Senator BOGGS. Mr. Chairman, I want to ask you and the Secretary, shouldn't the record show, Mr. Secretary, the Department's appraisal of the health hazard at the present time in the automobile fumes and the solid waste area?

Mr. QUIGLEY. I think it should.

Senator BOGGS. Is there a presently existing health hazard?

Mr. QUIGLEY. I don't know whether I want to get into that thicket or not. But again speaking as a layman there is some evidence and some of it disturbing. This is not to say that expert opinion to the contrary it cannot and it will be produced.

Senator BOGGS. Will you put an appraisal of that in the record?

Mr. QUIGLEY. We will give you the benefit of what information and views we have on it.

Senator BOGGS. Thank you.

(Subsequently the following memorandums were submitted:)

BACKGROUND INFORMATION REGARDING THE PUBLIC HEALTH ASPECTS OF SOLID WASTE DISPOSAL

PUBLIC HEALTH ASPECTS OF SOLID WASTE DISPOSAL

Too often, refuse disposal operations are open dumps festering scars that disfigure the landscape. Flies, rats, mosquitoes, and other disease-carrying pests find large quantities of food, a favored breeding area, and suitable harborage in the piles of exposed refuse. The polluted drainage from open dumps is an additional insult to ground and surface water supplies in the area. The characteristic foul odors, produced by the recomposition of the refuse, together with the smoke created by inefficient open burning, are often identifiable for miles.

Unfortunately, the other currently used methods of solid waste disposal have certain inherent shortcomings from a public health point of view. Sanitary landfills, for example, cannot be used in areas where the water table is near the ground surface without risking ground water pollution. Incineration, at best, creates some air contamination and produces ashes and other residues which must be buried.

Inadequately designed and improperly operated municipal incinerators contribute significant quantities of objectionable air contaminants. Added to these sources are backyard trash burners, onsite incinerators in apartments and commercial buildings, and onsite open burning of bulky refuse, all of which contribute additional air contaminants in most communities. Even where municipal incinerators have been built using current design criteria and good operating practices have been followed, air pollution is frequently a troublesome problem. The current state of the art of incineration was reviewed in detail at the 1964 National Incinerator Conference sponsored by the American Society of Mechanical Engineers. The following excerpts from the foreword of the proceedings of the conference by the general chairman, Mr. Viggo Westergaard, are particularly revealing:

"There has been little guidance that is available in published form for the incinerator designer of today. In most cases he is completely dependent upon his own personal experience and his own commonsense in resolving problems with which he is faced. Examples of successful furnaces as well as optimistic hopes for plants on the way to completion have often been described at length. thus furnishing vicarous experience for the incinerator designer. It need hardly be stated that this approach, valuable as it is, is insufficient as a basis for an imaginative, yet sound excursion into the new and untried. If the science of incineration is to develop at a rate comparable to technology in general, emphasis must be placed on more scientific methods."

This statement publicly recognizes the need for further research and development in incineration. Parallel work is sorely neded on other methods of solid waste disposal.

A copy of a detailed paper on "The Public Health Aspects of Solid Waste Disposal" which was presented by Dr. Robert J. Anderson at the National Conference on Solid Waste Research is attached to provide additional information on this subject.

PUBLIC HEALTH ASPECTS OF SOLID WASTE DISPOSAL

RESEARCH NEEDED IN SOLID WASTES

(Robert J. Anderson, M.D.)

It has been said a number of times in recent years by competent experts that this country is at least 10 years behind in coming to grips with the problem of environmental health.

These men, scientists and public administrators, point to the explosive expansion of our chemical industry, the surging trend toward living in cities or metropolitan areas, and the continued growth of our whole industrial complex, with its accompanying effect on the general environment.

These three movements, it is explained, have aggravated in increasing measure our problems of water pollution, air pollution, and radiation hazards and have created the need for additional work in occupational health safeguards, restaurant sanitation and general milk and food purity activities, and research into the dangers of the use of pesticides, among others.

Although I am certainly in agreement with the general assertion of our 10year lag, I think it fair to say that in some of these fields of activity, such as water pollution control, our greatly increased efforts in recent years may have put us less than 10 years behind. In other fields, however, we are considerably more than 10 years behind. In this category I would certainly put the general problem of solid waste collection and disposal.

With its complexities, it may seem to some a little hard to classify solid waste disposal as an environmental health problem. The discussion proceeds almost immediately to the difficult questions of economics, engineering, and city planning aspects, and other nonhealth angles.

It is necessary to remind ourselves, I believe, that disposal of solid wastes is fundamentally a health problem. Just as we who are concerned with this problem are conscious of the fact that no really new or radically different ideas have emerged in waste disposal operations for half a century, so we must also remember that 42 years ago one of the pioneers (1) in the field laid down three basic requirements for waste disposal; the first was the absence of danger to public health. And it still holds true. In other words, the barriers and difficulties we face here are economic and engineering and jurisdictional, but the reason we are concerned is the protection of the public health.

Let us examine for a moment the nature of the various health factors that create our concern.

The most prevalent disposal system of serious danger to health is, of course, the open dump, with its flies and rats. Typhoid fever, cholera, summer diarrhea. dysentery, tuberculosis, anthrax, and ophthalmia, as well as intestinal worms, can be transmitted by fiies. The importance of adequate refuse handling in controlling those communicable diseases was long age recognized.

The control of fly breeding through adequate garbage collection, elimination of garbage dumps, and proper disposal of feces are the first rules for the control of typhoid fever (2).

In addition, plague, murine typhus fever, leptospirosis, rat-bite fever, trichinosis, food poisoning, richettsialpox, lymphocytic choriomeningitis, and rabies can be transmitted by rats and mice, while malaria, yellow fever, dengue, mosquito borne encephalitis, and filariasis can be transmitted by mosquitoes.

Poor refuse handling commonly provides food for flies, cockroaches, and domestic rodents. Open cans and bottles catch and hold water in which mosquitoes can breed so that many individual citizens unknowingly but actively encourage the proliferation of these disease-carrying pests.

Many experts in this field have pointed out that garbage is usually the chief source of food for rats in urban areas (3). Food-handling establishments and grocery stores are particularly attractive to rats, but many rat infestations are supported entirely on improperly stored garbage. Limitations of food, water, or harborage are the only determinants to the size of a community's rat population.

The ability of flies to quickly find and oviposit on any suitable material, including garbage, is well known. The infestation of garbage in containers was studied in detail at Phoenix, Ariz., and it was found that Phaenicia pallesens adults displayed the ability to enter a garbage container through openings as small as one-eighth of an inch in diameter (4). Other studies (5) revealed that

as many as 70,000 flies were produced per cubic foot of garbage exposed to ovipositing flies.

When flies infest garbage, the larvae are usually concealed in the garbarge or in the lower part of the can so that the householder ordinarily is unaware of their presence. Although many of these larvae are carted away when the refuse is collected, studies have shown that during warm weather large numbers of larvae migrate from the cans before the refuse is collected. Campbell and Black (6), for example, found that an average of 1,128 fly larvae per can per week migrated from 30 refuse cans to pupate before the combined refuse was collected at Concord, Calif. During the 2 years of study, a maximum count of 23,208 larvae was obtained from one can in a single week. Of interest was the fact that low counts were obtained consistently from only two cans, apparently because one householder used a garbage grinder and the other always wrapped the garbage in newspapers.

The fly-infested refuse that is ordinarily collected during warm weather must be carefully handled to prevent fly production. In compacting the cover material at sanitary landfills to prevent fly emergence, a California study (7) showed that there were four essential factors to consider: soil that can be compacted, suitable equipment for compacting the soil, adequate range of soil moisture, and adequate thickness of cover.

Although no reasonable amount of uncompacted cover would prevent emergence (since house flies have emerged through 5 feet of uncompacted cover) only a 6-inch layer of compacted cover was sufficient to prevent fly emergence.

In addition to disease transmitted by vectors, air pollution is becoming a more serious problem. Open dumps, where burning is used to reduce the volume of solid wastes, almost always produce large quantities of smoke and odors. Improperly designed and operated municipal incinerators also contribute significant quantities of objectionable air contaminants. Added to these sources, backyard trash burners, onsite incinerators, and onsite open burning of bulky refuse contribute additional air contaminants in most communities.

One scientist (8) noted recently that, according to data collected in statewide air pollution surveys, "burning dumps cause air pollution problems in about 25 percent of the urban communities of the country. * * * They are the most frequently reported cause for localized air pollution problems.”

Another study (9) investigated the source and nature of air contaminants which produce asthma in New Orleans. A statistically significant relationship was found between the daily asthma admissions at Charity Hospital emergency clinic and the prevalence of one air pollutant, a poor combustion particle associated with silica. All possible sources of this material were not examined; however, air samples taken at a dump in the summer of 1961 revealed large quantities of this particle.

Water pollution is also becoming a serious factor in this picture. Wherever refuse is deposited on land, the impact on surface waters or subterranean aquifers may be significant.

The available information concerning the effects of refuse fills on the quality of the adjacent ground water has been organized and reviewed by a research contractor for the California State Water Pollution Control Board (10). This study was done because the drinking water supply of a major city was becoming objectionable. The study showed that there are three basic mechanisms by which refuse fills can pollute the ground water: (a) direct horizontal leaching of the refuse by ground water, (b) vertical leaching by percolating water, and (c) the transfer of gases produced during refuse decomposition by diffusion and convection.

Further investigations were recommended on gas production and movement, leaching rates, percolation, and methods of controlling the movement of gas and water in landfills.

In an earlier study by the California State Water Pollution Control Board (11), it was concluded that the movement of water through incinerator ash dumps will leach soluble salts and alkalies from the dump. An investigation at a sanitary landfill (12) proved that ground water in the immediate vicinity will become grossly polluted by continuous or intermittent contact with deposited refuse. Bacterial and organic contamination may be very limited in range, but chemical pollution, that is, mineral salts, may travel some distance before the effects of dilution are evident. Although the passage of landfill leachate through sand or gravel may be expected to improve conditions so far as bacterial and organic pollution is concerned, chemical pollution can be expected to reach the ground 46-378 0-65

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water along with percolating water. Therefore, proper location and operating practices that prevent supersaturation of a fill are essential, thus compounding the problem of the engineer out searching for new ground for landfill operations. From an occupational health and accident prevention standpoint, solid waste handling presents additional formidable problems. A study (13) of the department of sanitation of New York City, found that arthritis, cardiovascular diseases, muscle and tendon diseases (particularly muscle ailments affecting the back), skin diseases, and hernia could all be classified as occupational diseases of refuse collectors. Sanitation workers were also found to have an extremely high injury frequency rate, exceeding that of all other occupations previously studied, with the exception of logging. The study report also observed that "the rate was more than twice as high as that for firemen and policemen, and surpasses even that of stevedores."

These statistics are even more startling when the methods used for selection of these men are considered. New York City sanitation candidates must first pass a qualifying written examination, then a physical examination, and finally a series of tests to determine physical fitness. The physical fitness tests were compiled by the head of the physical education department of New York University to determine endurance, agility, strength, and coordination. The tests (14) consisted of a qualifying lift of a 120-pound weighted can to a 42-foot shelf; followed by (a) an 80-pound dumbbell military press with each hand; (b) a 60-pound abdominal lift; (c) an agility test, consisting of broad jump, hurdle, fence trap, and scaling an 8-foot wall; (d) a 120-yard run against time with a 50-pound dumbbell in each hand; plus (e) a coordination test in which the candidate operated a specially constructed mock-up of a sanitation truck.

Some indication of the rigorous selection made with such a testing procedure was given in the following records of a 1939 test: 85,000 men filed for the job; the final list contained the names of the top 7,800 candidates of the 22,000 men who survived all phases of the examination.

Many fires and home accidents are caused by poor refuse handling practices. Discarded items that are not properly stored for collection are also particularly attractive to children. Unsanitary and unsafe conditions in yards and family refuse storage areas have resulted in literally thousands of minor and severe accidents. In one case, a 13-year-old boy and his friend were playing in the alley behind his house. In the trash, they found some old milk bottles with "some fluid" in them. One of the boys struck a match and threw it into one of the bottles. The resulting explosion caused third-degree facial burns and required long-term hospitalization.

While the accident aspect of our problem is in a sense minor, it illustrates the manner in which the whole problem is growing. Our data have shown that the increasing use of pesticide products in the home and various new miracle drugs, so-called because of their potency, has resulted in correspondingly greater amounts of these materials in the solid waste load and more accidents such as I have just mentioned.

I hope that these varied examples demonstrate that we believe this problem to be an integral concern of the whole environmental health picture. In its budget to the Congress, the Public Health Service has taken steps recently to make the solid waste activities a separate and distinct area of Federal activity. organizationally, and also in the area of research grants.

Many people are already at work on this problem. Manufacturers who have been making incinerators for decades are trying to improve the efficiency of their machines. Others are working on composting and similar methods. We wish them all good luck. But we also believe that a vast reservoir of experience and knowledge exists in our city and county government officials and professionals. We believe that if this conference can bring that knowledge and skill together with young researchers for a joint effort we can lay the groundwork for real results.

REFERENCES

(1) Hering, R., and Greeley, S. A.: Collection and disposal of municipal refuse. McGraw-Hill Book Co., New York, 1921.

(2) American Public Health Association: Control of communicable diseases in man. New York, 1960, p. 210.

(3) Brown, R. Z.: Biological factors in domestic rodent control. Rodent control series, pt. 2. PHS Publication No. 773. U.S. Government Printing Office, Washington, D.C., 1960.

(4) Siverly, R. E., and Schoof, H. F.: Utilization of various production media by muscoid flies in a metropolitan area. I. Adaptability of different flies for infestation of prevalent media. Ann Entomol Soc America 48: 258, July 1955.

(5) Siverly, R. E., and Schoof, H. F.: Utilization of various production media by muscoid flies in a metropolitan area. II. Seasonal influence on degree and extent of fly production. Ann Entomol Soc America 48: 320, September 1960.

(6) Campbell, E., and Black, R. J.: The problem of migration of mature fly larvae from refuse containers and its implication on the frequency of refuse collection. Calif Vector Views 7: 9, February 1960.

(7) Black, R. J., and Barnes, A. M.: Effect of earth cover on fly emergence from sanitary landfills. Public Works 89: 91, February 1960.

(8) Schueneman, J. J.: Air pollution problems and control programs in the United States. J Air Pollution Control Assoc 13: 116, March 1963.

(9) Lewis, R., Gilkenson, M. M., and McCaldin, R. O.: Air pollution and New Orleans asthma. Public Health Rep 77: 947, November 1962.

(10) California State Water Pollution Control Board: Effects of refuse dumps on ground water quality. CSWPCB Publication No. 24. California State Printing Office, Sacramento, August 1961.

(11) California State Water Pollution Control Board: Report on the investigation of leaching of ash dumps. CSWPCB Publication No. 2. Sacramento, 1954. (12) California State Water Pollution Control Board: Report on the investigation of leaching of a sanitary landfill. CSWPCB Publication No. 10. Sacramento, 1954.

(13) Sliepcevich, E. M.: Effects of work conditions upon the health of the uniformed sanitationmen of New York City. Doctoral dissertation. Springfield College, Springfield, Mass., June 1955.

(14) Donchin, A.: DS strongboys faced the "Superman" test. Sweep 1: 13, winter 1959.

HEALTH EFFECTS OF AUTOMOTIVE EXHAUST

Automobile exhaust, even without the assistance of Los Angeles sunshine, can be lethal. The coroners' records attest that the man in the street is aware of this reliable means of self-destruction. No person is resistant when the time and concentration are correct to give the effective dose. The effective agent is carbon monoxide. Theoretically, the combustion of hydrocarbons in a 100-percent efficient automobile engine would emit only carbon dioxide and water in its exhaust. There also would be a small amount of some combinations of nitrogen and oxygen from the air drawn through the engine. Since a perfect automobile engine has not as yet been developed, the emissions from our present gasoline engines contain numerous chemical compounds such as hydrocarbons, alcohols, aldehydes, ketones, phenols, epoxides, peroxides, carbon monoxide, et cetera, many of which, when in proper concentrations, are highly toxic to man, animals, and plants.

The toxicity of carbon monoxide is well known for higher concentrations. It combines with hemoglobin in the red blood cell 200 to 300 times more readily than oxygen, thereby interrupting the normal oxygen supply to the body tissues. Clinically, there usually are no symptoms when less than 10 percent of hemoglobin is bound by CO. With 10 to 20 percent of carboxy hemoglobin, symptoms of headache, nausea, vomiting, and disturbance of vision begin to appear. At higher saturations, mental confusion and muscular incoordination result. When 60 percent of hemoglobin is bound to CO, death results from asphyxia.

Special work shifts are provided for traffic police, tunnel workers, and others who share the hazards of occupational exposure to CO. Police, garagemen, and mechanics occasionally are reported who have no detectable organic disease, yet have symptoms of CO poisoning. The frequent complaints are those of fatigue, headache, nausea, excessive sweating, bleeding, angina pectoris, etc. It is important to note that many cases of human cardiac dysfunction have been related to chronic carbon monoxide poisoning. It should be added, however, that there is some disagreement on this matter; some authorities doubt the occcurrence of chronic CO poisoning while there is sufficient evidence to cause others to believe the contrary. For example, individuals affiliated with anemias, chronic cardiorespiratory diseases, and generalized arteriosclerosis cannot tolerate safety any reduction in their blood's oxygen-carrying capacity. The 1962 report of the Surgeon General on motor vehicles, air pollution, and health provided Congress an excellent review of the status of knowledge on health effects of carbon monoxide.