Table of Contents
Full Report 
[PDF Version, 6.10 MB]
Foreword | Disclaimer | Chapter 1
| Chapter 2 | Chapter 3
Chapter 4 | Chapter 5
| Chapter 6 | Chapter 7 | Chapter 8
Chapter 9 | Appendices | Tables |
Figures
1.2 The Public Health Assessment Process
1.3 Purpose of This Guidance Manual
1.4 Organization of the Guidance Manual
Chapter 2: Public Health Assessment Overview
2.1.2 Factors to Be Considered in All Public Health Assessments
2.1.3 How Does a Public Health Assessment Differ from a Risk Assessment?
2.3 Who Conducts Public Health Assessments?
2.4 What Is the Role of the Site Community?
2.5 How Is a Public Health Assessment Conducted?
2.5.2 Collecting Needed Information
2.5.3 Exposure Evaluation: Evaluating Environmental Contamination Data
2.5.4 Exposure Evaluation: Identifying Exposure Pathways
2.5.5 Health Effects Evaluation: Conducting Screening Analyses
2.5.6 Health Effects Evaluation: Conducting In-Depth Analyses
2.5.7 Formulating Conclusions and Recommendations and Developing a Public Health Action Plan
Chapter 3: Obtaining Site Information
3.1.2 Community Health Concerns
3.1.3 Environmental Contamination Information
3.1.4 Exposure Pathway Information
3.1.5 Health Outcome Data
3.1.6 Substance-Specific Information
3.2.2 Internet Resources
3.2.3 Community Members and Other Stakeholders
3.2.4 Site Representatives
3.2.5 Conducting the Site Visit
3.4 Documenting Relevant Information
3.5 Confidentiality and Privacy Issues
References
Other Resources
Chapter 4: Involving and Communicating With the Community
4.1.2 Goals and Objectives for Community Involvement
4.1.3 Program Areas Addressing Community Needs
4.2.2 Confidentiality and Privacy
4.2.3 Cultural Sensitivity
4.2.4 Environmental Justice
4.2.5 Principles of Effective Communication
4.3.2 Developing Community Involvement Strategies
4.3.3 Types of Community Involvement Activities
4.4.2 Community Meetings
4.4.3 Community Groups and Committees
4.4.4 Fact Sheets and Other Materials
4.4.5 Media Support
4.4.6 Establishing Information Repositories
4.4.7 Access to Experts and Toll-Free Hotline
4.6 Community Health Concerns in Public Health Assessment Documents
4.6.2 How to Present Responses to Community Health Concerns in The PHA
Other Resources
Chapter 5: Exposure Evaluation: Evaluating Environmental Contamination
5.1.2 Validity of Environmental Sampling Data
5.1.3 Representativeness of Environmental Sampling Data
5.1.4 Conclusions About Data Usability
5.3 Considering Background Concentrations
5.4 Identifying and Filling Critical Data Gaps
5.5 Summarizing and Presenting Environmental Data in the Public Health Assessment Document
References
Other Resources
Chapter 6: Exposure Evaluation: Evaluating Exposure Pathways
6.2.2 Identifying Affected Media
6.2.3 Identifying Physical/Safety Hazards
6.3.2 Physical and Chemical-Specific Factors That Influence Environmental Fate and Transport
6.3.3 Site-Specific Factors That Influence Environmental Fate and Transport
6.4.2 Exposure Routes
6.4.3 Temporal and Spatial Considerations
6.4.4 Conditions That Could Prevent Exposure
6.5.2 Estimating Numbers of People in Potentially Exposed Populations
6.6.2 Potential Exposure Pathways
6.6.3 Eliminated Exposure Pathways
6.7.2 When an Exposure Investigation Should Be Considered
References
Other Resources
Chapter 7: Health Effects Evaluation: Screening Analysis
7.2 Conducting Environmental Guideline Comparisons 7.3 Conducting Health Guideline Comparisons 7.4 Other Factors That Influence the Screening Analysis
7.5 Presenting Screening Analysis Findings in the Public Health Assessment Document
References
Other Resources
Chapter 8: Health Effects Evaluation: In-depth Analysis
8.2 Tools and Resources Needed to Support an In-depth Analysis
8.3 Evaluating Study(ies) on Which Exceeded Health Guidelines are Based
8.3.2 Assess the Relevance of the Critical Study
8.5 Evaluating Substance-specific Factors that Can Increase or Decrease the Potential for Harm
8.5.2 Mechanistic Data
8.5.3 Sensitive Populations and Life Stages
8.5.4 Multiple Chemical Exposures
References
Other Resources
Chapter 9: Determining Conclusions and Recommendations
9.1.2 Presenting Conclusions in the Public Health Assessment Document
9.2.2 Actions for Site Characterization
9.2.3 Health Activities
9.2.4 Factors To Consider When Developing Recommendations and the PHAP
9.2.5 Presenting Recommendations and Public Health Action Plan in the Public Health Assessment Document
Appendix A: Tribal-specific Resources and Considerations
Appendix B: ATSDR Glossary of Terms
Appendix C: Community Check List
Appendix D: Guidelines for Effective Communication
Appendix E: Chemical- and Site-Specific Factors That May Affect Contaminant Transport
Appendix F: Derivation of Comparison Values
Appendix G: Calculating Exposure Doses
Appendix H: Public Health Conclusion Categories
Table 3-1. Contamination Information Needed by Environmental Medium
Table 3-2. Site-Specific Information That May Be Needed To Evaluate Contaminant Fate and Transport
Table 3-3. Information Available Through Government Agencies
Table 3-4. Useful Government Sources of Information
Table 3-5. Sample Site Summary Table
Table 4-1. ATSDR Program Areas with Responsibilities for Working with Communities
Table 4-2. Issues to be Considered When Developing Community Involvement Strategies
Table 6-1. Documenting Exposure Pathways
Table 7-1. Additional Sources of Environmental Guidelines
Table 9-1. Summary of Conclusion Categories
Table 9-2. Summary of Conclusion Categories With Recommended Public Health Actions
Table 9-3. Factors to Consider When Selecting Health Activities
Table 9-5. Example Conclusions, Recommendations, and Public Health Actions
Figure 1-1. Basic Components of the Public Health Assessment Process
Figure 2-2. Overview of the Public Health Assessment Process
Figure 2-3. Information Needed To Evaluate Exposures and Health Effects
Figure 3-1. The Basic Iterative Information-Gathering Process for a Public Health Assessment
Figure 3-2. Basic Data Needs for Conducting a Public Health Assessment
Figure 4-1. Components of Effective Community Involvement
Figure 5-1. Examples of Maps Used to Display Environmental Data
Figure 6-1. Evaluating Exposure Pathways
Figure 6-2. Site Conceptual Model—Exposure Pathway Schematic
Figure 6-3. Site Conceptual Model—Exposure Pathway Evaluation
Figure 7-1. Screening Analysis Overview
Figure 7-2. Environmental Guideline Hierarchy
Figure 8-1. Overview of In-depth Analysis
Figure 8-2. Schematic of Various Low-dose Extrapolation Methods
Figure 8-3. Factors Affecting Whether Environmental Contamination May Result in Harmful Effects
Figure 8-4. Health Outcome Data Evaluation Decision Tree (for evaluating site-related exposures)
Figure 9-1. Overview of Conclusion and Recommendation Process
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