Meeting Summary the 2009 Vieques Scientific Consultation

IV. Recurring Themes

1. Take immediate actions to stop current and future exposures.

Some participants urged ATSDR to consider issuing a (public health statement) letter to the Department of Defense (DoD) requesting that until ATSDR further characterizes the public health issues at the site, DoD:

• Stop vegetation burning.
  • All parties should consider the risk/benefit trade-off between the burning activities and the need to remove the unexploded ordnance (UXO) safely.
  • More work needs to be done to determine alternative methods to clear vegetation so that the military can find and destroy UXO and to address questions such as, “does burning the vegetation put more people at risk?”
• Stop on-island detonation of UXO.
  Explore alternative methods such as removing the items to an off-shore barge for detonation.
• Stop leakage and flushing of contamination from the lagoon to the sea
  Some participants urged immediate action to stop leakage and flushing of the lagoon near the live impact area until contaminants can be fully characterized.

2. Withdraw the previous conclusions.

Some participants urged ATSDR to withdraw the conclusions from the previous Public Health Assessments in order to take a “fresh look” at the data. In some cases, the science may have evolved since the documents were developed. As part of this process, the Agency might include a statement indicating that the conclusions were premature and should be reconsidered based on new science, data and methods. Additionally, ATSDR should explain the level of uncertainty in the previous documents.

• Additional analysis is necessary to fully characterize mercury in fish. This should take into account changes in science and recommendations from other agencies such as the Food and Drug Administration.
• The focus should not be on collecting additional environmental samples at this time. The Agency should look at the data that are available from other sources to characterize current exposures. This includes air monitoring data from the current Navy activities.
• Reanalyze the data based on different assumptions. Start the analysis from a worst-case scenario. Ensure that the assumptions are realistic; then determine if the scenario would be true for a subset or all of the population.
• The Agency needs to rebuild the community’s confidence in future work. This should include working with independent scientists and conducting peer reviews for documents that are developed.
• Future work needs to demonstrate a clear commitment to public health protection. This includes clearly documenting uncertainties and considering the impacts on clean-up activities and other work that may be influenced by the Agency’s conclusions.

3. Multi-Agency/Multi-Faceted Effort

• Future work should bring together representatives from multiple agencies to fully characterize and address possible exposures.
• Work is needed to fully characterize the environmental contamination in Vieques. Efforts should include biomonitoring, an evaluation of possible health outcomes, and reviews of the available data pertaining to plants, fish, marine environment, cisterns, other water collection systems and soil data from the island. This should also include strategies to address data gaps.

4. Healthcare Access

Future work should take into account deficiencies in the healthcare system and identify this as a public health problem. For example, people must travel to the main island for treatment for conditions such as cancer. As a result, many people can’t complete their treatment.

5. Environmental Health Protection

Additional work is needed to determine if and when advisories for foods, such as fish and locally grown produce, are needed to reduce or stop exposures. These actions should consider a balance between health protection, economics, nutritional value, and local customs.

6. Governance, Oversight and Process

Future work to assess exposures in Vieques needs to be completed quickly using the best science possible. Some participants suggested that this should include external oversight and involvement that might include universities or others.

* Individual recommendations from the 2009 meeting were taken into consideration, and many of the issues are being addressed in the Summary Report.

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