S-EPA
                                 United States
                                 Environmental Protection
                                 Agency
                                 Health Effects Research
                                 Laboratory
                                 Cincinnati OH 45268
                                 Research and Development
                                 EPA-600/S1-81-058  Aug 1981
Project  Summary
                                 Development  of
                                 Methodology  for  Determining
                                 Risk  Assessment When
                                 Sludge  is  Applied  to  Land
                                Peter R. Jutro and Anil Nerode
                                  This project explored the feasibility
                                of  developing  a  risk assessment
                                methodology that could be applied to
                                sludge management decision making.
                                It examined cadmium, since this sub-
                                stance is one of the best studied and
                                most extensively reported contami-
                                nants.

                                 The methodology developed allows
                                determination of the proportion of the
                                population experiencing given levels
                                of exposure to a toxic substance under
                                specified management  strategies. In
                                addition, it provides for the evaluation
                                of the damage caused by such expo-
                                sure. When both the dosage-response
                                analysis and the exposure population
                                analysis are joined, the distribution of
                                population into levels of response can
                                be established. Each requires separate
                                categories of data. The first is the
                                result of controlled  experiments and
                                carefully designed   epidemiological
                                statistical studies. The second con-
                                sists of ongoing data bases on a
                                national scale, including both meas-
                                urements of background levels of the
                                toxic substance and  data on the actual
                                levels at the various stages of the dis-
                                posal and dispersal  procedures. This
                                report  establishes  that these data
                                bases  are required. The problems
                                associated with both categories  of
                                data are considered  and discussed.
                                  To determine feasibility of risk
                                assessment, the study began an ex-
                                ploratory analysis of modeling, data
                                bases  and transfer  characteristics
                                needed for an actual risk assessment.
                                Existing data bases were reanalyzed
                                on a single systematic basis in a form
                                which was suitable for undertaking
                                the exercise. This  study used non-
                                parametric, robust  and resistant sta-
                                tistics for determining empirical distri-
                                butions  characterizing the desired
                                transfer characteristics.
                                  On the basis of the study, it appears
                                feasible to use risk assessment for
                                decision  making on toxic substance
                                disposal. Much of the required data is
                                being gathered currently, but in an
                                inefficient fashion not appropriate for
                                risk assessment. It will be necessary to
                                formulate appropriate data gathering
                                and record keeping protocols. This will
                                eventually happen as  regulators and
                                industry realize that the only way to
                                defend their decisions is through such
                                risk analysis using  the best current
                                data and techniques.
                                  This Project Summary was develop-
                                ed by EPA's Health Effects Research
                                Laboratory, Cincinnati, OH.  to an-
                                nounce  key findings of the research
                                project that is fully documented in a
                                separate report of the same title (see
                                Project Report ordering information at
                                back).

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Discussion
  The purpose  of this project was  to
determine the feasibility of applying risk
assessment  methodology  to sludge
management decisions.  The results
might be used as a  possible model for
the larger problem of environmental risk
assessment. The latter was the subject
of two National Academy of  Sciences
reports on chemicals in  the environ-
ment, which suggested directions for
risk assessment methodology
  The  risk  assessment  problem  for
environmental decision making became
more prominent after the appearance of
Lowrance'S Of Acceptable Risk. It was
intended to delineate the distinction be-
tween risk and safety, where risk analy-
sis was a quantitative assessment  of
consequences of decisions, and safety
analysis was the assessment of level of
risk acceptable  to society. This report
accepts that distinction, and is confined
to risk, not safety.
  One  approach  to risk  assessment
evaluates  the fundamental quantity in
determining risk to the populace (in the
case of effects of toxic substances and
in some other situations) by the degree
of exposure of the populace, determined
by the summing of all exposures along
alternate pathways  by which the toxic
substance reaches the populace.
  This  approach is refined  to  give a
methodology which, in principle, would
determine what proportion of the popu-
lation experiences each level of expo-
sure to the toxic substance under some
specified  management  strategy  for
handling the substance.  Ideally, this
would  consist of charting the  move-
ments of the substance from  source to
final  human  exposure  along the
principle exposure paths followed by the
substance, allowing summation of  all
exposure to obtain total exposure. This
is an ideal aim, but in the presence of
limited  empirical  data,  ingenuity  is
required to establish approximate total
exposure.
  A second part to risk analysis, assum-
ing that the first approach was empiri-
cally determined, concerns the damage
such an exposure may cause in terms of
societal or  individual  losses. This  is
substantially the  question  of  both:
(1)  establishing dose-response  rela-
tions, in which the dose is the exposure
level,  and (2) measuring the  response
either in physiological terms (e g., organ
load of a toxic substance), or in epidem-
iclogical  terms (such  as  excess
morbidity and mortality). It is only when
both exposure population analysis and
dosage  response  or epidemiological
analysis are joined that the distribution
of population into levels of response can
be established. Safety analysis can then
be undertaken determining whetherthe
population  response  does or does not
represent   acceptable damage.  Also,
whether  an  alternative  management
strategy is called for, which reduces the
fraction of the population with damag-
ing response  above a certain level.
  Two separate  categories  of  data
requirements  are  involved  The  first
consists of results of carefully control-
led experiments and carefully designed
epidemiological  statistical studies.  In
the case of land application of sludge,
such results and others are required for
plant  uptake data from cadmium  in
sludge, human uptake data from  cad-
mium in food, animal uptake data from
cadmium  in  grain,  physiological  re-
sponse data for ingestion of cadmium in
food, etc. The second category of data
consists of ongoing data bases which
are on a national scale.  These include
both  measurements of  background
levels of the toxic substances in the
medium involved, and data on the actual
levels persistent throughout the country
at the many stages of the disposal and
dispersal procedures. This is a massive
data base  requirement.  Many of the
results, however, would  be invaluable
for many risk assessment efforts other
than sludge management.
  Concerning the first category of data,
one reason that the dosage response
data has not  been sufficiently empha-
sized  in  assessing   damage  is  an
assumption that  the response is either
proportional to the total dose received,
or given by an a priori function of dose,
independent of the circumstances. Two
reasons that epidemiological studies of
health effects  have  not been used
extensively are the possibility of con-
founding  causes   for  observed
phenomena other  than those that are
apparent in an uncontrolled  "experi-
ment," andthe immense size of the data
bases and processing effort required. It
is important to stress that,  very often,
only the  relative risks  of alternate
disposal plans can be estimated well,
and not the absolute risks of any  one.
Thus, one may determine that one route
will lead to many times the exposure of
another, without being able to specify
any one's  exposure   consequences
accurately.
  Since there is interest in simultan-
eously controlling  at acceptable levels
all toxic substances in the environment,
it is necessary to keep records for many
substances at once in the national data
bases. This  makes the whole problem
multivariate and vector, rather than uni-
variate and  scalar. It complicates deci-
sion making, since a strategy which will
lower exposure to one  toxic substance
may very well raise exposure to another.
For this reason, no rules for safety based
on risk analysis (e.g., population expos-
ure, dosage-response,  epidemiological
response) are  likely to  be forthcoming.
The principal purpose of such analyses
is to show the probable consequences
in the form of response and damage that
each  alternative  strategy will entail.
Then  comes the  problem of deciding
among  the competing alternatives.
Each alternative entails resulting popu-
lation  exposure  and population
response  distributions of each  of 'n'
toxic substances This results in a vector
of exposure distributions and a vector of
response  distributions.  When specifi-
cally  applied  to  sludge  management
decisions, each proposed strategy for
sludge disposal leads to both a popula-
tion  exposure  and  a  population
response  distribution  for  each toxic
substance in sludge.
  The disposal alternatives  for sludge
are:  pyrolysis  or incineration, water
disposal (e.g., ocean dumping), and land
application (including both agricultural
use and simple land storage and dis-
posal). Each  alternative  has well-known
general advantages and disadvantages.
Incinerated sludge yields air pollution
byproducts which impact the environ-
ment, enter the food chain, and produce
health effects  directly through lung
respiration.  Ocean dumping disturbes
ocean ecosystems, the marine environ-
ment  and the sea animal food chain to
man. Land application and land disposal
result in increased plant uptake of sub-
stances which enter the food chain to
man directly through human ingestion
and indirectly through use as animal
fodder. It also  causes toxic substances
to leave  application areas,  in runoff,
entering lakes, rivers and groundwater.
Each   alternative  yields  deleterious
effects to man, due to breathing, eating,
or drinking toxic substances, and each
alternative has its own health effects.
The purpose of risk analysis in sludge
management, therefore, is to assess the
relative effects of toxic substances on
human  health  in the  alternative dis-
posal  schemes.
  This requires the  establishment of   {
population exposure distributions  for
each toxic substance in sludge for each

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disposal alternative. It  requires estab-
lishment  of  dose-response  and
epidemiological  results to determine
the population response distributions
for each health effect dependent upon
each toxic substance for each alterna-
tive disposal scheme. Since population
exposure  depends  on  some  kind  of
summing over all pathways leading to
man, and each pathway involves differ-
ent transport mechanisms,  different
transformations of form for the contam-
inants, different mgestion routes in man
with differing efficiencies, and different
physiological systems  exposed to the
contaminants, this is a very complicated
endeavor
  This report is restricted to what can be
obtained from  current data bases in
both the  literature and  in  computer
storage systems.  It was decided  to
examine one  important substance  on
which  a great mass of literature has
currently been assembled, cadmium in
sludge  The  reasoning  is that if risk
assessment is feasible for any contami-
nant in sludge, it should be feasible for
cadmium. This,  therefore, is  a  "best
possible" case for risk assessment. If it
is infeasible for cadmium in sludge, it is
very likely to be infeasible altogether
The only drawback is that although cad-
mium  is  very  harmful  on  general
chemical  grounds in the forms that
might  be  ingested  from sludge, very
little   has   been  done  for  dosage-
response  studies to  demonstrate
adverse health effects  In addition, the
epidemiological  approach for  demon-
strating increased mortality, morbidity
and chronic effects has not been sys-
tematically applied.
  The  best way to determine feasibility
of  risk assessment for  cadmium  in
sludge  was  to  begin  an exploratory
analysis of modeling, data bases, and
transfer characteristics needed for  an
actual  risk  assessment.  This  did  not
include evaluation of data bases needed
for all subsystems which enter into
population exposure calculations, or for
the epidemiological  approach to deter-
mining health effects
  The  evaluation  of   the  effects  of
sludge, independent of which disposal
alternative or combination of alterna-
tives is evaluated, include  sources of
sludge,  measurement  of  cadmium
content as a function of sewage plant
characteristics, and  output variability
  The  risk of any one disposal  method
can only be evaluated  after establish-
ment of a large  reliable data base for
each stage of translocation and trans-
formation of the sludge cadmium. Since
systematic  risk evaluation as a subject
is in its infancy, some necessary  data
bases do not currently exist. Those that
do exist, having been accumulated for
other purposes in  existing  measure-
ment programs, may not be adequate to
describe the  transfer features from
stage to stage of the disposal process.
What can  be done at present is  to
reanalyze the existing data bases  on a
single systematic basis. This would  be
in  a form suitable for establishing the
desired  transfer characteristic for each
stage and combining them to obtain a
final population exposure analysis. Also
to  see if it  is feasible to upgrade these
measurement  programs  and  to
introduce new ones  to fill in the present
gaps, so as to demonstrate the feasibil-
ity of at least population exposure analy-
sis for each disposal method
  This  study  used  non-parametric,
robust and  resistant statistics, with the
purpose of  determining empirical distri-
bution characterizing the desired trans-
fer characteristics The data bases  used
are  as  follows  For land application,
there is information on soil uptake of
cadmium   from  applied   sludge  and
applied cadmium salts under a variety of
conditions, and on plant uptake, both as
a function  of soil cadmium and  as a
function of applied  cadmium in sludge
or salt form. Some literature is available
on  animal  and human food uptake of
cadmium   from   cadmium-containing
food, and on distribution of cadmium in
human  diets  (market  basket,  institu-'
tional  diets).  There  is an  extremely
amorphous literature  on  the  health
effects of dietary ingested cadmium
  This  information  was  accumulated
neither  on  a  common statistical basis
nor on a transfer characteristics basis  It
was necessary to  reanalyze  all  this
literature  data from  its  raw form  to
obtain an insight as to whether further
experiments designed to fit into transfer
form for risk assessment would leadtoa
reliable  population  exposure analysis.
Even the proper indicators (measure-
ments of appropriate observable quanti-
ties) have not been standardized; these
are such quantities as cadmium content
of   sludge,  available  soil cadmium,
standard soils, standard  definition  of
plant load  or  exposure, and standard
definition of human load  or exposure
through dietary mgestion. This is parti-
ally due to what exact forms the cadmi-
um takes, and the strong association of
their effects with  those of other heavy
metals  Another problem  concerns the
lack of human and animal in vivo non-
destructive testing for which there are
methodologies not yet used at this time.
A non-parametric  reanalysis  of  the
available data in this area was done.
  The purpose of these reanalyses was
to determine whether natural  refine-
ments  of  present  day  experimental
measurement practice  would lead to a
coherent set of transfer characteristics.
These  would yield, for each relevant
form of cadmium, the proportion of the
population  with a  given incremental
exposure due to a given regimen of land
application of sludge  Failing  this,  if
enough identification of transfer char-
acteristics would result to identify the
feasibility of controlling certain stages
of the  sludge   disposal system,  the
analysis of the proportion of population
with a given exposure level might result
in a predetermined way at specifiable
cost.
  The remaining problem concerns the
determination of the  human  health
effects at a given exposure level. This
would be the result of clinical trials, of
extrapolation  from animal experiments,
or of epidemiological studies of correla-
tion  of  mgestion  levels with likely
mortality and morbidity and  chronic
symptoms on a  population basis. The
former is preferable to the latter, but
often the epidemiological route is the
only one available in exploratory data
analysis, due to the  lack of suitable
clinical  experiments.  In the  present
case, the information on'dietary distri-
bution of  cadmium available through
regional  market basket surveys is  so
inadequate in method and sample, that
correlation with regional health  effects
is simply not  possible,  even  on an
exploratory basis.  This  is due  to the
chosen  sampling technique.  For  the
health effects of given exposure level to
dietary cadmium, therefore, there is no
easy solution. Current technology may
be  adequate  to  supply some  dose-
response information on an in vivo basis
once the usefulness has been empha-
sized. Past measurements of cadmium
level in cadavers with given symptoms
apparently  does not contribute  much
information for the transfer character-
istics of  dose-response  needed  for
exposure-health  effect analysis for risk
assessment,  since  the  corresponding
exposure levels  of  the cadavers are
unknown.'

Recommendations
 (1)  Risk  assessment  of  sludge
     management should assess

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    comparative population exposure
    and  health  effects obtained for
    each of the main sludge manage-
    ment alternatives:  land applica-
    tion,  incineration,  and  ocean
    dumping
(2)  Risk assessment of these alterna-
    tives  in sludge management is
    best carried out in the context of a
    general risk assessment program
    for heavy metals and probably for
    toxic substances. The many nec-
    essary  data bases for  each  risk
    assessment for sludge manage-
    ment are certain  to be used as
    subsystem descriptions for  risk
    assessments   for  other  toxic
    substance management problems
    not involving sludge management.
(3)  The  empirical distribution of the
    nation's sludge output, character-
    ized by  heavy metal levels, needs
    to be  collected on an  ongoing
    basis.   A  record   keeping   and
    reporting  system should be man-
    dated.  Exploratory  data  analysis
    on preliminary data indicates  that
    the monitoring resources should
    be utilized to maximize the num-
    ber  of  sludge  plants  sampled,
    rather than the number of times a
    single plant is sampled.
(4)  The  distribution of land area by
    yearly  application  rate  of sludge
    needs to be evaluated by sampling,
    together with descriptions of land
    type and  crop  The result is the
    cadmium  loading pattern  Explor-
    atory data analysis reveals  that
    cadmium  availability  for  plant
    uptake  depends  on  recency of
    application. This possibility should
    be investigated as a potential con-
    trol point  in the land use strategy;
    it should certainly be incorporated
    as a design element in any future
    studies of plant uptake following
    sludge application.
(5)  For  a  variety of  plants  (corn,
    soybeans, etc ) the relative propor-
    tion that each one accounts for in
    the mix of crops that will be grown
    on sludge-amended soil should be
    ascertained, as should the distri-
    bution of  cultivars within species
    The analysis should be separated
    at this point by plant type.
(6)  From existing data and from  new
    work,  as  required, the response
    (uptake and translocation) of these
    cultivars and species  needs to be
    found, or a  plausible distribution
    of such responses needs to be
    estimated, and the resulting distri-
     bution  convolved  with the one
     described in recommendation 4,
     the cadmium loading pattern. One
     may imagine that the problem has
     been refined to that proportion of
     the whole cadmium problem that
     is represented  by  the fraction of
     the total acreage that is devoted to
     the particular cultivar.
 (7)  The distribution should then be
     refined further  by  plant part, and
     the  task here  is simply to keep
     track of the separated distribu-
     tions of uptake in leaf, grain, and
     stover.
 (8)  Population  physiological  and
     epidemiological  response  to
     dietary cadmium exposure has not
     been  established  by   current
     research. This is a necessary com-
     ponent of risk  assessment if the
     latter is to be based on population
     response, rather than  population
     exposure
 (9)  The measurements needed forthe
     forms of cadmium  at each level of
     the risk analysis process have not
     been standardized. This is essen-
     tial for uniformity and reliability of
     results.  This is the  problem of
     validating the indicators of risk.
(10)  The data bases are not organized
     nationally so as to  facilitate popu-
     lation  exposure  analysis,   i.e.,
     exposure to cadmium via air, food
     and  water.  Thus,  programs for
     accumulating the  missing bases
     and programs for  rationally stor-
     ing the bases in compatible form
     need to be developed
(11)  It  is  desirable  to collect  the
     bivariate distributions  expressing
     the   dependencies  of  pairs  of
     variables (assuming to be inde-
     pendent in the stage diagrams) as
     well  as the marginals of these
     distributions described above, at
     least for all heavy  metals.
(12)  The  statistical  methodology for
     estimating  distributions  that
     result from the combinations used
     for population  exposure analysis
     from sampled  data for the com-
     ponent  distributions  should  be
     developed further  The non-para-
     metric  approach  appears to  be
     best suited mathematically forthis
     purpose

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 Peter R. Jutro and Anil Nerode are with Cornell University, Ithaca, NY 14853
 Norman E. Kowal is the EPA Project Officer fsee below).
 The complete report, entitled "Development of Methodology for Determining
  Risk Assessment When Sludge is Applied to Land, "(Order No. PB81 -240 012;
  Cost: $15.50, subject to change)'will be available only frorrr
        National Technical Information Service
        5285 Port Royal Road
        Springfield, VA 22161
        Telephone: 703-487-4650
 The EPA Project Officer can be contacted at.
        Health Effects Research Laboratory
        U S.  Environmental Protection Agency
        Cincinnati, OH 45268
US GOVERNMENT PRINTING OFFICE, 1981 —757-012/7319

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