NEHA June 2023 Journal of Environmental Health

ADVANCEMENT OF THE PRACTICE

 DIRECT FROM ATSDR

APPLETREE: Building Local Capacity to Respond to Environmental Exposures

Audra Henry, MS

Janet Cowins, PhD

Site Health Assessments Site health assessments help determine if and how people might be exposed to harm- ful site-related releases and recommend actions to protect people’s health. As part of the ATSDR (2022a) public health assess- ment process, ATSDR and its APPLETREE partners do the following: •Establish communication mechanisms, including engaging communities, before and throughout the process. • Collect various types of site information. • Obtain, compile, and evaluate the usability and quality of environmental and biologi- cal sampling data. • Conduct sequential scientific evaluations, including exposure pathways evaluation, screening analysis, exposure point con- centrations and calculations, and in-depth toxicological eects evaluation. •Conduct exposure investigations, when appropriate, to fill data gaps and better understand potential site exposures. Site health assessments are done for vari- ous hazardous waste sites, including those on the U.S. National Priorities List (NPL), brownfields, community-petitioned sites, and other facilities. ATSDR and its APPLE- TREE partners consider demographics, envi- ronmental health burden, health equity, and other factors for each site. They then write public health assessments and health consul- tations to summarize site health assessment findings and recommend health-protective actions. For example, the New Jersey Depart- ment of Health (2023) prepared a public health assessment focused on the public health implications of exposure to arsenic, lead, and other contaminants in soil, sedi- ment, drinking water, and surface water at

Editor’s Note: As part of our continued e ort to highlight innovative approaches to improve the health and environment of communities, the Journal is pleased to publish regular columns from the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR’s activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health. The findings and conclusions in this column are those of the author(s) and do not necessarily represent the ocial position of CDC, ATSDR, or the National Center for Environmental Health. Audra Henry is the program services section chief in the Oce of Capacity Development and Applied Prevention Science at ATSDR. She serves as the program ocer for the APPLETREE program. Dr. Janet Cowins is an environmental health scientist in the Oce of Capacity Development and Applied Prevention Science at ATSDR. She serves as a technical project ocer for the APPLETREE program.

Introduction In 1987, the Agency for Toxic Substances and Disease Registry (ATSDR) developed a nonresearch cooperative agreement program to help accomplish its public health mission. That program is known as the Partnership to Promote Local Eorts to Reduce Environ- mental Exposure (APPLETREE). APPLE- TREE funds 30 state health departments that work closely with communities; local, state, and federal agencies and organizations; tribal governments; and other entities to address site-specific issues and recommend actions to protect public health. It is the largest cooper-

ative agreement program within ATSDR and builds state capacity to: • respond to threats from human exposure to hazardous substances in the environment, • engage communities with site contamina- tion and potential health eects, and • implement activities to address local envi- ronmental health issues of concern. APPLETREE activities are primarily focused on protecting public health through site health assessments, community engagement, and capacity building and prevention activities such as Choose Safe Places for Early Care and Education (CSPECE; Grants.gov, 2022).

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