, and five program-specific divisions supporting six program areas: Public Health Assessments, Toxicological Profiles, Emergency Response, Exposure and Disease Registries, Health Effects Research, and Health Education. The Division of Community Health Investigations manages an office in Washington, D.C., and offices in each of the 10 EPA regions, including locations such as Boston, New York, Philadelphia, Atlanta, Chicago, Dallas, Kansas City (Kansas), Denver, San Francisco, and Seattle. These regional offices work with EPA, state and local health departments, health professionals, community groups, and other partners to implement programs.

Programs

A key job of the Agency for Toxic Substances and Disease Registry is to carry out public health assessments and health consultations. The agency evaluates every site on or proposed for the National Priorities List, known as Superfund sites, to see if dangerous substances there could harm people and to suggest ways to prevent or reduce contact with those substances. It also provides health consultations, which are narrower in focus and often requested by the EPA or state and local agencies, to answer specific health questions like the impact of a particular chemical. The public can also petition for these assessments or consultations. ATSDR uses its own scientists or works with states through cooperative agreements to offer technical help. In 2009, it completed over 200 public health assessments and now handles roughly 1,000 health consultations annually. During site investigations, the agency looks at environmental data, health records, and community feedback, but it usually does not gather its own environmental samples, depending instead on partners like the EPA for that information.

Quality of work

ATSDR has been described as widely regarded as the world's leading agency on public health and the environment, but it has also faced scrutiny from Congress and other groups. Much criticism stems from the agency being overtasked yet understaffed and underfunded for much of its history. In August 1991, the General Accounting Office published a report faulting the quality of ATSDR's original public health assessments and questioning their usefulness, partly blaming deadlines imposed by the Superfund Amendments and Reauthorization Act of 1986. The report noted that after meeting the SARA deadline, ATSDR was able to increase the rigor of its assessments. In May 1992, the Environmental Health Network and the National Toxics Campaign Fund published a report noting structural limitations to the work of CDC and ATSDR. In April 2008, a House subcommittee held a hearing on formaldehyde exposures in FEMA trailers provided after Hurricane Katrina, and a subsequent report noted shortcomings in ATSDR's original health consultation on the issue. A March 2009 report called for leadership changes, stating that ATSDR appears to avoid confronting obvious toxic culprits and instead denies, delays, minimizes, or ignores legitimate concerns.