Press Briefing Transcripts

CDC and FEMA Discuss Preliminary Test Results from Trailers and Mobile Homes in Louisiana and Mississippi

February 14, 2008

OPERATOR:  Once again, please stand by for the CDC media conference call.  Your lines will be placed on listen only until we open up for questions and answers.  At that time, you may press star one to ask a question.  Today′s conference will be recorded.  If you have any objections, you may disconnect at this time.  Once again, we thank you for your patience and please standby we will begin shortly.

JULIE L.  GERBERDING MD., M.P.H; DIRECTOR, CENTERS FOR DISEASE CONTROL AND PREVENTION:  I′m Dr. Julie Gerberding, the Director of the Centers for Disease Control and Prevention and I′m joined today by with Administrator Paulison from the Federal Emergency Management Administration, CDC and FEMA.

We′re here to provide some provide some perspective on a recent tests in homes that are being used by some of the Katrina survivors.  And I really couldn′t help but think, as I was flying in today and flying over some of these homes, that while we′re going to be talking about trailers and mobile homes and park trailers, what we′re really talking about are people and the homes that they′ve been occupying, sometimes for up to two years since the Katrina situation occurred.

And I think we want to keep in mind that these people have exhibited great patience and great courage with us.  We hope that the information we provide today can help them make the decision so that we can help them relocate to a safer environment.

Let me start with a few facts.  CDC and FEMA have been working together to conduct tests of the trailers and mobile homes and park trailers that are the residence of many people in the Gulf region since that hurricane occurred.

We conducted a test of 519 of these places.  It represents a random and statistically appropriate sample of the variety of places that people were staying.  And we conducted this test beginning in December, completing on January 23rd.

The raw data came to us at CDC on February 4th and we were able to get those data out in, at least their preliminary forms today, to the people who need them most, the people who are living in these homes.

What we observed, first of all, was that there is no magic cutoff for formaldehyde that indicates safe or not safe.  And there′s great variability across everything that we measured in terms of the levels.  And we can′t predict, in any given situation based on type of home or the manufacturer or the brand whether the level would be higher or lower.

So there was a great deal of variability.  We also observed that the majority of the tests revealed relatively low levels of formaldehyde in the sense that we would not expect people who were in those homes for short periods of time to have any symptoms.

But about a third of the homes did have levels that could be expected to cause symptoms in people who were vulnerable.  And by vulnerable, I mean people who have very young children, older people, and especially people who already have airway diseases that would make them more susceptible to irritation and symptoms such as runny nose, cough, or sometimes even problems breathing could be a conspicuous problem for them.

Five percent of the homes or so had levels that were at the high end, and even people without vulnerability might experience some respiratory symptoms if they spent time in those homes.  Now what we actually did, of course, was just take a snapshot of formaldehyde levels on a day in the life of a home in this region.

And that snapshot is helping us understand and confirm what we suspected all along, that in some of these situations the formaldehyde levels are high enough where there could be a health hazard to the people who are living there, and certainly emphasizes the importance of what FEMA′s already been doing, which is trying to help people relocate into safer, permanent housing.

But a snapshot is only a point in time.  And we know that if we took the same snapshot in the summer when the weather′s warmer, that we would probably see even higher levels in some of these trailers.

So we′re making the recommendation that all of the people in these situations be relocated to safer, permanent housing as quickly as possible, and certainly before the warm summer months arrive, because we want people to be as safe as they can possibly be.

We also recognize that people are in their homes for more than a snapshot.  They live in these homes and they may have been living in them for a few years since the hurricanes occurred.  Exposures do add up over time.

With formaldehyde, the degree of risk from chronic exposure is still somewhat uncertain, but it is classified as a carcinogen, and we do want to be sensitive to the fact that people who spend a lot of time in their trailers could be at risk for cumulative exposure effects.

And for that reason we are going to be working with FEMA to try and create a way to assess if people living in these trailers may have health effects as a result of formaldehyde.  And we′ve already started this process for the children, and we hope to extend this to include all the people living in the homes over time.

There are some things that people in this situation can do right now.  One of them is to improve the ventilation, because although the formaldehyde comes usually from the building materials, when the facility is closed down the air′s not moving, formaldehyde can accumulate and not escape, so it makes the levels higher.

So good ventilation and spending as much time as possible outside of the home, especially if you have little children or are in a vulnerable group.  In addition, it′s really important that people not smoke inside their trailer, or anywhere for that matter, because tobacco not only can contain formaldehyde, it also increases airway irritation and this makes people more susceptible to the effects of formaldehyde in the situation that they′re in.

It′s also important that people know right now they can ask questions.  CDC has a hot line, 1-800-CDCINFO where people can call to get information about health effects, and I′m sure my colleague from FEMA will talk about the resources that FEMA has made available for people who need help and advice right now.

And of course if anyone feels that they have symptoms or are worried about symptoms of formaldehyde exposure, they should contact their clinician and get the medical advice and treatment that they need.

There are also some things that the government is going to do based on this information.  I′m going to let my colleague talk about the relocation efforts, and the help and acceleration of relocation we anticipate, but we′re also going to do something specific to reach out to the people whose homes were tested.

Already CDC experts are here in Louisiana.  My colleague, Dr. Mike McGeehin is one of the world′s experts in this area.  He′s here.  Additional team members will be arriving from both CDC and FEMA over the next several days.  They′re coming with the tools and the educational and informational kits that they′re creating.  And beginning next week– they will be going door-to-door to hand deliver to each individual home the information about their test results and take time to explain what it means and what it doesn′t mean and what the next steps are.

So that will be happening very quickly.  I don′t expect that process to go on over a long period of time and we′re going to do it as fast as we can.

We′ll also be conducting some large community groups both here and in Mississippi and elsewhere to inform the people who didn′t necessarily participate in the testing for this assessment, but also have concerns or questions and need to have a chance to speak face-to-face with people who are experts.  So we will be doing that as quickly as we can.

I′ve already mentioned the importance of registering people who′ve lived in the homes so that they can have their health concerns addressed over time.  But we want to be very clear that there are still a lot of questions about formaldehyde and its importance as a health hazard.  So we have agreed to establish this technical advisory panel, bring in experts.

Right now the experts don′t have agreement on a number of the issues, but we hope that by doing some new science which is already in progress and looking at as much information as we can quickly pull together, we′ll be able to do a better job of predicting health hazards and most importantly, doing something about them.

So let me just conclude with a thank you, first and foremost to the people again who are the Katrina survivors and have been courageous and patient during this long period of time.  Also for the advocates who have been standing up for them, the community leaders but also the state local health departments and the people who have been part of the overall emergency response.

It takes a community of people working together to deal with something as complicated as this, is, and I think folks have been working really hard.  We hope we′ve been doing our part as well.  I also just would like to end with kind of a personal request.

I had a chance to visit New Orleans several times in my life, usually for fun or for scientific meetings, but since I′ve been the CDC Director I think this has mostly come at times when there′s a great health issue.

So just a few days after I became the director I was here for the West Nile outbreak in the south and that was an impressive demonstration of how a community could really pull together to deal with a very rapidly emerging situation.  I, of course, came back with many others in the wake of the hurricane.

I hope that the next time that I′m here, that we′re here to celebrate permanent and safe housing for the people who have waited a long time for that.  And that perhaps our next Valentine′s Day can be one where home really is where the heart is.  Let me turn this now over to my colleague, Mr. Paulison.

R.  DAVID PAULISON, ADMINISTRATOR, FEDERAL EMERGENCY MANAGEMENT AGENCY:  Thank you Dr. Gerberding.  I appreciate those comments.  As you heard FEMA asked health experts at the CDC to investigate formaldehyde levels in the travel trailers that were used to house those that had been displaced by not only Katrina but Hurricane Rita.  We now have some verbal preliminary results from the CDC of testing of that analysis.

As a result of these preliminary findings FEMA is going to continue our aggressive action to provide for the safety and well being of the residents of these travel trailers by finding alternative housing.  Since November we have moved out over  15,000 families; they have moved out of these travel trailers into some other housing.

We′re not going to wait for the final results but we′re going to work to continue or expand our actions with the residents that need to be relocated.  We had a peak of almost 144,000 families in these travel trailers and 105,000 of those have already moved out.

And we continue to have between 800 and 1,000 families a week move out of these travel trailers.  As I stated before, and you′ve heard from Dr. Gerberding, our primary concern is the health and well being of those who we′re assisting.  So let me outline some of the actions that we′re going to be taking.  First, FEMA will coordinate with CDC to provide occupants with public health information to ensure that they have a full understanding of the health risk of living in these travel trailers.

As you heard, CDC experts are on the ground, and are on hand, and will begin the process of making personal visits, as soon as next week CDC and FEMA a personnel team, will visit each of the 519 tested units, and provide them specific results of their home, and advise them on a course of action and we will be ready to advise them on housing alternatives.

Once we receive the final results of the test from CDC, we will hand-deliver, to every household, a flier with the general results of the study with health information, advice, and information on how to contact FEMA to expedite their relocation.

Second, FEMA will increase the pace to relocate households from trailers to apartments, or other alternative housing, but preferably, in locations that are convenient to their work, convenient to the schools, and close to the community.

Third, where apartments or alternative housings are not available, we will relocate households to hotels and motels for a period of time that may be necessary to find alternative housing, when it becomes available.

Fourth, in the event that hotel or motel spaces aren′t available, we′ll relocate households to other alternative housings, as options become available, such as pre-tested mobile homes, or as Katrina cottages that we see are going on the ground in Mississippi and Louisiana.

Fifth, FEMA will provide case-worker assistance to occupants to ensure best access to information and programs that can lead to self-sufficiency.  Case-workers will meet with residents.  According to their specific residential needs, including medical, employment or educational requirements, case-workers will then provide them with information on housing options, and help them make the best choice in housing that meets their needs.

The priority of relocation will be those occupants expressing health concerns, and those most susceptible to health risks, such as the elderly, households with young children, those with respiratory challenges or those who are at units that have high readings.

To ensure that these relocations can proceed expeditiously, FEMA will, as needed, we will enter into direct contracts with hotels in order to obtain the needed hotel/motel capacity.  We′ll utilize contract resources to support that relocation.  If needed, we′ll provide food and food vouchers we′ll enter into direct lease agreements with landlords, and we′ll contract with temporary storage and/or shipping of household property.

We′ll also contract the boarding and care of household pets, for families to be relocated to hotels or apartments that do not allow pets.  If they′re moved into an unfurnished apartment, we′ll provide furniture for rental units working with local volunteer agencies, where possible or purchase that furniture if we have to.  We′ll contract with moving teams, and equipment to assist in movement of households with special medical needs and we′re going to provide additional staff on the ground, to facilitate and manage that step process.

We′re also going to form a joint federal state relocation task force that will oversee a safe, compassionate and timely consistent implementation.  So this will help us sharpen our focus, integrate our capabilities and capacities with our federal partners at HHS, at CDC, at HUD, at the Veterans Administration and USGA, as well as volunteer and private organizations here in the state.  FEMA teams are already on the ground.

We′ve expanded our toll-free formaldehyde information and relocation assistance call center, that are now available seven days a week, 24 hours a day.  Residents can call 1-866-562-2381.  Let me repeat that one more time.  That′s 1-866-562-2381.  And relocation teams and case-workers are already on the ground, working to identify the matched families with available housing.  As I said earlier, over 15,000 families have moved out since November, and between 800 and 1,000 families are moving out each week.

I′ll repeat again, our priority remains the health and safety of the residents in travel trailers.  We have been leaning forward and continue to act to provide information to our residents in an expedited manner as possible.  Thank you.  Now, what we′d like to do is take any questions that you might have.

UNIDENTIFIED PARTICIPANT:  Mr. Paulison, could you talk about the concern from citizens who are living in these trailers.  To a lot of people in this area, it sounds somewhat disingenuous because FEMA′s known about this problem for close to two years now and only now coming forward saying there is good medical evidence out there that shows there are concerns.

What can you tell people, the elderly, the sick, the young, who have been living and now they face a long-term health problem because they′ve been living where the government told them it was safe?

PAULISON:  First of all, we have not be doing, saying, not doing anything.  Like I said, we′ve moved over 15,000 families out just since November, 105,000 families have moved out since we started, so we′ve been very aggressively moving people out of travel trailers and mobile homes in a park model in this area.

We do care about the people and we′ve been moving them as fast as we can.  We did not have a lot of information two years ago or the 18 months ago when we started.  That′s why we asked CDC,  who are the experts in these medical needs,  to come in, test these trailers, tell us exactly what we had and what we need to do and they′ve done that.

So along with the aggressive approach we′ve been taking, we′re going to take a more aggressive approach.  We′re going to start moving people into hotels and motels until we can find apartments.  You that live here know that apartments are hard to find right now, so we′re going to move them to hotels and motels.

We have offered consistently over the last two years if you want to move out, we′ll move you out immediately and we′ve done that.  A lot of people have called about health issues.  We′ve offered to move them and they′ve refused.

I think with this information, we get information out to people, when we asked them to move out of these travel trailers, include them in at least the hotel or motel first leading to an apartment, they will do so.

UNIDENTIFIED PARTICIPANT:  Do you have an estimate of how much more this, is going to cost?

PAULISON:  We have not worked up a cost estimate yet.  It really doesn′t matter.  We have to move people out of the travel trailers regardless of the formaldehyde.  The fact that they′ve been in these travel trailers for almost two years some people, those are not good living conditions, and we understand that.

That was the only tool FEMA had in its toolbox at the time.  We′re looking at other alternative housing pieces now, so we′re going to move people out and be very aggressive about it to get people out of these units and into some decent housing.

UNIDENTIFIED PARTICIPANT:  When you had Rita and Katrina population, what′s the raw number of people you still have to move out of the trailers into other housing units?

UNIDENTIFIED PARTICIPANT:  We have out of the 143, almost 144,000 families we′ve started with, we′re down to about 38,000, but about 30,000 of those are actually on private property and most of those are backed up in the driveway rebuilding their homes.

So the population of those who are in group sites is much, much less than that, probably 5,000 or 6,000 that are in group sites.  We′ll focus on to get those closed down, those that are backed up in the driveways rebuilding their homes or not in those travel trailers as much as people who are in the group sites.  So we′re going to focus on the people who have health problems, with small children and also with a keen focus on closing the group sites down and getting those people some decent housing.

UNIDENTIFIED PARTICIPANT:  Now in the process moving forward as far as like relocating people and families and vulnerable populations who live in these travel trailers, but what about addressing their existing medical needs that have come about because of living there?

UNIDENTIFIED PARTICIPANT:  Well, we′ve gone, we′ve already started working with CDC to address the tracking the children who′ve been living in these travel trailers, and we′re going to also work with them on a separate registry to expand that to everyone who′s been in those, so we can follow people along and see what we have.

We don′t know what the long-term effects are and we don′t know what we′re going to have, so we′re going to work with CDC very closely and find out exactly what we have and where we′re going to go with this type of thing.

UNIDENTIFIED PARTICIPANT:  But I guess I mean specifically as far as their health care.

UNIDENTIFIED PARTICIPANT:  Cold you repeat the question from the phone please?  Can we take the questions from the phone please?

UNIDENTIFIED PARTICIPANT:  Yes, why don′t we take a question from the phone?

OPERATOR:  Thank you, David Hurley, ABC News, your line is open.

DAVID HURLEY, ABC NEWS:  Thank you just went to mute there.  Can you give us an idea of how much this has cost so far and how much – I know you answered the question and you don′t have a cost on how much more it′s going to cost, but how much have you invested in this already, trailers and as well as how much this hotel/motel may cost?  And when you say 38,000 trailers, how many individuals is that?  How many people?

PAULISON:  The number of individuals we′d have to guess.  I don′t have a handle on that.  You figure about three people, you know, per unit as an average, so you can do the math on that.  I don′t have at hand what we′ve spent so far.

We purchased travel trailers.  They were anywhere from $7,000 to $12,000 a piece, you know, we have bought 140,000 of them.  We bought mobile homes.  We bought park models, but those are necessary expenses to house people.

So we′ll add up costs at the end of the day, but the real issue is, it′s not really what it′s going to cost but how quickly we can move people out, out of the travel trailers into apartments and that′s what we have to do.

UNIDENTIFIED PARTICIPANT:  Is it true that these very same trailers are now for sale to the public?

PAULISON:  We have- we suspended sales of travel trailers a long time ago, several months ago.  We have not made a decision yet what we′re going to do with them.  We′re going to have, obviously over 100,000 of these left and whether we decide to sell them or do something else that will be a decision down the road.

UNIDENTIFIED PARTICIPANT:  If so, what about the (INAUDIBLE) trailers that you were sending from Arkansas (INAUDIBLE)?  They′ll be the same travel trailers.

PAULISON:  No, we′re using mobile homes.  Now some of the mobile homes here have tested high.  So what we′re doing is what we did in California, the travel- the mobile homes have been closed up for a period of time in Hope, Arkansas.

We′ve aired those out.  We air them out for 7 to 14 days and we test them and if they′re testing low then we move.  That′s what we did in California.  We did the same thing in Arkansas.  We′re not going to give somebody a mobile home that tests high in formaldehyde.  We′re simply not going to do that.

UNIDENTIFIED PARTICIPANT:  Let′s go to the phones, please.

OPERATOR:  Mike Brunker,  MSNBC.COM, your line is open.

MIKE BRUNKER, MSNBC.COM:  Thank you.  I have a question for Mr. Paulison.  Has FEMA done any investigation of the manufacturing process to get an explanation of how these high levels came to exist and if not does it intend to do so?

PAULISON:  We are working with CDC.  CDC is doing a study now on taking some of these travel trailers apart to see exactly what the issues are, you know, we didn′t order travel trailers with extra formaldehyde.

We bought the same ones we′ve been buying for 20 years and the issue came up with Katrina and Rita, probably because of the length of time people are in them.  But we need to find out what the issue is, going to find out what is causing high formaldehyde rates in some of these units.

As Dr. Gerberding said the readings were generally low for most of them but over 30 percent were too high.  So we′re not going to make any distinction.  We′re simply going to start moving people out and really, just give them some decent housing.

BRUNKER:  If someone is experiencing health problems how quickly can FEMA get them relocated?  Do you have hotels under contract right now?

PAULISON:  We are  – what we′ve been doing the last-  since November, if someone calls with a health problem we move them out immediately like the next few days.  We get them out and put them into a hotel or motel and then we start trying to find an apartment that fits the size of their family and their needs.

UNIDENTIFIED PARTICIPANT:  Has FEMA conducted a comparative cost analysis between setting people up in private hotels and motels and creating their own government taxpayer funded housing for the people?

PAULISON:  No.  FEMA, we are not housing experts that′s obvious.  We should not be in the housing business.  That′s a HUD issue.  All the people that are in apartments now are being transitioned into HUD programs.  They′re the ones that need to manage it.  We have not done that.  No, we have not done the cost analysis.

UNIDENTIFIED PARTICIPANT:  Is FEMA transitioning with HUD or working with HUD at all on this, issue?

PAULISON:  We have not yet.  That may be something we want to look at.  Part of the issue is, don′t forget, we had a catastrophe in this community.  There was no alternate housing.

The only thing that we could do to keep people in the state and around the community was to put them in these type of units.

UNIDENTIFIED PARTICIPANT:  Or put them in Tennessee in a trailer.  It seems like two-and-a-half years is an awful long time to come up with a new plan to work collaboratively with the new government.

PAULISON:  The normal stay in travel trailers after a disaster is 18 months.  And in Florida we have people in longer than that.  It takes that long for houses to get rebuilt, so it′s not a success with the amount of time.

What we′re trying to do is, again, travel trailers and mobile homes has served the population who have been through disasters, served us very well for the last 20 years.  It′s just now we have an issue with that.

We recognize that that may not be the right thing to do.  So it′s a new program we′ve put in place.  And we feel that what apartments are available, that′s where people should go and not necessarily group sites or travel trailers.

UNIDENTIFIED PARTICIPANT:  Do you know how long the relocation is going to take for everybody …

PAULISON:  CDC is recommending that we try to get as many people out as we can by the summertime.  We′re going to shoot for that.  We already had a goal of getting everybody out of group sites by summer, mainly for hurricane reasons, not for the heat, for hurricane season coming up.

So we′re going to work very hard to meet their recommendations to move people out as quickly as we can and get them into whatever available housing we can find around the area, and keep them as close as we can.  Therefore the jobs have …

UNIDENTIFIED PARTICIPANT:  Let′s go to the phones, please.

OPERATOR:  Thank you.  Gary Mischeils, Mississippi Public Radio, please go ahead.

GARY MISCHEILS, MISSISSIPPI PUBLIC RADIO:  Dr. Paulison, what financial long-term financial ability for long-term health effects of this formaldehyde will FEMA accept?

PAULISON:  We have not looked at that particular piece of it yet.  We′ll work with CDC to see one, do we have long-term health effects that, you know, we don′t know a lot about formaldehyde.  I don′t.  I′m not the expert in them, definitely.  And, you know, we′ll work and see how we′re going to – we have not made a decision, I guess, the answer on that one.

UNIDENTIFIED PARTICIPANT:  Mr. Paulison, do you anticipate using trailers again next hurricane season if we find ourselves in the same predicament, or do you have other housing options at this point?

PAULISON:  We will not ever use trailers again.  We may use mobile homes just like we′re doing in Arkansas and California.  But we will not use trailers again.  They′re too small, we saw they do not work well particularly in large group sites.  We put families in them.  That is not a good housing alternative for us.

UNIDENTIFIED PARTICIPANT:  What′s the difference between the make-up of a mobile home and a travel trailer?  I mean, they have the same …

PAULISON:  A couple of things.  One, the travel trailers are much smaller.  They′re constructed, they′re made for short-term camping, those types of things.  The mobile home is designed to live in for 20 years.

There are HUD standards, they go into the materials that go into mobile homes that are not – that are not applied to travel trailers.  So we feel like the mobile homes are a safe place to put people.  Again, we had some mobile homes tested very high here, which was a surprise to us.  So we′re going to make sure that we test any of our mobile homes before we put them on the ground to put people in them.

UNIDENTIFIED PARTICIPANT:  Mr. Paulison, do you think that FEMA works with the kind of urgency that is required?  I mean I know you said you didn′t a whole lot two years ago, but the concerns about headaches, and bloody noses were brought to FEMA′s attention 23 months ago.

PAULISON:  I think we have moved very quickly, based on what we knew.  You know, hindsight is 20/20.  We can look back and say yeah, maybe we shouldn′t have did something differently.

With the information we had, we thought we moved very quickly.  We put fliers out to people, we visited their homes, we told people what to do about airing their trailers out, and we′ve worked with CDC, we′ve worked with other agencies to do the best we could do with the information we have.

What we know right now, or found out now with these testings is, you know, we′re going to move people out of these things.  And they′ve been in too long.  They′ve been in two years, and we′re very cognizant of that.

UNIDENTIFIED PARTICIPANT:  Assume there are some people in the New Orleans area that want to stay next to their house as they rebuilt in their trailer.  Will you allow them to stay if they want to stay?

PAULISON:  And we′re – and that′s a great question.  We′ve been mulling over that one the last several days.  We have a joint housing group that I′ll talk about we′re putting together.  I′m going to put that in their lap to make those decisions.

You know, if somebody′s backed into their driveway, rebuilding their home, and, you know, we′ve had issues with some of the homes have been – copper being stolen, other items, so they want to be there to protect their homes.

That′s going to be a tough decision for us.  Definitely the group sites we need to move people out and it′s going to be some tough choices.  Some people aren′t going to want to move.  But again those overall decisions we′re going to put in that joint housing group and working with the state, working with the local community on how we′re going to deal with that when those issues come up.  We′ve been trying to get …

UNIDENTIFIED PARTICIPANT:  A lot of communities in Gulf Coast Mississippi have put limits on whether there should be cottages or travel trailers and indeed mobile homes go.  They′re not allowing these bigger units to be put in.  Wit the information we have now, what can we do about all these local governments to convince them that people really do need these travel trailers?

PAULISON:  You know, we have no control over local or state laws.  So all we can do is talk with them, encourage them to allow us to do that.  We understand that some of the local communities don′t want them there.  But they′re their residents, you know, they were there before and we need to, you know, my opinion we need to let them come back again.

So, but we, again, that′s a local issue.  There′s no …

UNIDENTIFIED PARTICIPANT:  Let′s go to the …

PAULISON:  You know, Dr. Gerberding′s here also.

UNIDENTIFIED PARTICIPANT:  Doctor …

UNIDENTIFIED PARTICIPANT:  Let′s go to the phone please.  Let′s go to the phone please.

OPERATOR:  Thank you.  Ana Radelat, Gannett News Service, your line is open.

ANA RADELAT, GANNETT NEWS SERVICE:  Hi.  I have some real questions and I′m sorry, maybe you′ve – I′ve had trouble hearing some of the answers, so you may have answered some of these.

Is this going to be – are people going to be forced to leave their units?  For instance when their test results come by, when you give them the results and say a person lives in a trailer that′s tested extremely high.

Are you going to say, OK, we′re moving you in the next few days and there′s no other – nothing else, you know, there′s no recourse that the person in the trailer has?  I guess that what I′m saying is, is this going to be a forced move for many residents?

The other question I have is how many mobile homes were tested as opposed to – what′s the break down of mobile homes and trailers?

And the third question is I thought this testing would – was going to determine which brands of trailers were more prone to high formaldehyde than others.  Did it?  And if so which ones tested higher?

PAULISON:  I′ll answer the first question and let Dr. Gerberding answer the next two.  The first question is, that we answered earlier, is we have a joint housing group that′s going to make those recommendations on whether we physically force people to move out of a travel trailer or a mobile home if they don′t want to, even though they test high.

So that′s a question we′ve been dealing with over the last couple of days.  How are we going to do this and we don′t have an answer yet, but that will fall into the lap of working with the state, working with local community of what we′re going to do with people that – when they enter the test high and people don′t want to move.

GERBERDING:  In terms of the sampling methodology used the proportionate statistics were basically applied so that if there were X proportion of mobile homes out of the total, then X proportion of mobile homes were included in the sample.  So an effort was made to make a sample pool that accurately reflected the distribution of the homes under consideration.

We are not sure that we will be able to draw any concurrences about those trailers (INAUDIBLE) particular brand or manufacturer, but that analysis, is not complete yet.  In fact, that′s still in progress and we won′t probably have data from that for several weeks.  That′s a more sophisticated kind of sub-set analysis, and the statistics are something that have to be peer-reviewed, and make sure that we get that exactly right because we don′t′ want to draw any unfair conclusions about it, associations, if they′re in fact not scientific valid.

So that′s part of why I emphasize that the information we′re releasing today, we brought out because we wanted to emphasize how important it was for people to move before the onset of the warmer weather.  But we have more work to do, and you will see more information coming out of this as we go forward.

UNIDENTIFIED PARTICIPANT:  Doctor, we came in late on your remarks, but were you able to make any definitive links between formaldehyde in these trailers and ill health effects on the people that live in them?

GERBERDING:  This sampling was not designed to make that association.  This design was only there to look at the amount of formaldehyde in the set of trailers.  But obviously, as we know more about those levels, it gives us the opportunity to carry this forward, and to do a more sophisticated correlation, or even, we call it longitudinal study, where we can follow people over time.

Ideally, we would like people to be out before such a longitudinal study could make any sense.  So we may be looking more retrospectively, to see if there′s any relationship between what we could project was the total amount of exposure, or the highest amount of exposure, and the health effects.

Unfortunately, it′s not a perfect correlation.  There are a lot of individual factors that influence who responds to formaldehyde.  So it′s not just the level in the environment that′s key.  And as I said before, there are other sources of formaldehyde in the trailer, including tobacco smoke, which is obviously a major factor that can confuse a lot of this information.

But some dry cleaning products, many other products that people might have in their homes, release volatile compounds, like formaldehyde, that can also increase the levels.  So, we know that this, isn′t entirely a problem related to the trailers.  It′s going to be very difficult to sort out all of those variables without a great deal more science.

UNIDENTIFIED PARTICIPANT:  How many trailers did you look at?

GERBERDING:  We looked at 519 trailers.  That′s based on a very sophisticated, statistical sampling analysis, and in my estimation, was a very proper approach to doing this so that we had enough statistical power to draw the inferences that we have.  Let′s take a phone question.

OPERATOR:  Thank you.  Shelley Bluejay-Pierce, Native American Times, please go ahead.

SHELLEY BLUEJAY-PIERCE, NATIVE AMERICAN TIMES:  Good morning, this, is Shelley Bluejay-Pierce, Native American Times.  Over the past year and a half, I′ve had the opportunity to interview several of the FEMA trailer and mobile home occupants in the hurricane areas.

One particular person is Lindsay Huckabee, who also testified before the House Oversight Committee hearing about the severe health effects that her family has endured, continues to endure, in a mobile home provided by FEMA.  I have heard both of you discussing what these ongoing follow-ups and studies and things like that are going to be all about, with the occupants that have been in these mobile homes and trailers.

One of the comments that′s consistently come into me as a reporter, is that a lot of the people, including the Huckabees, they′ve not been able to afford to move out of their mobile home, and be able to finish their projects of moving into another home, or purchase another land sight, because of their enormous health-care costs.

With all the expense we′re putting forward as alternative housing, and all this follow-up and study, what are we doing for the individual people who have literally spent thousands of dollars in medical health-care?

PAULISON:  Well, first of all, if they are living in a trailer and they′re having physical symptoms, we said repeatedly, and we′ve delivered pamphlets, we′ve visited every travel trailer and mobile-home, that we will move them out immediately.  They don′t have to stay there.

As far as the medical bills, we don′t have a program to deal with that at this point, but that′s one of the issues we have to look at in the long run.  From the room

UNIDENTIFIED PARTICIPANT:  This, is a CDC question.  To point it out that mobile homes had high levels of formaldehyde, there′s a whole population of people who live in mobile homes that have nothing to do with the disaster issue.  My question is, is the CDC going to expand this sort of review to include those homes?

GERBERDING:  We need to be very clear that the sample of homes included in this are homes that FEMA has been using, not the universal mobile homes that people are living in.  One of the things we know, for example, is that formaldehyde levels are highest when the units are new, and the older they are the formaldehyde dissipates and it basically goes away.

So there′s nothing that we can say about mobile homes generally from the findings in a very small subset of products that were evaluated here.  I think what needs to happen is that, as Mr. Paulison said, we learned something about mobile homes, and we need to step back and see what relevance, if anything, has in there and there is a mechanism that is set in place to bring some experts together to take a look at this.

I could also mention that mobile homes have been evaluated for formaldehyde in the past, and one of the trends that has been hinted at over time is that manufacturers are improving their manufacturing practices, that in fact the building materials in mobile homes are improving, and that the average levels in mobile homes overall are declining, so manufacturers know that they have a role to play and that there are alternatives.  So we′ll be able to say a lot more about that as we do more science.

UNIDENTIFIED PARTICIPANT:  We′ll take two more questions, one from the phone and then one more from office here please.

OPERATOR:  Thank you. Leslie Eaton, the New York Times, your line is open.

LESLIE EATON, NEW YORK TIMES:  Thanks very much.  It′s Leslie Eaton from the New York Times.  If I′m doing the math right, it sounds like you have about 8,000 people, 8,000 families left in group homes, group sites rather, that you need to move out pretty much right away.

We heard earlier in New Orleans from people who said their group sites were being closed, and they didn′t have any place to go.  Are you confident that you can find places for all these people so quickly?

UNIDENTIFIED PARTICIPANT:  We think so.  We′re again about 1,000, 800 or 1,000 a week have already been moving out.  We′re putting a joint housing group together, a solution team together with the state with our private sector people, again with HHS and with HUD and others to help us find affordable housing or housing that′s close.

We′ll move them into motels and hotels if we have to, to get people out, and then we′ll look for something longer term like an apartment or a house or something like that.  So yes, we think we can.  We think we′re going to accomplish that by summertime.

UNIDENTIFIED PARTICIPANT:  Doctor, we understand there was a curing process involved when people first moved into these homes.  Did you all look into whether or not a home that was not properly ventilated when it was first occupied had a higher risk than those that (INAUDIBLE).  Did you narrow your study down?

GERBERDING:  This study was not designed to ask that particular question, so we won′t have that information from the results that are yet to be analyzed here, but I will again say that there is other research going on, including some research looking at these homes and deconstructing them to try to understand exactly where is this product mostly likely to cause problems, whether the most important culprit, what can we do to mitigate it?  Are there things that could be done even in a travel trailer that would reduce the level of formaldehyde after it′s purchased and so forth?

So there′s a lot of science going on with CDC, ATSDR but also with our collaborators in other agencies of the academic sector, and I think we′re going to learn a lot in the next year or two, but we do not have that information now.  And it′s creating, you know, this air of uncertainly where on the side of caution we have to really encourage people to move out of these homes until we can straighten this out.

UNIDENTIFIED PARTICIPANT:  Thank you very much everybody.

OPERATOR:  Thank you.  That does conclude today′s CDC Media Conference Call.  We do thank you for your participation.  You may now disconnect your lines.

END

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES