31496 Federal Register / Vol. 63, No. 110 /Tuesday, June 9, 1998 / Notices

6803, INTERNET address

phs3@cdc.gov.

For programmatic technical assistance

contact: Sharon Conley, Financial

Acquisition Specialist, Office of

Program Operations & Management

(OPOM), Agency for Toxic Substances

and Disease Registry (ATSDR), 1600

Clifton Road, NE., Mailstop E–60,

Atlanta, Georgia 30333, Telephone (404)

639–0559, INTERNET address

sac7@cdc.gov.

Also, the CDC home-page on the

Internet: http://www.cdc.gov is available

for copies of this Announcement and

funding documents as well as

application forms.

Dated: June 3, 1998.

Georgi Jones,

Director, Office of Policy and External Affairs,

Agency for Toxic Substances and Disease

Registry.

[FR Doc. 98–15256 Filed 6–8–98; 8:45 am]

BILLING CODE 4163–70–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Agency for Toxic Substances and

Disease Registry

[ATSDR–135]

Availability of ATSDR Decision

Document Regarding the Bunker Hill,

Idaho, Medical Monitoring Program

AGENCY: Agency for Toxic Substances

and Disease Registry (ATSDR),

Department of Health and Human

Services (HHS).

ACTION: Notice of availability for public

review and comment of draft Decision

Document Regarding the Bunker Hill,

Idaho, Medical Monitoring Program.

SUMMARY: ATSDR has reviewed

scientific literature and clinical

information in order to assess the need

for medical monitoring at Bunker Hill,

Idaho. ATSDR has determined that there

is a definable population at significantly

increased risk of disease that will

benefit from a medical monitoring

program. ATSDR has judged that the

medical monitoring program is

appropriate to provide periodic medical

evaluation and referrals to improve the

public health status of the affected

population. The current literature and

expert panel workshop held by ATSDR

reflect that medical monitoring at

Bunker Hill would be good public

health practice and of medical benefit to

the affected populations. This notice is

announcing the availability of the draft

report documenting ATSDR’s

justification for implementing a medical

monitoring program for the population

at the Bunker Hill Site: the ‘‘ATSDR

Decision Document Regarding the

Bunker Hill, Idaho, Medical Monitoring

Program’’, is available for public review

and comment.

DATES: Comments must be received by

July 9, 1998.

ADDRESSES: The report is available

through Dr. Vivian Rush, MD, Medical

Officer, ATSDR-Division of Health

Education and Promotion, 1600 Clifton

Road, NE., Mailstop E–33, Atlanta,

Georgia 30333, E-mail address

vcr1@cdc.gov and telephone (404) 639–

5080.

FOR FURTHER INFORMATION CONTACT: Dr.

Vivian Rush, Medical Officer, ATSDR;

telephone (404) 639–5080.

SUPPLEMENTARY INFORMATION: Section

104 (i)(9) of the Comprehensive

Environmental Response,

Compensation, and Liability Act

(CERCLA), as amended [42 U.S.C. 9604

(i)(9)], provides for the Administrator of

ATSDR to initiate a health surveillance

program for populations at a significant

increased risk of adverse health effects

as a result of exposure to hazardous

substances released from a facility. A

program ATSDR includes under health

surveillance is referred to as ‘‘Medical

Monitoring or Screening’’ and is

defined, as published in the Federal

Register on July 28, 1995 (60 FR 38840),

in ‘‘ATSDR’s Final Criteria for

Determining the Appropriateness of a

Medical Monitoring Program under

CERCLA’’ as ‘‘the periodic medical

testing to screen people at significant

increased risk for disease.’’ There are 7

Medical Monitoring criteria associated

with this program and they are as

follows:

(1) There should be evidence of

contaminant levels in environmental

media that would suggest the high

likelihood of environmental exposure to

a hazardous substance and subsequent

adverse health outcomes.

(2) There should be a well-defined,

identifiable target population of concern

in which exposure to a hazardous

substance at a sufficient level has

occurred.

(3) There should be documented

human health research that

demonstrates a scientific basis for a

reasonable association between an

exposure to a hazardous substance and

a specific adverse health effect (such as

an illness or change in a biological

marker of effect).

(4) The monitoring should be directed

at detecting adverse health effects that

are consistent with the existing body of

knowledge and amenable to prevention

or intervention measures.

(5) The general requirements for a

medical screening program should be

satisfied. Those requirements are:

• The natural history of the disease

process should be understood

sufficiently for screening.

• The early detection through

screening should be known to have an

impact on the natural history of that

disease process.

• There should be an accepted

screening test that meets the

requirements for validity, reliability,

estimates of yield, sensitivity,

specificity, and acceptable cost.

(6) An accepted treatment,

intervention or both for the condition

(outcome or marker of exposure) must

exist and a referral system should be in

place prior to the initiation of a medical

monitoring program.

(7) The logistics of the system must be

resolved before the program can be

initiated.

Background

The 21-square-mile Bunker Hill

Superfund site includes the Bunker Hill

mining and smelting complexes and the

communities of Pinehurst, Page,

Smelterville, Kellogg and Wardner in

Shoshone county, in Silver Valley of

northern Idaho. Mining and mineral

refining has been the dominant industry

in the Silver Valley for more than 100

years. The mining and mineral refining

activities have severely impacted the

landscape, vegetation, and the quality of

the air, and soils in the area. A

population of workers and residents

who have worked in and lived

surrounding the former Bunker Hill lead

and zinc smelting facility have been

exposed to lead (and probably other

heavy metals) in the past at levels of

public health concern (i.e., at levels

where health effects could be expected

to occur). The most serious exposures

took place during the 1970’s after a

baghouse fire resulted in large amounts

of lead to be released into the air of

towns surrounding the smelter.

Epidemiologic studies have shown

adverse health effects in the populations

that were present during the past high

exposure periods. Since the smelter’s

closure in 1981, the exposures have

markedly decreased. In addition, the

Panhandle Health District has

implemented a program to detect excess

exposure in the community and

provides information and education on

preventing harmful exposures and

scientific literature supports these

findings.
Federal Register / Vol. 63, No. 110 /Tuesday, June 9, 1998 / Notices 31497

Dated: June 3, 1998.

Georgi Jones,

Director, Office of Policy and External Affairs,

Agency for Toxic Substances and Disease

Registry.

[FR Doc. 98–15255 Filed 6–8–98; 8:45 am]

BILLING CODE 4163–70–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Centers for Disease Control and

Prevention

[30DAY–15–98]

Agency Forms Undergoing Paperwork

Reduction Act Review

The Centers for Disease Control and

Prevention (CDC) publishes a list of

information collection requests under

review by the Office of Management and

Budget (OMB) in compliance with the

Paperwork Reduction Act (44 U.S.C.

Chapter 35). To request a copy of these

requests, call the CDC Reports Clearance

Officer at (404) 639–7090. Send written

comments to CDC, Desk Officer; Human

Resources and Housing Branch, New

Executive Office Building, Room 10235;

Washington, DC 20503. Written

comments should be received within 30

days of this notice.

Proposed Projects

1. Prostate and Colorectal Cancer

Screening in the Managed Care

Environment—New—National Center

for Chronic Disease Prevention and

Health Promotion (NCCDPHP). Prostate

and colorectal cancer are among the

leading causes of cancer deaths in the

U.S. Prostate cancer screening has

increased rapidly during the past few

years; however, little is known about

actual rates of screening, or the

proportion of men screened who present

with symptoms or who are at high risk

for prostate cancer. Evidence suggests

that colorectal cancer screening can save

lives and efforts are under way to

increase participation in screening.

However, little information is available

to monitor screening rates. It is also

unknown how well self-reported

prostate and colorectal cancer screening

rates, which are often used in

population surveys, compare to actual

screening rates. Therefore, the Centers

for Disease Control and Prevention

(CDC), National Center for Chronic

Disease Prevention and Health

Promotion, Division of Cancer

Prevention and Control, intends to

conduct a survey of prostate and

colorectal cancer screening test

utilization. As an increasing number of

people are served by managed care

organizations where they may receive

cancer screening tests, the proposed

study population are members of

managed care organizations.

A sample of members (men aged 40

years and older and women 50 years

and older) of 3 managed care

organizations will be interviewed over

the telephone, and the medical charts of

the participants will be abstracted. The

information collected will include

demographic information, prostate and

colorectal cancer screening tests

received within the past 5 years, and the

reasons and outcomes of the tests. The

total annual burden hours are 530.

Respondents No. of respondents

No. of responses/respondent

Average burden of response (in

hrs.)

Total burden

(in hrs.)

Survey ............................................................................................................... 2120 1 0.25 530

2. Weekly and Annual Morbidity and

Mortality Reports—(0920–0007)—

Extension—Epidemiology Program

Office—In 1878, Congress authorized

the U.S. Marine Hospital Service (later

re-named the U.S. Public Health

Service) to collect morbidity reports on

cholera, smallpox, plague, and yellow

fever from U.S. consuls overseas. This

information was to be used for

instituting quarantine measures to

prevent the introduction and spread of

these diseases in the United States. In

1879, a specific Congressional

appropriation was made for the

collection and publication of reports of

these notifiable diseases. The authority

for weekly reporting and publication

was expanded by Congress in 1893 to

include data from state and municipal

authorities throughout the U.S. To

increase the uniformity of the data,

Congress enacted a law in 1902

directing the Surgeon General of the

Public Health Service to provide forms

for the collection and compilation of

data and for the publication of reports

at the national level.

In 1961, responsibility for the

collection of data on nationally

notifiable diseases and deaths in 121

U.S. cities was transferred from the

National Office of Vital Statistics to

CDC. For 37 years, the MMWR has

consistently served as CDC’s main

communication mode for disease

outbreaks and trends in health and

health behavior. In collaboration with

the Council of State and Territorial

Epidemiologists (CSTE), CDC has

demonstrated the efficiency and

effectiveness of computer transmission

of data.

The data collected electronically for

publication in the MMWR provides

information which CDC and State

epidemiologists use to detail and more

effectively interrupt outbreaks.

Reporting also provides the timely

information needed to measure and

demonstrate the impact of changed

immunization laws or a new therapeutic

measure. Users of data include, but are

not limited to, congressional offices,

state and local health agencies, health

care providers, and other health related

groups.

The dissemination of public health

information is accomplished through

the MMWR series of publications. The

publications consist of the MMWR, the

CDC Surveillance Summaries, the

Recommendations and Reports, and the

Annual Summary of Notifiable Diseases.

The total annual burden hours are

4,927.