director was given a copy of the of the draft report and remembers reviewing at least one time the analysts believe that review processes went through four rounds providing comments back to the analysts on what they needed to do to improve the report there was no process  in place to guarantee that anyone else between the two analyst and the director and deputy director had a chance to review the report there was no control sheet to indicate to the director who else had reviewed it in most agencies this is a standard form to guarantee that a d and there was a failure of leadership to establish effective systems to guarantee that important health public health documents were reviewed properly and based on the best science there was also a stunning lack of concern for how import of this consultation was to thousands of american families it appears that this consultation was received only a cursory review by the director's office by the director of self and the deputy director claims only the vaguest memories of any concerns regarding the report another director another official a t s t or had a very different reaction to the formaldehyde consultation when he saw it after the report was reviewed and seven letter read in relevant part the health consultation has been can complete without a policy review by our senior technical staff i am concerned that this health consultation is incomplete and perhaps misleading this letter like the prior consultation was sent to the office of chief counsel at mr rick preston an attorney there mr president preston told our staff that he simply put the letter in his file and did not mention it to that hearing doctor from order to revise consultation posted in october two thousand and seven and shifted the blame for the consultation the failings of the consultation arguing that dr de rosa who was the one who asked the questions t questions about the report should be removed from his position because of the poor quality of the formaldehyde health consultation i want to make it very clear to the management of c d c and a t f see or that this committee employees it isn't dr de rosa and i want to emphasize that nothing should happen to dr de rosa except that he be restored to his previous position i think back to when you were a child and you were sick the safest place was to be at home in bed here we have government providing families with homes that were making children sick where do those children go to be safe where to families turn for help are mandated to intervene to protect the public health public from adverse health consequences of toxic chemicals but in this case we find the leadership at the very top level of the to recognize i will recognize mr sensenbrenner of wisconsin thank you mr chairman they's hearing touches on some of the core issues lawmakers face in implementing policy based on science as the former chairman of this full committee and the ranking member of the subcommittee as well as being the ranking member of the select committee on global warming i probably have had more experience with this intersection than most of my colleagues how do you rely on good science to make informed decisions in the public interest first and foremost decisions require good science and good scientific recommendations the agency for toxic substances and disease registry which are referred to as the a t f the as the chairman as has the mission is quote to serve the public by using the best science taking responsive public health actions and providing trusted health information to prevent harmful exposures and disease related to toxi substances unquote this mission is intended to serve not only lawmakers and other federal agencies but also individuals like today's witnesses lynn the lindsey huckabee ms huckabee his family experience various health problems since moving into trailers provided by the federal emergency management agency today too little has been communicated about what effect the formaldehyde levels in her fema provided trailer have had on her family's health after an extensive subcommittee investigation it appears that one of the principal failings within eighty s t r is its review process i hope to hear testimony from agency officials about that review process and how it can be strengthened in the future to prevent situations like this from occurring regardless of the merits of an individual scientist good scientist requires review and contribution from various perspectives leads to recent instances a proven itself incapable of sufficient review a t s the recently released a report entitled public health implications of hazardous subjects in the twenty six us great lakes areas of concern before its slated release a t s the ship withheld the report's release because according to the agency significant scientific concerns have come to their attention i am convinced that those concerns are legitimate  therefore confused as to how the report cleared a t s t r s review process watchdog agencies and congressional committees are justifiably concerned when a report on public health is pulled with minimal explanation days before released if this report was so fatally flawed why were problems not uncovered during a t s t two years of review before the report was cleared for release a t s the i r s initial health consultation  formaldehyde levels and thema trailers similarly failed the public that consultation titled formaldehyde sampling at fema temporary housing units dated february one two thousand and seven concluded that the average concentration of formaldehyde per day in ventilated trailers after the fourth day of sampling and for the remainder of the study was below the level of concern for sensitive individuals of zero point three parts per million that conclusion lead fema to believe the concentrations of formaldehyde in fema provided housing units did not present a public health hazard that was not the message the report's authors intended to convey a kapatid internal review process could have determined that the consultation was potentially misleading before it was ever transmitted to fema first competent review could have determined that there were potential problems with the report stated a level of concern the consultation does not discuss why it chose this level nor is it discussed the problems could occur at much lower levels the stated level was three times higher than the level used by several other government agencies and according to many experts above the level where many individuals will experience negative health effects while the consultations authors had a strong argument for choosing this level the level should have been subject to at least some degree of internal review the health consultation also focused exclusively on the short term effects and failed to mention the potential long term effects of exposure to corral the hide in the possible risk of cancer dr christopher  the director of the division of toxicology and environmental medicine first read the release nearly a month after it was prince made into fema he pointed out some of the consultations flaws and argued that as written it was perhaps misleading on march seventeenth two thousand and seven eighty s wrote to rick preston and fee ms office of general counsel who had originally requested the consultation to raise these concerns mr preston however did not share these concerns with other officials of thema for its part a t s took no action to immediately revise its report nor did it raise any protest as fema continued to rely on the health consultation as evidence of the trailers acceptability a month and a half after the report was transmitted to thema the report was still flawed and the public was still on informed as today's hearing will make clear far too little is known about the effects of formaldehyde the bot what level should be considered problematic clearly risk managers have to accept exposure to some level of formaldehyde suggestion that there is no safe level of formaldehyde are simply not helpful because  formaldehyde is ubiquitous sitting in this hearing room today we're breathing in formaldehyde it has long been known that these levels are higher in trailers and mobile homes both because of the materials used in the relatively poor air exchange but exactly what level is unacceptable is not clear dated feb twenty ninth two thousand and eight from the centers for disease control titled interim findings and formaldehyde levels in fema supplied travel trailer parked models and mobile homes provided information about formaldehyde levels and fema supplied occupied travel trailers parked models and mobile homes that were still being used as of january of this year this report found that the average formaldehyde concentration in these units was seventy seven parts per billion well above what it termed a typical us background levels of ten to thirty parts per billion the range of concentration  tested trailers was however extremely broad the lowest tested trailer registered only three parts per billion well below the u s average while a highest concentration measured five hundred ninety parts per billion the interim report recommended fast action finding that its conditions supported the need to move quickly before the weather in the region warms up the real located residents of the us go of course reason region displaced by hurricanes katrina rita who still live and travel trailers parked models in mobile homes this recommendation is broad sweeping and authoritative but it raises as many questions as it provides answers there's the c d c recommend relocating everyone in fema provided trailers even in those trailers with formaldehyde concentrations below the typical background norms and us homes if not what level is the appropriate level of concern  americans living in trailers and mobile homes not provided by fema be concerned about formaldehyde levels doing a wide scale testing for formaldehyde concentrations the public will not be served by drastic action based upon limited science relocating individuals who are experiencing health effects is an urge priority but causing a panic among individuals who are perfectly safe will only result in unnecessary expense in the those who are actually in the we need a clearer understanding of formaldehyde and its effects on human health before we act more broadly as the ranking member of the global warming committee i know too well how science intensified under constant media exposure can lead to paranoia that seems to require immediate wide scale and admittedly well intentioned action as policy makers we depend on agencies to produce high quality thoroughly review science and to provide prudent objective advice we haven't gotten that from a t f and as a result we're really operating in the blind in terms of what our response should be to this problem and i thank the chair for indulging me to speak for more than five minutes i thank you mr sensenbrenner and i appreciate your going more over your time than i have whenever my time making me look better by comparison into the record documents that have been collected by the subcommittee during the course its work on this matter and those doctors have already been provided to the bond already without objection so ordered i now would like to introduce our witnesses our first panel today our first witness is dr heidi sinclair dr sinclair is it is assistant professor of pediatrics at leas and state university and is the medical director of the baton october two thousand and five until just last month well gentleman yield we know all about the kill mississippi because if your favorites you tell me oughta go back to work that's brett far e the ranking member agreed earlier that all sports analogies would be college basketball but i think the the early exit of the university of wisconsin has changed  our last witness is miss becky gillette the formaldehyde campaign manager for the sierra club gulf coast environmental restoration task force welcome to all of our witnesses you will have five minutes for your spoken testimony your written testimony will be included in the record for the hearing when you all complete your testimony we will begin with questions and each member will have five minutes to question the panel it is a practice of the subcommittee to take testimon under oath if any of you have any objection to being sworn in if not all of you may also be represented by counsel is anyone here represented by counsel and now would you please stand and raise your right  hand do you swear to tell the truth and nothing but the truth all the witnesses affirm that they would tell the truth dr sinclair please begin good morning thank you chairman miller and congressman sense brenner for inviting me to testify today my name is dr heidi sinclair with the leanna state university health science center the views expressed here and did not refer the views and opinions of l a few h s c i'm here today as a community pediatrician an advocate for vulnerable children i too was displaced by hurricane katrina i relocated to baton rouge in june of two thousand and six to accept the position of medical director of the baton rouge children's health project established post katrina by the children's health fund in collaboration with l s d pediatrics in baton rouge our projects mobile medical units have provided comprehensive medical and mental health care to over four hundred children in families displaced to the baton rouge area as team a trailer group sites were being established a number of concerns were expressed regarding the safety and suitability of both the travel trailers and the group sites themselves we were concerned then as we are now the people living in these trailers are continually being exposed to formaldehyde which is most readily absorbed through the respiratory tract by breathing symptoms associated with formaldehyde exposure includes sinus irritation respiratory problems skin rashes ira taishan knology and stomach aches as well as neurological problems such as headaches fatigue depression and saw me a difficulty concentrating since we began seeing patients at the fema trailer villages presenting problems have included many symptoms consistent with formaldehyde exposure well  zero eight parts per million or eight parts per billion as minimal risk level for long term formaldehyde exposure is important to emphasize that much remains unclear about formaldehyde most human studies have been limited to adult occupational exposure children however are more likely to be affected by even low level exposure to formaldehyde in their living environment because they generally spend more time at home have a higher respiratory rate have a greater surface to mass ratio are closer to the ground and formaldehyde concentrations are higher closer to the ground and have immature metabolic systems that may not them to clear absorb formaldehyde as quickly as adults there are also concerns about possible long term consequences of formaldehyde exposure which include changes to the immune system that can increase allergic responsiveness in general possible reproductive or developmental toxicity and increased risk of nasal and nasal frenzel carcinomas and possibly lung cancer throat cancer blood disorders following reports in two thousand and six of elevated formaldehyde in the mississippi gulf coast area travel trailers i discussed concerns regarding formaldehyde in travel trailers in our area with colleagues at the office of public health the children's health fund and elsewhere the health consultation of formaldehyde sampling at fema temporary housing units released by eighty s t r and february of two thousand and seven seven added confusion regarding what might be considered safe levels of formaldehyde in this report zero point three parts per million or three hundred parts per billion was chosen as the level of concern this level however is nearly forty times higher than what is established by the eighty s t r as a minimal risk level for long term exposure misinterpretations of the study and other misconceptions may have served to minimize understanding of the possible exposure risk to those living in travel trailers in our area in july two thousand and seven fim announced that they would work with c d c to test occupied travel trailers i contacted the c d c and learned that the testing would be random residents would not be able to request to have their trailer tested it was unclear if individual results were going to be given to residents and the actual study start date was on them th provided our project with a few test kits all of the tests were elevated with seven of the eight trailers testing between one hundred and three hundred parts per billion ten to twenty five times above eighty s d r's able risk level for long term exposure and at least five times above levels often present in conventional homes a summary of this testing sample was shared with persons with the office of public health the children's health fund and others i was contacted in the summer and fall of two thousand and seven by c d c representatives and participated in a phone conference with c d c representatives regarding their upcoming study on occupied travel trailers a t s d r's october two thousand and seven update in revision seems to be an effort to clarify that there feb fema consultation was not meant to imply that formaldehyde levels in the travel trailers were safe for long term occupancy this update also mentions concerns of and summary i would like to share my conclusions and recommendations first i am glad that fema acknowledged that travel trailers are designed for short term recreational use and are not intended for housing i recommend that the more actively involved local government non profits and family and child advocates and planning safe and appropriate house in options for displaced families second i am surprised that the c d c did wait so long to initiate formaldehyde testing of occupied travel trailers given the state concerns of some of their own representatives as early as july two thousand and six and given reports by eighty s t r in february of two thousand and seven that cited formaldehyde levels so greatly above their own defined minimal risk level for long term exposure addition to daily anxieties and stresses of displacement as fema works with local agencies to find more appropriate and safe healthy solutions for families we recommend that coordinated efforts be made to prevent any further disruption and endangerment finally i recommend the c d c consider expanding their proposed child health study to a wider sample of children displaced affected by hurricane katrina and look forward to contributing to such a study and any way i might be able thank you first like to thank the committee for bringing this up in congress and holding somebody accountable for what's been going on my name is lindsey huckabee i'm not an expert on formaldehyde i'm not a scientist i'm a woman a wife and a mother who's finke countless hours dealing firsthand with the effects of formaldehyde on august twenty ninth of two thousand and five our apartment was destroyed along with all its belongings we contacted fema and were told that we qualified for their housing temporary housing program we received trailer in december of two thousand and five it was a single wide mobile home not a travel trailer like many people belief whenever we first entered it we noticed that there was a real strong offensive smell we had sinus issues going on my six year old immediately started having nosebleeds along with my four year old and the twenty nine months since we received our first fema trailer our family has suffered many health issues four of my five children have been treated for asthma four of them are currently on prescriptions for breathing treatments none of which were asthmatic before we moved into the trailer my husband and i have allergy symptoms sinus symptoms and we have been tested for allergies and nothing shows up on  test my husband had a tumor and his soft palate that was removed it was considered non cancerous but still malignant because of its rate of growth are your nose throat doctor feels that formaldehyde could have been a contributing factor to this while it cannot be proven he said that he will make a note of it for further study my daughter layla was four when we moved into the trailer she's now six she developed moderate as much she had sinus infections severe enough to require two surgeries whenever i asked the e m t if the surgeries were really necessary because they were very invasive he asked me if i could be out of that trailer in thirty days or less i told him that no i had nowhere to go he said then she must be put through this because he fears that her nasal passages would not be wide enough to exchange air we had formaldehyde test on our trailer in april of two thousand and seven our first trailer was a fleetwood homebuilt november of two thousand and five the test came back at point one eight parts per million which is above the point one believed to be harmful as human to humans there's no way to know how high it was in the sixteen months we lived there before having it tested since fema and the c d c suggest that opening windows well i guess the fumes and lower the level i have to believe it was much higher since we did this repeatedly we reported our findings to fema we were told that we would be provided with a replacement unit that would be f the second trailer was a two thousand and five model built by destiny holmes we had a formaldehyde test done on it before we moved into it found that its levels were point zero one eight parts per million it was lower than the ones that we had received but in researching i found that point zero zero eight is what is considered safe for long term use this was still above that whenever i'm form female of our new findings they said it's lower than the one for so we're good safe levels when i called thema to help a number they gave us she told me i need to call the c d c to find out what was the safe level of formaldehyde we called the c d c number that was provided by fema first we were told to call fema back the c d c was handling after insisting that i had already called the member told to call the c d c number i was transferred to six different people none of which were willing to give me a name or an employee id number each one told us they knew nothing about formaldehyde that they didn't know anything about any levels and one of them even told us she didn't know anything about working with female on this so whenever we got off the phone we were just as confused as we were in the beginning i was able to meet with some of the c d c director some of the c d c employees at a town meeting held  i was told by one of them they knew nothing about the formaldehyde until after the july two thousand and seven hearing i find this really hard to believe considering my own pediatrician and spoken with the c d c about doing a child health study we went back and forth with the c trying to get a safe number to find out you know with we were running air purifiers trying to find out if our trailer was indeed safe we thought it decrease of symptoms once we had the the air purifiers running we were told there is no safe level of formaldehyde for living in twenty four hours a day i feel like since the c d c and fema and a t s t are all new a year in advance from today about the formaldehyde in the trailers i feel like essentially we were lab rats we were put in this situation we were exposed to this and seeing as this large group of scientists knew about it it seems like they should have at least been doing studies to find out what the effects were this is not a new chemical it's around used in everything for decades if not longer i think that it's a shame that this high tech agency has no more information on this than they do have  gillett my name spanky chill and i'm formaldehyde campaign director for sierra club after katrina became common knowledge that the fema trailers had serious air quality problems people complained about burning eyes respiratory problems rashes headaches and even bloody noses sierra club began formaldehyde testing in april of two thousand and four and continued through two thousand and seven what we found was that sixty one out of our sixty nine tests eighty eight percent were over the point one ppm limit that e p a had set and when you use the much much lower levels recommended by the a t s t our recommendations not a single trial or what saif we tasted seventeen different brands of trial lawyers and all had at least one high test and there were three deaths of people in the trailers that we tested that we believe could have been caused by the vermeil the high finally in october of two thousand  over a year after katrina many people men in the trial lawyers for over a year e p a tested the trial lawyers but there was still lie after delay in releasing the results of those famous had asked eighty s t r to evaluate those test results i also contacted eighty s t r several times and no one ever got back to me when it was finally released to the a p s the our health consultation was a huge disappointment the report said that formaldehyde averaged one point two parts per million at the beginning of the test and drop to point three p p m after four days of constant ventilation this was shocking because one point two parts per million is extremely high and i found it incredible that eighty s t r could say point three parts for million was below the level of health concern at that level most people that walking into a trailer will experience immediate distress and a t s the our own standards are many magneto's tubes lower a p s c our gave completely erroneous advice covering up this problem when the health of tens of thousands of families was at stake finally in october two thousand and seven over two years after katrina a year after the e p a testing a t s b are revised its health consultation to more accurately report the problem but that was two years that women were living in these tyler's getting pregnant haven't miscarriages haven't still bars and losing babies to sids adults and children were getting cancer people with asthma were literally finding it difficult to breathe and mothers are getting up in the middle of the night to get breathing treatments to their children if i recall call calling earl shorty to give him the results of their fema trailer testing his wife does the right call and was coughing so bad in the background that it was painful to hear her a few days later she passed away one woman i tested teresa coggins a diabetic went into a coma for eight days running up a one hundred thousand dollars hospital bill another woman christine lawrence told me that her head felt like a balloon that was about to burst but it fema an eighty s t r care no there was a callous disregard for the health of the trial residents and there was an appalling lack of urgency but this negligence is only the tip of the iceberg contaminated communities often feel let down by eighty s t r are turning monique harden co author of report that details injustices louisiana says quote any help that you can provide and getting the science and technology committee to connect the dots between a t s t ours role in the talks and fema trailers with its quote public health unquote work in communities plagued by pollution would be greatly appreciated the problem that we have is that a t s d r s conduct in the fema trailer kong crisis is not an aberration but it's consistent with the way it has always worked sow meyer who retired from the as director of the division of prevention in the dallas regional office wrote we strongly believe there is a national pattern in the manner in which a t s t are conducts or consultations and assessments and that this pattern could result in great risk to the public health of many communities it is our perception that eighty s c r embodies a philosophy and consequently a methodology and guidance that is designed towards the non identification or trivialisation of public health problems and quote our tax dollars are being used to lie to us about the impact of toxic pollution harmful and inaccurate advice regarding formaldehyde and fema tylers is just the latest example congress could help by calling for an independent national academies of science investigation into the process by which health consultations are developed and communicated katrina was quote the perfect storm to be exposed formaldehyde poisoning that's been allowed in our buildings now for decades fema just purchased what was available to sale for the general public there are many other people other than disaster victims who are at risk here the c d c needs to take immediate steps to do a survey and consultation regarding formaldehyde and building materials if there is one benefit that can come out of all the misery and death that's resulted from from out to hide and seem to trial lawyers let it be that the citizens of the us are finally afforded the same protections that are provided under law and europe japan and even china thank you over july last july and some of nyasha wrote and asked for the results of our testing were never given the opportunity to tell them about the scope of the problem and the thing that really bothered me is i february of two thousand and seven described the results below the point three level zero point three level part for million as being a nuisance effect would you describe the effect on your family if you consider nosebleeds science in fact so at sorry science infections asthma attacks repeat hospital hospitalizations from the monia asthmatic bronchitis  tumors if you consider all of these minor nuisances then i guess you could agree with that i mean after it could be worse i suppose bible staff that that was not actually in the written report but that is based upon the nuisance effect is based on interviews with with staff dr sinclair and if you have tens of thousands of americans over the course of couple years they're going to have bad things happen to them you heard mr gillette describe  yes in the trailers this is do you concur that the formaldehyde exposure may very well have been a contributing factor in some of those to us i would say it very well may have been a contributing factor you cannot prove cause and effect but many of the symptoms that our families children exhibited while common in general pediatric population are also   treatment and seeing families that lived in those trailers to travel trailers in our area may not have had as high levels of formaldehyde as those in the mississippi gulf coast because most of them were put together before katrina not to put together as quickly after katrina as those the mississippi gulf coast the symptoms that many of my patients were exhibiting were not as dramatic as many of those reported by pediatricians and families in the mississippi gulf coast area however they were persistent and difficult to treat what i am more concerned about are the possible long term health effects of these families exposure to from aldehyde over the past two and a half years and what do you think should be the what should we do to try to help for those folks who've been in the trailers for health consequences should there be a continuing effort to to pay attention to their what happens to them medically i believe so first of all families should never have been put in these travel trailers to begin with they're not meant for  occupy for a living they're not up to electrical standards they have stones that would explode they're not up to storm standards they're very well two hundred square feet that being said now that people have lived in these travel trailers for a year two years two and a half years i think it would be very beneficial to create a data bank to track families and children and to follow their long term health and so if there's a certain concerning symptoms that future health care providers could be alerted to the fact that they had lived in the travel trailers and maybe have a little bit higher level of concern that some of the symptoms might not just be a general cold as my allergies but maybe a symptom of something more concerning israel whatever do you think there should be to follow the longer term health of the time i think it's not enough to follow their health that you need to provide free health care to people they've been poisoned by their own government and the problem is that many many of these people are still struggling to get their lives back together they lost everything in the storm there's no affordable housing that you can get into rental rights have doubled the government needs to get some sort of formaldehyde swat team together that really bo up on how do you treat people that are exhibiting the symptoms of formaldehyde poisoning because a lot of the health care providers don't know and they're actually in some cases giving treatment that we think may be doing more harm than good so we really need this a concerted effort on training people that are specialists in treating families who have been exposed to formaldehyde this long after people men exposed to high levels of it become more sensitive many of them may get multiple chemical sensitivity so there really needs to be some free clinics provided for these people and and again as far as tracking i'll just say one thing some of these people have moved all over the us and it's going to be difficult to track them but definitely needs to be needs to be done and not just for children but there are two aspects to this issue one is the aspect of the fact that there have been people who have been exposed to unacceptably high levels of formaldehyde because the t s t are did not do its job  properly the other issue is to make sure that a catastrophe like this never happens again and i think that this committee could probably be the most constructive getting on the not acceptable science and what is more problematical in my opinion is that the deficiencies in the report should have been caught earlier and were not now this is not the only case where the the not only dropped the ball but fumbled it in the and in my opening remarks i did refer to the issue of the public health implications of hazardous substances and twenty six areas of concern in the great lakes let me say that there was a premature release of that report the public health officials both in wisconsin and minnesota reviewed the prematurely released report and have sent letters to dr howard from kin who is the director of the a t f the are stating that his report failed and this is a little bit closer to home for me than the gulf coast is but it shows that the problems of inadequate and iranian scientific review in the eighty s the are not limited to the usual formaldehyde in the trailers that fema provided to people who are displaced by the two storms analyzing toxic substances and what i think is probably the greatest natural resource in the united states and that's the great lakes which are the largest body of fresh water in the world i ask unanimous consent to include the letter from the state of  wisconsin division of public health signed by the chief medical officer henry anderson the as well as a letter that was sent to dr from can by the minnesota department of public health and specifically by and how much they have opened up the population of this country to disease serious medical conditions because they haven't done their job properly and i would hope week while i was commuting back and forth the first year before i relocated to baton rouge and i had headaches the whole time i was there i had difficulty sleeping this is before i knew anything about formaldehyde i always kept my windows open and the doors open and  assumed that my headaches were because i wasn't sleeping well as far as our own medical mobile unit when we come on in the mornings especially in the hot weather you do you notice the smell and you do have burning eyes and we run the that our medical mobile unit for just eight hours which is our work day and it tested lower it was still of what you p a recommends for an eight hour workday exposure which is one hundred one hundred parts per billion but was less than what osha recommends for eight hour workday exposure which is the three hundred parts per billion so this is where some of this confusion has come up is that the the zero point three parts per million or three hundred parts per billion is considered and except the ball level by osha for an eight hour workday exposure but not an acceptable level for long term exposure in a living environment and when you found that you were having headaches and not sleeping well in all of that and as you understood better what was going on what did you do about getting people out of these mobile homes that had such high levels of formaldehyde this is this is the real challenge because the cure for that is really to get out of the of the mobile of the travel trailers and mayor nagin request that families be sent to their doctors and doctors give them advice about what to do about the formaldehyde exposure is frustrating for me as a as a health care provider because my advice is to get out of the travel trailers so that's basically what we've been doing is just advising people and so you can get out run the air conditioners don't smoke inside don't use work with other agencies though to find them other housing i mean if this was a high exposure and how successful were you in getting them out of these travel trailers the rental market in baton rouge is extremely tight right now as is the rental market in new orleans and the list of house thing that our case manager was able to find in the baton rouge area we've managed find three apartments for about three hundred families we talked to she also talked with a theme the case manager they were much more successful they had about five apartments catholic charities has been very helpful in assisting families they managed to place three hundred sixty seven families last fall but but it's been a real it's been a real challenge and so the other real issue here is the fact of the house and shortage question is that i'm concerned about two things is one that this never happened again and two what are you going to do to track all of those people that were living in these travel trailers that had the high level of formaldehyde this is also been a great area of frustration for me because we want to keep track of our families as they move out so that we can continue providing care to them what we do is we basically just let them know where we are they have our phone numbers but there has not been a data bank to keep track of families that have been in the travel trailer don't you think that would be a good idea i definitely think that would be a good idea is it what it what do you need to do to make that happen the ema i talked to fame and they said that they have only kept track of those families that they're still providing rental assistance to louisiana family recovery corps is not keeping a list of families sort of list lived in problem a we all of you excuse me for interrupting you but it seems to me that you've got several agencies involved and that you might sit down and talk to one another and say this is something that we really need to do and begin that process and who's in charge and who's go it how are you going to do that in a concerted effort because it's not ok to say well you know this agency is doing this this agent she's doing that and then when he end up nobody is is really doing it  hope that happens and i have any time left now i think i agree because it has been really really difficult to find out where people are going and follow their health ok but i think it's incumbent upon all the agencies that are involved to in fact do that i just have a quick question for  why do you think they have trivialized the health problems i mean that you brought that up in your testimony you know i think there's a couple things one is i don't think that i think it was hard for people to believe that this housing was as talks as it was because it is stuff the sold of the general public and so then there was the issue well what do we do about it and there are affordable housing out there i know people who have loved ones who've died in the trailers that i think were killed by the formaldehyde they're still living in the trailers they don't have anywhere else to go but what do you see the solution but the bigger the one big solution is that you have to reform how that c d c works and so that it stops you know covering for big polluters it's more interested really in corporate america than it is the health of the people and that's a big problem these health consultations that are done across the country almost never find any connection between huge amounts of pollution and people being sick and dying all around there and so i tell you change that mindset that oh we really just can't prove that all that talk to pollution is causing these people to die you know it harms all of us because if you have pollution on the gulf getting in our food we're getting in our air and we need to reduce our pollution and we can't do that as well as we have a bedroll licensee that keeps telling people that pollution doesn't matter that it's not really harmful and secondly i just have one thing it's not really a question i am so sorry this happened to your family and hopefully this won't happen in the future health care costs i know that the most average program to reimburse for many of the medical bills do you know about how much you have spent have you asked for that money back have you asked for reimbursement and have you received any reimbursement from thema at this point no absolutely no reimbursement in fact i heard a rumor that there was that they were doing that we faxed in all of our medical information notes from our doctors and heard absolutely nothing back from fema so if they are in fact reimbursing people that's  brand new news to me thank you so i think this should i believe so i mean if it's you know if you've got you know several doctors saying look this was if not one hundred percent cause it was definitely made worse but i think humans having enough problems coming up with the things that they've already said they're going to do as far as food vouchers and things like that they haven't got a grasp on that yet either dr sensor that we know the long term health effects of chronic for formaldehyde exposure and can the toxicity be passed on to future children and grandchildren of these residents we do not know there have been fairly premature births and miscarriages but again there haven't been long term studies of exposure living environments there have been cell studies that show that formaldehyde at fairly low levels can be geno toxic can cause changes to chromosomes and break ridge of sister primitives and may be related to to birth defects but this isn't clear do you know how many that have lived in the travel trailers yeah hundred one hundred forty thousand two hundred forty thousand trailers families yeah yeah at renaissance village which is the the largest fema trailer village in louisiana there have been over eight hundred families that have moved in and out of renaissance village and the peak population their estimates range from four hundred the official number to about twenty five hundred the unofficial number including friends and families that were living with others in the thank you i think we're ready to start back introduce our second panel dr merrill carroll is a professor emeritus of environmental and occupational health asas at the university of pittsburgh she is the former president of the society of toxicology and the former secretary former in this title is now a matter of dispute as our witnesses should know the from having observed the previous panel and from what we've already told them or their testimony the spoken testimony should be limited  to five minutes each with some indulgence after which the members of the committee will ask five minutes of questions each it is again the practice of the subcommittee to take testimony under oath do either of you have you swear to tell the truth and nothing but the truth the witnesses have taken the dr carol you may begin here and miller mr sensenbrenner and members of the subcommittee thank you for inviting me to testify today in describing my background i'm a former president of this is idea of toxicology i was also the secretary general of the international union of this is an association of toxicologists from all six continents i could gimmickry i was associate dean for research in academic affairs at the graduate school of public health at the university of pittsburgh and currently i am a professor emeritus of environmental occupational health sciences at the university distressed at my testimony today reflects only my opinions as a toxicologist i have conducted research for thirty four years on mechanisms of chemically induced lung and skin ash published nearly two hundred scientific articles books chapters and monographs particularly relevant to two thousand and seven monograph and titled improving indoor environmental quality for public health that discusses effects of indoor environments on human health in the brief time that i have available today and it will be five minutes i would like to comment on one of the major recommendations of the a s g d r february two thousand and seven health  advisory specifically that zero point three ppm concentration of formaldehyde be designated a level of concern for sensitive individuals a level of concern being defined as a level above which individuals with hyper hide would suffer adverse health effects in my opinion the level has to be lowered in an outdoor air formaldehyde is normally present in concentrations around two point zero two parts per million indoors the concentration is typically ten to twenty times higher depending on various factors such as construction materials furnishings the age of the housing with newer homes should probably releasing more formaldehyde by off gassing heating ventilation also affect the formaldehyde concentration most people can detect the presence of point five ppm formaldehyde at this and higher concentrations exactly causes i nose and throat irritation with symptoms of eyes hearing or perhaps eye nose and throat burning hostin is cough difficulty in breathing however formaldehyde can be irritating at a concentration that is even lower a percentage of the population develops irish cation when exposed to a concentration below the odor threshold and around the point three david level of concern sensitive individuals may have adverse effects when exposed to yet lower concentrations but you individuals would include those with hyper reactive or twitchy airways those with underlying disease or with a viral infection of the lungs among other concerns infants in the elderly would reasonably be expected to be more responsive to irritants such as formaldehyde the a narrow airways make children more susceptible than adults to agents such as irritants direct cause airway constriction d r proposal of february two thousand and seven suggest point three ppm formaldehyde as a level of concern for sensitive individuals the bases for this proposal was the osha guideline for acceptable workplace exposures with a maximum point seven ppm formaldehyde averaged over an eight hour work it must be emphasized that the osha permissible exposure is an occupational standard established for healthy adults expect to have only an eight hour exposure in order to apply this guidelines to endure environments that would say for a general population one must lower the permissible concentration because the population is diverse not only with respect to age but with respect to underlying health status and concurrent environmental exposures and they may be exposed to twenty four hours a day ten years ago a review was published that critically looked at one hundred fifty scientific articles on formaldehyde and concluded that our irritating occurred at point two four p ppm in about twenty percent of the population and these are non sensitive subjects the authors of that article concluded that an indoor environment where exposures might occur twenty four hours a day would maintain a concentration of formaldehyde be low point one ppm and that would protect virtually all persons and summaries to protect residents again ad against adverse effects from formaldehyde inside their trailers guidelines most take into consideration the diversity of the exposed population as well as the diversity of the indoor environments including the temperature ventilation for energies and other chemical suggestion there point three p p m to be does it need a level of concern for formaldehyde might protect non sensitive individuals but it would not protect those that are sensitive a level of concern should be lowered and should not exceed point one ppm uncertainty remains regarding the likelihood of chronic health effects resulting from continued formaldehyde exposure and trailers and for this reason the level of concern has to be and other distinguished members of the subcommittee i am christa rose and i have been working for the federal government for twenty eight years today i will respond to the issues posed in your letter of invitation dated february twenty seventh two thousand and eight i would like to note for the record that i am not here as a representative of eighty s t r but rather as an individual i would also emphasize like to emphasize that my remarks today and other stated concerns should no way be construed as a reflection on many of the highly talented and motivated well intentioned staff of my agency i served as a director for the division of toxic ology in environmental medicine at eighty s t r from one thousand nine hundred one until two thousand seven i have a degree in ecology master's degree and a ph d in biology from miami university of ohio and have held academic appointments at the universities of virginia and maine over a period of ten years before coming reviewed publications and have served on the editorial review committees of over ten professional journals i've been a charter member of the world health organization steering group for risk assessment since one thousand nine hundred four i'm a member of the american college of toxicology and one of the hundred eighty elected fellows of the the mission of a t s d r is to serve the public by using the best science taking responsive public health actions and providing trusted health information to prevent harmful exposures and disease related to toxic substances there are a range of activities that a t f undertakes as a response of the health mandates outlined in the circle or superfund legislation of these one of these is a health consultation developed as a formal response to time sensitive issues as was the case in the aftermath of hurricane katrina following the agency's initial response to this tragic event eighty s d r was also engaged in ongoing verbal and written evaluations and discussions for a wide range of information on behalf of  and fema these included the evaluation of formaldehyde levels in the air of unoccupied fema trailers in contrast to health consultation such a valuations are more informal usually verbal in periodic discussions of available data as it emerges initial discussions regarding sampling protocols and data collection of formaldehyde in trailers used by  fema and analyzed by e p a began in june of two thousand and six because of the sensitivity of emergency events and preparedness another coordination activities i began our series of weekly reports in one nine nine for all senior staff including senior agency leadership these reports summarized significant events in these oftentimes sensitive programatic areas and the details that we provided  regarding the work we did in support of e p a and fema were frequently included in these reports in early december two thousand and six dr howard from can stated to me i had not kept him adequately informed of the fact that we were evaluating samples on behalf of sima that were collected by e p a i advised dr from can that this was a routine collaboration that has occurred between eighty s t r an e p a over a period of twenty five years especially dealing with  time sensitive events of the environmental contamination doctor from can request that his name be deleted from the mailing list for these weekly reports in september of two thousand and seven because he found them to be unhelpful in early as december fourth two thousand and six at the specific direction of fema its attorney for the office of legal counsel my divisions the r t c did not share the evaluation through the usual division review and approval channels instead they provided the drafts of the consultation to the director's office of preparedness terrorism and emergency response opteron this was done without my knowledge and i was unaware of the role of doctor from can solve this in the oversight of this effort until summer two thousand and seven it was soo this channel that doctors from can and syncs provided review and comment on the draft during the period between which is a syndicating my time is up  two thousand and seven it was to this channel that doctors from consent syncs provided review and comment on the draft consultation during the period intervening between the point at which a sampling data was provided to my division z r t and the release of the consultation to female on february first two thousand and seven doctors from sinks in from can provided review in comment on the draft consultation during this period at no time did i have any contact regarding this effort with either fema or e p the health consultation was forwarded to fema that were first two thousand and seven i was unaware of this until we see two health consultation on february twenty seventh when a copy of the report appeared upon my desk after initial review with a consultation i immediately contacted dr from can soften by telephone and e mail to state my concerns regarding the limitations of consultation i stated the report failed to address longer term health effects especially issue that formaldehyde is a carcinogen that same day i sent a second e mail transmitting a proposed amendment to the consul to address these longer term health concerns after repeated requests to issue an amendment to the original console i was directed by dr from can to report for my proposed response to  hyman then acting director of opt for at this point i concluded that the lead for this effort resided solely within the office of the director specifically the office of preparedness prevention and after i had no further involvement with the fema consultation until late june two thousand and seven when there was a briefing for congressional staff regarding this issue however in the interim repeatedly cautioned dr from can and other senior staff regarding the issues confronted by the agency in this matter for example on june first i wrote to dr franklin outlining my concerns in response to requests from bring these issues to the attention of my management we had very little constructive follow up effort i recommended that we use the health guidance values in the talks logical profile for formaldehyde as a point of departure for any discussion regarding safe levels this was after repeated requests from sema to be strict our evaluations to short term exposures i did state that as our efforts went forward that health interventions must be pursued to address the clinical manifestations of acumen acute formaldehyde toxicity i stated that such clinical signs were a harbinger of a pending public health catastrophe that may be transgenerational in its impact and i stressed the importance of alerting residents to the sensual reproductive developmental and carcinogenic affects formaldehyde the response i received was that such matters should not be discussed in the emails so they might be misinterpreted you if you if you had to think i would simply close by saying that i know that this is been a complicated matter for everyone involved that there are no often no straightforward answers to complicated situations however i think that we need to invoke the maps in a public health practice articulated by bernadino rama xeni for centuries ago does appear that there was testing at various points first by the sierra club then by female there were different standards for safe exposure concerned from exposure and this particular photo exposure didn't fit neatly into some standard but based upon the testing that had already writing only consistent with the health effects of formaldehyde i felt that the level that had to virtually been used was not an appropriate level that the levels i referred to just recently were  many times lower than that point zero zero eight parts per million if people were going to be there for a period of a year or longer less than that perhaps point zero three parts per million those would have been the values that i would have insisted be included in such a consultation as a point of departure looking at the other parameters that may govern the exposure and the health effects of formaldehyde in the situation presented by the trailers up here old you have thank you that on that topic yes there are other agencies in other countries that have the stablished guidelines for safe indoor air one of them is very consistent that this should have been the safe level and that this should have been measured in the trailers the what the levels actually were thank you dr broken you said in your testimony that you were not here investigation there was some suggestion that there was actually a conscious effort to exclude you from the review chain for the report and your spirit adamantly  not and because they knew what your position would be your superiors adamantly deny that is a case and they say that they put into place expedited review procedures because of the urgency surrounding  certainly applaud the government trying to act quickly on its on its feet when circumstances require that but were you part of the did you did you design the review procedures that it that excluded you that did not include you in the review i did not did you review in fact review this report i did not review the february first consultation and when did you first see it again every twenty seven and how quickly after that did you when did you do something if ever upon reading the report i called the office of the director i spoke with the personnel there and indicated that we had a significant issue with this document because it was incomplete and perhaps misleading i followed that up with an e mail to that effect i then rapidly drafted a proposed amendment pointing out that there was a concern regarding the longer term health effects that same afternoon and that this was a letter that could be forwarded over my signature or forwarded over any one signature for that  amend our initial consul i understand that your superiors both at a t f the or both in their interviews with our staff and their expected testimony later today i will say that you're responsible for the work of your team even though it was not directly reviewed by you do you bond do you have a response of that in fact that was the reason i was most concerned in my initial review i felt that our internal procedures governing the review of any division document had not been followed and that this is why the consul turned out as it did i later learned that that was not the case i later learned that this was being dealt with in the aftermath of katrina where staff were tasked as needed independent of a given management chain to provide the needed input on a consultation or other evaluation typically this would have gone through several levels of review prior to that not knowing the involvement of dr from in sinks at the time i did meet with my staff to reaffirm our standard operating procedures in clear terms and didn't learn about the other aspects of the review and clearance process prior to summer of two thousand but i know that the federal employment system has incentive bonuses for for the best employees to keep them in federal employment if you've gotten one of those in the past in two thousand and six i received a very substantial and generous bonus and salary raise based on my performance and how much was that it was five percent of my salary as an increase i believe and ten thousand dollars bonus and that was the most recent review before the one which you were found to be lacking it was ok for both doctor care od the chair now warns himself that he  urgency when it was very clear that fema was continuing to count that report as authority for their needing to