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Public Health Assessments & Health Consultations
PUBLIC HEALTH ASSESSMENT
CORNHUSKER ARMY AMMUNITION PLANT
GRAND ISLAND, HALL COUNTY, NEBRASKA
PATHWAYS ANALYSIS
To determine whether nearby residents are exposed to contaminants migrating from a site, ATSDRevaluates the environmental and
human components that lead to human exposure. This pathwaysanalysis consists of five elements: source of contamination, transport
through an environmentalmedium, a point of exposure, a route of human exposure (for example, dermal contact or ingestion), andan
exposed population.
ATSDR identifies exposure pathways as completed, potential, or eliminated. For a completed pathwayto exist, five elements must be
present to provide evidence that exposure to a contaminant has occurred,is occurring, or will occur. A potential pathway, however, is
defined as a situation in which at least oneof the five elements is missing, but could exist. Potential pathways indicate that exposure to
acontaminant could have occurred, could be occurring, or could occur in the future. Pathways areeliminated when at least one of the five
elements is missing and will never be present.
A. Completed Exposure Pathways
Private Well Pathway
Past, current, and future exposure pathways are possible by way of ingestion of contaminatedgroundwater from private wells. Waste
sources at the site appear to be responsible for contaminationof groundwater near CAAP and Capital Heights. A major waste source was
removed and remediatedin 1987, when approximately 44,000 tons of soil were incinerated. However, the groundwatercontamination
plume is moving northeasterly at approximately 75 to 827 ft/year. Historically, between464 and 800 household drinking water supplies
were affected or potentially affected (1). CAAP begansampling in 1982 and detected high concentrations of explosives in groundwater.
Because local soilsare highly permeable, it is likely that groundwater contamination began when the installation initiatedsurface
discharge of contaminants. In January, 1984, CAAP provided bottled water to approximately264 residents whose well-water contained
RDX concentrations greater than 35 ppb. CAAP thenextended the Grand Island water supply line to the Capital Heights area and offered
residents theopportunity to use that drinking water source. The Grand Island water supply is not (and likely neverwill be) considered a
potential pathway.
A recent survey conducted by the City of Grand Island Utilities Department reported that five residenceschose not to connect to the city
supply, but to continue to use their private wells for drinking water (25). Those homes are on Route 1, West 13th Street, and Engleman
Road. It is unclear whether those privatewells have been sampled recently. In addition, some residents live outside the area accessible to
the citywater connection, but near the contaminated groundwater plume. CAAP sampled private well waterfrom 10 residences on
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O'Flannagan, O'Grady, and North Webb streets in July, 1991. The analysesshowed that water from six of the ten wells contained
concentrations of RDX greater than or close tothe 2 ppb action limit. The six concentrations ranged from 1.92 to 4.63 ppb. CAAP
provided thoseresidents with an alternative water supply and planned to periodically check other areas to determineif an alternative
water supply is necessary (12). Further study of the area resulted in a proposal toextend permanent water supplies (26). The proposal
and public comment period (August 24-September24, 1992) was discussed at a public meeting on August 27, 1992 (27).
Reportedly, most residents have continued to use contaminated water for lawn and garden watering, andswimming pools. In addition,
commercial irrigation wells used for crop irrigation and animal wateringare still operating. Recent information indicates that plants can
efficiently absorb RDX. ATSDRdiscussed that information with USATHAMA, EPA, NDEC, and NDH and recommended stopping useof
contaminated water for irrigation of private vegetable gardens. On July 30, 1991, NDEC and NDHadvised residents not to eat vegetables
grown in gardens irrigated with water from private wells. Inaddition, NDEC and NDH recommended that residents stop using private
wells for garden irrigationand stop using as compost grass clippings from lawns irrigated with private well water. ATSDRattended a
public meeting sponsored by the state agencies on August 5, 1991, to discuss the newinformation with the public.
Residents using private wells were probably exposed to RDX and other explosives by way of ingestion,inhalation, and skin contact.
Although ingestion is the most likely route of exposure to explosives,inhalation and skin contact could be routes for other, unknown
contaminants. Analyses of watersamples historically have not included all potential contaminants; therefore, ATSDR is unable toevaluate
all of the contaminants to which people could have been exposed. Groundwater plume locationand movement have not been completely
characterized because of the lack of well construction data(except for the University of Nebraska monitoring wells), sampling frequency,
and sampling parameters. Existing plume maps are difficult to read and often do not include sufficient detail about location. Thus,the
exposed population and the concentrations to which people are being exposed are difficult todetermine. Capital Heights is approximately
two miles from the CAAP boundary. Estimating theplume migration at an average 400 ft/yr up to 800 ft/yr, the first contaminants could
have taken between13 and 26 years to reach the affected private wells. CAAP began operating in the 1940s and the CapitalHeights
subdivision was developed in the early 1960s. The contamination might have already reachedthe private wells when the subdivision was
developed. Residents using those wells could have beenexposed to some level of contaminants by way of ingestion and skin contact for
approximately 30 years. Residents using private wells between CAAP and Capital Heights could have had a longer exposure.
Because the plume continues to migrate, residents near the affected areas can request from CAAPcontinued testing of their drinking
water. If the water becomes contaminated, an alternative source,either bottled water or the city's water supply, can be substituted to
eliminate exposure.
B. Potential Exposure Pathways
Little sampling information exists to document potential exposure pathways. Limited information isavailable on numbers of persons
who might be exposed to contaminants.
Until more information becomes available, ATSDR cannot further assess those pathways or theirimportance.
Air Pathway
Air releases probably occurred from the 1940s until the mid 1970s, during open burning of wasteexplosives, solvents, oils, and other
debris. Particulates and vapors associated with the burning representa past completed pathway to workers and nearby residents by way
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of inhalation. Prevailing winds arefrom the south in the summer and from the northwest in the winter. Summer winds are
usuallymoderate to strong (1). The closest housing area is approximately one-half mile northwest and threemiles east. Although it is
unlikely that critical concentrations of hazardous materials reached thoseareas, no air sampling data were available from that period to
thoroughly evaluate the pathway.
On­Site Soil Pathway
Past, current, and future exposure pathways are possible because of contamination present in surfacesoils on site. Former employees,
current tenants, and remedial workers could have been or are beingexposed to some level of contaminants by way of ingestion,
inhalation, or skin contact withcontaminated surface soils. Limited surface soil sampling has been conducted, and current employeesand
tenants have access to many of the potentially contaminated on-site areas. A major remediationeffort to remove contaminated soil took
place in 1987. The extent of the remaining contamination hasnot been fully characterized, although further characterization is proposed
in the RI/FS workplan. ATSDR will review that information when it becomes available.
A soil sample collected near a building in the North Magazine Area had lead contamination as high as1,460 ppm. That area has not been
thoroughly characterized and hazardous substances may be in oraround individual magazine areas. Many current tenants use those
areas and sometimes bring theirchildren on post; thus, a possible exposure pathway exists. Restricting access would eliminate
theexposure.
Sediment Pathway
The eastern channel, western channel, and the railroad ditch accumulate runoff from the site, and, whenflowing, eventually discharge to
Silver Creek. Those three primary collectors of surface runoff couldhave transported contaminants into sediments and surface waters. No
sampling has been conducted toverify that exposure pathway. Access to Silver Creek is unrestricted. Sampling is planned for theditches
as part of the RI/FS. Because most of the contamination was discharged into collection sumpsand transferred to the leach pits, large
volumes or high concentrations of waste probably were nottransported off site by the ditches.
Food Chain Pathway
Past, current, and future exposure pathways are possible by way of ingestion of contaminated cattle andcrops. Irrigation wells are used to
water animals and crops both on and off site. Several irrigation wellscontain RDX-contaminated water. Recent studies indicate that
crops can uptake explosives (28, 29). Discussions were held among ATSDR, USATHAMA, EPA, NDEC, and NDH about possible
vegetablecontamination, and, in August 1991, CAAP began sampling vegetables and soil from residentialgardens as well as soil from
yards irrigated with RDX- and TNT-contaminated water. As described inthe Environmental Contamination and Other Hazards section,
RDX was not found in vegetables at concentrations higher than the health-based risk level of 0.19 ppm.
The effects of watering cattle with contaminated water or of cattle ingesting contaminated soil have notbeen evaluated. From the limited
information available (see the Public Health Implications section)about uptake of explosives by plants or animals, it is unlikely that
concentrations would be high enoughto cause acute adverse health effects after eating meat or vegetables for a short period. For
significantexposure to occur over a long period, the food source would have to continuously contain contaminantsat concentrations
above health-based risk levels. Generally, families eat meat obtained from severalsuppliers rather than from a single source. Therefore,
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the chances that a family would ingestcontaminated meat over an extended period would be low. If a family regularly obtained their
meatfrom the same supplier, however, a greater potential for exposure would exist.
The same would be true of most commercial supplies of vegetables. On the other hand, if over a longperiod of time a family relied on its
own gardens (watered with contaminated water), or on a roadsidevegetable stand that sold vegetables from the same source (watered
with contaminated water), theamount of exposure might be of concern. CAAP has made the city's water supply available to thefeedlot
areas. Using the city water supply for watering livestock would eliminate the possibility ofcontaminant accumulation in cattle.
C. Summary of Pathways Analysis
The private well pathway is considered complete because exposure to some level of contaminants hasoccurred via ingestion and skin
contact. People exposed include residents drinking contaminated privatewell water. Potential exposure pathways include on-site surface
soil, sediment, food chain, and air. Exposure to surface soil and sediment could occur via ingestion and skin contact. Exposure
tocontaminants could result from ingestion of contaminated food. Past inhalation of contaminants mighthave resulted from open
burning on-site. Potentially exposed persons include former employees and nearby residents. Tables 8 and 9 outline exposure pathways.
Table 8.
Completed Exposure Pathway
PATHWAY
NAME

COMPOUNDS

EXPOSURE PATHWAY ELEMENTS
SOURCE

Private
Wells

Explosives,
VOCs

CAAP

MEDIA

Groundwater

POINT OF
EXPOSURE

ROUTE OF
EXPOSURE

EXPOSED POPULATION

Residences
and
Businesses

Ingestion,
Inhalation,
Skin Contact

Residents and workers near Capital
Heights in the contamination plume,
especially those using private well
water for vegetable and lawn watering
and in swimming pools

TIME

COMMENTS

Past
Present
Future

Sampling confirmed
contamination in 1983.
Most residents are using
city water. All of the
possible contaminants
have not been analyzed
for.

Table 9.
Potential Exposure Pathways
PATHWAY
NAME

COMPOUNDS

EXPOSURE PATHWAY ELEMENTS
SOURCE

On­Site
Surface
Soil

Explosives,
heavy metals,
other
unknowns

CAAP

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MEDIA

Surface Soil

POINT OF
EXPOSURE

On-site soils

ROUTE OF
EXPOSURE

Ingestion,
Inhalation,
and Skin
Contact

TIME

COMMENTS

Past
Present
Future

Limited soil sampling data
are available for both on
and off site; however, offsite migration is unlikely.

EXPOSED POPULATION

Former employees, current
tenants, and remedial
workers

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Sediment

Unknown

CAAP

Sediment

Eastern and
western channels,
railroad ditch,
Silver Creek

Ingestion,
Skin Contact

Nearby residents (especially
children)

Past
Present
Future

No sediment sampling data
were available; however,
contamination is likely.

Ambient
Air

Unknown

CAAP

Air

Former employees
and nearby
residents and
workers at
businesses

Inhalation

Former employees and
nearby residents

Past

No sampling data are
available. Workers
conducting open burning
and downwind residents
might have been exposed.

Food
Chain

Unknown

CAAP,
local
farms,
and
gardens

Food Chain
(cattle, corn,
alfalfa, and
other crops)

On- and off-site
agricultural areas
and residential
yards

Ingestion

Consumers of farm products
and residents using
contaminated water for
garden and yard irrigation

Past
Present
Future

Surface soil data are not
available for all areas.
Extensive plant or animal
uptake information was not
available.

PUBLIC HEALTH IMPLICATIONS
In this section we will discuss health effects that might occur in people exposed to specific contaminants;evaluate state and local health
databases that address those health effects; and address specificcommunity health concerns.
A. Toxicological Evaluation
To understand health effects that may be caused by a specific chemical, several factors related to theinteraction of the chemical with the
individual must be considered. Health effects caused by a specificchemical are sometimes related to the route of entry into the body (i.e.,
inhalation vs ingestion of water). The amount or dose of a chemical to which a person is exposed may also determine the type or
severityof health effects. Health effects are related not only to the dose to which the person is exposed, but tothe amount of chemical that
the body actually absorbs. The manner in which a specific chemical isabsorbed, metabolized or otherwise broken down by natural body
mechanisms also determines the typeof health effects that may result.
To determine the possible health effects produced by specific chemicals, ATSDR considers thepreviously discussed factors as described
in the scientific literature. Compilation by ATSDR of thisinformation has resulted in a number of chemical-specific ATSDR documents
called toxicologicalprofiles. Toxicological profiles are used for guidance in determining concentrations of specific chemicalsin the
environment (i.e., air, soil, and water) that may be harmful to health under certain conditions (i.e.inhalation, dermal exposure, or
ingestion) for different periods of exposure (acute, intermediate, orchronic). When toxicological profiles are not available for a certain
chemical, we review varioussources, including the scientific literature, research reports, and reports from regulatory agencies.
The Pathways Analyses section of this document discussed the most likely chemicals to which peoplehave been exposed or are now being
exposed. This section will discuss the health effects that may becaused by those chemicals. Those chemicals have been found on post in
soil and groundwater as wellas in groundwater off post. Because little human exposure to contaminated soil is believed to be takingplace
on post, the chemical-specific health effects will be discussed with respect to groundwater only.
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HEXAHYDRO­1,3,5­TRINITRO­1,3,5­TRIAZINE (RDX)
Information in the literature about the health effects of RDX in humans is primarily limited to plantworkers exposed to RDX dust by way
of inhalation. Effects have included insomnia, restlessness,irritability, disorientation, epileptiform seizures (convulsions), and
unconsciousness (30). Workers inthe report were exposed to finely powdered RDX dust; absorption was probably by inhalation.
Allgenerally recovered within one day. No abnormalities were observed in workers' blood or urine. Whenexposure was prevented by
hygienic measures, no further adverse effects were seen. Health effects fromexposure to smoke when RDX-containing plastic explosives
were burned to heat food were also seenin U.S. soldiers in Vietnam (31, 32). Symptoms of central nervous system (CNS) toxicity,
ranging fromconfusion to multiple seizures followed by amnesia, were seen.
Few studies have investigated inhalation exposure to more moderate concentrations of RDX in the air. A study was conducted of
munitions plant workers exposed to RDX and HMX to determineabnormalities of the hematologic, hepatic, and renal systems. Of 93
workers with varying degrees ofexposure, no abnormal findings or presence of autoimmune disease were observed. No symptoms
ofacute central nervous system toxicity were seen (33).
Acute CNS toxicity has also been seen after ingestion of RDX-containing material. Reports of soldiersin Vietnam eating RDX for
purported hallucinogenic effects document generalized convulsions andstates of consciousness varying from coma to lethargy. Moderate
changes in liver and kidney functionwere observed. No fatalities resulted, and mental capacity and other changes returned to normal
within10-30 days (34, 35). The levels of RDX ingested in those cases ranged, if known, from 25-180 grams(g) of C-4 plastic explosive
(91% RDX).
Ingestion of approximately 1.23 g (85 mg/kg body weight) C-4 by a three-year-old child also resultedin convulsive CNS symptoms, but
no long-lasting liver or kidney damage (36). The child ingestedRDX from plastic explosive brought home on the contaminated clothing
of his mother, who worked ina munitions plant.
The reports described here provide information about severe health effects after acute inhalation oringestion of RDX. However, because
the routes of exposure and the doses vary from the situation foundat CAAP, the data do not adequately address possible chronic health
effects of long-term exposure toRDX in drinking water. When adequate studies in humans are not available, studies in animals mustbe
used to extrapolate information applicable to the exposure situation.
Three 24-month continuous feeding studies have been performed in mice and rats (37­39). The highestdoses of RDX used in those
studies (40-100 mg/kg body weight/day) resulted in increased mortality,CNS effects, weight loss, anemia, liver toxicity, renal toxicity,
testicular degeneration, and inflammationof the prostate. Inflammation of the prostate was seen at 1. mg/kg body weight/day, but not at
0.3mg/kg body weight/day (39). Testicular degeneration was seen in mice receiving 35 mg/kg bodyweight/day, but no toxic effects were
seen at 7 mg/kg body weight/day (37).
The three studies also addressed the question of carcinogenicity of RDX. The two studies in rats foundno evidence of carcinogenicity
(38, 39). The combined incidence of hepatocellular carcinomas andadenomas was significantly increased compared to control animals
in female mice receiving 7, 35, and100 mg RDX/kg body weight/day over a two-year period (37). No significant increases were found
atthe 1.5 mg/kg body weight/day dose level. The increased rates of carcinomas and adenomas were notsignificant when considered
separately.
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Based on various criteria of sensitivity and completeness in animal studies, EPA has used certain studiesto develop guideline values to
protect human health. A series of guidelines can be developed,progressing at each step to include a greater number of considerations to
protect human health.
The starting point for those EPA guidelines is the selection of a scientifically appropriate study. ForRDX, the lowest dose in mice that
gave no demonstrable effect was 0.3 mg/kg body weight/day (39). The next highest dose of 1.5 mg/kg body weight/day caused an
inflammation of the prostate gland. Aninitial EPA guideline called the No Observed Adverse Effect Level (NOAEL), for RDX is the dose
of0.3 mg/kg body weight/day.
The next guideline is the EPA Reference Dose (RfD). A RfD is an estimate of a daily exposure tohumans that is likely to be without
appreciable risk of deleterious effects over a lifetime. The RfD startswith the NOAEL and modifies it through consideration of
uncertainty factors derived from the EPAOffice of Drinking Water guidelines which consider variations in experiments or species of
animals usedin the experiments. Using the RfD, the EPA Drinking Water Equivalent Level (DWEL) is calculated;the DWEL is the
lifetime exposure level, assuming 100% exposure from drinking water, at whichadverse noncarcinogenic health effects would not be
expected to occur. The DWEL considers theassumed body weight (70 kg) and the assumed daily water consumption (2 L/day) of an
adult. TheDWEL for RDX is 0.105 mg/L or 105 μg/L.
From the DWEL, an EPA Lifetime Health Advisory (HA) can be calculated. The EPA Lifetime HArepresents that portion of an
individual's total exposure attributed to drinking water and is consideredprotective of noncarcinogenic adverse health effects over a
lifetime exposure. The HA for a chemicalis a concentration in drinking water at which adverse health effects would not be anticipated
and whichincludes a margin of safety to protect the most sensitive members of the population at risk (40). An HAis calculated from the
DWEL with the consideration that drinking water may not be the only source ofexposure. If data are not available, a factor of 20% is
used. For chemicals, such as RDX, that havebeen classified as Group C chemicals (possible carcinogens because experimental data are
not complete)a further lowering of the HA value can take carcinogenicity into account. After these factors areconsidered, the EPA
Lifetime Health Advisory for RDX is 0.002 mg/L or 2 g/L (i.e., 2 parts perbillion [ppb]). Similar water quality criteria for RDX have been
calculated by others and compared tothe values derived by EPA (41, 42).
As can be seen, the amount of RDX that a person can drink over a lifetime and not be adversely affected begins from an amount shown in
experimental animals not to cause an effect. From that experimental data point, several assumptions are used to build safety factors into
the final value. Therefore, 2 μg/L of RDX in contaminated water represents an estimate of a safe level. If a person drinks less water, is
exposed for only a few years, or is influenced by a number of other biological factors, the actual amount of RDX that would cause an
adverse health effect might vary considerably. Because 2 μg/L is only a guideline, drinking water with higher levels of RDX
contamination may or may not adversely affect health.
2,4,6­TRINITROTOLUENE (TNT)
During large-scale production of TNT during WWI, many workers in munitions factories died of TNTintoxication (43­45). With
application of hygienic precautions (such as periodic hand-washing, routinechanges of protective clothing, and respiratory protection) to
prevent inhalation exposure, fatalitiesdecreased. Liver disease and aplastic anemia were the primary causes of death. Absorption of
TNTthrough the skin or lungs can produce cyanosis (lack of oxygen-carrying capacity of the blood), severeliver damage, anemia, cataract
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formation, CNS manifestations, and kidney damage. Although thoseeffects of TNT are well documented, they primarily result from
exposure by way of inhalation and notthrough ingestion of contaminated drinking water, as may occur at CAAP.
Long-term, low-dose TNT-ingestion studies have been carried out in mice, rats, and dogs (46­48). Athigher doses in mice and rats (1070 mg/kg body weight/day), over a 24 to 26-week period,hematological signs of anemia and liver damage were noted. When dogs were
fed TNT (0.5, 2, 8, or32 mg/kg body weight/day) over 26 weeks, liver damage was noted at all dosage levels (48). Increasedincidence of
urinary bladder papilloma and carcinoma was found in female rats (46). Using this study,EPA classified TNT as a Group C chemical
(possible human carcinogen) (43). The dog studies showedsimilarities to TNT effects in man and data from them were used to develop
EPA Lifetime HA criteria(43).
Based on a Low Observed Adverse Effect Level (LOAEL) of a 0.5 mg/kg body weight/day dose, an RfD for RDX was determined. A
DWEL was calculated and modified by considering drinking water as one of a number of potential sources of contamination and by an
additional uncertainty factor based on the limited evidence of carcinogenicity. This resulted in an EPA Lifetime HA for TNT of 0.002
mg/L or 2 μg/L. Similar water quality criteria have been developed by other agencies and compared to the EPA Health Advisory (49,
50).
OCTAHYDRO­1,3,5,7­TETRANITRO 1,3,5,7­TETRAZOCINE (HMX)
Little information is available about human exposure to HMX. Health effects of HMX were studiedin explosive plant workers, but results
were inconclusive because HMX was a contaminant of otherproducts, e.g., TNT and RDX (see RDX discussion and 33). Some dermal
toxicity following exposureto HMX was noted (51).
Few animal studies have been performed to determine the health effects of HMX. In a 14-day study of rats fed high doses (9,000 mg/kg
body weight/day) of HMX, pathological changes in liver were noted (52). In a 14-day mouse study, CNS effects were seen at 100 mg/kg
body weight/day (53). In a more chronic study over 13 weeks, rats were fed HMX at doses between 50 and 1,500 mg/kg body
weight/day. Pathological changes in the liver were seen at 450 mg/kg body weight/day (54). The NOAEL was 50 mg/kg body
weight/day. EPA used that study to calculate a Lifetime HA. The HA level is 0.35 mg/L, or rounded off to 400 μg/L. HMX is classified as
a Class D chemical (not classified as to human carcinogenicity) because no studies have been performed to address its carcinogenicity.
1,3­DINITROBENZENE (DNB)
Data about health effects after exposure to DNB are limited. Six workers exposed to an unknownconcentration of 1,3-DNB dust
developed cyanosis that began within one day of exposure and lastedtwo weeks (55). Health effects also included anemia accompanied
by palpitations, dizziness, andfatigue. Anemia persisted an average of 3 days. Follow-up examinations over a 10-year period did
notreveal any adverse health effects. Well-documented health effects in animals include toxic effectsresulting in death and pathological
effects on the liver, spleen, and testes. These effects resulted inweight loss, anemia, and decreased reproductive capacity (56­59). Some
evidence of increased toxicityin older (as compared to younger) animals was noted (58). A 16-week study of ingestion by rats of 1,3-DNB
in drinking water used doses of 0.4-1.14 mg/kg body weight/day (59). Based on splenic andtesticular effects, a dose of 0.4 mg/kg body
weight/day was established as the NOAEL. From thatvalue, EPA developed a lifetime H A of 1 μg/L (60). High uncertainty factors were
included becauseof lack of long-term studies. DNB is considered a Class D chemical (not classified as to humancarcinogenicity) because
of lack of information about its carcinogenicity.
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1,3,­TRINITROBENZENE (TNB)
No information is available on the health effects of TNB. Because of its structural similarity to DNB, assumptions are made that its health
effects might be similar to those caused by DNB. Using the experiment described for DNB (59), EPA has developed a Lifetime H A for
TNB. Because of the uncertainty of using DNB studies to develop guidelines for TNB, additional safety assumptions were included in the
calculations. As a result, the livetime H A for TNB is 0.1 μg/L, which is 10 times less than that for DNB (61).
1,1­DICHLOROETHENE (DCE)
The scientific literature contains information about human and laboratory animal exposure to DCE. DCE is toxic to both humans and
laboratory animals (62). Human exposure to DCE occurs primarily in the industrial work environment and at areas in and around
hazardous waste sites. Most available information on adverse health effects associated with DCE exposure in humans comes from
reports of accidental exposure to high concentrations for short periods. Repeated exposure to high levels may be associated with liver
damage. Exposure by breathing DCE appears to be more harmful than exposure by way of food or water. EPA has established a longterm drinking water health advisory of 7 μg/L, below which DCE in water may not cause health effects. DCE is classified by EPA as a
group C chemical agent (a possible human carcinogen) because information about its carcinogenicity is not complete.
1,2­DICHLOROETHANE (DCA)
Acute exposure to DCA occurs primarily by inhalation or by ingestion (63). Exposure to high levels can cause irregular beats which may
lead to heart damage. Liver, lung, and CNS damage may also occur after acute exposure. Exposure to lower levels can result in eye
irritation, cough, and bronchitis. Little information is available about long-term, low-dose exposure. In animal experiments, exposure to
DCA has been associated with tumors of the liver, pancreas, adrenal glands, stomach, breast, and lung. EPA has established a child
longer term health advisory for drinking water of 700 μg/L. DCA is classified by EPA as a probable carcinogen.
TRICHLOROETHYLENE (TCE)
Trichloroethylene is a man-made chemical used primarily as a solvent to remove grease, or for production of other chemicals. Animal
studies of TCE in drinking water have shown health effects that include liver and kidney toxicity and fetal damage (64). Using animal
studies, EPA has established a drinking water standard of μg/L for TCE. No determination about the carcinogenicity of TCE has been
made.
NITRATES
Nitrates are not considered to be directly toxic at concentrations less than 1000 mg/L. In some people,however, nitrates can be reduced
in the body to nitrites (65). Nitrites are known to causemethemoglobinemia in infants (66). Methemoglobinemia is the condition in
which hemoglobin bindsinefficiently with oxygen and can result in cyanosis, which is a bluish discoloration of the skin and
lips.Methemoglobinemia in infants rarely occurs when the concentration of nitrates in drinking water is lessthan 10 mg/L. The region
where CAAP is located has a problem with nitrates in drinking water;occasionally, levels of nitrates greater than the MCL of 10 mg/L are
found in Grand Island city wells.
B. Health Outcome Data Evaluation
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ATSDR reviewed existing cancer rates for Hall County. No significant differences between cancer ratesin Hall County and Nebraska as a
whole were seen (see Appendix). No information is available oncancer rates in the specific population of interest (persons living in
residences around CAAP who areexposed to contaminated drinking water). Therefore, the crude rates may not reflect an accurate
pictureof the incidence in the area. Demographics information on that population at the level needed todetermine whether there is a
health impact from hazardous wastes at CAAP is not available. Specificdemographic information will be obtained through future health
studies as determined by the HealthActivities Recommendation Panel of ATSDR (see Recommendations section).
C. Community Health Concerns Evaluation
Following are ATSDR's responses to each of the community concerns about health:
What are the health effects of RDX, and what is a safe level of RDX in drinking water? Whatis the risk of getting
cancer from drinking RDX­contaminated water?
Most of the information available about the health effects of RDX in humans concerns exposure ofmunitions plant workers to RDX by
way of inhalation of powdered explosive. Severe health effects ofthe central nervous system (CNS) resulting in seizures have been seen.
The approximate amount ofRDX that caused seizures in a small child after accidental ingestion was more than 3,000 times theamount of
RDX found in a liter of drinking water (the highest amount found) in the CAAP area. Noscientific information is available concerning the
long-term effects on humans drinking RDX-contaminated water. EPA has estimated safe drinking water levels using information on the
observedeffects of RDX in experimental animals. That amount has been calculated to be 2 μg/L.
Liver carcinomas and adenomas have been seen in RDX-exposed laboratory animals. Otherexperiments, however, clearly show no
carcinogenic potential of RDX. Because of the lack ofconclusive information, EPA has classified RDX as a possible carcinogen.
What are the health effects of TNT and other contaminants that may be in the contaminateddrinking water? What are
safe levels for those contaminants in drinking water?
The situation with TNT is much the same as with RDX. Information about human health effects causedby TNT is primarily available
from documented health effects in ammunition plant workers. Severeliver disease and anemia have been seen; however, most symptoms
cleared after removal of the exposuresource. Because those effects resulted from inhalation of explosive powder, they may or may not
berelevant to the question about health effects associated with long-term ingestion through drinking water. Animal studies have been
used to determine long-term drinking water effects. Anemia and liver diseasewere the primary effects. EPA has used those studies to
determine guidelines for safe drinking waterstandards; the estimated amount is 2 μg/L (based on 70 years' exposure). Few data are
available aboutVOCs in the groundwater. Further analysis for VOCs will be included in future sampling periods. Health effects of other
contaminants, such as VOCs, are discussed in the Toxicologic Evaluation section.
Does RDX accumulate in cattle that drink contaminated water?
No experimental information is available about the accumulation of RDX or other explosivescontaminants in the meat of cattle. Studies
in rats that have ingested high levels of RDX have shownminimal accumulation in fat (40). Calculations using those studies and
assuming various otherparameters suggest that the levels of explosives in the drinking water of cattle around CAAP are nothigh enough
to be of concern (20). That type of information, however, is not as useful as would be awell-designed study to determine actual amounts
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of contaminants in selected animals from the feedlotadjacent to CAAP. Using present information, however, and considering that
contaminants in meatwould not all be consumed by a single person for an extended amount of time, the exposure of cattle
tocontaminated drinking water probably does not pose a threat to human health. However, CAAP hasmade the city's water supply
available to the feedlots. Using the city water supply for watering livestockwould eliminate the possibility of accumulation of
contaminants in cattle.
Does RDX accumulate in crops irrigated with contaminated water?
In terms of human health, the accumulation of RDX in crops is probably more crucial thanaccumulation in cattle. Commercial crops,
even if they do accumulate RDX, would not pose much ofa threat because they would be distributed to various feedlots or to different
human markets. Oneperson would not be continuously exposed to a concentrated source of RDX. On the other hand, if RDXaccumulated
in plants in a private garden, a greater threat would exist. Plants would be eaten by thesame people over an extended period of time. Two
research studies have been performed to address thequestion of accumulation of RDX and TNT in plants (28, 29). TNT has been found
to absorb to the soilas well as be taken up by plants. Plants can assimilate TNT from the soil, however, TNT is then brokendown into
several metabolic products by the plants. The health effects of those compounds are notknown. The majority of TNT remains in the root
of the plant. Findings by the same research groupwere different for RDX. RDX was shown to accumulate in the soil much less readily
than TNT, butwas also not broken down as rapidly. Plants, including bush bean and wheat efficiently absorbed RDX. RDX was also more
mobile in plants than was TNT. The highest concentrations of RDX were foundin the seeds of the bush bean plants; concentrations as
high as 600 μg/g (ppm) of seeds were found. Those findings are surprising compared to plant accumulation rates of some other
chemicals. In August,1991, CAAP began sampling vegetables and soil from residential gardens as well as soil from yardsirrigated with
RDX- and TNT-contaminated water. Results from the vegetable sampling indicate thatRDX and TNT were not detected above the 0.19
ppm health risk detection limit (see EnvironmentalContamination and Other Hazards section) (19). The number of samples and the
design of the studywere limited; no highly contaminated vegetables were found. Because of remaining uncertainties,however, ATSDR
recommends that vegetable gardens be watered only with city water (or some othersource of uncontaminated water).
Should private well water be used in swimming pools?
Although exposure to RDX through skin at concentrations detected in private well samples in the areais unlikely, good practice would be
to use only city water for swimming pools. That practice would alsocut down on incidental ingestion of contaminants while swimming.
What is the extent and exact location of the contaminated water plume? Does more than one plume exist?
To define a contamination plume, appropriate numbers and types of sampling wells must be placed atthe leading edge of the movement
of the groundwater. Currently, the number and type of monitoringwells are not adequate for complete mapping of the plume. Although
most of the contaminationprobably originated from the load lines, not enough information about the hydrogeology of the area isknown
to evaluate individual plumes. Additional monitoring wells will be installed to further definethe movement of the contamination plume.
Definition of the plume will help determine the need formonitoring drinking water wells used in the area.
Is the drinking water at Northwest High School contaminated?
The drinking water at Northwest High School was sampled in 1991 and tested for RDX, TNT, andother explosives. No contamination
above EPA's 2 μg/L lifetime health advisory was seen. However,because Northwest High School is near areas with documented
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contamination, and the water hasnaturally high nitrate levels, school officials are in the process of obtaining water from the city.
Have all residential drinking water wells been tested?
A great number of water samples have been tested over the past few years. The Nebraska Departmentof Environmental Control has also
completed a well survey to determine the location of all drinkingwater wells and those wells have now been included in a sampling plan.
A comprehensive list andsampling results of all wells sampled, has not been completed. That information, presented in a mannerthat
accurately places residential, monitoring, and agricultural wells, on a map is critical forunderstanding the human health implications of
the contaminated groundwater.
Was the incineration of soil at CAAP successful in removing all the contamination?
The incineration program was successful in removing much of the explosives contamination in the targetareas. Because of the
interference of high water tables during excavation, the extent of removal is notcertain. Further sampling to confirm any remaining
contamination in those areas is needed.
What is the extent of contamination of buildings and soil on the installation itself?
The process of determining the extent of contamination in many of the study areas listed in Table 1 iscurrently in preliminary stages.
Contaminants have been found in some soil samples, but not others;and the study is far from complete. To be certain that some areas do
not contain hazardous materialsthat could contaminate the environment, a more comprehensive sampling program is underway as
partof the RI/FS investigation.
D. Summary of Public Health Implications
This discussion has addressed specific health effects that may result from exposure (primarily byingestion) to specific chemicals,
including explosives and volatile organic chemicals. In most cases, theeffects of long-term ingestion of those compounds are not known.
The potential for adverse healtheffects, however, does exist. Government agencies have developed values to provide estimates of levelsat
which no long-term adverse health effects would be expected. Because of the nature of thoseestimates (based on limited animal studies),
conservative safety factors are included in the calculations. Therefore, consumption of contaminates in water at levels higher than the
advisory values for someperiod of time will not, with certainty, result in adverse health effects. On the other hand, the avoidanceof
contaminated water sources, regardless of the concentration of the contaminant, is the best way toprotect health.
The ability to detect health effects that might have occurred because of past exposure to chemicals inthe groundwater around CAAP is
limited. Statistical databases that consider pertinent health anddisease information are not available.
The removal of contaminated soil at CAAP that was contributing to groundwater contamination wasan initial step in reducing spread of
the contamination. Awareness of the public about health issuessurrounding the contamination and the ability to obtain uncontaminated
water are important aspects of protecting of human health.
CONCLUSIONS
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ATSDR considers contamination from CAAP a public health hazard because of long-term human exposures to hazardous substances.
Evidence exists that exposures have occurred and are occurring. The estimated exposures are to a substance or substances at
concentrations in the environment that, uponlong-term exposure, could cause adverse health effects to any segment of the nearby
population. Thoseadverse health effects might be the result of either carcinogenic or noncarcinogenic toxicity from a chemical exposure.
1. Environmental sampling of on-site soil has indicated contamination with explosives, metals, andvolatile organic compounds
(VOCs). Sampling conducted to date is not adequate to determinethe extent of contamination around all areas of the post.
Proposed sampling during the RI/FSincludes screening a large number of samples with field techniques. A percentage of
thosesamples will be quantified for the same compounds using laboratory techniques. Furthersampling, using a more complete
analyte list, will be performed on selected samples from the field sampling.
Magazine storage areas are leased to the public, primarily for storage of household goods;families have access to the area. If the
relatively limited access to the remainder of the postchanges as a result of increased tenant or other activity, concern for a public
health threat wouldincrease. No sediment sampling has been conducted, but it is unlikely that large volumes orhigh concentrations
of contaminants were discharged via surface runoff to off-site areas becausethe waste was originally concentrated in sumps.
Sediment sampling and further soil samplingwill be conducted during the RI/FS. In addition to potential soil and sediment
contamination,buildings contain asbestos and chipping lead paint. Further environmental sampling, to beperformed during the
RI/FS, is necessary to determine the state of on-post property beforechanges in land use occur.
2. Contamination of groundwater with explosives and possibly other undetermined compounds offpost has in the past and continues
to pose a public health hazard. Groundwater, which is usedfor drinking and irrigation downgradient of CAAP, is contaminated, and
the contaminationcontinues to spread. Groundwater on and off site is contaminated with explosives, nitrates, andpossibly VOCs.
Past sampling analyses did not include all of the potential contaminants ofconcern. The proposed sampling includes VOCs, heavy
metals, pesticides, and explosives. However, all of the biotransformation products and/or impurities associated with the
explosivesare not currently listed for screening samples. Some of these compounds will be detected, however, as tentatively
identified compounds.
3. Neither the number of residents exposed nor the concentration of explosives and othercontaminants to which they were exposed by
way of groundwater ingestion over time can beestimated with great accuracy. The groundwater samples were not analyzed for all of
thecontaminants of concern; the sampling techniques varied; and the detection limits historicallywere too high. The problems with
those evaluations have been partially alleviated by recently increased technical capability.
4. Ingestion of contaminated meat or vegetables might represent a food chain pathway. A cattlefeedlot and a well are adjacent to
CAAP in the area of groundwater contamination. No directscientific evidence is available to demonstrate at what concentrations
explosives mightaccumulate in the fat or meat of cattle. Available information from laboratory animal studiesshows little
accumulation occurs. No evidence exists supporting the idea that corn or cattlewould accumulate concentrations of explosives that
would cause an acute toxic effect in peopleingesting those foods over a short periods. On the other hand, no sampling studies or
controlledlaboratory experiments in cattle have been performed to show whether or not explosivesaccumulation may occur when
cattle drink water containing explosives at the concentrations found in groundwater in the CAAP area.
Vegetables from a garden irrigated with contaminated water (especially RDX-contaminated)eaten by a single family over an
extended period of time are a potential health threat. A recentlaboratory study has shown RDX accumulation in plants, including
distribution, withoutmetabolic breakdown, into seeds. Concentrations may not be expected to be high enough tocause acute toxic
effects after short-term ingestion, but may be a cause for concern over anextended period. Discussions took place among ATSDR,
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USATHAMA, EPA, NDEC, andNDH concerning possible vegetable contamination, and, in August, 1991, CAAP begansampling
vegetables and soil from residential gardens, as well as soil from yards irrigated withRDX- and TNT-contaminated water. Results
from the vegetable sampling indicate that RDXand TNT were not detected at levels above the 0.19 ppm health risk value
established forconsumption of vegetables.
If lawns are watered with contaminated water, any potential health effects would be related tosoil exposure. Analyses of soil
samples taken in September, 1991, indicated no contaminationwith RDX.
5. Inconsistencies in groundwater sampling procedures, frequency, QA/QC, and parameters rendersome results questionable.
Limited information about well construction adds to the conclusionthat extent of contamination has not been adequately defined.
6. Available sampling data were poorly organized and difficult to interpret. Groundwater plumemaps do not depict contamination in
relation to stationary objects, such as roads or buildings. The available maps are confusing and would be difficult to use for decision
making. Wellsurvey information failed to adequately determine which residents are currently drinking fromprivate wells in or near
the contamination plume. Most residents have accepted connection tocity drinking water, but a recent survey indicated that some
residents may still be drinkingcontaminated water. CAAP sampled 10 residences on O'Flannagan, O'Grady, and North Webbstreets
in July, 1991, as part of the periodic check on groundwater plume movement. Theanalyses showed that six of the 10 were above or
close to the 2 ppb action limit. CAAP willprovide those residents with an alternative water supply and will periodically check other
areasto determine if alternative water supplies are necessary. Information has not been obtained about other uses of private well
water, such as for swimming pools, gardens, or lawns.
7. Findings indicate that groundwater contamination from nitrates originates from various sources,including animal waste, nitrogenbased fertilizers, and, possibly, sources at CAAP. Accordingto the CAAP RI/FS workplan, private wells and monitoring wells will be
monitored for nitrate contamination.
RECOMMENDATIONS
1. Currently, magazine areas at CAAP are leased to individuals for storage. Access to those areasis not limited, and visitors may
include families with children. Because of the potential foringestion of contaminated soil, ATSDR recommends limiting the public's
access (especiallychildren) to the areas until the extent of contamination is further characterized during the RI/FS.
2. Currently, potential exposure of workers or others to contaminants in most areas of the post islimited. If human activities at CAAP
increase, health concerns will increase. RI/FS fieldworkat CAAP began in December, 1991, to characterize the extent of
contamination around thenitrate production area, shop area, and load lines. Although the proposed sampling plan isextensive,
ATSDR recommends that the analyte list proposed for the final phase two samplingbe applied during the laboratory confirmation
phase of the field-tested samples. Selectedadditional analytes from Table 5 should also be considered for inclusion.
Determining contaminant concentrations in the top three inches of soil is important forevaluating the potential for human
exposure by way of ingestion, inhalation, and dermalcontact. ATSDR recommends evaluating the results of sampling before
changes in land use orhuman activity take place at CAAP.
3. ATSDR recommends continued monitoring of wells used for drinking water. Monitoringshould be systematically conducted at
drinking water wells close to currently defined areas ofgroundwater contamination. Continued, systematic surveillance of private
well use and ofdevelopment of new
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wells in locations adjacent to the affected area should be established. Institutional controls

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well use and ofdevelopment of new wells in locations adjacent to the affected area should be established. Institutional controls
should be implemented to prevent future well construction in affected areas.
4. Information should be obtained about accumulation of RDX, TNT, and HMX in cattle thatdrink water containing those
contaminants. That information could be obtained from controlledlaboratory experiments or field feedlot studies. CAAP has made
the city's water supplyavailable to the feedlots; that supply should be used for watering livestock to eliminate thepossibility of
contaminant accumulation in cattle until additional studies show thataccumulation of those contaminants is not likely.
Additional sampling of vegetables, including crops grown at CAAP, is planned during the RI/FSprocess and should be carried out
to further define uptake of explosives in plants. Until thatsampling is complete, and the results evaluated, vegetable gardens
previously watered withcontaminated well water should only be watered with city water (or some other source ofuncontaminated
water). Future sampling of vegetables and soils should be performed (becauseof the possibility of residual soil contamination) to
further ensure the safety of vegetables fromgardens even after use of city water for gardens begins.
ATSDR recommends monitoring currently used on- and off-site irrigation wells.
The use of explosives-contaminated water for on-site crop irrigation should be discontinueduntil additional studies show that crops
are not affected.
5. Although adverse health effects resulting from dermal (skin) exposure to RDX at concentrationsdetected in private well samples in
the area are unlikely, a cautious approach would be to useonly city water in swimming pools. That approach would also eliminate
incidental ingestion of contaminants while swimming.
6. Data, both past and current, should be organized in a concise format that can be used by thepublic, including owners of private
wells and elected officials, to understand current and futuredrinking water issues. That organization is crucial so that individuals
can make their own decisions about issues that have a direct effect on health.
7. Private well users should be informed that a regional nitrate contamination problem exists andthat, although water samples may
not show contamination from explosives or other CAAP-related contaminants, nitrate levels above 10 ppm exceed EPA's MCL.
8. The Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) of1980, as amended, requires ATSDR to
perform public health actions needed at hazardous wastesites. To determine if public health actions are needed, ATSDR's Health
ActivitiesRecommendation Panel (HARP) has evaluated the data and information developed in theCornhusker Army Ammunition
Plant Public Health Assessment. Community health educationhas been conducted by the Nebraska Department of Health, the
Nebraska Department ofEnvironmental Control, and the U.S. Army through various public meetings andcommunications. To
assist in evaluation of health effects caused by exposure to RDX, HARPhas requested a technical consultation on RDX biomarkers.
Because people might have beenexposed to RDX or other contaminants at levels that could cause illness, HARP determined
thatsite-specific surveillance and disease- and symptom-prevalence studies are needed as follow-up health activities.
PUBLIC HEALTH ACTIONS
The public health action plan (PHAP) for the Cornhusker Army Ammunition Plant NPL site containsa description of actions to be taken
by ATSDR and/or other governmental agencies at and in the vicinityof the site subsequent to the completion of this public health
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assessment. The purpose of the PHAP isto ensure that this public health assessment not only identifies public health hazards, but
provides a planof action designed to mitigate and prevent adverse human health effects resulting from exposure tohazardous substances
in the environment. Included is a commitment on the part of ATSDR to followup on this plan to ensure that it is implemented. The
public health actions to be implemented are asfollows:
A. Actions Undertaken
1. CAAP has provided the area community with alternate water supplies (bottled water andconnections to municipal water supplies)
for potable use when contamination was detected in residential wells.
2. CAAP, USATHAMA, EPA, NDEC, NDOH, and ATSDR held discussions concerningincorporation of explosives into plants. Those
discussions resulted in the notification of thecommunity of the concern and the sampling of vegetables and soils in the plume area.
Althoughdata did not indicate acute public health concern, NDEC, NDOH and ATDSR recommendedcontinued use by residents of
city water for yards and gardens.
B. Actions Planned
1. CAAP, USATHAMA, EPA, NDOH, NDEC, and ATSDR will continue to provide pertinentinformation to the community about
exposure to hazardous substances associated with the site.
2. ATSDR will conduct a symptom and disease study, biological medical testing and site-specific surveillance in the community living
near the site.
3. CAAP will perform further field studies to evaluate the potential for uptake of contaminants into plants from contaminated
irrigation water. This will be carried out during the RI/FS process.
4. ATSDR will provide an annual follow-up to this PHAP, outlining the actions completed and those in progress. That report will be
placed in repositories that contain copies of this public health assessment, and will be provided to persons who request it.
ATSDR will reevaluate and expand the PHAP when needed. New environmental, toxicological, orhealth outcome data, or the results of
implementing the above proposed actions may determine the need for additional actions at the CAAP site.
PREPARERS OF REPORT
Environmental Assessor:
Diane Jackson
Chemical Engineer
Defense Facilities Assessment Section
Federal Programs Branch

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Health Effects Assessor:
Gary H. Campbell, Ph.D.
Environmental Health Scientist
Defense Facilities Assessment Section
Federal Programs Branch
ATSDR Regional Representatives:
David Parker
ATSDR, EPA Region VII, Kansas City, MO
Roberta Erlwein
ATSDR, EPA Region VII, Kansas City, MO
REFERENCES
1. USATHAMA, Cornhusker Army Ammunition Plant Remedial Investigation and FeasibilityStudy, Draft Technical Plan, April 1991.
2. Agency for Toxic Substances and Disease Registry. Preliminary Health Assessment forCornhusker Army Ammunition Plant. Hall
County, Grand Island, Nebraska. Atlanta: ATSDR,October 1988.
3. USATHAMA, Cornhusker Army Ammunition Plant Remedial Investigation and FeasibilityStudy, Draft Sampling and Analysis
Plan, Volume 1, Field Sampling Plan, April 1991.
4. Agency for Toxic Substances and Disease Registry. ATSDR Record of Activity for telephone communication with Nebraska
Department of Environmental Control. June 27, 1991.
5. USATHAMA, Cornhusker Army Ammunition Plant (Excessing Assessment), EnvironmentalAssessment Report Draft Document,
June 1991.
6. 1980 Census of Population, Volume 1, part 29, Nebraska, 1983. 1990 Census of Population and Housing, Summary Tape File 1,
Nebraska, 1991. U.S. Department of Commerce, Bureau of the Census.
7. Nebraska Department of Health, Lincoln, Nebraska, Vital Statistics Report, 1989.
8. Nebraska Department of Health, Lincoln, Nebraska, Cancer Incidence and Mortality inNebraska: 1988; July 1990.
9. Environmental Protection Agency, Cornhusker Army Ammunition Plant, Compilation ofInformation Obtained through Phone
Interviews and Groundwater Sampling Data, Draft,Geo/Resource Consultants, Inc., February 1991.
10. USATHAMA, Cornhusker Army
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Ammunition Plant Remedial Investigation and FeasibilityStudy, Draft Community Relations Plan,17/23

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10. USATHAMA, Cornhusker Army Ammunition Plant Remedial Investigation and FeasibilityStudy, Draft Community Relations Plan,
April 1991.
11. Agency for Toxic Substances and Disease Registry. ATSDR Trip Report. NebraskaDepartment of Health and Nebraska Department
of Environmental Control Public Meeting,attended by Gary H. Campbell, PhD, and David Parker, ATSDR, August 5, 1991.
12. Agency for Toxic Substances and Disease Registry. ATSDR Trip Report. U.S. Army Public Meeting, attended by Gary H. Campbell,
PhD, Diane Jackson, and Roberta Erlwein, ATSDR, November 7, 1991.
13. Headquarters, Department of the Army, Military Explosives, Department of the ArmyTechnical Manual TM 9-1300-214, November
1967.
14. U.S. Army Corps of Engineers, Environmental Transformation Products of Nitroaromatics and Nitramines, February 1990.
15. USATHAMA, Cornhusker Army Ammunition Plant Remedial Investigation and FeasibilityStudy, Draft Sampling and Analysis
Plan, Volume I-Field Sampling Plan, August 1991.
16. USATHAMA, Cornhusker Army Ammunition Plant Remedial Investigation and FeasibilityStudy, Draft Technical Plan, August
1991.
17. Cabral, JRP. Hydrazine: Laboratory Evidence, pgs 71-74. In Wald, NJ and Doll, R, eds, Interpretation of Negative Epidemiological
Evidence for Carcinogenicity (IARC Scientific Publications No. 65). Lyon: International Agency for Research on Cancer, 1985.
18. Agency for Toxic Substances and Disease Registry. Toxicological Profile for N-Nitrosodimethylamine. December 1989.
19. USATHAMA, Cornhusker Army Ammunition Plant Remedial Investigation and FeasibilityStudy. Analytical Results of Soil, Biota,
and Groundwater Sampling at Residences in CapitalHeights and Le Heights Subdivisions, Grand Island, Nebraska, prepared by
ENSR Consultingand Engineering, Document No. 6583-033-400, November 1991.
20. Rosenblatt DH. Calculation of TNT and RDX concentration limits for feedlot water supplies. Minutes of the 21st Explosives Safety
Seminar. 1984.
21. Spaulding, RF and Fulton, JW. Groundwater munition residues and nitrate near Grand Island,Nebraska, U.S.A. Conservation and
Survey Division, Institute of Agriculture and NaturalResources, University of Nebraska, Lincoln, NE 68588, 1988.
22. U.S. Environmental Protection Agency, Cornhusker Army Ammunition Plant Initial RI/FS Site Evaluation Scoping Report,
Technical Review of Documents. December 1988.
23. University of Nebraska Cooperative Extension Service, Institute of Agriculture and Natural Resources, Nitrogen and Irrigation
Management Hall County Water Quality Special Report, February 1, 1984.
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24. U.S. Environmental Protection Agency, Final Report, Preliminary Assessment GrandIsland/Capital Heights, Grand Island, Hall
County, Nebraska. December 18, 1989.
25. Agency for Toxic Substances and Disease Registry. ATSDR Record of Activity for telephone communication with USATHAMA,
Randall Cerar, September 25, 1991.
26. USATHAMA, Cornhusker Army Ammunition Plant Engineering Evaluation/Cost Analysis(EE/CA), July, 1992.
27. USATHAMA, Fact Sheet, Public Meeting, Grand Island, Nebraska, August 27, 1992.
28. Cataldo DA, Harvey SD, Fellows RJ, Bean RM, and McVeety BD. An evaluation of theenvironmental fate and behavior of munitions
materiel (TNT, RDX) in soil and plant systems: Environmental fate and behavior of TNT. Pacific Northwest Laboratory, U.S. Army
Medical Research and Development Command Contract. 1989.
29. Cataldo DA, Harvey SD, and Fellows RJ. An evaluation of the environmental fate andbehavior of munitions materiel (TNT, RDX)
in soil and plant systems: Environmental fate andbehavior of RDX. Pacific Northwest Laboratory, U.S. Army Medical Research
andDevelopment Command Contract. 1990.
30. Kaplan, AS, Berghout CF, Peczenik A. Human intoxication from RDX. Arch. Environ. Health 1965;10:877-883.
31. Ketel WB, and Hughes JR. Toxic encephalopathy with seizures secondary to ingestion of composition C-4: A clinical and
electroencephalographic study. Neurology 1972;22:871-876.
32. Hollander AI, and Colbach EM. Composition C-4-induced seizures: A report of five cases. U.S. Army Vietnam Med. Bull.
1969;14(31):1529-1530.
33. Hathaway JA, and Buck CR. Absence of health hazards associated with RDX manufacture and use. J. Occup. Med. 1977;19(4):269272.
34. Stone WJ, Paletta TL, Heiman EM, Bruce JI, Knepshield JH. Toxic effects following ingestion of C-4 plastic explosive. Arch. Intern.
Med. 1969;124:726-730.
35. Knepshield JH, and Stone WJ. Toxic effects following ingestion of C-4 plastic explosive. In:Keup W, ed. Drug abuse: Current
concepts and research. New York: Charles C. Thomas.1972;pp 296-301.
36. Woody RC, Kearns GL, Brewster MA, Turley CP, Sharp GB, and Lake RS. The neurotoxicity of cyclotrimethylenetrinitramine
(RDX) in a child: A clinical and pharmacokinetic evaluation. Clinical Toxicology 1986;24(4):305-319.

37. Lish PM, Levine BS, Furedi EM,
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Sagartz EM, Rac VS. Determination of the chronicmammalian toxicological effects of RDX:

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37. Lish PM, Levine BS, Furedi EM, Sagartz EM, Rac VS. Determination of the chronicmammalian toxicological effects of RDX:
Twenty-four month chronic toxicity/carcinogenicitystudy of hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) in the B6C3F1 hybrid
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42. Etnier E, and Hartley WR. Comparison of water quality criterion and lifetime health advisoryfor hexahydro-1,3,5-trinitro-1,3,5triazine (RDX). Regulatory Toxicology and Pharmacology 1990;11:118-122.
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62. Agency for Toxic Substances and Disease Registry. Toxicological Profile for 1,1-Dichloroethene. Atlanta: ATSDR, December 1989.
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FIGURES

Figure 1. General Location of Cornhusker Army Ammunition Plant

Figure 2. Environmental Study Areas, Cornhusker Army Ammunition Plant

Figure 3. Soil Map of Hall County, Nebraska

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Figure 4. RDX Area Map
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Page last reviewed: February 8, 2010
Page last updated: February 8, 2010
Content source: Agency for Toxic Substances and Disease Registry

Agency for Toxic Substances and Disease Registry, 4770 Buford Hwy NE, Atlanta, GA 30341
Contact CDC: 800-232-4636 / TTY: 888-232-6348

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